Sequential Treatment Approach to Cutaneous Squamous Cell and Basal Cell Carcinomas: Case Report

By: Vanessa A. Carter, BS
Posted: Monday, January 24, 2022

Axel Hauschild, MD, of the University Hospital Schleswig-Holstein, Campus Kiel, Germany, and colleagues shared the details of a case of simultaneously occurring advanced cutaneous squamous cell and basal cell carcinomas. The patient was treated sequentially with the PD-1 antibody cemiplimab-rwlc and then the Hedgehog inhibitor sonidegib and appeared to exhibit a complete response. The full case report was published in the Journal of the European Academy of Dermatology and Venereology.

A 78-year-old woman presented with three previous incomplete resections of a deep-infiltrating, locally advanced, asymptomatic basal cell carcinoma, as well as two rapidly growing exophytic lesions in the left preauricular and cervical areas. Her last surgery was performed 2 weeks before admission. The lesion on the mandibula was identified as the primary tumor, with the lesion near the ear defined as a metastasis that infiltrated the skin and the parotid gland. Additionally, a CT scan revealed multiple lymph node metastases of the neck.

Cemiplimab was recommended as a systemic treatment by the interdisciplinary tumor board. There was already a notable decrease in the size of the cutaneous squamous cell carcinomas after a single 350-mg infusion, as they became necrotic. After 13 cycles, administered every 3 weeks, a complete response of these lesions was reported. Of note, the basal cell carcinoma remained unchanged, but it was not considered for curative resection or irradiation. Instead, the patient was administered 200 mg of oral sonidegib per day.

After 3 months, the basal cell carcinoma demonstrated notable regression and complete response, which was confirmed by three punch biopsies; both cutaneous squamous cell carcinoma lesions remained in complete response. Both therapies were reported to be well tolerated by the patient, with grade 1 mild fatigue syndrome as the sole reported adverse event. There was no apparent impairment to quality of life, the authors noted, and treatment with sonidegib was continued for another 3 months to maintain response.

Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.

Journal of the European Academy of Dermatology and Venereology