Hempel Conrad, Vladimirova Gabriela, Horn Susanne, Horn Lars-Christian, Ziemer Mirjana
Department of Dermatology, Venereology und Allergology, University Medical Center Leipzig, Leipzig, Germany.
Rudolf-Schönheimer-Institute for Biochemistry, University Medical Center Leipzig, Leipzig, Germany.
J Dtsch Dermatol Ges. 2025 Jan;23(1):30-37. doi: 10.1111/ddg.15551. Epub 2024 Nov 3.
Most patients with unresectable locally advanced cutaneous squamous cell carcinoma (cSCC) benefit from cemiplimab, but some do not respond. Our study aims to identify clinical and histopathological features predicting response to cemiplimab.
We analyzed 15 patients treated with cemiplimab, assessing clinical, demographic, histopathological, and immunohistochemical characteristics and correlating them with treatment response. Furthermore, effectiveness and safety were evaluated in our cohort.
Our cohort included 12 males and 3 females, with a mean age of 78.1 years. The majority of tumors, accounting for 66.7%, were located in the head and neck region. Treatment was well-tolerated, with only one grade 3 colitis. There was no correlation between immune-related adverse events and treatment response. Non-responders were younger (69.4 vs. 82.5 years). A history of hematological malignancy correlated with poorer response. High mitotic rate, poor tumor differentiation, high vimentin and p53, and low E-cadherin expression were associated with worse response. Conversely, higher intratumoral inflammatory infiltrate density, presence of necrotic areas, and lower mismatch repair-protein staining correlated with better response.
Cemiplimab is a safe and effective therapy, particularly in elderly patients. Well-differentiated tumors with low proliferative index, intratumoral inflammatory infiltrate, and tumor necrosis may predict better clinical response.
大多数不可切除的局部晚期皮肤鳞状细胞癌（cSCC）患者可从西米普利单抗治疗中获益，但部分患者无反应。我们的研究旨在确定预测西米普利单抗治疗反应的临床和组织病理学特征。
我们分析了15例接受西米普利单抗治疗的患者，评估其临床、人口统计学、组织病理学和免疫组化特征，并将这些特征与治疗反应相关联。此外，我们还评估了队列中的有效性和安全性。
我们的队列包括12名男性和3名女性，平均年龄为78.1岁。大多数肿瘤（占66.7%）位于头颈部区域。治疗耐受性良好，仅出现1例3级结肠炎。免疫相关不良事件与治疗反应之间无相关性。无反应者年龄较小（69.4岁对82.5岁）。血液系统恶性肿瘤病史与较差的反应相关。有丝分裂率高、肿瘤分化差、波形蛋白和p53高表达以及E-钙黏蛋白低表达与较差的反应相关。相反，肿瘤内炎症浸润密度较高、存在坏死区域以及错配修复蛋白染色较低与较好的反应相关。
西米普利单抗是一种安全有效的治疗方法，尤其在老年患者中。分化良好、增殖指数低、肿瘤内有炎症浸润和肿瘤坏死的肿瘤可能预示着更好的临床反应。
