Use of Cetuximab in Multimodality Treatment of Cutaneous Squamous Cell Carcinoma
Posted: Thursday, February 14, 2019
According to Shauna Higgins, MD, of the Department of Medical Oncology, Keck School of Medicine, University of Southern California, Los Angeles, and colleagues, cetuximab may be most efficacious when administered with concurrent therapies such as surgery or irradiation in patients with high-risk cutaneous squamous cell carcinoma. This conclusion came from a recent study published in Dermatologic Surgery. Larger prospective studies are needed, they noted, to establish the optimal dosing and frequency of cetuximab treatment in this patient population.
High-risk cutaneous squamous cell carcinoma is defined as tumors with a diameter greater than 2 cm. In addition, this subset of skin cancer is associated with a poorly differentiated histology, perineural invasion, and invasion beyond subcutaneous fat.
The investigators searched medical records using Current Procedural Terminology codes for cetuximab and cutaneous squamous cell carcinoma. Demographic data and tumor characteristics, along with treatment regimens and follow-up times, were collected. A total of 20 cases were analyzed; 17 patients received cetuximab as part of multimodality treatment. Many patients (60%) underwent primary treatment of surgery and then concurrent cetuximab and irradiation.
Three patients experienced a complete response, and seven patients experienced a partial response to cetuximab treatment, yielding an overall response of 50% and a combined median disease-free survival of 6.35 months (range 1–46.8 months). As for survival, it was significantly correlated with the type of treatment, with the combination approach of surgery, irradiation and cetuximab showing the highest relative survival.
“Despite the standardization of features associated with high-risk cutaneous squamous cell carcinoma, an advanced subset of cutaneous squamous cell carcinoma , there is no established consensus regarding proper management of this tumor,” commented Dr. Higgins and colleagues. Given their study findings, they noted that investigations into combining cetuximab with checkpoint inhibitors and other targeted immunotherapies may be warranted.
Disclosure: The study authors reported no conflicts of interest.