Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy.
UOC di Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
J Eur Acad Dermatol Venereol. 2022 Jan;36 Suppl 1:19-22. doi: 10.1111/jdv.17400.
Common primary cutaneous squamous cell carcinoma (CSCC) accounts for 20% of keratinocyte cancers that is usually successfully treated with surgery or radiotherapy. In a minority of cases, CSCC lesions may progress to locally advanced or metastatic disease that may be difficult to be treated causing significant morbidity and mortality. Chemotherapies and targeted therapy with anti-epidermal growth factor receptor antibodies have been used off-label in small studies and case reports of advanced CSCC, but data are scarce and response short-lived. Recently, two PD-1 immune checkpoint inhibitors, cemiplimab and pembrolizumab, have been approved for the treatment of advanced CSCC; specifically the former can be administered in patients with locally advanced and metastatic tumours, while the latter in case of recurrent metastatic CSCC. The introduction of immune checkpoint inhibitors represents a breakthrough in the treatment of CSCC, since numerous clinical trials showed that these agents may provide remarkable clinical benefit with an acceptable safety profile, in a high-need population who had no standard of care. In addition, real-world studies are needed to validate the results observed in clinical trials and numerous clinical trials in the neoadjuvant or adjuvant setting are ongoing. Finally, further studies should investigate predictive biomarkers useful to better select patients to maximize the treatment efficacy.
常见的原发性皮肤鳞状细胞癌（CSCC）约占角化细胞癌的 20%，通常通过手术或放疗成功治疗。在少数情况下，CSCC 病变可能进展为局部晚期或转移性疾病，治疗可能较为困难，导致发病率和死亡率显著升高。在晚期 CSCC 的小型研究和病例报告中，已将化疗和表皮生长因子受体抗体的靶向治疗超适应证用于治疗，但数据稀缺，且应答持续时间短。最近，两种 PD-1 免疫检查点抑制剂，西米普利单抗和帕博利珠单抗，已被批准用于治疗晚期 CSCC；具体而言，前者可用于局部晚期和转移性肿瘤患者，而后者用于复发性转移性 CSCC。免疫检查点抑制剂的引入代表了 CSCC 治疗的突破，因为多项临床试验表明，这些药物可能在高需求人群中提供显著的临床获益，且安全性可接受，这些人群没有标准治疗方法。此外，需要真实世界研究来验证临床试验中观察到的结果，并且正在进行新辅助或辅助治疗环境中的多项临床试验。最后，应进一步研究有助于更好地选择患者以最大限度提高治疗效果的预测生物标志物。
