Yeo Nicholas, Genenger Benjamin, Aghmesheh Morteza, Thind Amarinder, Napaki Sarbar, Perry Jay, Ashford Bruce, Ranson Marie, Brungs Daniel
Illawarra Shoalhaven Local Health District (ISLHD), NSW Health, Wollongong, NSW 2500, Australia.
Molecular Horizons, University of Wollongong, Wollongong, NSW 2500, Australia.
Cancers (Basel). 2023 Oct 17;15(20):5026. doi: 10.3390/cancers15205026.
Approximately 3-5% of patients with cutaneous squamous cell carcinoma (CSCC) develop advanced disease, accounting for roughly 1% of all cancer deaths in Australia. Immunotherapy has demonstrated significant clinical benefit in advanced CSCC in several key phase II studies; however, there are limited data for patients treated outside of clinical trials. This is particularly relevant in advanced CSCC, which is most often seen in elderly patients with significant comorbidities. Thus, we aim to describe our experience with immunotherapy in a cohort of patients with advanced CSCC in Australia. We retrospectively reviewed all advanced CSCC patients treated with immunotherapy within the Illawarra and Shoalhaven Local Health District. Among the 51 patients treated with immunotherapy, there was an objective response rate (ORR) of 53% and disease control rate (DCR) of 67%. Our most significant predictor of response was sex, with male patients more likely to have better responses compared to female patients (DCR 85% vs. 41%, < 0.0001), as well as improved progression-free survival (HR 4.6, 95%CI 1.9-10.8, = 0.0007) and overall survival (HR 3.0, 95%CI 1.3-7.1, = 0.006). Differential expression analysis of 770 immune-related genes demonstrated an impaired CD8 T-cell response in female patients. Our observed ORR of 53% is similar to that described in current literature with durable responses seen in the majority of patients.
约3%-5%的皮肤鳞状细胞癌（CSCC）患者会发展为晚期疾病，在澳大利亚约占所有癌症死亡人数的1%。免疫疗法在几项关键的II期研究中已证明对晚期CSCC具有显著的临床益处；然而，关于非临床试验中治疗患者的数据有限。这在晚期CSCC中尤为相关，晚期CSCC最常见于有严重合并症的老年患者。因此，我们旨在描述我们在澳大利亚一组晚期CSCC患者中使用免疫疗法的经验。我们回顾性分析了伊拉瓦拉和肖尔黑文地方卫生区接受免疫疗法治疗的所有晚期CSCC患者。在接受免疫疗法治疗的51例患者中，客观缓解率（ORR）为53%，疾病控制率（DCR）为67%。我们最重要的缓解预测因素是性别，男性患者比女性患者更有可能有更好的缓解（DCR 85%对41%，<0.0001），无进展生存期也有所改善（HR 4.6，95%CI 1.9-10.8，=0.0007）和总生存期（HR 3.0，95%CI 1.3-7.1，=0.006）。对770个免疫相关基因的差异表达分析表明，女性患者的CD8 T细胞反应受损。我们观察到的53%的ORR与当前文献中描述的相似，大多数患者出现持久缓解。
