Treatment of unresectable squamous cell carcinoma of the skin with epidermal growth factor receptor antibodies - a case series

Abstract

Non-melanoma skin cancer (NMSC), including squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), is the most common malignancy. Unresectable or metatstatic SCC is rare and therapy can be difficult because of advanced age and comorbidities. Targeted therapy with monoclonal antibodies (mAbs) against EGFR is an option in these patients. The aim of this presentation is to provide additional evidence on the safety of anti-EGFR mAbs in long-term palliation and adjuvant treatment of advanced SCC. This is a retrospective analysis of 4 patients with locally advanced or metastatic SCC who received cetuximab and/or panitumumab. 3 patients (2 females, 1 male, ages 86 to 93) received cetuximab for the treatment of unresectable SCC. In 2 patients partial remissions were achieved and maintained with continuous treatment for 17 and 18 months. Another patient achieved complete remission after 16 cetuximab treatments and is still free of disease with ongoing therapy after an overall observation period of 16 months. In a fourth patient, with recurrent loco-regional metastatic disease of the scalp and neck, adjuvant cetuximab followed by panitumumab was introduced after extensive surgery. 2 patients had a grade II-III skin rash successfully treated with topical erythromycin, systemic doxycyclin and dose modification. Cetuximab is suitable for palliation in elderly patients, able to maintain remissions and prevent disease progression over extended periods of continuing treatment without significant toxicity. Furthermore, adjuvant anti-EGFR therapy may be a promising treatment strategy in patients with a high risk of recurrence.