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P75. The role of cemiplimab in treating locally advanced cutaneous SCC: a UK single centre experience and the implications for surgical management.

Thursday, March 5, 2026
4:16 PM - 4:23 PM MST
Location: 105A-C
Introduction: While over 95% of patients presenting with cutaneous squamous cell carcinoma (cSCC) are cured with surgery or radiotherapy, a subset develops locally advanced disease and undergo major resection.  In the head and neck region, such resections may include maxillectomy, partial craniectomy, rhinectomy or orbital exenteration, often necessitating free tissue transfer for reconstruction. These are high-risk procedures associated with prolonged recovery and uncertain oncological, functional, and aesthetic outcomes. Immune checkpoint inhibitors have shown promise in this setting.  We report a single-centre UK experience of cemiplimab for locally advanced cSCC and our surgical experience of operating on a cemiplimab patient cohort.


Methods: This retrospective chart review included all patients treated with cemiplimab for ≥3 months between November 2021 and May 2025. We report the overall response rate (ORR) and in patients who progressed on treatment, describe operative findings and surgical outcomes. We present our early experience and discuss patient selection.


Results:

Twenty-five consecutive patients were included, with a median follow up of 16 months. The median age was 79 years (range 48- 90), and 88% of locally advanced cSCCs were in the head and neck. 96% of patients had mild or moderately severe ACE-27 comorbidity decompensation score.  The ORR was 64%, comprising 11 complete and 5 partial responses.  The median time to clinical response was three weeks.  Among the 20 patients with operable disease, three (15%) underwent surgical resection for progressive disease with no surgical complications attributable to earlier cemiplimab exposure.  In total, 85% of patients avoided surgical intervention.  At the time of data-cut off, neither median progression free survival nor median overall survival had been reached. Immunotherapy-related toxicities of any grade occurred in 68% of patients, with grade 3 events observed in 14%, leading to one treatment discontinuation. 8 patients (32%) received oral corticosteroids during their treatment course for management of toxicity. 


Conclusions: Cemiplimab continues to demonstrate robust activity in patients with advanced cSCC in this real-world population, with durable responses in long-term survivors.  Salvage surgery appears feasible for patients with disease progression.

Learning Objectives:

  • To evaluate the role of cemiplimab in optimizing treatment outcomes for patients with locally advanced cutaneous squamous cell carcinoma.
  • To assess how cemiplimab influences surgical planning, timing, and operative decision-making in the management of advanced cutaneous SCC.