SUNY Upstate Medical University, Syracuse, USA.
J Investig Med High Impact Case Rep. 2022 Jan-Dec;10:23247096221121408. doi: 10.1177/23247096221121408.
Cemiplimab, a monoclonal antibody directed against programmed death receptor 1 (PD-1), has shown promising results in cutaneous squamous cell carcinoma (cSCC). In a nonrandomized trial where cemiplimab 3 mg/kg was given every 2 weeks for up to 96 weeks, a 44% response rate was noted. This case series discusses 3 unique scenarios of patients with advanced cSCC treated with cemiplimab. The first case is of an end stage kidney disease (ESKD) patient with failed living donor kidney transplant who had developed recurrent cSCC despite several excisions and topical 5-flurouracil and acitretin therapy. He received 8 cycles of cemiplimab leading to resolution. This case serves as an example of the safety and efficacy of cemiplimab in a complex patient who is a kidney transplant recipient on hemodialysis. The second case describes an elderly gentleman with inoperable cSCC initially treated with radiotherapy who later received 9 cycles of cemiplimab for recurrent metastatic disease with excellent response. This case supports the safe and effective use of cemiplimab in an elderly patient. In the third case, cSCC presented itself as a large fungating mass that would have otherwise necessitated limb amputation and was successfully treated with 18 cycles of cemiplimab. This case highlights the dramatic response to cemiplimab obviating the need for surgical intervention and resulting in limb salvage.
西普单抗是一种针对程序性死亡受体 1（PD-1）的单克隆抗体，在皮肤鳞状细胞癌（cSCC）中显示出良好的疗效。在一项非随机试验中，每 2 周给予西普单抗 3mg/kg，最长可达 96 周，观察到 44%的缓解率。本病例系列讨论了 3 例晚期 cSCC 患者接受西普单抗治疗的独特情况。第一个病例是一名终末期肾病（ESKD）患者，他在活体供肾移植失败后，尽管进行了多次切除和局部 5-氟尿嘧啶和阿维 A 治疗，但仍反复发作 cSCC。他接受了 8 个周期的西普单抗治疗，导致疾病缓解。该病例说明了西普单抗在接受血液透析的肾移植受者这一复杂患者中的安全性和疗效。第二个病例描述了一名无法手术的 cSCC 老年男性，最初接受放疗，后来因复发性转移性疾病接受了 9 个周期的西普单抗治疗，反应良好。该病例支持在老年患者中安全有效地使用西普单抗。在第三个病例中，cSCC 表现为一个大的隆起性肿块，如果不进行截肢，否则需要截肢，用 18 个周期的西普单抗成功治疗。该病例强调了对西普单抗的显著反应，避免了手术干预的需要，并导致肢体保存。
