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Dhillon J, Li DQ, Burnier M, Shenouda G, Arthurs BP, El-Hadad C. Cemiplimab for metastatic squamous cell carcinoma of the orbit, periocular adnexa, and thigh. Orbit 2024; 43:258-264. [PMID: 36052515 DOI: 10.1080/01676830.2022.2118789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/25/2022] [Indexed: 10/14/2022]
Abstract
The current case presentation highlights the potential of cemiplimab, a programmed cell death protein-1 (PD-1) inhibitor, as first-line treatment for periocular metastatic cutaneous squamous cell carcinoma (SCC) without requiring curative surgery or radiotherapy. A 64-year-old male presented with a progressing 4.5 × 3.0 cm left upper eyelid lesion initially diagnosed as psoriasis. Work-up revealed cutaneous SCC with tumor invasion into extraconal fat and lacrimal gland, and metastasis to the left parotid lymph node. The patient also presented with a suspicious lesion on his left medial thigh found to be a second primary on pathology. To avoid orbital exenteration and treat the multifocal disease, the patient was started on intravenous cemiplimab immunotherapy. Following six doses, repeated FGD-PET-CT revealed a complete response of the left eyelid lesion and residual low-grade hypermetabolic activity of the left medial thigh lesion. Biopsy confirmed chronic inflammation and fibrosis with no signs of malignancy. This unique case with dual primary cutaneous SCC provides support for cemiplimab in treating locally invasive periocular SCC, and potentially abrogating the need for highly morbid exenteration procedures to preserve binocular vision.
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Affiliation(s)
- Jobanpreet Dhillon
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, USA
| | - Daniel Q Li
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
| | - Miguel Burnier
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
| | - George Shenouda
- Department of Radiation Oncology, McGill University, Montreal, QC, USA
| | - Bryan P Arthurs
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
| | - Christian El-Hadad
- Department of Ophthalmology & Visual Sciences, McGill University, Montreal, QC, USA
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2
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Huang C, Zhang K, Guo Y, Shen C, Liu X, Huang H, Dou X, Yu B. The crucial roles of m 6A RNA modifications in cutaneous cancers: Implications in pathogenesis, metastasis, drug resistance, and targeted therapies. Genes Dis 2023; 10:2320-2330. [PMID: 37554186 PMCID: PMC10404882 DOI: 10.1016/j.gendis.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/11/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022] Open
Abstract
N6-methyladenosine (m6A) is the most abundant internal modification on RNA. It is a dynamical and reversible process, which is regulated by m6A methyltransferase and m6A demethylase. The m6A modified RNA can be specifically recognized by the m6A reader, leading to RNA splicing, maturation, degradation or translation. The abnormality of m6A RNA modification is closely related to a variety of biological processes, especially the occurrence and development of tumors. Recent studies have shown that m6A RNA modification is involved in the pathogenesis of skin cancers. However, the precise molecular mechanisms of m6A-mediated cutaneous tumorigenesis have not been fully elucidated. Therefore, this review will summarize the biological characteristics of m6A modification, its regulatory role and mechanism in skin cancers, and the recent research progress of m6A-related molecular drugs, aiming to provide new ideas for clinical diagnosis and targeted therapy of cutaneous cancers.
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Affiliation(s)
- Cong Huang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong 518036, China
| | - Kaoyuan Zhang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, China
| | - Yang Guo
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong 518036, China
| | - Changbing Shen
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, China
| | - Xiaoming Liu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, China
| | - Haiyan Huang
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, China
| | - Xia Dou
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, China
| | - Bo Yu
- Department of Dermatology, Skin Research Institute of Peking University Shenzhen Hospital, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, Guangdong 518036, China
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3
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Yeo N, Genenger B, Aghmesheh M, Thind A, Napaki S, Perry J, Ashford B, Ranson M, Brungs D. Sex as a Predictor of Response to Immunotherapy in Advanced Cutaneous Squamous Cell Carcinoma. Cancers (Basel) 2023; 15:5026. [PMID: 37894393 PMCID: PMC10605413 DOI: 10.3390/cancers15205026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/11/2023] [Accepted: 10/14/2023] [Indexed: 10/29/2023] Open
Abstract
Approximately 3-5% of patients with cutaneous squamous cell carcinoma (CSCC) develop advanced disease, accounting for roughly 1% of all cancer deaths in Australia. Immunotherapy has demonstrated significant clinical benefit in advanced CSCC in several key phase II studies; however, there are limited data for patients treated outside of clinical trials. This is particularly relevant in advanced CSCC, which is most often seen in elderly patients with significant comorbidities. Thus, we aim to describe our experience with immunotherapy in a cohort of patients with advanced CSCC in Australia. We retrospectively reviewed all advanced CSCC patients treated with immunotherapy within the Illawarra and Shoalhaven Local Health District. Among the 51 patients treated with immunotherapy, there was an objective response rate (ORR) of 53% and disease control rate (DCR) of 67%. Our most significant predictor of response was sex, with male patients more likely to have better responses compared to female patients (DCR 85% vs. 41%, p < 0.0001), as well as improved progression-free survival (HR 4.6, 95%CI 1.9-10.8, p = 0.0007) and overall survival (HR 3.0, 95%CI 1.3-7.1, p = 0.006). Differential expression analysis of 770 immune-related genes demonstrated an impaired CD8 T-cell response in female patients. Our observed ORR of 53% is similar to that described in current literature with durable responses seen in the majority of patients.
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Affiliation(s)
- Nicholas Yeo
- Illawarra Shoalhaven Local Health District (ISLHD), NSW Health, Wollongong, NSW 2500, Australia
| | - Benjamin Genenger
- Molecular Horizons, University of Wollongong, Wollongong, NSW 2500, Australia
- School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2500, Australia
| | | | - Amarinder Thind
- Illawarra Shoalhaven Local Health District (ISLHD), NSW Health, Wollongong, NSW 2500, Australia
- School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2500, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Sarbar Napaki
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2500, Australia
- Anatomical Pathology, Wollongong Hospital, Wollongong, NSW 2500, Australia
- Southern IML/Sonic Healthcare, Wollongong, NSW 2500, Australia
| | - Jay Perry
- School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Bruce Ashford
- Illawarra Shoalhaven Local Health District (ISLHD), NSW Health, Wollongong, NSW 2500, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Marie Ranson
- Molecular Horizons, University of Wollongong, Wollongong, NSW 2500, Australia
- School of Chemistry and Molecular Bioscience, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Daniel Brungs
- Illawarra Shoalhaven Local Health District (ISLHD), NSW Health, Wollongong, NSW 2500, Australia
- Molecular Horizons, University of Wollongong, Wollongong, NSW 2500, Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, NSW 2500, Australia
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Lhuillier M, Brière M, Artifoni M, Chapal M, Peuvrel L, Saint-Jean M. Cemiplimab-induced cytokine-release syndrome: second case reported and review of the literature. Immunotherapy 2023; 15:229-234. [PMID: 36789558 DOI: 10.2217/imt-2021-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Cemiplimab, a human monoclonal antibody directed against PD-1, has provided more options in the treatment of locally advanced or metastatic cutaneous squamous-cell carcinoma at an unresectable state. Immune checkpoint inhibitors can induce several unfavorable reactions generally referred to as immune-related adverse effects. Cytokine-release syndrome is an immune-related adverse event that is infrequent and not well known. Diagnosis is difficult because of the unspecific symptoms (e.g., fever, hypotension) but it can also be life threatening. The authors report the case of a 62-year-old treated by cemiplimab for a cutaneous squamous-cell carcinoma of the diaper fold with iliac and inguinal lymph node extension. He presented with severe cytokine-release syndrome, concluding with the discontinuation of cemiplimab.
