Treatment of Advanced Cutaneous Squamous Cell Carcinoma: A Mohs Surgery and Dermatologic Oncology Perspective

Abstract

Locally advanced or metastatic cutaneous squamous cell carcinoma no longer amenable to surgical resection or primary radiation therapy requires an alternative approach to treatment. Until 2018, management consisted of limited systemic chemotherapies, which carried marginal clinical benefit. The introduction of immunotherapy with anti-PD-1 antibodies resulted in alternative treatment options for advanced cutaneous squamous cell carcinoma with substantial antitumor activity, durable response and acceptable safety profile. The field of immunotherapeutics continues to expand with adjuvant, neoadjuvant and intralesional studies currently in progress. Herein, the authors discuss their approach for the treatment of advanced cutaneous squamous cell carcinoma from the perspective of a Mohs surgeon and a dermatologic oncologist.

Keywords::

• advanced cutaneous squamous cell carcinoma
• cemiplimab
• immunotherapy
• locally advanced cutaneous squamous cell carcinoma
• metastatic cutaneous squamous cell carcinoma
• oncholytic immunotherapy
• pembrolizumab
• radiation therapy
• targeted therapy

Financial & competing interests disclosure

Michael R Migden has participated on advisory boards and received honoraria from Regeneron Pharmaceuticals, Inc., Sun Pharmaceuticals, and Sanofi; advisory role with Rakuten Medical. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

Michael R Migden has participated on advisory boards and received honoraria from Regeneron Pharmaceuticals, Inc., Sun Pharmaceuticals, and Sanofi; advisory role with Rakuten Medical. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.