Department of Dermatology, Saitama Medical University, Morohongo 38, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
Curr Treat Options Oncol. 2019 Mar 14;20(4):30. doi: 10.1007/s11864-019-0629-2.
Advanced (i.e., unresectable) cutaneous squamous cell carcinoma (cSCC) is a rare condition with a dismal prognosis. Although less than 5% of cSCC patients develop metastases or local recurrence after complete excision, advanced cSCC is difficult to treat. These conditions tend to develop in elderly patients, although, at times, metastases are noted in middle-aged patients. Once metastasis occurs in cSCC, the 10-year survival rates fall to less than 20% for patients with regional lymph node involvement and less than 10% for patients with distant metastases, indicating that cSCC can be difficult to treat effectively when it is advanced. Traditionally, platinum-based therapy has been considered as a conventional option for advanced cSCC. It is efficacious to some degree, but the toxic effects of the combination treatments often prohibit their use in elderly patients. It has been a decade since the development of epidermal growth factor receptor (EGFR) inhibitors as agents that are less toxic. However, evidence regarding systemic therapy for advanced cSCC is limited because of a lack of high-quality prospective studies. Remarkably, the US Food and Drug Administration (FDA) approved an anti-PD-1 antibody treatment (cemiplimab) for the treatment of patients who are not candidates for curative surgery or curative radiation. It will be a promising treatment option for these types of rare conditions.
晚期（即不可切除）皮肤鳞状细胞癌（cSCC）是一种罕见的疾病，预后较差。尽管不到 5%的 cSCC 患者在完全切除后会发生转移或局部复发，但晚期 cSCC 很难治疗。这些情况往往发生在老年患者中，但有时也会发生在中年患者中。一旦 cSCC 发生转移，局部淋巴结受累患者的 10 年生存率降至<20%，远处转移患者的 10 年生存率降至<10%，这表明晚期 cSCC 很难有效治疗。传统上，铂类治疗被认为是晚期 cSCC 的常规选择。它在一定程度上是有效的，但联合治疗的毒性作用常常使它们无法在老年患者中使用。自开发表皮生长因子受体（EGFR）抑制剂作为毒性较小的药物以来，已经过去了十年。然而，由于缺乏高质量的前瞻性研究，晚期 cSCC 的系统治疗证据有限。值得注意的是，美国食品和药物管理局（FDA）批准了一种抗 PD-1 抗体治疗（cemiplimab）用于治疗不适合根治性手术或根治性放疗的患者。对于这些类型的罕见疾病，这将是一种有前途的治疗选择。
