Anti-PD-1 Therapy Shows Promising Response Rates in Cutaneous Squamous Cell Carcinoma

Squamous cell carcinoma
Squamous cell carcinoma
In this review, an investigator highlights the latest results of immune checkpoint inhibitors (ICI) for the treatment of locally advanced and metastatic cutaneous squamous-cell carcinoma.

Anti-programmed cell death-1 receptor (anti-PD-1) antibodies demonstrate response rates of nearly 50% in both locally advanced and metastatic cutaneous squamous cell carcinoma (cSCC) according to study data published in Dermatologic Therapy.

Studies of immune checkpoint inhibitors (ICI), specifically anti-PD-1 antibodies such as cemiplimab and pembrolizumab, have shown promising results in patients with phase 2 locally advanced and/or metastatic sCCC. In 2 separate studies, patients with locally advanced or metastatic cSCC were treated with cemiplimab 3 mg/kg every 2 weeks. In a phase 2 study of 78 patients treat with cemplimab with locally advanced cSCC, an objective response in 44% of patients (95% CI, 32-35) was observed, with 13% of patients achieving a complete response and 31% demonstrating a partial response. In 29% of patients serious treatment-related adverse events occurred. In a separate phase 2 study of 59 patients with metastatic cSCC who were treated with cemplimab, an overall response rate of 49.2% (95% CI. 35.9-62.5) was seen, with a median progression-free survival (PFS) of 18.4 months.

The most common treatment-related adverse events observed were diarrhea, fatigue and nausea. Grade ≥3 immune-related adverse events were observed in 13.6% of patients. A French phase 2 trial ofpembrolizumab in patients with unresectable sCCC with no prior systemic therapy revealed similar positive results. At week 15, of 39 patients there were 2 complete and 13 partial responses for an objective response rate of 38.5%. Severe treatment-related adverse events occurred in 8% of patients.

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Limitations of the study include a focus on a selected patient population and therefore the results may not be generalizable to all patient populations.

The author concluded that anti-PD-1 antibodies demonstrated clinical effectiveness of ICI treatment in patients with unresectable, locally advanced or metastatic cSCC and may be a more favorable treatment strategy than chemotherapy.

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Benzaquen M. Update on the anti-programmed cell death-1 receptor antibodies in advanced cutaneous squamous-cell carcinoma (published online March 24, 2020). Dermatol Ther. doi: 10.1111/dth.13325