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Affiliation(s)
- Marine Lhuillier
- Department of Medical Oncology, ICO Cancer Center, Saint-Herblain, 44800, France
| | - Magali Brière
- Department of Infectious Disease, ICO Cancer Center, Saint-Herblain, 44800, France
| | - Mathieu Artifoni
- Department of Internal Medicine, University Hospital of Nantes, 44000, France
| | - Marion Chapal
- Departement of Nephrology, Hospital of Vendée, La Roche-Sur-Yon, 85000, France
| | - Lucie Peuvrel
- Department of Medical Oncology, ICO Cancer Center, Saint-Herblain, 44800, France
| | - Mélanie Saint-Jean
- Department of Medical Oncology, ICO Cancer Center, Saint-Herblain, 44800, France
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Li D, Ma L, Bao J, Cao L, Min W. PD-L1 Biomolecules Associated with Clinical Features in Non-Melanoma Skin Cancer. Clin Cosmet Investig Dermatol 2023; 16:1-8. [PMID: 36628329 PMCID: PMC9826606 DOI: 10.2147/ccid.s383481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/18/2022] [Indexed: 01/05/2023]
Abstract
Background Increasing evidence has indicated that several B7 family members play critical roles in the progress of many cancers. However, the clinical significance of the B7 family in cutaneous squamous cell carcinoma (cSCC) is still elusive. The purpose of this study is to investigate the potential role of B7-H1 biomolecules (PD-L1) in regulating the tumorigenesis and progression of cSCC, the most common non-melanoma skin cancer. Methods We collected transcriptome data of cSCC patients from TCGA databases (n = 496) and subjected the transcription data to bioinformatical analysis. Differential expression of B7-H1 genes with a grade-dependent pattern was identified. We collected paraffin sections of skin squamous carcinoma and analyzed by immunohistochemical staining. We further examined the PD-L1 levels of CD14+ cells in peripheral blood of each cSCC patient and normal subjects by flow cytometry. Results It was found that higher expression of PD-L1 was associated with poor prognosis of cSCC patients and shorter overall survival. These observations were further verified in the clinical paraffin sections and in peripheral blood T cells. Conclusion Our study reveals that PD-L1 is a potential prognostic marker in clinical prognosis for cSCC patients and could be valuable for cSCC treatment.
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Affiliation(s)
- Dan Li
- Department of Dermatology, the Affiliated Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China
| | - Liwen Ma
- Department of Dermatology, the Affiliated Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China
| | - Jun Bao
- Department of Dermatology, the Affiliated Hospital of Nanjing University Medical School, Nanjing, People’s Republic of China
| | - Lei Cao
- Clinical Immunology Laboratory, the First Affiliated Hospital of Soochow University, Soochow University, Suzhou, People’s Republic of China
| | - Wei Min
- Department of Dermatology, the First Affiliated Hospital of Soochow University, Soochow University, Suzhou, People’s Republic of China,Correspondence: Wei Min, Email
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Recent Advances in Immunotherapy for Patients with Head and Neck Cutaneous Squamous Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14215325. [PMID: 36358744 PMCID: PMC9657466 DOI: 10.3390/cancers14215325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Cutaneous squamous cell cancer is a form of skin cancer, which is typically found in older fair-skinned individuals with frequent sun exposure. Most patients present with limited disease and can be treated with a combination of surgery and/or radiation with favorable outcomes. A small percentage of patients present with more aggressive, widespread disease. Immunotherapy has dramatically improved outcomes and has become the preferred treatment option for these patients. In this review article, the rationale for using immunotherapy in patients with squamous cell skin cancer is discussed. A summary of the new treatment options currently being explored is also provided. Abstract Cutaneous squamous cell carcinoma (CSCC) is the second most common non-melanoma skin cancer. A majority of patients present with localized disease, but some can present with locally advanced or metastatic disease. Most of these advanced cases occur in the anatomical head and neck region and are associated with more aggressive disease, necessitating prompt and effective treatment. Prior to the emergence of immunotherapy, systemic treatment options were limited to platinum-based chemotherapy and salvaged with targeted epidermal growth factor therapy. These therapies were associated with poor efficacy and increased toxicity in an often frail, older population. Immunotherapy has dramatically improved outcomes in this patient population due to its favorable side effect profile, durable treatment response, and improved overall outcomes. In this review, an overview of the recent advances of immunotherapy in the management of CSCC in the anatomical head and neck region is provided, with a focus on advanced presentations.
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Samaran Q, Samaran R, Ferreira E, Haddad N, Fottorino A, Maillard H, Dreno B, Meyer N, Azria D, Maubec E, Gaudy-Marqueste C, Molinari N, Stoebner PE, Dereure O. Anti-PD-1 for the treatment of advanced cutaneous squamous cell carcinoma in elderly patients: a French multicenter retrospective survey. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04246-0. [PMID: 35962286 PMCID: PMC9374288 DOI: 10.1007/s00432-022-04246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/01/2022] [Indexed: 11/08/2022]
Abstract
Background Anti-PD1 agents are currently recommended as first-line treatment in advanced cutaneous squamous cell carcinoma (acSCC) by updated European guidelines. Although acSCC frequently affects elderly patients with multiple comorbidities, this subset of patients is often excluded of registration clinical trials. Purpose To assess anti-PD-1 efficacy and safety in elderly acSCC patients in real-life conditions and describe this specific population with oncogeriatric evaluation tools. Methods A multicenter retrospective study including acSCC patients at least 70 years old treated with PD-1 inhibitors was conducted in French referral centers. The primary endpoint was the overall response rate (ORR). Secondary endpoints included safety data, time to response (TTR), duration of response (DOR), overall survival (OS), and progression-free survival (PFS). Results 63 patients were included. ORR was 57.1% (95% CI 44.0–69.5), median TTR and DOR were 3 and 5.5 months respectively. Median OS was not reached (95% CI 12.5 months-not reached) at data cut-off after a median follow-up of 8 months while median PFS was 8 months. (95% CI 5 months-not reached). Grade 3–5 adverse effects occurred in 47.6% of patients. 41.3% of patients experienced degradation of ECOG performance status during anti-PD-1 treatment. Nutritional state worsened in 27% of patients and 57.1% lost weight during treatment. Conclusion In this particular subset of acSCC patients PD-1 inhibitors obtain results similar to those obtained in younger populations included in pivotal clinical trials, with acceptable safety. A specific oncogeriatric evaluation at treatment initiation and during follow-up appears important in this setting most notably to help manage toxicity. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04246-0.
