Initial systemic therapy in advanced cutaneous squamous cell carcinoma not amenable to locoregional therapy

The decision to start systemic therapy and the selection of agent(s) depend on availability and access to treatment, disease-related symptoms, and patient performance status and comorbidities. Given the rarity of this disease, clinical trials are encouraged at any time during treatment, where available. Refer to UpToDate content on systemic treatment of advanced cutaneous SCC.

SCC: squamous cell carcinoma.

* We do not offer immunotherapy agents to patients with SCC secondary to immunosuppression related to allogeneic organ transplantation. For other patients, multiple clinical factors influence eligibility for immunotherapy including patient performance status, medical comorbidities, history of autoimmune disease, and use of immunosuppressive therapy or glucocorticoids. Refer to UpToDate content on systemic treatment of metastatic melanoma with molecular alterations.

¶ Any of these agents are reasonable, as they have not been directly compared in clinical trials, and all are effective and less toxic than other available systemic agents.

Δ Response rates are limited for systemic chemotherapy. Alternative options include cisplatin either as monotherapy or in combination with other agents (eg, fluorouracil with or without bleomycin; anthracyclines); single-agent carboplatin; topical fluorouracil, capecitabine, and methotrexate.

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Initial systemic therapy in advanced cutaneous squamous cell carcinoma not amenable to locoregional therapy