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Wu Z, Tao C, Yang L, Yan Y, Pan L, Zhang L. Treatment benefit of electrochemotherapy for superficial squamous cell carcinoma: a systematic review and single-arm meta-analysis. Clin Transl Oncol 2024; 26:2608-2617. [PMID: 38758386 DOI: 10.1007/s12094-024-03522-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Treating aggressive superficial squamous cell carcinoma (SCC) poses challenges due to invasiveness. Palliative care is recommended for inoperable cases with extensive tumors near vital organs, risking disfigurement or functional impairment. Electrochemotherapy (ECT) is an emerging cutaneous tumor treatment, but its efficacy against superficial SCC remains uncertain. This study conducts a systematic review and single-arm meta-analysis to evaluate ECT's effectiveness against superficial SCC and provide current evidence for clinical practice. METHODS Embase, PubMed and Cochrane Library were searched for studies up to May 2023. The random effects model analyzed complete response (CR) and partial response (PR), with subgroup assessment based on drug dosage, treatment response evaluation, tumor size, primary/recurrent status, and tumor location. RESULTS Ten studies involving 162 patients and 208 tumors were included. Pooled CR and PR rates for ECT-treated superficial SCC were 66.5% (95% CI 48.4%-82.5%; I2 = 84%) and 20.3% (95% CI 10.5%-32.3%; I2 = 70%), respectively. Subgroup analysis indicated ECT's superiority in treating primary tumors (PR: 70%, CR: 30%) and tumors ≤ 3 cm (PR: 81.3%, CR: 10.1%) compared to recurrent tumors (PR: 56.7%, CR: 36.5%) and tumors > 3 cm (PR: 45.2%, CR: 34.4%). CONCLUSION This single-arm meta-analysis confirms ECT's efficacy against superficial SCC, especially in primary tumors and those ≤ 3 cm in diameter. The study highlights the impact of tumor location and response evaluation on ECT's benefits, warranting further investigation through additional research.
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Affiliation(s)
- Zhuoxia Wu
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin, China
| | - Chen Tao
- School of Mathematics and Statistics, Northeast Normal University, Changchun, 130024, Jilin, China.
| | - Liehao Yang
- Department of Dermatology, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin, China
| | - Yan Yan
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin, China
| | - Lingfeng Pan
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin, China
| | - Lianbo Zhang
- Department of Plastic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin, China
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De Falco V, Napolitano S, Franco R, Zito Marino F, Formisano L, Esposito D, Suarato G, Napolitano R, Esposito A, Caraglia F, Giugliano MC, Cioli E, Famiglietti V, Bianco R, Argenziano G, Ronchi A, Ciardiello D, Nardone V, D’Ippolito E, Del Tufo S, Ciardiello F, Troiani T. Overexpression of CCL-20 and CXCL-8 genes enhances tumor escape and resistance to cemiplimab, a programmed cell death protein-1 (PD-1) inhibitor, in patients with locally advanced and metastatic cutaneous squamous cell carcinoma. Oncoimmunology 2024; 13:2388315. [PMID: 39206096 PMCID: PMC11352706 DOI: 10.1080/2162402x.2024.2388315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/29/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
Cemiplimab has demonstrated relevant clinical activity in cutaneous squamous cell carcinoma (cSCC) but mechanisms of primary and acquired resistance to immunotherapy are still unknown. We collected clinical data from locally advanced and/or metastatic cSSC patients treated with cemiplimab in two Italian University centers. In addition, gene expression analysis by using Nanostring Technologies platform to evaluate 770 cancer- and immune-related genes on 20 tumor tissue samples (9 responders and 11 non-responders to cemiplimab) was performed. We enrolled 81 patients with a median age of 82 years. After 16.4 months of median follow-up, 12- and 24-months PFS were 53% and 42%, respectively; while 12- and 24-months OS were 71% and 61%, respectively. Treatment was well tolerated. Overall response rate (ORR) was 58%, with a disease control rate (DCR) of 77.8%. The difference between genes expressed in responder versus non-responder patient samples was substantial, particularly for genes involved in immune system regulation. Cemiplimab-resistant tumors were associated with over-expression of CCL-20 and CXCL-8. Cemiplimab confirmed efficacy and safety data in real-life cSCC patients. Overexpression of CCL-20 and CXCL-8 could represent biomarkers of lack of response to immunotherapy.
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MESH Headings
- Humans
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Monoclonal, Humanized/administration & dosage
- Male
- Skin Neoplasms/drug therapy
- Skin Neoplasms/genetics
- Skin Neoplasms/pathology
- Female
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- Aged
- Aged, 80 and over
- Drug Resistance, Neoplasm/genetics
- Drug Resistance, Neoplasm/drug effects
- Interleukin-8/genetics
- Interleukin-8/metabolism
- Tumor Escape/drug effects
- Tumor Escape/genetics
- Middle Aged
- Immune Checkpoint Inhibitors/therapeutic use
- Immune Checkpoint Inhibitors/pharmacology
- Programmed Cell Death 1 Receptor/antagonists & inhibitors
- Programmed Cell Death 1 Receptor/genetics
- Programmed Cell Death 1 Receptor/metabolism
- Gene Expression Regulation, Neoplastic/drug effects
- Antineoplastic Agents, Immunological/therapeutic use
- Antineoplastic Agents, Immunological/pharmacology
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Affiliation(s)
- Vincenzo De Falco
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Stefania Napolitano
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, via Luciano Armanni, Naples, Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, via Luciano Armanni, Naples, Italy
| | - Luigi Formisano
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Napoli, Italy
| | - Daniela Esposito
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Napoli, Italy
| | - Gabriella Suarato
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Rossella Napolitano
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alfonso Esposito
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesco Caraglia
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Maria Cristina Giugliano
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Eleonora Cioli
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Famiglietti
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Roberto Bianco
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Napoli, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, via Luciano Armanni, Naples, Italy
| | - Davide Ciardiello
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
- Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Milan, Italy
| | - Valerio Nardone
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Emma D’Ippolito
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Sara Del Tufo
- Radiology Unit, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Fortunato Ciardiello
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Teresa Troiani
- Medical Oncology Unit, Department of Precision Medicine, Università della Campania “Luigi Vanvitelli”, Naples, Italy
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Comune R, Ruggiero A, Portarapillo A, Villani A, Megna M, Tamburrini S, Masala S, Sica G, Sandomenico F, Bortolotto C, Preda L, Scaglione M. Cutaneous Squamous Cell Carcinoma: From Diagnosis to Follow-Up. Cancers (Basel) 2024; 16:2960. [PMID: 39272818 PMCID: PMC11394133 DOI: 10.3390/cancers16172960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/14/2024] [Accepted: 08/16/2024] [Indexed: 09/15/2024] Open
Abstract
Cutaneous squamous cell carcinoma (SCC) is the second most frequent skin cancer, accounting for approximately 20% of all cutaneous malignancies, and with an increasing incidence due to the progressive increment of the average age of life. The diagnosis is usually firstly suspected based on clinical manifestations; however, dermoscopic features may improve diagnostic sensitivity in cases of an uncertain diagnosis and may guide the biopsy, which should be performed to histopathologically prove the tumor. New diagnostic strategies may improve the sensitivity of the cutaneous SCC, such as reflectance confocal microscopy and line-field confocal optical coherence, for which increasing data have been recently published. Imaging has a central role in the staging of the diseases, while its exact role, as well as the choice of the best techniques, during the follow-up are not fully clarified. The aim of this literature review is to describe diagnostic clinical and instrumental tools of cutaneous SCC, with an insight into the role of imaging in the diagnosis and follow-up of cutaneous SCC.
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Affiliation(s)
- Rosita Comune
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Antonio Portarapillo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Stefania Tamburrini
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, 80147 Naples, Italy
| | - Salvatore Masala
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Piazza Università, 21, 07100 Sassari, Italy
| | - Giacomo Sica
- Department of Radiology, Monaldi Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy
| | - Fabio Sandomenico
- Radiology Unit, Buon Consiglio Fatebenefratelli Hospital, 80123 Naples, Italy
| | - Chandra Bortolotto
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Lorenzo Preda
- Diagnostic Imaging and Radiotherapy Unit, Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Mariano Scaglione
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Piazza Università, 21, 07100 Sassari, Italy
- Department of Radiology, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK
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4
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Brown M, Williams A, Chilcott RP, Brady B, Lenn J, Evans C, Allen L, McAuley WJ, Beebeejaun M, Haslinger J, Beuttel C, Vieira R, Guidali F, Miranda M. Topically Applied Therapies for the Treatment of Skin Disease: Past, Present, and Future. Pharmacol Rev 2024; 76:689-790. [PMID: 38914467 DOI: 10.1124/pharmrev.123.000549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 05/31/2024] [Accepted: 06/03/2024] [Indexed: 06/26/2024] Open
Abstract
The purpose of this review is to summarize essential biological, pharmaceutical, and clinical aspects in the field of topically applied medicines that may help scientists when trying to develop new topical medicines. After a brief history of topical drug delivery, a review of the structure and function of the skin and routes of drug absorption and their limitations is provided. The most prevalent diseases and current topical treatment approaches are then detailed, the organization of which reflects the key disease categories of autoimmune and inflammatory diseases, microbial infections, skin cancers, and genetic skin diseases. The complexity of topical product development through to large-scale manufacturing along with recommended risk mitigation approaches are then highlighted. As such topical treatments are applied externally, patient preferences along with the challenges they invoke are then described, and finally the future of this field of drug delivery is discussed, with an emphasis on areas that are more likely to yield significant improvements over the topical medicines in current use or would expand the range of medicines and diseases treatable by this route of administration. SIGNIFICANCE STATEMENT: This review of the key aspects of the skin and its associated diseases and current treatments along with the intricacies of topical formulation development should be helpful in making judicious decisions about the development of new or improved topical medicines. These aspects include the choices of the active ingredients, formulations, the target patient population's preferences, limitations, and the future with regard to new skin diseases and topical medicine approaches.
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Affiliation(s)
- Marc Brown
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Adrian Williams
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Robert P Chilcott
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Brendan Brady
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Jon Lenn
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Charles Evans
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Lynn Allen
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - William J McAuley
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Mubinah Beebeejaun
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Jasmin Haslinger
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Claire Beuttel
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Raquel Vieira
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Florencia Guidali
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
| | - Margarida Miranda
- MLBT Investments and Consultancy, Aylesbury, United Kingdom (M.Br.); MedPharm Ltd, Guildford, United Kingdom (M.Br., B.B., C.E., J.H., F.G.); Reading School of Pharmacy, Reading, United Kingdom (A.W.); School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom (R.P.C., W.J.M.); MedPharm Ltd, Durham. North Carolina (J.L., L.A., C.B.); Medicine Development and Supply, GlaxoSmithKline R&D, Stevenage, United Kingdom (M.Be.); Department of Dermatology, CUF Tejo Hospital, Lisbon, Portugal (R.V.); Centro de Investigação Interdisciplinar Egas Moniz, Egas Moniz School of Health and Science, Monte de Caparica, Portugal (M.M.); and Department of Chemistry, Coimbra Chemistry Center, University of Coimbra, Coimbra, Portugal (M.M.)
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5
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Álvarez-Salafranca M, Zaballos P. [Translated article] Dermoscopy of Squamous Cell Carcinoma: From Actinic Keratosis to Invasive Forms. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00650-1. [PMID: 39102978 DOI: 10.1016/j.ad.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 08/07/2024] Open
Abstract
When the dermoscopy of squamous cell carcinoma and its precursors we differentiate among keratin-related, vascular, and pigment-related criteria. Non-pigmented actinic keratoses are characterized by the "strawberry pattern". Pigmented actinic keratosis shows a significant dermatoscopic overlap with lentigo maligna, but the presence of pigmented scales, erythema, and prominent follicles favors its diagnosis. Bowen's disease is characterized by clustered glomerular vessels, white-yellowish scales, and brown or grey dots arranged in lines in its pigmented variant. Finally, dermoscopy allows us to detect invasive squamous cell carcinoma in its early stages and differentiate it from its precursors. Furthermore, its presentation may vary depending on the degree of differentiation, with keratin-associated criteria predominating in well-differentiated tumors, while an atypical vascular pattern will predominate in poorly differentiated tumors.
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Affiliation(s)
- M Álvarez-Salafranca
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, Spain.
| | - P Zaballos
- Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla, Tarragona, Spain
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6
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Laus AC, Gomes INF, da Silva ALV, da Silva LS, Milan MB, AparecidaTeixeira S, Martin ACBM, do Nascimento Braga Pereira L, de Carvalho CEB, Crovador CS, de Paula FE, Nascimento FC, de Freitas HT, de Lima Vazquez V, Reis RM, da Silva-Oliveira RJ. Establishment and molecular characterization of HCB-541, a novel and aggressive human cutaneous squamous cell carcinoma cell line. Hum Cell 2024; 37:1170-1183. [PMID: 38565739 PMCID: PMC11194207 DOI: 10.1007/s13577-024-01054-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is a common type of skin cancer that can result in significant morbidity, although it is usually well-managed and rarely metastasizes. However, the lack of commercially available cSCC cell lines hinders our understanding of this disease. This study aims to establish and characterize a new metastatic cSCC cell line derived from a Brazilian patient. A tumor biopsy was taken from a metastatic cSCC patient, immortalized, and named HCB-541 after several passages. The cytokeratin expression profile, karyotypic alterations, mutational analysis, mRNA and protein differential expression, tumorigenic capacity in xenograft models, and drug sensitivity were analyzed. The HCB-541 cell line showed a doubling time between 20 and 30 h and high tumorigenic capacity in the xenograft mouse model. The HCB-541 cell line showed hypodiploid and hypotetraploidy populations. We found pathogenic mutations in TP53 p.(Arg248Leu), HRAS (Gln61His) and TERT promoter (C228T) and high-level microsatellite instability (MSI-H) in both tumor and cell line. We observed 37 cancer-related genes differentially expressed when compared with HACAT control cells. The HCB-541 cells exhibited high phosphorylated levels of EGFR, AXL, Tie, FGFR, and ROR2, and high sensitivity to cisplatin, carboplatin, and EGFR inhibitors. Our study successfully established HCB-541, a new cSCC cell line that could be useful as a valuable biological model for understanding the biology and therapy of metastatic skin cancer.
