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Management of Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients

  • Skin Cancer (JA Carucci, Section Editor)
  • Published:
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Abstract

The lifelong immunosuppression required for maintenance of allograft function in organ transplant recipients (OTR) increases the risk of cutaneous malignancies in this population. Prolonged survival posttransplantation further permits the development of late dermatologic complications of iatrogenic immunosuppression, particularly skin cancer. Cutaneous squamous cell carcinoma (CSCC) is the most common posttransplant malignancy, and in OTR can present as multiple, aggressive, and rapidly metastasizing lesions that are challenging to manage. Due to the high morbidity and potential mortality of CSCC in OTR, close dermatologic surveillance and aggressive treatment are essential. This review will address the challenge of managing posttransplant CSCC in the OTR population with a summary of the current therapeutic strategies in this patient cohort. The management of metastatic CSCC remains challenging, despite promising results from chemotherapeutic agents and novel targeted molecular inhibitors combined with radiation therapy. Ultimately, therapeutic considerations for CSCC in OTR should be determined in a multidisciplinary setting including the dermatologist, the transplant team, and appropriate specialists.

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Abbreviations

AJCC:

American Joint Commission on Cancer

BCC:

Basal cell carcinoma

CSCC:

Cutaneous squamous cell carcinoma

HPV:

Human papilloma virus

SLNB:

Sentinel lymph node biopsy

NMSC:

Nonmelanoma skin cancer

OTR:

Organ transplant recipients

PDT:

Photodynamic therapy

CCPDMA:

Circumferential peripheral and deep margin assessment

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ferreira FR, Ogawa MM, Nascimento LFC, Tomimori J. Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients : experience of a referral center. An Bras Dermatol. 2014;89(5):745–50.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Gogia R, Binstock M, Hirose R, Boscardin WJ, Chren M-M, Arron ST. Fitzpatrick skin phototype is an independent predictor of squamous cell carcinoma risk after solid organ transplantation. J Am Acad Dermatol. 2013;68(4):585–91. This is a study that found that there was an increased risk for SCC in OTR with each incremental decrease in Fitzpatrick skin phototype. The authors also found an increased risk for male subjects as well as subjects aged fifty years and older at the time of the transplantation.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Mackintosh LJ, Geddes CC, Herd RM. Skin tumours in the West of Scotland renal transplant population. Br J Dermatol. 2013;168(5):1047–53.

    Article  CAS  PubMed  Google Scholar 

  4. Pollard JD, Hanasono MM, Mikulec AA, Le QT, Terris DJ. Head and neck cancer in cardiothoracic transplant recipients. Laryngoscope. 2000;110(8):1257–61.

    Article  CAS  PubMed  Google Scholar 

  5. Ducroux E, Boillot O, Ocampo MA, Decullier E, Roux A, Dumortier J, et al. Skin cancers after liver transplantation: retrospective single-center study on 371 recipients. Transplantation. 2014;98(3):335–40.

    Article  PubMed  Google Scholar 

  6. Bavinck JNB, Harwood CA, Genders RE, Wisgerhof HC, Plasmeijer EI, Mitchell L, et al. Pain identifies squamous cell carcinoma in organ transplant recipients: the SCOPE-ITSCC PAIN study. Am J Transplant. 2014;14(3):668–76.

    Article  Google Scholar 

  7. Krynitz B, Edgren G, Lindelöf B, Baecklund E, Brattström C, Wilczek H, et al. Risk of skin cancer and other malignancies in kidney, liver, heart and lung transplant recipients 1970 to 2008--a Swedish population-based study. Int J Cancer. 2013;132(6):1429–38.

    Article  CAS  PubMed  Google Scholar 

  8. Zwald FO, Brown M. Skin cancer in solid organ transplant recipients: advances in therapy and management: part I. Epidemiology of skin cancer in solid organ transplant recipients. J Am Acad Dermatol. 2011;65(2):253–61.

