Journal of Clinical and Aesthetic Dermatology • Hot Topics in Squamous Cell Carcinoma July 2024 • News & Trends

NEW PUBLICATION SHOWS DECISIONDX®-SCC IDENTIFIES HIGH-RISK SQUAMOUS CELL CARCINOMA PATIENTS WHO ARE LIKELY TO BENEFIT FROM ADJUVANT RADIATION THERAPY AND THOSE WHO CAN CONSIDER DEFERRING TREATMENT BASED ON BIOLOGICAL RISK OF METASTASIS

Recent research has shown that use of the 40- gene expression profile (GEP) test, DecisionDx-SCC, can identify patients with cutaneous squamous cell carcinoma (cSCC) who would receive the most benefit from adjuvant radiation therapy (ART) due to increased risk of metastasis. Similarly, patients with the lowest risk of metastasis can be identified. Implementation of the 40-GEP test can help inform ART-related decision-making in patients with cSCC.

Researchers have found that patients with high-stage cSCC treated with wide local excision (WLE) face an increased risk of adverse survival outcomes, compared to those treated with Mohs micrographic surgery (MMS). The rates of local and any recurrence were 22.1 and 34.2 percent, respectively, in the WLE group, compared to 10.8 and 17.0 percent, respectively, in the MMS group. Nodal and distant metastases occurred less frequently in the MMS group, compared to the WLE group. The disease-specific survival rate was 8.5 percent for patients who underwent MMS, compared to 20.3 percent for those treated with WLE.

KERATINOCYTE CANCERS MOST COMMONLY LOCATED ON THE HEAD AND NECK, US STUDY FINDS

The incidence of head and/or neck keratinocyte carcinomas was 53.8 percent in a Medicare cohort, according to a study published in JAMA Dermatology. The next most common site of keratinocyte carcinomas was upper limbs, accounting for 17.8 percent of cases. Head and/or neck basal cell carcinoma (BCC) was more common than head and/or neck cSCC (63.8% vs. 44.3%). A total of 26.7 percent of cSCC cases were located on the upper limbs, and 14.9 percent of BCC cases were located on the trunk.

MOHS SURGERY TECHNIQUES MIGHT CAUSE HYPERPIGMENTATION AMONG PATIENTS WITH SKIN OF COLOR

Among patients who underwent MMS, the incidence of postinflammatory hyperpigmentation (PIH) was significantly higher for patients with Fitzpatrick skin types IV to V (48%), compared to those with Fitzpatrick skin types I to III (18.2%). The rate of PIH was 87.5 percent with grafts and granulation in skin of color patients, which was significantly higher than the PIH rate of 30.7 percent with layered linear repairs and flaps. PIH occurred more frequently in cases with postoperative complications, such as necrosis or infection.

In a Phase II trial, all 11 participants with low- or intermediate-risk cSCC experienced treatment response with talimogene laherparepvec (T-VEC) injection. Median age was 73 years, and all patients were White. Most patients (90.9%) achieved completes response, and 9.1 percent experienced partial response. Median time to response was 35 days. At two-years post-treatment, patients had fewer invasive tumors than at one- and two-years pre-treatment.

RESEARCH BITE—A retrospective analysis of drugs associated with the development of cutaneous SCC reported by patients on the FDA’s adverse events reporting system

From 1997 to 2023, there were 4,792 cases of cutaneous squamous cell carcinoma (cSCC) reported as adverse events (AEs) from medications. The medications most frequently associated with cSCC as an AE were lenalidomide (14.9%), tacrolimus (8.5%), and adalimumab (8.0%). Of the top 10 medications associated with cSCC development, nine had immunosuppressive components. Corticosteroid and calcineurin inhibitor use were associated with increased risk of cSCC for male individuals, compared to female individuals. Female patients faced higher odds of developing cSCC with monoclonal antibody use, compared to male patients.

Source: Jean-Pierre P, Nouri K. A retrospective analysis of drugs associated with the development of cutaneous squamous cell carcinoma reported by patients on the FDA’s adverse events reporting system. Arch Dermatol Res. 2024;316(6):250.