Cetuximab for Immunotherapy-Refractory/Ineligible Cutaneous Squamous Cell Carcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Patients and Methods
3. Results
3.1. Patients
3.2. Efficacy
3.3. Toxicities
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients (N = 23) | Cohorts A and B (N = 13) | Cohort A (N = 11) | Cohort B (N = 2) | Cohort C (N = 10) | |
---|---|---|---|---|---|
Age | 68 {49–89} | 72 {54–89} | 72 {54–89} | 71.5 {65–77} | 67.5 {49–75} |
Gender | |||||
Males | 15 (65.2%) | 11 (84.6%) | 10 (90.9%) | 1 (50%) | 4 (40%) |
Females | 8 (34.8%) | 2 (15.4%) | 1 (9.1%) | 1 (50%) | 6 (60%) |
Race | |||||
White | 23 (100%) | 13 (100%) | 11 (100%) | 2 (100%) | 10 (100%) |
Comorbidities on Systemic Immunosuppression or Lymphodepleting Therapy | 9 (39.1%) | 1 (7.7%) | - | 1 (50%) | 8 (80%) |
Secondary Cancer | 1 (4.3%) | 1 (7.7%)—CLL | - | 1 (50%)—CLL | - |
Autoimmunity | 3 (13%) | - | - | - | 3 (30%) |
Kidney Transplant | 3 (13%) | - | - | - | 3 (30%) |
Heart Transplant | 1 (4.3%) | - | - | - | 1 (10%) |
Liver Transplant | 1 (4.3%) | - | - | - | 1 (10%) |
Primary Site | |||||
Scalp | 2 (8.7%) | 2 (15.4%) | 2 (18.2%) | - | - |
Face | 10 (43.5%) | 3 (23.1%) | 3 (27.3%) | - | 7 (70%) |
Trunk | 3 (13%) | 2 (15.4%) | 1 (9.1%) | 1 (50%) | 1 (10%) |
Upper Extremity | 3 (13%) | 3 (23.1%) | 2 (18.2%) | 1 (50%) | - |
Lower Extremity | 5 (21.7%) | 3 (23.1%) | 3 (27.3%) | - | 2 (20%) |
Disease Stage at Time of Therapy | |||||
Locally Advanced | 9 (39.1%) | 3 (23.1%) | 3 (27.3%) | - | 6 (60%) |
Metastatic | 14 (60.9%) | 10 (76.9%) | 8 (72.3%) | 2 (100%) | 4 (40%) |
Line Cetuximab Use | |||||
First | 9 (39.1%) | - | - | - | 9 (90%) |
Second or More | 14 (60.9%) | 13 (100%) | 11 (100%) | 2 (100%) | 1 (10%) |
Concurrent Radiation | 9 (39.1%) | 6 (46.2%) | 6 (54.5%) | - | 3 (30%) |
Cohort | Patient | Location of Radiation | Dosing and Fractions | Radiation Goal | Measurable Distant Disease | Response to Cetuximab | Progression after Cetuximab |
---|---|---|---|---|---|---|---|
A (n = 6/11, 54.5%) | 1 | Primary Tumor | 66 Gy, 33 fractions | Definitive | Yes: Distal Lymph Nodes | PR | No |
2 | Regional Lymph Node | 30 Gy, 10 fractions | Palliative | Yes: Distal Lymph Nodes | PR | No | |
3 | Regional Lymph Node | 54 Gy, 18 fractions | Palliative | Yes: Distal Lymph Nodes and Bone | SD | Yes | |
4 | Primary Tumor + Regional Lymph Node | 70 Gy, 35 fractions | Definitive | No | SD | No | |
5 | Metastatic Cutaneous Lesion | 40 Gy, 10 fractions | Palliative | Yes: Distal Lymph Nodes | PR | Yes | |
6 | Primary Tumor | 66 Gy, 33 fractions | Definitive | Yes: Pulmonary Metastasis | PR | No | |
C (n = 3/10, 30%) | 1 | Primary Tumor | 70 Gy, 35 fractions | Definitive | No | PR | No |
2 | Regional Lymph Nodes | 30 Gy, 15 fractions | Palliative | No | PR | Yes | |
3 | Regional Lymph Nodes | 70 Gy, 35 fractions | Definitive | No | PR | Yes |