    Article  PubMed  Google Scholar 

  9. Berg D, Otley CC. Skin cancer in organ transplant recipients: epidemiology, pathogenesis, and management. J Am Acad Dermatol. 2002;47(1):1–17.

    Article  PubMed  Google Scholar 

  10. Carroll RP, Ramsay HM, Fryer AA, Hawley CM, Nicol DL, Harden PN. Incidence and prediction of nonmelanoma skin cancer post-renal transplantation: a prospective study in Queensland, Australia. Am J Kidney Dis. 2003;41(3):676–83.

    Article  PubMed  Google Scholar 

  11. Ong CS, Keogh AM, Kossard S, Macdonald PS, Spratt PM. Skin cancer in Australian heart transplant recipients. J Am Acad Dermatol. 1999;40(1):27–34.

    Article  CAS  PubMed  Google Scholar 

  12. Brown VL, Atkins CL, Ghali L, Cerio R, Harwood CA, Proby CM. Safety and efficacy of 5% Imiquimod cream for the treatment of skin dysplasia in high-risk renal transplant recipients. Arch Dermatol. 2005;141(8):985–93.

    Article  CAS  PubMed  Google Scholar 

  13. Otley CC. Organization of a specialty clinic to optimize the care of organ transplant recipients at risk for skin cancer. Dermatol Surg. 2000;26(7):709–12.

    Article  CAS  PubMed  Google Scholar 

  14. Christenson LJ, Geusau A, Ferrandiz C, Brown CD, Ulrich C, Stockfleth E, et al. Specialty clinics for the dermatologic care of solid-organ transplant recipients. Dermatol Surg. 2004;30(4 Pt 2):598–603.

    PubMed  Google Scholar 

  15. Zwald FO, Brown M. Skin cancer in solid organ transplant recipients: advances in therapy and management: part II. Management of skin cancer in solid organ transplant recipients. J Am Acad Dermatol. 2011;65(2):263–79.

    Article  PubMed  Google Scholar 

  16. Rashtak S, Dierkhising RA, Kremers WK, Peters SG, Cassivi SD, Otley CC. Incidence and risk factors for skin cancer following lung transplantation. J Am Acad Dermatol. 2015;72(1):92–8.

    Article  PubMed  Google Scholar 

  17. Spanogle JP, Kudva YC, Dierkhising RA, Kremers WK, Roenigk RK, Brewer JD, et al. Skin cancer after pancreas transplantation. J Am Acad Dermatol. 2012;67(4):563–9.

    Article  PubMed  Google Scholar 

  18. Brewer JD, Colegio OR, Phillips PK, Roenigk RK, Jacobs MA, Van de Beek D, et al. Incidence of and risk factors for skin cancer after heart transplant. Arch Dermatol. 2009;145(12):1391–6.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Wheless L, Jacks S, Mooneyham Potter KA, Leach BC, Cook J. Skin cancer in organ transplant recipients: more than the immune system. J Am Acad Dermatol. 2014;71(2):359–65.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Madeleine MM, Carter JJ, Johnson LG, Wipf GC, Davis C, Berg D, et al. Risk of squamous cell skin cancer after organ transplant associated with antibodies to cutaneous papillomaviruses, polyomaviruses, and TMC6/8 (EVER1/2) variants. Cancer Med. 2014;3(5):1440–7.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Bouwes Bavinck JN, Euvrard S, Naldi L, Nindl I, Proby CM, Neale R, et al. Keratotic skin lesions and other risk factors are associated with skin cancer in organ-transplant recipients: a case-control study in The Netherlands, United Kingdom, Germany, France, and Italy. J Investig Dermatol. 2007;127(7):1647–56.

