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. The treatment history of this patient is remarkable as the disease had progressed through all lines of conventional therapy established in the literature. We decided to initiate treatment with epidermal growth factor receptor (EGFR) inhibitor cetuximab and we reassessed the patient after 12 weeks with a whole-body CT scan, documenting stability in the size and radiologic features of the disease. Cetuximab, like all current treatments for advanced cSCC, is administered off-label and proved effective in preventing further progression of disease in our patient.
Highlights
First published: 21 Jun 2019, 8:933. This case describes the effective use of cetuximab in an extensive thoracic cutaneous squamous cell carcinoma resistant to all previous lines of chemotherapy
Cetuximab is a monoclonal antibody first approved for metastatic colon-rectal carcinoma with epidermal growth factor receptor (EGFR) expression
EGFR is overexpressed in the majority of squamous cell carcinoma (SCC) and the drug is indicated, in association with radiotherapy, for locally advanced head-neck SCC, or with chemotherapy for recurrent/ metastatic disease
Summary
This case describes the effective use of cetuximab in an extensive thoracic cutaneous squamous cell carcinoma resistant to all previous lines of chemotherapy. EGFR is overexpressed in the majority of SCCs and the drug is indicated, in association with radiotherapy, for locally advanced head-neck SCC, or with chemotherapy for recurrent/ metastatic disease. It is normally used at the standard weekly dosage of 250mg/m2. 2000: Patient reports onset of nodular skin lesion 2013: Incisional biopsy: BCC CT scan (23-Jan-2013): high local burden of disease (5.0cm AP diameter), with destructive osteo-muscular infiltration. - vismodegib 150mg daily from Feb to Nov-2013 2014: relapse of nodular skin lesion Excision biopsy (Feb-2014): SCC Wide surgical excision (22-May-2014): not radical Adjuvant chemotherapy:. AP, anterior-posterior; BCC, basal cell carcinoma; CT, computerized tomography; SCC, squamous cell carcinoma; PD-L1, programmed cell death ligand-1
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