Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective study

Background: Chronic wounds increase the risk of the development of cutaneous squamous cell carcinoma (SCC), often resulting in poor prognosis in part because of delayed diagnosis. Cemiplimab, an anti-PD-1 agent, is recommended as first-line treatment for metastatic or locally advanced SCC not eligib...

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Main Authors: M. Antoszczak, E. Maubec, A.-B. Duval-Modeste, A. Jannic, C. Jacobzone-Leveque, R. Lesbazeilles, F. Skowron, D. Solub, J. Ancel, L. Mortier, M. Viguier
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:EJC Skin Cancer
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772611824002611
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author M. Antoszczak
E. Maubec
A.-B. Duval-Modeste
A. Jannic
C. Jacobzone-Leveque
R. Lesbazeilles
F. Skowron
D. Solub
J. Ancel
L. Mortier
M. Viguier
author_facet M. Antoszczak
E. Maubec
A.-B. Duval-Modeste
A. Jannic
C. Jacobzone-Leveque
R. Lesbazeilles
F. Skowron
D. Solub
J. Ancel
L. Mortier
M. Viguier
author_sort M. Antoszczak
collection DOAJ
description Background: Chronic wounds increase the risk of the development of cutaneous squamous cell carcinoma (SCC), often resulting in poor prognosis in part because of delayed diagnosis. Cemiplimab, an anti-PD-1 agent, is recommended as first-line treatment for metastatic or locally advanced SCC not eligible for curative surgery, chemotherapy or radiation. However, its efficacy in SCC originating from chronic wounds remains uncertain. Objective: This retrospective study assessed the efficacy and safety of cemiplimab in patients with SCC originating from chronic wounds. Methods: We included patients receiving cemiplimab for SCC on chronic wounds between August 2018 and January 2021. The primary endpoint was progression-free survival (PFS) determined by Kaplan-Meier analysis. Secondary endpoints included response rate and safety. Results: We included 17 patients, predominantly female (59 %), with median age 58 years (interquartile range 49–77). SCC typically originated from leg ulcers (47 %) and presented at locally advanced (41 %) or metastatic stage (41 %). With cemiplimab, often received as third-line therapy (41 %), the median PFS was 6.1 months (95 % confidence interval [CI], 2.97–7.70), with the best response rate 47 % and complete response rate 12 %. We found immune-related adverse events in 24 % of cases. Short PFS was associated with distant metastasis at treatment initiation. Conclusion: Despite response rates comparable to other SCC types, median PFS was low with cemiplimab treatment for SCC originating from chronic wounds, likely due to the aggressive nature and/or high frequency of altered performance status. Anti-PD-1 therapy remains a primary treatment option for inoperable cases. Further prospective studies are warranted to confirm these findings and optimize treatment strategies.
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spelling doaj-art-ec4af130a98a4eefa6ac6c308d6216e42025-08-20T02:50:09ZengElsevierEJC Skin Cancer2772-61182024-12-01210027310.1016/j.ejcskn.2024.100273Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective studyM. Antoszczak0E. Maubec1A.-B. Duval-Modeste2A. Jannic3C. Jacobzone-Leveque4R. Lesbazeilles5F. Skowron6D. Solub7J. Ancel8L. Mortier9M. Viguier10Dermatology Department, Robert-Debré Hospital, Reims-Champagne Ardenne University, EA7509 IRMAIC, Reims, FranceDermatology Department, Avicenne University Hospital, Assistance Publique–Hôpitaux de Paris (AP-HP), Sorbonne-Paris-Nord University, Bobigny, France; INSERM UMR1124, Paris Cité University, FranceDermatology Department, Charles-Nicolle Hospital, Rouen, FranceDermatology Department, Henri-Mondor Hospital, APHP, Créteil, FranceDermatology Department, Scorff Hospital, Lorient, FranceDermatology Department, Poitiers University Hospital, Poitiers, FranceDermatology Department, North Drome Hospital, Romans-Sur-Is, FranceDermatology Department, Louis Pasteur Hospital, Le Coudray, FranceUniversité de Reims Champagne-Ardenne, INSERM, P3Cell, UMR-S 1250, SFR CAP Santé, Reims, FranceDermatology Department, Lille University Hospital, Lille, France; INSERM UMR1189, Lille University, FranceDermatology Department, Robert-Debré Hospital, Reims-Champagne Ardenne University, EA7509 IRMAIC, Reims, France; Correspondence to: Department of Dermatology, Hôpital Robert-Debré, Avenue du Général Koenig, Reims Cedex 51092, France.Background: Chronic wounds increase the risk of the development of cutaneous squamous cell carcinoma (SCC), often resulting in poor prognosis in part because of delayed diagnosis. Cemiplimab, an anti-PD-1 agent, is recommended as first-line treatment for metastatic or locally advanced SCC not eligible for curative surgery, chemotherapy or radiation. However, its efficacy in SCC originating from chronic wounds remains uncertain. Objective: This retrospective study assessed the efficacy and safety of cemiplimab in patients with SCC originating from chronic wounds. Methods: We included patients receiving cemiplimab for SCC on chronic wounds between August 2018 and January 2021. The primary endpoint was progression-free survival (PFS) determined by Kaplan-Meier analysis. Secondary endpoints included response rate and safety. Results: We included 17 patients, predominantly female (59 %), with median age 58 years (interquartile range 49–77). SCC typically originated from leg ulcers (47 %) and presented at locally advanced (41 %) or metastatic stage (41 %). With cemiplimab, often received as third-line therapy (41 %), the median PFS was 6.1 months (95 % confidence interval [CI], 2.97–7.70), with the best response rate 47 % and complete response rate 12 %. We found immune-related adverse events in 24 % of cases. Short PFS was associated with distant metastasis at treatment initiation. Conclusion: Despite response rates comparable to other SCC types, median PFS was low with cemiplimab treatment for SCC originating from chronic wounds, likely due to the aggressive nature and/or high frequency of altered performance status. Anti-PD-1 therapy remains a primary treatment option for inoperable cases. Further prospective studies are warranted to confirm these findings and optimize treatment strategies.http://www.sciencedirect.com/science/article/pii/S2772611824002611Squamous cell carcinomaImmunotherapyWounds and injuriesLeg ulcer
spellingShingle M. Antoszczak
E. Maubec
A.-B. Duval-Modeste
A. Jannic
C. Jacobzone-Leveque
R. Lesbazeilles
F. Skowron
D. Solub
J. Ancel
L. Mortier
M. Viguier
Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective study
EJC Skin Cancer
Squamous cell carcinoma
Immunotherapy
Wounds and injuries
Leg ulcer
title Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective study
title_full Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective study
title_fullStr Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective study
title_full_unstemmed Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective study
title_short Efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds: A French retrospective study
title_sort efficacy and safety of cemiplimab in cutaneous squamous cell carcinoma on chronic wounds a french retrospective study
topic Squamous cell carcinoma
Immunotherapy
Wounds and injuries
Leg ulcer
url http://www.sciencedirect.com/science/article/pii/S2772611824002611
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