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Affiliation(s)
- Quentin Samaran
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France. .,Department of Dermatology, Nîmes University Hospital and Montpellier University, Nîmes, France. .,Chru de Montpellier-Hôpital St Eloi-Service de Dermatologie, 80, Avenue Augustin Fliche, 34295, Montpellier Cedex 5, France.
| | - Romain Samaran
- Department of Dermatology, Le Mans Hospital, Le Mans, France.,Department of Dermatology, Nantes University Hospital and Nantes University, Nantes, France
| | - Ernestine Ferreira
- Department of Geriatrics, Montpellier University Hospital and Montpellier University, Montpellier, France
| | - Naeda Haddad
- Department of Dermatology, Avicenne Hospital (AP-HP) and Paris 13 University, Bobigny, France
| | - Antoine Fottorino
- Department of Oncodermatology, La Timone Hospital (AP-HM) and Aix-Marseille University, Marseille, France
| | - Hervé Maillard
- Department of Dermatology, Le Mans Hospital, Le Mans, France
| | - Brigitte Dreno
- Department of Dermatology, Nantes University Hospital and Nantes University, Nantes, France
| | - Nicolas Meyer
- Institut Universitaire Du Cancer de Toulouse, Toulouse University Hospital, Toulouse, France
| | - David Azria
- Fédération Universitaire d'Oncologie Radiothérapie, ICM-Institut Régional du Cancer Montpellier, Montpellier, France
| | - Eve Maubec
- Department of Dermatology, Avicenne Hospital (AP-HP) and Paris 13 University, Bobigny, France
| | - Caroline Gaudy-Marqueste
- Department of Oncodermatology, La Timone Hospital (AP-HM) and Aix-Marseille University, Marseille, France
| | - Nicolas Molinari
- IDESP, INSERM, Department of Statistics, Univ Montpellier, CHU Montpellier, Montpellier, France
| | | | - Olivier Dereure
- Department of Dermatology, Montpellier University Hospital and Montpellier University, Montpellier, France
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8
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Immunotherapy for the Treatment of Squamous Cell Carcinoma: Potential Benefits and Challenges. Int J Mol Sci 2022; 23:ijms23158530. [PMID: 35955666 PMCID: PMC9368833 DOI: 10.3390/ijms23158530] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023] Open
Abstract
Melanoma and nonmelanoma skin cancers (NMSCs) are recognized as among the most common neoplasms, mostly in white people, with an increasing incidence rate. Among the NMSCs, squamous cell carcinoma (SCC) is the most prevalent malignancy known to affect people with a fair complexion who are exposed to extreme ultraviolet radiation (UVR), have a hereditary predisposition, or are immunosuppressed. There are several extrinsic and intrinsic determinants that contribute to the pathophysiology of the SCC. The therapeutic modalities depend on the SCC stages, from actinic keratosis to late-stage multiple metastases. Standard treatments include surgical excision, radiotherapy, and chemotherapy. As SCC represents a favorable tumor microenvironment with high tumor mutational burden, infiltration of immune cells, and expression of immune checkpoints, the SCC tumors are highly responsive to immunotherapies. Until now, there are three checkpoint inhibitors, cemiplimab, pembrolizumab, and nivolumab, that are approved for the treatment of advanced, recurrent, or metastatic SCC patients in the United States. Immunotherapy possesses significant therapeutic benefits for patients with metastatic or locally advanced tumors not eligible for surgery or radiotherapy to avoid the potential toxicity caused by the chemotherapies. Despite the high tolerability and efficiency, the existence of some challenges has been revealed such as, resistance to immunotherapy, less availability of the biomarkers, and difficulty in appropriate patient selection. This review aims to accumulate evidence regarding the genetic alterations related to SCC, the factors that contribute to the potential benefits of immunotherapy, and the challenges to follow this treatment regime.
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9
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Guida M, Quaglino P, Queirolo P. Editorial: The Evolving Role of Immunotherapy in Non-Melanoma Skin Cancers. Front Oncol 2022; 12:870509. [PMID: 35664785 PMCID: PMC9159761 DOI: 10.3389/fonc.2022.870509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Michele Guida
- Rare Tumors and Melanoma Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Tumori Giovanni Paolo II, Bari, Italy
| | - Pietro Quaglino
- Dermatologic Clinic, University of Turin Medical School, University of Turin, Turin, Italy
| | - Paola Queirolo
- Melanoma, Sarcoma and Rare Tumors Oncology Department, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
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10
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Swanson L, Kassab I, Tsung I, Worden FP, Fontana RJ. Infrequent liver injury from cemiplimab in patients with advanced cutaneous squamous cell carcinoma. Immunotherapy 2022; 14:409-418. [PMID: 35232282 DOI: 10.2217/imt-2021-0191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To describe the incidence and outcomes of liver injury in patients with advanced cutaneous squamous cell carcinoma (cSCC) receiving cemiplimab. Methods: Charts of cSCC patients receiving cemiplimab between 28 September 2018 and 14 July 2020 were reviewed. Liver injury was determined using laboratory criteria, and causality assessment was completed. Results: Of 39 cemiplimab-treated patients, four (10.3%) developed liver injury. Two cases of hepatotoxicity were attributed to immune-mediated liver injury caused by cemiplimab and the two other cases were attributed to other causes. The four patients with liver injury had tumor responses and survival similar to those of the patients without liver injury. Conclusion: Liver injury arising during cemiplimab therapy is mild and infrequent in cSCC patients. Due to its favorable safety profile, cemiplimab should be considered in patients with cSCC and pre-existing liver disease.
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Affiliation(s)
- Linnea Swanson
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ihab Kassab
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Irene Tsung
- Division of Hematology & Oncology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Francis P Worden
- Division of Hematology & Oncology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Robert J Fontana
- Division of Gastroenterology & Hepatology, University of Michigan, Ann Arbor, MI 48109, USA
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11
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Qiu CG, Shen B, Sun XQ. Significant Biomarkers Identification Associated with Cutaneous Squamous Cell Carcinoma Progression. Int J Gen Med 2022; 15:2347-2360. [PMID: 35264873 PMCID: PMC8901050 DOI: 10.2147/ijgm.s357022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/21/2022] [Indexed: 12/13/2022] Open
Affiliation(s)
- Cheng-Gang Qiu
- Department of Burn, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311200, Zhejiang, People’s Republic of China
| | - Bin Shen
- Department of Burn, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311200, Zhejiang, People’s Republic of China
| | - Xiao-Qi Sun
- Department of Plastic Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311200, Zhejiang, People’s Republic of China
- Correspondence: Xiao-Qi Sun, Department of Plastic Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, 728 Yucai North Road, Chengxiang Town, Xiaoshan District, Hangzhou, Zhejiang, 311200, People’s Republic of China, Email
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Liu T, Jiang F, Yu LY, Wu YY. Lidocaine represses proliferation and cisplatin resistance in cutaneous squamous cell carcinoma via miR-30c/SIRT1 regulation. Bioengineered 2022; 13:6359-6370. [PMID: 35212616 PMCID: PMC8974189 DOI: 10.1080/21655979.2022.2031419] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This study aimed to determine the effects of lidocaine on cell proliferation and cisplatin resistance in A431 human cutaneous squamous cell carcinoma (cSCC) cells and elucidate the underlying mechanism. Cell proliferation, colony numbers, and cisplatin resistance were determined in A431 or cisplatin-resistant A431 (A431-R) cells that were first transfected with miR-30c-inhibitor or miR-30c-mimic, respectively, and then treated with different concentrations of lidocaine, cisplatin, or both. The expression levels of miR-30c and Sirtuin 1 (SIRT1) in A431 and A431-R cells were determined by quantitative real-time polymerase chain reaction and Western blotting. Lidocaine suppressed A431 cell proliferation and cisplatin resistance in a dose- and time-dependent manner via the miR-30c/SIRT1 pathway. MiR-30c overexpression also suppressed cell proliferation and cisplatin resistance in A431 cells by directly targeting and downregulating SIRT1, thus enhancing the protective effects of lidocaine. Conversely, SIRT1 upregulation or miR-30c inhibition antagonized the inhibitory effects of lidocaine. Our results suggest that lidocaine may suppress the progression of cSCC by activating the miR-30c/SIRT1 pathway, indicating its promising potential as a treatment strategy for cSCC.
