Delaitre L, Martins-Héricher J, Truchot E, Denis D, Prophette B, Maillard H, Bénéton-Benhard N
Service de dermatologie, centre hospitalier du Mans, 72000 Le Mans, France.
Service de dermatologie, centre hospitalier du Mans, 72000 Le Mans, France.
Ann Dermatol Venereol. 2020 Apr;147(4):279-284. doi: 10.1016/j.annder.2019.10.031. Epub 2019 Dec 23.
The recommended treatments for advanced squamous cell carcinoma (SCC) (chemotherapy, radiotherapy, anti-EGFR) and advanced basal cell carcinoma (BCC) (vismodegib and sonidegib) have many side effects. Nivolumab (anti-PD1 antibody) may be used as second-line therapy in SCC of the head and neck. We report the case of a patient with advanced SCC and BCC which regressed under pembrolizumab.
A 69-year-old man consulted for a large vertex SCC measuring 15cm in diameter. He also had BCC on the left nostril and sternal Bowen disease. Radiological assessment revealed cervical and parotid lymph node involvement. Treatment with pembrolizumab 2mg/kg every 3 weeks was decided at a Multidisciplinary Concertation Meeting. Tumor regression of the vertex SCC was noted at the third course of treatment, as well as regression of the nasal BCC and the sternal Bowen disease. A complete response was observed after 11 courses of treatment for SCC, 7 courses for BCC, and 10 courses for Bowen disease.
We report an original case of cure of BCC with anti-PD1 (pembrolizumab) prescribed for locally advanced inoperable SCC. The place of this treatment in the therapeutic arsenal remains to be defined. Clinical trials are in progress concerning use of this treatment in advanced cutaneous SCC and inoperable BCC.
晚期鳞状细胞癌（SCC）的推荐治疗方法（化疗、放疗、抗表皮生长因子受体治疗）以及晚期基底细胞癌（BCC）的推荐治疗方法（维莫德吉和索尼德吉）均有许多副作用。纳武单抗（抗程序性死亡蛋白1抗体）可用于头颈部SCC的二线治疗。我们报告了1例晚期SCC和BCC患者在帕博利珠单抗治疗下病情缓解的病例。
一名69岁男性因直径15cm的巨大头顶SCC前来就诊。他左侧鼻孔还有BCC以及胸骨部鲍温病。影像学评估显示有颈部和腮腺淋巴结受累。在多学科会诊会议上决定每3周给予2mg/kg帕博利珠单抗进行治疗。在第3个疗程时发现头顶SCC出现肿瘤消退，同时鼻BCC和胸骨部鲍温病也出现消退。SCC经过11个疗程治疗、BCC经过7个疗程治疗、鲍温病经过10个疗程治疗后观察到完全缓解。
我们报告了1例使用为局部晚期无法手术切除的SCC所开具的抗程序性死亡蛋白1（帕博利珠单抗）治愈BCC的独特病例。这种治疗方法在治疗手段中的地位仍有待确定。关于该治疗方法在晚期皮肤SCC和无法手术切除的BCC中的应用，相关临床试验正在进行。
