University Medical Center of Southern Nevada, Las Vegas, NV 89102, USA.
Comprehensive Cancer Centers of Nevada, Las Vegas, NV 89148, USA.
Oncotarget. 2023 Jul 7;14:709-718. doi: 10.18632/oncotarget.28470.
Treatment for locally advanced cutaneous squamous cell cancers (laCSCC) remains poorly defined. Most laCSCC tumors express high levels of epidermal growth factor receptors (EGFR). Cetuximab has activity in other EGFR expressing cancers and enhances the effectiveness of radiotherapy.
A retrospective review of institutional data identified eighteen patients with laCSCC treated with cetuximab induction and concurrent radiotherapy. The loading dose of cetuximab was 400 mg/m² IV. Subsequent weekly doses of 250 mg/m² IV were infused throughout the period of radiation. The treatment doses ranged from 4500-7000 cGy, with a dose fraction of 200-250 cGy.
The objective response rate was 83.2% with 55.5% complete responses and 27.7% partial responses. Median progression-free survival was 21.6 months. Progression-free survival was 61% at 1 year and 40% at 2 years. With longer follow-up, some patients developed a local recurrence (16.7%), distant metastases (11.1%) or a second primary cancer (16.3%). Cetuximab was well tolerated, with 68.4% patients experienced only mild acneiform skin rash or fatigue (Grade 1 or 2). Radiotherapy produced expected side effects (skin erythema, moist desquamation, mucositis).
Cetuximab plus radiotherapy represents an active and tolerable treatment option for laCSCC, including patients with contraindications for checkpoint inhibitor therapy.
局部晚期皮肤鳞状细胞癌（laCSCC）的治疗仍未明确。大多数 laCSCC 肿瘤表达高水平的表皮生长因子受体（EGFR）。西妥昔单抗在其他表达 EGFR 的癌症中具有活性，并增强放射治疗的效果。
对机构数据的回顾性分析确定了 18 例接受西妥昔单抗诱导和同期放疗的 laCSCC 患者。西妥昔单抗的负荷剂量为 400mg/m² IV。随后每周剂量为 250mg/m² IV，在整个放疗期间输注。治疗剂量范围为 4500-7000cGy，剂量分数为 200-250cGy。
客观缓解率为 83.2%，完全缓解率为 55.5%，部分缓解率为 27.7%。中位无进展生存期为 21.6 个月。无进展生存期在 1 年时为 61%，在 2 年时为 40%。随着随访时间的延长，一些患者出现局部复发（16.7%）、远处转移（11.1%）或第二原发癌（16.3%）。西妥昔单抗耐受性良好，68.4%的患者仅出现轻度痤疮样皮疹或疲劳（1 级或 2 级）。放射治疗产生了预期的副作用（皮肤红斑、湿性脱屑、黏膜炎）。
西妥昔单抗联合放疗是 laCSCC 的一种有效且耐受良好的治疗选择，包括对检查点抑制剂治疗有禁忌的患者。