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Affiliation(s)
- Ana Carolina Laus
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Izabela Natalia Faria Gomes
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Aline Larissa Virginio da Silva
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Luciane Sussuchi da Silva
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Mirella Baroni Milan
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Silvia AparecidaTeixeira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Ana Carolina Baptista Moreno Martin
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Letícia do Nascimento Braga Pereira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | | | - Camila Souza Crovador
- Department of Surgery of Melanoma and Sarcoma, Barretos Cancer Hospital, São Paulo, Brazil
| | - Flávia Escremin de Paula
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Flávia Caroline Nascimento
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Helder Teixeira de Freitas
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
| | - Vinicius de Lima Vazquez
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
- Department of Surgery of Melanoma and Sarcoma, Barretos Cancer Hospital, São Paulo, Brazil
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil
- Life and Health Sciences Research Institute (ICVS) Medical School, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Barretos School of Health Sciences, Dr. Paulo Prata-FACISB, Barretos, São Paulo, Brazil
| | - Renato José da Silva-Oliveira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Antenor Duarte Villela, 1331, Barretos, São Paulo, Zip Code: 14784 400, Brazil.
- Barretos School of Health Sciences, Dr. Paulo Prata-FACISB, Barretos, São Paulo, Brazil.
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7
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Nardone V, Napolitano S, Gagliardi F, Esposito A, Caraglia F, Briatico G, Scharf C, Ronchi A, D'Onofrio I, D'Ippolito E, Russo A, Belfiore MP, Franco R, Argenziano G, Ciardiello F, Reginelli A, Cappabianca S, Troiani T. Previous radiotherapy increases the efficacy of cemiplimab in the treatment of locally advanced and metastatic cutaneous squamous cell carcinoma: A retrospective analysis. J Am Acad Dermatol 2024:S0190-9622(24)00919-8. [PMID: 38885840 DOI: 10.1016/j.jaad.2024.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Cemiplimab, a programmed cell death-1 inhibitor approved in 2018 for patients with locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) who are ineligible for curative therapies, lacks clarity regarding the optimal patient selection despite its known efficacy. OBJECTIVE This retrospective study aims to assess the real-world treatment patterns and outcomes in patients with cSCC at our institution. METHODS A retrospective analysis of consecutively treated patients with cemiplimab for cSCC was conducted. Progression-free survival (PFS) and overall survival were evaluated alongside clinical-pathologic characteristics. RESULTS Forty-five patients were included, of which 73.3% were male with a median age of 77 years. After 18 months of median follow-up median PFS and overall survival were not reached with a mean of 21.3 months ± 2.2 months and 25.3 ± 2.1 months, respectively. Univariate and multivariate analyses revealed significant correlations only between PFS and previous radiotherapy (P values: .043 and .046, respectively). LIMITATIONS Limitations include its retrospective nature, the low number of patients analyzed, and the potential for inherent biases. CONCLUSIONS The study reveals a significant association between prior radiotherapy and improved PFS in cemiplimab-treated cSCC, suggesting the potential for combining radiotherapy with cemiplimab. Further exploration of this combined approach is warranted.
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Affiliation(s)
- Valerio Nardone
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
| | - Stefania Napolitano
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Federico Gagliardi
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alfonso Esposito
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Caraglia
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giulia Briatico
- Dermatology Unit, Mental and Physical Health and Preventive Medicine Department, University of Campania "L. Vanvitelli", Naples, Italy
| | - Camila Scharf
- Dermatology Unit, Mental and Physical Health and Preventive Medicine Department, University of Campania "L. Vanvitelli", Naples, Italy
| | - Andrea Ronchi
- Pathology Unit, Mental and Physical Health and Preventive Medicine Department, University of Campania "L. Vanvitelli", Naples, Italy
| | - Ida D'Onofrio
- Radiotherapy Unit, Division Ospedale del Mare, Ospedale del Mare, ASL Napoli 1 Centro, Naples, Italy
| | - Emma D'Ippolito
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Anna Russo
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Maria Paola Belfiore
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Renato Franco
- Pathology Unit, Mental and Physical Health and Preventive Medicine Department, University of Campania "L. Vanvitelli", Naples, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Mental and Physical Health and Preventive Medicine Department, University of Campania "L. Vanvitelli", Naples, Italy
| | - Fortunato Ciardiello
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Teresa Troiani
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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8
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Pazdrowski J, Szewczyk M, Pazdrowski P, Seraszek-Jaros A, Niewinski P, Golusiński W. Risk factors for local and nodal recurrence in patients with head and neck cutaneous squamous cell carcinoma in a high-reference oncological center in Poland. Rep Pract Oncol Radiother 2024; 29:204-210. [PMID: 39143967 PMCID: PMC11321774 DOI: 10.5603/rpor.99904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/18/2024] [Indexed: 08/16/2024] Open
Abstract
Background The behavior of cutaneous squamous cell carcinoma (cSCC) of the head and neck remains poorly understood. There is much controversy regarding the risk of local and nodal recurrences, as well as individual/environmental factors that increase the risk, such as tumor size, perineural invasion, and the state of the immune system. The objective was to analyze factors influencing local and/or regional lymph node recurrence in patients with cSCC in the head and neck region. Material and methods This retrospective single-centre study included 521 patients with cSCC of the head and neck region, with local recurrence observed in 11% and nodal recurrence in 5%. Various potential risk factors were analyzed. Results Statistically significant risk factors for both local and nodal recurrence include: tumor recurrence (p < 0.0001, p < 0.0001 respectively), tissue inflammation confirmed histopathologically (p < 0.0001, p = 0.0019, respectively), tumor size ≥ 10 mm (p = 0.018, p = 0.0056, respectively), invasion depth > 2 mm (p = 0.0238, p = 0.0031, respectively). Risk factors significant only for local recurrence include: surgical margins (p = 0.0056), tumor differentiation grade (p = 0.0149). No risk factors were found to be significant solely for nodal recurrence. Conclusion The authors argue that, in addition to classically recognized risk factors for local and nodal recurrence, attention should be paid to the presence of tissue inflammation confirmed histopathologically. It is also suggested to consider a tumor size of 10 mm as a threshold, increasing the risk of recurrence, instead of the frequently proposed 20 mm.
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Affiliation(s)
- Jakub Pazdrowski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Center, Poznan, Poland
| | - Mateusz Szewczyk
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Center, Poznan, Poland
| | - Pawel Pazdrowski
- Head and Neck Surgery Student Group, Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Seraszek-Jaros
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, Poznan, Poland
| | - Patryk Niewinski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Center, Poznan, Poland
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Center, Poznan, Poland
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9
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de Jong E, Genders R, Harwood CA, Green AC, Plasmeijer EI, Proby C, Geissler E, Ferrándiz-Pulido C, Ducroux E, Euvrard S, Geusau A, Jahn-Bassler K, Borik-Heil L, Rácz E, Nägeli M, Hofbauer GFL, Piaserico S, Russo I, Mackintosh L, Borges-Costa J, Angeliki-Gkini M, Zavattaro E, Savoia P, Imko-Walszuk B, Dębska-Slizień A, Garmyn M, van Kelst S, Ricar J, Cetkovska P, Matin R, Güleç AT, Seçkin D, Anene CA, Oliveira WRP, Rademaker M, Goeman J, van Geloven N, Ruiz E, Murad F, Karn E, Schmults CD, Bouwes Bavinck JN. Cumulative incidence and risk factors for cutaneous squamous cell carcinoma metastases in organ transplant recipients: The Skin Care in Organ Transplant Patients in Europe-International Transplant Skin Cancer Collaborative metastases study, a prospective multicenter study. J Am Acad Dermatol 2024; 90:1200-1209. [PMID: 38301923 DOI: 10.1016/j.jaad.2024.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/23/2023] [Accepted: 01/07/2024] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Solid organ transplant recipients (SOTRs) are believed to have an increased risk of metastatic cutaneous squamous cell carcinoma (cSCC), but reliable data are lacking regarding the precise incidence and associated risk factors. METHODS In a prospective cohort study, including 19 specialist dermatology outpatient clinics in 15 countries, patient and tumor characteristics were collected using standardized questionnaires when SOTRs presented with a new cSCC. After a minimum of 2 years of follow-up, relevant data for all SOTRs were collected. Cumulative incidence of metastases was calculated by the Aalen-Johansen estimator. Fine and Gray models were used to assess multiple risk factors for metastases. RESULTS Of 514 SOTRs who presented with 623 primary cSCCs, metastases developed in 37 with a 2-year patient-based cumulative incidence of 6.2%. Risk factors for metastases included location in the head and neck area, local recurrence, size > 2 cm, clinical ulceration, poor differentiation grade, perineural invasion, and deep invasion. A high-stage tumor that is also ulcerated showed the highest risk of metastasis, with a 2-year cumulative incidence of 46.2% (31.9%-68.4%). CONCLUSIONS SOTRs have a high risk of cSCC metastases and well-established clinical and histologic risk factors have been confirmed. High-stage, ulcerated cSCCs have the highest risk of metastasis.
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Affiliation(s)
- Estella de Jong
- Department of Dermatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
| | - Roel Genders
- Department of Dermatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Catherine A Harwood
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Adèle C Green
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Elsemieke I Plasmeijer
- Department of Dermatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands; Department of Dermatology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Charlotte Proby
- Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Edward Geissler
- Division of Experimental Surgery, Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | | | - Emilie Ducroux
- Department of Dermatology, Edouard Herriot Hospital, Lyon, France
| | - Sylvie Euvrard
- Department of Dermatology, Edouard Herriot Hospital, Lyon, France
| | - Alexandra Geusau
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Karin Jahn-Bassler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Liliane Borik-Heil
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Emõke Rácz
- Department of Dermatology, University Medical Centre Groningen (UMCG), University of Groningen, Groningen, The Netherlands
| | - Mirjam Nägeli
- Department of Dermatology, University Hospital of Zürich, University of Zürich, Zürich, Switzerland
| | - Günther F L Hofbauer
- Department of Dermatology, University Hospital of Zürich, University of Zürich, Zürich, Switzerland
| | - Stefano Piaserico
- Unit of Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Irene Russo
- Unit of Dermatology, Department of Medicine (DIMED), University of Padua, Padua, Italy; Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, IOV-IRCSS, Padua, Italy
| | - Lorna Mackintosh
- Department of Dermatology, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - João Borges-Costa
- Department of Dermatology, Hospital de Santa Maria and Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Maria Angeliki-Gkini
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Elisa Zavattaro
- Dermatology Unit, Departments of Translational Medicine and Health Science, University of Eastern Piedmont, Novara, Italy
| | - Paola Savoia
- Dermatology Unit, Departments of Translational Medicine and Health Science, University of Eastern Piedmont, Novara, Italy
| | - Beata Imko-Walszuk
- N Dermatology and STD Outpatient Clinic, Copernicus Medical Centre, Gdansk, Poland
| | - Alicja Dębska-Slizień
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marjan Garmyn
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Sofie van Kelst
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Jan Ricar
- Department of Dermatovenereology, Charles University Hospital, Pilsen, Czech Republic
| | - Petra Cetkovska
- Department of Dermatovenereology, Charles University Hospital, Pilsen, Czech Republic
| | - Rubeta Matin
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Ayşe Tülin Güleç
- Department of Dermatology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Deniz Seçkin
- Department of Dermatology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Chinedu Anthony Anene
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Centre for Cancer Biology and Therapy, School of Applied Sciences, London South Bank University, London, United Kingdom
| | | | - Marius Rademaker
- Department of Dermatology, Waikato Clinical Campus, University of Auckland, Hamilton, New Zealand
| | - Jelle Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Nan van Geloven
- Department of Biomedical Data Sciences, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Emily Ruiz
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Fadi Murad
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Emily Karn
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
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10
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Ksienski D, Truong PT, Bone JN, Egli S, Clarkson M, Patterson T, Lesperance M, Lakkunarajah S. Advanced cutaneous squamous cell carcinoma: Impact of age on the safety and efficacy of cemiplimab and the prognostic significance of blood biomarkers. J Geriatr Oncol 2024; 15:101789. [PMID: 38710153 DOI: 10.1016/j.jgo.2024.101789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/23/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Age-related differences in the safety profile of cemiplimab for patients with locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) have not been well described. We investigated the association of increasing age with immune related adverse events (irAE) from cemiplimab, efficacy outcomes, and the prognostic significance of pre-treatment blood biomarkers in contemporary practice. MATERIALS AND METHODS Patients starting first-line cemiplimab for locally advanced or metastatic cSCC at British Columbia Cancer between April 2019 and January 2023 were identified. Landmark four-month logistic regression analysis compared the odds of developing irAE or sequelae amongst patients aged <75 years to those aged 75-84 or ≥ 85. Objective responses were determined using Response Evaluation Criteria in Solid Tumors version 1.1. Univariable Cox proportional hazard (PH) regression modelling of factors associated with overall survival (OS) was performed. RESULTS Of 106 patients, the proportions aged <75, 75-84, and ≥ 85 years were 34%, 45%, and 21%, respectively. Overall, the proportion of patients with irAE ≥ grade 3, cemiplimab discontinuation, and hospitalization for immune toxicity was 27.4%, 31.1%, and 11.3%, respectively. There was no clear association between age and the odds of high grade irAE. However, increased odds of cemiplimab discontinuation was observed in patients aged 75-84 years (p = 0.05). Patients ≥85 years had increased hospitalizations due to irAE (OR = 5.00, 95% CI = 0.97-37.52) with two treatment-related deaths. Objective responses were similar across age cohorts (50.0%, 60.4%, and 54.5%) but progressive disease was higher in the age ≥ 85 group (22.2%, 18.8%, and 31.8%). On Cox PH regression analysis, age ≥ 85 years (vs. <75), Eastern Cooperative Oncology Group performance status 2-3 (vs. 0-1), and neutrophil to lymphocyte ratio (NLR) ≥7.80 (vs. <7.80) were associated with shorter survival. DISCUSSION While the odds of high grade irAE were similar across age groups, significant age-related differences in treatment discontinuation and hospitalization due to immune toxicity were observed. Despite a higher incidence of primary progression and shorter OS in the oldest cohort, cemiplimab yielded robust objective responses regardless of age. Higher pre-treatment NLR was associated with shorter survival and the cut-point identified requires further study.
