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Nissinen L, Riihilä P, Viiklepp K, Rajagopal V, Storek MJ, Kähäri VM. C1s targeting antibodies inhibit the growth of cutaneous squamous carcinoma cells. Sci Rep 2024; 14:13465. [PMID: 38866870 PMCID: PMC11169539 DOI: 10.1038/s41598-024-64088-3] [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: 02/13/2024] [Accepted: 06/05/2024] [Indexed: 06/14/2024] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the most common metastatic skin cancer. The incidence of cSCC is increasing globally and the prognosis of metastatic disease is poor. Currently there are no specific targeted therapies for advanced or metastatic cSCC. We have previously shown abundant expression of the complement classical pathway C1 complex components, serine proteases C1r and C1s in tumor cells in invasive cSCCs in vivo, whereas the expression of C1r and C1s was lower in cSCCs in situ, actinic keratoses and in normal skin. We have also shown that knockdown of C1s expression results in decreased viability and growth of cSCC cells by promoting apoptosis both in culture and in vivo. Here, we have studied the effect of specific IgG2a mouse monoclonal antibodies TNT003 and TNT005 targeting human C1s in five primary non-metastatic and three metastatic cSCC cell lines that show intracellular expression of C1s and secretion of C1s into the cell culture media. Treatment of cSCC cells with TNT003 and TNT005 significantly inhibited their growth and viability and promoted apoptosis of cSCC cells. These data indicate that TNT003 and TNT005 inhibit cSCC cell growth in culture and warrant further investigation of C1s targeted inhibition in additional in vitro and in vivo models of cSCC.
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Affiliation(s)
- Liisa Nissinen
- Department of Dermatology and FICAN West Cancer Centre Research Laboratory, University of Turku and Turku University Hospital, Hämeentie 11 TE6, 20520, Turku, Finland
| | - Pilvi Riihilä
- Department of Dermatology and FICAN West Cancer Centre Research Laboratory, University of Turku and Turku University Hospital, Hämeentie 11 TE6, 20520, Turku, Finland
| | - Kristina Viiklepp
- Department of Dermatology and FICAN West Cancer Centre Research Laboratory, University of Turku and Turku University Hospital, Hämeentie 11 TE6, 20520, Turku, Finland
| | | | | | - Veli-Matti Kähäri
- Department of Dermatology and FICAN West Cancer Centre Research Laboratory, University of Turku and Turku University Hospital, Hämeentie 11 TE6, 20520, Turku, Finland.
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Magalhães RF, Buffo TH, Gonçalves HDS, Barcaui CB, de Moraes AM. Field cancerization in dermatology. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S113. [PMID: 38865533 PMCID: PMC11164289 DOI: 10.1590/1806-9282.2024s113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 06/14/2024]
Affiliation(s)
- Renata Ferreira Magalhães
- Universidade Estadual de Campinas, Clinical Hospital, Division of Dermatology – São Paulo (SP), Brazil
| | - Thais Helena Buffo
- Universidade Estadual de Campinas, Clinical Hospital, Department of Dermatology Surgery and Skin Cancer, Division of Dermatology – São Paulo (SP), Brazil
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Kandolf L, Peris K, Malvehy J, Mosterd K, Heppt MV, Fargnoli MC, Berking C, Arenberger P, Bylaite-Bučinskiene M, Del Marmol V, Dirschka T, Dreno B, Forsea AM, Harwood CA, Hauschild A, Heerfordt IM, Kauffman R, Kelleners-Smeets N, Lallas A, Lebbe C, Leiter U, Longo C, Mijušković Ž, Pellacani G, Puig S, Saiag P, Šitum M, Stockfleth E, Salavastru C, Stratigos A, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes). J Eur Acad Dermatol Venereol 2024; 38:1024-1047. [PMID: 38451047 DOI: 10.1111/jdv.19897] [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: 08/29/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024]
Abstract
A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non-hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised.
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Affiliation(s)
- Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Josep Malvehy
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Markus V Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Matilda Bylaite-Bučinskiene
- Clinic of Infectious Diseases and Dermatovenereology, Centre of Dermatovenereology, Vilnius University, Vilnius, Lithuania
| | - Veronique Del Marmol
- Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Thomas Dirschka
- Faculty of Health, University Witten-Herdecke, Witten, Germany
- CentroDerm Clinic, Wuppertal, Germany
| | - Brigitte Dreno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
| | - Ana-Maria Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 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
| | - Ida Marie Heerfordt
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Roland Kauffman
- Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | - Nicole Kelleners-Smeets
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Celeste Lebbe
- Université Paris Cite, AP-HP Dermato-oncology, Cancer institute APHP, Nord Paris cité, INSERM U976, Saint Louis Hospital, Paris, France
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Caterina Longo
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Željko Mijušković
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Susana Puig
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Philippe Saiag
- Department of General and Oncologic Dermatology, Ambroise Paré Hospital, APHP, & EA 4340 "Biomarkers in Cancerology and Hemato-Oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Mirna Šitum
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Eggert Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Yan J, Wang B, Zhang G, Liao C, Zhao Z, Wang P, Wang X. Neoadjuvant Photodynamic Therapy: An Updated Therapeutic Approach for Non-Melanoma Skin Cancers. Curr Treat Options Oncol 2024:10.1007/s11864-024-01209-0. [PMID: 38761266 DOI: 10.1007/s11864-024-01209-0] [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] [Accepted: 04/17/2024] [Indexed: 05/20/2024]
Abstract
OPINION STATEMENT Non-melanoma skin cancers (NMSCs) are the most common malignancy and surgical excision is considered treatment of choice for the majority of cases. However, surgery can be very extensive in cases of large, multiple, or cosmetic-sensitive tumors located on areas such as scalp and face or genital region, leading to significant functional and cosmetic deficit. Aminolaevulinic acid photodynamic therapy (ALA-PDT) has emerged as a widely used approach in a variety of skin diseases, demonstrating remarkable efficacy in treatment of actinic keratosis, Bowen disease and basal cell carcinoma. Besides, when employed as a preoperative intervention, ALA-PDT effectively reduces tumor size and minimizes subsequent local surgical morbidity. With its minimally invasive nature and proven effectiveness, ALA-PDT holds significant promise as a neoadjuvant treatment option for NMSCs. In cases where the tumor is large, invasive, multiple, or located in cosmetically and functionally sensitive areas, or when considering patient factors such as age, comorbidity, willingness to undergo surgery, and post-operative quality-of-life, surgical intervention or radiotherapy alone may be impracticable or unacceptable. In such scenarios, neoadjuvant ALA-PDT can offer remarkable outcomes. In order to further ensure the maximum benefit of patients from neoadjuvant PDT, collaboration with multidisciplinary teams and whole-process management may be in need.
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Affiliation(s)
- Jia Yan
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Bo Wang
- Avera Medical Group Aberdeen, South Dakota, Aberdeen, 57401, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Caihe Liao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Zijun Zhao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, 200443, China.
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Ju S, Rokohl AC, Guo Y, Yao K, Fan W, Heindl LM. Personalized treatment concepts in extraocular cancer. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:69-77. [PMID: 38590555 PMCID: PMC10999489 DOI: 10.1016/j.aopr.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/10/2024] [Accepted: 02/28/2024] [Indexed: 04/10/2024]
Abstract
Background The periocular skin is neoplasms-prone to various benign and malignant. Periocular malignancies are more aggressive and challenging to cure and repair than those in other skin areas. In recent decades, immunotherapy has significantly advanced oncology, allowing the autoimmune system to target and destroy malignant cells. Skin malignancies, especially periocular tumors, are particularly sensitive to immunotherapy. This technique has dramatically impacted the successful treatment of challenging tumors. Main text Extraocular cancers, including eyelid (basal cell carcinoma, squamous cell carcinoma, melanoma, merkel cell carcinoma), conjunctival tumors (conjunctival melanoma, ocular surface squamous neoplasia) and other rare tumors, are unique and challenging clinical situations. Several genetic alterations associated with the pathogenesis of these diseases have been identified, and molecular mechanism are essential for the development of the immunotherapy agents, such as Hedgehog pathway inhibitors (vismodegib and sonidegib) for basal cell carcinoma, BRAF/MEK inhibitors (vemurafenib, dabrafenib, and encorafenib) for melanoma, and immune checkpoint inhibitors (Avelumab, pembrolizumab) for Merkel cell carcinoma. Conclusions The optimal treatment for periocular skin cancer depends on the type and size of the tumor and whether it involves orbital and adnexal structures. Adjuvant and neoadjuvant therapy with chemotherapy-targeted therapies and immune checkpoint inhibitors should be considered based on tumor type, tumor molecular profile, expected response rate, and candidacy for systemic treatment.
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Affiliation(s)
- Sitong Ju
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße, Cologne, Germany
| | - Alexander C. Rokohl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße, Cologne, Germany
- Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
| | - Yongwei Guo
- Eye Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ke Yao
- Eye Center, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Wanlin Fan
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße, Cologne, Germany
| | - Ludwig M. Heindl
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße, Cologne, Germany
- Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany
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Krönert MIC, Schwarzenböck SM, Kurth J, Heuschkel M, Krause BJ, Emmert S, Tietze JK. Patient-Orientated Evaluation of Treatment of Non-Melanoma Skin Cancer with Rhenium-188 Compared to Surgery. Healthcare (Basel) 2024; 12:921. [PMID: 38727478 PMCID: PMC11083370 DOI: 10.3390/healthcare12090921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Non-melanoma skin cancers (NMSCs) are responsible for up to one-third of all human malignancies. Surgery is usually the treatment of choice, but patients often experience pain during the procedure. Topical rhenium-188 resin skin cancer treatment (RSCT) may be a valid therapeutic alternative. METHODS In this monocentric pilot study, 19 patients suffering from NMSC were treated with RSCT. Most of these patients had also experienced surgery, either because they developed a new NMSC in aftercare, or they had suffered previously from NMSC. Three RSCT-treated patients, who had no exposure to surgery so far, were paired with three matched patients, who had received surgery. We sought to evaluate and compare the patients' experience with both treatments. A questionnaire assessed patients' perceptions regarding side effects, aesthetic outcomes, wound care, fear of complications, and personal treatment preferences. Patients evaluated the different parameters of their either RSCT- or surgery-treated lesions on a scale from 0-10. RESULTS Patients were more afraid of complications before surgery than before RSCT (p = 0.04). Treatment with RSCT caused significantly less pain on treatment day (mean 0.56) than surgery (mean 2.32) (0 no pain, 10 maximum pain) (p = 0.02) and 14 days after the procedure (mean 0.89 versus mean 2.47) (p = 0.02). On day 14, RSCT-treated lesions were also significantly less itchy (mean 0.34) than after surgery (mean 1.50). Most patients were very satisfied with the aesthetic outcome after both RSCT (mean 8.42) and surgery (mean 8.31) (p = 0.89). In the case of a new NMSC, the majority of patients who experienced both treatments would rather be treated primarily with RSCT (44%) or would consider both options (31%); only 19% preferred surgery. CONCLUSION Patients evaluated RSCT as less painful than surgery. The aesthetic outcomes of both treatments were comparable. For pain-sensitive patients, RSCT might be a preferable treatment option.
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Affiliation(s)
- Maila I. C. Krönert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (M.I.C.K.); (S.E.)
| | - Sarah M. Schwarzenböck
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Jens Kurth
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Martin Heuschkel
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Bernd J. Krause
- Department of Nuclear Medicine, University Medical Center Rostock, 18057 Rostock, Germany; (S.M.S.); (J.K.); (M.H.); (B.J.K.)
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (M.I.C.K.); (S.E.)
| | - Julia K. Tietze
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, 18057 Rostock, Germany; (M.I.C.K.); (S.E.)
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Barker CA, Dufault S, Arron ST, Ho AL, Algazi AP, Dunn LA, Humphries AA, Hultman C, Lian M, Knott PD, Yom SS. Phase II, Single-Arm Trial of Induction and Concurrent Vismodegib With Curative-Intent Radiation Therapy for Locally Advanced, Unresectable Basal Cell Carcinoma. J Clin Oncol 2024:JCO2301708. [PMID: 38630954 DOI: 10.1200/jco.23.01708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/17/2023] [Accepted: 02/08/2024] [Indexed: 04/19/2024] Open
Abstract
PURPOSE Locally advanced, unresectable basal cell carcinoma (LA BCC) can be treated with radiation therapy (RT), but locoregional control (LRC) rates are unsatisfactory. Vismodegib is a hedgehog pathway inhibitor (HPI) active in BCC that may radiosensitize BCC. We evaluated the combination of vismodegib and RT for patients with LA BCC. METHODS In this multicenter, single-arm, phase II study, patients with unresectable LA BCC received 12 weeks of induction vismodegib, followed by 7 weeks of concurrent vismodegib and RT. The primary end point was LRC rate at 1 year after the end of treatment. Secondary end points included objective response, progression-free survival (PFS), overall survival (OS), safety, and patient-reported quality of life (PRQOL). RESULTS Twenty-four patients received vismodegib; five were unable to complete 12 weeks of induction therapy. LRC was achieved in 91% (95% CI, 68 to 98) of patients at 1 year. The response rate was 63% (95% CI, 38 to 84) after induction vismodegib and 83% (95% CI, 59 to 96) after concurrent vismodegib and RT. With a median follow-up of 5.7 years, 1-year PFS and OS rates were 100% and 96%, and at 5 years PFS and OS rates were 78% and 83%, respectively. Distant metastasis or BCC-related death has not been observed. The most frequent treatment-related adverse events (AEs) were dysgeusia, fatigue, and myalgias occurring in 83%, 75%, and 75% of patients. No grade 4 to 5 treatment-related AEs occurred. PRQOL demonstrated clinically meaningful improvements in all subscales, with emotions and functioning improvements persisting for a year after the end of treatment. CONCLUSION In patients with unresectable LA BCC, the combination of vismodegib and RT yielded high rates of LRC and PFS and durable improvements in PRQOL.
