Real-world assessment of response to anti-PD1 therapy in advanced cutaneous squamous cell carcinoma

Photo by National Cancer Institue


Immune checkpoint therapy has revolutionized the management of advanced cutaneous squamous cell carcinoma (CSCC). It is critical to assess efficacy in the real-world setting, including the population generally deemed trial ineligible due to poor performance status and immunosuppression. Thus, we aimed to evaluate the clinical benefit of response to anti-PD-1 therapy in a retrospective advanced CSCC cohort. To do so, we performed a real-world study of patients with advanced CSCC treated with immunotherapy from 2016 – 2020 at Massachusetts General Hospital. We report an objective response rate of 34%, including 14% with complete response and a disease control rate of 70%. The median PFS was 1.2 years and the median OS was 3.3 years. Response was likely independent of underlying immunosuppressive conditions and type of anti-PD-1 therapy, but patients with a poor performance status at baseline were associated with poorer outcomes on univariable and multivariable analysis. We demonstrate that the response rates to anti-PD-1 therapy among real-world advanced CSCC patients are comparable to efficacy in pivotal trial reports and appear independent of immunosuppression status. However, clinical performance status at baseline is a likely predictor of response to treatment.

Sophia Shalhout
Cutaneous Oncology Research Fellow

My research interests include clinical and translational research in advanced skin cancers.