Immune checkpoint inhibitors for advanced or metastatic basal cell carcinoma: how much evidence do we need?

Immunotherapy ◽  
2021 ◽  
Author(s):  
Elissar Moujaess ◽  
Reine Merhy ◽  
Joseph Kattan ◽  
Anne-Sophie Sarkis ◽  
Roland Tomb
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Unmet Need ◽  
Case Series ◽  
Metastatic Basal Cell Carcinoma

Basal cell carcinoma (BCC) is one of the most frequent and most curable tumors at its early stages. BCC rarely metastasizes and its treatment in this setting is still challenging. Hedgehog inhibitors showed an activity in advanced or metastatic disease. However, there is an unmet need for new agents. Immune checkpoint inhibitors have been assessed in melanoma and other cutaneous tumors, and very recently an anti-PD1 was approved for advanced BCC. In this paper, available data are reviewed on experimental and preclinical studies evaluating immunotherapy in BCC, as well as on the clinical evidence supporting the efficacy and safety of immune checkpoint inhibitors for advanced or metastatic BCC based on case reports, case series and clinical trials.

Metastatic Basal Cell Carcinoma: Four Case Reports, Review of Literature, and Immunohistochemical Evaluation

2006 ◽  
Vol 130 (1) ◽  
pp. 45-51
Author(s):  
Diana N. Ionescu ◽  
Muammar Arida ◽  
Drazen M. Jukic
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Case Reports ◽  
Small Sample ◽  
Ki 67 ◽  
Immunohistochemical Markers ◽  
Metastatic Basal Cell Carcinoma ◽  
Metastatic Sites

Abstract Context.—Metastatic basal cell carcinoma (BCC) is relatively rare and is seldom considered a complication in the routine treatment and follow-up of patients with BCC. Although multiple studies have tried to distinguish aggressive from nonaggressive BCCs, to our knowledge, no consistent clinical, histopathologic, or immunohistochemical features have yet been reported. Objective.—To report 4 cases of metastatic BCCs and to evaluate these in addition to known nonmetastatic BCCs with specific immunostains in an attempt to find distinct morphologic or immunohistochemical patterns that could be helpful in identifying aggressive BCCs. Design.—We reviewed 4 cases of metastatic BCCs and recorded the clinical and morphologic findings. We then searched our archives for 14 cases of BCC that followed the usual nonaggressive course. We evaluated these 18 cases with immunohistochemical stains for Ki-67, p53, and bcl-2. Results.—In metastasizing BCC, Ki-67 staining was slightly higher in metastatic sites than in primary sites (average 63% and 51%, respectively). p53 was expressed in 3 of 4 primary sites and 2 of 4 metastatic sites. Bcl-2 was positive in both primary and metastatic sites in 3 of 4 cases. In the 14 cases of nonaggressive BCC, staining for Ki-67 averaged 38%, p53 was positive in 11 cases, and Bcl-2 staining was noted in 13 cases. Conclusions.—Overall, in the small sample that we evaluated, the immunohistochemical markers for Ki-67, p53, and Bcl-2 did not distinguish between metastatic and nonaggressive BCCs.

Metastatic Basal Cell Carcinoma: Report of Two Cases and Literature Review

2005 ◽  
Vol 9 (1) ◽  
pp. 10-15 ◽  
Author(s):  
Patricia T. Ting ◽  
Richard Kasper ◽  
John P. Arlette
Keyword(s):  
Basal Cell Carcinoma ◽  
Literature Review ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Case Reports ◽  
Rare Complication ◽  
High Morbidity ◽  
Regional Lymph Nodes ◽  
Treatment Measures ◽  
Metastatic Basal Cell Carcinoma

Background: Metastatic basal cell carcinoma (MBCC) is defined as primary cutaneous basal cell carcinoma (BCC) that spreads to distant sites as histologically similar metastatic deposits of BCC. There are less than 300 reported cases of MBCC in the literature. Methods: This article examines two cases of MBCC and provides a literature review of risk factors inherent in epidemiology, patient demographics, and the clinicohistopathological characteristics of primary and metastatic BCC lesions. Results: MBCC is a rare complication of BCC with high morbidity and mortality rates. Patients with MBCC often begin with long-standing primary BCC lesions that are either large or recurrent after treatment. Cases of MBCC have a higher incidence of the more aggressive histologic patterns (morpheic, infiltrating, metatypical, and basosquamous). Perineural space invasion may be an indicator of aggressive disease. Metastases often involve regional lymph nodes, lungs, bone, and skin. Conclusion: These case reports and review provide important diagnostic and management considerations for primary BCC and MBCC. Early intervention with aggressive treatment measures may improve the prognosis and survival of MBCC patients.

