Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Oct 26;11(11):2903.
doi: 10.3390/biomedicines11112903.

Supraorbital Basosquamous Carcinoma Treated with Cemiplimab Followed by Sonidegib: A Case Report and Review of the Literature

Ilaria Proietti  1 , Luca Filippi  2 , Ersilia Tolino  1 , Nicoletta Bernardini  1 , Francesca Svara  1 , Federica Trovato  1 , Claudio Di Cristofano  3 , Vincenzo Petrozza  3 , Oreste Bagni  4 , Andrea Vizzaccaro  1 , Nevena Skroza  1 , Concetta Potenza  1
Affiliations
Case Reports

Supraorbital Basosquamous Carcinoma Treated with Cemiplimab Followed by Sonidegib: A Case Report and Review of the Literature

Ilaria Proietti et al. Biomedicines. .

Abstract

Basal cell carcinoma (BCC) is a skin cancer with low local aggressiveness and a low tendency to metastasize. Basosquamous Carcinoma (BSC) represents an aggressive histological subtype of BCC with intermediate features between Squamous Cell Carcinoma (SCC) and BCC. Cemiplimab is currently approved as first-line therapy in SCC and second-line therapy in BCC patients who have progressed on or are intolerant of a Hedgehog pathway Inhibitor (HHI). Our study describes the case of a 59-year-old man with BSC who was successfully treated with 5 cycles of Cemiplimab as first-line therapy and Sonidegib as second-line therapy. Currently, the efficacy of Cemiplimab against BSC and other histopathological subtypes of BCC has not been fully elucidated, as has the role of sequential or combination therapy with Cemiplimab and HHI in the management of BSC. The aim of this case report is to highlight the need to outline the use of checkpoint inhibitors in BCCs and focus attention on the synergistic role of Cemiplimab and HHIs in such a controversial entity as BSC.

Keywords: Basal cell carcinoma; Cemiplimab; Sonidegib; Squamous Cell Carcinoma; basosquamous carcinoma; hedgehog inhibitors; immunotherapy.

PubMed Disclaimer

Conflict of interest statement

Unrestricted grant from Sun pharma for this case report publication.

Figures

Figure 1
Figure 1
At the right fronto-orbital level, we observe an irregularly shaped, broad plaque with several shallow crusts (A). As indicated by arrows, PET/CT with 18F-FDG shows focal increased tracer uptake corresponding to the supraorbital lesion at presentation (B,C). After five therapeutic cycles, the patient exhibits significant clinical improvement (D). Also, PET/CT demonstrates a significant reduction in tracer incorporation (E,F). Section of an incisional biopsy from a large skin lesion showing an invasive cSCC before adjuvant treatment with Cemiplimab (G). A section of skin from the same area after medical treatment was negative for residual SCC and diffuse dermal inflammatory infiltrate (H). Residual BCC (I).
Figure 2
Figure 2
After 5 cycles of Cemiplimab, some papular lesions with dermoscopic features of BCC are clinically evident (please refer to arrows).
Figure 3
Figure 3
(a) Baseline FDG PET showed a focal area of tracer increased incorporation in the soft tissues adjacent to the supraorbital bone; (b) FDG PET carried at 3 months after Cemiplimab identified a small area of residual tracer uptake in the same region, indicative of a partial metabolic response; (c) FDG PET after 3 years of immunotherapy depicted a complete metabolic response (please refer to arrows).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Stratigos A.J., Sekulic A., Peris K., Bechter O., Prey S., Kaatz M., Lewis K.D., Basset-Seguin N., Chang A.L.S., Dalle S., et al. Cemiplimab in locally advanced basal cell carcinoma after hedgehog inhibitor therapy: An open-label, multi-centre, single-arm, phase 2 trial. Lancet Oncol. 2021;22:848–857. doi: 10.1016/S1470-2045(21)00126-1. - DOI - PubMed
    1. Guidelines CUTANEUS TUMORS NOT MELANOMA Basal Cell Carcinoma; AIOM 2021. [(accessed on 15 June 2023)]. Available online: https://www.iss.it/documents/20126/8403839/LG-AIOM-313.
    1. Basset-Seguin N., Herms F. Update in the Management of Basal Cell Carcinoma. Acta Derm. Venereol. 2020;100:284–290. doi: 10.2340/00015555-3495. - DOI - PMC - PubMed
    1. McDaniel B., Badri T., Steele R.B. StatPearls. StatPearls Publishing; Treasure Island, FL, USA: 2023. Basal Cell Carcinoma. - PubMed
    1. Dika E., Scarfì F., Ferracin M., Broseghini E., Marcelli E., Bortolani B., Campione E., Riefolo M., Ricci C., Lambertini M. Basal Cell Carcinoma: A Comprehensive Review. Int. J. Mol. Sci. 2020;21:5572. doi: 10.3390/ijms21155572. - DOI - PMC - PubMed

Publication types