Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations

Cutaneous squamous cell carcinoma (cSCC) may develop in patients with dysregulated immune activation (pre-existing autoimmune diseases or immunosuppression due to hematopoietic/solid organ transplant recipients), patients with a compromised immune function (long-term immunosuppression), and patient...

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Autores principales:	Paolo Bossi, Luigi Lorini
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2021
Materias:	cutaneous squamous cell carcinoma special population auto-immune disease immunosuppression immunodepression Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/a16522c58247449582ace749140ddfe6
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spelling	oai:doaj.org-article:a16522c58247449582ace749140ddfe62021-11-17T08:27:36ZTreatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations10.5826/dpc.11S2a170S2160-9381https://doaj.org/article/a16522c58247449582ace749140ddfe62021-11-01T00:00:00Zhttp://dpcj.org/index.php/dpc/article/view/2137https://doaj.org/toc/2160-9381 Cutaneous squamous cell carcinoma (cSCC) may develop in patients with dysregulated immune activation (pre-existing autoimmune diseases or immunosuppression due to hematopoietic/solid organ transplant recipients), patients with a compromised immune function (long-term immunosuppression), and patients carrying chronic viral infections, or those affected by lymphoproliferative diseases. It should be also considered that patients presenting with immunosuppression have a high incidence of cSCC (65–250-times higher than general population), highlighting the central role played by the immune system in the development of cSCC. All these cases must be considered as “special populations” for treatment with immune checkpoint inhibitors (ICIs), as the safety and activity of these drugs have not been studied on these specific cases, since these patients were excluded from clinical trials leading to approval of ICIs. It is therefore important to gain as much information as possible from the analysis of real-life data, to derive an indication to be adopted in everyday clinical setting. Moreover, therapeutic alternatives other than ICIs are scarce, mainly consisting in chemotherapy and anti-EGFR agents, whose activity is lower than immunotherapy and whose toxicity (particularly with chemotherapy) are not sustainable by this frail population. Here, we describe the current evidence of treatment with ICIs in special populations and conclude that it is necessary to find a balance between treatment risks (toxicities) and benefits (efficacy), as well as engaging a multidisciplinary team of experts to thoroughly manage and treat these patients. Paolo BossiLuigi LoriniMattioli1885articlecutaneous squamous cell carcinomaspecial populationauto-immune diseaseimmunosuppressionimmunodepressionDermatologyRL1-803ENDermatology Practical & Conceptual, Vol 11, Iss S2 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cutaneous squamous cell carcinoma special population auto-immune disease immunosuppression immunodepression Dermatology RL1-803
spellingShingle	cutaneous squamous cell carcinoma special population auto-immune disease immunosuppression immunodepression Dermatology RL1-803 Paolo Bossi Luigi Lorini Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations
description	Cutaneous squamous cell carcinoma (cSCC) may develop in patients with dysregulated immune activation (pre-existing autoimmune diseases or immunosuppression due to hematopoietic/solid organ transplant recipients), patients with a compromised immune function (long-term immunosuppression), and patients carrying chronic viral infections, or those affected by lymphoproliferative diseases. It should be also considered that patients presenting with immunosuppression have a high incidence of cSCC (65–250-times higher than general population), highlighting the central role played by the immune system in the development of cSCC. All these cases must be considered as “special populations” for treatment with immune checkpoint inhibitors (ICIs), as the safety and activity of these drugs have not been studied on these specific cases, since these patients were excluded from clinical trials leading to approval of ICIs. It is therefore important to gain as much information as possible from the analysis of real-life data, to derive an indication to be adopted in everyday clinical setting. Moreover, therapeutic alternatives other than ICIs are scarce, mainly consisting in chemotherapy and anti-EGFR agents, whose activity is lower than immunotherapy and whose toxicity (particularly with chemotherapy) are not sustainable by this frail population. Here, we describe the current evidence of treatment with ICIs in special populations and conclude that it is necessary to find a balance between treatment risks (toxicities) and benefits (efficacy), as well as engaging a multidisciplinary team of experts to thoroughly manage and treat these patients.
format	article
author	Paolo Bossi Luigi Lorini
author_facet	Paolo Bossi Luigi Lorini
author_sort	Paolo Bossi
title	Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations
title_short	Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations
title_full	Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations
title_fullStr	Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations
title_full_unstemmed	Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations
title_sort	treatment of cutaneous squamous cell carcinoma with immune checkpoint inhibitors in special populations
publisher	Mattioli1885
publishDate	2021
url	https://doaj.org/article/a16522c58247449582ace749140ddfe6
work_keys_str_mv	AT paolobossi treatmentofcutaneoussquamouscellcarcinomawithimmunecheckpointinhibitorsinspecialpopulations AT luigilorini treatmentofcutaneoussquamouscellcarcinomawithimmunecheckpointinhibitorsinspecialpopulations
_version_	1718425814917185536

Treatment of Cutaneous Squamous Cell Carcinoma with Immune Checkpoint Inhibitors in Special Populations

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