Cetuximab as a Component of Multimodality Treatment of High-Risk Cutaneous Squamous Cell Carcinoma: A Retrospective Analysis From a Single Tertiary Academic Medical Center.

BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer and has potential for regional or distant metastasis. Despite the standardization of features associated with high-risk cSCC, an advanced subset of cSCC, there is no established consensus regarding proper management of this tumor. OBJECTIVE: To evaluate the efficacy of cetuximab, add to existing management options, and aid in the development of standardized treatment for this tumor. MATERIALS AND METHODS: Medical records were searched using Current Procedural Terminology codes for cetuximab and cSCC. Demographic data and tumor characteristics, along with treatment regimens and follow-up times, were collected. A total of 20 cases were examined. RESULTS: Of the 20 cases, 3 experienced a complete response and 7 experienced a partial response, yielding an overall response of 50% and a combined median disease-free survival of 6.35 months (range 1-46.8 months). CONCLUSION: As most of the patients who experienced a response received cetuximab as part of a multimodality treatment approach, cetuximab may be most efficacious when administered with concurrent therapies such as surgery or radiation. Further larger prospective studies to determine the optimal dosing and frequency of cetuximab and the utility of concurrent therapies are warranted.

Hypothyroidism Potentially Linked to Cutaneous Squamous Cell Carcinoma: Retrospective Study at a Single Tertiary Academic Medical Center.

BACKGROUND: There are multiple known risk factors for the development of cutaneous squamous cell carcinoma (SCC). OBJECTIVE: To determine whether patients with cutaneous SCC have a higher prevalence of hypothyroidism than the general US population. MATERIALS AND METHODS: A retrospective review was performed for patients seen at the University of Southern California with cutaneous SCC. Chart review was performed for the presence of hypothyroidism and thyroid replacement therapy before the diagnosis of SCC for each patient. Multiple prevalence studies were gathered from the literature for comparison, reporting the prevalence of overt and subclinical hypothyroidism in the general US population and/or elderly US population. RESULTS: Of the 265 patients diagnosed with SCC of the skin, 61 (23%) of patients were found to have a preceding diagnosis of hypothyroidism. The prevalence of hypothyroidism among the population of SCC patients was significantly greater than the prevalence of hypothyroidism (overt and subclinical) in any general and/or elderly US population reported. CONCLUSION: Patients with SCC of skin are more likely to have a history of hypothyroidism than the general population. The authors conclude that hypothyroidism may be linked to the development of cutaneous SCC.

Cisplatin and Cetuximab Treatment for Metastatic Cutaneous Squamous Cell Carcinoma: A Systematic Review.

BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is the second most common form of skin cancer and metastasizes in 2% to 5% of cases. OBJECTIVE: Systematic evaluation of published cases of metastatic cSCC (mSCC) treated with cisplatin or cetuximab from 1989 to 2014. MATERIALS AND METHODS: A literature search was performed to identify cases of mSCC treated with cisplatin or cetuximab. Patient demographics, tumor characteristics, response rates, and disease-free survivals were extracted. RESULTS: A total of 60 cases of mSCC treated with cisplatin and 9 cases treated with cetuximab reported in the literature from 1989 to 2014 were included in the analysis. Patients treated with cetuximab obtained a complete response of 67%, an overall response of 78%, and a median disease-free survival of 25 (range 3-48) months. Patients treated with cisplatin obtained a complete response of 22%, an overall response of 45%, and a median disease-free survival of 14.6 (range 3-112) months. CONCLUSION: Head-to-head prospective clinical studies between cetuximab and cisplatin are needed to determine which is more efficacious. In addition, prospective tumor registries and randomized controlled trials should be developed in order to establish the ideal systemic regimen in cSCC.