array:25 [
  "pii" => "S0001731022001661"
  "issn" => "00017310"
  "doi" => "10.1016/j.ad.2021.04.011"
  "estado" => "S300"
  "fechaPublicacion" => "2022-06-01"
  "aid" => "2955"
  "copyright" => "AEDV"
  "copyrightAnyo" => "2022"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2022;113:610-5"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0001731022003404"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2022.05.001"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "3041"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2022;113:T610-T615"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Comunicaci&#243;n breve</span>"
      "titulo" => " Cemiplimab en el carcinoma de c&#233;lulas escamosas cut&#225;neo avanzado&#58; experiencia del mundo real en un centro oncol&#243;gico monogr&#225;fico"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "T610"
          "paginaFinal" => "T615"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma&#58; Real-World Experience in a Monographic Oncology Center"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1300
              "Ancho" => 1733
              "Tamanyo" => 332696
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Caso 8&#58; cSCC avanzado con invasi&#243;n orbital&#44; invasi&#243;n perineural cl&#237;nica&#44; y met&#225;stasis ganglionares regionales&#46; &#40;A-C&#41;&#58; fotograf&#237;as cl&#237;nicas del paciente antes de iniciar la terapia&#44; tras 2 ciclos&#44; y tras 8 ciclos&#44; respectivamente&#46; En &#40;A&#41;&#44; existe ptosis obvia del p&#225;rpado derecho debido a la invasi&#243;n perineural tumoral&#46; &#40;D-F&#41;&#58; im&#225;genes de RM ponderadas en T2 antes de iniciar la terapia&#44; tras 4 ciclos&#44; y tras 18 ciclos&#44; respectivamente&#46; La masa grande frontal observada en &#40;D&#41; ha desaparecido completamente en &#40;F&#41; lo cual refleja&#44; por tanto&#44; la respuesta completa al tratamiento&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "E&#46; R&#237;os-Vi&#241;uela, P&#46; &#193;lvarez, J&#46; Lavernia, C&#46; Serra-Guill&#233;n, C&#46; Requena, E&#46; Bernia, A&#46; Diago, B&#46; Llombart, O&#46; Sanmart&#237;n"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "R&#237;os-Vi&#241;uela"
            ]
            1 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "&#193;lvarez"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Lavernia"
            ]
            3 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Serra-Guill&#233;n"
            ]
            4 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Requena"
            ]
            5 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Bernia"
            ]
            6 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Diago"
            ]
            7 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Llombart"
            ]
            8 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Sanmart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022003404?idApp=UINPBA000044"
    "url" => "/00017310/0000011300000006/v1_202206190516/S0001731022003404/v1_202206190516/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S000173102200415X"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2022.01.040"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "3056"
    "copyright" => "AEDV"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "pgl"
    "cita" => "Actas Dermosifiliogr. 2022;113:T583-T609"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Consensus Document</span>"
      "titulo" => " Practical Update of the Guidelines Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology &#40;GPs&#41; on the Treatment of Psoriasis With Biologic Agents&#58; Part 2&#8212;Management of Special Populations&#44; Patients With Comorbid Conditions&#44; and Risk"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "T583"
          "paginaFinal" => "T609"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Actualizaci&#243;n pr&#225;ctica de las recomendaciones del Grupo de Psoriasis de la Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a &#40;GPS&#41; para el tratamiento de la psoriasis con terapia biol&#243;gica&#46; Parte 2 &#171;Manejo de poblaciones especiales&#44; pacientes con comorbilidad y gesti&#243;n del riesgo&#187;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1010
              "Ancho" => 2925
              "Tamanyo" => 201671
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Efficacy of biologic drugs &#40;including biosimilars and new-generation synthetic molecules&#41; in psoriatic arthritis according to phase III randomized controlled trials&#46;<a class="elsevierStyleCrossRef" href="#bib1315"><span class="elsevierStyleSup">80</span></a> TNF indicates tumor necrosis factors&#59; IL&#44; interleukin&#59; ADA&#44; adalimumab&#59; ETN&#44; etanercept&#59; IFX&#44; infliximab&#59; CER&#44; certolizumab pegol&#59; UST&#44; ustekinumab&#59; BRO&#44; brodalumab&#59; SEC&#44; secukinumab&#59; IXE&#44; ixekizumab&#59; BIME&#44; bimekizumab&#59; GUS&#44; guselkumab&#59; IL&#44; interleukin&#59; PsA&#44; psoriatic arthritis&#59; RIS&#44; risankizumab&#59; TIL&#44; tildrakizumab&#46;</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Colors&#46; Dark green means that the domain was the primary endpoint of a completed phase III trial designed to assess that