scholarly journals Cardiac Toxicity Associated with Immune Checkpoint Inhibitors: Case Series and Review of the Literature

2019 ◽  
Vol 12 (1) ◽  
pp. 260-276 ◽  
Author(s):  
Nikhil Agrawal ◽  
Arjun Khunger ◽  
Pankit Vachhani ◽  
Teresa A. Colvin ◽  
Alexander Hattoum ◽  
...  
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Troponin I ◽  
Cardiac Toxicity ◽  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Case Series ◽  
Fulminant Myocarditis ◽  
Comprehensive Cancer Center ◽  
Cancer Center

The development of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of patients with advanced stage cancers. However, immune-related adverse events are frequently observed. Cardiac toxicity from ICI therapy can range from asymptomatic troponin-I elevations to conduction abnormalities of the heart and even fulminant myocarditis. Although rare, myocarditis is a potentially fatal adverse effect of ICI therapy. We present a series of five cases of ICI-related cardio-toxicity diagnosed and managed at Roswell Park Comprehensive Cancer Center along with a review of published case reports in the literature. Our series highlights the importance of high clinical suspicion, early diagnosis of myocarditis, and prompt initiation of immunosuppressive therapy.

Safety and Efficacy of Immune Checkpoint Inhibitors in Children and Young Adults with Haematological Malignancies: Review and Future Perspectives

2021 ◽  
Vol 19 ◽  
Author(s):  
Eleni Tsotridou ◽  
Eleni Vasileiou ◽  
Elpis Mantadakis ◽  
Athanasios Tragiannidis
Keyword(s):  
Clinical Trials ◽  
Young Adults ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Safety Data ◽  
Case Series ◽  
Great Promise ◽  
Haematological Malignancies

Despite the marked improvement in overall survival rates of paediatric patients with haematological malignancies that has been achieved during the last decades, there is still a pressing need for novel therapeutic approaches for the subset of patients with relapsed or refractory disease. Immune checkpoint inhibitors aim to induce potent anti-tumour immune responses by targeted blockade of inhibitory receptors and have shown great promise in preclinical models and studies in the adult population. However, paediatric malignancies present unique features and so far, experience with these agents remains limited. In the current review we present an overview of efficacy and safety data from case reports, case series and clinical trials employing the use of immune checkpoint inhibitors in children, adolescents and young adults with haematological malignancies. We also discuss new possibilities involving novel targets and combination treatments and provide a summary of the currently registered clinical trials.

Metastatic basal cell carcinoma: Differences in survival by site of spread.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8585-8585 ◽  
Author(s):  
Margaret Elizabeth McCusker ◽  
Jeannie Hou ◽  
Lisa Wang ◽  
Huibin Yue ◽  
Axel Hauschild
Keyword(s):  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Basal Cell ◽  
Survival Data ◽  
Case Reports ◽  
Historical Context ◽  
Case Series ◽  
Distant Metastases ◽  
Survival Duration ◽  
Tumor Spread

8585 Background: Basal cell carcinoma (BCC), the most common skin cancer, rarely metastasizes. Consequently, the epidemiology of metastatic BCC (mBCC) is poorly characterized. The largest published mBCC review includes 170 cases reported from 1894–1980 (von Domarus H, Stevens P. J Am Acad Dermatol 1984;10:1043-60). Targeted therapies with hedgehog signaling pathway inhibitors, such as vismodegib, are currently being developed to treat this rare disease. The objective of the current analysis was to provide an updated description of the epidemiology and survival outcomes for mBCC. Methods: A PubMed literature search was conducted for mBCC case reports published in English during 1981–2011. mBCC cases that met the following criteria were evaluated: primary BCC located on skin; primary tumor and metastasis confirmed by pathology, and metastasis was not the result of direct tumor spread. Only cases with survival data giving dates (month and year) or durations were included in the analysis. Differences between groups were assessed with t tests and χ2 tests as appropriate. Survival was assessed with Kaplan–Meier (K-M) methods. Results: We identified 101 mBCC cases that met the selection criteria; 38 patients (38%) had lymph node-only disease (LD) and 63 (62%) had distant metastases (DM). In both groups, males predominated. DM patients were younger at mBCC diagnosis (mean 59 vs 66 y for LD). Among 96 cases with treatment data for metastatic disease, more DM patients received chemotherapy (25% vs 9% for LD), but more LD patients underwent surgery (85% vs 52% for DM). Survival duration ranged from 0 to 120+ months in all patients. The overall 1-y probability of survival after mBCC diagnosis was 75.7% (95% CI 67.2–84.2%), with lower survival in DM patients (69.1%; 95% CI 57.5–80.7%) vs LD patients (86.5%; 95% CI 75.5–97.5%). Conclusions: Patients with LD and DM mBCC may have different clinical courses and outcomes. Based on published case reports, DM patients were younger at mBCC diagnosis and had a lower 1-y survival probability vs LD patients. To our knowledge, these are the first K-M survival estimates reported for an mBCC case series of this size. These data help to provide a historical context for novel mBCC therapies under development, such as vismodegib.

