{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:39:47Z","timestamp":1787726387982,"version":"build-2784847793"},"reference-count":33,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Immune checkpoint inhibitors (ICI) have transformed the treatment landscape of advanced cutaneous squamous cell carcinoma (cSCC). The influence of comorbidities and concomitant medications on treatment efficacy remains incompletely defined.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To evaluate the impact of comorbid conditions and commonly prescribed medications on progression\u2010free survival (PFS) and overall survival (OS) in patients with advanced cSCC receiving ICI.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this multicentre cohort study, 273 patients with unresectable or metastatic cSCC treated with ICI were identified from the prospective ADOReg skin cancer registry. Data on comorbidities, such as haematologic malignancies, immunosuppressive conditions, cardiovascular disease and concomitant medications, such as immunosuppressive agents and anticoagulants, were analysed. Treatment outcomes were measured as PFS and OS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among first\u2010line patients (\n n<\/jats:italic>\n \u2009=\u2009253), immunosuppressive conditions were associated with shorter PFS (5.5 vs. 24.4\u2009months,\n p<\/jats:italic>\n \u2009=\u20090.012) and OS (16.6 vs. 34.1\u2009months,\n p<\/jats:italic>\n \u2009<\u20090.001). Haematologic malignancies were likewise linked to poorer PFS (18.6 vs. 27.0\u2009months,\n p<\/jats:italic>\n \u2009=\u20090.032) and OS (17.0 vs. 33.6\u2009months,\n p<\/jats:italic>\n \u2009=\u20090.0067). Concomitant anticoagulant therapy correlated with longer PFS (49.3 vs. 17.4\u2009months,\n p<\/jats:italic>\n \u2009=\u20090.032), but not OS (\n p<\/jats:italic>\n \u2009=\u20090.22). In multivariate analysis, immunosuppressive disease remained independently associated with shorter OS (HR\u2009=\u20099.88, 95% CI: 1.11\u201387.5,\n p<\/jats:italic>\n \u2009=\u20090.040) and anticoagulant use with longer PFS (HR\u2009=\u20090.34, 95% CI: 0.15\u20130.80,\n p<\/jats:italic>\n \u2009=\u20090.014). These associations were confirmed in Cox models weighted by inverse probability of treatment (IPTW), supporting robustness to confounding. No effect was attributable to any specific anticoagulant subclass.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our analyses suggest that immunosuppressive disease is an independent predictor of shortened OS, underscoring the critical role of host immune competence. We further report a novel, independently significant association between anticoagulant use and prolonged PFS. Other associations should be regarded as exploratory. These findings highlight host\u2010related factors as potential modulators of ICI efficacy and merit prospective validation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jdv.70307","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T07:25:49Z","timestamp":1769757949000},"page":"1525-1534","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Role of comorbidities and medication on immunotherapy efficacy in cSCC: A DeCOG multicentre analysis"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3999-5902","authenticated-orcid":false,"given":"Glenn","family":"Geidel","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"B\u00e4nsch","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Fekade","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"R\u00fcnger","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Zell","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Smit","sequence":"additional","affiliation":[{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Institute of Tumor Biology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2073-3909","authenticated-orcid":false,"given":"Julian","family":"K\u00f6tt","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Heidrich","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Fleur Hiege Center for Skin Cancer Research University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Institute of Tumor Biology University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Weichenthal","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Hospital of Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selma","family":"Ugurel","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical School and University Medical Center OWL, Klinikum Bielefeld Rosenh\u00f6he, Bielefeld University Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8019-1577","authenticated-orcid":false,"given":"Ulrike","family":"Leiter","sequence":"additional","affiliation":[{"name":"Division of Dermatooncology, Department of Dermatology University Medical Center Tuebingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Mohr","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venerology Elbe Klinikum Buxtehude Buxtehude Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0347-065X","authenticated-orcid":false,"given":"Alexandra","family":"Geusau","sequence":"additional","affiliation":[{"name":"Department of Dermatology Medical University of Vienna Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6863-8719","authenticated-orcid":false,"given":"Stephan","family":"Grabbe","sequence":"additional","affiliation":[{"name":"Department of Dermatology University Medical Center of the Johannes Gutenberg\u2010University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4603-1825","authenticated-orcid":false,"given":"Markus V.","family":"Heppt","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Uniklinikum Erlangen Friedrich\u2010Alexander\u2010University Erlangen\u2010N\u00fcrnberg Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Gutzmer","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology, Allergology and Phlebology, Johannes Wesling Klinikum, M\u00fchlenkreiskliniken A\u00f6R University Medical Center of the Ruhr University Bochum Minden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Utikal","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim Ruprecht\u2010Karl University of Heidelberg Mannheim Germany"},{"name":"Skin Cancer Unit German Cancer Research Center (DKFZ) Heidelberg Germany"},{"name":"DKFZ Hector Cancer Institute at the University Medical Center Mannheim Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010Christoph","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Dermatology Venereology and Allergology, University Medical Center Leipzig Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Haferkamp","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology University Medical Center Regensburg Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Susok","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Klinikum Dortmund gGmbH University Witten\/Herdecke Dortmund Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"Schilling","sequence":"additional","affiliation":[{"name":"Department of Dermatology Goethe University Frankfurt, University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Dippel","sequence":"additional","affiliation":[{"name":"Department of Dermatology Skin Tumor Center, Klinikum Ludwigshafen gGmbH Ludwigshafen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imke","family":"von Wasielewski","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venerology and Allergology, Skin Cancer Center Hannover University Hospital Hannover Medical School Hannover Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica C.","family":"Hassel","sequence":"additional","affiliation":[{"name":"Department of Dermatology and National Center for Tumor Diseases (NCT), NCT Heidelberg a Partnership between DKFZ and University Hospital Heidelberg Medical Faculty Heidelberg, Heidelberg University Heidelberg 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