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Affiliation(s)
- Tao Liu
- Department of Anesthesiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Fei Jiang
- Department of Anesthesiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Li-Yuan Yu
- Department of Anesthesiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - You-Yang Wu
- Department of Anesthesiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
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13
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Argenziano G, Fargnoli MC, Fantini F, Gattoni M, Gualdi G, Pastore F, Pellacani G, Quaglino P, Queirolo P, Troiani T. Identifying candidates for immunotherapy with cemiplimab to treat advanced cutaneous squamous cell carcinoma: an expert opinion. Ther Adv Med Oncol 2022; 14:17588359211066272. [PMID: 35035534 PMCID: PMC8753075 DOI: 10.1177/17588359211066272] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/22/2021] [Indexed: 01/10/2023] Open
Abstract
Cutaneous squamous cell carcinoma (CSCC) is the second most common skin
malignancy in white-skinned populations. Only a minority of patients (<5%)
develop advanced disease, but this is often difficult to treat and characterised
by a poor prognosis. Cemiplimab, a fully human IgG4 monoclonal antibody against
programmed cell death-1 receptor, is indicated for advanced (i.e. locally
advanced or metastatic) CSCC. Although the definition of metastatic CSCC is
clear, there is currently no agreed definition of locally advanced CSCC. In
recent guidelines, locally advanced CSCC was described as non-metastatic CSCC
that is unlikely to be cured with surgery, radiotherapy or combination
treatment. A multi-disciplinary advisory group of Italian CSCC experts was
convened to develop criteria to assist in identifying appropriate candidates for
cemiplimab therapy in advanced CSCC, based on the literature and clinical
experience. In locally advanced CSCC, absolute, or mandatory, criteria for the
use of cemiplimab are deep invasion, multiple lesions without defined margins,
inadequate surgical excision margins and multiple recurrences, whereas relative
criteria include large lesions, in critical or functionally significant areas
and that are surgically complex. In addition, physicians should consider patient
willingness/preferences (an absolute criterion), and their age and health
status/comorbidities (relative criteria). It is hoped that these proposed
absolute and relative criteria will help guide rational identification of
patients who will receive maximum benefit from immunotherapy, while more
clinical data accumulate.
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Affiliation(s)
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio, Coppito 2, 67100 L'Aquila, Italy
| | | | | | - Giulio Gualdi
- Dermatologic Clinic, Department of Medicine and Aging Science, University G. D'Annunzio Chieti-Pescara, Italy
| | | | | | - Pietro Quaglino
- Clinica Dermatologica, AOU Città della Salute e della Scienza, Università degli Studi di Torino, Torino, Italy
| | - Paola Queirolo
- Melanoma, Sarcoma and Rare Tumors Oncology Department, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Teresa Troiani
- Oncology Unit, Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
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14
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Brambullo T, Azzena GP, Toninello P, Masciopinto G, De Lazzari A, Biffoli B, Vindigni V, Bassetto F. Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review. Front Oncol 2021; 11:783257. [PMID: 34950589 PMCID: PMC8690035 DOI: 10.3389/fonc.2021.783257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022] Open
Abstract
Among the non-melanoma skin cancers (NMSC) the squamous cell carcinoma (SCC) is one of the most challenging for the surgeon. Local aggressiveness and a tendency to metastasize to regional lymph nodes characterize the biologic behavior. The variants locally advanced and metastatic require wide excision and node dissection. Such procedures can be extremely detrimental for patients. The limit of the surgery can be safely pushed forward with a multidisciplinary approach. The concept of skin oncoplastic surgery, the ablative procedures and the reconstructive options (skin graft, pedicled flap, microsurgical free flap) are discussed together with a literature review.
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Affiliation(s)
- Tito Brambullo
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Gian Paolo Azzena
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Paolo Toninello
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Giuseppe Masciopinto
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Alberto De Lazzari
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Bernardo Biffoli
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Vincenzo Vindigni
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Franco Bassetto
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
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15
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de Jong E, Lammerts MUPA, Genders RE, Bouwes Bavinck JN. Update of advanced cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2021; 36 Suppl 1:6-10. [PMID: 34855246 PMCID: PMC9299882 DOI: 10.1111/jdv.17728] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 10/07/2021] [Indexed: 12/20/2022]
Abstract
The incidence of cutaneous squamous cell carcinoma (cSCC) is rapidly increasing. A growing part of this patient group is formed by immunocompromised patients, for example organ-transplant recipients (OTR). Although over 90% of the cSCC show a relatively harmless clinical behaviour, there is also a chance of developing advanced cSCC and metastases. Locally advanced cSCC are defined as cSCC that have locally advanced progression and are no longer amenable to surgery or radiation therapy. Better understanding of the clinical behaviour of cSCC is essential to discriminate between low- and high-risk cSCC. Staging systems are important and have recently been improved. Genetic characterisation of SCC will likely become an important tool to help distinguish low and high-risk cSCC with an increased potential to metastasise in the near future. Available treatments for high-risk and advanced cSCC include surgery, radiotherapy, chemotherapy and targeted therapy with epidermal growth factor receptors inhibitors. Anti-PD-1 antibodies show promising results with response rates of up to 50% in both locally advanced and metastatic cSCC but, in its present form, is not suitable for OTR.