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MESH Headings
- Humans
- Aged
- Aged, 80 and over
- Male
- Female
- Antibodies, Monoclonal, Humanized/therapeutic use
- Antibodies, Monoclonal, Humanized/adverse effects
- Skin Neoplasms/drug therapy
- Skin Neoplasms/blood
- Carcinoma, Squamous Cell/drug therapy
- Carcinoma, Squamous Cell/blood
- Age Factors
- Prognosis
- Antineoplastic Agents, Immunological/therapeutic use
- Antineoplastic Agents, Immunological/adverse effects
- Biomarkers, Tumor/blood
- British Columbia
- Retrospective Studies
- Middle Aged
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Affiliation(s)
- Doran Ksienski
- BC Cancer-Victoria, British Columbia, Canada; University of British Columbia, Victoria, British Columbia, Canada.
| | - Pauline T Truong
- BC Cancer-Victoria, British Columbia, Canada; University of British Columbia, Victoria, British Columbia, Canada
| | - Jeffrey N Bone
- Biostatistics, Clinical Research Support Unit, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Sarah Egli
- BC Cancer-Victoria, British Columbia, Canada
| | | | | | - Mary Lesperance
- University of Victoria, Department of Mathematics and Statistics, Victoria, British Columbia, Canada
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11
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Cozma EC, Banciu LM, Celarel AM, Soare E, Srichawla BS, Kipkorir V, Găman MA. Molecular mechanisms of human papilloma virus related skin cancers: A review. Medicine (Baltimore) 2024; 103:e38202. [PMID: 38787972 PMCID: PMC11124606 DOI: 10.1097/md.0000000000038202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/19/2024] [Indexed: 05/26/2024] Open
Abstract
The human papillomavirus (HPV) belongs to the Papillomaviridae family of viruses which includes small, double-stranded DNA viral agents. Approximately 90% of HPV infections occur asymptomatically and resolve spontaneously. However, infection with high-risk viral strains can lead to the development of preneoplastic lesions, with an increased propensity to become cancerous. The location of these malignancies includes the oral cavity, cervix, vagina, anus, and vulva, among others. The role of HPV in carcinogenesis has already been demonstrated for the aforementioned neoplasia. However, regarding skin malignancies, the mechanisms that pinpoint the role played by HPV in their initiation and progression still elude our sight. Until now, the only fully understood mechanism of viral cutaneous oncogenesis is that of human herpes virus 8 infection in Kaposi sarcoma. In the case of HPV infection, however, most data focus on the role that beta strains exhibit in the oncogenesis of cutaneous squamous cell carcinoma (cSCC), along with ultraviolet radiation (UVR) and other environmental or genetic factors. However, recent epidemiological investigations have highlighted that HPV could also trigger the onset of other non-melanocytic, for example, basal cell carcinoma (BCC), and/or melanocytic skin cancers, for example, melanoma. Herein, we provide an overview of the role played by HPV in benign and malignant skin lesions with a particular focus on the main epidemiological, pathophysiological, and molecular aspects delineating the involvement of HPV in skin cancers.
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Affiliation(s)
- Elena-Codruta Cozma
- University of Medicine and Pharmacy of Craiova, Craiova, Romania
- Elias University Emergency Hospital, Bucharest, Romania
| | | | | | - Elena Soare
- Elias University Emergency Hospital, Bucharest, Romania
| | | | - Vincent Kipkorir
- Department of Human Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
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12
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Queirolo P, Cinquini M, Argenziano G, Bassetto F, Bossi P, Boutros A, Clemente C, de Giorgi V, Del Vecchio M, Patuzzo R, Pennachioli E, Peris K, Quaglino P, Reali A, Zalaudek I, Spagnolo F. Guidelines for the diagnosis and treatment of cutaneous squamous cell carcinoma: a GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology. ESMO Open 2024; 9:103005. [PMID: 38688192 PMCID: PMC11067535 DOI: 10.1016/j.esmoop.2024.103005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/10/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024] Open
Abstract
Cutaneous squamous cell carcinoma (CSCC) accounts for ∼20%-25% of all skin tumors. Its precise incidence is often challenging to determine due to limited statistics and its incorporation with mucosal forms. While most cases have a favorable prognosis, challenges arise in patients presenting with locally advanced or metastatic forms, mainly appearing in immunocompromised patients, solid organ transplantation recipients, or those facing social difficulties. Traditionally, chemotherapy and targeted therapy were the mainstays for advanced cases, but recent approvals of immunotherapeutic agents like cemiplimab and pembrolizumab have revolutionized treatment options. These guidelines, developed by the Italian Association of Medical Oncologists (AIOM) using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach, aim to guide clinicians in diagnosing, treating, and monitoring patients with CSCC, covering key aspects from primitive tumors to advanced stages, selected by a panel of experts selected by AIOM and other national scientific societies. The incorporation of these guidelines into clinical practice is expected to enhance patient care and address the evolving landscape of CSCC management.
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Affiliation(s)
- P Queirolo
- Division of Melanoma, Sarcomas and Rare Tumors, IRCCS European Institute of Oncology, Milan
| | - M Cinquini
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan
| | - G Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples
| | - F Bassetto
- Clinic of Plastic Surgery, Department of Neuroscience, Padua University Hospital, Padua
| | - P Bossi
- IRCCS Humanitas Research Hospital, Milan
| | - A Boutros
- Department of Internal Medicine and Medical Specialties, School of Medicine, University of Genoa, Genoa
| | - C Clemente
- Surgical Pathology Department, IRCCS Galeazzi Sant'Ambrogio, Milan
| | - V de Giorgi
- Dermatology Unit, Azienda USL Toscana Centro, Florence; Section of Dermatology, Department of Health Sciences, University of Florence, Florence
| | - M Del Vecchio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
| | - R Patuzzo
- Fondazione IRCCS Istituto Nazionale Dei Tumori, Melanoma and Sarcoma Unit, Milan
| | - E Pennachioli
- Division of Melanoma, Sarcomas and Rare Tumors, IRCCS European Institute of Oncology, Milan
| | - K Peris
- Dermatology, Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, Rome; Dermatology, Department of Medical and Surgery Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - P Quaglino
- Department of Medical Sciences, Clinic of Dermatology, University of Turin, Turin
| | - A Reali
- Radiation Oncology Department, Michele e Pietro Ferrero Hospital, Verduno
| | - I Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste
| | - F Spagnolo
- Oncologia Medica 2, IRCCS Ospedale Policlinico San Martino, Genova; Department of Surgical Sciences and Integrated Diagnostics (DISC), Plastic Surgery Division, University of Genova, Genoa, Italy.
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13
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Rudolph V, Leven AS, Eisenburger R, Schadendorf D, Wiegand S. Interdisciplinary management of skin cancer. Laryngorhinootologie 2024; 103:S100-S124. [PMID: 38697144 DOI: 10.1055/a-2171-4570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
The interdisciplinary treatment of skin cancer in the head and neck area requires close collaboration between different specialist disciplines. The most common non-melanoma skin cancer tumor entities are cutaneous squamous cell carcinoma and basal cell carcinoma as well as their precursor lesions. One of the less common tumors is Merkel cell carcinoma, which also occurs primarily in light-exposed areas and, in contrast to squamous and basal cell carcinoma, is more likely to metastasize. Due to the low tendency of basal cell carcinoma as well as cutaneous squamous cell carcinoma to metastasize, a cure can often be achieved by surgery. If the tumor growth exceeds certain levels it may require collaboration between dermatology and otorhinolaryngology. The primary goal of this interdisciplinary collaboration is to achieve a functional, cosmetically and aesthetically acceptable result in addition to adequate tumor treatment. Depending on the stage of the tumor and the clinical course, a case may be discussed in an interdisciplinary tumor board in order to determine a personalised, appropriate and adequate treatment concept for each patient, including prevention, therapy and follow-up.
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Affiliation(s)
- Victoria Rudolph
- Klinik für Dermatologie, Universitätsmedizin Essen & Westdeutsches Tumorzentrum, Essen & Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort Essen/Düsseldorf & Nationales Centrum für Tumorerkrankungen (NCT)-West, Campus Essen, & Research Alliance Ruhr, Research Center One Health, Universität Duisburg-Essen, Essen, Germany
| | - Anna-Sophia Leven
- Klinik für Dermatologie, Universitätsmedizin Essen & Westdeutsches Tumorzentrum, Essen & Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort Essen/Düsseldorf & Nationales Centrum für Tumorerkrankungen (NCT)-West, Campus Essen, & Research Alliance Ruhr, Research Center One Health, Universität Duisburg-Essen, Essen, Germany
| | - Robin Eisenburger
- Klinik für Dermatologie, Universitätsmedizin Essen & Westdeutsches Tumorzentrum, Essen & Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort Essen/Düsseldorf & Nationales Centrum für Tumorerkrankungen (NCT)-West, Campus Essen, & Research Alliance Ruhr, Research Center One Health, Universität Duisburg-Essen, Essen, Germany
| | - Dirk Schadendorf
- Klinik für Dermatologie, Universitätsmedizin Essen & Westdeutsches Tumorzentrum, Essen & Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort Essen/Düsseldorf & Nationales Centrum für Tumorerkrankungen (NCT)-West, Campus Essen, & Research Alliance Ruhr, Research Center One Health, Universität Duisburg-Essen, Essen, Germany
| | - Susanne Wiegand
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig, Deutschland
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14
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Antonetti P, Pellegrini C, Caponio C, Bruni M, Dragone L, Mastrangelo M, Esposito M, Fargnoli MC. Photodynamic Therapy for the Treatment of Bowen's Disease: A Review on Efficacy, Non-Invasive Treatment Monitoring, Tolerability, and Cosmetic Outcome. Biomedicines 2024; 12:795. [PMID: 38672152 PMCID: PMC11048221 DOI: 10.3390/biomedicines12040795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024] Open
Abstract
Bowen's disease represents the in situ form of cutaneous squamous cell carcinoma; although it has an excellent prognosis, 3-5% of lesions progress to invasive cutaneous squamous cell carcinoma, with a higher risk in immunocompromised patients. Treatment is therefore always necessary, and conventional photodynamic therapy is a first-line option. The aim of this review is to provide an overview of the clinical response, recurrence rates, safety, and cosmetic outcome of photodynamic therapy in the treatment of Bowen's disease, considering different protocols in terms of photosensitizers, light source, and combination treatments. Photodynamic therapy is a valuable option for tumors at sites where wound healing is poor/delayed, in the case of multiple and/or large tumors, and where surgery would be difficult or invasive. Dermoscopy and reflectance confocal microscopy can be used as valuable tools for monitoring the therapeutic response. The treatment is generally well tolerated, with mild side effects, and is associated with a good/excellent cosmetic outcome. Periodic follow-up after photodynamic therapy is essential because of the risk of recurrence and progression to cSCC. As the incidence of keratinocyte tumors increases, the therapeutic space for photodynamic therapy will further increase.
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Affiliation(s)
- Paolo Antonetti
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Cristina Pellegrini
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Chiara Caponio
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Manfredo Bruni
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Lorenzo Dragone
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Mirco Mastrangelo
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
| | - Maria Esposito
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (P.A.); (C.P.); (M.B.); (M.M.); (M.E.)
- Dermatology Unit, Ospedale San Salvatore, 67100 L’Aquila, Italy;
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15
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Dessinioti C, Liopyris K, Stratigos AJ. Diagnosis of invasive cutaneous squamous cell carcinoma, imaging and staging. Ital J Dermatol Venerol 2024; 159:118-127. [PMID: 38650493 DOI: 10.23736/s2784-8671.24.07670-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The assessment of patients with a lesion raising the suspicion of an invasive cutaneous squamous cell carcinoma (cSCC) is a frequent clinical scenario. The management of patients with cSCC is a multistep approach, starting with the correct diagnosis. The two main diagnostic goals are to differentiate from other possible diagnoses and correctly recognize the lesion as cSCC, and then to determine the tumor spread (perform staging), that is if the patient has a common primary cSCC or a locally advanced cSCC, or a metastatic cSCC (with in-transit, regional lymph nodal, or rarely distant metastasis). The multistep diagnostic approach begins with the clinical characteristics of the primary cSCC, it is complemented with features with dermoscopy and, if available, reflectance confocal microscopy and is confirmed with histopathology. The tumor spread is assessed by physical examination and, in some cases, ultrasound and/or computed tomography or magnetic resonance imaging, mainly to investigate for regional lymph node metastasis or for local infiltration into deeper structures. In the last step, the clinical, histologic and radiologic findings are incorporated into staging systems.
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Affiliation(s)
- Clio Dessinioti
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Konstantinos Liopyris
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Alexander J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece -
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16
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Rampinelli V, Pinacoli A, Piazza C. Head and neck nonmelanoma skin cancers: surgical management and debated issues. Curr Opin Otolaryngol Head Neck Surg 2024; 32:62-70. [PMID: 38193646 PMCID: PMC10919275 DOI: 10.1097/moo.0000000000000960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE OF REVIEW This review critically assesses the current literature and guidelines, aiming to clarify some of the most important factors that impact surgical strategies of head and neck nonmelanoma skin cancers (NMSCs), focusing on squamous, basal, and Merkel cell carcinomas. RECENT FINDINGS Recent developments underscore the complexity of treatment for NMSC, particularly in the head and neck region. There is a lack of high-level evidence for the management of these tumors, especially in advanced stages. The need to tailor the extent of surgical margins and parotid/neck management to different histotypes, considering the varying risk factors for recurrence, is beginning to emerge in the literature. Moreover, the role of immunotherapy and targeted therapies for locally advanced disease, alongside traditional treatment options, is progressively growing. SUMMARY NMSCs represent a heterogeneous group of malignancies with varying treatment complexities and prognoses. Management of NMSC is evolving towards an increasingly personalized strategy within a multidisciplinary therapeutic framework.
