Although cemiplimab has been approved for locally advanced (la) and metastatic (m) cutaneous squamous-cell carcinomas (CSCCs), its real-life value has not yet been demonstrated. An early-access program enrolled patients with la/mCSCCs to receive cemiplimab. Endpoints were best overall response rate (BOR), progression-free survival (PFS), overall survival (OS), duration of response (DOR) and safety. The 245 patients (mean age 77 years, 73% male, 49% prior systemic treatment, 24% immunocompromised, 27% Eastern Cooperative Oncology Group performance status (PS) ≥ 2) had laCSCCs (35%) or mCSCCs (65%). For the 240 recipients of ≥1 infusion(s), the BOR was 50.4% (complete, 21%; partial, 29%). With median follow-up at 12.6 months, median PFS was 7.9 months, and median OS and DOR were not reached. One-year OS was 73% versus 36%, respectively, for patients with PS < 2 versus ≥ 2. Multivariate analysis retained PS ≥ 2 as being associated during the first 6 months with PFS and OS. Head-and-neck location was associated with longer PFS. Immune status had no impact. Severe treatment-related adverse events occurred in 9% of the patients, including one death from toxic epidermal necrolysis. Cemiplimab real-life safety and efficacy support its use for la/mCSCCs. Patients with PS ≥ 2 benefited less from cemiplimab, but it might represent an option for immunocompromised patients.

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Summary:Between 1990 and 1997, 55 patients with high risk multiple myeloma underwent high-dose therapy with peripheral blood stem cell transplantation. Intensification consisted of high-dose L-PAM in 54 patients, and 15 patients underwent a second high-dose treatment. Thirty patients received total body irradiation. Twenty patients were more than 60 years old. Thirty-five patients were intensified during first response. The overall response rate was 78%. There were four toxic deaths. The median overall survivals after intensification and after first treatment of myeloma were greater than 48 months and 71 months, respectively. Conversely freedom from progression after intensification was short, with a median of 22 months. Freedom from progression was significantly shorter in patients older than 60 (12 months), and in patients who had received more than 75 mg/m 2 of L-PAM before intensification (16 months). Although intensification is feasible in elderly patients the benefit appears to be reduced in this subgroup of patients. Prior therapy with high cumulative doses of L-PAM should be avoided in patients who will receive high-dose L-PAM for therapeutic intensification. Keywords: myeloma; elderly; L-PAM; PBSC The alkylating agents L-PAM and cyclophosphamide were the first agents to significantly increase the median survival in patients with high risk myeloma, from 7 to 30 months after diagnosis. The administration of high-dose L-PAM, alone or with growth factors and/or stem cell support has yielded encouraging results in a number of non-randomized series, with higher response rates, including a large fraction of complete or very good partial responses. at 5 years vs 12%) than the use of standard-dose chemotherapy.A major concern with the use of bone marrow grafts is the potential role played by contaminating myeloma cells in relapse. Various authors have advocated the use of peripheral blood stem cells (PBSC) for bone marrow reconstitution, in order to limit tumor cell contamination and to shorten the cytopenic period.6,7 Recent reports have analyzed the use of positively selected CD34(+) stem cells. 8,9 Ongoing trials using CD34(+) stem cells are currently under way.We report the results of therapeutic intensification in 55 myeloma patients treated at the Centre Hospitalier Lyon Sud over a 6-year period. The majority of patients had chemosensitive disease, and 36% were 60 years old or more at the time of intensification. Fifteen patients underwent double intensification. A number of disease-or treatmentrelated factors were analyzed for their potential influence on overall and progression-free survival. Patients and methods Patient characteristicsBetween January 1990 and September 1997, 55 patients received high-dose intravenous L-PAM, with or without total body irradiation (TBI) for multiple myeloma. Patient and treatment characteristics are shown in Table 1. There were 31 males and 24 females. The median age at intensification was 58 years (range 25-66, and 20 patients were 60 years old or more). Nine patients ha...

TPF (docetaxel, cisplatin, fluorouracil) is the standard chemotherapy used for induction in locally advanced head and neck squamous cell carcinoma (LAHNSCC).Its toxicity limits it to younger patients with good functional status and without significant comorbidity. Since modified TPF (mTPF) demonstrated higher tolerability with similar efficacy in gastric cancer, we tested this scheme on frail patients.From July 2010 to July 2014, the files of the 48 patients treated for LAHNSCC with mTPF in three French institutions were retrospectively collected. mTPF was chosen because of age>70 years, or severe denutrition, or PS>1, or severe comorbidities or after severe toxicity of standard TPF. During the first 4 cycles, 2 patients died, 14 secondary hospitalizations were required and 10 patients stopped treatment due to no lethal toxicity. Two patients died during radiotherapy.The response rate was 83% (19% complete response). With a median follow-up of 15.2 months, 4 patients died during treatment, 8 died of non-head and neck cancer related disorders, 18 progressed (17 deaths) and 18 were free of disease. The median overall survival was 18.5 months (95% IC: 16.9-30.0). mTPF is effective in terms of response rate compared with the standard TPF and could become a new option in induction for frail patients with LAHNSCC.