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Surgery and cetuximab most effectively treated very high-risk CSCC
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Patients with very high-risk cutaneous squamous cell carcinoma appeared to have improved outcomes following surgery and adjuvant cetuximbab when compared with other therapies, according to study results.
Researchers conducted a retrospective review of all cutaneous squamous cell carcinoma (CSCC) cases identified among patients seen in the Mohs micrographic surgical division at Columbia University Medical Center, New York, between 2000 and 2011.
“We sought to establish an aggressive CSCC management protocol by reviewing high-risk CSCC [HCSCC] and very high-risk CSCC [VCSCC] cases,” the researchers reported.
A total of 1,591 CSCC cases were treated, and 27 patients with HCSCC (n=5) and VCSCC (n=22) were identified.
Four of the patients with HCSCC were treated with surgery, while one had surgery and adjuvant radiation. During a median follow-up of 5 years, all remained disease-free.
Four of the patients with VCSCC received surgery alone, with one (25%) displaying complete response (CR) and three (75%) having disease progression within a year. Two of the patients died of disease-specific death.
Surgery and adjuvant radiation were used to treat of 11 of the patients with VCSCC. Among those patients, four (36.4%) showed CR during a median follow-up of 3 years, while seven (63.6%) displayed disease progression, with a median time to recurrence of 6 months.
Six of the VCSCC patients were treated with surgery and cetuximab. Three patients (50%) showed CR during a median follow-up of 3 years, while two (33%) displayed disease progression within 4 months. One of the patients died of disease-specific death. One patient (17%) began cetuximab prior to surgery but could not tolerate it and was not assessed.
One patient with VCSCC, who received surgery and adjuvant radiation and cetuximab, showed no evidence of recurrence.
“This study … includes the only report of the use of cetuximab in CSCC demonstrating a durable, sustained response to this therapy with a median follow-up of 2.5 years,” the researchers concluded. “It is our hope that with future research, this treatment paradigm might be further refined to provide superior outcomes for patients with VCSCC.”
Disclosure: The researchers report no financial disclosures.
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