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Affiliation(s)
- Christopher A Barker
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Suzanne Dufault
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA
| | - Sarah T Arron
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Alan L Ho
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Alain P Algazi
- Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Lara A Dunn
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Audrey A Humphries
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
| | - Carter Hultman
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
| | - Ming Lian
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - P Daniel Knott
- Department of Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA
- Department of Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA
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Pihl C, Andersen F, Bjerring P, Haedersdal M, Lerche CM. Efficacy of Combinational Treatment versus Nicotinamide Monotherapy in the Prevention of Ultraviolet Radiation-Induced Skin Cancer. Dermatology 2024; 240:453-461. [PMID: 38599196 DOI: 10.1159/000538445] [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: 01/24/2024] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION Ultraviolet radiation (UVR) is the primary risk factor for keratinocyte carcinomas. Oral supplementation with nicotinamide (NAM) is reported to reduce the formation of new keratinocyte carcinomas. NAM's photoprotection is mediated by enhanced DNA repair. We wanted to explore whether NAM in combination with antiproliferative (metformin [Met]) or antioxidant (phloroglucinol [PG]) compounds could potentially enhance its photoprotective effects. METHODS Hairless mice (C3.Cg-Hrhr/TifBomTac) were treated orally with either a standard dose of NAM monotherapy (NAM-mono; 600 mg/kg) or NAM (400 mg/kg) combined with Met (200 mg/kg) (NAM-Met) or PG (75 mg/kg) (NAM-PG). Mice were irradiated with 3.5 standard erythema doses of UVR three times per week to induce tumour development. Photoprotective effects were based on (i) tumour onset of the first three tumours, (ii) skin photodamage, and (iii) DNA damage (cyclobutane pyrimidine dimers [CPDs] and pyrimidine-pyrimidone (6-4) photoproducts [6-4PPs]). RESULTS All mice treated with NAM demonstrated a delay in tumour onset and reduced tumour burden compared to the UV control group (NAM, NAM-Met, NAM-PG vs. UV control: p ≤ 0.015). NAM-mono and NAM-PG increased time until all three tumours with no difference between them, indicating a similar degree of photoprotection. NAM-mono had no effect on DNA damage compared to the UV control group (p > 0.05), whereas NAM-PG reduced 6-4PP lesions (p < 0.01) but not CPDs (p > 0.05) compared to NAM-mono. NAM-Met delayed the onset of the third tumour compared to the UV control but demonstrated a quicker onset compared to NAM-mono, suggesting inferior photoprotection compared to nicotinamide monotherapy. CONCLUSION NAM-PG was as effective in delaying UVR-induced tumour onset as NAM-mono. The reduction in 6-4PP lesions may indicate that the mechanism of NAM-PG is better suited for photoprotection than NAM-mono. NAM-mono was superior to NAM-Met, indicating a dose dependency of NAM's photoprotection. These results highlight the potential for combining photoprotective compounds to enhance photoprotection.
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Affiliation(s)
- Celina Pihl
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Flemming Andersen
- Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark
- Department of Dermatology, Private Hospital Molholm, Vejle, Denmark
| | - Peter Bjerring
- Department of Dermatology, Aalborg University Hospital, Aalborg, Denmark
| | - Merete Haedersdal
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Catharina Margrethe Lerche
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
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Zhou K, Wu C, Cheng W, Zhang B, Wei R, Cheng D, Li Y, Cao Y, Zhang W, Yao Z, Zhang X. Transglutaminase 3 regulates cutaneous squamous carcinoma differentiation and inhibits progression via PI3K-AKT signaling pathway-mediated Keratin 14 degradation. Cell Death Dis 2024; 15:252. [PMID: 38589352 PMCID: PMC11001918 DOI: 10.1038/s41419-024-06626-5] [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: 11/15/2023] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
Cutaneous squamous carcinoma is the second most common epithelial malignancy, associated with significant morbidity, mortality, and economic burden. However, the mechanisms underlying cSCC remain poorly understood. In this study, we identified TGM3 as a novel cSCC tumor suppressor that acts via the PI3K-AKT axis. RT-qPCR, IHC and western blotting were employed to assess TGM3 levels. TGM3-overexpression/knockdown cSCC cell lines were utilized to detect TGM3's impact on epithelial differentiation as well as tumor cell proliferation, migration, and invasion in vitro. Additionally, subcutaneous xenograft tumor models were employed to examine the effect of TGM3 knockdown on tumor growth in vivo. Finally, molecular and biochemical approaches were employed to gain insight into the tumor-suppressing mechanisms of TGM3. TGM3 expression was increased in well-differentiated cSCC tumors, whereas it was decreased in poor-differentiated cSCC tumors. Loss of TGM3 is associated with poor differentiation and a high recurrence rate in patients with cSCC. TGM3 exhibited tumor-suppressing activity by regulating cell proliferation, migration, and invasion both in vitro and in vivo. As a novel cSCC tumor differentiation marker, TGM3 expression was positively correlated with cell differentiation. In addition, our results demonstrated an interaction between TGM3 and KRT14 that aids in the degradation of KRT14. TGM3 deficiency disrupts keratinocytes differentiation, and ultimately leads to tumorigenesis. Furthermore, RNA-sequence analysis revealed that loss of TGM3 enhanced EMT via the PI3K-AKT signaling pathway. Deguelin, a PI3K-AKT inhibitor, blocked cSCC tumor growth induced by TGM3 knockdown in vivo. Taken together, TGM3 inhibits cSCC tumor growth via PI3K-AKT signaling, which could also serve as a tumor differentiation marker and a potential therapeutic target for cSCC. Proposed model depicted the mechanism by which TGM3 suppress cSCC development. TGM3 reduces the phosphorylation level of AKT and degrades KRT14. In the epithelial cell layer, TGM3 exhibits a characteristic pattern of increasing expression from bottom to top, while KRT14 and pAKT are the opposite. Loss of TGM3 leads to reduced degradation of KRT14 and activation of pAKT, disrupting keratinocyte differentiation, and eventually resulting in the occurrence of low-differentiated cSCC.
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Affiliation(s)
- Kaili Zhou
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chenglong Wu
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wenjie Cheng
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Boyuan Zhang
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruoqu Wei
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Daian Cheng
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan Li
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Cao
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Wenqing Zhang
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Zhirong Yao
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
| | - Xue Zhang
- Dermatology Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Department of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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10
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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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11
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Silvestrini AVP, Morais MF, Debiasi BW, Praça FG, Bentley MVLB. Nanotechnology strategies to address challenges in topical and cellular delivery of siRNAs in skin disease therapy. Adv Drug Deliv Rev 2024; 207:115198. [PMID: 38341146 DOI: 10.1016/j.addr.2024.115198] [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: 10/09/2023] [Revised: 12/14/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
Gene therapy is one of the most advanced therapies in current medicine. In particular, interference RNA-based therapy by small interfering RNA (siRNA) has gained attention in recent years as it is a highly versatile, selective and specific therapy. In dermatological conditions, topical delivery of siRNA offers numerous therapeutic advantages, mainly by inhibiting the expression of target transcripts directly in the skin. However, crossing the stratum corneum and overcoming intracellular barriers is an inherent challenge. Substantial efforts by scientists have moved towards the use of multimodal and multifunctional nanoparticles to overcome these barriers and achieve greater bioavailability in their site of action, the cytoplasm. In this review the most innovative strategies based on nanoparticle and physical methods are presented, as well as the design principles and the main factors that contribute to the performance of these systems. This review also highlights the synergistic contributions of medicine, nanotechnology, and molecular biology to advancing translational research into siRNA-based therapeutics for skin diseases.
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Affiliation(s)
- Ana Vitoria Pupo Silvestrini
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Av. do Café, s/n, 14040-903 Ribeirão Preto, SP, Brazil
| | - Milena Finazzi Morais
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Av. do Café, s/n, 14040-903 Ribeirão Preto, SP, Brazil
| | - Bryan Wender Debiasi
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Av. do Café, s/n, 14040-903 Ribeirão Preto, SP, Brazil
| | - Fabíola Garcia Praça
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Av. do Café, s/n, 14040-903 Ribeirão Preto, SP, Brazil
| | - Maria Vitória Lopes Badra Bentley
- School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Av. do Café, s/n, 14040-903 Ribeirão Preto, SP, Brazil.
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12
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Dachani S, Kaleem M, Mujtaba MA, Mahajan N, Ali SA, Almutairy AF, Mahmood D, Anwer MK, Ali MD, Kumar S. A Comprehensive Review of Various Therapeutic Strategies for the Management of Skin Cancer. ACS OMEGA 2024; 9:10030-10048. [PMID: 38463249 PMCID: PMC10918819 DOI: 10.1021/acsomega.3c09780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024]
Abstract
Skin cancer (SC) poses a global threat to the healthcare system and is expected to increase significantly over the next two decades if not diagnosed at an early stage. Early diagnosis is crucial for successful treatment, as the disease becomes more challenging to cure as it progresses. However, identifying new drugs, achieving clinical success, and overcoming drug resistance remain significant challenges. To overcome these obstacles and provide effective treatment, it is crucial to understand the causes of skin cancer, how cells grow and divide, factors that affect cell growth, and how drug resistance occurs. In this review, we have explained various therapeutic approaches for SC treatment via ligands, targeted photosensitizers, natural and synthetic drugs for the treatment of SC, an epigenetic approach for management of melanoma, photodynamic therapy, and targeted therapy for BRAF-mutated melanoma. This article also provides a detailed summary of the various natural drugs that are effective in managing melanoma and reducing the occurrence of skin cancer at early stages and focuses on the current status and future prospects of various therapies available for the management of skin cancer.
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Affiliation(s)
- Sudharshan
Reddy Dachani
- Department
of Pharmacy Practice, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Al-Dawadmi 11961, Saudi Arabia
| | - Mohammed Kaleem
- Department
of Pharmacology, Babasaheb Balpande College of Pharmacy, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur 440037, Maharashtra, India
| | - Md. Ali Mujtaba
- Department
of Pharmaceutics, Faculty of Pharmacy, Northern
Border University, Arar 91911, Saudi Arabia
| | - Nilesh Mahajan
- Department
of Pharmaceutics, Dabasaheb Balpande College of Pharmacy, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur 440037, Maharashtra, India
| | - Sayyed A. Ali
- Department
of Pharmaceutics, Dabasaheb Balpande College of Pharmacy, Rashtrasant Tukadoji Maharaj Nagpur University, Nagpur 440037, Maharashtra, India
| | - Ali F Almutairy
- Department
of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah 51452, Saudi Arabia
| | - Danish Mahmood
- Department
of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah 51452, Saudi Arabia
| | - Md. Khalid Anwer
- Department
of Pharmaceutics, College of Pharmacy, Prince
Sattam Bin Abdulaziz University, P.O. Box 173, Al-Kharj 11942, Saudi Arabia
| | - Mohammad Daud Ali
- Department
of Pharmacy, Mohammed Al-Mana College for
Medical Sciences, Abdulrazaq Bin Hammam Street, Al Safa 34222, Dammam, Saudi Arabia
| | - Sanjay Kumar
- Department
of Life Sciences, Sharda School of Basic Sciences and Research, Sharda University, Uttar Pradesh 201306, India
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13
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Peirano D, Vargas S, Hidalgo L, Donoso F, Abusleme E, Sanhueza F, Cárdenas C, Droppelmann K, Castro JC, Uribe P, Zoroquiain P, Navarrete-Dechent C. Management of periocular keratinocyte carcinomas with Mohs micrographic surgery and predictors of complex reconstruction: a retrospective study. An Bras Dermatol 2024; 99:202-209. [PMID: 37989688 PMCID: PMC10943309 DOI: 10.1016/j.abd.2023.05.004] [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: 03/14/2023] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Skin cancer is the most frequent cancer worldwide and the most frequent periocular tumor. Keratinocyte Carcinomas (KC) located in periorificial areas, such as periocular tumors, are considered high-risk tumors. Mohs Micrographic Surgery (MMS) is considered the first line for the treatment of high-risk KC, providing a lower recurrence rate than conventional wide excision. OBJECTIVE To describe the clinical-pathological features of periocular KC treated with MMS in a tertiary university center in Chile. METHODS A single-center, retrospective study of patients with KC located on the periocular area, that underwent MMS between 2017‒2022. MMS details were recorded. RESULTS One hundred thirteen patients with periocular carcinomas were included. The mean age was 59 ± 13 years; 52% were women. The most frequent location was the medial canthus (53%), followed by the lower eyelid (30.1%). The most frequent BCC histology was the nodular variant (59.3%). Regarding MMS, the average number of stages was 1.5 ± 0.7, and 54% of the cases required only 1 stage to achieve clear margins. To date, no recurrence has been reported. Tumors larger than 8.5 mm in largest diameter or 43.5 mm2 were more likely to require complex reconstruction. STUDY LIMITATIONS Retrospective design and a relatively low number of patients in the SCC group. Possible selection bias, as larger or more complex cases, may have been referred to oculoplastic surgeons directly. CONCLUSION The present study confirms the role of MMS for the treatment of periocular KCs. Periocular KCs larger than 8.5 mm might require complex reconstruction. These results can be used to counsel patients during pre-surgical visits.