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Affiliation(s)
- Vittorio Rampinelli
- Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili, Department of Surgical and Medical Specialties, Radiological Sciences, and Public Health, University of Brescia, School of Medicine, Brescia, Italy
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17
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Álvarez-Salafranca M, Zaballos P. Dermoscopy of Squamous Cell Carcinoma: From Actinic Keratosis to Invasive Forms. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00270-9. [PMID: 38556203 DOI: 10.1016/j.ad.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 04/02/2024] Open
Affiliation(s)
- M Álvarez-Salafranca
- Servicio de Dermatología, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - P Zaballos
- Servicio de Dermatología, Hospital de Sant Pau i Santa Tecla, Tarragona, España
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18
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Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:T224-T230. [PMID: 38185206 DOI: 10.1016/j.ad.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/12/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
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Affiliation(s)
- P Díaz-Calvillo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - A Martínez-López
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Servicio de Dermatología, Hospital Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
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19
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Tirado-Perez JP, Oakley A, Gansel R. Excision pathways for keratinocyte cancers diagnosed by teledermatology: a retrospective review. J Prim Health Care 2024; 16:90-95. [PMID: 38546776 DOI: 10.1071/hc23098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/10/2023] [Indexed: 04/02/2024] Open
Abstract
Introduction The New Zealand population has one of the highest incidences of skin cancer in the world. Hospital waiting lists for surgical excision of keratinocytic skin cancers (basal cell carcinoma and squamous cell carcinoma) are lengthy, and increasingly, excisions are undertaken in primary care. Teledermatology, in response to general practitioners' electronic referrals (e-referrals), can improve clinical communication between general practitioners and dermatologists. Aim The aim of this study was to evaluate an excision pathway for keratinocytic cancers diagnosed by teledermatology. Methods A retrospective observational descriptive review of a 3-month cohort of primary care e-referrals was undertaken. Results Three hundred and fifty eight suspected keratinocytic cancers (KCs) were diagnosed by teledermatology; histology reports confirmed KC in 201 of 267 excisions (75%). The majority (77.2%) were excised by general practitioners an average of 25 days after the dermatologist's recommendation. The rest were excised by plastic surgeons in private (3.4%) or at a public hospital (19.5%) after an average of 40 or 134 days, respectively. Discussion E-referral pathways are now widely implemented. However, the ideal workflow for skin cancer management is unknown. We have demonstrated in New Zealand that surgery can be undertaken in primary care within a month of a teledermatology diagnosis and excision recommendation. Conclusion This study reports prompt excision of KCs by general practitioners after an e-referral and a teledermatology response.
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Affiliation(s)
- J P Tirado-Perez
- Dermatology Department, Virgen Macarena University Hospital, Sevilla, Spain
| | - A Oakley
- Department of Dermatology, Te Whatu Ora Health New Zealand Waikato, Hamilton, New Zealand; and Department of Medicine, The University of Auckland, Auckland
| | - R Gansel
- Department of Dermatology, Te Whatu Ora Health New Zealand Waikato, Hamilton, New Zealand
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20
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Díaz-Calvillo P, Sánchez-Díaz M, Rodríguez-Pozo JÁ, Martínez-Ruiz V, Martínez-López A, Arias-Santiago S. Impact of COVID-19 Pandemic on Cutaneous Squamous Cell Carcinoma: A Single-Centre Study of Epidemiologic, Clinic and Histopathological Factors. ACTAS DERMO-SIFILIOGRAFICAS 2024; 115:224-230. [PMID: 37858857 DOI: 10.1016/j.ad.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic may have adversely affected the early diagnosis of skin cancer. OBJECTIVE To compare epidemiological, clinical and histopathological characteristics in patients undergoing cutaneous squamous cell carcinoma (SCC) surgery before and after the beginning of the pandemic. MATERIAL & METHODS We conducted a cross-sectional study including two case series: (1) patients operated on for SCC in the year after the first state of alarm in Spain (15 March 2020), and (2) patients with SCC operated on in the previous year. Epidemiological, clinical and histopathological variables, tumour stage and risk grade were collected. RESULTS 248 patients were included (127 undergoing surgery before the pandemic and 121 after the pandemic). After the beginning of the pandemic, the percentage of high-risk SCC significantly increased from 35.3% to 46.2% (p=0.011). However, no significant differences were found in thickness, perineural invasion or metastases. CONCLUSIONS Although there has not been a significant reduction in the number of SCC operated on after the pandemic, there has been a significant increase in high-risk SCC. All this could lead to an increase in skin cancer mortality in the future.
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Affiliation(s)
- P Díaz-Calvillo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - M Sánchez-Díaz
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - J Á Rodríguez-Pozo
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - V Martínez-Ruiz
- TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Granada, Granada, Spain
| | - A Martínez-López
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain.
| | - S Arias-Santiago
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Investigational and Translational Dermatology Research Group, Instituto de Investigación Biosanitaria (IBS), Granada, Spain; Department of Dermatology, University of Granada, Granada, Spain
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21
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Seretis K, Boptsi E, Boptsi A. Extracellular Vesicles as Novel Diagnostic and Therapeutic Agents for Non-Melanoma Skin Cancer: A Systematic Review. Int J Mol Sci 2024; 25:2617. [PMID: 38473864 DOI: 10.3390/ijms25052617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Standard non-melanoma skin cancer (NMSC) treatment involves surgery, recently combined with chemotherapy or immunotherapy in cases of advanced tumors. EVs, including exosomes, are integral to carcinogenesis, and are found in NMSC releasing mediators impacting tumor progression. Nevertheless, the precise intercellular signaling role of NMSC-derived EVs remains unclear. This review aims to elucidate their potential role in NMSC diagnosis and treatment. This systematic review encompassed literature searches in electronic databases from inception to September 2023, based on certain inclusion and exclusion criteria, addressing NMSC-derived EVs, their molecular cargo, and their implications in the diagnosis, prognosis, and treatment of NMSC. Key components were identified. Extracellular vesicle (EV) proteins and RNA have emerged as diagnostic biomarkers in EV-based liquid biopsy. Circular RNA CYP24A1, known for its molecular stability, holds promise as a diagnostic biomarker. Long noncoding RNAs (lincRNA-PICSAR) and Desmoglein 2 (DSg2) are linked to drug resistance, serving as prognostic biomarkers. EV mediators are being actively investigated for their potential role as drug delivery agents. In conclusion, this systematic review showed that NMSC-derived EVs display promise as therapeutic targets and diagnostic biomarkers. Further research is imperative to fully comprehend EV mechanisms and explore their potential in cancer diagnosis and treatment.
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Affiliation(s)
- Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, 45100 Ioannina, Greece
| | - Eleni Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, 45100 Ioannina, Greece
| | - Anastasia Boptsi
- Department of Plastic Surgery, Medical School, University of Ioannina, 45100 Ioannina, Greece
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22
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Lonsdorf AS, Edelmann D, Albrecht T, Brobeil A, Labrenz J, Johanning M, Schlenk RF, Goeppert B, Enk AH, Toberer F. Differential Immunoexpression of Inhibitory Immune Checkpoint Molecules and Clinicopathological Correlates in Keratoacanthoma, Primary Cutaneous Squamous Cell Carcinoma and Metastases. Acta Derm Venereol 2024; 104:adv13381. [PMID: 38323498 PMCID: PMC10863621 DOI: 10.2340/actadv.v104.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 12/20/2023] [Indexed: 02/08/2024] Open
Abstract
Beyond established anti-programmed cell death protein 1/programmed cell death ligand 1 immunotherapy, T-cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibition motif domain (TIGIT) and its ligand CD155 are promising novel inhibitory immune checkpoint targets in human malignancies. Yet, in cutaneous squamous cell carcinoma, evidence on the collective expression patterns of these inhibitory immune checkpoints is scarce. Complete tumour sections of 36 cutaneous squamous cell carcinoma, 5 cutaneous metastases and 9 keratoacanthomas, a highly-differentiated, squamoproliferative tumour, with disparately benign biologic behaviour, were evaluated by immunohistochemistry for expression of programmed cell death ligand 1 (Tumor Proportion Score, Immune Cell Score), TIGIT, CD155 and CD8+ immune infiltrates. Unlike keratoacanthomas, cutaneous squamous cell carcinoma displayed a strong positive correlation of programmed cell death ligand 1 Tumor Proportion Score and CD115 expression (p < 0.001) with significantly higher programmed cell death ligand 1 Tumor Proportion Score (p < 0.001) and CD155 expression (p < 0.01) in poorly differentiated G3-cutaneous squamous cell carcinoma compared with keratoacanthomas. TIGIT+ infiltrates were significantly increased in programmed cell death ligand 1 Immune Cell Score positive primary tumours (p = 0.05). Yet, a strong positive correlation of TIGIT expression with CD8+ infiltrates was only detected in cutaneous squamous cell carcinoma (p < 0.01), but not keratoacanthomas. Providing a comprehensive overview on the collective landscape of inhibitory immune checkpoint expression, this study reveals associations of novel inhibitory immune checkpoint with CD8+ immune infiltrates and tumour differentiation and highlights the TIGIT/CD155 axis as a potential new target for cutaneous squamous cell carcinoma immunotherapy.
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Affiliation(s)
- Anke S Lonsdorf
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany.
| | - Dominic Edelmann
- German Cancer Research Center, Heidelberg, Germany; NCT Trial Center, National Center for Tumor Diseases, German Cancer Research Center and Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Albrecht
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Alexander Brobeil
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Tissue Bank of the National Center for Tumor Diseases, Heidelberg, Germany
| | - Jannik Labrenz
- German Cancer Research Center, Heidelberg, Germany; NCT Trial Center, National Center for Tumor Diseases, German Cancer Research Center and Heidelberg University Hospital, Heidelberg, Germany
| | - Moritz Johanning
- German Cancer Research Center, Heidelberg, Germany; NCT Trial Center, National Center for Tumor Diseases, German Cancer Research Center and Heidelberg University Hospital, Heidelberg, Germany
| | - Richard F Schlenk
- German Cancer Research Center, Heidelberg, Germany; NCT Trial Center, National Center for Tumor Diseases, German Cancer Research Center and Heidelberg University Hospital, Heidelberg, Germany
| | - Benjamin Goeppert
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Institute of Pathology and Neuropathology, RKH Klinikum Ludwigsburg, Germany
| | - Alexander H Enk
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Ferdinand Toberer
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
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23
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Markopoulos G, Lampri E, Tragani I, Kourkoumelis N, Vartholomatos G, Seretis K. Intraoperative Flow Cytometry for the Rapid Diagnosis and Validation of Surgical Clearance of Non-Melanoma Skin Cancer: A Prospective Clinical Feasibility Study. Cancers (Basel) 2024; 16:682. [PMID: 38398076 PMCID: PMC10887295 DOI: 10.3390/cancers16040682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Non-melanoma skin cancer (NMSC) is the most prevalent cancer in humans, with a high global incidence. We present a prospective clinical feasibility study on the use of intraoperative flow cytometry (iFC) for the instant diagnosis of NMSC and its complete surgical clearance. Flow cytometry, a laser-based technique, quantifies cell features, which has applications in cancer research. This study aim is to explore the potential applicability of iFC in detecting and characterizing NMSC and its surgical margins. In total, 30 patients who underwent diagnosis for NMSC were recruited. The method demonstrated high sensitivity (95.2%) and specificity (87.1%), with an accuracy of 91.1%, as confirmed with a receiver operating characteristic curve analysis. The results also indicated that most tumors were diploid, with two cases being hypoploid. The average G0/G1 fractions for normal and tumor tissue samples were 96.03 ± 0.30% and 88.03 ± 1.29%, respectively, with the tumor index escalating from 3.89 ± 0.30% to 11.95 ± 1.29% in cancerous cells. These findings underscore iFC's capability for precise intraoperative NMSC characterization and margin evaluation, promising enhanced complete tumor excision rates. Given the technique's successful application in various other malignancies, its implementation in NMSC diagnosis and treatment holds significant promise and warrants further research in clinical trials.
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Affiliation(s)
- Georgios Markopoulos
- Haematology Laboratory-Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, 45110 Ioannina, Greece; (G.M.); (G.V.)
| | - Evangeli Lampri
- Department of Pathology, Medical School, University of Ioannina, 45110 Ioannina, Greece; (E.L.); (I.T.)
| | - Ioulia Tragani
- Department of Pathology, Medical School, University of Ioannina, 45110 Ioannina, Greece; (E.L.); (I.T.)
| | - Nikolaos Kourkoumelis
- Department of Medical Physics, Medical School, University of Ioannina, 45110 Ioannina, Greece;
| | - Georgios Vartholomatos
- Haematology Laboratory-Unit of Molecular Biology and Translational Flow Cytometry, University Hospital of Ioannina, 45110 Ioannina, Greece; (G.M.); (G.V.)
| | - Konstantinos Seretis
- Department of Plastic Surgery, Medical School, University of Ioannina, 45110 Ioannina, Greece
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Verdaguer-Faja J, Toll A, Boada A, Guerra-Amor Á, Ferrándiz-Pulido C, Jaka A. Management of Cutaneous Squamous Cell Carcinoma of the Scalp: The Role of Imaging and Therapeutic Approaches. Cancers (Basel) 2024; 16:664. [PMID: 38339415 PMCID: PMC10854799 DOI: 10.3390/cancers16030664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common subtype of skin cancer. The scalp is one of the most frequently affected locations and is associated with a higher rate of complications, compared to other locations. In addition, it has a characteristic thickness and anatomical structure that may influence both growth pattern and treatment of primary cSCC; while clinical peripheral margins may be easily achieved during the surgery, vertical excision of the tumor is limited by the skull. Despite having a unique anatomy, current guidelines do not contemplate specific recommendations for scalp cSCC, which leads to inconsistent decision-making in multidisciplinary committees when discussing tumors with high risk factors or with close margins. This article provides specific recommendations for the management of patients with scalp cSCC, based on current evidence, as well as those aspects in which evidence is lacking, pointing out possible future lines of research. Topics addressed include epidemiology, clinical presentation and diagnosis, imaging techniques, surgical and radiation treatments, systemic therapy for advanced cases, and follow-up. The primary focus of this review is on management of primary cSCC of the scalp with localized disease, although where relevant, some points about recurrent cSCCs or advanced disease cases are also discussed.
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Affiliation(s)
- Júlia Verdaguer-Faja
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (J.V.-F.); (A.B.)