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Affiliation(s)
- E de Jong
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - M U P A Lammerts
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - R E Genders
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - J N Bouwes Bavinck
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
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16
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Kaufmann R. PD-1 - blockade in advanced cutaneous squamous cell carcinoma - fresh breeze in a deadly lull. J Eur Acad Dermatol Venereol 2021; 36 Suppl 1:3-5. [PMID: 34855247 DOI: 10.1111/jdv.17398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/18/2021] [Indexed: 11/30/2022]
Affiliation(s)
- R Kaufmann
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt, Frankfurt am Main, Germany
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17
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Baggi A, Quaglino P, Rubatto M, Depenni R, Guida M, Ascierto PA, Trojaniello C, Queirolo P, Saponara M, Peris K, Spagnolo F, Bianchi L, De Galitiis F, Potenza MC, Proietti I, Marconcini R, Botticelli A, Barbieri V, Licitra L, Alfieri S, Ficorella C, Cortellini A, Fargnoli MC, Troiani T, Tondulli L, Bossi P. Real world data of cemiplimab in locally advanced and metastatic cutaneous squamous cell carcinoma. Eur J Cancer 2021; 157:250-258. [PMID: 34536948 DOI: 10.1016/j.ejca.2021.08.018] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/03/2021] [Accepted: 08/13/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) has an overall favourable outcome, except for patients with an advanced stage disease. The programmed death protein-1 (PD-1) inhibitor cemiplimab has been approved for use in advanced cSCC. We report clinical outcomes from the named patient programme-compassionate use of cemiplimab for patients with advanced cSCC in Italy. METHODS This is a retrospective, observational, multicentre study. We analysed medical records of patients with advanced cSCC treated with cemiplimab between May 2019 and February 2020 in 17 referral Italian centres. We assessed the safety profile according to the Common Terminology Criteria for Adverse Events, version 5.0 (CTCAE v 5.0), the clinical activity in terms of response rate, clinical benefit and duration of response and baseline clinical-pathologic characteristics associated with response. RESULTS 131 patients were included, with a median age of 79 years. Of them, 9.2% had a concurrent chronic lymphoproliferative disease and 8.5% a concomitant autoimmune disease. Some 42.7% of the total patients had at least one treatment-related adverse events (AEs); out of above, 9.2% had grade 3-4 adverse events, and there were two fatal adverse events. The overall response rate (ORR) was 58%, and the disease control rate (DCR) was 71.7%. Cutaneous squamous cell carcinomas (cSCCs) arising on the head and neck area (p = 0.007) and haemoglobin values in normal range (p = 0.034) were significantly associated with a better response, while cSCCs on the genitalia (p = 0.041), treatment with any systemic antibiotic within 1 month of cemiplimab initiation (p = 0.012), performance status ≥1 (p = 0.012), chronic corticosteroids therapy (p = 0.038), previous radiation therapy to lymph nodes (p = 0.052) and previous chemotherapy (p = 0.0020) were significantly associated with a worse response. CONCLUSIONS Our real-world study showed safety and effectiveness results comparable to those obtained in clinical trials. We identified some clinical and biochemical factors potentially associated with response to cemiplimab.
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Affiliation(s)
- Alice Baggi
- University of Brescia, Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, ASST-Spedali Civili, Brescia, Lombardia, Italy
| | - Pietro Quaglino
- University of Turin, Dermatologic Clinic, Department of Medical Sciences Torino, Piemonte, Italy
| | - Marco Rubatto
- University of Turin, Dermatologic Clinic, Department of Medical Sciences Torino, Piemonte, Italy
| | - Roberta Depenni
- Università degli Studi di Modena e Reggio Emilia, Department of Oncology, Hematology, Modena, Emilia-Romagna, Italy
| | - Michele Guida
- IRCCS Istituto Oncologico di Bari Giovanni Paolo II, Oncology Department, Bari, Puglia, Italy
| | - Paolo Antonio Ascierto
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy
| | - Claudia Trojaniello
- Unit of Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Campania, Italy
| | - Paola Queirolo
- IEO, Division of Medical Oncology for Melanoma, Sarcoma and Rare Tumors, Milano, Lombardia, Italy
| | - Maristella Saponara
- IEO, Division of Medical Oncology for Melanoma, Sarcoma and Rare Tumors, Milano, Lombardia, Italy
| | - Ketty Peris
- Università Cattolica del Sacro Cuore Campus di Roma, Istitute of Dermatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
| | - Francesco Spagnolo
- IRCCS Ospedale Policlinico San Martino, Skin Cancer Unit, Genova, Liguria, Italy
| | - Luca Bianchi
- University of Rome Tor Vergata, Dermatologic Unit, Department of Systems Medicine, Roma, Lazio, Italy
| | | | - Maria Concetta Potenza
- Sapienza University of Rome, Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies Polo Pontino, Terracina, Italy
| | - Ilaria Proietti
- Sapienza University of Rome, Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies Polo Pontino, Terracina, Italy
| | - Riccardo Marconcini
- Azienda Ospedaliero Universitaria Pisana, Medical Oncology Unit, Pisa, Italy
| | - Andrea Botticelli
- Sapienza University of Rome, Clinical and Molecular Department, Umberto I Policlinico di Roma, Roma, Lazio, Italy
| | - Vito Barbieri
- Azienda Ospedaliera di Catanzaro Pugliese Ciaccio, U.O. Oncologia, Catanzaro, Calabria, Italy
| | - Lisa Licitra
- Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Cancer Medical Oncology 3 Department, University of Milan, Department of Hematology and Oncology, Milano, Lombardia, Italy
| | - Salvatore Alfieri
- Fondazione IRCCS Istituto Nazionale dei Tumori, Head and Neck Cancer Medical Oncology 3 Department, Milano, Lombardia, Italy
| | - Corrado Ficorella
- University of L'Aquila Department of Clinical Sciences and Applied Biotechnology, L'Aquila, Abruzzo, Italy; San Salvatore Hospital, Medical Oncology, L'Aquila, Abruzzo, Italy
| | - Alessio Cortellini
- University of L'Aquila Department of Clinical Sciences and Applied Biotechnology, L'Aquila, Abruzzo, Italy; Imperial College London, Department of Surgery and Cancer, London, UK
| | - Maria Concetta Fargnoli
- University of L'Aquila Department of Clinical Sciences and Applied Biotechnology, L'Aquila, Abruzzo, Italy; San Salvatore Hospital, Medical Oncology, L'Aquila, Abruzzo, Italy
| | - Teresa Troiani
- University of Campania Luigi Vanvitelli, Medical Oncology, Department of Precision Medicine, Napoli, Campania, Italy
| | - Luca Tondulli
- Integrated University Hospital of Verona, Oncology Department, University Hospital of Verona, Verona, Veneto, Italy
| | - Paolo Bossi
- University of Brescia, Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, ASST-Spedali Civili, Brescia, Lombardia, Italy.
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18
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Boutros A, Cecchi F, Tanda ET, Croce E, Gili R, Arecco L, Spagnolo F, Queirolo P. Immunotherapy for the Treatment of Cutaneous Squamous Cell Carcinoma. Front Oncol 2021; 11:733917. [PMID: 34513710 PMCID: PMC8427439 DOI: 10.3389/fonc.2021.733917] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/09/2021] [Indexed: 12/30/2022] Open
Abstract
Cutaneous squamous cell carcinoma (CSCC) accounts for approximately 20% of all keratinocytic tumors. In most cases, the diagnosis and treatments are made on small, low-risk lesions. However, in about 5% of cases, CSCC may present as either locally advanced or metastatic (i.e. with locoregional lymph nodes metastases or distant localizations). Prior to the introduction of immunotherapy in clinical practice, the standard treatment of advanced CSCC was not clearly defined, and up to 60% of patients received no systemic therapy. Thanks to a strong pre-clinical rationale, clinical trials led to the FDA (Food and Drug Administration) and EMA (European Medicines Agency) registration of cemiplimab, a PD-1 inhibitor that achieved encouraging results in terms of objective response, overall survival, and quality of life. Subsequently, the anti-PD-1 pembrolizumab received the approval for the treatment of advanced CSCC by the FDA only. In this review, we will focus on the definition of advanced CSCC and on the current and future therapeutic options, with a particular regard for immunotherapy.