domain&#59; light green&#44; that the domain was the secondary endpoint in a completed phase III trial&#59; dark blue&#44; that the domain is the primary endpoint in an ongoing phase III trial with phase II results available&#59; and light blue&#44; that the domain is a secondary endpoint in an ongoing phase III trial with phase II results available&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#43; efficacious&#59; &#8722; not efficacious&#59; &#43;&#63; few data or data not published in indexed journals&#59;&#63;&#63; No data available&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a</span> Approved for axial spondyloarthritis &#40;ankylosing spondylitis&#47;nonradiographic axial spondyloarthritis&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib1540"><span class="elsevierStyleSup">125</span></a></p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">b</span> Not approved for psoriatic arthritis&#59; phase III RCT discontinued by sponsor&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">c</span> Not approved for psoriatic arthritis&#59; phase III RCT underway&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;M&#46; Carrascosa, L&#46; Puig, I&#46;B&#46; Romero, L&#46; Salgado-Boquete, E&#46; del Alc&#225;zar, J&#46;J&#46;A&#46; Lencina, D&#46; Moreno, P&#46; de la Cueva"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Carrascosa"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Puig"
            ]
            2 => array:2 [
              "nombre" => "I&#46;B&#46;"
              "apellidos" => "Romero"
            ]
            3 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Salgado-Boquete"
            ]
            4 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "del Alc&#225;zar"
            ]
            5 => array:2 [
              "nombre" => "J&#46;J&#46;A&#46;"
              "apellidos" => "Lencina"
            ]
            6 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Moreno"
            ]
            7 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "de la Cueva"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173102200415X?idApp=UINPBA000044"
    "url" => "/00017310/0000011300000006/v1_202206190516/S000173102200415X/v1_202206190516/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S0001731022003404"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2022.05.001"
      "estado" => "S300"
      "fechaPublicacion" => "2022-06-01"
      "aid" => "3041"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2022;113:T610-T615"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Comunicaci&#243;n breve</span>"
        "titulo" => " Cemiplimab en el carcinoma de c&#233;lulas escamosas cut&#225;neo avanzado&#58; experiencia del mundo real en un centro oncol&#243;gico monogr&#225;fico"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "T610"
            "paginaFinal" => "T615"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma&#58; Real-World Experience in a Monographic Oncology Center"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1300
                "Ancho" => 1733
                "Tamanyo" => 332696
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Caso 8&#58; cSCC avanzado con invasi&#243;n orbital&#44; invasi&#243;n perineural cl&#237;nica&#44; y met&#225;stasis ganglionares regionales&#46; &#40;A-C&#41;&#58; fotograf&#237;as cl&#237;nicas del paciente antes de iniciar la terapia&#44; tras 2 ciclos&#44; y tras 8 ciclos&#44; respectivamente&#46; En &#40;A&#41;&#44; existe ptosis obvia del p&#225;rpado derecho debido a la invasi&#243;n perineural tumoral&#46; &#40;D-F&#41;&#58; im&#225;genes de RM ponderadas en T2 antes de iniciar la terapia&#44; tras 4 ciclos&#44; y tras 18 ciclos&#44; respectivamente&#46; La masa grande frontal observada en &#40;D&#41; ha desaparecido completamente en &#40;F&#41; lo cual refleja&#44; por tanto&#44; la respuesta completa al tratamiento&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "E&#46; R&#237;os-Vi&#241;uela, P&#46; &#193;lvarez, J&#46; Lavernia, C&#46; Serra-Guill&#233;n, C&#46; Requena, E&#46; Bernia, A&#46; Diago, B&#46; Llombart, O&#46; Sanmart&#237;n"
            "autores" => array:9 [
              0 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "R&#237;os-Vi&#241;uela"
              ]
              1 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "&#193;lvarez"
              ]
              2 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Lavernia"
              ]
              3 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Serra-Guill&#233;n"
              ]
              4 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Requena"
              ]
              5 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Bernia"
              ]
              6 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Diago"
              ]
              7 => array:2 [
                "nombre" => "B&#46;"
                "apellidos" => "Llombart"
              ]
              8 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "Sanmart&#237;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022003404?idApp=UINPBA000044"
      "url" => "/00017310/0000011300000006/v1_202206190516/S0001731022003404/v1_202206190516/es/main.assets"
    ]
  ]
  "en" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Brief Communication</span>"
