Introduction:

Non-melanoma skin cancer is the most common cancer amongst caucasians. Most of these tumors are curable by surgical resection, whereas radiotherapy (RT) and chemotherapy (CT) represent alternative treatments. However, 20% of these tumors are cutaneous squamous cell carcinomas (CSCC), 5% of which appear as locally advanced or metastatic. A locally advanced CSCC involving the ear, the eye or the nose is often non-resectable.

Cemiplimab is a human monoclonal antibody that binds to Programmed cell Death-1 (PD-1) receptors, blocking their interaction with PD-Ligand 1 and 2 (PD-L1, PD-L2), already officially approved for such cases.

Objective:

We aim at presenting the treatment of a recurrent locally advanced CSCC of the face involving the ear, the parotid and the carotid with cemiplimab.

Case report:

We present an 87years-old male patient suffering from a recurrent locally advanced CSCC of the face involving the ear, the parotid and the carotid. He had already been treated by RT, but relapsed and proved life-threatening due to hemorrhage. No distal metastases have been observed.

We decided to start cemiplimab after a thorough discussion with the patient and his family. After the third administration of cemiplimab, the improvement is more than obvious. The previously ulcerated tumor of the cheek with a diameter of around 7cm involving the external auditory meatus disappeared. Both the skin of the cheek and the external auditory meatus have healed, though already irradiated. After the fourth administration of cemiplimab we performed a CT scan, which showed no infiltration of neither the parotid gland nor the carotid.

We keep on with cemiplimab with no side-effects up to now.

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