MD Anderson: Many skin cancer tumors disappear with new therapy

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More than 60% of patients with an advanced stage squamous cell skin cancer saw their tumors nearly or completely disappear when treated with immunotherapy before surgery, a new study says. Photo by Tech Sgt. Scott Johnson/U.S. Air Force

More than six in 10 patients with an advanced stage of a common type of skin cancer saw their tumors nearly or completely disappear when treated with immunotherapy before surgery — results likely to change how physicians target these cancers.

That’s according to the University of Texas MD Anderson Cancer Center, which reported the findings Monday at the European Society for Medical Oncology Congress 2022 in Paris.

Each year, about 1 million people in the United States are diagnosed with squamous cell carcinoma of the skin, and resultant tumors may affect the eyes, ears, nose and mouth.

The current standard of care for the cancer involves surgical excision and radiation, which may cause disfigurement and loss of important functions, such as vision, hearing or smell.

Researchers said the pre-surgical immunotherapy allowed “less invasive, function-preserving” surgery in some cases.

The study on cutaneous squamous cell carcinoma was published in Monday’s New England Journal of Medicine.

“I think where it’s really going to make a huge difference is quality of life,” Gross said. “If you can avoid radiation or have a smaller surgery, and you can keep your eye, ear or nose, that’s a huge win for people.

That’s the excitement of this approach: the chance to make life so much better for our patients in the future,” Dr. Neil Gross, the study’s lead author and director of clinical research in MD Anderson Cancer Center’s Department of Head and Neck Surgery, said in a news release.

MD Anderson led an international, multicenter Phase II clinical trial in the United States, Australia and Europe enrolled 79 patients, mostly men, averaging 73 years old, with stages II to IV cutaneous squamous cell carcinoma.

And 51% of them, treated with up to four doses of the drug cemiplimab, had what is called a “pathologic complete response,” meaning no tumor cells were found at surgery.

Another 13% of patients had a “major pathological response,” meaning less than 10% of a viable tumor was found at surgery.

In 2018, the Food and Drug Administration approved cemiplimab for patients with metastatic cutaneous squamous cell carcinoma who are not candidates for curative surgery or radiation.

In the study, seventy of the 79 participants underwent surgery. Of the nine patients who did not have surgery, three declined because imaging showed their cancer responded to the immunotherapy, two did not follow up, two had progressive disease and two experienced adverse events, the research abstract said.

Fourteen patients experienced severe, but not immediately, life-threatening adverse events. The most common side effects were fatigue (30%), rash (14%), diarrhea (14%) and nausea (14%). Four patients died, and on death, an exacerbation of cardiac failure, was considered related to treatment.

According to the news release, the research team said it will continue to follow the study participants and hopes to address still-unanswered questions about the optimal number of doses before surgery.

the team also hopes to determine which patients can safely avoid radiation or surgery, and how to predict which patients are most likely to respond to immunotherapy.

Gross said he was “excited to see how this new treatment approach impacts outcomes, including quality of life, as we continue long-term follow-up.”

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