    "titulo" => "Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma&#58; Real-World Experience in a Monographic Oncology Center"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "610"
        "paginaFinal" => "615"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "E&#46; R&#237;os-Vi&#241;uela, P&#46; &#193;lvarez, J&#46; Lavernia, C&#46; Serra-Guill&#233;n, C&#46; Requena, E&#46; Bernia, A&#46; Diago, B&#46; Llombart, O&#46; Sanmart&#237;n"
        "autores" => array:9 [
          0 => array:4 [
            "nombre" => "E&#46;"
            "apellidos" => "R&#237;os-Vi&#241;uela"
            "email" => array:1 [
              0 => "elisariosvi@hotmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "P&#46;"
            "apellidos" => "&#193;lvarez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Lavernia"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Serra-Guill&#233;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Requena"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Bernia"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Diago"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "B&#46;"
            "apellidos" => "Llombart"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "O&#46;"
            "apellidos" => "Sanmart&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Department of Dermatology&#44; Instituto Valenciano de Oncolog&#237;a&#44; Valencia&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Oncology&#44; Instituto Valenciano de Oncolog&#237;a&#44; Valencia&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Department of Dermatology&#44; Hospital Universitario Miguel Servet&#44; Zaragoza&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Cemiplimab en el carcinoma de c&#233;lulas escamosas cut&#225;neo avanzado&#58; experiencia del mundo real en un centro oncol&#243;gico monogr&#225;fico"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1300
            "Ancho" => 1733
            "Tamanyo" => 332194
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Case 8&#58; advanced cSCC with orbital invasion&#44; clinical perineural invasion&#44; and regional nodal metastases&#46; &#40;A&#8211;C&#41;&#58; clinical pictures of the patient before the start of therapy&#44; after 2 cycles&#44; and after 8 cycles&#44; respectively&#46; In &#40;A&#41;&#44; there is obvious ptosis of the right eyelid because of tumoral perineural invasion&#46; &#40;D&#8211;F&#41;&#58; T2-weighted MRI images before the start of therapy&#44; after 4 cycles&#44; and after 18 cycles&#44; respectively&#46; The large&#44; frontal mass seen in &#40;D&#41; has disappeared completely in &#40;F&#41;&#44; thus showing a complete treatment response&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous squamous cell carcinoma &#40;cSCC&#41; is the second most common cutaneous neoplasm&#44; and its incidence has increased in the last decades&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#44;2</span></a> Most cases of cSCC carry a good prognosis and can be treated with complete surgical excision&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#44;3</span></a> However&#44; a small percentage of cases fall within the category of advanced cSCC&#44; which is defined as a tumor that is surgically unresectable&#44; that is not susceptible to curative radiation therapy&#44; and&#47;or that has developed nodal or visceral metastases&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#44;4</span></a> Management of patients with advanced cSCC is often challenging&#44; and until recently the choice of systemic medications was limited and of modest efficacy&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3&#8211;6</span></a> Of late&#44; however&#44; there is increasing evidence on the efficacy of immunotherapy in cSCC&#46; Cemiplimab &#40;an anti-PD1 monoclonal antibody&#41; is the first immunotherapeutic agent approved for the treatment of metastatic or locally advanced cSCC&#44; and it has demonstrated substantial antitumor activity with an acceptable safety profile in clinical trials&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">7&#8211;9</span></a> Evidence from real-world studies with cemiplimab is still scarce&#44; and consists mainly on single case reports&#44; with only two recent retrospective studies of patients treated with several PD-1 inhibitors &#40;including cemiplimab&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">10&#44;11</span></a> In the present study we report the clinical outcomes of 13 patients with advanced cSCC treated with cemiplimab&#46; The main outcome measurement was treatment response&#46; Secondary objectives were to evaluate treatment-related adverse events &#40;AEs&#41; and progression-free survival &#40;PFS&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">A prospective observational study was performed&#44; including 13 patients treated with cemiplimab at Fundaci&#243;n Instituto Valenciano de Oncolog&#237;a between April 2019 and November 2020 &#40;6 with locally advanced disease&#44; 7 with nodal or visceral metastatic disease&#41;&#46; Treatment was administered intravenously at the approved dose of 350<span class="elsevierStyleHsp" style=""></span>mg every 3 weeks&#46; A partial response &#40;PR&#41; was defined as a reduction of &#8805;20&#37; of the clinical and&#47;or radiological