Eric Whitman, MD, of Atlantic Health, and Gino K. In, MD, MPH, of USC Norris Comprehensive Cancer Center, open this OncLive My Treatment Approach program on matching immunotherapy to the patient in advanced cutaneous squamous cell carcinoma.

Dr Whitman and Dr In discuss the FDA approval of adjuvant cemiplimab for patients with high-risk cutaneous squamous cell carcinoma who have completed surgery and adjuvant radiation yet remain at elevated risk for recurrence.

The faculty examine KEYNOTE-630, the adjuvant trial of pembrolizumab in cutaneous squamous cell carcinoma, and why it produced a different result than C-POST.

Dr Whitman introduces cosibelimab, the third checkpoint inhibitor approved in advanced cutaneous squamous cell carcinoma, and the faculty examine what distinguishes it mechanistically from cemiplimab and pembrolizumab.

With efficacy across the approved checkpoint inhibitors largely comparable, the faculty turn to tolerability as a differentiating factor and examine cosibelimab in detail.

Dr Whitman raises a further structural distinction, noting that cosibelimab retains an active Fc domain capable of mediating antibody-dependent cellular cytotoxicity.

Dr Whitman presents the first clinical scenario, a 68-year-old man with a cutaneous squamous cell carcinoma of the temple who has undergone resection.

The faculty examine how comorbidities factor into the adjuvant treatment decision for the 68-year-old patient, who carries a cardiac history and diabetes.

Dr Whitman presents the second clinical scenario, a 79-year-old woman with a large ulcerated cutaneous squamous cell carcinoma of the right lower leg measuring 6.8 cm and progressively enlarging over roughly 8 months.

Dr Whitman describes what stands out clinically about the 79-year-old patient, beginning with the interaction between advanced age, accumulated chronic disease, and the clinical impression formed at the bedside.

The faculty consider whether neoadjuvant checkpoint inhibitor therapy has a role in cutaneous squamous cell carcinoma, particularly for tumors that are borderline resectable or would require morbid surgery.

Dr Whitman poses a variation on the second case, asking how management would change if the patient were a kidney transplant recipient rather than a patient with chronic kidney disease alone.

The faculty address management after progression on checkpoint inhibitor monotherapy in patients who are not candidates for further surgery or radiation.

Dr Whitman closes the discussion by asking Dr In where he sees treatment of advanced cutaneous squamous cell carcinoma evolving and what developments he most hopes to see.