- Departament de Medicina, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Agustí Toll
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain;
| | - Aram Boada
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (J.V.-F.); (A.B.)
- Departament de Medicina, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Álvaro Guerra-Amor
- Department of Dermatology, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain;
| | - Carla Ferrándiz-Pulido
- Departament de Medicina, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain;
| | - Ane Jaka
- Department of Dermatology, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain; (J.V.-F.); (A.B.)
- Departament de Medicina, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
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25
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Pham JP, Rodrigues A, Goldinger SM, Sim HW, Liu J. Epidermal growth factor receptor inhibitors in advanced cutaneous squamous cell carcinoma: A systematic review and meta-analysis. Exp Dermatol 2024; 33:e14978. [PMID: 37971204 DOI: 10.1111/exd.14978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/01/2023] [Accepted: 11/04/2023] [Indexed: 11/19/2023]
Abstract
Patients with advanced cutaneous squamous cell carcinoma (cSCC) who are not eligible for or who fail to respond to anti-PD1 immunotherapy have few treatment options. Epidermal growth factor receptor (EGFR) inhibitors have been investigated as a therapeutic option for advanced cSCC; however, data are limited to small single-arm trials or retrospective studies. A systematic review and meta-analysis was conducted to PRISMA guidelines (CRD42023394300). Studies reporting on outcomes of EGFR inhibition in advanced cSCC were identified. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and adverse event (AE) rate were pooled using a random effects model and the inverse variance method. Twelve studies (six prospective, six retrospective) were identified, representing 324 patients. Pooled ORR was 26% (95% confidence interval [CI] 18-36), median PFS was 4.8 months (95% CI 3.9-6.6) and median OS was 11.7 months (95% CI 9.2-14.1). Any grade AEs occurred in 93% of patients (95% CI 85-97) while grade 3 and higher AEs occurred in 30% (95% CI 14-54). These results were similar between anti-EGFR monoclonal antibodies (MAbs) and tyrosine kinase inhibitors (TKIs). EGFR inhibitors can be considered in patients with advanced cSCC who are contraindicated for or progress on first-line anti-PD1 immunotherapy. Future studies should evaluate their activity and safety following anti-PD1, identify predictive biomarkers for their efficacy and explore combination approaches.
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Affiliation(s)
- James P Pham
- Department of Medical Oncology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Darlinghurst, New South Wales, Australia
| | - Anthony Rodrigues
- Department of Medical Oncology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Darlinghurst, New South Wales, Australia
| | - Simone M Goldinger
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Hao-Wen Sim
- Department of Medical Oncology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Darlinghurst, New South Wales, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Jia Liu
- Department of Medical Oncology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, St Vincent's Clinical Campus, Darlinghurst, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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26
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Yadav R, Din S, Moussaris H, Yadav V, Raman S, Gandhi A, Avezbakiyev B, Wang JC. Atypical Site of Presentation of a Rare Type of SMARCA4-Positive Cutaneous Squamous Cell Carcinoma of the Skin: Case Report and Review of the Literature. J Investig Med High Impact Case Rep 2024; 12:23247096241271977. [PMID: 39215660 PMCID: PMC11366091 DOI: 10.1177/23247096241271977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/16/2024] [Accepted: 06/25/2024] [Indexed: 09/04/2024] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) comprises 20% of cases of nonmelanoma skin cancers in the United States. In total, 3% to 5% of squamous cell carcinoma (SCC) are metastatic at the time of presentation, associated with significant mortality due to a lack of standardized treatment options. In total, 95% of these tumors are amenable to the initial standard of treatment, which is surgical resection. However, a small percentage of them require systemic therapy as they are either locally advanced to regional lymph nodes or have distant metastasis. The common sites of presentation of cSCC are the scalp and the face with predictable spread to the intra-parotid, upper jugular, and perifacial lymph nodes. In our case report, however, our patient had a large lump lesion on the upper back, an unusual site of presentation of cSCC, with locally advanced metastasis to the left axillary lymph nodes. Subsequently, the tumor marker study revealed a positive SMARCA4 variant (the essential ATPase subunit of the Switch (SWI)/Sucrose Nonfermenting (SNF) chromatin-remodeling complex) that is even rarer in the context of cSCC. Furthermore, abnormalities in SWI/SNF chromatin-remodeling complex subunits have shown promising results as a target therapy for immune checkpoint inhibitor (ICI) therapy. We present an atypical presentation site of locally advanced rare variant SMARCA4-positive cSCC in a patient who received treatment with chemoradiation and systemic therapy with ICI after primary surgical resection. To date, only 2 cases of SMARCA4-positive cSCC were found in the literature with no details of the treatment received. Our case is unique in its atypical site of presentation as well as showing partial response to radiotherapy (RT) and systemic therapy with ICI.
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Affiliation(s)
- Ruchi Yadav
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Shaun Din
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Harry Moussaris
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Vivek Yadav
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Anjula Gandhi
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | | | - J. C. Wang
- Brookdale University Hospital Medical Center, Brooklyn, NY, USA
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27
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Zou DD, Sun YZ, Li XJ, Wu WJ, Xu D, He YT, Qi J, Tu Y, Tang Y, Tu YH, Wang XL, Li X, Lu FY, Huang L, Long H, He L, Li X. Single-cell sequencing highlights heterogeneity and malignant progression in actinic keratosis and cutaneous squamous cell carcinoma. eLife 2023; 12:e85270. [PMID: 38099574 PMCID: PMC10783873 DOI: 10.7554/elife.85270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most frequent of the keratinocyte-derived malignancies with actinic keratosis (AK) as a precancerous lesion. To comprehensively delineate the underlying mechanisms for the whole progression from normal skin to AK to invasive cSCC, we performed single-cell RNA sequencing (scRNA-seq) to acquire the transcriptomes of 138,982 cells from 13 samples of six patients including AK, squamous cell carcinoma in situ (SCCIS), cSCC, and their matched normal tissues, covering comprehensive clinical courses of cSCC. We identified diverse cell types, including important subtypes with different gene expression profiles and functions in major keratinocytes. In SCCIS, we discovered the malignant subtypes of basal cells with differential proliferative and migration potential. Differentially expressed genes (DEGs) analysis screened out multiple key driver genes including transcription factors along AK to cSCC progression. Immunohistochemistry (IHC)/immunofluorescence (IF) experiments and single-cell ATAC sequencing (scATAC-seq) data verified the expression changes of these genes. The functional experiments confirmed the important roles of these genes in regulating cell proliferation, apoptosis, migration, and invasion in cSCC tumor. Furthermore, we comprehensively described the tumor microenvironment (TME) landscape and potential keratinocyte-TME crosstalk in cSCC providing theoretical basis for immunotherapy. Together, our findings provide a valuable resource for deciphering the progression from AK to cSCC and identifying potential targets for anticancer treatment of cSCC.
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Affiliation(s)
- Dan-Dan Zou
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
- Department of Dermatology, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, KunmingYunnanChina
| | - Ya-Zhou Sun
- Clinical Big Data Research Center, The Seventh Affiliated Hospital of Sun Yat-sen UniversityShenzhen, GuangdongChina
- School of Medical, Shenzhen Campus of Sun Yat-sen UniversityShenzhen, GuangdongChina
| | - Xin-Jie Li
- School of Medical, Shenzhen Campus of Sun Yat-sen UniversityShenzhen, GuangdongChina
| | - Wen-Juan Wu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
| | - Dan Xu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
| | - Yu-Tong He
- School of Medical, Shenzhen Campus of Sun Yat-sen UniversityShenzhen, GuangdongChina
| | - Jue Qi
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
| | - Ying Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
| | - Yang Tang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
| | - Yun-Hua Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
| | - Xiao-Li Wang
- Department of Dermatology, Changzheng Hospital, Naval Medical UniversityShanghaiChina
| | - Xing Li
- Department of Dermatology, People's Hospital of Chuxiong Yi Autonomous Prefecture, ChuxiongYunnanChina
| | - Feng-Yan Lu
- Department of Dermatology, Qujing Affiliated Hospital of Kunming Medical University, The First People’s Hospital of QujingYunnanChina
| | - Ling Huang
- Department of Dermatology, First Affiliated Hospital of Dali University, DaliYunnanChina
| | - Heng Long
- Wenshan Zhuang and Miao Autonomous Prefecture Dermatology Clinic, Wenshan Zhuang and Miao Autonomous Prefecture Specialist Hospital of Dermatology, WenshanYunnanChina
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical UniversityYunnanChina
| | - Xin Li
- School of Medical, Shenzhen Campus of Sun Yat-sen UniversityShenzhen, GuangdongChina
- Guangdong Provincial Key Laboratory of Digestive Cancer Research, The Seventh Affiliated Hospital of Sun Yat-sen UniversityGuangdongChina
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28
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Stratigos AJ, Garbe C, Dessinioti C, Lebbe C, van Akkooi A, Bataille V, Bastholt L, Dreno B, Dummer R, Fargnoli MC, Forsea AM, Harwood CA, Hauschild A, Hoeller C, Kandolf-Sekulovic L, Kaufmann R, Kelleners-Smeets NW, Lallas A, Leiter U, Malvehy J, Del Marmol V, Moreno-Ramirez D, Pellacani G, Peris K, Saiag P, Tagliaferri L, Trakatelli M, Ioannides D, Vieira R, Zalaudek I, Arenberger P, Eggermont AMM, Röcken M, Grob JJ, Lorigan P. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma. Part 1: Diagnostics and prevention-Update 2023. Eur J Cancer 2023; 193:113251. [PMID: 37717283 DOI: 10.1016/j.ejca.2023.113251] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 09/19/2023]
Abstract
Invasive cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in white populations, accounting for 20% of all cutaneous malignancies. Overall, cSCC mostly has very good prognosis after treatment, with 5-year cure rates greater than 90%. Despite the overall favourable prognosis and the proportionally rare deaths, cSCC is associated with a high total number of deaths due to its high incidence. A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), the European Society for Radiotherapy and Oncology (ESTRO), the European Union of Medical Specialists (UEMS), the European Academy of Dermatology and Venereology (EADV) and the European Organization of Research and Treatment of Cancer (EORTC), was formed to update recommendations on cSCC, based on current literature and expert consensus. Part 1 of the guidelines addresses the updates on classification, epidemiology, diagnosis, risk stratification, staging and prevention in immunocompetent as well as immunosuppressed patients.
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Affiliation(s)
- Alexander J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece.
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Clio Dessinioti
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Celeste Lebbe
- Université Paris Cite, Dermato-Oncology AP-HP Hôpital Saint Louis, Cancer Institute APHP. Nord-Université Paris Cite, INSERM U976, Paris, France
| | - Alexander van Akkooi
- Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia; Melanoma Institute Australia, Sydney, New South Wales, Australia
| | | | - Lars Bastholt
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Brigitte Dreno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
| | - Reinhard Dummer
- Skin Cancer Centre at University Hospital Zurich, Zurich, Switzerland
| | - Maria Concetta Fargnoli
- Dermatology Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ana Maria Forsea
- Carol Davila University of Medicine and Pharmacy Bucharest, Department of Oncologic Dermatology, Elias University Hospital Bucharest, Bucharest, Romania
| | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University Hospital (UKSH), Kiel, Germany
| | - Christoph Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | | | - Roland Kaufmann
- Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | - Nicole Wj Kelleners-Smeets
- GROW-School for Oncology and Reproduction, Maastricht, the Netherlands; Department of Dermatology, Maastricht University Medical Centre+, Maastricht University, Maastricht, the Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Josep Malvehy
- Dermatology Department of Hospital Clinic of Barcelona, University of Barcelona, IDIBAPS, CIBER de enfermedades raras, Instituto Carlos III, Barcelona Spain
| | - Veronique Del Marmol
- Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - David Moreno-Ramirez
- Department of Medical and Surgical Dermatology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Philippe Saiag
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, APHP, and EA 4340 'Biomarkers in Cancerology and Hemato-oncology', UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Luca Tagliaferri
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Myrto Trakatelli
- Department of Dermatology, Papageorgiou Hospital, Aristotle University Department of Medicine, Thessaloniki, Greece
| | | | - Ricardo Vieira
- Department of Dermatology Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Iris Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alexander M M Eggermont
- University Medical Center Utrecht and Princess Máxima Center, Utrecht, the Netherlands; Comprehensive Cancer Center Munich, Technical University Munich and Ludwig Maximilian University, Munich, Germany
| | - Martin Röcken
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | | | - Paul Lorigan
- Division of Cancer Sciences, University of Manchester, Manchester, UK; Department of Medical Oncology, Christie NHS Foundation Trust, Manchester, UK
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29
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Wolf CL, Pruett C, Lighter D, Jorcyk CL. The clinical relevance of OSM in inflammatory diseases: a comprehensive review. Front Immunol 2023; 14:1239732. [PMID: 37841259 PMCID: PMC10570509 DOI: 10.3389/fimmu.2023.1239732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/30/2023] [Indexed: 10/17/2023] Open
Abstract
Oncostatin M (OSM) is a pleiotropic cytokine involved in a variety of inflammatory responses such as wound healing, liver regeneration, and bone remodeling. As a member of the interleukin-6 (IL-6) family of cytokines, OSM binds the shared receptor gp130, recruits either OSMRβ or LIFRβ, and activates a variety of signaling pathways including the JAK/STAT, MAPK, JNK, and PI3K/AKT pathways. Since its discovery in 1986, OSM has been identified as a significant contributor to a multitude of inflammatory diseases, including arthritis, inflammatory bowel disease, lung and skin disease, cardiovascular disease, and most recently, COVID-19. Additionally, OSM has also been extensively studied in the context of several cancer types including breast, cervical, ovarian, testicular, colon and gastrointestinal, brain,lung, skin, as well as other cancers. While OSM has been recognized as a significant contributor for each of these diseases, and studies have shown OSM inhibition is effective at treating or reducing symptoms, very few therapeutics have succeeded into clinical trials, and none have yet been approved by the FDA for treatment. In this review, we outline the role OSM plays in a variety of inflammatory diseases, including cancer, and outline the previous and current strategies for developing an inhibitor for OSM signaling.