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Affiliation(s)
- Dominga Peirano
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián Vargas
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonel Hidalgo
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisca Donoso
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eugenia Abusleme
- Department of Ophtalmology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Sanhueza
- Department of Ophtalmology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Consuelo Cárdenas
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Katherine Droppelmann
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Camilo Castro
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Uribe
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Zoroquiain
- Department of Pathology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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14
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Li C, Sun C, Mahapatra KD, Riihilä P, Knuutila J, Nissinen L, Lapins J, Kähäri VM, Homey B, Sonkoly E, Pivarcsi A. Long noncoding RNA plasmacytoma variant translocation 1 is overexpressed in cutaneous squamous cell carcinoma and exon 2 is critical for its oncogenicity. Br J Dermatol 2024; 190:415-426. [PMID: 37930852 DOI: 10.1093/bjd/ljad419] [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: 06/30/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) is one of the most common and fastest increasing forms of cancer worldwide with metastatic potential. Long noncoding RNAs (lncRNAs) are a group of RNA molecules with essential regulatory functions in both physiological and pathological processes. OBJECTIVES To investigate the function and mode of action of lncRNA plasmacytoma variant translocation 1 (PVT1) in cSCC. METHODS Quantitative reverse transcriptase polymerase chain reaction and single-molecule in situ hybridization were used to quantify the expression level of PVT1 in normal skin, premalignant skin lesions, actinic keratosis (AK) and primary and metastatic cSCCs. The function of PVT1 in cSCC was investigated both in vivo (tumour xenografts) and in vitro (competitive cell growth assay, 5-ethynyl-2'-deoxyuridine incorporation assay, colony formation assay and tumour spheroid formation assay) upon CRISPR-Cas9-mediated knockout of the entire PVT1 locus, the knockout of exon 2 of PVT1, and locked nucleic acid (LNA) gapmer-mediated PVT1 knockdown. RNA sequencing analysis was conducted to identify genes and processes regulated by PVT1. RESULTS We identified PVT1 as a lncRNA upregulated in cSCC in situ and cSCC, associated with the malignant phenotype of cSCC. We showed that the expression of PVT1 in cSCC was regulated by MYC. Both CRISPR-Cas9 deletion of the entire PVT1 locus and LNA gapmer-mediated knockdown of PVT1 transcript impaired the malignant behaviour of cSCC cells, suggesting that PVT1 is an oncogenic transcript in cSCC. Furthermore, knockout of PVT1 exon 2 inhibited cSCC tumour growth both in vivo and in vitro, demonstrating that exon 2 is a critical element for the oncogenic role of PVT1. Mechanistically, we showed that PVT1 was localized in the cell nucleus and its deletion resulted in cellular senescence, increased cyclin-dependent kinase inhibitor 1 (p21/CDKN1A) expression and cell cycle arrest. CONCLUSIONS Our study revealed a previously unrecognized role for exon 2 of PVT1 in its oncogenic role and that PVT1 suppresses cellular senescence in cSCC. PVT1 may be a potential biomarker and therapeutic target in cSCC.
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Affiliation(s)
- Chen Li
- Department of Medical Biochemistry and Microbiology (IMBIM)
| | - Chengxi Sun
- Department of Medical Biochemistry and Microbiology (IMBIM)
- Department of Clinical Laboratory, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong, China
| | | | - Pilvi Riihilä
- Department of Dermatology
- FICAN West Cancer Research Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Jaakko Knuutila
- Department of Dermatology
- FICAN West Cancer Research Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Liisa Nissinen
- Department of Dermatology
- FICAN West Cancer Research Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Jan Lapins
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Veli-Matti Kähäri
- Department of Dermatology
- FICAN West Cancer Research Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Bernhard Homey
- Department of Dermatology, University Hospital Duesseldorf, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Enikö Sonkoly
- Department of Medical Biochemistry and Microbiology (IMBIM)
- Dermatology and Venereology Division, Department of Medicine Solna
- Dermatology and Venereology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Andor Pivarcsi
- Department of Medical Biochemistry and Microbiology (IMBIM)
- Dermatology and Venereology Division, Department of Medicine Solna
- Dermatology and Venereology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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15
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Bone M, Inman GJ. Exon-specific oncogenic function of the long noncoding RNA plasmacytoma variant translocation 1 in cutaneous squamous cell carcinoma: a promising potential therapeutic target. Br J Dermatol 2024; 190:300-301. [PMID: 38037672 PMCID: PMC10873561 DOI: 10.1093/bjd/ljad476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/08/2023] [Indexed: 12/02/2023]
Affiliation(s)
- Max Bone
- Cancer Research UK Scotland Institute and School of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Gareth J Inman
- Cancer Research UK Scotland Institute and School of Cancer Sciences, University of Glasgow, Glasgow, UK
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16
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Romashin D, Rusanov A, Arzumanian V, Varshaver A, Poverennaya E, Vakhrushev I, Netrusov A, Luzgina N. Exploring the Functions of Mutant p53 through TP53 Knockout in HaCaT Keratinocytes. Curr Issues Mol Biol 2024; 46:1451-1466. [PMID: 38392212 PMCID: PMC10887868 DOI: 10.3390/cimb46020094] [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: 01/02/2024] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Approximately 50% of tumors carry mutations in TP53; thus, evaluation of the features of mutant p53 is crucial to understanding the mechanisms underlying cell transformation and tumor progression. HaCaT keratinocytes represent a valuable model for research in this area since they are considered normal, although they bear two gain-of-function mutations in TP53. In the present study, transcriptomic and proteomic profiling were employed to examine the functions of mutant p53 and to investigate the impact of its complete abolishment. Our findings indicate that CRISPR-mediated TP53 knockout results in significant changes at the transcriptomic and proteomic levels. The knockout of TP53 significantly increased the migration rate and altered the expression of genes associated with invasion, migration, and EMT but suppressed the epidermal differentiation program. These outcomes suggest that, despite being dysfunctional, p53 may still possess oncosuppressive functions. However, despite being considered normal keratinocytes, HaCaT cells exhibit oncogenic properties.
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Affiliation(s)
| | | | | | | | | | | | - Alexander Netrusov
- Faculty of Biology, Lomonosov Moscow State University, Moscow 119234, Russia
- Faculty of Biology and Biotechnology, HSE University, Moscow 101000, Russia
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17
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Izumi T, Teramoto Y, Kamimura A, Doi R, Takai S, Mori T, Koizumi S, Kawahara Y, Aitake U, Lei X, Inomata N, Inafuku K, Nakamura Y. Favorable efficacy of S-1 treatment for locoregionally advanced cutaneous squamous cell carcinoma in the head and neck region. J Dermatol 2024; 51:271-279. [PMID: 38009848 DOI: 10.1111/1346-8138.17057] [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: 10/17/2023] [Revised: 11/08/2023] [Accepted: 11/10/2023] [Indexed: 11/29/2023]
Abstract
Cutaneous squamous cell carcinoma is usually treated with surgery; however, locoregionally advanced cutaneous squamous cell carcinoma can be difficult to resect. Although recent guidelines from Western countries recommend using anti-programmed cell death protein 1 (PD-1) antibodies, including cemiplimab and pembrolizumab, there are no approved anti-PD-1 antibodies for locoregional cutaneous squamous cell carcinoma in Asian countries. S-1 is an oral drug with a low incidence of severe toxicity that can be used for head and neck cancers, including head and neck locoregional cutaneous squamous cell carcinoma, in Japan. We retrospectively evaluated patients with head and neck locoregional cutaneous squamous cell carcinoma treated with S-1 at two Japanese institutions (2008-2022). The initial dosage was determined by the body surface area (<1.25 m2 : 80 mg/day, 1.25-1.5 m2 : 100 mg/day, ≥1.5 m2: 120 mg/day) for 28 consecutive days. The outcome measures were objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). Fourteen patients were included. The ORR was 78%, and the complete response (CR) rate was 64.3%. The median PFS and OS were not reached (NR) (95% confidence interval [CI], 5.9 months-NR) and NR (95% CI, 13.8 months-NR), respectively. The 12-month PFS and OS rates were 51% and 85%, respectively. Six of the nine patients who achieved CR showed no recurrence during the follow-up period (median follow-up, 24.7 months). After CR, three patients experienced recurrence. Among these, two resumed S-1 treatment and subsequently underwent salvage surgery, resulting in a sustained absence of recurrence. One patient developed lung metastasis and died, although S-1 therapy was resumed. Only one patient (7.1%) developed grade 3 anemia. S-1 showed favorable efficacy and low toxicity in patients with head and neck locoregionally advanced cutaneous squamous cell carcinoma. S-1 may be a good alternative to the anti-PD-1 antibody for treating head and neck locoregionally advanced squamous cell carcinoma.
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Affiliation(s)
- Teruaki Izumi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
- Department of Dermatology, Showa University, Tokyo, Japan
| | - Yukiko Teramoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Anna Kamimura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Reiichi Doi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Sayaka Takai
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Tatsuhiko Mori
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shigeru Koizumi
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
- Department of Dermatology, Kimitsu Chuo Hospital, Kisarazu, Japan
| | - Yu Kawahara
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Urara Aitake
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Xiaofeng Lei
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
- Department of Dermatology, Showa University, Tokyo, Japan
| | - Naoko Inomata
- Department of Dermatology, Showa University, Tokyo, Japan
| | - Kazuhiro Inafuku
- Department of Dermatology, Kimitsu Chuo Hospital, Kisarazu, Japan
| | - Yasuhiro Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
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Liu J, Lu J, Wu L, Zhang T, Wu J, Li L, Tai Z, Chen Z, Zhu Q. Targeting tumor-associated macrophages: Novel insights into immunotherapy of skin cancer. J Adv Res 2024:S2090-1232(24)00026-2. [PMID: 38242529 DOI: 10.1016/j.jare.2024.01.013] [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: 11/13/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND The incidence of skin cancer is currently increasing, and conventional treatment options inadequately address the demands of disease management. Fortunately, the recent rapid advancement of immunotherapy, particularly immune checkpoint inhibitors (ICIs), has ushered in a new era for numerous cancer patients. However, the efficacy of immunotherapy remains suboptimal due to the impact of the tumor microenvironment (TME). Tumor-associated macrophages (TAMs), a major component of the TME, play crucial roles in tumor invasion, metastasis, angiogenesis, and immune evasion, significantly impacting tumor development. Consequently, TAMs have gained considerable attention in recent years, and their roles have been extensively studied in various tumors. However, the specific roles of TAMs and their regulatory mechanisms in skin cancer remain unclear. AIM OF REVIEW This paper aims to elucidate the origin and classification of TAMs, investigate the interactions between TAMs and various immune cells, comprehensively understand the precise mechanisms by which TAMs contribute to the pathogenesis of different types of skin cancer, and finally discuss current strategies for targeting TAMs in the treatment of skin cancer. KEY SCIENTIFIC CONCEPTS OF OVERVIEW With a specific emphasis on the interrelationship between TAMs and skin cancer, this paper posits that therapeutic modalities centered on TAMs hold promise in augmenting and harmonizing with prevailing clinical interventions for skin cancer, thereby charting a novel trajectory for advancing the landscape of immunotherapeutic approaches for skin cancer.
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Affiliation(s)
- Jun Liu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Shanghai 200443, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China
| | - Jiaye Lu
- School of Medicine, Shanghai University, 99 Shangda Road, Shanghai 200444, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China
| | - Ling Wu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Shanghai 200443, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China
| | - Tingrui Zhang
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Shanghai 200443, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China
| | - Junchao Wu
- School of Medicine, Shanghai University, 99 Shangda Road, Shanghai 200444, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China
| | - Lisha Li
- School of Medicine, Shanghai University, 99 Shangda Road, Shanghai 200444, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China
| | - Zongguang Tai
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Shanghai 200443, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China.
| | - Zhongjian Chen
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Shanghai 200443, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China.
| | - Quangang Zhu
- Shanghai Skin Disease Hospital, School of Medicine, Tongji University, 1278 Baode Road, Shanghai 200443, China; Shanghai Engineering Research Center of Topical Chinese Medicine, 1278 Baode Road, Shanghai 200443, China.
