Cetuximab is efficient and safe in patients with advanced cutaneous squamous cell carcinoma: a retrospective, multicentre study

Abstract

// Henri Montaudié 1 , Julien Viotti 2 , Patrick Combemale 3 , Caroline Dutriaux 4 , Nicolas Dupin 5 , Caroline Robert 6 , Laurent Mortier 7 , Régis Kaphan 8 , Anne-Bénédicte Duval-Modeste 9 , Stéphane Dalle 10 , Julie De Quatrebarbes 11 , Andrea Stefan 12 , Florence Brunet-Possenti 13 , Maria Kogay 14 , Alexandra Picard-Gauci 1 , Gilles Poissonnet 15 and Frédéric Peyrade 14 1 Department of Dermatology, University Hospital of Nice, Nice, France 2 Epidemiology, Biostatistics and Health Data Departments, Antoine Lacassagne Center, Nice, France 3 Department of Dermatology, Centre Léon Bérard, Lyon, France 4 Department of Dermatology, University Hospital of Bordeaux, Bordeaux, France 5 Department of Dermatology, Hôpital Cochin, APHP, Paris, France 6 Department of Dermatology, Institut Gustave Roussy, Villejuif, France 7 Department of Dermatology, University Hospital Lille, Lille, France 8 Medical Oncology Department, Cannes Hospital, Cannes, France 9 Department of Dermatology, University Hospital of Rouen, Rouen, France 10 Department of Dermatology, ImmuCare, Institut de Cancérologie des Hospices Civils de Lyon, Centre de Recherche en Cancérologie de Lyon, University Hospital of Lyon, Lyon, France 11 Department of Dermatology, CHR, Annecy, France 12 Department of Dermatology, University Hospital of Caen, Caen, France 13 Department of Dermatology, Hôpital Bichat, APHP, Paris, France 14 Medical Oncology Department, Antoine Lacassagne Center, Nice, France 15 Department of Surgery, Antoine Lacassagne Center, Nice, France Correspondence to: Henri Montaudié, email: [email protected] Keywords: cutaneous squamous cell carcinoma; cetuximab; epidermal growth factor receptor Received: June 24, 2019     Accepted: November 13, 2019     Published: January 28, 2020 ABSTRACT There is no standard of care for unresectable cutaneous squamous cell carcinoma (cSCC). Chemotherapy, alone or combined with radiotherapy, is commonly used mostly as palliative treatment; moreover, its poor safety profile limits its use most of the time, especially in elderly patients. Thus, alternative options are needed. Targeted molecular inhibitors, such as the epidermal growth factor receptor inhibitor cetuximab, seem promising, but data are limited. We retrospectively evaluated clinical outcomes of cetuximab as a single agent in this indication. The primary endpoint was the Disease Control Rate (DCR) at 6 weeks according to RECIST criteria. Secondary endpoints included DCR at 12 weeks, objective response rate (ORR) at 6 and 12 weeks, progression-free-survival (PFS), overall survival (OS), and safety profile. Fifty-eight patients received cetuximab as monotherapy. The median age was 83.2 (range, 47.4 to 96.1). The majority of patients was chemotherapy naïve. The median follow-up was 11.7 months (95% CI: 9.6-30.1). The DCR at 6 and 12 weeks was 87% and 70%, respectively. The ORR was 53% and 42%, respectively, at 6 and 12 weeks. The median PFS and OS were 9.7 months (95% CI: 4.8-43.4) and 17.5 months (95% CI: 9.4-43.1), respectively. Fifty-one patients (88%) experienced toxicity, and 67 adverse events related to cetuximab occurred. Most of them (84%) were grade 1 to 2. Our study shows that cetuximab is safe and efficient for the treatment of patients, even elderly ones, with advanced cSCC. These results indicate that cetuximab is a promising agent to test in new combinations, especially with immune checkpoint inhibitors such as anti–PD-1 agents.

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