Cyclophosphamide, fluorouracil and low-dose interleukin-2 and salvage combination chemotherapy in advanced cutaneous squamous cell carcinoma

Abstract

A 70-year-old female with metastatic cutaneous squamous cell carcinoma (cSCC) and low-grade non-Hodgkin’s lymphoma, not amenable to cisplatin combination therapy, was treated with cyclophoshamide (Cyc)-fluorouracil (FU)-interleukin-2 (IL-2) in light of high tumor immunogenicity and the potential activity of this regimen. Cyc 300 mg/m² and FU 500 mg/m² intravenously on day 1 and IL-2 4.5 MIU/day on days 3-6 and 17-20 subcutaneously every 4 weeks; Carboplatin (C) AUC 2 and paclitaxel (P) 85 mg/m² on days 1, 8 and 15 ± capecitabine (Cape) every 4 weeks. After partial remission (PR) of lung metastases and local control with two cycles of first therapy followed by PR with five cycles of CP ± Cape, right mastectomy was performed with evidence of viable tumor. Subsequently, the patient underwent 3 cycles of chlorambucil and is alive after 13 months of follow-up. Safety and activity of chemo-immunotherapy and salvage treatment can be achieved in cSCC.

Keywords

Cutaneous squamous cell carcinoma / cyclophosphamide / fluorouracil / interleukin-2 / regulatory T cells / myeloid-derived suppressor cells

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