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Negrutiu M, Danescu S, Popa T, Focșan M, Vesa ȘC, Baican A. Advancements in Basal Cell Carcinoma Diagnosis: Non-Invasive Imaging and Multimodal Approach. J Clin Med 2023; 13:39. [PMID: 38202046 PMCID: PMC10779576 DOI: 10.3390/jcm13010039] [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: 11/11/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: The aim of this study was to correlate the diagnostic criteria described in dermatoscopy, ultrasonography (US), ex vivo confocal microscopy, and histology to the most common subtypes of basal cell carcinoma (BCC). (2) Methods: We conducted a prospective study including 46 BCC cases, which were analyzed with dermatoscopy using the Delta 30 dermatoscope and Vidix 4.0 videodermoscope, with US using a high-resolution 20 MHz linear probe, with confocal microscopy, along with histopathological analysis. (3) Results: This study categorized BCC by histological subtype, with nodular being the most common (84.8%) and various other subtypes represented. US measurements of tumor thickness correlated strongly with the histopathological depth of invasion index (DI). Dermatoscopy analysis revealed significant associations between specific features and BCC subtypes. The DI was directly related to arborized vessels but inversely related to short, fine telangiectasias, maple-leaf-like areas, and spoke-wheel areas. The presence of ulceration was directly related to the DI. Confocal microscopy images exhibited several characteristics, including fluorescence, nuclear crowding, peripheral palisading, clefting, increased nuclear-cytoplasmic (N/C) ratio, and a "cauliflower-like" appearance. (4) Conclusion: The advanced detection of BCC through imagistic techniques like dermatoscopy, confocal microscopy, and ultrasound improves the diagnosis and may offer valuable insights for treatment in the future by evaluating lesion characteristics.
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Affiliation(s)
- Mircea Negrutiu
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
| | - Sorina Danescu
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
| | - Theodor Popa
- Department of Rehabilitation, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Monica Focșan
- Nanobiophotonics and Laser Microspectroscopy Center, Interdisciplinary Research Institute on Bio-Nano-Sciences, Babes-Bolyai University, 400271 Cluj-Napoca, Romania;
| | - Ștefan Cristian Vesa
- Department of Functional Sciences, Discipline of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania;
| | - Adrian Baican
- Department of Dermatology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (M.N.); (A.B.)
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20
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Kovacs D, Flori E, Bastonini E, Mosca S, Migliano E, Cota C, Zaccarini M, Briganti S, Cardinali G. Targeting Fatty Acid Amide Hydrolase Counteracts the Epithelial-to-Mesenchymal Transition in Keratinocyte-Derived Tumors. Int J Mol Sci 2023; 24:17379. [PMID: 38139209 PMCID: PMC10743516 DOI: 10.3390/ijms242417379] [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: 11/22/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
The endocannabinoid system regulates physiological processes, and the modulation of endogenous endocannabinoid (eCB) levels is an attractive tool to contrast the development of pathological skin conditions including cancers. Inhibiting FAAH (fatty acid amide hydrolase), the degradation enzyme of the endocannabinoid anandamide (AEA) leads to the increase in AEA levels, thus enhancing its biological effects. Here, we evaluated the anticancer property of the FAAH inhibitor URB597, investigating its potential to counteract epithelial-to-mesenchymal transition (EMT), a process crucially involved in tumor progression. The effects of the compound were determined in primary human keratinocytes, ex vivo skin explants, and the squamous carcinoma cell line A431. Our results demonstrate that URB597 is able to hinder the EMT process by downregulating mesenchymal markers and reducing migratory potential. These effects are associated with the dampening of the AKT/STAT3 signal pathways and reduced release of pro-inflammatory cytokines and tumorigenic lipid species. The ability of URB597 to contrast the EMT process provides insight into effective approaches that may also include the use of FAAH inhibitors for the treatment of skin cancers.
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Affiliation(s)
- Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Enrica Flori
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Emanuela Bastonini
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Sarah Mosca
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Emilia Migliano
- Department of Plastic and Reconstructive Surgery, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy;
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (C.C.); (M.Z.)
| | - Marco Zaccarini
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (C.C.); (M.Z.)
| | - Stefania Briganti
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
| | - Giorgia Cardinali
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy; (D.K.); (E.F.); (E.B.); (S.M.); (S.B.)
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21
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Qin N, Ma J, Lee EH, Barker CA. Quality of Life Before and After Radiation Therapy for Early-Stage Keratinocyte Carcinoma: A Longitudinal Analysis. Int J Radiat Oncol Biol Phys 2023; 117:1090-1095. [PMID: 37791935 DOI: 10.1016/j.ijrobp.2023.05.044] [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: 03/17/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Little is known about patient-reported quality of life (QOL) before and after radiotherapy (RT) for early keratinocyte carcinoma (KC). The present study tested the hypothesis that QOL is hypothesized to deteriorate soon after RT, with subsequent improvement of a magnitude similar to other KC treatments. METHODS AND MATERIALS This observational study assessed prospectively collected longitudinal patient-reported QOL data at a single center. Patients undergoing external beam RT for early-stage (T0-2, <4 cm) KC that completed the Skindex-16 (S16) or Skin Cancer Index (SCI) before and at least once after RT were included. These indices include subscales of symptoms, emotions, and functioning for S16 and emotional, social, and appearance for SCI. RESULTS 81 patients (median age 79 years) were treated for early KC, most being basal cell carcinomas (87%) on the face (80%) an average of 1.3 cm in diameter. Composite S16 scores and total SCI scores showed significant, clinically meaningful improvements at 3 months and 6 weeks after RT, respectively. QOL declined at 6 weeks after treatment on the S16 symptoms subscale. Concurrently, S16 and SCI emotional subscales significantly improved, and this trend persisted for 2+ years. Improvements in S16 functioning and SCI social and appearance QOL occurred after RT. The magnitude of improvement in QOL 3-12 months after RT was comparable to what has been previously reported after other types of KC treatments, like surgery. CONCLUSIONS QOL related to symptoms deteriorates during the first 6 weeks after RT for early KC, but it improves by 3 months. QOL related to emotions, functioning, social, and appearance all improve after RT. These changes in QOL are similar to those observed after other treatments of early KC.
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Affiliation(s)
- Nancy Qin
- Departments of Radiation Oncology and
| | | | - Erica H Lee
- Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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22
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Mortaja M, Demehri S. Skin cancer prevention - Recent advances and unmet challenges. Cancer Lett 2023; 575:216406. [PMID: 37734530 DOI: 10.1016/j.canlet.2023.216406] [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: 07/07/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common malignancy in the world. Among many identified risk factors, immunosuppression is a major factor that contributes to cSCC development. Organ transplant recipients (OTRs) are at markedly increased risk of developing multiple cSCCs with a propensity for advanced metastatic disease, leading to significant morbidity and mortality. The severity of the cSCC phenotype in OTRs highlights the urgent need to identify effective preventive modalities in this population. Despite recent advances in skin cancer prevention (e.g., nicotinamide) and treatment (e.g., immune checkpoint blockade), these modalities have limited utility in OTRs due to the lack of efficacy or significant side effect. Topical treatments against precancerous skin lesions, actinic keratosis (AK), remain the primary strategy to prevent cSCC in OTRs, which also have significant deficiencies in this population. Herein, we review the epidemiology, risk factors, and current cSCC prevention strategies. We highlight the gaps and future clinical strategies to address cSCC risk in high-risk populations.
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Affiliation(s)
- Mahsa Mortaja
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Shadmehr Demehri
- Center for Cancer Immunology and Cutaneous Biology Research Center, Department of Dermatology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA.
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23
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Maher NG, Prosser N, Aivazian K, Colebatch AJ, Ferguson PM, Karim RZ, McKenzie CA, Rawson RV, Lo SN, Scolyer RA. Inter-rater concordance of basal cell carcinoma subtypes: influences on reporting format and opportunities for further classification modifications. Pathology 2023; 55:800-805. [PMID: 37393148 DOI: 10.1016/j.pathol.2023.04.003] [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: 11/28/2022] [Revised: 03/02/2023] [Accepted: 04/03/2023] [Indexed: 07/03/2023]
Abstract
Diagnosis of basal cell carcinoma (BCC) higher risk subtypes influences management strategies because of their propensity to recur locally. Subtyping is prone to inter-observer variability, and subtyping definitions are inconsistently applied. This study sought to compare the interobserver reproducibility of individual BCC subtypes using the 4th edition World Health Organization (WHO) Classification of Skin Tumours (CoST) definitions, with classification into lower and higher risk histological subtype groups. Ninety-one BCC cases were rated by seven pathologists, noting the presence of BCC subtype(s), and providing a higher or lower risk subtype grouping per case. Raters were provided with definitions as per the 4th edition WHO CoST for 10 listed BCC subtypes. Surgical specimen type was noted. Subgroup analysis was performed to exclude cases when the tumour deep front was not well visualised, or there was tangential sectioning (n = 6). Light's kappa was used to assess inter-rater reliability. From the total group (n = 91), five BCC subtypes showed a sufficient number of ratings for computing a κ statistic. From these five subtypes, superficial subtype showed substantial inter-rater agreement (κ = 0.64), and the other four subtypes showed moderate inter-rater agreement [nodular (κ = 0.45), sclerosing/morphoeic (κ = 0.45), infiltrating (κ = 0.49) and micronodular (κ = 0.57)]. Two-tiered rating into either higher or lower risk subtype showed substantial inter-rater agreement (κ = 0.72). Our results suggest a need to more precisely define BCC subtypes. We suggest reporting BCC subtype using a two-tiered risk grouping, followed by specific subtypes present. Further studies examining the inter-rater reliability of less common BCC subtypes are required.
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Affiliation(s)
- Nigel G Maher
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Natasha Prosser
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia
| | - Karina Aivazian
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Andrew J Colebatch
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Peter M Ferguson
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Rooshdiya Z Karim
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Catriona A McKenzie
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Robert V Rawson
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Serigne N Lo
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Richard A Scolyer
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
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Tietze JK, Heuschkel M, Krönert MIC, Kurth J, Bandow G, Ojak G, Grünwald P, Herold JI, Thiem A, Dreßler M, Krause BJ, Emmert S, Schwarzenböck SM. Topical 188Re Ionizing Radiation Therapy Exerts High Efficacy in Curing Nonmelanoma Skin Cancer. Clin Nucl Med 2023; 48:869-876. [PMID: 37682602 DOI: 10.1097/rlu.0000000000004824] [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: 09/09/2023]
Abstract
PURPOSE OF THE REPORT Nonmelanoma skin cancer (NMSC) is the most frequent malignancy. Surgical intervention is the common treatment but may lead to disappointing results; alternative treatment options are needed. METHODS In this monocentric pilot study, topical 188Re resin was investigated as a treatment for invasive NMSC up to 3-mm thickness. Twenty-two patients with 40 histologically confirmed NMSCs with a median size of 1.25 cm2 (range, 0.04-16.8 cm2) and a median tumor thickness of 0.35 mm (range, 0.1-2.1 mm) were included. Patients were treated once with 188Re resin with a targeted dose of 50 Gy. The median applied activity was 111.4 MBq (range, 21.0-168.0 MBq), and the median treatment time was 89 minutes (range, 38-175 minutes). The response rate, adverse events, and cosmetic outcome were assessed at 14 days, 4 months, and 12 months. RESULTS Response rate at 12 months was 97.5%, with 95% complete responses (clinically or histologically proven in case of clinical doubt). Most adverse events were reported at 14 days, with 20% itching and 12.5% mostly minor pain. Forty-nine percent of the lesions showed hypopigmentation only at 12 months. Forty-one percent of the lesions were graded as cosmetically superior to the expected result after surgery and 51.3% as comparable to successful surgery. The cosmetic outcome on the head and face was superior compared with the trunk and leg (P = 0.003). CONCLUSION 188Re resin is a highly effective treatment for NMSC up to 3-mm thickness and a valid alternative to surgery, specifically for tumors located on sensitive areas such as nose or ear.
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Affiliation(s)
- Julia K Tietze
- From the Clinic and Policlinic for Dermatology and Venereology
| | - Martin Heuschkel
- Department of Nuclear Medicine, University Medical Center Rostock, Rostock, Germany
| | | | - Jens Kurth
- Department of Nuclear Medicine, University Medical Center Rostock, Rostock, Germany
| | - Gesine Bandow
- From the Clinic and Policlinic for Dermatology and Venereology
| | - Gregor Ojak
- From the Clinic and Policlinic for Dermatology and Venereology
| | - Pavel Grünwald
- From the Clinic and Policlinic for Dermatology and Venereology
| | | | - Alexander Thiem
- From the Clinic and Policlinic for Dermatology and Venereology
| | - Miriam Dreßler
- From the Clinic and Policlinic for Dermatology and Venereology
| | - Bernd J Krause
- Department of Nuclear Medicine, University Medical Center Rostock, Rostock, Germany
| | - Steffen Emmert
- From the Clinic and Policlinic for Dermatology and Venereology
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25
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Tang H, Seykora JT, Ko CJ. Squamous carcinogenesis: potential truncal mutations. Hum Pathol 2023; 140:32-38. [PMID: 37001739 DOI: 10.1016/j.humpath.2023.03.016] [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: 01/31/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Squamous carcinogenesis is incompletely understood, but more recent genetic studies support that the order of acquired mutations is important. This paper will review more recent genetic studies with an emphasis on the potential truncal mutations, mutations critical to the trunk of the cancer evolutionary tree, in actinic keratosis, squamous cell carcinoma in situ, cutaneous squamous cell carcinoma, keratoacanthoma, and keratoacanthoma-like squamous proliferation.
