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Advanced Squamous Cell Carcinoma: What’s New?

  • Skin Cancer (E Tongdee and O Markowitz, Section Editors)
  • Published:
Current Dermatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Advanced cutaneous squamous cell carcinoma (cSCC), though rare, is fatal with an 89% 5-year mortality rate. The diagnostic criteria for advanced basal cell carcinoma were recently redefined with the introduction of hedgehog inhibitors such as vismodegib. Similarly, the authors suggest redefining the diagnostic criteria of advanced cSCC given the introduction of immune checkpoint inhibitors in order to broaden the patient population that can benefit from both new and old treatment options as potential neoadjuvants.

Recent Findings

Cemiplimab is a programmed death-1 (PD-1) inhibitor recently FDA-approved in 2018 for advanced cSCC with improved response rates (47–50%) compared to prior treatments. Given the lack of standardization, we suggest the diagnostic criteria of advanced cSCC to consider the patient condition, age, comorbidities, immunosuppression, and cosmetic outcome when determining a treatment regimen. Patients with diffuse cSCC due to immunosuppression may benefit from acitretin, while lesions on the lip may have a poor cosmetic outcome with surgery and may benefit from neoadjuvant therapy.

Summary

Advanced cSCC does not have standardized diagnostic criteria likely due to the lack of treatment options until now. Additional treatment options may be beneficial to a broader patient population when redefining advanced cSCC to include factors such as immunosuppression and cosmetic outcome from the perspective of the patient.

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Authors and Affiliations

  1. Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Emily Tongdee, Corinna Psomadakis, Nadeem Marghoob, Pavan Paka & Orit Markowitz

  2. Department of Dermatology, Mount Sinai Medical Center, 5 E 98th St., New York, NY, 10029, USA

    Emily Tongdee, Corinna Psomadakis, Nadeem Marghoob, Pavan Paka & Orit Markowitz

  3. Department of Dermatology, New York Harbor Healthcare System, Brooklyn, NY, USA

    Emily Tongdee, Corinna Psomadakis, Nadeem Marghoob, Pavan Paka & Orit Markowitz

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  1. Emily Tongdee
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Correspondence to Orit Markowitz.

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Conflict of Interest

Orit Markowitz received payment from Regeneron for PD-1 inhibitor consultations.

Emily Tongdee, Corinna Psomadakis, Nadeem Marghoob, and Pavan Paka declare no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Tongdee, E., Psomadakis, C., Marghoob, N. et al. Advanced Squamous Cell Carcinoma: What’s New?. Curr Derm Rep 8, 117–121 (2019). https://doi.org/10.1007/s13671-019-0261-1

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