Case Report: Cetuximab and nivolumab use in advanced cutaneous squamous cell carcinoma resistant to chemotherapy

Alvise Sernicola,Sara Grassi,Salvatore Lampitelli,Stefano Calvieri,Antonio Giovanni Richetta,Federica Marraffa,Patrizia Maddalena

doi:10.12688/f1000research.19149.2

Alvise Sernicola, Sara Grassi + Show 5 more

Open Access

https://doi.org/10.12688/f1000research.19149.2

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Journal: F1000Research	Publication Date: Dec 31, 2019
Citations: 2	License type: CC BY 4.0

Affiliation: Sapienza University of Rome

Abstract

We present the case of a 60-year-old man with unresectable cutaneous squamous cell carcinoma (cSCC) of the sternal area, which was not amenable to radiation therapy (stage III, T3N0M0). The treatment history of this patient is remarkable as the disease had progressed through all lines of conventional therapy established in the literature. The patient was treated with epidermal growth factor receptor (EGFR) inhibitor cetuximab for 35 cycles and restaged after 12 months of therapy with a whole body CT scan, documenting stage IV disease (T3N2bM1). The use of cetuximab as a single agent was effective for a limited time and we decided to initiate combination therapy with cetuximab and nivolumab. Restaging after six months of this combination regimen documented stable disease.

Highlights

The patient reported intermittent pain and bleeding (Figure 1). This case describes the effective use of cetuximab and nivolumab in an extensive thoracic cutaneous squamous cell carcinoma resistant to all previous lines of chemotherapy
We were challenged to select an effective treatment in this advanced case and resorted to epidermal growth factor receptor (EGFR) inhibitor therapy
Cetuximab is approved for the treatment of locally or regional advanced squamous cell carcinoma (SCC) of the head and neck region or for recurrent or metastatic disease

Summary

21 Jun 2019

University of Padova, Any reports and responses or comments on the article can be found at the end of the article. Following progression to stage IV disease after one year of cetuximab, combination therapy with the addition of PD-1 blocker nivolumab was administered for another six months, achieving disease stability. This choice reflects recent advancements in the treatment scenario of advanced cSCC, with anti-PD-1 monoclonal antibody cemiplimab established as the standard of care in immune-competent patients. Any further responses from the reviewers can be found at the end of the article contraindications to immunotherapy[4].

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