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Affiliation(s)
- Haiming Tang
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, 06510, USA.
| | - John T Seykora
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christine J Ko
- Department of Pathology, School of Medicine, Yale University, New Haven, CT, 06510, USA; Department of Dermatology, School of Medicine, Yale University, New Haven, CT, 06510, USA
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26
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Matts PJ, Nash JF. Sunscreens - another endangered species? Int J Cosmet Sci 2023; 45 Suppl 1:20-32. [PMID: 37799079 DOI: 10.1111/ics.12902] [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: 03/10/2023] [Revised: 04/28/2023] [Accepted: 05/10/2023] [Indexed: 10/07/2023]
Abstract
Skin cancer continues to increase in incidence year-on-year and represents the most common form of cancer across the globe. Every human undergoes premature ageing, particularly on the face, neck and hands. Both phenomena are driven primarily by chronic, daily exposure to solar ultraviolet radiation (UVR). While sunscreen products play a primary role in the prevention of UVR skin damage, the active ingredients, i.e., UVR filters, are facing unprecedented challenges in the coming 10 years and their future is by no means certain. This article, therefore, reviews afresh the facts around photoprotection and the role of sunscreen products in the prevention of acute (sunburn) and chronic (cancer, photoageing) skin damage and compares/contrasts these with various emerging questions and opinions around UVR filter technology. We present a passionate defence of this remarkable technology, but also attempt to imagine a world without it.
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Affiliation(s)
- Paul J Matts
- The Procter & Gamble Company, Reading, Berkshire, UK
| | - J Frank Nash
- The Procter & Gamble Company, Cincinnati OH, USA
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27
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Jansen FM, den Broeder N, Lubeek SFK, Savelkoul EHJ, Marcus CM, Hoentjen F, van Dop WA. Cumulative thiopurine dosing and keratinocyte skin cancer in inflammatory bowel disease: a case-control study. Eur J Gastroenterol Hepatol 2023; 35:1123-1130. [PMID: 37665613 DOI: 10.1097/meg.0000000000002617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND AND AIM Patients with inflammatory bowel disease (IBD) treated with thiopurines are at increased risk of keratinocyte skin cancer (KSC). Most international guidelines recommend yearly dermatological screening of thiopurine-treated patients. Whether the association between the development of KSC and the use of thiopurines is dose-dependent remains unclear. The aim of this study was to investigate the association between the cumulative thiopurine dose and KSC development in patients with IBD which can be helpful to assist in further skin cancer risk stratification and personalization of screening recommendations in patients with IBD. METHODS We performed a single-center case-control study, including patients with IBD with and without a history of KSC (cases and controls, respectively). The primary outcome was the association of cumulative azathioprine, mercaptopurine and thioguanine dose with KSC development. Univariable and multivariable logistic regression analyses were performed, the latter corrected for age and smoking, known risk factors of KSC. RESULTS We included 50 cases and 150 controls, predominantly white population. Age and current azathioprine use were univariably significantly associated with KSC development. In multivariable logistic regression analyses, age at inclusion remained significantly associated. Cumulative doses of thiopurines (separate or combined) or duration of thiopurine use did not impact KSC risk, also after correcting for age and smoking. CONCLUSION Cumulative thiopurine dose and duration did not show an association with KSC development. Future KSC risk stratification, based on all available KSC risk factors, may aid in selecting individuals who can benefit most from dermatologic screening programs.
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Affiliation(s)
- Fenna M Jansen
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences
| | - Nathan den Broeder
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences
| | - Satish F K Lubeek
- Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Edo H J Savelkoul
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences
| | - Carlijne M Marcus
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences
| | - Frank Hoentjen
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Willemijn A van Dop
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Radboud Institute for Molecular Life Sciences
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Caruntu C, Ilie MA, Neagu M. Looking into the Skin in Health and Disease: From Microscopy Imaging Techniques to Molecular Analysis. Int J Mol Sci 2023; 24:13737. [PMID: 37762038 PMCID: PMC10531494 DOI: 10.3390/ijms241813737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
The skin is a complex organ that includes a wide variety of tissue types with different embryological origins [...].
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Affiliation(s)
- Constantin Caruntu
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | | | - Monica Neagu
- Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, 050095 Bucharest, Romania;
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
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Navarrete-Dechent C, Mori S, Connolly K, Shah K, Dusza SW, Rossi AM, Lee EH, Busam KJ, Nehal KS. Staging System Performance and Clinical Outcomes for Cutaneous Squamous Cell Carcinoma of the Ear: A Single-Center Retrospective Study. Dermatol Surg 2023; 49:747-754. [PMID: 37235869 PMCID: PMC10524321 DOI: 10.1097/dss.0000000000003842] [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] [Indexed: 05/28/2023]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) of the ear is associated with poor outcomes. No studies have evaluated current staging system performance in this specific location. OBJECTIVE Describe clinicopathologic characteristics and outcomes of ear cSCC and evaluate the performance of current staging systems. METHODS Retrospective study including cases diagnosed and treated at a cancer center from January 2000 to December 2014. Demographic, clinical, and pathologic data were collected from clinical records. Biopsy slides were rereviewed and patients were staged according to the American Joint Committee on Cancer (AJCC) seventh, eighth, and Brigham Women's Hospital (BWH) staging. RESULTS Of 125 patients, the mean age at diagnosis was 71.9 years (SD 12.5), with most men (89.6%, n = 112). Median follow-up was 22.3 months. Local recurrence and survival risk factors were similar to cSCC outside the ear. The Akaike's Information Criterion (AIC) estimates showed that the BWH system better predicted outcomes than the AJCC seventh, and the AJCC eighth, with AIC values of 189.9, 270.5, and 274.1, respectively. Limitations of the study include retrospective design, single center study, and no control group. CONCLUSION Current staging systems perform well at stratifying risk in ear cSCC.
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Affiliation(s)
- Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shoko Mori
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Dermatology, Weill Cornell Medicine, New York, NY, USA
| | - Karen Connolly
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kalee Shah
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stephen W. Dusza
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anthony M. Rossi
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erica H. Lee
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Klaus J. Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kishwer S. Nehal
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Li C, Sun C, Lohcharoenkal W, Ali MM, Xing P, Zheng W, Görgens A, Gustafsson MO, El Andaloussi S, Sonkoly E, Pivarcsi A. Cutaneous squamous cell carcinoma-derived extracellular vesicles exert an oncogenic role by activating cancer-associated fibroblasts. Cell Death Discov 2023; 9:260. [PMID: 37495566 PMCID: PMC10372068 DOI: 10.1038/s41420-023-01555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is a fast-increasing cancer with metastatic potential. Extracellular vesicles (EVs) are small membrane-bound vesicles that play important roles in intercellular communication, particularly in the tumor microenvironment (TME). Here we report that cSCC cells secrete an increased number of EVs relative to normal human epidermal keratinocytes (NHEKs) and that interfering with the capacity of cSCC to secrete EVs inhibits tumor growth in vivo in a xenograft model of human cSCC. Transcriptome analysis of tumor xenografts by RNA-sequencing enabling the simultaneous quantification of both the human and the mouse transcripts revealed that impaired EV-production of cSCC cells prominently altered the phenotype of stromal cells, in particular genes related to extracellular matrix (ECM)-formation and epithelial-mesenchymal transition (EMT). In line with these results, co-culturing of human dermal fibroblasts (HDFs) with cSCC cells, but not with normal keratinocytes in vitro resulted in acquisition of cancer-associated fibroblast (CAF) phenotype. Interestingly, EVs derived from metastatic cSCC cells, but not primary cSCCs or NHEKs, were efficient in converting HDFs to CAFs. Multiplex bead-based flow cytometry assay and mass-spectrometry (MS)-based proteomic analyses revealed the heterogenous cargo of cSCC-derived EVs and that especially EVs derived from metastatic cSCCs carry proteins associated with EV-biogenesis, EMT, and cell migration. Mechanistically, EVs from metastatic cSCC cells result in the activation of TGFβ signaling in HDFs. Altogether, our study suggests that cSCC-derived EVs mediate cancer-stroma communication, in particular the conversion of fibroblasts to CAFs, which eventually contribute to cSCC progression.
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Affiliation(s)
- Chen Li
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Dermatology and Venereology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Chengxi Sun
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Department of Clinical Laboratory, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Warangkana Lohcharoenkal
- Unit of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, SE, 17176, Sweden
| | - Mohamad Moustafa Ali
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Pengwei Xing
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Wenyi Zheng
- Department of Laboratory Medicine, Clinical Research Center, Karolinska Institutet, Stockholm, Sweden
| | - André Görgens
- Department of Laboratory Medicine, Clinical Research Center, Karolinska Institutet, Stockholm, Sweden
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Manuela O Gustafsson
- Department of Laboratory Medicine, Clinical Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Samir El Andaloussi
- Department of Laboratory Medicine, Clinical Research Center, Karolinska Institutet, Stockholm, Sweden
| | - Enikö Sonkoly
- Dermatology and Venereology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Unit of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, SE, 17176, Sweden
| | - Andor Pivarcsi
- Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden.
- Dermatology and Venereology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
- Unit of Dermatology and Venerology, Department of Medicine, Karolinska Institutet, Stockholm, SE, 17176, Sweden.
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31
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Hope RH, Dowdle TS, Hope L, Pruneda C. Mohs micrographic surgery for keratinocyte carcinomas: clinicopathological predictors of the number of stages. Proc AMIA Symp 2023; 36:608-615. [PMID: 37614851 PMCID: PMC10444016 DOI: 10.1080/08998280.2023.2236478] [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: 05/03/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 08/25/2023] Open
Abstract
Background The number of Mohs stages needed to remove a keratinocyte carcinoma affects resource use, expenses, and repair complexity. This study aimed to identify clinicopathological predictors associated with increased or decreased stages and areas for further research. Methods A retrospective review was conducted from a single private practice with two Mohs surgeons of 2788 consecutive Mohs cases between January 2017 and December 2021, analyzing the average number of stages taken versus national norms (P = 0.21) and subgroups using unpaired t tests (*<0.05). Results Several tumor features were significantly associated with fewer stages: squamous cell carcinomas, Mohs appropriate use criteria score of 7 or 8, preoperative size <0.25 cm2, tumors on the lips and extremities (including hands/fingers), and smoking. Clinicopathological features significantly associated with more stages included Mohs appropriate use criteria score of 9, recurrent skin cancers, basal cell carcinomas, tumor size of 2.25-3.99 cm2, cancers on ears, solid organ transplant patients, treatment delays >180 days, and patients ≥90 years old. Conclusions Significant predictors exist for both increased and decreased numbers of Mohs micrographic surgery stages required to eradicate a tumor, which may help Mohs surgeons facilitate, plan, and allocate resources more effectively. Areas for further research in Mohs micrographic surgery are identified.
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Affiliation(s)
- Richard H. Hope
- Lubbock Dermatology and Skin Cancer Center, Lubbock, Texas, USA
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Travis S. Dowdle
- Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota, USA
| | - Landon Hope
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Corley Pruneda
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Lin A, Schmalbach CE. Surgery in the Era of Immunotherapy for Advanced Head and Neck Non-melanoma Skin Cancer. Curr Oncol Rep 2023; 25:735-742. [PMID: 37010785 DOI: 10.1007/s11912-023-01391-8] [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] [Accepted: 01/17/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE OF REVIEW Surgery remains the mainstay of treatment for non-melanoma skin cancer (NMSC). Immunotherapy (IO) has emerged as an alternative option. This review provides a contemporary summary of how to incorporate IO into the management of advanced NMSC. Evidence-based outcomes and recent clinical trials are provided with emphasis on the three most common NMSC diagnoses: cutaneous squamous cell carcinoma (cSCC), basal cell carcinoma (BCC), and merkel cell carcinoma (MCC). RECENT FINDINGS Surgical resection while preserving form and function remains the standard of care for the majority of NMSCs. In recalcitrant cases failing traditional surgery and/or primary radiation, patient ineligible for such treatments, or unresectable disease, IO has emerged as a promising alternative. In the majority of cases, it is a supplanting primary chemotherapy. Surgery remains the standard of care for NMSC. Immunotherapy has emerged as an alternative option for non-surgical candidates and as a neoadjuvant means to minimize morbidity.
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Affiliation(s)
- Alice Lin
- Department of Otolaryngology-Head and Neck Surgery, Kaiser Permanente School of Medicine, Pasadena, CA, USA
| | - Cecelia E Schmalbach
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
- Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
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Kuo AM, Lee EH, Rossi AM, Nehal KS, Cordova MA, Steckler AM, Lian M, Cohen G, Zhang Z, Zelefsky MJ, Kasper ME, Barker CA. A Multicenter Prospective Trial of Electronic Skin Surface Brachytherapy for Keratinocyte Carcinoma: Early Cosmesis, Quality of Life, and Adverse Events. Int J Radiat Oncol Biol Phys 2023; 116:544-550. [PMID: 36586493 PMCID: PMC10686635 DOI: 10.1016/j.ijrobp.2022.12.032] [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: 06/16/2022] [Revised: 11/29/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Keratinocyte carcinomas are amenable to many treatments, including radiation therapy (RT). Electronic skin surface brachytherapy (ESSB) enables the precise delivery of radiation without radioisotopes. In this prospective multicenter clinical trial, we characterized early outcomes of ESSB prospectively through both patient- and clinician-reported measures. To corroborate the cosmesis observations, we also assessed patient-reported quality of life (QoL) and adverse events. METHODS AND MATERIALS Patients ≥60 years old with stage T1N0M0 keratinocyte carcinoma were treated with ESSB. At 2-, 6-, and 12-weeks post-treatment, cosmesis from ESSB was assessed by both the patient and a clinician study investigator as either "good," "fair," or "bad." The Skindex-16 and the Skin Cancer Index (SCI) were used to assess patient QoL before and after treatment. Adverse events were assessed using the Common Toxicity Criteria for Adverse Events, version 4.0. RESULTS Cosmesis and QoL were collected at 97% (99/102) of possible patient follow-up times. By 12 weeks post-treatment, 93.9% (31/33) of patient-reported and 96.9% (31/32) of clinician-reported cosmesis outcomes were "good." Compared with baseline, total Skindex-16 score significantly deteriorated at 2 weeks post-treatment (10.5 vs 24.5, P <.001), but significantly improved at 6 weeks (10.5 vs 4.7, P = .014) and 12 weeks (10.5 vs 2.1, P = .001) post-treatment. The total SCI score significantly improved from baseline to 6 weeks (78.4 vs 89.0, P = .001) post-treatment. The most frequent adverse events were radiation dermatitis, skin pain, and pruritus. All adverse events resolved to Grade ≤1 by 12 weeks post-treatment. CONCLUSIONS This prospective, multicenter study demonstrated that ESSB is associated with a high rate of "good" early patient-reported cosmesis and increasing QoL and satisfaction with time. Validated assessments demonstrated a significant improvement in quality of life and resolution of moderate early adverse events by 6 to 12 weeks after treatment and corroborate the observation of favorable cosmesis.
