In a patient with high-risk cutaneous squamous cell carcinoma of the face with extracapsular extension after ipsilateral neck dissection and rapid contralateral cervical nodal recurrence, what is the optimal management?

In various published series, around half of patients fail to achieve a complete response to cemiplimab. From the clinical details, the current active area of disease appears to be the contralateral neck with no distant disease. Curative treatment is preferred. C-POST trial established surgery + adju...

In our series of unresectable cutaneous cell carcinoma (about 125 cases), we have an almost 50% complete clinical remission with cemiplimab. This is now the treatment of choice for such patients. For those who do not respond and cannot be resected with salvage surgery, the best option is probably ip...

I would suggest going with cemiplimab right now. If there is a response after 4 cycles, then a surgery can be attempted (albeit at a lesser scale) to determine the pathologic response. If the patient has achieved pCR, then further cemiplimab can be withheld (as per the NRG protocol, which is still u...

It is quite interesting that each specialist advocates for their own specialty.

The case presented has a poor prognosis given the ENE. If this were simply the presentation, yes, radiotherapy followed by adjuvant cemiplimab is the correct answer (C-POST study).

However, this case presents as a rapid re...