    PubMed Central  CAS  PubMed  Google Scholar 

  22. Wang J, Aldabagh B, Yu J, Arron ST. Role of human papillomavirus in cutaneous squamous cell carcinoma: a meta-analysis. J Am Acad Dermatol. 2014;70(4):621–9.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Aldabagh B, Angeles JGC, Cardones AR, Arron ST. Cutaneous squamous cell carcinoma and human papillomavirus: is there an association? Dermatol Surg. 2013;39(1 Pt 1):1–23.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Karia PS, Jambusaria-Pahlajani A, Harrington DP, Murphy GF, Qureshi AA, Schmultz CD. Evaluation of American Joint Committee on Cancer, International Union Against Cancer, and Brigham and Women’s Hospital Tumor staging for cutaneous squamous cell carcinoma. J Clin Oncol. 2014;32(4):327–34. The authors examined three tumor staging systems and found that the Brigham and Women’s Hospital Tumor staging system had improved distinctiveness, homogeneity, and monotonicity as compared to the other two systems.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Webber T, Wolf JM. Squamous cell carcinoma of the hand in solid organ transplant patients. J Hand Surg [Am]. 2014;39(3):567–70.

    Article  Google Scholar 

  26. Kempf W, Mertz KD, Hofbauer GF, Tinguely M. Skin cancer in organ transplant recipients. Pathobiology. 2013;80(6):302–9.

    Article  PubMed  Google Scholar 

  27. Farasat S, Yu SS, Neel VA, Nehal KS, Lardaro T, Mihm MC, et al. A new American Joint Committee on Cancer staging system for cutaneous squamous cell carcinoma: creation and rationale for inclusion of tumor (T) characteristics. J Am Acad Dermatol. 2011;64(6):1051–9.

    Article  PubMed  Google Scholar 

  28. Metchnikoff C, Mully T, Singer JP, Golden JA, Arron ST. The 7th edition AJCC staging system for cutaneous squamous cell carcinoma accurately predicts risk of recurrence for heart and lung transplant recipients. J Am Acad Dermatol. 2012;67(5):829–35.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Jambusaria-Pahlajani A, Miller CJ, Quon H, Smith N, Klein RQ, Schmults CD. Surgical monotherapy versus surgery plus adjuvant radiotherapy in high-risk cutaneous squamous cell carcinoma: a systematic review of outcomes. Dermatol Surg. 2009;35(4):574–85.

    Article  CAS  PubMed  Google Scholar 

  30. Jambusaria-Pahlajani A, Hess SD, Katz KA, Berg D, Schmults CD. Uncertainty in the perioperative management of high-risk cutaneous squamous cell carcinoma among Mohs surgeons. Arch Dermatol. 2010;146(11):1225–31.

    Article  PubMed  Google Scholar 

  31. Ross AS, Schmults CD. Sentinel lymph node biopsy in cutaneous squamous cell carcinoma: a systematic review of the English literature. Dermatol Surg. 2006;32(11):1309–21.

    CAS  PubMed  Google Scholar 

  32. Ulrich C, Kanitakis J, Stockfleth E, Euvrard S. Skin cancer in organ transplant recipients--where do we stand today? Am J Transplant. 2008;8(11):2192–8.

    Article  CAS  PubMed  Google Scholar 

  33. Bernat García J, Morales Suárez-Varela M, Vilata JJ, Marquina A, Pallardó L, Crespo J. Risk factors for non-melanoma skin cancer in kidney transplant patients in a Spanish population in the Mediterranean region. Acta Derm Venereol. 2013;93(4):422–7.

    Article  PubMed  Google Scholar 

  34. Thomas BR, Barnabas A, Agarwal K, Aluvihare V, Suddle AR, Higgins EM, et al. Patient perception of skin-cancer prevention and risk after liver transplantation. Clin Exp Dermatol. 2013;38(8):851–6.

    Article  CAS  PubMed  Google Scholar 

  35. Ismail F, Mitchell L, Casabonne D, Gulati A, Newton R, Proby CM, et al. Specialist dermatology clinics for organ transplant recipients significantly improve compliance with photoprotection and levels of skin cancer awareness. Br J Dermatol. 2006;155(5):916–25.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Clowers-Webb HE, Christenson LJ, Phillips PK, Roenigk RK, Nguyen TH, Weaver AL, et al. Educational outcomes regarding skin cancer in organ transplant recipients: randomized intervention of intensive vs standard education. Arch Dermatol. 2006;142(6):712–8.