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Affiliation(s)
- Andrea Boutros
- Oncologia Medica 2, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genova, Italy
| | - Federica Cecchi
- Oncologia Medica 2, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
| | - Enrica Teresa Tanda
- Oncologia Medica 2, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy.,Genetics of Rare Cancers, Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy
| | - Elena Croce
- Oncologia Medica 2, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genova, Italy
| | - Riccardo Gili
- Oncologia Medica 2, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy.,Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genova, Italy
| | - Luca Arecco
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genoa, Genova, Italy.,U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Spagnolo
- Oncologia Medica 2, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genova, Italy
| | - Paola Queirolo
- Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, European Institute of Oncology (IEO), European Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milano, Italy
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Newman JG, Hall MA, Kurley SJ, Cook RW, Farberg AS, Geiger JL, Koyfman SA. Adjuvant therapy for high-risk cutaneous squamous cell carcinoma: 10-year review. Head Neck 2021; 43:2822-2843. [PMID: 34096664 PMCID: PMC8453797 DOI: 10.1002/hed.26767] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 04/29/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
Standard of care for high-risk cutaneous squamous cell carcinoma (cSCC) is surgical excision of the primary lesion with clear margins when possible, and additional resection of positive margins when feasible. Even with negative margins, certain high-risk factors warrant consideration of adjuvant therapy. However, which patients might benefit from adjuvant therapy is unclear, and supporting evidence is conflicting and limited to mostly small retrospective cohorts. Here, we review literature from the last decade regarding adjuvant radiation therapy and systemic therapy in high-risk cSCC, including recent and current trials and the role of immune checkpoint inhibitors. We demonstrate evidence gaps in adjuvant therapy for high-risk cSCC and the need for prognostic tools, such as gene expression profiling, to guide patient selection. More large-cohort clinical studies are needed for collecting high-quality, evidence-based data for determining which patients with high-risk cSCC may benefit from adjuvant therapy and which therapy is most appropriate for patient management.
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Affiliation(s)
- Jason G. Newman
- Department of Otorhinolaryngology – Head and Neck SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Mary A. Hall
- Research and Development, Castle Biosciences, Inc.FriendswoodTexasUSA
| | - Sarah J. Kurley
- Research and Development, Castle Biosciences, Inc.FriendswoodTexasUSA
| | - Robert W. Cook
- Research and Development, Castle Biosciences, Inc.FriendswoodTexasUSA
| | - Aaron S. Farberg
- Section of DermatologyBaylor University Medical CenterDallasTexasUSA
| | - Jessica L. Geiger
- Department of Hematology and Medical OncologyCleveland ClinicClevelandOhioUSA
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20
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Bennardo L, Bennardo F, Giudice A, Passante M, Dastoli S, Morrone P, Provenzano E, Patruno C, Nisticò SP. Local Chemotherapy as an Adjuvant Treatment in Unresectable Squamous Cell Carcinoma: What Do We Know So Far? ACTA ACUST UNITED AC 2021; 28:2317-2325. [PMID: 34201867 PMCID: PMC8293038 DOI: 10.3390/curroncol28040213] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 12/16/2022]
Abstract
Background: Squamous cell carcinoma (SCC) is one of the most common cancers involving skin and oral mucosa. Although this condition's gold-standard treatment is the surgical removal of the lesions, the physician must propose alternative treatments in some cases due to the patient's ineligibility for surgery. Among the available alternative therapies, local chemotherapy may represent an initial treatment in combination with radiotherapy or systemic chemotherapy due to the low frequency of side-effects and the lack of necessity for expensive devices. Methods: In this paper, we review all available literature in various databases (PubMed, Scopus-Embase, Web of Science), proposing local chemotherapy as a treatment for cutaneous and oral SCC. Exclusion criteria included ocular lesions (where topical treatments are common), non-English language, and non-human studies. Results: We included 14 studies in this review. The majority were case reports and case series describing the treatment of non-resectable localized SCC with either imiquimod or 5-fluorouracil. We also analyzed small studies proposing combination treatments. Almost all studies reported an excellent clinical outcome, with a low risk of relapses in time. Conclusions: Resection of the lesion remains the gold-standard treatment for SCC. When this approach is not feasible, local chemotherapy may represent a treatment alternative, and it may also be associated with radiotherapy or systemic chemotherapy.
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Affiliation(s)
- Luigi Bennardo
- Unit of Dermatology, Mariano Santo Hospital, 87100 Cosenza, Italy; (P.M.); (E.P.)
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (F.B.); (A.G.); (M.P.); (S.D.); (C.P.); (S.P.N.)
- Correspondence: ; Tel.: +39-096-1364-7195
| | - Francesco Bennardo
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (F.B.); (A.G.); (M.P.); (S.D.); (C.P.); (S.P.N.)
| | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (F.B.); (A.G.); (M.P.); (S.D.); (C.P.); (S.P.N.)
| | - Maria Passante
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (F.B.); (A.G.); (M.P.); (S.D.); (C.P.); (S.P.N.)
| | - Stefano Dastoli
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (F.B.); (A.G.); (M.P.); (S.D.); (C.P.); (S.P.N.)
| | - Pietro Morrone
- Unit of Dermatology, Mariano Santo Hospital, 87100 Cosenza, Italy; (P.M.); (E.P.)
| | - Eugenio Provenzano
- Unit of Dermatology, Mariano Santo Hospital, 87100 Cosenza, Italy; (P.M.); (E.P.)
| | - Cataldo Patruno
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (F.B.); (A.G.); (M.P.); (S.D.); (C.P.); (S.P.N.)
| | - Steven Paul Nisticò
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy; (F.B.); (A.G.); (M.P.); (S.D.); (C.P.); (S.P.N.)
