Key opinion leaders close the discussion by considering the future of cutaneous squamous cell carcinoma (CSCC) and promising emerging regimens.
PUBLISHED June 15, 2020
Anna C. Pavlick, DO: We want something much more optimistic. Where are we going with this disease? Where do you see the future of treatment options for patients evolving now that we have some cemiplimab in our arsenal of therapeutic options? What are your hopes and expectations for where you expect therapy or management of cutaneous squamous cell to be going?
Anthony Rossi, MD, FAAD: That’s a great question. As a dermatologist and a Mohs’ surgeon, I always think of trying to get these lesions as early as possible or even be more preventive in my approach to the patient. Especially in our organ transplant population, if we can switch their immunosuppression from something that we know is very causative of future squamous cell carcinomas—like the calcineurin inhibitors, if we can get them on an MTOR inhibitor—we know that has a decreased risk of cutaneous squamous cell carcinoma. Trying to be proactive in our approach to prevention is always exciting for me.
Now that we are still seeing advance in metastatic squamous cells, knowing that we have a form of immunotherapy like cemiplimab is helpful for us to know, because for patients who may have an increased morbidity from surgery and radiation and are still leading active lifestyles may not want to undergo all that, we do have this new option, which is really important for us to consider.
Anna C. Pavlick, DO: Yeah, I agree. And it’s not 100% effective; it’s 50%. But that’s an amazingly good cornerstone to start building on, looking at whether we can add EGFR receptor inhibitors to cemiplimab to increase the efficacy. We’ve got some investigational agents that are injectable into the tumor. Can we use that to create more of an immunologically driven environment in conjunction with cemiplimab to get better cell kill? There are so many exciting future options. Can we use radiation and cemiplimab together to get more bang for our buck? That’s another question being looked at in clinical trials.
So I think the number of clinical trials are really exponentially increasing every day when it comes to cutaneous squamous cell because there’s so many options and I think we need to now push that needle from 50% to 75% and hopefully in our lifetime we can get it pretty darn close if not to 100. But I think when it comes to how do we impact it most, I think awareness and prevention is clearly where we need to start, although we have these therapies, I hope there’s a time in my life where I don’t have to talk about therapy and I can go out there and just talk about education and prevention.
Anthony Rossi, MD, FAAD: For sure. I think these off-label neoadjuvant or off-label adjuvant trials might really be helpful and hopeful.
Anna C. Pavlick, DO: I hope everyone enjoyed that as much as I did. Thank you, Dr. Rossi, for such an informative and stimulating discussion. And to our viewing audience, we hope you found this Cure® ExpertConnections® program to be useful informative as well. Thank you.
Anthony Rossi, MD, FAAD: Thank you, Dr. Pavlick, for being such a wonderful colleague and so information rich.