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ESMO E-Learning: Cutaneous Squamous Cell Carcinomas (CSCC)

New E-Learning module by Prof Hauschild is now available. Watch the presentation and take the CME test today!

E-learning video block

This content is for ESMO members only.



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Learning objectives

  1. Describe epidemiology data related to cutaneous squamous cell carcinomas 
  2. Understand the role of surgery, radiotherapy and systemic treatment in the management of patients with cutaneous squamous cell carcinomas
  3. Learn about novelties on use of immune checkpoint inhibitors in the management of patients with advanced cutaneous squamous cell carcinomas


This E-Learning module provides in depth information about the epidemiology of cutaneous squamous cell carcinomas (CSCC), the role of different treatment modalities (surgery, radiotherapy, systemic treatment) in the management of these patients and elaborate a future outlook in terms of research of such a small patient population, but with great medical needs.

The author states that surgery is generally curative for patients with high-stage CSCC, including those with early nodal disease, but it is not an option for a small subset of patients.

Previously, these patients were treated with chemotherapy and off-label EGFR inhibitors. Response rates averaged 20% between agents, with low durability and high recurrence risk.

PD-1 inhibitors have shown efficacy in patients with CSCC ineligible for surgery, mainly due to the high tumour mutational burden associated with CSCC. Currently, cemiplimab is the only approved agent for unresectable CSCC in Europe. Response rates are around 40% to 50%, with high durability and lasting control. Both cemiplimab and pembrolizumab are approved in the US.

Checkpoint inhibitors stimulate the immune system, which can be a problem for some patients, such as immunosuppressed patients. The author advises that eligibility for immunotherapy should be evaluated on a case-by-case basis with a need for multicentre studies in immunocompromised patients.

Immune-related adverse events (irAEs) can happen at any time and can affect any organ system. Corticosteroids are the cornerstone of management, along with treatment holidays and drug discontinuation in more severe cases. Non-thyroid endocrine irAEs are usually permanent and affect about 1% of patients.

Future research agenda in CSCC encompasses strategies with combination of PD1 inhibitors with irradiation, targeted agents, such as cetuximab, lenvatinib, intralesional agents like oncolytic viruses, with CTLA-4 antibodies, etc. The author also emphasizes about high medical need particularly for patients with PD1-refractory CSCC.

Declaration of interest

Axel Hauschild has reported:
Financial Interests:
BMS, MSD, Philogen, PierreFabre, Regereron, Sanofi, Novartis, Roche, Eisai, Immunocore, Replimune, Seagen: Advisory Board, Personal.
MerckPfizer, Invited Speaker, Personal.
BMS, MSD, PierreFabre, Amgen, Roche: Local PI, Institutional.
Regeneron, Novartis: Coordinating PI, Institutional.

Last update: 15 Feb 2022

This E-learning module was published in 2022. The CME test expired in 2024.

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