Cutaneous squamous cell carcinoma

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Elizabeth Buchbinder, MD
Boston, MA

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5 regimens on this page
8 variants on this page


Guidelines

NCCN

Neoadjuvant chemotherapy

Bleomycin & Cisplatin

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Regimen

Study Evidence
Denic 1999 Pilot, <20 patients reported

Chemotherapy

21-day cycle for 3 cycles

Subsequent treatment

References

  1. Denic S. Preoperative treatment of advanced skin carcinoma with cisplatin and bleomycin. Am J Clin Oncol. 1999 Feb;22(1):32-4. link to original article contains protocol PubMed

Advanced or metastatic disease, all lines of therapy

Cemiplimab monotherapy

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Variant #1, weight-based dose

Study Evidence
Migden et al. 2018 (R2810-ONC-1423; R2810-ONC-1540) Phase I/II

Note: this is the dose used in Groups 1 & 2.

Immunotherapy

14-day cycle for up to 96 weeks

Variant #2, fixed-dose

FDA-recommended dose
Study Evidence
Migden et al. 2018 (R2810-ONC-1423; R2810-ONC-1540) Phase I/II

Note: this is dose used in Group 3 of the phase II trial.

Immunotherapy

21-day cycle for up to 54 weeks

References

  1. R2810-ONC-1423; R2810-ONC-1540: Migden MR, Rischin D, Schmults CD, Guminski A, Hauschild A, Lewis KD, Chung CH, Hernandez-Aya L, Lim AM, Chang ALS, Rabinowits G, Thai AA, Dunn LA, Hughes BGM, Khushalani NI, Modi B, Schadendorf D, Gao B, Seebach F, Li S, Li J, Mathias M, Booth J, Mohan K, Stankevich E, Babiker HM, Brana I, Gil-Martin M, Homsi J, Johnson ML, Moreno V, Niu J, Owonikoko TK, Papadopoulos KP, Yancopoulos GD, Lowy I, Fury MG. PD-1 blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma. N Engl J Med. 2018 Jul 26;379(4):341-351. Epub 2018 Jun 4. link to original article contains verified protocol PubMed

Cetuximab monotherapy

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Variant #1, weekly, indefinite

Study Evidence
Maubec et al. 2011 Phase II

Chemotherapy

Given for at least 6 weeks, to be continued until progression of disease or unacceptable toxicity

Variant #2, weekly x 3 mo

Study Evidence
Kim et al. 2011 Case report

Chemotherapy

3 month course

Variant #3, intermittent

Study Evidence
Miller et al. 2010 Case report

Chemotherapy

  • Cetuximab (Erbitux) 400 mg/m2 IV once on day 1, then 250 mg/m2 IV once per day on days 8, 15, 22

6-month cycles, given indefinitely unless progression occurs

References

  1. Case report: Bauman JE, Eaton KD, Martins RG. Treatment of recurrent squamous cell carcinoma of the skin with cetuximab. Arch Dermatol. 2007 Jul;143(7):889-92. link to original article PubMed
  2. Case report: Suen JK, Bressler L, Shord SS, Warso M, Villano JL. Cutaneous squamous cell carcinoma responding serially to single-agent cetuximab. Anticancer Drugs. 2007 Aug;18(7):827-9. link to original article PubMed
  3. Case report: Arnold AW, Bruckner-Tuderman L, Zuger C, Itin PH. Cetuximab therapy of metastasizing cutaneous squamous cell carcinoma in a patient with severe recessive dystrophic epidermolysis bullosa. Dermatology. 2009;219(1):80-3. Epub 2009 May 13. link to original article PubMed
  4. Case report: Miller K, Sherman W, Ratner D. Complete clinical response to cetuximab in a patient with metastatic cutaneous squamous cell carcinoma. Dermatol Surg. 2010 Dec;36(12):2069-74. Epub 2010 Oct 11. link to original article contains verified protocol PubMed content property of HemOnc.org
  5. Case report: Kim S, Eleff M, Nicolaou N. Cetuximab as primary treatment for cutaneous squamous cell carcinoma to the neck. Head Neck. 2011 Feb;33(2):286-8. link to original article contains verified protocol PubMed
  6. Maubec E, Petrow P, Scheer-Senyarich I, Duvillard P, Lacroix L, Gelly J, Certain A, Duval X, Crickx B, Buffard V, Basset-Seguin N, Saez P, Duval-Modeste AB, Adamski H, Mansard S, Grange F, Dompmartin A, Faivre S, Mentré F, Avril MF. Phase II study of cetuximab as first-line single-drug therapy in patients with unresectable squamous cell carcinoma of the skin. J Clin Oncol. 2011 Sep 1;29(25):3419-26. Epub 2011 Aug 1. link to original article contains verified protocol PubMed

Cisplatin & Doxorubicin

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Regimen

Study Evidence
Guthrie et al. 1990 Non-randomized

Chemotherapy

21-day cycles

References

  1. Case series: Guthrie TH, Porubsky ES. Successful systemic chemotherapy of advanced squamous and basal cell carcinoma of the skin with cis-diamminedichloroplatinum III and doxorubicin. Laryngoscope. 1982 Nov;92(11):1298-9. link to original article PubMed
  2. Case series: Guthrie TH Jr, McElveen LJ, Porubsky ES, Harmon JD. Cisplatin and doxorubicin. An effective chemotherapy combination in the treatment of advanced basal cell and squamous carcinoma of the skin. Cancer. 1985 Apr 15;55(8):1629-32. PubMed
  3. Case series: Guthrie TH Jr, Porubsky ES, Luxenberg MN, Shah KJ, Wurtz KL, Watson PR. Cisplatin-based chemotherapy in advanced basal and squamous cell carcinomas of the skin: results in 28 patients including 13 patients receiving multimodality therapy. J Clin Oncol. 1990 Feb;8(2):342-6. link to original article contains verified protocol PubMed

Cisplatin, Interferon alfa-2a, Isotretinoin

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Regimen

Study Evidence
Shin et al. 2002 Phase II

Note: Shin et al. 2002 did not clearly specify whether the interferon alfa used in the trial was 2a or 2b, but based on the details in the paper and the references cited, it is inferred that interferon alfa-2a was used.

Chemoimmunotherapy

References

  1. Shin DM, Glisson BS, Khuri FR, Clifford JL, Clayman G, Benner SE, Forastiere AA, Ginsberg L, Liu D, Lee JJ, Myers J, Goepfert H, Lotan R, Hong WK, Lippman SM. Phase II and biologic study of interferon alfa, retinoic acid, and cisplatin in advanced squamous skin cancer. J Clin Oncol. 2002 Jan 15;20(2):364-70. link to original article contains verified protocol PubMed

Investigational agents

Drugs with some degree of promising activity in clinical trials.