Locally advanced and metastatic Cutaneous Squamous Cell Carcinoma (cSCC)

Authored by Open Medicine, published on 2026-05-05 17:59:45.0

  1. LA / Metastatic cSCC
    Diagnosis + MDT Review
    • Resectable?
      • Borderline Resectable
        → Neoadjuvant PD-1 inhibitor (Cemiplimab; emerging)
        • Reassess → Surgery
          • Surgery
            • High / Very High Risk?
              • Adjuvant RT ± Cemiplimab
                (C-POST, Category 2A evolving)
              • Surveillance
      • Unresectable / Not RT Candidate
        • Checkpoint inhibitor (preferred)
          Prefer PD-1: NCCN hierarchy, strongest evidence, neoadjuvant/adjuvant Cemiplimab (Category 1; EMPOWER-CSCC-1) Pembrolizumab (Category 1) Use Cosibelimab: access/toxicity/PD-L1 strategy Cosibelimab-ipdl (FDA-approved; CK-301-101)
          • Response?
            • CR/PR → Continue IO ± RT
              • Surveillance / Follow-up
            • SD/PD → Add RT or Change Therapy
              • Second-line: Cetuximab / Chemotherapy / Trial (Category 2A)
                • Surveillance / Follow-up
      • Surgery
        • High / Very High Risk?
          • Adjuvant RT ± Cemiplimab
            (C-POST, Category 2A evolving)
          • Surveillance
tosprivacy