Objectives: To describe the outcomes of patients with primary or recurrent cutaneous squamous cell carcinoma involving the skull base treated with Cemiplimab immunotherapy.
Study Design: Retrospective chart review
Methods: We conducted a retrospective chart review of eight patients treated with Cemiplimab immunotherapy for primary or recurrent cutaneous squamous cell carcinoma involving the skull base. We investigated response to disease based on clinical assessment of symptoms and patient physical exam as well as radiographic response.
Results: Of the eight patients included, seven were male and average age was 76 years. Six (75%) patients had prior radiotherapy. Seven patients had skull base involvement when starting immunotherapy, while one had skull base involvement initially in their disease course. Areas of disease involvement included V2 at foramen rotundum (2), V3 at foramen ovale (1), TMJ and infratemporal fossa (2), stylomastoid foramen (1), supraorbital foramen (1) and parietal calvarium/dura (1). Average treatment duration was eight months. Positive clinical response seen in 5 patients (63%) in the first three months on clinical and radiographic assessment. Four patients had no evidence of disease at one year follow up. Progression of disease was seen in three patients. Average number of treatments was 16.6 for those that responded. Three patients continued treatment indefinitely and two elected for observation. There were no significant treatment side effects causing treatment delays or cessation of treatment.
Conclusions: Cemiplimab immunotherapy remains an efficacious treatment modality for patients with advanced or recurrent cutaneous squamous cell carcinoma involving the skull base. Treatment was well tolerated throughout.