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Affiliation(s)
- Cody L. Wolf
- Department of Biomolecular Sciences, Boise State University, Boise, ID, United States
| | - Clyde Pruett
- Department of Biological Sciences, Boise State University, Boise, ID, United States
| | - Darren Lighter
- Department of Biological Sciences, Boise State University, Boise, ID, United States
| | - Cheryl L. Jorcyk
- Department of Biomolecular Sciences, Boise State University, Boise, ID, United States
- Department of Biological Sciences, Boise State University, Boise, ID, United States
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30
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Kuzmanovszki D, Kiss N, Tóth B, Tóth V, Szakonyi J, Lőrincz K, Hársing J, Kuroli E, Imrédi E, Kerner T, Patyánik M, Wikonkál NM, Szabó Á, Brodszky V, Rencz F, Holló P. Real-World Experience with Cemiplimab Treatment for Advanced Cutaneous Squamous Cell Carcinoma-A Retrospective Single-Center Study. J Clin Med 2023; 12:5966. [PMID: 37762907 PMCID: PMC10531652 DOI: 10.3390/jcm12185966] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The systemic treatment of advanced cutaneous squamous cell carcinoma (cSCC) has seen significant developments in recent years. The anti-PD1 inhibitor cemiplimab has demonstrated efficacy in clinical trials, but real-world data are still limited. Here, we aimed to evaluate the efficacy and the safety of cemiplimab in a real-world clinical setting. METHODS A retrospective analysis was carried out for all patients who received at least two doses of cemiplimab at our department between February 2020 and January 2023. Progression-free survival (PFS), overall survival (OS), the objective response rate (ORR), the disease control rate (DCR) and adverse events (AEs) were evaluated. RESULTS Twenty-five patients were included with a median age of 78 (65-82) years. The median treatment duration was 48 (16-72) weeks. Five (20%) patients were immunocompromised. Sixteen patients (64%) developed AEs, including 36% serious AEs (SAEs) of grade ≥ 3. Six patients (24%) were withdrawn from treatment due to the occurrence of AEs. Among the 25 patients, 52% showed an objective response (3 complete and 10 partial responses), 76% had controlled disease and 24% experienced progression. Among the five immunocompromised patients, the ORR was 60%, while the DCR was 80%. CONCLUSIONS This retrospective real-world study revealed that locally advanced or metastatic cSCC could be effectively treated with cemiplimab even in elderly, polymorbid and immunocompromised patients.
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Affiliation(s)
- Daniella Kuzmanovszki
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Béla Tóth
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Veronika Tóth
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - József Szakonyi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Kende Lőrincz
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Judit Hársing
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Enikő Kuroli
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Eleonóra Imrédi
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Tünde Kerner
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
| | - Mihály Patyánik
- Uzsoki Street Hospital, Practice Hospital of the Faculty of General Medicine, Semmelweis University, H-1145 Budapest, Hungary;
| | - Norbert M. Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
- Central Hospital of Northern Pest-Military Hospital, H-1139 Budapest, Hungary
| | - Ákos Szabó
- Department of Health Policy, Corvinus University of Budapest, H-1093 Budapest, Hungary; (Á.S.); (V.B.); (F.R.)
- Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, H-1085 Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, H-1093 Budapest, Hungary; (Á.S.); (V.B.); (F.R.)
| | - Fanni Rencz
- Department of Health Policy, Corvinus University of Budapest, H-1093 Budapest, Hungary; (Á.S.); (V.B.); (F.R.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary; (N.K.); (B.T.); (V.T.); (J.S.); (K.L.); (J.H.); (E.K.); (E.I.); (T.K.); (N.M.W.); (P.H.)
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Sabbadini C, Patta F, Lorenzon L, Farsad M, Nobile C. Cutaneous squamous cell carcinoma of the lip successfully treated with rhenium-188 brachytherapy. Dermatol Reports 2023; 15:9560. [PMID: 37790652 PMCID: PMC10543199 DOI: 10.4081/dr.2023.9560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 01/10/2023] [Indexed: 10/05/2023] Open
Abstract
Cutaneous squamous cell carcinoma (SCC) is the second most common form of skin cancer. In most cases, non-invasive SCC has a good prognosis and is curable by surgical resection. Nevertheless, a small percentage of patients pose specific management problems due to the technical difficulty of maintaining function and aesthetics because of the size or location of the tumor. An emerging therapeutic approach with high-dose brachytherapy using a nonsealed rhenium-188 resin, commercially known as Rhenium-Skin Cancer Therapy®, has been shown to be highly effective in non-invasive carcinoma, up to a thickness of 2-3 mm.
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Affiliation(s)
- Chiara Sabbadini
- Department of Dermatology, Venereology and Allergology, Hospital of Brunico
| | - Federico Patta
- Department of Dermatology, Venereology and Allergology, Hospital of Brunico
| | | | - Mohsen Farsad
- Department of Nuclear Medicine, Hospital of Bolzano, Italy
| | - Carla Nobile
- Department of Dermatology, Venereology and Allergology, Hospital of Brunico
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32
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Lang R, Welponer T, Richtig E, Wolf I, Hoeller C, Hafner C, Nguyen VA, Kofler J, Barta M, Koelblinger P, Hitzl W, Emberger M, Laimer M. Nivolumab for locally advanced and metastatic cutaneous squamous cell carcinoma (NIVOSQUACS study)-Phase II data covering impact of concomitant haematological malignancies. J Eur Acad Dermatol Venereol 2023; 37:1799-1810. [PMID: 37210651 DOI: 10.1111/jdv.19218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Monoclonal antibodies, such as cemiplimab and pembrolizumab, against the programmed death receptor (PD)-1 have become the current standard of care and first-line treatment of advanced cutaneous squamous cell carcinoma (cSCC), proving remarkable clinical benefit and acceptable safety. OBJECTIVES To assess efficacy and safety of the anti-PD-1 antibody nivolumab in patients with locally advanced and metastatic cSCC. METHODS Patients received open-label nivolumab 240 mg intravenously every 2 weeks for up to 24 months. Patients with concomitant haematological malignancies (CHMs), either non-progressing or stable under active therapy, were eligible for inclusion. RESULTS Of 31 patients with a median age of 80 years, 22.6% of patients achieved an investigator assessed complete response, resulting in an objective response rate (ORR) of 61.3% and a disease control rate (DCR) of 64.5%. Progression-free survival (PFS) was 11.1 months, and the median overall survival (OS) was not reached after 24 weeks of therapy. Median follow-up was 23.82 months. Subgroup analysis of the CHM cohort (n = 11; 35%) revealed an ORR of 45.5%, a DCR of 54.5%, a median PFS of 10.9 months, and median OS of 20.7 months. Treatment related adverse events were reported in 58.1% of all patients (19.4% grade 3, the remaining grade 1 or 2). PD-L1 expression and CD-8+ T-cell infiltration did not significantly correlate with clinical response, although a trend towards a shorter PFS of 5.6 months was observed with PD-L1 negativity and low CD8+ intratumoral infiltration. CONCLUSION This study demonstrated robust clinical efficacy of nivolumab in patients with locally advanced and metastatic cSCCs and a tolerability comparable to data of other anti-PD-1 antibodies. Favourable outcomes were obtained despite involving the oldest hitherto reported study cohort for anti-PD-1 antibodies and a significant proportion of CHM patients prone to high risk tumours and an aggressive course otherwise typically excluded from clinical trials.
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Affiliation(s)
- R Lang
- Department of Dermatology and Allergology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - T Welponer
- Department of Dermatology and Allergology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - E Richtig
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Wolf
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - C Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Hafner
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - V A Nguyen
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Kofler
- Department of Dermatology, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria
| | - M Barta
- Department of Dermatology and Venereology, Hospital of Wels-Grieskirchen, Wels-Grieskirchen, Austria
| | - P Koelblinger
- Department of Dermatology and Allergology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - W Hitzl
- Research and Innovation Management, Biostatistics and Publication of Clinical Trial Studies, Paracelsus Medical University Salzburg, Salzburg, Austria
- Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, Salzburg, Austria
- Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | - M Laimer
- Department of Dermatology and Allergology, Paracelsus Medical University Salzburg, Salzburg, Austria
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33
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Rentroia-Pacheco B, Tokez S, Bramer EM, Venables ZC, van de Werken HJ, Bellomo D, van Klaveren D, Mooyaart AL, Hollestein LM, Wakkee M. Personalised decision making to predict absolute metastatic risk in cutaneous squamous cell carcinoma: development and validation of a clinico-pathological model. EClinicalMedicine 2023; 63:102150. [PMID: 37662519 PMCID: PMC10468358 DOI: 10.1016/j.eclinm.2023.102150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/14/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023] Open
Abstract
Background Cutaneous squamous cell carcinoma (cSCC) is a common skin cancer, affecting more than 2 million people worldwide yearly and metastasising in 2-5% of patients. However, current clinical staging systems do not provide estimates of absolute metastatic risk, hence missing the opportunity for more personalised treatment advice. We aimed to develop a clinico-pathological model that predicts the probability of metastasis in patients with cSCC. Methods Nationwide cohorts from (1) all patients with a first primary cSCC in The Netherlands in 2007-2008 and (2) all patients with a cSCC in 2013-2015 in England were used to derive nested case-control cohorts. Pathology records of primary cSCCs that originated a loco-regional or distant metastasis were identified, and these cSCCs were matched to primary cSCCs of controls without metastasis (1:1 ratio). The model was developed on the Dutch cohort (n = 390) using a weighted Cox regression model with backward selection and validated on the English cohort (n = 696). Model performance was assessed using weighted versions of the C-index, calibration metrics, and decision curve analysis; and compared to the Brigham and Women's Hospital (BWH) and the American Joint Committee on Cancer (AJCC) staging systems. Members of the multidisciplinary Skin Cancer Outcomes (SCOUT) consortium were surveyed to interpret metastatic risk cutoffs in a clinical context. Findings Eight out of eleven clinico-pathological variables were selected. The model showed good discriminative ability, with an optimism-corrected C-index of 0.80 (95% Confidence interval (CI) 0.75-0.85) in the development cohort and a C-index of 0.84 (95% CI 0.81-0.87) in the validation cohort. Model predictions were well-calibrated: the calibration slope was 0.96 (95% CI 0.76-1.16) in the validation cohort. Decision curve analysis showed improved net benefit compared to current staging systems, particularly for thresholds relevant for decisions on follow-up and adjuvant treatment. The model is available as an online web-based calculator (https://emc-dermatology.shinyapps.io/cscc-abs-met-risk/). Interpretation This validated model assigns personalised metastatic risk predictions to patients with cSCC, using routinely reported histological and patient-specific risk factors. The model can empower clinicians and healthcare systems in identifying patients with high-risk cSCC and offering personalised care/treatment and follow-up. Use of the model for clinical decision-making in different patient populations must be further investigated. Funding PPP Allowance made available by Health-Holland, Top Sector Life Sciences & Health, to stimulate public-private partnerships.
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Affiliation(s)
- Barbara Rentroia-Pacheco
- Department of Dermatology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Selin Tokez
- Department of Dermatology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Edo M. Bramer
- Department of Dermatology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Zoe C. Venables
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, United Kingdom
- National Disease Registration Service, NHS England, United Kingdom
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Harmen J.G. van de Werken
- Department of Immunology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - David van Klaveren
- Department of Public Health, Center for Medical Decision Making, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Antien L. Mooyaart
- Department of Pathology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Loes M. Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands
| | - Marlies Wakkee
- Department of Dermatology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
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Tong JY, Huilgol SC, James C, Selva D. Recommendations for risk stratification of periocular squamous cell carcinoma. Surv Ophthalmol 2023; 68:964-976. [PMID: 37172747 DOI: 10.1016/j.survophthal.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/15/2023]
Abstract
Periocular squamous cell carcinoma is a common cutaneous malignancy with generally favorable outcomes; however, the periocular region is intrinsically a high-risk location, and there exist a subset of lesions with a propensity for poor outcomes. Orbital invasion, intracranial perineural spread, nodal and distant metastasis are feared complications. There are several staging systems for eyelid carcinoma and cutaneous squamous cell carcinoma, but the definition of high-risk lesions remains heterogeneous. It is unclear exactly which lesions can be safely deescalated, and which require nodal evaluation and adjuvant multimodal therapy. We seek to answer these questions by summarizing the literature on clinicopathologic variables, molecular markers, and gene profiling tests in periocular squamous cell carcinoma, with the extrapolation of data from the cutaneous squamous cell carcinoma literature. Standardized pathology reports with information on tumor dimensions, histological subtype and grade, perineural invasion, and lymphovascular invasion should become uniform. Integration with gene expression profiling assessments will individualize and improve the predictive accuracy of risk stratification tools to ultimately inform multidisciplinary decision-making.
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Affiliation(s)
- Jessica Y Tong
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia; Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Shyamala C Huilgol
- Adelaide Skin & Eye Centre, South Australia, Australia; Department of Dermatology, Royal Adelaide Hospital, The University of Adelaide, Adelaide, South Australia, Australia
| | - Craig James
- Clinpath Laboratories, Adelaide, South Australia, Australia
| | - Dinesh Selva
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, Australia; Adelaide Skin & Eye Centre, South Australia, Australia
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35
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Mager L, Gardeen S, Carr DR, Shahwan KT. Cemiplimab for the Treatment of Advanced Cutaneous Squamous Cell Carcinoma: Appropriate Patient Selection and Perspectives. Clin Cosmet Investig Dermatol 2023; 16:2135-2142. [PMID: 37581012 PMCID: PMC10423569 DOI: 10.2147/ccid.s381471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023]
Abstract
Five percent of patients with cutaneous squamous cell carcinoma develop locally advanced or metastatic disease that is not amenable to definitive surgical or radiation therapy. Cemiplimab, an antibody against programmed death receptor-1, was approved in the United States for the treatment of locally advanced and metastatic cutaneous squamous cell carcinoma in 2018. We performed a literature review on the use of cemiplimab in cutaneous squamous cell carcinoma, with an emphasis on efficacy, safety and tolerability, patient selection, and future directions. Embase and PubMed were searched for relevant terms, and 23 peer-reviewed journal articles presenting primary data on cemiplimab treatment in 5 or more subjects with cutaneous squamous cell carcinoma were included and summarized. Objective response rates in locally advanced and metastatic disease ranged from 42.9% to 50.8% in Phase I/II clinical trials and 32-77% (median 58%) in post-approval observational studies. Phase II trials looking at neoadjuvant use also had favorable response rates. Real-world studies demonstrated cemiplimab efficacy in periorbital tumors, tumors with large caliber perineural invasion, and tumors in solid organ transplant recipients. Cemiplimab was safe and well-tolerated in most patients. While side effects such as fatigue, diarrhea, pruritus, and rash were fairly common, only 9.8% of adverse events required cessation of therapy in phase II trials. Severe adverse events were primarily immune-mediated, including pneumonitis, myocarditis, myositis, and autoimmune hepatitis; the risk of treatment-related death was 3% in clinical trials. Further research on cemiplimab therapy in cutaneous squamous cell carcinoma is needed, and trials are now underway to obtain Phase IV long-term real-world data, further data on adjuvant and neoadjuvant use, and additional data in special populations such as stem cell and solid organ transplant recipients.
