{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T16:47:09Z","timestamp":1775753229631,"version":"3.50.1"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Anti-PD1 antibodies have gained popularity in the treatment of skin cancers. These drugs have been FDA approved for treatment of cutaneous melanoma and unresectable\/metastatic squamous cell carcinoma of the skin. However, the use of anti-PD1 antibodies is not established for resectable cutaneous squamous cell carcinoma, as the mainstay treatment is surgical excision.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>A 49-year-old female with Xeroderma Pigmentosum presented with an ulcerating lateral nasal mass causing obstruction. Biopsy confirmed cutaneous squamous cell carcinoma and was staged as IVA (T2N2cM0) based on PET-CT findings, which showed a 2.7 \u00d7 2.3 cm left nasal mass and radiotracer-avid cervical lymph nodes. Despite surgical recommendations, the patient declined surgery due the expected morbidity and disfigurement. Instead, she received neoadjuvant Pembrolizumab (200 mg IV every 3 weeks). After two cycles, PET-CT and MRI showed significant reduction in the nasal mass and decreased cervical lymph node involvement. On physical exam, the nasal lesion had resolved. Multidisciplinary tumor board discussion recommended radiation therapy instead of neck dissection, considering the patient's clinical response and potential surgical morbidity. After a third Pembrolizumab cycle, she received 66 Gy in 33 fractions, followed by continued adjuvant immunotherapy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1488400","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T04:24:58Z","timestamp":1728620698000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Case report: Neoadjuvant-intent pembrolizumab resulted in complete response in a xeroderma pigmentosum patient with locally advanced resectable cutaneous squamous cell carcinoma of the nose"],"prefix":"10.3389","volume":"11","author":[{"given":"Nader G.","family":"Zalaquett","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Kreidieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bassem","family":"Youssef","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Mourad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firas","family":"Kreidieh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.hoc.2018.08.001","article-title":"Cutaneous squamous cell carcinoma","volume":"33","author":"Waldman","year":"2019","journal-title":"Hematol Oncol Clin."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1001\/jamadermatol.2015.1187","article-title":"Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population, 2012","volume":"151","author":"Rogers","year":"2015","journal-title":"JAMA Dermatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/j.jaad.2012.11.037","article-title":"Cutaneous squamous cell carcinoma: estimated incidence of disease, nodal metastasis, and deaths from disease in the United States, 2012","volume":"68","author":"Karia","year":"2013","journal-title":"J Am Acad Dermatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1001\/jamadermatol.2013.2139","article-title":"Factors predictive of recurrence and death from cutaneous squamous cell carcinoma: a 10-year, single-institution cohort study","volume":"149","author":"Schmults","year":"2013","journal-title":"JAMA Dermatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1016\/S1470-2045(08)70178-5","article-title":"Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: a prospective study","volume":"9","author":"Giese","year":"2008","journal-title":"Lancet Oncol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1016\/S0190-9622(08)81509-5","article-title":"Nonmelanoma skin cancer in the United States: incidence","volume":"30","author":"Miller","year":"1994","journal-title":"J Am Acad Dermatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1111\/bjd.15324","article-title":"Cutaneous squamous cell carcinoma: an epidemiological review","volume":"177","author":"Green","year":"2017","journal-title":"Br J Dermatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1093\/pubmed\/fdt032","article-title":"Measuring current and future cost of skin cancer in England","volume":"36","author":"Vallejo-Torres","year":"2014","journal-title":"J Public Health."},{"key":"B9","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1016\/j.jaad.2017.10.007","article-title":"Guidelines of care for the management of cutaneous squamous cell carcinoma","volume":"78","author":"Alam","year":"2018","journal-title":"J Am Acad Dermatol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"502723","DOI":"10.1155\/2011\/502723","article-title":"Cutaneous squamous cell carcinoma of the head and neck","volume":"2011","author":"Gurudutt","year":"2011","journal-title":"J Skin Cancer."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3892\/mco.2024.2739","article-title":"Metastatic patterns and treatment options for head and neck cutaneous squamous cell carcinoma","volume":"20","author":"Iancu","year":"2024","journal-title":"Molec Clin Oncol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"733917","DOI":"10.3389\/fonc.2021.733917","article-title":"Immunotherapy for the treatment of cutaneous squamous cell carcinoma","volume":"11","author":"Boutros","year":"2021","journal-title":"Front Oncol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e390614","DOI":"10.1200\/EDBK_390614","article-title":"Neoadjuvant immunotherapy in melanoma: the paradigm shift","volume":"43","author":"Hieken","year":"2023","journal-title":"Am Soc Clin Oncol Educ Book."