The Evolving Treatment Landscape in Advanced Cutaneous Squamous Cell Carcinoma

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. The faculty describe how immune checkpoint blockade has reshaped a disease once managed with cytotoxic chemotherapy and EGFR-directed therapy, neither of which produced durable benefit in most patients. They emphasize the dramatic and sometimes rapid responses achievable with anti-PD-1 and anti-PD-L1 agents in locally advanced and metastatic disease. Both physicians then frame what makes this population distinct from other solid tumor populations treated with immunotherapy. Patients tend to be older, carry substantial cumulative sun damage and multiple chronic comorbidities, and in some cases are immunosuppressed following solid organ transplant. That combination, they note, shapes nearly every downstream treatment decision discussed in the program, from adjuvant therapy through management of unresectable disease.