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Affiliation(s)
- Layna Mager
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | | | - David R Carr
- Department of Dermatology, The Ohio State University Medical Center, Columbus, OH, USA
| | - Kathryn T Shahwan
- Department of Dermatology, The Ohio State University Medical Center, Columbus, OH, USA
- Department of Dermatology, Altru Health System, Grand Forks, ND, USA
- Department of Internal Medicine, University of North Dakota, Grand Forks, ND, USA
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36
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Samaran Q, Samaran R, Ferreira E, Haddad N, Fottorino A, Maillard H, Dreno B, Meyer N, Azria D, Maubec E, Gaudy-Marqueste C, Molinari N, Stoebner PE, Dereure O. Anti-PD-1 for the treatment of advanced cutaneous squamous cell carcinoma in elderly patients: a French multicenter retrospective survey. J Cancer Res Clin Oncol 2023; 149:3549-3562. [PMID: 35962286 PMCID: PMC9374288 DOI: 10.1007/s00432-022-04246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/01/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Anti-PD1 agents are currently recommended as first-line treatment in advanced cutaneous squamous cell carcinoma (acSCC) by updated European guidelines. Although acSCC frequently affects elderly patients with multiple comorbidities, this subset of patients is often excluded of registration clinical trials. PURPOSE To assess anti-PD-1 efficacy and safety in elderly acSCC patients in real-life conditions and describe this specific population with oncogeriatric evaluation tools. METHODS A multicenter retrospective study including acSCC patients at least 70 years old treated with PD-1 inhibitors was conducted in French referral centers. The primary endpoint was the overall response rate (ORR). Secondary endpoints included safety data, time to response (TTR), duration of response (DOR), overall survival (OS), and progression-free survival (PFS). RESULTS 63 patients were included. ORR was 57.1% (95% CI 44.0-69.5), median TTR and DOR were 3 and 5.5 months respectively. Median OS was not reached (95% CI 12.5 months-not reached) at data cut-off after a median follow-up of 8 months while median PFS was 8 months. (95% CI 5 months-not reached). Grade 3-5 adverse effects occurred in 47.6% of patients. 41.3% of patients experienced degradation of ECOG performance status during anti-PD-1 treatment. Nutritional state worsened in 27% of patients and 57.1% lost weight during treatment. CONCLUSION In this particular subset of acSCC patients PD-1 inhibitors obtain results similar to those obtained in younger populations included in pivotal clinical trials, with acceptable safety. A specific oncogeriatric evaluation at treatment initiation and during follow-up appears important in this setting most notably to help manage toxicity.
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Affiliation(s)
- Quentin Samaran
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
- Department of Dermatology, Nîmes University Hospital and Montpellier University, Nîmes, France
- Chru de Montpellier—Hôpital St Eloi—Service de Dermatologie, 80, Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France
| | - Romain Samaran
- Department of Dermatology, Le Mans Hospital, Le Mans, France
- Department of Dermatology, Nantes University Hospital and Nantes University, Nantes, France
| | - Ernestine Ferreira
- Department of Geriatrics, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Naeda Haddad
- Department of Dermatology, Avicenne Hospital (AP-HP) and Paris 13 University, Bobigny, France
| | - Antoine Fottorino
- Department of Oncodermatology, La Timone Hospital (AP-HM) and Aix-Marseille University, Marseille, France
| | - Hervé Maillard
- Department of Dermatology, Le Mans Hospital, Le Mans, France
| | - Brigitte Dreno
- Department of Dermatology, Nantes University Hospital and Nantes University, Nantes, France
| | - Nicolas Meyer
- Institut Universitaire Du Cancer de Toulouse, Toulouse University Hospital, Toulouse, France
| | - David Azria
- Fédération Universitaire d’Oncologie Radiothérapie, ICM—Institut Régional du Cancer Montpellier, Montpellier, France
| | - Eve Maubec
- Department of Dermatology, Avicenne Hospital (AP-HP) and Paris 13 University, Bobigny, France
| | - Caroline Gaudy-Marqueste
- Department of Oncodermatology, La Timone Hospital (AP-HM) and Aix-Marseille University, Marseille, France
| | - Nicolas Molinari
- IDESP, INSERM, Department of Statistics, Univ Montpellier, CHU Montpellier, Montpellier, France
| | | | - Olivier Dereure
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
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Lagebro V, Piersiala K, Petro M, Lapins J, Grybäck P, Margolin G, Kumlien Georén S, Cardell LO. A Novel Method Using Fine Needle Aspiration from Tumor-Draining Lymph Nodes Could Enable the Discovery of New Prognostic Markers in Patients with Cutaneous Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:3297. [PMID: 37444407 PMCID: PMC10340690 DOI: 10.3390/cancers15133297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Cutaneous squamous cell cancer (cSCC) is the second most common form of skin cancer, characterized by abnormal, accelerated growth of squamous cells. When caught early, most cSCCs are curable. About 5 percent of the cSCC cases have advanced to such an extent, generally metastatic, that they are far more dangerous, with very poor prognosis and challenging to treat. All efforts to find biomarkers, in blood or in the tumor itself, for early identification of patients with a risk for metastasis have so far failed. The present study describes a novel method that enables the identification of lymphocyte markers in tumor-draining lymph nodes. Six patients with advanced cSCC were analyzed using a combination of a sentinel lymph node biopsy (SLNB) protocol, fine needle aspiration (FNA), and flow cytometry. Immunological results from the sentinel nodes were combined with corresponding data from peripheral blood and unfixed tumor tissues. The result demonstrates a striking difference between the subsets of T-cells from the three compartments. Our interpretation of this first pilot study is that the ability to follow specific immunological markers on lymphocytes in tumor-draining lymph nodes will enable the identification of novel prognostic biomarkers not detectable in material from blood and tumor tissues.
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Affiliation(s)
- Vilma Lagebro
- Division of ENT Diseases, Department of Clinical Sciences, Intervention, and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Krzysztof Piersiala
- Division of ENT Diseases, Department of Clinical Sciences, Intervention, and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Marianne Petro
- Division of ENT Diseases, Department of Clinical Sciences, Intervention, and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jan Lapins
- Department of Medical Medicine, Unit of Dermatology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Per Grybäck
- Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Gregori Margolin
- Division of ENT Diseases, Department of Clinical Sciences, Intervention, and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, 171 76 Stockholm, Sweden
- Medical Unit Head Neck, Lung and Skin Cancer, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Susanna Kumlien Georén
- Division of ENT Diseases, Department of Clinical Sciences, Intervention, and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Lars-Olaf Cardell
- Division of ENT Diseases, Department of Clinical Sciences, Intervention, and Technology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, 171 76 Stockholm, Sweden
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Elaldi R, Chamorey E, Schiappa R, Sudaka A, Anjuère F, Villarmé A, Culié D, Bozec A, Montaudié H, Poissonnet G. Comparative Performance of Four Staging Classifications to Select «High-Risk» Head and Neck Cutaneous Squamous Cell Carcinomas. J Clin Med 2023; 12:3929. [PMID: 37373623 DOI: 10.3390/jcm12123929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Many classifications exist to select patients with "high-risk" head and neck cutaneous squamous cell carcinoma (HNCSCC). OBJECTIVE To compare the performance of the Brigham and Women's Hospital (BWH) classification with the performance of the American Joint Committee on Cancer 8th Edition (AJCC8), the Union for International Cancer Control 8th Edition (UICC8), and the National Comprehensive Cancer Network (NCCN) classifications. METHODS In this single-center retrospective study, HNCSCC resected in a tertiary care center were classified as "low-risk" or "high-risk" tumors according to the four classifications. Rates of local recurrence (LR), lymph node recurrence (NR), and disease-specific death (DSD) were collected. The performance of each classification was then calculated in terms of homogeneity, monotonicity, and discrimination and compared. RESULTS Two hundred and seventeen HNCSCC from 160 patients, with a mean age of 80 years, were included. For predicting the risk of any poor outcome and risk of NR, the BWH classification had the best specificity and positive predictive value. However, its concordance index was not significantly higher than that of the AJCC8 and UICC8 classifications. The NCCN classification was the least discriminant. CONCLUSIONS AND RELEVANCE This study suggests that the BWH classification is the most appropriate for predicting the risk of poor outcomes in patients with HNCSCC when compared with the NCCN, UICC8, and AJCC8 classifications.
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Affiliation(s)
- Roxane Elaldi
- Face and Neck Surgery Department, Antoine Lacassagne Center, 06100 Nice, France
- CNRS UMR7275, Institut de Pharmacologie Moléculaire et Cellulaire, Université Côte d'Azur, 06560 Valbonne, France
| | - Emmanuel Chamorey
- Statistics Department, Antoine Lacassagne Center, 06100 Nice, France
| | - Renaud Schiappa
- Statistics Department, Antoine Lacassagne Center, 06100 Nice, France
| | - Anne Sudaka
- Anatomopathology Department, Antoine Lacassagne Center, 06100 Nice, France
| | - Fabienne Anjuère
- CNRS UMR7275, Institut de Pharmacologie Moléculaire et Cellulaire, Université Côte d'Azur, 06560 Valbonne, France
| | - Agathe Villarmé
- Face and Neck Surgery Department, Antoine Lacassagne Center, 06100 Nice, France
| | - Dorian Culié
- Face and Neck Surgery Department, Antoine Lacassagne Center, 06100 Nice, France
| | - Alexandre Bozec
- Face and Neck Surgery Department, Antoine Lacassagne Center, 06100 Nice, France
| | - Henri Montaudié
- Dermatology Department, University Hospital of Nice, 06200 Nice, France
- INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, Université Côte d'Azur, 06200 Nice, France
| | - Gilles Poissonnet
- Face and Neck Surgery Department, Antoine Lacassagne Center, 06100 Nice, France
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Ferrarotto R, Bonini F, De Sousa LG. New and emerging drugs for the treatment of advanced cutaneous squamous cell carcinoma. Expert Opin Emerg Drugs 2023. [PMID: 37144289 DOI: 10.1080/14728214.2023.2208345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
INTRODUCTION Cutaneous squamous cell carcinoma (CSCC) is the second most common form of human cancer. Treatment of locally advanced and/or recurrent CSCC is often challenging. A subset of patients are not candidates for curative-intent therapies due to extent of loco-regional disease, refractoriness to prior local therapy, or presence of distant metastasis. AREAS COVERED Traditionally, CSCC has been treated with surgery and/or radiotherapy, but in some instances, local therapies can lead to significant functional morbidity or are no longer feasible. Until 2018, systemic therapy options to treat patients with advanced CSCC were limited. Recently, clinical studies have shown activity of Immune Checkpoint Inhibitors (ICI) in patients with advanced CSCC. This article reviews the current systemic therapy options for CSCC with a focus on ICI and emerging promising therapies in the treatment of this challenging disease. EXPERT OPINION ICI is currently the most effective and tolerable systemic therapy in the treatment of non-immunosuppressed advanced CSCC and can lead to cure in a subset of patients. Combinatorial therapies to overcome resistance to ICI may further increase the proportion of patients who will benefit from ICI and may help improve the quantity and quality of life of patients affected by this disease.
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Affiliation(s)
- Renata Ferrarotto
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, United States
| | - Flavia Bonini
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, United States
| | - Luana Guimaraes De Sousa
- Department of Thoracic-Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, United States
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40
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Abstract
Skin cancer is the most common malignancy in the world, and the majority of cases affect the skin of the head and neck. The face is a particularly emotive area for patients who often present with a lesion that is causing them concern. This article reviews the identification, diagnosis and principles of management of non-melanoma skin cancer of the head and neck. There are many lesions of the skin which are benign and mimic skin cancer. The differential of head and neck skin lesions and how to determine their nature is discussed. The vast majority of non-melanoma skin cancer are basal cell carcinoma, followed by squamous cell carcinoma. These and the other types of non-melanoma skin cancer are described and illustrated. Current methods of clinical identification, diagnosis and evaluation of skin cancers are clarified, and contemporary treatment paradigms are presented.
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Affiliation(s)
- Nick Roland
- Department of Otolaryngology/Head and Neck Surgery, Liverpool University Hospital Trust, Liverpool, UK
| | - Aamir Memon
- Department of Dermatology, Ramsay Renacres Hall Hospital, Halsall, Ormskirk, UK
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41
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Cozma EC, Banciu LM, Soare C, Cretoiu SM. Update on the Molecular Pathology of Cutaneous Squamous Cell Carcinoma. Int J Mol Sci 2023; 24:ijms24076646. [PMID: 37047618 PMCID: PMC10095059 DOI: 10.3390/ijms24076646] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer, originating from keratinocytes of the spinous layer. Numerous risk factors have been discovered for the initiation and growth of this type of cancer, such as exposure to UV and ionizing radiation, chemical carcinogens, the presence of immunosuppression states, chronic inflammation, infections with high-risk viral strains, and, last but not least, the presence of diseases associated with genetic alterations. The important socio-economic impact, as well as the difficulty associated with therapy for advanced forms, has made the molecular mechanisms underlying this neoplasia more and more intensively studied, with the intention of achieving a better understanding and advancing the treatment of this pathology. This review aims to provide a brief foray into the molecular, genetic, and epigenetic aspects of this cancer, as well as the treatment methods, ranging from the first used to the latest targeted therapies.
