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Efficacy of Neoadjuvant Cemiplimab Treatment for Cutaneous Squamous Cell Carcinoma—A Systematic Review
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Faculdade de Ciências Médicas da Santa Casa de São Paulo, FCMSCSP, Sao Paulo 01224-001, SP, Brazil
2
Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo 05508-220, SP, Brazil
*
Authors to whom correspondence should be addressed.
Int. J. Mol. Sci. 2025, 26(16), 8109; https://doi.org/10.3390/ijms26168109 (registering DOI)
Submission received: 16 June 2025
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Revised: 7 August 2025
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Accepted: 16 August 2025
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Published: 21 August 2025
(This article belongs to the Special Issue Molecular Research in Skin Health and Disease)
Simple Summary
Cutaneous squamous cell carcinoma (cSCC) accounts for 50% of primary skin cancers, and the worldwide incidence is increasing. The classic treatment options can often lead to negative cosmetic impacts, an inferior quality of life, and have limited efficacy and poor tolerability. The aim of this review was to analyze the Neoadjuvant Cemipimab setting as an alternative therapeutic strategy for cSCC patients. Data from different articles and trials was explored and compared, where the use of neoadjuvant Cemiplimab seems to be an emerging and promising alternative treatment. The mean complete pathologic response rates from the triggered trials were 72%, indicating high efficacy. Although some long-term studies and real-world settings still need more certainty, there already are studies that have shown positive therapy results for immunocompromised patients and patients with multiple comorbidities. Therefore, neoadjuvant Cemiplimab is a safe, possible, and efficient treatment for cSCC patients.
Abstract
Skin cancer is the most common cancer form worldwide, and it is primarily divided into melanoma and non-melanoma types, with non-melanoma being the most prevalent condition. Cutaneous squamous cell carcinoma (cSCC) accounts for 50% of primary skin cancers and is characterized by uncontrolled keratinocyte proliferation. cSCC’s current standard treatment is surgical resection and chemotherapy. Unfortunately, these methods often lead to disfigurement, functional morbiditly, and compromised function. In contrast to immunotherapy, emerging scenarios have shown promising results, especially in neoadjuvant settings. Cemiplimab (Libtayo®; Regeneron, Tarrytown, NY, USA), a PD-1 monoclonal antibody, has shown efficacy in treating advanced or metastatic cSCC, and its use as a neoadjuvant therapy has been recently explored. This review aims to evaluate Cemiplimab in the neoadjuvant setting for cSCC treatment. The Methodology followed PRISMA guidelines, this review analyzed studies on Cemiplimab as a neoadjuvant therapy for cSCC that were sourced from PubMed, Web of Science, and Scopus. Only controlled trials, cohort studies, case series, and systematic reviews were included. From 341 records, 21 studies were included, and six clinical trials provided key data about neoadjuvant Cemiplimab’s response rates, efficacy, adverse effects, and safety considerations. The targeted data revealed a neoadjuvant Cemiplimab mean pathologic response rate of 72%, with a 62% objective response rate. Treatment-related adverse events (TRAEs) affect 66% of patients, though most cases are not severe. The most common include fatigue, maculopapular rash, and diarrhea. The studies showed high rates of complete pathological responses (cPRs) and major pathological responses (mPRs), suggesting a strong therapeutic potential. Neoadjuvant Cemiplimab for cSCC therapy shows high response rates, low recurrence, improved survival, and manageable side effects. The current literature indicates that Cemiplimab may also be effective when used in immunosuppressed patients. Despite more research still being needed to confirm its long-term benefits and the effects of the drug’s use outside of clinical trials, there is strong evidence to consider neoadjuvant Cemiplimab as a promising and efficient treatment.
