Chemotherapy in the management of advanced cutaneous squamous cell carcinoma in organ transplant recipients: Theoretical and practical considerations

BACKGROUND. The use of chemotherapy in organ transplant recipients (OTRs) with advanced and metastatic cutaneous squamous cell carcinoma (SCC) remains relatively unexplored in dermatology. Advances in the use of chemotherapy in metastatic head and neck squamous cell carcinoma (HNSCC) may be applicable to this increasingly common disease. OBJECTIVE. The objective of this study was to determine whether recent advances in the role of chemotherapy in the management of HNSCC and cutaneous SCC offer insights into treatment strategies for metastatic cutaneous SCC. METHODS. We reviewed the literature pertaining to treatment of advanced and metastatic HNSCC and cutaneous SCC, with particular attention to the role of chemotherapy. In addition, specialists in the fields of cutaneous oncology and dermatologic surgery, head and neck surgery, medical oncology, and radiation oncology were consulted for expert multidisciplinary advice. RESULTS. Specific roles for chemotherapy in the management of advanced and cutaneous HNSCC are discussed and summarized. In addition, we propose theoretical analogies in the treatment of advanced and metastatic cutaneous SCC in OTRs. CONCLUSIONS. The head and neck surgery and oncology literature is rich with experience in locoregionally advanced and metastatic HNSCC, and adaptation of management concepts may prove feasible in the management of OTRs with advanced and metastatic cutaneous SCC.