    Article  PubMed  Google Scholar 

  37. Reichrath J, Nürnberg B. Solar UV-radiation, vitamin D and skin cancer surveillance in organ transplant recipients (OTRs). Adv Exp Med Biol. 2008;624:203–14.

    Article  PubMed  Google Scholar 

  38. Colegio OR, Hanlon A, Olasz EB, Carucci JA. Sirolimus reduces cutaneous squamous cell carcinomas in transplantation recipients. J Clin Oncol. 2013;31(26):3297–8.

    Article  PubMed  Google Scholar 

  39. Wells JL, Shirai K. Systemic therapy for squamous cell carcinoma of the skin in organ transplant recipients. Am J Clin Oncol. 2012;35(5):498–503.

    Article  PubMed  Google Scholar 

  40. Francis S, Berg D. Reducing skin malignancy risk in organ transplant recipients. Skin Ther Lett. 2013;18(1):1–3.

    Google Scholar 

  41. Rival-Tringali AL, Euvrard S, Decullier E, Claudy A, Faure M, Kanitakis J. Conversion from calcineurin inhibitors to sirolimus reduces vascularization and thickness of post-transplant cutaneous squamous cell carcinomas. Anticancer Res. 2009;29(6):1927–32.

    CAS  PubMed  Google Scholar 

  42. Euvrard S, Morelon E, Rostaing L, Goffin E, Brocard A, Tromme I, et al. Sirolimus and secondary skin-cancer prevention in kidney transplantation. N Engl J Med. 2012;367(4):329–39.

    Article  CAS  PubMed  Google Scholar 

  43. Hoogendijk-van den Akker JM, Harden PN, Hoitsma AJ, Proby CM, Wolterbeek R, Bouwes Bavinck JN, et al. Two-year randomized controlled prospective trial converting treatment of stable renal transplant recipients with cutaneous invasive squamous cell carcinomas to Sirolimus. J Clin Oncol. 2013;31(10):1317–23. The authors found that converting patients to Sirolimus from their original immunosupression did not have a benefit for CSSC survival at 2 years.

    Article  CAS  PubMed  Google Scholar 

  44. Mudigonda T, Levender MM, O’Neill JL, West CE, Pearce DJ, Feldman SR. Incidence, risk factors, and preventative management of skin cancers in organ transplant recipients: a review of single- and multicenter retrospective studies from 2006 to 2010. Dermatol Surg. 2013;39(3 Pt 1):345–64.

    Article  CAS  PubMed  Google Scholar 

  45. Endrizzi B, Ahmed R, Ray T, Dudek A, Lee P. Capecitabine to reduce nonmelanoma skin carcinoma burden in solid organ transplant recipients. Dermatol Surg. 2013;39(4):634–45.

    Article  CAS  PubMed  Google Scholar 

  46. Glogau RG. The risk of progression to invasive disease. J Am Acad Dermatol. 2000;42(1 Pt 2):23–4.

    Article  CAS  PubMed  Google Scholar 

  47. Ritchie SA, Patel MJ, Miller SJ. Therapeutic options to decrease actinic keratosis and squamous cell carcinoma incidence and progression in solid organ transplant recipients: a practical approach. Dermatol Surg. 2012;38(10):1604–21.

    Article  CAS  PubMed  Google Scholar 

  48. Ingham AI, Weightman W. The efficacy and safety of topical 5% 5-fluorouracil in renal transplant recipients for the treatment of actinic keratoses. Australas J Dermatol. 2014;55(3):204–8.

    Article  PubMed  Google Scholar 

  49. Hua HK, Jin C, Yang LJ, Tao SQ, Zhu XH. Expression of cyclooxygenase-2 in squamous cell carcinoma and keratoacanthoma and its clinical significance. Cell Biochem Biophys.

  50. Ulrich C, Hackethal M, Ulrich M, Howorka A, Forschner T, Sterry W, et al. Treatment of multiple actinic keratoses with topical diclofenac 3% gel in organ transplant recipients: a series of six cases. Br J Dermatol. 2007;156(3):40–2.