diameter&#44; and a complete response &#40;CR&#41; as the complete clinical and radiological disappearance of the tumor&#46; Progression was defined as an increase of the tumoral bulk of &#8805;10&#37;&#46; Stable disease did not meet criteria for either progression or complete or partial responses&#46; Patients with disease progression received up to 6 cemiplimab cycles before treatment discontinuation&#46; All patients were followed jointly both by the Oncology and Dermatology departments&#44; and underwent a thorough physical exam and clinical interview prior to each infusion&#44; as well as control laboratory tests including a complete blood cell count and a basic biochemistry panel &#40;electrolytes&#44; liver and kidney function and lactate dehydrogenase levels&#41;&#46; Control clinical pictures were carried out every 6-9 weeks by the Dermatology department&#46; Control imaging studies were performed with variable periodicity&#58; to confirm clinical treatment responses&#44; to assess disease progression&#44; and to verify response maintenance&#46; PDL-1 expression was studied in histological samples of 11 cases&#46; A descriptive statistical analysis was performed with the program IBM-SPSS 25&#46;0&#46; This study was approved by the institutional review board of Fundaci&#243;n Instituto Valenciano de Oncolog&#237;a&#44; and informed consent was obtained from patients or their families following the procedures established by the ethics committee at our hospital&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0015" class="elsevierStylePara elsevierViewall">A total of 13 patients were included in this study&#46; All but one patient were men&#44; and most of them elderly &#40;median age 81&#44; range 56&#8211;91&#41;&#46; The main clinical characteristics and treatment outcomes are depicted in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Patients received a median of 6 cycles of cemiplimab &#40;range 1&#8211;23&#41;&#46; Overall&#44; 8 cases &#40;62&#37;&#41; responded to cemiplimab after a median of 2 cycles &#40;range 2-4&#41;&#46; Three patients &#40;23&#37;&#41; showed a complete response and 5 &#40;38&#37;&#41; a PR&#46; Responding patients received a median of 9 treatment cycles&#46; All but one patient with an initial PR presented subsequent disease progression&#44; leading to drug discontinuation&#46; One of the patients with a CR &#40;case 2&#41; died of unrelated causes while still receiving cemiplimab&#46; In case 8&#44; cemiplimab was suspended after 11 cycles &#40;5 cycles after achieving a complete radiological response&#41;&#44; with no progression to date&#46; Finally&#44; the last patient with a CR &#40;case 4&#41; is still receiving cemiplimab &#40;23 cycles to date&#41;&#58; because of the high-risk location of the tumor&#44; treatment discontinuation seemed too risky&#46; PFS for responding patients was 5&#46;9 months &#40;range 1&#46;9-15&#46;5&#41;&#46; Five patients showed no response to treatment &#40;one of whom was lost to follow-up after receiving only one treatment cycle&#41;&#46; The median follow-up was 9 months &#40;range 3&#46;5-16&#41;&#46; Regarding treatment-related toxicity&#44; 6 patients &#40;46&#37;&#41; developed AEs&#46; Most of them were mild &#40;G1&#41;&#44; and none of the patients in our series presented a serious or lethal adverse reaction&#46; No patients discontinued treatment due to AEs&#46; The most common side effects were fatigue&#44; dizziness and diarrhea &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Finally&#44; PD1-L expression was measured in 11 cases&#44; with a median value of 10&#37; &#40;range 1&#8211;90&#37;&#41;&#46; PD1-L expression did not appear to be related to treatment response&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Cemiplimab demonstrated substantial antitumor activity in the clinical trials that lead to its approval&#44; with an objective response rate of almost 50&#37; in the treatment of locally advanced and metastatic cSCC&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">7&#8211;9</span></a> In our series&#44; we observed a remarkably high rate of CR &#40;23&#37;&#41;&#44; with a higher overall response rate &#40;RR&#41; as compared to clinical trials &#40;62&#37;&#41;&#46; Data from the previous two other real-world studies differ&#58; Hanna et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> found a lower overall RR as compared to clinical trials &#40;31&#46;5&#37;&#41;&#44; while Salzmann et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> reported a higher RR &#40;58&#46;7&#37;&#41;&#46; Experience with pembrolizumab and nivolumab is more limited&#44; but preliminary results show very similar RR than those of cemiplimab&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">10&#44;11</span></a> It is still unclear why some patients show extraordinary responses to immunotherapy&#44; and others do not respond at all&#46; Focus has been placed in the role of PD-L1 expression and in the presence of TILs&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> Surprisingly&#44; the available data suggests that treatment response does not seem to be related to PD-L1 expression&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> Our series further supports these findings&#44; with patients with complete responses showing very variable levels pf PD-L1 