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21
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Xiong W, Wu L, Tang R, Zhang Q, Guo Q, Song S. Grape Seed Proanthocyanidins (GSPs) Inhibit the Development of Cutaneous Squamous Cell Carcinoma by Regulating the hsa_circ_0070934/miR-136-5p/PRAF2 Axis. Cancer Manag Res 2021; 13:4359-4371. [PMID: 34103991 PMCID: PMC8179753 DOI: 10.2147/cmar.s302084] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 04/26/2021] [Indexed: 01/22/2023] Open
Abstract
Background Grape seed proanthocyanidins (GSPs) have been shown to inhibit the progression of many cancers, including cutaneous squamous cell carcinoma (CSCC). Circular RNA (circRNA) is a key regulator for cancer progression. However, it is unclear whether GSPs can mediate the progression of CSCC by regulating circRNA. Methods Quantitative real-time PCR was conducted to determine the expression of hsa_circ_0070934, microRNA (miR)-136-5p and prenylated Rab acceptor family 2 (PRAF2). MTT assay and colony formation assay were used to assess cell proliferation. Cell cycle process and apoptosis were detected by flow cytometry, and cell migration and invasion were measured by transwell assay. Western blot analysis was utilized to examine protein expression. In addition, dual-luciferase reporter assay and RIP assay were used to evaluate the interaction between miR-136-5p and hsa_circ_0070934 or PRAF2. Subcutaneous xenograft models were constructed to explore the function of GSPs on CSCC tumor growth in vivo. Results GSPs could reduce hsa_circ_0070934 expression and inhibit CSCC cell proliferation, cell cycle process, migration, invasion, while promote apoptosis. Overexpressed hsa_circ_0070934 could reverse the suppressive effect of GSPs on CSCC cell progression. MiR-136-5p could be sponged by hsa_circ_0070934, and its overexpression also abolished the positively regulation of hsa_circ_0070934 on the progression of GSPs-induced CSCC cells. PRAF2 was a target of miR-136-5p, and its expression could be decreased by GSPs and increased by hsa_circ_0070934. The inhibitory effect of miR-136-5p on CSCC cell progression could be reversed by PRAF2 overexpression. Additionally, GSPs also could inhibit CSCC tumor growth in vivo. Conclusion Our data showed that GSPs regulated the hsa_circ_0070934/miR-136-5p/PRAF2 axis to restrain CSCC progression.
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Affiliation(s)
- Weibiao Xiong
- Xiong Wei-Biao Workroom, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, 330003, People's Republic of China
| | - Lan'e Wu
- Xiong Wei-Biao Workroom, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, 330003, People's Republic of China
| | - Runke Tang
- Department of Rehabilitation, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, 330003, People's Republic of China
| | - Qingqing Zhang
- Xiong Wei-Biao Workroom, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, 330003, People's Republic of China
| | - Qian Guo
- Xiong Wei-Biao Workroom, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, 330003, People's Republic of China
| | - Shuhua Song
- Department of Dermatology, Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, Jiangxi, 330003, People's Republic of China
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Mittal A, Wang M, Vidyarthi A, Yanez D, Pizzurro G, Thakral D, Tracy E, Colegio OR. Topical arginase inhibition decreases growth of cutaneous squamous cell carcinoma. Sci Rep 2021; 11:10731. [PMID: 34031449 PMCID: PMC8144401 DOI: 10.1038/s41598-021-90200-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 05/04/2021] [Indexed: 02/06/2023] Open
Abstract
Cutaneous squamous cell carcinomas (cSCC) are among the most commonly diagnosed malignancies, causing significant morbidity and mortality. Tumor-associated macrophage (TAM) expression of arginase is implicated in tumor progression, and therapeutic use of arginase inhibitors has been studied in various cancers. However, investigating potential cSCC immunotherapies including arginase inhibition in pre-clinical models is hampered by the lack of appropriate tumor models in immunocompetent mice. PDV is a cSCC cell line derived from chemical carcinogenesis of mouse keratinocytes. PDVC57 cells were derived from a PDV tumor in C57BL/6 (B6) mice. Unlike PDV, PDVC57 tumors grow consistently in B6 mice, and have increased TAMs, decreased dendritic and T cell intra-tumor infiltration. Arginase inhibition in cSCC tumors using Nω-hydroxy-nor-arginine (nor-NOHA) reduced tumor growth in B6 mice but not immunodeficient Rag1-deficient mice. nor-NOHA administration increased dendritic and T cell tumor-infiltration and PD-1 expression. The combination of nor-NOHA and anti-PD-1 therapy with nivolumab enhanced anti-PD-1 therapeutic efficacy. This study demonstrates the therapeutic potential of transcutaneous arginase inhibition in cSCC. A competent immune microenvironment is required for tumor growth inhibition using this arginase inhibitor. Synergistic co-inhibition of tumor growth in these results, supports further examination of transcutaneous arginase inhibition as a therapeutic modality for cSCC.
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Affiliation(s)
- Amit Mittal
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, USA
| | - Mike Wang
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, USA ,grid.32224.350000 0004 0386 9924Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA ,grid.240614.50000 0001 2181 8635Department of Dermatology, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263 USA
| | - Aurobind Vidyarthi
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, USA
| | - Diana Yanez
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, USA
| | - Gabriela Pizzurro
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, USA
| | - Durga Thakral
- grid.47100.320000000419368710Department of Dermatology, Yale School of Medicine, New Haven, USA
| | - Erin Tracy
- grid.240614.50000 0001 2181 8635Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, USA
| | - Oscar R. Colegio
- grid.240614.50000 0001 2181 8635Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, USA ,grid.240614.50000 0001 2181 8635Department of Dermatology, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY 14263 USA
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Zhang Z, Guo H, Yang W, Li J. Exosomal Circular RNA RNA-seq Profiling and the Carcinogenic Role of Exosomal circ-CYP24A1 in Cutaneous Squamous Cell Carcinoma. Front Med (Lausanne) 2021; 8:675842. [PMID: 34109199 PMCID: PMC8180850 DOI: 10.3389/fmed.2021.675842] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 04/29/2021] [Indexed: 12/15/2022] Open
Abstract
Objective: Aberrantly expressed exosomal circular RNAs (circRNAs) have been reported in various human cancers. Nevertheless, it remains elusive in cutaneous squamous cell carcinoma (cSCC). Herein, based on RNA-seq, we systematically uncovered the expression and implication of exosomal circRNAs in cSCC. Methods: Plasma exosomes derived from cSCC and healthy subjects were characterized by nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM), and western blot. Differentially expressed exosomal circular RNAs (circRNAs) were screened by RNA-seq analysis, which were validated by RT-qPCR. Among them, the biological structure of circ-CYP24A1 was validated by Sanger sequencing and RNase R digestion. Si-circ-CYP24A1 was transfected into exosomes, followed by incubation with A431 and SCL-1 cells. Then, viability, apoptosis, migration, and invasion were evaluated by CCK-8, TUNEL staining and migration assays. Results: This study identified 25 up- and 76 down-regulated exosomal circRNAs in cSCC than healthy subjects. Among them, circulating circ-CYP24A1 was confirmed to be up-regulated in cSCC. Circ-CYP24A1 had a covalently closed circular structure and was not sensitive to RNase R digestion. After incubation with si-circ-CYP24A1-transfected exosomes, proliferation, migration, and invasion were lowered while apoptosis was enhanced in A431 and SCL-1 cells. Meanwhile, si-circ-CYP24A1-transfected exosomes significantly decreased the expression of downstream targets CDS2, MAVS, and SOGA in cSCC cells. Conclusion: Collectively, our study identified that targeting exosomal circ-CYP24A1 could suppress cSCC progression by weakening tumor malignant behaviors, which might provide a promising therapeutic target and non-invasive diagnostic biomarker for cSCC.
