Cemiplimab in an Elderly Frail Population of Patients With Locally Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: A Single-Center Real-Life Experience From Italy
| Autor: | Angela Monica Sciacovelli, Elisabetta Sara Montagna, Francesco Macina, Annalisa Nardone, Raffaella Massafra, Anna Albano, Simona Ferraiuolo, Eustachio Ruggieri, Livia Fucci, Stefania Tommasi, Andrea Armenio, Federica De Luca, Ivana De Risi, Raffaele Filotico, Michele Guida, Davide Quaresmini, Francesco Figliuolo, Annarita Fanizzi, Michele Traversa, Sabino Strippoli, Fabio Mele |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Population Single Center elderly patients Internal medicine medicine Adverse effect education RC254-282 Original Research education.field_of_study business.industry Incidence (epidemiology) Neoplasms. Tumors. Oncology. Including cancer and carcinogens advanced cutaneous squamous cell carcinoma medicine.disease Rash Oncology Tolerability immunocompromised patients cemiplimab Skin cancer medicine.symptom business checkpoint inhibitors Cohort study |
| Zdroj: | Frontiers in Oncology, Vol 11 (2021) Frontiers in Oncology |
| Popis: | BackgroundCutaneous squamous cell carcinoma (CSCC) is the second most common skin cancer whose incidence is growing parallel to the lengthening of the average lifespan. Cemiplimab, an antiPD-1 monoclonal antibody, is the first approved immunotherapy for patients with locally advanced CSCC (laCSCC) or metastatic CSCC (mCSCC) thanks to phase I and II studies showing high antitumor activity and good tolerability. Nevertheless, at present, very few data are available regarding cemiplimab in real-life experience and in frail, elderly, and immunosuppressed patients as well as regarding biomarkers able to predict response so as to guide therapeutic choices.Patients and MethodsWe built a retroprospective cohort study including 30 non-selected patients with laCSCC (25) and mCSCC (five) treated with cemiplimab from August 2019 to November 2020. Clinical outcomes, toxicity profile, and correlations with disease, patients, and peripheral blood parameters are explored.ResultsThe median age was 81 years (range, 36–95), with 24 males and five patients having an immunosuppressive condition, while the frailty prevalence was 83% based on index derived from age, Eastern Cooperative Oncology Group performance status, and Charlson Comorbidity Index. We reported 23 responses (76.7%) with nine complete responses (30%). A statistically significant higher response rate was observed in head and neck primary tumors and in patients with hemoglobin level >12 g/dl. No difference was observed with respect to frailty, median age, sex, and body mass index. The baseline low neuthophil/lymphocyte ratio and low platelet/lymphocyte ratio resulted to be also correlated with a better response. Moreover, lymphocyte, neutrophil, and monocyte behaviors had an opposite trend in responders and non-responders. An overall response was reported in four of five immunosuppressed patients. Seventeen patients (57.6%) have an ongoing response and are still alive. Six responders had interrupted treatment (two for toxicity and four for personal choice) but maintained their response. The treatment was well tolerated by the majority of patients. The most common adverse events were fatigue in seven patients (23.3%) and skin toxicity in 10 patients (33.3%), including pruritus in six patients, rash in three patients, and bullous erythema in one patient.ConclusionsIn our real-life experience, cemiplimab showed a high antitumor activity with acceptable safety profile similar to those in trials with selected patients. Moreover, its antitumor activity resulted to be not impaired in very elderly patients and in those with immunocompromised status. |
| Databáze: | OpenAIRE |
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