scholarly journals Perspective of Immune Checkpoint Inhibitors in Thymic Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1065
Author(s):  
Kyoichi Kaira ◽  
Hisao Imai ◽  
Hiroshi Kagamu
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Thymic Carcinoma ◽  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Objective Response ◽  
Experimental Studies ◽  
Case Series ◽  
Phase Ii Studies ◽  
Dismal Prognosis

Thymic carcinoma is a rare neoplasm with a dismal prognosis, and there are no established therapeutic regimens for metastatic or recurrent disease. Immune checkpoint inhibitors (ICIs), such as PD-1/PD-L1 antibodies, are widely approved in several human cancers, contributing to prolonging survival in thoracic tumors. Thymic carcinoma exhibits histologic properties of squamous cell carcinoma (SQC), and resembles the SQC of the lung. ICIs are not approved in thymic carcinoma. Thus, several clinical trials have been undertaken to demonstrate if they are therapeutically effective for patients with thymic carcinoma. In our review, three prospective phase II studies and several case series were discussed in thymic carcinoma. We found that the objective response rate, disease control rate, and progression-free survival in PD-1 blockade monotherapy were approximately 20%, 73%, and four months, respectively. Two exploratory investigations indicated that PD-L1 within tumor cells exhibits a possibility of the therapeutic prediction of PD-1 blockade in thymic carcinoma. Several case reports, alongside their treatment content, have also been reviewed. The therapeutic efficacy of PD-1 blockade monotherapy is still limited in patients with thymic carcinoma. Future perspectives focus on the therapeutic implication of tyrokinase inhibitors plus ICIs or new experimental agents plus ICIs alongside several ongoing experimental studies.

scholarly journals Current Status and Prospects of Immunotherapy for Gynecologic Melanoma

2021 ◽  
Vol 11 (5) ◽  
pp. 403
Author(s):  
Mayuka Anko ◽  
Yusuke Kobayashi ◽  
Kouji Banno ◽  
Daisuke Aoki
Keyword(s):  
Targeted Therapy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Kinase Inhibitors ◽  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Treatment Options ◽  
Case Series ◽  
Current Status ◽  
Kit Mutation

Gynecologic melanomas are rare and have a poor prognosis. Although immunotherapy (immune checkpoint inhibitors) and targeted therapy has greatly improved the systemic treatment of cutaneous melanoma (CM) in recent years, its efficacy in gynecologic melanomas remains uncertain because of the rarity of this malignancy and its scarce literature. This review aimed to evaluate the literature of gynecologic melanomas treated with immunotherapy and targeted therapy through a PubMed search. We identified one study focusing on the overall survival of gynecologic melanomas separately and five case series and nine case reports concentrating on gynecologic melanomas treated with an immune checkpoint inhibitor and/or targeted therapy. Furthermore, the KIT mutation has the highest rate among all mutations in mucosal melanoma types. The KIT inhibitors (Tyrosine kinase inhibitors: TKIs) imatinib and nilotinib could be the treatment options. Moreover, immune checkpoint inhibitors combined with KIT inhibitors may potentially treat cases of resistance to immune checkpoint inhibitors. However, because of the different conditions and a small number of cases, it is difficult to evaluate the efficacy of immunotherapy and targeted therapy for gynecologic melanoma rigorously at this time. Further prospective cohort or randomized trials of gynecologic melanoma alone are needed to assess the treatment with solid evidence.

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