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Affiliation(s)
- Zheng Zhang
- Department of Dermatology, Key Laboratory of Immunodermatology, The First Hospital of China Medical University, Shenyang, China
| | - Hao Guo
- Department of Dermatology, Key Laboratory of Immunodermatology, The First Hospital of China Medical University, Shenyang, China
| | - Wenjia Yang
- Department of Dermatology, Key Laboratory of Immunodermatology, The First Hospital of China Medical University, Shenyang, China
| | - Jiuhong Li
- Department of Dermatology, Key Laboratory of Immunodermatology, The First Hospital of China Medical University, Shenyang, China
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Identifying an lncRNA-Related ceRNA Network to Reveal Novel Targets for a Cutaneous Squamous Cell Carcinoma. BIOLOGY 2021; 10:biology10050432. [PMID: 34068010 PMCID: PMC8152267 DOI: 10.3390/biology10050432] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/03/2021] [Accepted: 05/09/2021] [Indexed: 02/07/2023]
Abstract
Simple Summary The exact functions and molecular mechanism of lncRNAs, acting as competitive endogenous RNAs in a cutaneous squamous cell carcinoma, remain unexplored. The present study was conducted to identify the differentially expressed lncRNAs and mRNAs and establish the lncRNA-related competing endogenous RNA networks associated with a cutaneous squamous cell carcinoma. A competing endogenous RNA network consisting of 137 miRNA-lncRNA and 221 miRNA-mRNA pairs was constructed. As for the functional analysis of the mRNAs in the network, a FoxO signaling pathway, an autophagy and cellular senescence were the top enrichment terms based on the Kyoto Encyclopedia of Genes and Genomes analysis. We identified five core mRNAs and built a core mRNA-associated competing endogenous RNA network. Finally, one lncRNA HLA-F-AS1 and three mRNAs named AGO4, E2F1 and CCND1 in the core mRNA-associated competing endogenous RNA network were validated with the same expression patterns. The core mRNAs and their associated lncRNAs may provide potential therapeutic targets for cutaneous squamous cell carcinomas. Abstract A cutaneous squamous cell carcinoma (cSCC) derived from keratinocytes is the second most common cause of non-melanoma skin cancer. The accumulation of the mutational burden of genes and cellular DNA damage caused by the risk factors (e.g., exposure to ultraviolet radiation) contribute to the aberrant proliferation of keratinocytes and the formation of a cSCC. A cSCC encompasses a spectrum of diseases that range from recursor actinic keratosis (AK) and squamous cell carcinoma (SCC) in situ (SCCIS) to invasive cSCCs and further metastatic SCCs. Emerging evidence has revealed that lncRNAs are involved in the biological process of a cSCC. According to the ceRNA regulatory theory, lncRNAs act as natural miRNA sponges and interact with miRNA response elements, thereby regulating the mRNA expression of their down-stream targets. This study was designed to search for the potential lncRNAs that may become potential therapeutic targets or biomarkers of a cSCC. Considering the spirit of the study to be adequately justified, we collected microarray-based datasets of 19 cSCC tissues and 12 normal skin samples from the GEO database (GSE42677 and GSE45164). After screening the differentially expressed genes via a limma package, we identified 24 differentially expressed lncRNAs (DElncRNAs) and 3221 differentially expressed mRNAs (DEmRNAs). The miRcode, miRTarBase, miRDB and TargetScan databases were used to predict miRNAs that could interact with DElncRNAs and DEmRNAs. A total of 137 miRNA-lncRNA and 221 miRNA-mRNA pairs were retained in the ceRNA network, consisting of 31 miRNAs, 11 DElncRNAs and 155 DEmRNAs. For the functional analysis, the top enriched biological process was enhancer sequence-specific DNA binding in Gene Ontology (GO) terms. The FoxO signaling pathway, autophagy and cellular senescence were the top enrichment terms based on a Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. The combination of a STRING tool and Cytoscape software (plug-in MCODE) identified five core mRNAs and built a core mRNA-associated ceRNA network. The expression for five identified core mRNAs and their related nine lncRNAs was validated using the external dataset GSE7553. Finally, one lncRNA HLA-F-AS1 and three mRNAs named AGO4, E2F1 and CCND1 were validated with the same expression patterns. We speculate that lncRNA HLA-F-AS1 may sponge miR-17-5p or miR-20b-5p to regulate the expression of CCND1 and E2F1 in the cSCC. The present study may provide potential diagnostic and therapeutic targets for cSCC patients.
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Lebas E, Marchal N, Rorive A, Nikkels AF. Cemiplimab for locally advanced cutaneous squamous cell carcinoma: safety, efficacy, and position in therapy panel. Expert Rev Anticancer Ther 2021; 21:355-363. [PMID: 33554680 DOI: 10.1080/14737140.2021.1876567] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Locally advanced cutaneous squamous cell carcinoma (lacSCC) is rare. Approximately one-fourth of the cases are observed among immunocompromised patients, in particular in solid organ transplant recipients (OTRs). LacSCC has a very poor prognosis. Surgery with or without radiotherapy remains the golden standard of treatment for cSCC. However, in advanced cases, there is a medical need for alternative treatment options. Classic systemic treatments include chemotherapy and/or EGFR inhibitors. Recently the effectiveness of programmed cell death protein-1 (PD-1) inhibitors has been demonstrated for lacSCC. Cemiplimab is a recombinant IgG4 human monoclonal antibody against the PD-1 protein for the intravenous treatment of lacSCC. AREAS COVERED The principal studies evaluating the efficacy and safety of cemiplimab for lacSCC are presented. EXPERT OPINION Cemiplimab is the first anti-PD-1 antibody that was FDA (2018) and EMA (2019) approved as a systemic treatment for lacSCC and/or metastatic cSCC when curative surgery or radiotherapy is no longer amenable. For this situation, experts currently recommend cemiplimab as a first-line systemic alternative. As cemiplimab therapy is potentially associated with a risk of organ graft rejection, pros and cons should be evaluated for every individual OTR patient with lacSCC.
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Affiliation(s)
- Eve Lebas
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
| | - Nathalie Marchal
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
| | - Andrée Rorive
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
| | - Arjen F Nikkels
- Departments of Dermatology and Medical Oncology Skin Cancer Center, University Hospital Centre, CHU Du Sart Tilman, Liège, BELGIUM
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Brancaccio G, Moscarella E, Briatico G, Verolino P, Alfano R, Argenziano G. Challenges and new perspectives in the treatment of advanced cutaneous squamous cell carcinoma. Minerva Med 2020; 111:589-600. [PMID: 32955822 DOI: 10.23736/s0026-4806.20.06821-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the overall excellent survival rates in patients affected by early cutaneous squamous cell carcinoma (CSCC), advanced forms of CSCC are associated with high patient mortality. To date, only limited therapeutic modalities have been implemented, including chemotherapy and radiotherapy. Systemic therapy was enriched by the addition of epidermal growth factor receptor inhibitors (EGFRi) in the last years. Unfortunately, the overall outcome of all these therapeutic strategies remains poor, therefore important unmet clinical needs persist. Thanks to a better understanding of the biology of advanced CSCC, new treatment options are now available. This article presents the current definition of advanced CSCC along with actual therapeutic options and discusses the strengths and limitations of a new promising systemic approach, which involves the use of immune checkpoint inhibitors.
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Affiliation(s)
| | - Elvira Moscarella
- Dermatology Unit, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Giulia Briatico
- Dermatology Unit, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Pasquale Verolino
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Roberto Alfano
- Department of Anesthesiology, Surgery and Emergency, Luigi Vanvitelli University of Campania, Naples, Italy
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