Australian Researchers Explore Immunotherapy-Related Concepts in Squamous Cell Skin Cancer
Posted: Monday, June 7, 2021
The morbidity rates related to non-melanoma skin cancers, especially in New Zealand and Australia, are significant. Although PD-1 inhibitors have ushered in a paradigm shift of treatment success, Danny Rischin, MD, of the Peter MacCallum Cancer Centre, Melbourne, and colleagues consider unique immunotherapy-related experiences to expand current clinical concepts in practice. The report, published in Frontiers in Oncology, discussed the phenomenon of pseudoprogression and the need to consider flexible treatment approaches for patients with multiple non-melanoma skin cancers.
“Translational research will be crucial to molecularly define the clinical spectrum of cutaneous squamous cell carcinoma and identify reliable predictive and prognostic markers to therapy, including mechanisms of immune evasion,” the researchers concluded.
The study team described four cases of patients with non-melanoma skin cancer. Two cases provided evidence that helped redefine the current understanding of pseudoprogression. Other cases highlighted tumor response in a patient with clinical deterioration and heterogeneous responses of two baseline lesions to immunotherapy, respectively.
New terminology was used to capture the phenomenon of pseudoprogression as “delayed response after confirmed progression,” because it demonstrates clinical and radiologic response after immune-confirmed disease progression. The results of the cases emphasized that clinicians should consider the timing and method of disease response assessments and acknowledge the limitations of most criteria to capture pseudoprogression, response rates, and best overall response assessments as part of patient reporting. In addition, existing imaging assessments may fail to reflect disease evolution and response, highlighting the need for further research into the predictive and prognostic roles of imaging techniques.
Disclosure: For full disclosures of the study authors, visit frontiersin.org.