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Affiliation(s)
- Elena-Codruta Cozma
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania
- Pathophysiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Laura Madalina Banciu
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Cristina Soare
- Dermatology Department, Elias University Emergency Hospital, 011461 Bucharest, Romania
- Surgery Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Sanda-Maria Cretoiu
- Department of Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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42
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Hunt SV, Jamison A, Malhotra R. Oral nicotinamide for non-melanoma skin cancers: A review. Eye (Lond) 2023; 37:823-829. [PMID: 35347291 PMCID: PMC10050186 DOI: 10.1038/s41433-022-02036-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/08/2022] [Accepted: 03/15/2022] [Indexed: 12/15/2022] Open
Abstract
There has been much interest in the role of oral nicotinamide supplementation in reducing the incidence of non-melanoma skin cancers. This article reviews the hypothesised mechanisms of action of nicotinamide, and the available literature outlining its role for this purpose. There have been five randomised controlled trials (RCT), one histopathological study and two case series exploring the effect of oral nicotinamide supplementation on UV-induced immunosuppression of the skin, and incidence of actinic keratoses and non-melanoma skin cancers (NMSC). The largest RCT received criticism of the statistical analyses used, but the critics still acknowledged a likely benefit of treatment with oral nicotinamide in reducing the incidence of NMSC. Nicotinamide has a favourable safety profile. Current evidence is not definitive that oral nicotinamide supplementation reduces the incidence of NMSC, but it constitutes a low-risk management option that may be particularly relevant for high-risk individuals, and should be discussed as an option for these patients.
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Affiliation(s)
| | - Aaron Jamison
- Corneoplastic unit, Queen Victoria Hospital, East Grinstead, England
| | - Raman Malhotra
- Corneoplastic unit, Queen Victoria Hospital, East Grinstead, England
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43
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Prados-Carmona A, Llamas-Molina JM, Velasco-Amador P, Ruiz-Villaverde R, Ruiz-Carrascosa JC. High-risk Squamous Cell Carcinoma, a surgical challenge: the other face of the SARS-CoV-2 pandemic. J DERMATOL TREAT 2023; 34:2192841. [PMID: 36927214 DOI: 10.1080/09546634.2023.2192841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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44
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Ozge Z, Sevil K, Ahmet Y, Hülya A, Sema A. Stathmin 1 and p53 Expression in Cutaneous Squamous Cell Carcinoma and Precursor Lesions. Am J Dermatopathol 2023; 45:170-175. [PMID: 36749137 DOI: 10.1097/dad.0000000000002381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/04/2022] [Indexed: 02/08/2023]
Abstract
ABSTRACT Studies on the relationship between stathmin 1 (STMN1) and cutaneous squamous cell carcinoma (cSCC) are limited. We aimed to evaluate the relationship between clinicopathological factors and STMN1 and p53 expressions in cSCC and compare them with those in the precursor lesions of cSCC and normal tissue. A total of 195 patients, followed between January 2014 and December 2021, with diagnoses of primary cSCC (n = 129), in situ cSCC (n = 20), or actinic keratosis (n = 46), as well as 29 histopathologically normal tissue samples, were included in the study. Immunohistochemical staining for STMN1 and p53 was performed. In the cSCC group, STMN1 scores were higher in poorly differentiated ( P = 0.001) and ulcerated ( P < 0.001) tumors. A linear relationship between STMN1 score and tumor area, tumor thickness, and mitosis was found ( P = 0.001, P = 0.003, and P < 0.001, respectively). There was no statistically significant correlation between STMN1 and p53 scores. Our results support the previous view that STMN1 may be associated with some adverse clinicopathological and high-risk features of cSCC. To the best of our knowledge, this is the first and largest study to investigate STMN1 expression in cSCC, precancerous lesions of cSCC, and normal tissues.
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Affiliation(s)
- Zorlu Ozge
- Tekirdağ Namık Kemal University School of Medicine, Department of Dermatology and Venereology, Tekirdağ, Turkey
| | - Karabağ Sevil
- Tekirdağ Namık Kemal University School of Medicine, Department of Pathology, Tekirdağ, Turkey; and
| | - Yolcu Ahmet
- Tekirdağ Namık Kemal University School of Medicine, Department of Radiation Oncology, Tekirdağ, Turkey
| | - Albayrak Hülya
- Tekirdağ Namık Kemal University School of Medicine, Department of Dermatology and Venereology, Tekirdağ, Turkey
| | - Aytekin Sema
- Tekirdağ Namık Kemal University School of Medicine, Department of Dermatology and Venereology, Tekirdağ, Turkey
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45
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Pham JP, Sivasubramaniam V, Gallagher R, Forstner D, Wong M, Liu J. Safety of cemiplimab for advanced cutaneous squamous cell carcinoma in a patient with p-ANCA-associated vasculitis. J Eur Acad Dermatol Venereol 2023; 37:e363-e365. [PMID: 36226470 DOI: 10.1111/jdv.18649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/30/2022] [Indexed: 11/29/2022]
Affiliation(s)
- James P Pham
- The Kinghorn Cancer Centre, St. Vincent's Hospital Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Vanathi Sivasubramaniam
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Sydpath, St Vincent's Pathology, Sydney, New South Wales, Australia
| | - Richard Gallagher
- The Kinghorn Cancer Centre, St. Vincent's Hospital Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Dion Forstner
- The Kinghorn Cancer Centre, St. Vincent's Hospital Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Genesis Care Radiation Oncology, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Muh Wong
- Department of Renal Medicine, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia
| | - Jia Liu
- The Kinghorn Cancer Centre, St. Vincent's Hospital Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, the University of Sydney, Sydney, New South Wales, Australia
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46
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Deutsch J, Dippel E, Delank KW. [Cutaneous squamous cell carcinoma of the head and neck]. Laryngorhinootologie 2023; 102:186-193. [PMID: 36455599 DOI: 10.1055/a-1953-7374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Cutaneous squamous cell carcinoma (cSCC), predominantly located on the scalp and face, is the second most prevalent skin cancer globally. Due to the increasing elderly population and rising incidence of cSCC, it has been gaining relevance in otorhinolaryngology. MATERIAL AND METHODS This review article is based on a selective PubMed literature search, German and European guidelines and the clinic's own experience. RESULTS In addition to chronic UV exposure, a disruption of the body's own immune system is becoming increasingly important. Vertical tumor thickness is associated with the highest risk of metastatic spread and local recurrence. Other significant risk factors are: horizontal tumor diameter, dedifferentiation, desmoplasia, perineural growth and localization on the face. Most cases are manageable by local excision with histological control of the excision margins. If regional metastases are clinically suspected, the draining cervical lymph node levels should be dissected depending on primary tumor location. cSCC of the upper face and the auricle primarily metastasize to the parotid gland. With the approval of the PD-1-blocking antibody cemiplimab in Europe, an active ingredient has been made available for the treatment of advanced cSCC where surgery or radiotherapy are no longer an option. CONCLUSIONS The otherwise very low mortality rate of cSCC increases considerably with metastases. Therefore, imaging, surgical therapy and follow-up intervals should be based on risk factors. This allows early detection of metastases or local recurrences and improves the prognosis.
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Affiliation(s)
- Jochen Deutsch
- HNO-Klinik, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany
| | - Edgar Dippel
- Hautklinik, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany
| | - K-Wolfgang Delank
- HNO-Klinik, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany
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47
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Real-Life Study of the Benefit of Concomitant Radiotherapy with Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma (cSCC): A Retrospective Cohort Study. Cancers (Basel) 2023; 15:cancers15020495. [PMID: 36672444 PMCID: PMC9856754 DOI: 10.3390/cancers15020495] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cemiplimab is a monoclonal antibody targeting the PD-1, and phase II trials have shown its efficacy in the treatment of advanced cutaneous squamous cell carcinoma in patients who are not candidates for curative surgery or radiation therapy as a first- or later-line treatment. A synergistic antitumoral response has been demonstrated with concurrent radiotherapy and PD1-immunotherapy. However, no real-life study has demonstrated this effect in advanced cutaneous squamous cell carcinoma. METHODS We conducted a real-life retrospective cohort study to investigate the benefit of concomitant therapy in 33 patients treated with cemiplimab at the University Hospital of Caen, alone (C group) or concomitant to radiotherapy (C/RT group). Our primary objectives were to evaluate the best overall response and objective response rate. Our secondary objectives were the disease control rate, median time to response, progression-free survival, overall survival, clinical benefit of radiotherapy, and safety data. After stopping cemiplimab administration, we performed a follow-up of our patients and performed a descriptive study. RESULTS We reported an objective response rate of 45.5%, including 47.6% in the cemiplimab group versus 41.6% in the concomitant group. The addition of radiotherapy to cemiplimab enables an earlier clinico-radiological response, with a median duration of 5.5 months in the cemiplimab group versus 3 months in the concomitant therapy group. The response to treatment was prolonged despite discontinuation of cemiplimab, with 91.6% (n = 11/12) and 83.3% (n = 10/12) patients in complete or partial remission at 6 months and 1 year after cessation of cemiplimab and no switch to another oncological treatment, respectively. Radiation therapy also provided a therapeutic effect in 83.3% of the patients in the concomitant group, without increasing the occurrence of adverse events. CONCLUSIONS Our study confirms the efficacy of cemiplimab and radiotherapy in the management of advanced cutaneous squamous cell carcinoma. Concomitant therapy permitted to obtain an earlier radiological response, a beneficial local therapeutic effect of radiotherapy, without any safety alert.
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48
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Kang T, Zhang C, Lei H, Luo R, Liu M, Wang S, Zhang X, Duan Q, Xiao S, Zheng Y. NPTX2 Promotes Epithelial-Mesenchymal Transition in Cutaneous Squamous Cell Carcinoma through METTL3-Mediated N6-Methyladenosine Methylation of SNAIL. J Invest Dermatol 2023; 143:977-988.e2. [PMID: 36638907 DOI: 10.1016/j.jid.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/29/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common type of skin cancer. NPTX2, a member of the neuronal pentraxin family, is reported to play inconsistent roles in different cancers. The role and mechanism of NPTX2 in cSCC remain unclear. In this study, we found that NPTX2 was overexpressed in both skin lesions and cell lines of cSCC. In vitro studies showed that NPTX2 facilitated cell proliferation, migration, invasion, colony formation, and epithelial‒mesenchymal translation in A431 and SCL-1 cells. NPTX2 interacted with METTL3, increased METTL3 expression, and improved N6-methyladenosine modification in cSCC cell lines. Mechanistically, NPTX2 facilitated epithelial‒mesenchymal translation by promoting METTL3-mediated N6-methyladenosine of SNAIL. METTL3 knockdown and N6-methyladenosine inhibition reversed the impacts of NPTX2 overexpression on cSCC cells. In vivo studies verified the role of NPTX2 as an oncogene in cSCC. Therefore, NPTX2 may be a potential therapeutic target for cSCC.
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Affiliation(s)
- Tong Kang
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Cheng Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hao Lei
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ruiting Luo
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng Liu
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shengbang Wang
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiu Zhang
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qiqi Duan
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shengxiang Xiao
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Zheng
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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Stratidakis N, Tagka A, Geronikolou SA, Giannakopoulos E, Panagiotopoulos A, Malachia E, Vitsos A, Karalis E, Dallas P, Stratigos A, Rallis M. Octenidine Versus Dispase Gels for Wound Healing After Cryosurgery Treatment in Patients with Basal Cell Carcinoma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:591-601. [PMID: 37581832 DOI: 10.1007/978-3-031-31986-0_57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
For a specific group of patients with basal cell carcinoma (small, low risk), cryosurgery could be the suggested treatment, which results in the formation of an ulcer in the lesion area. The proteolytic enzymes' contribution to the wound healing is an ongoing research goal. Preclinical animal experiments in the Laboratory of the Pharmaceutical Technology Department of the National and Kapodistrian University of Athens have showed that a dose of 5 U/mL of dispase gel after the formation of tissue rashes, significantly promoted wound healing. Herein, a feasibility study in 16 patients enrolled by the First Department of Dermatology of Andreas Syggros Hospital was designed: 5 U/mL of dispase gel (once every 3 days) versus a drug reference containing octenidine (daily administration). The evaluation of the healing effect, safety, and tolerance was done on days 1 (cryosurgery), 2, 7, 21, and 60. The study end point was considered either the ulcer complete healing or the eighth week since treatment initiation. Wound healing was faster with dispase gel and hemoglobin reduced rapidly after the seventh day. Yet, hydration was higher in the control group. Our non-parametric analysis provides evidence that the dispase gel shows faster healing compared to the reference drug, in humans, meriting further investigation in larger human sample sizes before massive production of the product.
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Affiliation(s)
- Nektarios Stratidakis
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece.
| | - Anna Tagka
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - Styliani A Geronikolou
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Efstathios Giannakopoulos
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios Panagiotopoulos
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Evdokia Malachia
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Andreas Vitsos
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Karalis
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevas Dallas
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Stratigos
- First Department of Dermatology and Venereology, "Andreas Syggros" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Michail Rallis
- Division of Pharmaceutical Technology, School of Pharmacy, National and Kapodistrian University of Athens, Athens, Greece
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50
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The Current Treatment Landscape of Cutaneous Squamous Cell Carcinoma. Am J Clin Dermatol 2023; 24:25-40. [PMID: 36512176 DOI: 10.1007/s40257-022-00742-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2022] [Indexed: 12/15/2022]
Abstract
Non-melanoma skin cancers (NMSCs) are the most common form of skin cancer worldwide. The global incidence of cutaneous squamous cell carcinoma (CSCC) is rising, with an estimated 2.4 million cases diagnosed in 2019. Chronic exposure to ultraviolet (UV) radiation is a major risk factor for developing CSCC. Most early-stage CSCCs are treated successfully with surgery or radiotherapy; however, locally advanced or metastatic disease can be associated with significant morbidity or mortality. Recently, the treatment paradigm for advanced CSCC has been revolutionised by the introduction of immunotherapy, which can achieve a response rate of approximately 50% with durable cancer control, and significant improvement in quality of life. With the regulatory approval of programmed death-1 (PD-1)-targeting drugs since 2018, immunotherapy is now recognised as the standard of care for first-line systemic therapy in advanced or metastatic CSCC.
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