A Case of sustained complete response of advanced cutaneous Squamous Cell Cancer of the scalp to Cemiplimab

Abstract

Cutaneous Squamous Cell Cancer (cSCC) is the second most common Non-Melanoma Skin Cancer (NMSC) after basal cell in the United States with increasing incidence due to advanced age and screening. It predominantly occurs in the head and neck region (scalp, face, ears, lips, nose, neck e.t.c) with chronic Ultra-Violet (UV) radiation from repeated sun exposure and immunosuppression being the main risk factor.It is a highly curable tumor but can lead to increased morbidity and mortality if it becomes advanced which can either be locally advanced or metastatic disease. The treatment modalities include surgical resection which is the first-line management option for operable tumors. Radiotherapy (RT) and chemotherapy are other treatment options. Recently, Immune targeted therapy has been approved for the treatment of advanced cutaneous squamous cell cancer and has demonstrated favorable responses so far.We present a case of metastatic cutaneous squamous cell cancer of the scalp and face with mediastinal and supraclavicular lymph node metastasis that achieved sustained complete remission following treatment with a fully human IgG4 monoclonal antibody directed against Programmed cell Death Ligand-1 (PD-L1) - Cemiplimab with no untoward effects since the beginning of therapy to date.

Keywords

• Cemiplimab
• Tumor profiling
• Mohs Micrographic Surgery
• Chemotherapy
• Radiotherapy