1303 The Role of Cemiplimab in the Management of Locally Advanced and Metastatic Squamous Cell Skin Cancers: A Case Report

Abstract This case report discusses the use of cemiplimab, an immune checkpoint inhibitor, as a single agent for management of locally advanced basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) in a 79-year-old male patient. The patient was initially referred to plastic surgery for facial lacerations closure after a fall and was incidentally found to have suspicious lesions on his central forehead, right lateral canthus, mid-face, & anterior shoulder. He had history of skin lesions treated with photodynamic therapy, and recent palliative radiotherapy and fixation of a right humerus pathological fracture. Biopsy of the lesions confirmed locally advanced BCC and SCC malignancies, and underwent staging imaging, which showed evidence of osseous metastasis and lymphadenopathy. The patient was offered operative treatment with hemi-maxillectomy, orbital exenteration, and neck and axillary dissection but opted for immunotherapy drug with cemiplimab in accordance with National Institute for Health and Care Excellence (NICE) guidelines for treatment. The patient's skin lesions improved significantly after 3 rounds of treatment with shrinkage of the right lateral canthus and right midface lesions, apparent resolution of the forehead lesion, and improvement in the chronic shoulder wound, and no palpable regional lymphadenopathy. This case report adds to the growing body of evidence supporting the use of checkpoint inhibitors for SCCs and BCCs, particularly in cases where surgery and radiotherapy are not suitable. It also discusses current guidelines and socio-economic implications of this treatment. Overall, further research/trials are needed to determine optimal management strategies and improve outcomes for patients with SCC and BCC.