Abstract
INTRODUCTION: Metastatic or locally advanced cutaneous squamous cell carcinomas (CSCC) affect mainly individuals over 75 years of age. Anti-PD1 therapy is the first-line treatment. Limited data are available on the continuation of immunotherapy after complete response (CR) has been achieved. MATERIALS AND METHODS: We present a retrospective monocentric study of patients over 75 years of age treated with anti-PD1 therapy for CSCC after early immunotherapy discontinuation. Patients were treated between 01/2019 and 01/2024. RESULTS: We identified 44 patients over 75 years of age treated with anti-PD1 therapy, 14 of whom achieved CR, leading to the discontinuation (31%). Median age was 83.5 years. Tumor were located on the head and neck in 92.9% of cases. Median follow-up was 20 months. Median time to CR was 5 months. Discontinuation occurred 1.3 months after the CR diagnosis. One-third of the patients experienced no adverse events. Only one patient experienced grade 3 toxicity, and 10 months after discontinuation of treatment, experienced a nodal recurrence. One death occurred 8 months after CR and was unrelated to CSCC or treatment. CONCLUSION: Anti-PD1 therapy is effective and safe in elderly patients. CR can be achieved quickly and maintained, despite early treatment discontinuation. The use of anti-PD1 therapy is therefore encouraged even in this fragile and comorbid population, with discontinuation planned as soon as a complete response is obtained to limit the duration of treatment and promote quality of life for patients. Further studies and prolonged follow-up are needed to establish guidelines regarding anti-PD1 discontinuation.