    Article  CAS  PubMed  Google Scholar 

  51. Ulrich C, Bichel J, Euvrard S, Guidi B, Proby CM, van de Kerkhof PC, et al. Topical immunomodulation under systemic immunosuppression: results of a multicentre, randomized, placebo-controlled safety and efficacy study of imiquimod 5% cream for the treatment of actinic keratoses in kidney, heart, and liver transplant patients. Br J Dermatol. 2007;157(2):25–31.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  52. Kovach BT, Stasko T. Use of topical immunomodulators in organ transplant recipients. Dermatol Ther. 2005;18(1):19–27.

    Article  PubMed  Google Scholar 

  53. Martin G, Swanson N. Clinical findings using ingenol mebutate gel to treat actinic keratoses. J Am Acad Dermatol. 2013;68(1 Suppl 1):39–48.

    Article  Google Scholar 

  54. Helsing P, Togsverd-Bo K, Veierød MB, Mørk G, Haedersdal M. Intensified fractional CO2 laser-assisted photodynamic therapy vs. laser alone for organ transplant recipients with multiple actinic keratoses and wart-like lesions: a randomized half-side comparative trial on dorsal hands. Br J Dermatol. 2013;169(5):1087–92.

    Article  CAS  PubMed  Google Scholar 

  55. Piaserico S, Belloni Fortina A, Rigotti P, Rossi B, Baldan N, Alaibac M, et al. Topical photodynamic therapy of actinic keratosis in renal transplant recipients. Transplant Proc. 2007;39(6):1847–50.

    Article  CAS  PubMed  Google Scholar 

  56. Hasson A, Navarrete-Dechent C, Nicklas C, de la Cruz C. Topical photodynamic therapy with methylaminolevulinate for the treatment of actinic keratosis and reduction of photodamage in organ transplant recipients: a case-series of 16 patients. Indian J Dermatol Venereol Leprol. 2012;78(4):448–53.

    Article  PubMed  Google Scholar 

  57. Wulf HC, Pavel S, Stender I, Bakker-Wensveen CA. Topical photodynamic therapy for prevention of new skin lesions in renal transplant recipients. Acta Derm Venereol. 2006;86(1):25–8.

    CAS  PubMed  Google Scholar 

  58. Dragieva G, Prinz BM, Hafner J, Dummer R, Burg G, Binswanger U, et al. A randomized controlled clinical trial of topical photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratoses in transplant recipients. Br J Dermatol. 2004;151(1):196–200.

    Article  CAS  PubMed  Google Scholar 

  59. Togsverd-Bo K, Lei U, Erlendsson AM, Taudorf EH, Philipsen PA, Wulf HC, et al. Combination of ablative fractional laser and daylight-mediated photodynamic therapy for actinic keratosis in organ transplant recipients - a randomized controlled trial. Br J Dermatol. 2015;172(2):467–74.

    Article  CAS  PubMed  Google Scholar 

  60. Harwood CA, Leedham-Green M, Leigh IM, Proby CM. Low-dose retinoids in the prevention of cutaneous squamous cell carcinomas in organ transplant recipients: a 16 year retrospective study. Arch Dermatol. 2005;141(4):456–64.

    Article  CAS  PubMed  Google Scholar 

  61. George R, Weightman W, Russ GR, Bannister KM, Mathew TH. Acitretin for chemoprevention of non-melanoma skin cancers in renal transplant recipients. Australas J Dermatol. 2002;43(4):269–73.

    Article  PubMed  Google Scholar 

  62. Carneiro RV, Sotto MN, Azevedo LS, Ianhez LE, Rivitti EA. Acitretin and skin cancer in kidney transplanted patients. Clinical and histological evaluation and immunohistochemical analysis of lymphocytes, natural killer cells and Langerhans’ cells in sun exposed and sun protected skin. Clin Transplant. 2005;19(1):115–21.