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Affiliation(s)
- Alyce M. Kuo
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Erica H. Lee
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | | | | | - Ming Lian
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gil’ad Cohen
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Zhigang Zhang
- Memorial Sloan Kettering Cancer Center, New York, NY
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Haasler L, von Montfort C, Kondadi AK, Golombek M, Ebbert L, Wenzel CK, Stahl W, Reichert AS, Brenneisen P. Involvement of necroptosis in the selective toxicity of the natural compound (±) gossypol on squamous skin cancer cells in vitro. Arch Toxicol 2023; 97:1997-2014. [PMID: 37210688 PMCID: PMC10256661 DOI: 10.1007/s00204-023-03516-1] [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: 12/21/2022] [Accepted: 05/08/2023] [Indexed: 05/22/2023]
Abstract
Cutaneous basal and squamous cell carcinoma reflect the first and second most common type of non-melanoma skin cancer, respectively. Especially cutaneous squamous cell carcinoma has the tendency to metastasize, finally resulting in a rather poor prognosis. Therapeutic options comprise surgery, radiation therapy, and a systemic or targeted chemotherapy. There are some good treatment results, but overall, the response rate of newly developed drugs is still modest. Drug repurposing represents an alternative approach where already available and clinically approved substances are used, which originally intended for other clinical benefits. In this context, we tested the effect of the naturally occurring polyphenolic aldehyde (±) gossypol with concentrations between 1 and 5 µM on the invasive squamous cell carcinoma cell line SCL-1 and normal human epidermal keratinocytes. Gossypol treatment up to 96 h resulted in a selective cytotoxicity of SCL-1 cells (IC50: 1.7 µM, 96 h) compared with normal keratinocytes (IC50: ≥ 5.4 µM, 96 h) which is mediated by mitochondrial dysfunction and finally leading to necroptotic cell death. Taken together, gossypol shows a high potential as an alternative anticancer drug for the treatment of cutaneous squamous cell carcinoma.
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Affiliation(s)
- Lisa Haasler
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Claudia von Montfort
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Arun Kumar Kondadi
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Mathias Golombek
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Lara Ebbert
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Chantal-Kristin Wenzel
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Wilhelm Stahl
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Andreas S Reichert
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Peter Brenneisen
- Institute of Biochemistry and Molecular Biology I, Medical Faculty, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany.
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Gantchev J, Messina-Pacheco J, Martínez Villarreal A, Ramchatesingh B, Lefrançois P, Xie P, Amar L, Xu HH, Raveendra K, Sikorski D, Guerra Ordaz DJ, Gill RPK, Lambert M, Litvinov IV. Ectopically Expressed Meiosis-Specific Cancer Testis Antigen HORMAD1 Promotes Genomic Instability in Squamous Cell Carcinomas. Cells 2023; 12:1627. [PMID: 37371097 DOI: 10.3390/cells12121627] [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: 03/29/2023] [Revised: 05/29/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Genomic instability is a prominent hallmark of cancer, however the mechanisms that drive and sustain this process remain elusive. Research demonstrates that numerous cancers with increased levels of genomic instability ectopically express meiosis-specific genes and undergo meiomitosis, the clash of mitotic and meiotic processes. These meiotic genes may represent novel therapeutic targets for the treatment of cancer. We studied the relationship between the expression of the meiosis protein HORMAD1 and genomic instability in squamous cell carcinomas (SCCs). First, we assessed markers of DNA damage and genomic instability following knockdown and overexpression of HORMAD1 in different cell lines representing SCCs and epithelial cancers. shRNA-mediated depletion of HORMAD1 expression resulted in increased genomic instability, DNA damage, increased sensitivity to etoposide, and decreased expression of DNA damage response/repair genes. Conversely, overexpression of HORMAD1 exhibited protective effects leading to decreased DNA damage, enhanced survival and decreased sensitivity to etoposide. Furthermore, we identified a meiotic molecular pathway that regulates HORMAD1 expression by targeting the upstream meiosis transcription factor STRA8. Our results highlight a specific relationship between HORMAD1 and genomic instability in SCCs, suggesting that selectively inhibiting HORMAD1, possibly, through STRA8 signaling, may provide a new paradigm of treatment options for HORMAD1-expressing SCCs.
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Affiliation(s)
- Jennifer Gantchev
- Research Institute of McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Julia Messina-Pacheco
- Research Institute of McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Department of Pathology, McGill University, Montreal, QC H4A 3J1, Canada
| | | | | | - Philippe Lefrançois
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Pingxing Xie
- Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Laetitia Amar
- Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | - Hong Hao Xu
- Faculty of Medicine, Laval University, Quebec City, QC G1V 0A6, Canada
| | | | - Daniel Sikorski
- Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | | | | | - Marine Lambert
- Research Institute of McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Ivan V Litvinov
- Research Institute of McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Division of Dermatology, Department of Medicine, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
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Winge MCG, Kellman LN, Guo K, Tang JY, Swetter SM, Aasi SZ, Sarin KY, Chang ALS, Khavari PA. Advances in cutaneous squamous cell carcinoma. Nat Rev Cancer 2023:10.1038/s41568-023-00583-5. [PMID: 37286893 DOI: 10.1038/s41568-023-00583-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 06/09/2023]
Abstract
Human malignancies arise predominantly in tissues of epithelial origin, where the stepwise transformation from healthy epithelium to premalignant dysplasia to invasive neoplasia involves sequential dysregulation of biological networks that govern essential functions of epithelial homeostasis. Cutaneous squamous cell carcinoma (cSCC) is a prototype epithelial malignancy, often with a high tumour mutational burden. A plethora of risk genes, dominated by UV-induced sun damage, drive disease progression in conjunction with stromal interactions and local immunomodulation, enabling continuous tumour growth. Recent studies have identified subpopulations of SCC cells that specifically interact with the tumour microenvironment. These advances, along with increased knowledge of the impact of germline genetics and somatic mutations on cSCC development, have led to a greater appreciation of the complexity of skin cancer pathogenesis and have enabled progress in neoadjuvant immunotherapy, which has improved pathological complete response rates. Although measures for the prevention and therapeutic management of cSCC are associated with clinical benefit, the prognosis remains poor for advanced disease. Elucidating how the genetic mechanisms that drive cSCC interact with the tumour microenvironment is a current focus in efforts to understand, prevent and treat cSCC.
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Affiliation(s)
- Mårten C G Winge
- Program in Epithelial Biology, Stanford University, Stanford, CA, USA
- Department of Dermatology, Stanford University, Redwood City, CA, USA
| | - Laura N Kellman
- Program in Epithelial Biology, Stanford University, Stanford, CA, USA
- Stanford Cancer Institute, Stanford University, Stanford, CA, USA
- Stanford Program in Cancer Biology, Stanford University, Stanford, CA, USA
| | - Konnie Guo
- Program in Epithelial Biology, Stanford University, Stanford, CA, USA
| | - Jean Y Tang
- Department of Dermatology, Stanford University, Redwood City, CA, USA
| | - Susan M Swetter
- Department of Dermatology, Stanford University, Redwood City, CA, USA
- Stanford Cancer Institute, Stanford University, Stanford, CA, USA
- Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA
| | - Sumaira Z Aasi
- Department of Dermatology, Stanford University, Redwood City, CA, USA
| | - Kavita Y Sarin
- Department of Dermatology, Stanford University, Redwood City, CA, USA
| | - Anne Lynn S Chang
- Department of Dermatology, Stanford University, Redwood City, CA, USA
| | - Paul A Khavari
- Program in Epithelial Biology, Stanford University, Stanford, CA, USA.
- Department of Dermatology, Stanford University, Redwood City, CA, USA.
- Stanford Cancer Institute, Stanford University, Stanford, CA, USA.
- Stanford Program in Cancer Biology, Stanford University, Stanford, CA, USA.
- Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA.
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37
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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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Levra Levron C, Watanabe M, Proserpio V, Piacenti G, Lauria A, Kaltenbach S, Tamburrini A, Nohara T, Anselmi F, Duval C, Elettrico L, Donna D, Conti L, Baev D, Natsuga K, Hagai T, Oliviero S, Donati G. Tissue memory relies on stem cell priming in distal undamaged areas. Nat Cell Biol 2023; 25:740-753. [PMID: 37081165 DOI: 10.1038/s41556-023-01120-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 02/28/2023] [Indexed: 04/22/2023]
Abstract
Epithelial cells that participated in wound repair elicit a more efficient response to future injuries, which is believed to be locally restricted. Here we show that cell adaptation resulting from a localized tissue damage has a wide spatial impact at a scale not previously appreciated. We demonstrate that a specific stem cell population, distant from the original injury, originates long-lasting wound memory progenitors residing in their own niche. Notably, these distal memory cells have not taken part in the first healing but become intrinsically pre-activated through priming. This cell state, maintained at the chromatin and transcriptional level, leads to an enhanced wound repair that is partially recapitulated through epigenetic perturbation. Importantly wound memory has long-term harmful consequences, exacerbating tumourigenesis. Overall, we show that sub-organ-scale adaptation to injury relies on spatially organized memory-dedicated progenitors, characterized by an actionable cell state that establishes an epigenetic field cancerization and predisposes to tumour onset.
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Affiliation(s)
- Chiara Levra Levron
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
| | - Mika Watanabe
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
| | - Valentina Proserpio
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
- Italian Institute for Genomic Medicine, Candiolo (TO), Italy
| | - Gabriele Piacenti
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
| | - Andrea Lauria
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
- Italian Institute for Genomic Medicine, Candiolo (TO), Italy
| | - Stefan Kaltenbach
- Shmunis School of Biomedicine and Cancer Research, George S Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Annalaura Tamburrini
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
- Italian Institute for Genomic Medicine, Candiolo (TO), Italy
| | - Takuma Nohara
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Francesca Anselmi
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
| | - Carlotta Duval
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
| | - Luca Elettrico
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
| | - Daniela Donna
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
| | - Laura Conti
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Torino, Italy
| | - Denis Baev
- Italian Institute for Genomic Medicine, Candiolo (TO), Italy
| | - Ken Natsuga
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Tzachi Hagai
- Shmunis School of Biomedicine and Cancer Research, George S Wise Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Salvatore Oliviero
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy
- Italian Institute for Genomic Medicine, Candiolo (TO), Italy
| | - Giacomo Donati
- Department of Life Sciences and Systems Biology, University of Turin, Torino, Italy.
- Molecular Biotechnology Center 'Guido Tarone', University of Turin, Torino, Italy.
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Sendín-Martín M, Posner J, Harris U, Moronta M, Conejo-Mir Sánchez J, Mukherjee S, Rajadhyaksha M, Kose K, Jain M. Quantitative collagen analysis using second harmonic generation images for the detection of basal cell carcinoma with ex vivo multiphoton microscopy. Exp Dermatol 2023; 32:392-402. [PMID: 36409162 PMCID: PMC10478030 DOI: 10.1111/exd.14713] [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: 08/23/2022] [Revised: 10/22/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer, and its incidence is rising. Millions of benign biopsies are performed annually for BCC diagnosis, increasing morbidity, and healthcare costs. Non-invasive in vivo technologies such as multiphoton microscopy (MPM) can aid in diagnosing BCC, reducing the need for biopsies. Furthermore, the second harmonic generation (SHG) signal generated from MPM can classify and prognosticate cancers based on extracellular matrix changes, especially collagen type I. We explored the potential of MPM to differentiate collagen changes associated with different BCC subtypes compared to normal skin structures and benign lesions. Quantitative analysis such as frequency band energy analysis in Fourier domain, CurveAlign and CT-FIRE fibre analysis was performed on SHG images from 52 BCC and 12 benign lesions samples. Our results showed that collagen distribution is more aligned surrounding BCCs nests compared to the skin's normal structures (p < 0.001) and benign lesions (p < 0.001). Also, collagen was orientated more parallelly surrounding indolent BCC subtypes (superficial and nodular) versus those with more aggressive behaviour (infiltrative BCC) (p = 0.021). In conclusion, SHG signal from type I collagen can aid not only in the diagnosis of BCC but could be useful for prognosticating these tumors. Our initial results are limited to a small number of samples, requiring large-scale studies to validate them. These findings represent the groundwork for future in vivo MPM for diagnosis and prognosis of BCC.