},{"key":"B14","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1056\/NEJMoa2211437","article-title":"Neoadjuvant\u2013adjuvant or adjuvant-only pembrolizumab in advanced melanoma","volume":"388","author":"Patel","year":"2023","journal-title":"New England J Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"727027","DOI":"10.3389\/fonc.2021.727027","article-title":"Immunotherapy for cutaneous squamous cell carcinoma: results and perspectives","volume":"11","author":"Alberti","year":"2022","journal-title":"Front Oncol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/S1470-2045(19)30728-4","article-title":"Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial","volume":"21","author":"Migden","year":"2020","journal-title":"Lancet Oncol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e9526","DOI":"10.1200\/JCO.2019.37.15_suppl.9526","article-title":"Phase 2 study of cemiplimab, a human monoclonal anti-PD-1, in patients (pts) with metastatic cutaneous squamous cell carcinoma (mCSCC; Group 1): 12-month follow-up","volume":"37","author":"Guminski","year":"2019","journal-title":"Am Soc Clin Oncol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1007\/s40265-020-01302-2","article-title":"Cemiplimab: a review in advanced cutaneous squamous cell carcinoma","volume":"80","author":"Lee","year":"2020","journal-title":"Drugs."},{"key":"B19","doi-asserted-by":"publisher","first-page":"79","DOI":"10.25251\/skin.2.supp.79","article-title":"Primary analysis of phase 2 results of cemiplimab, a human monoclonal Anti\u2013PD-1, in patients with locally advanced cutaneous squamous cell carcinoma","volume":"62","author":"Migden","year":"2019","journal-title":"Head Neck."},{"key":"B20","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1056\/NEJMoa1805131","article-title":"PD-1 blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma","volume":"379","author":"Migden","year":"2018","journal-title":"New Engl J Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"S78","DOI":"10.25251\/skin.2.supp.78","article-title":"Phase 1 study of cemiplimab, a human monoclonal anti-PD-1, in patients with unresectable locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC): final efficacy and safety data","volume":"2","author":"Owonikoko","year":"2018","journal-title":"SKIN J Cutaneous Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e000775","DOI":"10.1136\/jitc-2020-000775","article-title":"Phase 2 study of cemiplimab in patients with metastatic cutaneous squamous cell carcinoma: primary analysis of fixed-dosing, long-term outcome of weight-based dosing","volume":"8","author":"Rischin","year":"2020","journal-title":"J Immunother Cancer."},{"key":"B23","doi-asserted-by":"publisher","first-page":"v533","DOI":"10.1093\/annonc\/mdz255","article-title":"Adjuvant nivolumab (NIVO) versus ipilimumab (IPI) in resected stage III\/IV melanoma: 3-year efficacy and biomarker results from the phase III CheckMate 238 trial","volume":"30","author":"Larkin","year":"2019","journal-title":"Ann Oncol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"2916","DOI":"10.1200\/JCO.19.03054","article-title":"Pembrolizumab monotherapy for recurrent or metastatic cutaneous squamous cell carcinoma: a single-arm phase II trial (KEYNOTE-629)","volume":"38","author":"Grob","year":"2020","journal-title":"J Clin Oncol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.1200\/JCO.19.03357","article-title":"Phase II study of pembrolizumab as first-line, single-drug therapy for patients with unresectable cutaneous squamous cell carcinomas","volume":"38","author":"Maubec","year":"2020","journal-title":"J Clin Oncol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e9519","DOI":"10.1200\/JCO.2022.40.16_suppl.9519","article-title":"Long-term outcomes of a phase II trial of neoadjuvant immunotherapy for advanced, resectable cutaneous squamous cell carcinoma of the head and neck (CSCC-HN)","volume":"40","author":"Gross","year":"2022","journal-title":"Am Soc Clin Oncol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"4557","DOI":"10.1158\/1078-0432.CCR-21-0585","article-title":"Pilot phase II trial of neoadjuvant immunotherapy in locoregionally advanced, resectable cutaneous squamous cell carcinoma of the head and neck","volume":"27","author":"Ferrarotto","year":"2021","journal-title":"Clin Cancer Res."},{"key":"B28","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1001\/jamaoto.2024.0259","article-title":"Neoadjuvant-intent immunotherapy in advanced, resectable cutaneous squamous cell carcinoma","volume":"150","author":"Kim","year":"2024","journal-title":"JAMA Otolaryngol\u2013Head Neck Surg."},{"key":"B29","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1159\/000324509","article-title":"Radiation therapy for high-risk squamous cell carcinomas in patients with xeroderma pigmentosum: report of two cases and review of the literature","volume":"223","author":"Schaffer","year":"2011","journal-title":"Dermatology."},{"key":"B30","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.ejca.2017.06.022","article-title":"Rapid response of metastatic cutaneous squamous cell carcinoma to pembrolizumab in a patient with xeroderma pigmentosum: case report and review of the literature","volume":"83","author":"Deinlein","year":"2017","journal-title":"Eur J Cancer."},{"key":"B31","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1200\/PO.19.00028","article-title":"Response to pembrolizumab in a patient with xeroderma pigmentosum and advanced squamous cell carcinoma","volume":"3","author":"Steineck","year":"2019","journal-title":"JCO Precis Oncol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1111\/bjd.16270","article-title":"Efficacy of anti-programmed cell death-1 immunotherapy for skin carcinomas and melanoma metastases in a patient with xeroderma pigmentosum","volume":"178","author":"Salomon","year":"2018","journal-title":"Br J Dermatol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1488400\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T04:24:59Z","timestamp":1728620699000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1488400\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,11]]},"references-count":32,"alternative-id":["10.3389\/fmed.2024.1488400"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1488400","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,11]]},"article-number":"1488400"}}