    Article  PubMed  Google Scholar 

  63. Bonner JA, Harari PM, Giralt J, Azarnia N, Shin DM, Cohen RB, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med. 2006;354(6):567–78.

    Article  CAS  PubMed  Google Scholar 

  64. Jennings L, Schmults CD. Management of high-risk cutaneous squamous cell carcinoma. J Clin Aesthet Dermatol. 2010;3(4):39–48.

    PubMed Central  PubMed  Google Scholar 

  65. Mehrany K, Byrd DR, Roenigk RK, Weenig RH, Phillips PK, Nguyen TH, et al. Lymphocytic infiltrates and subclinical epithelial tumor extension in patients with chronic leukemia and solid-organ transplantation. Dermatol Surg. 2003;29(2):129–34.

    PubMed  Google Scholar 

  66. Connolly SM, Baker DR, Coldiron BM, Fazio MJ, Storrs PA, Vidimos AT, et al. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. J Am Acad Dermatol. 2012;67(4):531–50.

    Article  PubMed  Google Scholar 

  67. Motley R, Kersey P, Lawrence C. Multiprofessional guidelines for the management of the patient with primary cutaneous squamous cell carcinoma. Br J Plast Surg. 2003;56(2):85–91.

    Article  CAS  PubMed  Google Scholar 

  68. Stasko T, Brown MD, Carucci JA, Euvrard S, Johnson TM, Sengelmann RD, et al. Guidelines for the management of squamous cell carcinoma in organ transplant recipients. Dermatol Surg. 2004;30(4 Pt 2):642–50.

    PubMed  Google Scholar 

  69. Merritt BG, Lee NY, Brodland DG, Zitelli JA, Cook J. The safety of Mohs surgery: a prospective multicenter cohort study. J Am Acad Dermatol. 2012;67(6):1302–9.

    Article  PubMed  Google Scholar 

  70. Seidler AM, Bramlette TB, Washington C, Szeto H, Chen SC. Mohs versus traditional surgical excision for facial and auricular nonmelanoma skin cancer: an analysis of cost-effectiveness. Dermatol Surg. 2009;35(11):1776–87.

    Article  CAS  PubMed  Google Scholar 

  71. Cherpelis BS, Turner L, Ladd S, Glass LF, Fenske NA. Innovative 19-minute rapid cytokeratin immunostaining of nonmelanoma skin cancer in Mohs micrographic surgery. Dermatol Surg. 2009;35(7):1050–6.

    Article  CAS  PubMed  Google Scholar 

  72. Rowe DE, Carroll RJ, Day CL. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection. J Am Acad Dermatol. 1992;26(6):976–90.

    Article  CAS  PubMed  Google Scholar 

  73. Bangash HK, Colegio OR. Management of non-melanoma skin cancer in immunocompromised solid organ transplant recipients. Curr Treat Options Oncol. 2012;13(3):354–76.

    Article  PubMed  Google Scholar 

  74. Mendenhall WM, Ferlito A, Takes RP, Bradford CR, Corry J, Fagan JJ, et al. Cutaneous head and neck basal and squamous cell carcinomas with perineural invasion. Oral Oncol. 2012;48(10):918–22.

    Article  PubMed  Google Scholar 

  75. Schmitt AR, Brewer JD, Bordeaux JS, Baum CL. Staging for cutaneous squamous cell carcinoma as a predictor of sentinel lymph node biopsy results: meta-analysis of American Joint Committee on Cancer criteria and a proposed alternative system. JAMA Dermatol. 2014;150(1):19–24. The authors found that T2 lesions that are larger than 2 cm in diameter are most likeley to have positive SLNB findings.

    Article  PubMed  Google Scholar 

  76. Veness MJ, Morgan GJ, Palme CE, Gebski V. Surgery and adjuvant radiotherapy in patients with cutaneous head and neck squamous cell carcinoma metastatic to lymph nodes: combined treatment should be considered best practice. Laryngoscope. 2005;115(5):870–5.