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Affiliation(s)
- Mercedes Sendín-Martín
- Hospital Universitario Virgen del Rocío, Dermatology Department, Sevilla (Spain)
- Universidad de Sevilla, Department of Medicine, Sevilla (Spain)
| | - Jasmine Posner
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Ucalene Harris
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Matthew Moronta
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Julián Conejo-Mir Sánchez
- Hospital Universitario Virgen del Rocío, Dermatology Department, Sevilla (Spain)
- Universidad de Sevilla, Department of Medicine, Sevilla (Spain)
| | - Sushmita Mukherjee
- Weill Cornell Medicine, Dermatology Service, Department of Medicine, New York (USA)
| | - Milind Rajadhyaksha
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Kivanc Kose
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
| | - Manu Jain
- Memorial Sloan Kettering Cancer Center, Dermatology Service, Department of Medicine, New York (USA)
- Weill Cornell Medicine, Dermatology Service, Department of Medicine, New York (USA)
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Flori E, Mosca S, Cardinali G, Briganti S, Ottaviani M, Kovacs D, Manni I, Truglio M, Mastrofrancesco A, Zaccarini M, Cota C, Piaggio G, Picardo M. The Activation of PPARγ by (2Z,4E,6E)-2-methoxyocta-2,4,6-trienoic Acid Counteracts the Epithelial–Mesenchymal Transition Process in Skin Carcinogenesis. Cells 2023; 12:cells12071007. [PMID: 37048080 PMCID: PMC10093137 DOI: 10.3390/cells12071007] [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: 01/10/2023] [Revised: 03/17/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the most common UV-induced keratinocyte-derived cancer, and its progression is characterized by the epithelial–mesenchymal transition (EMT) process. We previously demonstrated that PPARγ activation by 2,4,6-octatrienoic acid (Octa) prevents cutaneous UV damage. We investigated the possible role of the PPARγ activators Octa and the new compound (2Z,4E,6E)-2-methoxyocta-2,4,6-trienoic acid (A02) in targeting keratinocyte-derived skin cancer. Like Octa, A02 exerted a protective effect against UVB-induced oxidative stress and DNA damage in NHKs. In the squamous cell carcinoma A431 cells, A02 inhibited cell proliferation and increased differentiation markers’ expression. Moreover, Octa and even more A02 counteracted the TGF-β1-dependent increase in mesenchymal markers, intracellular ROS, the activation of EMT-related signal transduction pathways, and cells’ migratory capacity. Both compounds, especially A02, counterbalanced the TGF-β1-induced cell membrane lipid remodeling and the release of bioactive lipids involved in EMT. In vivo experiments on a murine model useful to study cell proliferation in adult animals showed the reduction of areas characterized by active cell proliferation in response to A02 topical treatment. In conclusion, targeting PPARγ may be useful for the prevention and treatment of keratinocyte-derived skin cancer.
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Affiliation(s)
- Enrica Flori
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
- Correspondence: (E.F.); (M.P.)
| | - Sarah Mosca
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Giorgia Cardinali
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Stefania Briganti
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Monica Ottaviani
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Daniela Kovacs
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Isabella Manni
- SAFU Unit, Department of Research, Diagnosis and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Roma, Italy
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Arianna Mastrofrancesco
- Laboratory of Cutaneous Physiopathology and Integrated Center of Metabolomics Research, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Marco Zaccarini
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Carlo Cota
- Genetic Research, Molecular Biology and Dermatopathology Unit, San Gallicano Dermatological Institute, IRCCS, 00144 Rome, Italy
| | - Giulia Piaggio
- SAFU Unit, Department of Research, Diagnosis and Innovative Technologies, IRCCS Regina Elena National Cancer Institute, 00144 Roma, Italy
| | - Mauro Picardo
- Faculty of Medicine, Unicamillus International Medical University, 00131 Rome, Italy
- Correspondence: (E.F.); (M.P.)
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Kezic S, van der Molen HF. Occupational skin cancer: measurements of ultraviolet radiation exposure bring knowledge for prevention. Br J Dermatol 2023; 188:315-316. [PMID: 36653327 DOI: 10.1093/bjd/ljac127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 01/20/2023]
Abstract
Outdoor workers are at higher risk for keratinocyte cancer. Data-base of UV-exposure generated in the Genesis-UV study will facilitate specific prevention measures and workers’ health surveillance in outdoor occupations.
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Affiliation(s)
- Sanja Kezic
- Amsterdam UMC, University of Amsterdam, Public and Occupational Health, Amsterdam Public Health Research Institute, and Netherlands Center for Occupational Diseases, Amsterdam, the Netherlands
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Public and Occupational Health, Amsterdam Public Health Research Institute, and Netherlands Center for Occupational Diseases, Amsterdam, the Netherlands
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Lampley N, Rigo R, Schlesinger T, Rossi AM. Field Therapy for Actinic Keratosis: A Structured Review of the Literature on Efficacy, Cost, and Adherence. Dermatol Surg 2023; 49:124-129. [PMID: 36728061 DOI: 10.1097/dss.0000000000003677] [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: 09/10/2022] [Accepted: 11/06/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although there are evidence-based guidelines for actinic keratosis management, selecting a cost-effective field therapy is challenging because of limited studies comparing cost, efficacy, and adherence among treatments. OBJECTIVE To review the literature on field-directed therapies for actinic keratosis, comparing efficacy, cost, and adherence data for topical and in-office treatments. MATERIALS AND METHODS PubMed, Embase, Web of Science, and Google Scholar databases were searched from October 2020 to March 2021 for articles on field therapy for actinic keratosis. Total cost per regimen was estimated using wholesale acquisition cost package prices and Medicare coverage rates for May 2021. Effective cost was approximated by dividing total cost by complete response rate. RESULTS Efficacy data for various field therapies range widely, and long-term follow-up is limited. Cross-study comparisons are challenging because of heterogeneity of studies. Field-directed therapy with topical 5-fluorouracil and photodynamic therapy have similar effective cost. Adherence may significantly affect real-world efficacy and long-term clearance; this would favor shorter duration topical regimens or in-office procedures. CONCLUSION Standardization of future studies examining efficacy of field treatments for actinic keratosis will allow comparison across treatments. In-office treatments such as photodynamic therapy represent a cost-effective alternative to topical therapies with comparable efficacy.
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Affiliation(s)
| | - Rachel Rigo
- Department of Dermatology, Weill Cornell Medicine, New York, New York
| | - Todd Schlesinger
- Clinical Research Center of the Carolinas, Charleston, South Carolina
| | - Anthony M Rossi
- Department of Dermatology, Weill Cornell Medicine, New York, New York
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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Shea LK, Akhave NS, Sutton LA, Compton LA, York C, Ramakrishnan SM, Miller CA, Wartman LD, Chen DY. Combined Kdm6a and Trp53 Deficiency Drives the Development of Squamous Cell Skin Cancer in Mice. J Invest Dermatol 2023; 143:232-241.e6. [PMID: 36055401 PMCID: PMC10334302 DOI: 10.1016/j.jid.2022.08.037] [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: 04/13/2022] [Revised: 07/18/2022] [Accepted: 08/06/2022] [Indexed: 01/25/2023]
Abstract
Cutaneous squamous cell carcinoma (cSCC) has among the highest mutation burdens of all cancers, reflecting its pathogenic association with the mutagenic effects of UV light exposure. Although mutations in cancer-relevant genes such as TP53 and NOTCH1 are common in cSCC, they are also tolerated in normal skin and suggest that other events are required for transformation; it is not yet clear whether epigenetic regulators cooperate in the pathogenesis of cSCC. KDM6A encodes a histone H3K27me2/me3 demethylase that is frequently mutated in cSCC and other cancers. Previous sequencing studies indicate that roughly 7% of cSCC samples harbor KDM6A mutations, including frequent truncating mutations, suggesting a role for this gene as a tumor suppressor in cSCC. Mice with epidermal deficiency of both Kdm6a and Trp53 exhibited 100% penetrant, spontaneous cSCC development within a year, and exome sequencing of resulting tumors reveals recurrent mutations in Ncstn and Vcan. Four of 16 tumors exhibited deletions in large portions of chromosome 1 involving Ncstn, whereas another 25% of tumors harbored deletions in chromosome 19 involving Pten, implicating the loss of other tumor suppressors as cooperating events for combined KDM6A- and TRP53-dependent tumorigenesis. This study suggests that KDM6A acts as an important tumor suppressor for cSCC pathogenesis.
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Affiliation(s)
- Lauren K Shea
- Division of Oncology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Neal S Akhave
- Division of Oncology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Leslie A Sutton
- Division of Dermatology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Leigh A Compton
- Division of Dermatology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA; Department of Pathology & Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Conner York
- Division of Oncology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Sai Mukund Ramakrishnan
- Division of Oncology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Christopher A Miller
- Division of Oncology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Lukas D Wartman
- Division of Oncology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - David Y Chen
- Division of Dermatology, John T. Milliken Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.
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Dobre EG, Surcel M, Constantin C, Ilie MA, Caruntu A, Caruntu C, Neagu M. Skin Cancer Pathobiology at a Glance: A Focus on Imaging Techniques and Their Potential for Improved Diagnosis and Surveillance in Clinical Cohorts. Int J Mol Sci 2023; 24:ijms24021079. [PMID: 36674595 PMCID: PMC9866322 DOI: 10.3390/ijms24021079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/08/2023] Open
Abstract
Early diagnosis is essential for completely eradicating skin cancer and maximizing patients' clinical benefits. Emerging optical imaging modalities such as reflectance confocal microscopy (RCM), optical coherence tomography (OCT), magnetic resonance imaging (MRI), near-infrared (NIR) bioimaging, positron emission tomography (PET), and their combinations provide non-invasive imaging data that may help in the early detection of cutaneous tumors and surgical planning. Hence, they seem appropriate for observing dynamic processes such as blood flow, immune cell activation, and tumor energy metabolism, which may be relevant for disease evolution. This review discusses the latest technological and methodological advances in imaging techniques that may be applied for skin cancer detection and monitoring. In the first instance, we will describe the principle and prospective clinical applications of the most commonly used imaging techniques, highlighting the challenges and opportunities of their implementation in the clinical setting. We will also highlight how imaging techniques may complement the molecular and histological approaches in sharpening the non-invasive skin characterization, laying the ground for more personalized approaches in skin cancer patients.
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Affiliation(s)
- Elena-Georgiana Dobre
- Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, 050095 Bucharest, Romania
| | - Mihaela Surcel
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
| | - Carolina Constantin
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
| | | | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
- Correspondence:
| | - Monica Neagu
- Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, 050095 Bucharest, Romania
- Immunology Department, “Victor Babes” National Institute of Pathology, 050096 Bucharest, Romania
- Department of Pathology, Colentina University Hospital, 020125 Bucharest, Romania
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Mirali S, Tang E, Drucker AM, Turchin I, Gooderham M, Levell N, Beecker J, Bissonnette R, Catherall H, Lapointe McKenzie JA, Hawkins N, Hong CH, Kalia S, Papp K, Chan AW. Follow-up of Patients With Keratinocyte Carcinoma: A Systematic Review of Clinical Practice Guidelines. JAMA Dermatol 2023; 159:87-94. [PMID: 36322063 DOI: 10.1001/jamadermatol.2022.4590] [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: 11/06/2022]
Abstract
Importance Patients treated for cutaneous squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), collectively called keratinocyte carcinoma (KC), are at risk for recurrence, metastasis, and additional primary cutaneous malignant neoplasms. It is unclear how often patients should be seen for follow-up skin examination after initial treatment of KC. Objective To summarize the recommendations and evaluate the methodological quality of clinical practice guidelines for dermatologic follow-up of patients with BCC and invasive SCC. Evidence Review PubMed, MEDLINE, and Embase were searched for relevant articles published from January 2010 to March 2022. Search terms included guideline, squamous cell carcinoma, and basal cell carcinoma. National or international guidelines containing recommendations for follow-up frequency after a diagnosis of localized cutaneous KC were included. Quality was assessed using the 6 domains of the Appraisal of Guidelines Research and Evaluation II (AGREE II) tool: (1) scope and purpose; (2) stakeholder development; (3) rigor of development; (4) clarity of presentation; (5) applicability; and (6) editorial independence. The Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) was used to guide study reporting. Findings Among the 14 guidelines meeting eligibility criteria, there was little consensus on the appropriate follow-up frequency after initial KC treatment. Overall duration of follow-up ranged from a single posttreatment visit to lifelong surveillance. Most guidelines stratified their recommendations by recurrence risk. For low-risk BCC and guidelines that did not stratify by risk, follow-up recommendations ranged from every 6 to 12 months. For high-risk BCC, 1 guideline suggested follow-up every 3 months, while 4 recommended every 6 months. For low-risk SCC, 5 guidelines recommended annual follow-up; 3 guidelines, every 6 months; and 1 guideline, every 3 months. For high-risk SCC, recommendations included a range of follow-up frequencies, spanning every 3 months (n = 5 guidelines), 4 months (n = 1), 6 months (n = 6), or annually (n = 4). One guideline did not use risk stratification and recommended annual screening. The highest scoring AGREE II domain was "scope and purpose," which assessed the guideline's overall objectives, and the lowest scoring was "applicability," which assessed barriers and facilitators to implementation. Conclusions and Relevance The findings of this systemic review highlight variations in follow-up recommendations for patients after initial treatment for KC. Randomized clinical trials are needed to define an optimal follow-up regimen.