Associated Condition (n = 10) | Immunosuppressive Regimens | Concurrent Radiation | Best Response | Progression after Cetuximab |
---|---|---|---|---|
Kidney Transplantation (n = 3) | Cyclosporine + prednisone (n = 1) | No | CR | No * |
Tacrolimus (n = 1) | No | PD | N/A | |
Tacrolimus + mycophenolate (n = 1) | No | PD | N/A | |
Liver Transplantation (n = 1) | Tacrolimus + mycophenolate | Yes | PR | No |
Heart Transplantation (n = 1) | Tacrolimus + prednisone | Yes | PR | Yes |
Multiple Sclerosis (n = 1) | Fingolimod | No | PR | No * |
Wegener’s Granulomatosis (n = 1) | Prednisone | No | PR | Yes |
Severe Lichen Planus (n = 1) | Beclomethasone + triamcinolone | No | PR | No * |
Sjögren’s Syndrome (n = 1) | None (n = 1) | No | PR | No ** |
None (n = 1) | None (n = 1) | Yes | PR | Yes *** |
Response | All Patients (N = 23) | Cohorts A/B (N = 13) | Cohort A (N = 11) | Cohort B (N = 2) | Cohort C (N = 10) |
---|---|---|---|---|---|
ORR | 65.2% (15) | 53.9% (7) | 63.6% (7) | 0% (0) | 80% (8) |
DCR | 78.2% (18) | 77% (10) | 90.9% (10) | 0% (0) | 80% (8) |
CR | 8.7% (2) | 7.7% (1) | 9.1% (1) | - | 10% (1) |
PR | 56.5% (13) | 46.2% (6) | 54.5% (6) * | - | 70% (7) **** |
SD | 13% (3) | 23.1% (3) | 27.3% (3) ** | - | - |
PD | 21.7% (5) | 23.1% (3) | 9.1% (1) | 100% (2) *** | 20% (2) |
Toxicities | All Patients (N = 23) | Cohort A (N = 11) | Cohort B (N = 2) | Cohort C (N = 10) |
---|---|---|---|---|
All | 22 (95.7%) | 11 (100%) | 2 (100%) | 9 (90%) |
Rash | 6 (26.1%) | 4 (36.3%) | 1 (50%) | 1 (10%) |
Grade 1 | 1 (4.3%) | 1 (9.1%) | 1 (50%) | 0 (0%) |
Grade 2 | 5 (21.7%) | 4 (36.3%) | 0 (0%) | 1 (10%) ** |
Hypomagnesemia | 4 (17.4%) | 1 (9.1%) | 0 (0%) | 3 (30%) |
Grade 1 | 3 (13%) | 1 (9.1%) | 0 (0%) | 2 (20%) |
Grade 2 | 1 (4.3%) | 0 (0%) | 0 (0%) | 1 (10%) ** |
Hypomagnesemia with Rash | 10 (43.5%) | 5 (45.5%) | 1 (50%) | 4 (40%) |
Grade 1 | 3 (13%) | 2 (18.2%) | 0 (0%) | 1 (10%) |
Grade 2 | 7 (30.4%) | 3 (27.3%) | 1 (50%) | 3 (30%) **, Δ |
Other (all Grade 5) | 1 (4.3%) * | 0 (0%) | 0 (0%) | 1 (10%) *, ** |
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Share and Cite
Marin-Acevedo, J.A.; Withycombe, B.M.; Kim, Y.; Brohl, A.S.; Eroglu, Z.; Markowitz, J.; Tarhini, A.A.; Tsai, K.Y.; Khushalani, N.I. Cetuximab for Immunotherapy-Refractory/Ineligible Cutaneous Squamous Cell Carcinoma. Cancers 2023, 15, 3180. https://doi.org/10.3390/cancers15123180
Marin-Acevedo JA, Withycombe BM, Kim Y, Brohl AS, Eroglu Z, Markowitz J, Tarhini AA, Tsai KY, Khushalani NI. Cetuximab for Immunotherapy-Refractory/Ineligible Cutaneous Squamous Cell Carcinoma. Cancers. 2023; 15(12):3180. https://doi.org/10.3390/cancers15123180
Chicago/Turabian StyleMarin-Acevedo, Julian A., Bethany M. Withycombe, Youngchul Kim, Andrew S. Brohl, Zeynep Eroglu, Joseph Markowitz, Ahmad A. Tarhini, Kenneth Y. Tsai, and Nikhil I. Khushalani. 2023. "Cetuximab for Immunotherapy-Refractory/Ineligible Cutaneous Squamous Cell Carcinoma" Cancers 15, no. 12: 3180. https://doi.org/10.3390/cancers15123180