Hourbeigt K, Ehret M, Visseaux L, Durlach A, Petit A, Sanchez J, Grange-Prunier A, Barbe C, Servagi-Vernat S, Grange F
Department of Oncodermatology, Reims University Hospital, Reims, France.
Department of Biopathology, Reims University Hospital, Reims, France.
J Eur Acad Dermatol Venereol. 2020 Dec;34(12):2789-2794. doi: 10.1111/jdv.16465. Epub 2020 Aug 24.
The prognosis of unresectable cutaneous squamous cell carcinomas is very poor.
To evaluate the efficacy and safety of panitumumab alone or in association with radiotherapy in the treatment of unresectable cutaneous squamous cell carcinoma.
This was a monocentre retrospective study of all consecutive patients having received at least two courses of panitumumab, alone or in association with radiotherapy, between 2016 and 2019. The primary endpoint was the rate of best overall response, evaluated according to the RECIST 1.1 criteria. The secondary endpoints were the response and disease control rates at 6 weeks and 6 months, progression-free survival, overall survival and safety.
A total of 25 patients were included; their median age was 86 years, and 17 (86%) had a WHO performance status over 2. The best overall response rate was 52%, including four complete responses (16%) and nine partial responses (36%). All patients with complete response and five out of nine patients with partial response had received concurrent radiotherapy, in most cases in moderate to low doses (<40 Gray, 67%). The response rates at 6 weeks and 6 months were 12% and 28%, respectively. The control rates at 6 weeks and 6 months were 84% and 32%, respectively. Median progression-free survival was 6.9 months, and median overall survival was 10.5 months. Grade 3 side-effects, mostly dermatological, occurred in 16 patients (64%).
These results suggest that panitumumab remains pertinent in the treatment of unresectable cutaneous squamous cell carcinoma, in particular in association with radiotherapy, despite recent advances with anti-PD-1 antibodies. It presents several advantages: it can be used in very elderly or feeble patients, it does not provoke anaphylactic or other irreversible or life-threatening side-effects, and our study observed some long-term responses. Further prospective investigation of anti-EGFR antibodies, in association with anti-PD-1 antibodies and/or chemotherapy, should be conducted.
无法切除的皮肤鳞状细胞癌预后很差。
评估帕尼单抗单药或联合放疗治疗无法切除的皮肤鳞状细胞癌的疗效和安全性。
这是一项单中心回顾性研究，纳入了2016年至2019年间所有连续接受至少两个疗程帕尼单抗治疗的患者，治疗方式为单药或联合放疗。主要终点是根据RECIST 1.1标准评估的最佳总体缓解率。次要终点是6周和6个月时的缓解率和疾病控制率、无进展生存期、总生存期和安全性。
共纳入25例患者；他们的中位年龄为86岁，17例（86%）的世界卫生组织体能状态评分为2分以上。最佳总体缓解率为52%，包括4例完全缓解（16%）和9例部分缓解（36%）。所有完全缓解的患者以及9例部分缓解患者中的5例接受了同步放疗，大多数情况下为中低剂量（<40格雷，67%）。6周和6个月时的缓解率分别为12%和28%。6周和6个月时的疾病控制率分别为84%和32%。中位无进展生存期为6.9个月，中位总生存期为10.5个月。16例患者（64%）出现3级副作用，主要为皮肤方面。
这些结果表明，尽管抗PD - 1抗体有了新进展，但帕尼单抗在治疗无法切除的皮肤鳞状细胞癌方面仍然适用，特别是联合放疗时。它有几个优点：可用于非常年老或体弱的患者，不会引发过敏或其他不可逆或危及生命的副作用，并且我们的研究观察到了一些长期缓解情况。应进一步对抗表皮生长因子受体抗体联合抗PD - 1抗体和/或化疗进行前瞻性研究。