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Affiliation(s)
- Sara Mirali
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Evan Tang
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Aaron M Drucker
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Irina Turchin
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Brunswick Dermatology Center, Fredericton, New Brunswick, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
| | - Melinda Gooderham
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
- SKiN Centre for Dermatology, Peterborough, Ontario, Canada
- Department of Medicine, Queens University, Kingston, Ontario, Canada
| | - Nick Levell
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - Jennifer Beecker
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Division of Dermatology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Robert Bissonnette
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Innovaderm Research, Montreal, Quebec, Canada
| | - Helen Catherall
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
| | - Jo-Ann Lapointe McKenzie
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Save Your Skin Foundation, Penticton, British Columbia, Canada
| | - Nicole Hawkins
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Peak Medical Specialty Clinic, Okotoks, Alberta, Canada
- Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Chih-Ho Hong
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Surrey, British Columbia, Canada
| | - Sunil Kalia
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kim Papp
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Probity Medical Research, Waterloo, Ontario, Canada
- K Papp Clinical Research, Waterloo, Ontario, Canada
| | - An-Wen Chan
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Toronto, Ontario, Canada
- Skin Investigation Network of Canada (SkIN Canada), Toronto, Ontario, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Krasnoselskyi M, Bilyy O, Kulinich H, Lepekha I, Pidlisnyy R. Types of surgical approaches in locally advanced forms of basal cell carcinoma of the scalp in elderly patients. УКРАЇНСЬКИЙ РАДІОЛОГІЧНИЙ ТА ОНКОЛОГІЧНИЙ ЖУРНАЛ 2022. [DOI: 10.46879/ukroj.4.2022.89-102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background. Basal cell cancer is the most common type of skin cancer in fair-skinned adults older than 50 years. The incidence rate of this disease is growing around the world. Basal cell carcinomas (BCC) are heterogeneous: from superficial or nodular lesions with benign prognosis to large lesions which are very difficult to cure. The prognosis of treatment is connected with the risk of recurrence of basal cell cancer or its local destructive ability. Hedgehog pathway activation is a distinctive molecular event in these tumors, which has allowed Hedgehog inhibitors for lesions that are difficult to cure to be developed, and which are also beyond the reach of surgical treatment or radiation therapy. Immunotherapy may be offered for the treatment of tumors with a high mutational load which leads to tumor resistance to Hedgehog inhibitors. Surgical intervention is a standard treatment method for most BCCs because it allows excision margins to be controlled and it shows a low risk of recurrence. The issue of removal of locally advanced forms with simultaneous reparative stage in elderly patients remains challenging.
Purpose – to prove the high effectiveness of the surgical approach with simultaneous plastic surgery in locally advanced forms of BCC of the scalp in elderly patients.
Materials and methods. Clinical observation of female patient A., 87 years old, who was receiving treatment in the Department of Surgical Oncology regarding multiple advanced BCC of facial skin, and patient V., 91 years old, who was undergoing treatment in the Department of Surgical Oncology regarding advanced basal cell skin carcinoma of the left pinna. Observation and treatment were performed in the State Organization «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine».
Results. Clinical cases of locally advanced basal cell skin cancer in 2 elderly patients (87 and 91 years old) are presented. The effectiveness of the surgical approach with broad excision of the tumor and simultaneous reparative stage has been proven: in one case – a free split-skin autoplastic graft, in the other one – a full-thickness musculo-subcutaneous flap with axial blood circulation. In both cases there was no rejection of transplants; the scalp defects were completely covered, and a good cosmetic appearance was successfully achieved. In both cases, there were no significant complications observed. These examples have proven that the patients’ age of more than 90 years is not a counterindication to broad resections with simultaneous reparative stage in locally advanced BCC of the scalp.
Conclusions. Thus, modern methods of diagnostics and treatment of BCC allow the disease to be controlled in most cases. It is also possible to cure locally advanced BCCs in patients older than 85 years surgically with a simultaneous reconstructive stage, given the reasonable selection of the patients.
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Pedersen KK, Høyer-Hansen MH, Litman T, Hædersdal M, Olesen UH. Topical Delivery of Hedgehog Inhibitors: Current Status and Perspectives. Int J Mol Sci 2022; 23:ijms232214191. [PMID: 36430669 PMCID: PMC9692957 DOI: 10.3390/ijms232214191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
Abstract
Systemic treatment with hedgehog inhibitors (HHis) is available to treat basal cell carcinomas but their utility is limited by adverse effects. Topical delivery methods may reduce adverse effects, but successful topical treatment depends on sufficient skin uptake, biological response, and time in tumor tissue. The aim of this review was to evaluate the current status of topical HHi delivery for BCCs and discuss barriers for translating systemic HHis into topical treatments. A literature search identified 16 preclinical studies and 7 clinical trials on the topical delivery of 12 HHis that have been clinically tested on BCCs. Preclinical studies on drug uptake demonstrated that novel formulations, and delivery- and pre-treatment techniques enhanced topical HHi delivery. Murine studies showed that the topical delivery of sonidegib, itraconazole, vitamin D₃ and CUR-61414 led to biological responses and tumor remission. In clinical trials, only topical patidegib and sonidegib led to at least a partial response in 26/86 BCCs and 30/34 patients, respectively. However, histological clearance was not observed in the samples analyzed. In conclusion, the incomplete clinical response could be due to poor HHi uptake, biodistribution or biological response over time. Novel topical delivery techniques may improve HHi delivery, but additional research on cutaneous pharmacokinetics and biological response is needed.
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Affiliation(s)
- Kristian Kåber Pedersen
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
| | | | - Thomas Litman
- Molecular Biomedicine, LEO Pharma A/S, 2750 Ballerup, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Merete Hædersdal
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
| | - Uffe Høgh Olesen
- Department of Dermatology, Copenhagen University Hospital—Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
- Correspondence:
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Caruntu C, Tsatsakis AM, Tampa M, Georgescu SR, Gonzalez S. Editorial: Recent advances in keratinocyte carcinomas: From molecular mechanisms to clinical perspectives. Front Med (Lausanne) 2022; 9:1078020. [DOI: 10.3389/fmed.2022.1078020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
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Usama M, Naeem MA, Mirza F. Multi-Class Skin Lesions Classification Using Deep Features. SENSORS (BASEL, SWITZERLAND) 2022; 22:8311. [PMID: 36366009 PMCID: PMC9658979 DOI: 10.3390/s22218311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Skin cancer classification is a complex and time-consuming task. Existing approaches use segmentation to improve accuracy and efficiency, but due to different sizes and shapes of lesions, segmentation is not a suitable approach. In this research study, we proposed an improved automated system based on hybrid and optimal feature selections. Firstly, we balanced our dataset by applying three different transformation techniques, which include brightness, sharpening, and contrast enhancement. Secondly, we retrained two CNNs, Darknet53 and Inception V3, using transfer learning. Thirdly, the retrained models were used to extract deep features from the dataset. Lastly, optimal features were selected using moth flame optimization (MFO) to overcome the curse of dimensionality. This helped us in improving accuracy and efficiency of our model. We achieved 95.9%, 95.0%, and 95.8% on cubic SVM, quadratic SVM, and ensemble subspace discriminants, respectively. We compared our technique with state-of-the-art approach.
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Affiliation(s)
- Muhammad Usama
- School of Computing, National University of Computer & Emerging Sciences, Islamabad 44000, Pakistan
| | - M. Asif Naeem
- School of Computing, National University of Computer & Emerging Sciences, Islamabad 44000, Pakistan
| | - Farhaan Mirza
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland 1010, New Zealand
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Gross ND, Miller DM, Khushalani NI, Divi V, Ruiz ES, Lipson EJ, Meier F, Su YB, Swiecicki PL, Atlas J, Geiger JL, Hauschild A, Choe JH, Hughes BGM, Schadendorf D, Patel VA, Homsi J, Taube JM, Lim AM, Ferrarotto R, Kaufman HL, Seebach F, Lowy I, Yoo SY, Mathias M, Fenech K, Han H, Fury MG, Rischin D. Neoadjuvant Cemiplimab for Stage II to IV Cutaneous Squamous-Cell Carcinoma. N Engl J Med 2022; 387:1557-1568. [PMID: 36094839 PMCID: PMC9844515 DOI: 10.1056/nejmoa2209813] [Citation(s) in RCA: 103] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND In a pilot study involving patients with cutaneous squamous-cell carcinoma, a high percentage of patients had a pathological complete response with the use of two doses of neoadjuvant cemiplimab before surgery. Data from a phase 2 study are needed to confirm these findings. METHODS We conducted a phase 2, confirmatory, multicenter, nonrandomized study to evaluate cemiplimab as neoadjuvant therapy in patients with resectable stage II, III, or IV (M0) cutaneous squamous-cell carcinoma. Patients received cemiplimab, administered at a dose of 350 mg every 3 weeks for up to four doses, before undergoing surgery with curative intent. The primary end point was a pathological complete response (the absence of viable tumor cells in the surgical specimen) on independent review at a central laboratory, with a null hypothesis that a pathological complete response would be observed in 25% of patients. Key secondary end points included a pathological major response (the presence of viable tumor cells that constitute ≤10% of the surgical specimen) on independent review, a pathological complete response and a pathological major response on investigator assessment at a local laboratory, an objective response on imaging, and adverse events. RESULTS A total of 79 patients were enrolled and received neoadjuvant cemiplimab. On independent review, a pathological complete response was observed in 40 patients (51%; 95% confidence interval [CI], 39 to 62) and a pathological major response in 10 patients (13%; 95% CI, 6 to 22). These results were consistent with the pathological responses determined on investigator assessment. An objective response on imaging was observed in 54 patients (68%; 95% CI, 57 to 78). Adverse events of any grade that occurred during the study period, regardless of whether they were attributed to the study treatment, were observed in 69 patients (87%). Grade 3 or higher adverse events that occurred during the study period were observed in 14 patients (18%). CONCLUSIONS Neoadjuvant therapy with cemiplimab was associated with a pathological complete response in a high percentage of patients with resectable cutaneous squamous-cell carcinoma. (Funded by Regeneron Pharmaceuticals and Sanofi; ClinicalTrials.gov number, NCT04154943.).
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Affiliation(s)
- Neil D Gross
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - David M Miller
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Nikhil I Khushalani
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Vasu Divi
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Emily S Ruiz
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Evan J Lipson
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Friedegund Meier
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Yungpo B Su
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Paul L Swiecicki
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Jennifer Atlas
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Jessica L Geiger
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Axel Hauschild
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Jennifer H Choe
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Brett G M Hughes
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Dirk Schadendorf
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Vishal A Patel
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Jade Homsi
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Janis M Taube
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Annette M Lim
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Renata Ferrarotto
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Howard L Kaufman
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Frank Seebach
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Israel Lowy
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Suk-Young Yoo
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Melissa Mathias
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Keilah Fenech
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Hyunsil Han
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Matthew G Fury
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
| | - Danny Rischin
- From the Department of Head and Neck Surgery (N.D.G.) and the Department of Thoracic and Head and Neck Medical Oncology (R.F.), M.D. Anderson Cancer Center, Houston, and the Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas (J.H.); the Department of Medicine, Division of Hematology and Oncology (D.M.M.), the Department of Dermatology (D.M.M.), and the Department of Surgery (H.L.K.), Massachusetts General Hospital and Harvard Medical School, and the Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School (E.S.R.) - all in Boston; the Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL (N.I.K.); the Department of Otolaryngology-Head and Neck Surgery, Stanford Cancer Institute, Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA (V.D.); Bloomberg-Kimmel Institute for Cancer Immunotherapy and Sidney Kimmel Comprehensive Cancer Center (E.J.L., J.M.T.) and the Department of Dermatology, School of Medicine (J.M.T.), Johns Hopkins University, Baltimore; the Skin Cancer Center at the University Cancer Center and the National Center for Tumor Diseases Dresden, Department of Dermatology, University Hospital Carl Gustav Carus and Technische Universität Dresden, Dresden (F.M.), the Department of Dermatology, Schleswig-Holstein University Hospital, Kiel (A.H.), and the Department of Dermatology, University Hospital of Essen and German Cancer Consortium, Partner Site Essen, Essen (D.S.) - all in Germany; Head and Neck Medical Oncology, Nebraska Cancer Specialists, Omaha (Y.B.S.); Rogel Comprehensive Cancer Center, University of Michigan, Ann Arbor (P.L.S.); Levine Cancer Institute, Atrium Health, Charlotte (J.A.), and Duke Cancer Institute, Durham (J.H.C.) - both in North Carolina; Taussig Cancer Institute, Department of Hematology and Medical Oncology, Cleveland Clinic, Cleveland (J.L.G.); the Department of Cancer Care Services, Royal Brisbane and Women's Hospital and University of Queensland, Brisbane (B.G.M.H.), and the Department of Medical Oncology, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, VIC (A.M.L., D.R.) - both in Australia; the Departments of Dermatology, Medicine, and Oncology, George Washington University School of Medicine and Health Sciences, Washington, DC (V.A.P.); and Regeneron Pharmaceuticals, Tarrytown, NY (F.S., I.L., S.-Y.Y., M.M., K.F., H.H., M.G.F.)
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