Multidisciplinary management of locally advanced and metastatic cutaneous squamous cell carcinoma

  • J. Claveau Centre hospitalier universitaire de Québec–Université Laval
  • J. Archambault Centre hospitalier universitaire de Québec–Université Laval
  • D.S. Ernst Western University
  • C. Giacomantonio Dalhousie University
  • J.J. Limacher University of Toronto, Women’s College Hospital
  • C. Murray University of Toronto, Women’s College Hospital
  • F. Parent Centre hospitalier universitaire de Québec–Université Laval
  • D. Zloty University of British Columbia
Keywords: Cutaneous squamous cell carcinoma, locally advanced disease, metastatic disease, staging, stratification,, multidisciplinary management

Abstract

Non-melanoma skin cancers are the most prevalent form of cancer, with cutaneous squamous cell carcinoma (cscc) being the 2nd most common type. Patients presenting with high-risk lesions associated with locally advanced or metastatic cscc face high rates of recurrence and mortality. Accurate staging and risk stratification for patients can be challenging because no system is universally accepted, and no Canadian guidelines currently exist.

   Patients with advanced cscc are often deemed ineligible for either or both of curative surgery and radiation therapy (rt) and, until recently, were limited to off-label systemic cisplatin–fluorouracil or cetuximab therapy, which offers modest clinical benefits and potentially severe toxicity. A new systemic therapy, cemiplimab, has been approved for the treatment of locally advanced and metastatic cscc. In the present review, we provide recommendations for patient classification and staging based on current guidelines, direction for determining patient eligibility for surgery and rt, and an overview of the available systemic treatment options for advanced cscc and of the benefits of a multidisci­plinary approach to patient management.


Author Biography

D. Zloty, University of British Columbia

Department of Dermatology and Skin Science

Published
2020-06-22
How to Cite
Claveau, J., Archambault, J., Ernst, D., Giacomantonio, C., Limacher, J., Murray, C., Parent, F., & Zloty, D. (2020). Multidisciplinary management of locally advanced and metastatic cutaneous squamous cell carcinoma. Current Oncology, 27(4). https://doi.org/10.3747/co.27.6015
Section
Review Article