Cutaneous squamous cell carcinoma (SCC) is an already common disorder with a rapidly increasing incidence. Treatment of early disease depends primarily on surgery or destructive techniques. In contrast to the frequency of early SCC, unresectable or metastatic SCC is relatively rare, but potentially life-threatening without clearly treatment with conventional chemotherapy, such as cisplatin, is often precluded by a patient's age or medical comorbidities.
Herein, we report 2 cases of elderly patients (79 and 86 years old) with extensive, in-transit recurrence of SCCS who have been treated with palliative erlotinib plus metronomic chemotherapy with Vinorelbine (erlotinib at a dose of 100 mg per day continuously plus Vinorelbine at a dose of 20 mg per.os weekly during 2 moth, cyclophosphamide 50 mg daily per.os, methotrexate 2.5 mg per.os twice daily on days 1 and 4).
The drugs were well tolerated, with the exception of rash requiring dose reduction in 1 patient. Both patients had excellent responses to erlotinib plus metronomic combination with Vinorelbine: the first patient had complete response by week 18 of treatment and the second a near-complete response by week 16. In both cases, initial response to erlotinib was evident by week 3 of therapy.
Erlotinib in combination with metronomic chemotherapy plus Vinorelbine is well tolerated and does show promise in treatment of patients with unresectable or metastatic SCCS. Most common side effect was skin rash. A larger trial with longer follow up is warranted to establish the role of Erlotinib and an optimal combination therapy in improving quality of life in this patient population.
Clinical trial identification
All authors have declared no conflicts of interest.