Approximately 3–5% of patients with cutaneous squamous cell carcinoma (CSCC) develop advanced disease, accounting for roughly 1% of all cancer deaths in Australia. Immunotherapy has demonstrated significant clinical benefit in advanced CSCC in several key phase II studies; however, there are limited data for patients treated outside of clinical trials. This is particularly relevant in advanced CSCC, which is most often seen in elderly patients with significant comorbidities. Thus, we aim to describe our experience with immunotherapy in a cohort of patients with advanced CSCC in Australia. We retrospectively reviewed all advanced CSCC patients treated with immunotherapy within the Illawarra and Shoalhaven Local Health District. Among the 51 patients treated with immunotherapy, there was an objective response rate (ORR) of 53% and disease control rate (DCR) of 67%. Our most significant predictor of response was sex, with male patients more likely to have better responses compared to female patients (DCR 85% vs. 41%,p< 0.0001), as well as improved progression-free survival (HR 4.6, 95%CI 1.9–10.8,p= 0.0007) and overall survival (HR 3.0, 95%CI 1.3–7.1,p= 0.006). Differential expression analysis of 770 immune-related genes demonstrated an impaired CD8 T-cell response in female patients. Our observed ORR of 53% is similar to that described in current literature with durable responses seen in the majority of patients.
约3-5%的皮肤鳞状细胞癌（CSCC）患者会发展为晚期疾病，约占澳大利亚所有癌症死亡病例的1%。多项关键II期研究表明，免疫疗法在晚期CSCC治疗中展现出显著的临床获益；然而，临床试验之外接受治疗的患者数据仍较为有限。这在晚期CSCC中尤为重要，因为此类患者多为伴有显著合并症的老年人群。因此，本研究旨在描述澳大利亚晚期CSCC患者队列接受免疫治疗的临床经验。我们回顾性分析了伊拉瓦拉-肖尔黑文地方卫生区内所有接受免疫治疗的晚期CSCC患者。在51例接受免疫治疗的患者中，客观缓解率（ORR）为53%，疾病控制率（DCR）达67%。最重要的疗效预测因素是性别，男性患者较女性患者具有更好的治疗反应（DCR 85% vs. 41%，p<0.0001），无进展生存期（HR 4.6，95%CI 1.9-10.8，p=0.0007）和总生存期（HR 3.0，95%CI 1.3-7.1，p=0.006）也显著改善。对770个免疫相关基因的差异表达分析显示，女性患者的CD8 T细胞应答功能受损。本研究观察到的53% ORR与现有文献报道相符，且多数患者呈现持续缓解。
Sex as a Predictor of Response to Immunotherapy in Advanced Cutaneous Squamous Cell Carcinoma
肿瘤(癌症)患者之家