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ORR was assessed using logistic regression; PFS and OS were evaluated using Cox models, and DSS using cause-specific hazards. ROC analyses assessed biomarker discrimination. Baseline SIIBs (LMR, NLR, SIRI) were compared between early-stage (AJCC I\/II, non-ICI cohort,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959) and advanced-stage disease. Tumor characteristics, body mass index (BMI), and Charlson comorbidity index were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 110 patients, 79 (71.8%) achieved an objective response. Baseline LMR showed modest discrimination for ORR (AUC 0.64, 95% CI 0.53\u20130.75;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015) but did not retain statistical significance after adjustment for baseline clinical covariates (OR 1.35, 95% CI 0.95\u20131.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.096). Higher BMI was associated with improved PFS (HR 0.94 per kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 95% CI 0.89\u20131.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035) and showed a borderline association with OS (HR 0.92 per kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 95% CI 0.85\u20131.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.051). AJCC stage IV strongly predicted DSS (HR 14.03, 95% CI 1.80\u2013109.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.012). Baseline LMR was higher in early-stage than in advanced-stage disease (Hodges-Lehmann difference 0.43;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), whereas NLR did not differ significantly between stage groups; SIRI was modestly higher in advanced-stage disease (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In immunocompetent patients with advanced cSCC receiving PD-1 inhibition, BMI was prognostic for survival and AJCC stage remained the key driver of cSCC-specific mortality. Baseline LMR showed a modest association with response and differed between early- and advanced-stage disease, whereas other SIIBs were not consistently linked to tumor progression. Prospective validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00432-026-06423-x","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T11:17:48Z","timestamp":1772018268000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictors of response and survival in cemiplimab\u2013treated cutaneous squamous cell carcinoma: multicenter real-world evidence from Germany"],"prefix":"10.1007","volume":"152","author":[{"given":"Thilo","family":"Gambichler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefine","family":"Brune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"R\u00fcth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nessr","family":"Abu Rached","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Boms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sera S.","family":"Weyer-Fahlbusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kreuter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Hyun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen C.","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Susok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"issue":"12","key":"6423_CR11","first-page":"e70407","volume":"8","author":"F Arianmanesh","year":"2025","unstructured":"Arianmanesh F, Bagheri S, Karimi MA, Izadi S, Ahmadi MH (2025) The evaluation of Diagnostic, Prognostic, and predictive role of hematologic inflammatory indices NLR, PLR, and LMR in common solid tumors. 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N.A. received funding, travel support and\/or personal honoraria for lectures from Novartis Pharma, JanssenCilag GmbH, Recordati Rare Diseases Germany GmbH, UCB Pharma, Almirall Hermal GmbH, Bristol-Myers Squibb (BMS) and Johnson & Johnson that were independent of the work submitted. J.C.B is receiving speaker\u2019s bureau honoraria from Amgen, Incyte Merck-Serono and Regeneron is a paid consultant\/advisory board member for Merck-Serono, Incyte, 4SC and Regeneron. His group receives research grants from Regeneron, Merck Serono, and Alcedis. L.S. has received speakers and\/or advisory board honoraria from UCB, BMS, Sun-Pharma, MSD, and Novartis. The other authors report no conflicts or competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"This study was conducted according to the declaration of Helsinki and followed a protocol approved by our institutional ethics review board (#16-5985).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"50"}}