European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: Part 2. Treatment–Update 2023 - Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie
Article Dans Une Revue European Journal of Cancer Année : 2023

European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: Part 2. Treatment–Update 2023

1 NKUA - National and Kapodistrian University of Athens
2 Eberhard Karls Universität Tübingen = University of Tübingen
3 HIPI (UMR_S_976 / U976) - Immunologie humaine, physiopathologie & immunothérapie
4 Royal Prince Alfred Hospital [Sydney, Australia]
5 The University of Sydney
6 Melanoma Institute Australia [Sydney, NSW, Australia]
7 MV2C - Mount Vernon Cancer Centre [Northwood, UK]
8 OUH - Odense University Hospital
9 INCIT - Immunology and New Concepts in ImmunoTherapy
10 University hospital of Zurich [Zurich]
11 UNIVAQ - University of L'Aquila [Italy]
12 UMPCD - University of Medicine and Pharmacy “Carol Davila”
13 Barts and the London Medical School
14 UKSH - University Medical Center of Schleswig–Holstein = Universitätsklinikum Schleswig-Holstein
15 Medizinische Universität Wien = Medical University of Vienna
16 MFM2A - Medical Faculty Military Medical Academy [Belgrade, Serbia]
17 Frankfurt University Hospital
18 MUMC - Maastricht University Medical Centre
19 Maastricht University [Maastricht]
20 Aristotle University of Thessaloniki
21 University of Barcelona
22 IDIBAPS - Institut d'Investigacions Biomèdiques August Pi i Sunyer
23 CIBER de Enfermedades Raras (CIBERER)
24 ULB - Université libre de Bruxelles
25 Hospital Universitario Virgen Macarena [Séville]
26 UNIROMA - Università degli Studi di Roma "La Sapienza" = Sapienza University [Rome]
27 FPUAG - Fondazione Policlinico Universitario A. Gemelli [Rome]
28 Hôpital Ambroise Paré [AP-HP]
29 BECCOH - Biomarqueurs et essais cliniques en Cancérologie et Onco-Hématologie
30 Universidade de Coimbra [Coimbra]
31 Università degli studi di Trieste = University of Trieste
32 UK - Univerzita Karlova [Praha, Česká republika] = Charles University [Prague, Czech Republic]
33 UMCU - University Medical Center [Utrecht]
34 TUM - Technische Universität Munchen - Technical University Munich - Université Technique de Munich
35 LMU - Ludwig Maximilian University [Munich] = Ludwig Maximilians Universität München
36 AMU - Aix Marseille Université
37 APHM - Assistance Publique - Hôpitaux de Marseille
38 University of Manchester [Manchester]
39 The Christie NHS Foundation Trust [Manchester, Royaume-Uni]
Lars Bastholt
Reinhard Dummer
Aimilios Lallas

Résumé

In order to update recommendations on treatment, supportive care, education, and follow-up of patients with invasive cutaneous squamous cell carcinoma (cSCC), a multidisciplinary panel of experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), the European Society for Radiotherapy and Oncology (ESTRO), the European Union of Medical Specialists (UEMS), the European Academy of Dermatology and Venereology (EADV), and the European Organisation of Research and Treatment of Cancer (EORTC) was formed. Recommendations were based on an evidence-based literature review, guidelines, and expert consensus. Treatment recommendations are presented for common primary cSCC (low risk, high risk), locally advanced cSCC, regional metastatic cSCC (operable or inoperable), and distant metastatic cSCC. For common primary cSCC, the first-line treatment is surgical excision with postoperative margin assessment or micrographically controlled surgery. Achieving clear surgical margins is the most important treatment consideration for patients with cSCCs amenable to surgery. Regarding adjuvant radiotherapy for patients with high-risk localised cSCC with clear surgical margins, current evidence has not shown significant benefit for those with at least one high-risk factor. Radiotherapy should be considered as the primary treatment for non-surgical candidates/tumours. For cSCC with cytologically or histologically confirmed regional nodal metastasis, lymph node dissection is recommended. For patients with metastatic or locally advanced cSCC who are not candidates for curative surgery or radiotherapy, anti-PD-1 agents are the first-line systemic treatment, with cemiplimab being the first approved systemic agent for advanced cSCC by the Food and Drugs Administration/European Medicines Agency. Second-line systemic treatments for advanced cSCC, include epidermal growth factor receptor inhibitors (cetuximab) combined with chemotherapy or radiotherapy. Multidisciplinary board decisions are mandatory for all patients with advanced cSCC, considering the risks of toxicity, the age and frailty of patients, and co-morbidities, including immunosuppression. Patients should be engaged in informed, shared decision-making on management and be provided with the best supportive care to improve symptom management and quality of life. The frequency of follow-up visits and investigations for subsequent new cSCC depends on underlying risk characteristics.
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inserm-04209605 , version 1 (18-09-2023)

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Alexander Stratigos, Claus Garbe, Clio Dessinioti, Celeste Lebbe, Alexander van Akkooi, et al.. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: Part 2. Treatment–Update 2023. European Journal of Cancer, 2023, 193, pp.113252. ⟨10.1016/j.ejca.2023.113252⟩. ⟨inserm-04209605⟩
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