Evidence Based Analysis of Cisplatin for Treating Patients with Cutaneous Squamous Cell Carcinoma

Shao, Xin; Xu, Yunsheng; Zhang, Xueqi; Li, Wenfeng

doi:10.7314/apjcp.2014.15.22.9813

Cited by 11 publications

(3 citation statements)

References 25 publications

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“…Correspondingly, the proportion of patients treated with neck dissection, as well as the proportion of patients received postoperative adjuvant therapy, was significantly higher in SOTR, in agreement with previous studies 36 . Data supporting efficacy of systemic chemotherapy in metastatic cutaneous SCC are limited, 61,62 and the role of chemotherapy in the treatment of SOTR with CSCC‐HN is not clear. Toxicity to the patient and the transplanted organ remains a concern, especially in kidney recipients, and administration of chemotherapeutic agents such as cisplatin is often precluded by comorbidities and decreased performance status 63 .…”

Section: Discussionsupporting

confidence: 82%

Solid organ transplantation worsens the prognosis of patients with cutaneous squamous cell carcinoma of the head and neck region—Comparison between solid organ transplant recipients and immunocompetent patients

et al. 2020

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Background Cutaneous squamous cell carcinoma of the head and neck (CSCC‐HN) appears to behave more aggressively in immunosuppressed patients. We aimed to investigate this hypothesis by comparing solid organ transplant recipients (SOTR) with CSCC‐HN to immunocompetent patients. Methods A retrospective comparative study was conducted for SOTR and immunocompetent patients who were treated for CSCC‐HN. Results A total of 177 SOTR and 157 immunocompetent patients with CSCC‐HN were included. Lymph node metastases were more common in the SOTR group (9% vs 3%), and distant metastases occurred only in SOTR (3% of patients). SOTR had a higher rate of recurrences (19% vs 10%), which were mostly regional (7%) and distant (3%). The 2‐year disease‐specific survival of SOTR was lower (93% vs 100%). Conclusions SOTR with CSCC‐HN has significantly worse outcomes compared to immunocompetent patients. Solid‐organ transplantation should be regarded as a negative prognostic factor in patients with CSCC‐HN.

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Section: Discussionsupporting

confidence: 82%

Solid organ transplantation worsens the prognosis of patients with cutaneous squamous cell carcinoma of the head and neck region—Comparison between solid organ transplant recipients and immunocompetent patients

et al. 2020

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“…Management: metastatic cutaneous SCC: In patients with metastatic cutaneous SCC, systemic chemotherapy is recommended; however, data for systemic chemotherapy to treat cutaneous SCC is limited. Cisplatin alone or in combination with 5-FU has shown clinical efficacy (100,101).…”

Section: Modulation Of Immunosuppressionmentioning

confidence: 99%

Skin Cancers in Organ Transplant Recipients

Mittal

Colegio

2017

American Journal of Transplantation

170

104

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Long-term utilization of immunosuppression in organ transplant recipients (OTRs) leads to decreased immune-mediated tumor surveillance and development of malignant tumors. A delicate balance needs to be maintained in the intensity of immunosuppression to keep the risk of malignancy low without jeopardizing life-saving graft function. OTRs are prone to developing skin cancers that exhibit unique epidemiologic, pathophysiologic, and prognostic characteristics. In this review, we discuss the most commonly reported skin cancers in OTRs: squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Kaposi sarcoma, Merkel cell carcinoma, and malignant melanoma (MM). Tumors in this high-risk population are aggressive and may respond poorly to standard therapies; however, new targeted therapies are promising. Checkpoint inhibitor antibodies have been used for treatment of cutaneous SCC, Merkel cell carcinoma, and MM; epidermal growth factor receptor inhibitors have been used for cutaneous SCC; hedgehog pathway inhibitors have been used for BCC; and BRAF and MEK inhibitors are being used increasingly in the management of MM. Guidelines for dermatologic screening are variable and primarily based on expert opinion. Prospective evidence-based trials by multidisciplinary groups are needed to better define surveillance schedules for pre- and posttransplant cutaneous malignancies.

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“…Evidence of efficacy is limited and although cisplatin alone or in combination with 5-fluorouracil has shown some activity, DOR is short. 36,37 In metastatic MCC, conventional chemotherapy may similarly have initial activity, but responses are rarely durable. EGFR inhibition with cetuximab, either alone or in combination with RT or carboplatin, has an ORR of 47%.…”

Section: Introductionmentioning

confidence: 99%

Immune Checkpoint Inhibitors in Solid Organ Transplant Recipients With Advanced Skin Cancers—Emerging Strategies for Clinical Management

et al. 2023

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Use of immune checkpoint inhibitors (ICIs) in solid organ transplant recipients (SOTRs) with advanced skin cancers presents a significant clinical management dilemma. SOTRs and other immunosuppressed patients have been routinely excluded from ICI clinical trials with good reason: immune checkpoints play an important role in self- and allograft-tolerance and risk of acute allograft rejection reported in retrospective studies affects 10% to 65% of cases. These reports also confirm that cutaneous squamous cell carcinoma and melanoma respond to ICI therapy, although response rates are generally lower than those observed in immunocompetent populations. Prospective trials are now of critical importance in further establishing ICI efficacy and safety. However, based on current knowledge, we recommend that ICIs should be offered to kidney transplant recipients with advanced cutaneous squamous cell carcinoma, melanoma, or Merkel cell carcinoma if surgery and/or radiotherapy have failed. For kidney transplant recipients, this should be first line ahead of chemotherapy and targeted therapies. In SOTRs, the use of ICIs should be carefully considered with the benefits of ICIs versus risks of allograft rejection weighed up on a case-by-case basis as part of shared decision-making with patients. In all cases, parallel management of immunosuppression may be key to ICI responsiveness. We recommend maintaining immunosuppression before ICI initiation with a dual immunosuppressive regimen combining mammalian target of rapamycin inhibitors and either corticosteroids or calcineurin inhibitors. Such modification of immunosuppression must be considered in the context of allograft risk (both rejection and also its subsequent treatment) and risk of tumor progression. Ultimately, a multidisciplinary approach should underpin all clinical decision-making in this challenging scenario.

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Evidence Based Analysis of Cisplatin for Treating Patients with Cutaneous Squamous Cell Carcinoma

Cited by 11 publications

References 25 publications

Solid organ transplantation worsens the prognosis of patients with cutaneous squamous cell carcinoma of the head and neck region—Comparison between solid organ transplant recipients and immunocompetent patients

Solid organ transplantation worsens the prognosis of patients with cutaneous squamous cell carcinoma of the head and neck region—Comparison between solid organ transplant recipients and immunocompetent patients

Skin Cancers in Organ Transplant Recipients

Immune Checkpoint Inhibitors in Solid Organ Transplant Recipients With Advanced Skin Cancers—Emerging Strategies for Clinical Management

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