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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 (Basel) 2023; 15:3180. [PMID: 37370790 DOI: 10.3390/cancers15123180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Anti-PD1 therapy demonstrated impressive, prolonged responses in advanced cutaneous squamous cell carcinoma (CSCC). Therapy for ICI-refractory/ineligible disease remains unclear. We performed a retrospective analysis in locally-advanced/metastatic CSCC using cetuximab across three cohorts: immediately after ICI failure (A), not immediately following ICI failure (B), or without prior ICI (C). The primary endpoint was the overall response rate (ORR). Secondary endpoints included disease-control rate (DCR), progression-free survival (PFS), overall survival (OS), time-to-response (TTR) and toxicity. Twenty-three patients were included. In cohort A (n = 11), the ORR was 64% and DCR was 91%, with six ongoing responses at data cutoff. In cohort B (n = 2), all patients had progression as the best response. At a median follow-up of 21 months for A and B, TTR and PFS were 2.0 and 17.3 months, respectively. The median OS was not reached. In cohort C (n = 10), the ORR and DCR were 80%, including five ongoing responses at the data cutoff. At a median follow-up of 22.4 months, the TTR, PFS and OS were 2.5, 7.3 and 23.1 months, respectively. Cetuximab was well tolerated in all cohorts. In summary, cetuximab is effective in patients with failure/contraindications to ICI. Cetuximab immediately after ICI failure yielded particularly fast, durable responses. If confirmed, this could be the preferred therapy following ICI failure.
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Affiliation(s)
- Julian A Marin-Acevedo
- Medical Oncology, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN 46202, USA
| | | | - Youngchul Kim
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Andrew S Brohl
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Zeynep Eroglu
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Joseph Markowitz
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Ahmad A Tarhini
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Kenneth Y Tsai
- Department of Pathology, Division of Dermatopathology, Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Nikhil I Khushalani
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
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Beekman KE, Parker LM, DePalo DK, Elleson KM, Sarnaik AA, Tsai KY, Withycombe BM, Zager JS. Four cases of disseminated herpes simplex virus following talimogene laherparepvec injections for unresectable metastatic melanoma. JAAD Case Rep 2023; 33:56-58. [PMID: 36860805 PMCID: PMC9969237 DOI: 10.1016/j.jdcr.2022.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
| | - Lily M. Parker
- USF Health, Morsani College of Medicine, Tampa, Florida,Correspondence to: Lily M. Parker, BS, USF Health Morsani College of Medicine, 10920 N. McKinley Dr, Room 4123, Tampa, FL 33612
| | - Danielle K. DePalo
- Department of Cutaneous Oncology, Moffitt Cancer Center, Wesley Chapel, Florida
| | - Kelly M. Elleson
- Department of Cutaneous Oncology, Moffitt Cancer Center, Wesley Chapel, Florida
| | - Amod A. Sarnaik
- USF Health, Morsani College of Medicine, Tampa, Florida,Department of Cutaneous Oncology, Moffitt Cancer Center, Wesley Chapel, Florida
| | - Kenneth Y. Tsai
- Department of Anatomic Pathology and Tumor Biology, Moffitt Cancer Center, Wesley Chapel, Florida
| | | | - Jonathan S. Zager
- USF Health, Morsani College of Medicine, Tampa, Florida,Department of Cutaneous Oncology, Moffitt Cancer Center, Wesley Chapel, Florida
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Okten IN, Ismail S, Withycombe BM, Eroglu Z. Preclinical discovery and clinical development of encorafenib for the treatment of melanoma. Expert Opin Drug Discov 2020; 15:1373-1380. [PMID: 32720533 DOI: 10.1080/17460441.2020.1795124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Nearly 50% of patients with metastatic melanoma harbor a BRAFV600-mutation, which can be targeted with the use of BRAF and MEK inhibitors, either in the front-line or treatment-refractory setting. Encorafenib is the newest BRAF-inhibitor to have received FDA-approval in combination with the MEK inhibitor binimetinib. AREAS COVERED The authors provide an overview of the preclinical development and the clinical trials that led to the use of encorafenib in BRAFV600-mutant melanoma. They also give discussion on its current use in clinical practice, providing their expert perspectives on the subject. EXPERT OPINION Preclinical research has provided strong rationale for upgrading encorafenib investigation into clinical development/testing. However, there is not yet enough data to determine where encorafenib may fit in comparison to other drugs in the same class, and ongoing trials will further define its role in the treatment of melanoma. Of note, there are ongoing studies that further explore the role of encorafenib + binimetinib such as in combination regimens with immunotherapy drugs, and in brain metastases.
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Affiliation(s)
- Ilker N Okten
- Department of Cutaneous Oncology, Moffitt Cancer Center , Tampa, FL, USA
| | - Sadeka Ismail
- School of Pharmacy, Lake Erie College of Osteopathic Medicine , Bradenton, FL, USA
| | | | - Zeynep Eroglu
- Department of Cutaneous Oncology, Moffitt Cancer Center , Tampa, FL, USA
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