    Article  PubMed  Google Scholar 

  77. Reeves TD, Hill EG, Armeson KE, Gillespie MB. Cetuximab therapy for head and neck squamous cell carcinoma: a systematic review of the data. Otolaryngol Neck Surg. 2011;144(5):676–84.

    Article  Google Scholar 

  78. Dziunycz PJ, Lazarova Z, Duncan N, Wong S, Neuburg M, Hofbauer GF, et al. EGFRvIII expression in squamous cell carcinoma of the skin. JAMA Dermatol. 2013;149(10):1240–2.

    Article  PubMed  Google Scholar 

  79. Maubec E, Petrow P, Scheer-Senyarich I, Duvillard P, Lacroix L, Gelly J, et al. Phase II study of cetuximab as first-line single-drug therapy in patients with unresectable squamous cell carcinoma of the skin. J Clin Oncol. 2011;29(25):3419–26.

    Article  CAS  PubMed  Google Scholar 

  80. O’Bryan K, Sherman W, Niedt GW, Taback B, Manolidis S, Wang A, et al. An evolving paradigm for the workup and management of high-risk cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2013;69(4):595–602.

    Article  PubMed  Google Scholar 

  81. Leard LE, Cho BK, Jones KD, Hays SR, Tope WD, Golden JA, et al. Fatal diffuse alveolar damage in two lung transplant patients treated with cetuximab. J Heart Lung Transplant. 2007;26(12):1340–4.

    Article  PubMed  Google Scholar 

  82. Dorsey K, Agulnik M. Promising new molecular targeted therapies in head and neck cancer. Drugs. 2013;73(4):315–25.

    Article  CAS  PubMed  Google Scholar 

  83. Lindelöf B, Jarnvik J, Ternesten-Bratel A, Granath F, Hedblad MA. Mortality and clinicopathological features of cutaneous squamous cell carcinoma in organ transplant recipients: a study of the Swedish cohort. Acta Derm Venereol. 2006;86(3):219–22.

    Article  PubMed  Google Scholar 

  84. Moloney FJ, Elly PO, Ay EW, Conlon P, Murphy GM. Maintenance versus reduction of immunosuppression in renal transplant recipients with aggressive squamous cell carcinoma. Dermatol Surg. 2004;30(4 Pt 2):674–8.

    CAS  PubMed  Google Scholar 

  85. Moloney FJ, Comber H, O’Lorcain P, O’Kelly P, Conlon PJ, Murphy GM. A population-based study of skin cancer incidence and prevalence in renal transplant recipients. Br J Dermatol. 2006;154(3):498–504.

    Article  CAS  PubMed  Google Scholar 

  86. Carucci JA, Martinez JC, Zeitouni NC, Christenson L, Coldiron B, Zweibel S, et al. In-transit metastasis from primary cutaneous squamous cell carcinoma in organ transplant recipients and nonimmunosuppressed patients: clinical characteristics, management, and outcome in a series of 21 patients. Dermatol Surg. 2004;30(4 Pt 2):651–5.

    PubMed  Google Scholar 

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Stefan E. Lowenstein, Giorgia L. Garrett, Steven Y. He, Matt Mansh, and Sarah T. Arron declare that they have no conflict of interest.

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Authors and Affiliations

  1. School of Medicine, University of California at San Francisco, San Francisco, CA, 94143, USA

    Stefan E. Lowenstein & Steven Y. He

  2. Department of Dermatology, University of California at San Francisco, San Francisco, CA, 94115, USA

    Giorgia L. Garrett & Sarah T. Arron

  3. School of Medicine, Stanford University, Stanford, CA, 94305, USA

    Matthew Mansh

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  1. Stefan E. Lowenstein
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Correspondence to Sarah T. Arron.

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This article is part of the Topical Collection on Skin Cancer

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Lowenstein, S.E., Garrett, G.L., He, S.Y. et al. Management of Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients. Curr Derm Rep 4, 159–167 (2015). https://doi.org/10.1007/s13671-015-0114-5

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