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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Complete response of a large basosquamous carcinoma following treatment with cemiplimab and vismodegib
  1. Jonathan Pirruccello1,
  2. Muhammad Zubair Afzal1,
  3. Mariana Voudouri2 and
  4. Keisuke Shirai1
  1. 1Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
  2. 2Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03750
  1. Correspondence to Jonathan Pirruccello; jonathan.pirruccello{at}hitchcock.org

Abstract

The anti-PD-1 antibody cemiplimab has demonstrated effectiveness in the setting of locally advanced basal cell carcinoma (BCC) and squamous cell carcinoma. We describe a case of a large, locally invasive basosquamous carcinoma, an aggressive type of BCC, invading the left sternocleidomastoid muscle with near compression of the left internal jugular vein producing a severe anaemia secondary to ulceration and chronic blood loss. The patient was initially started on vismodegib monotherapy but failed to respond. He was then started on cemiplimab in addition to vismodegib. Improvement was noted after one cycle. After 21 cycles of cemiplimab, the left shoulder ulcerated lesion was completely re-epithelialised. He remains in complete remission after 31 cycles of cemiplimab in addition to vismodegib.

  • Cancer intervention
  • Malignant disease and immunosuppression

https://doi.org/10.1136/bcr-2022-251273

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    Footnotes

    • Contributors The following authors were not directly involved in the patient’s care, they contributed to the manuscript: JP—discussed case directly with the patient including hardship/effect on life (see patient perspective). Drafted the manuscript, MZA: edits. MV: histology slides and pathology input. The following author is the clinician in charge of the clinical care of the patient, who supervised the preparation of the manuscript, was responsible for obtaining informed consent from the patient/guardian/family members and is responsible for the overall integrity of the content of the manuscript: KS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.