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Advanced cutaneous squamous cell carcinoma: lines of therapy

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5 standard-of-care settings across 4 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

LineAll comersFRαRisk group
Early / localised1·1
Advanced, first line1··
Third line and beyond·1·
Other settings1··

Early / localised

SubgroupSettingApproachProducts and trialsEvidence
All comersAdjuvant after surgery and radiotherapyCemiplimab for high-risk disease (C-POST, 2025).85
Risk groupHigh-risk resectable diseaseExcision with margin control or Mohs surgery, nodal evaluation, and postoperative radiotherapy for perineural invasion, positive margins or nodal disease; neoadjuvant cemiplimab to shrink large tumours before surgery.93

Advanced, first line

SubgroupSettingApproachProducts and trialsEvidence
All comersLocally advanced or metastatic, first lineCemiplimab (EMPOWER-CSCC-1), pembrolizumab (KEYNOTE-629) or cosibelimab; radiotherapy for symptomatic sites.98

Third line and beyond

SubgroupSettingApproachProducts and trialsEvidence
FRαImmunotherapy-ineligible or refractoryCetuximab with or without radiotherapy, platinum-based chemotherapy, capecitabine; clinical trials of RP1 with cemiplimab or photoimmunotherapy.93

Other settings

SubgroupSettingApproachProducts and trialsEvidence
All comersTransplant recipientsReduce immunosuppression and switch to sirolimus or everolimus where possible; PD-1 blockade only after weighing graft rejection risk; surgery and radiotherapy preferred.91

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.