expression&#46; Optimal treatment duration is still unclear&#44; and there is not enough evidence to determine how long therapy should be maintained after an objective response has been achieved&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;10&#44;11</span></a> It seems&#44; however&#44; that patients responding to therapy induce a long-term response &#40;especially those with complete responses&#41;&#44; with few patients subsequently progressing&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> In our series&#44; this was not the case for patients with partial responses&#44; as all but one of them presented subsequent disease progression in spite of continuing therapy&#46; In patients with a complete response&#44; the decision to continue treatment was made based on their risk profile&#46; In case 5&#44; the high-risk location of the tumor and the fear to a potentially fatal disease recurrence prevented treatment discontinuation&#46; In case 8&#44; because of the tumor&#39;s low-risk location &#40;potentially susceptible to surgical treatment in case of recurrence&#41; we decided to discontinue treatment&#44; with no signs of disease progression during follow-up&#46; In this series of primarily elderly patients&#44; cemiplimab demonstrated a very good safety profile&#44; without any serious treatment-related AEs and without any treatment discontinuation due to intolerable AEs &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The most common AEs were similar to those reported in previous studies&#46; Nevertheless&#44; all patients receiving cemiplimab should be monitored for potential side effects&#44; as these could be severe or even lethal&#46; In summary&#44; cemiplimab showed evident antitumor activity&#44; albeit response rates were lower than previously reported in clinical trials&#46; In this case series&#44; the number of complete responses&#44; and the drug&#39;s good tolerability profile were significant&#46; The main limitations of this study are the small number of patients included and the relatively short follow-up &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Cemiplimab has proved to be effective in the treatment of advanced cSCC in real-world clinical practice&#46; Although preliminary data have yielded lower response rates than previously reported in clinical trials&#44; its significant antitumor activity and its good tolerability place it as one of the first-line therapies for advanced cSCC&#46; Further investigation is needed to define additional treatment approaches &#40;such as adjuvant and neo-adjuvant immunotherapy&#41; and to determine patient profiles that can predict the probability of treatment response&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conflict of interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1736582"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1532013"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1736581"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1532014"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflict of interests"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1532013"
          "palabras" => array:5 [
            0 => "Advanced cutaneous squamous cell carcinoma"
            1 => "Metastatic squamous cell carcinoma"
            2 => "Locally-advanced squamous cell carcinoma"
            3 => "Cemiplimab"
            4 => "PD-1 inhibitors"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1532014"
          "palabras" => array:5 [
            0 => "Carcinoma de c&#233;lulas escamosas cut&#225;neo"
            1 => "C&#225;ncer escamoso metast&#225;sico"
            2 => "Carcinoma de c&#233;lulas escamosas localmente avanzado"
            3 => "Cemiplimab"
            4 => "Inhibidores PD-1"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Management of advanced cSCC is challenging&#44; and many available systemic medications have modest efficacy&#46; Cemiplimab has demonstrated efficacy in the treatment of advanced cSCC in clinical trials&#44; but real-world data are still limited&#46; With the objective of evaluating the efficacy of cemiplimab in a real-world clinical setting&#44; we conducted a prospective observational study of 13 patients with advanced cSCC&#46; Six patients &#40;46&#37;&#41; had locally advanced disease&#44; while 7 &#40;54&#37;&#41; had metastatic disease&#46; A total of 8 patients &#40;62&#37;&#41; responded to cemiplimab&#46; Five &#40;38&#37;&#41; showed a partial response&#44; while 3 &#40;23&#37;&#41; showed a complete response&#46; Four patients with an initial partial response presented subsequent disease progression during follow-up&#46; Six patients &#40;46&#37;&#41; developed AEs&#44; most of which were mild &#40;G1&#41;&#46; PFS was 5&#46;9 months&#44; with a median follow-up was 9 months&#46; In conclusion&#44; cemiplimab demonstrated its utility in the treatment of advanced cSCC&#44; with acceptable response rates&#44; a remarkable number of complete responses&#44; and a very good safety profile&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El manejo del carcinoma de c&#233;lulas escamosas cut&#225;neo &#40;cSCC&#41; avanzado es complicado&#44; siendo modesta la eficacia de muchos de los f&#225;rmacos sist&#233;micos disponibles&#46; Cemiplimab ha demostrado su eficacia en el tratamiento del cSCC avanzado en ensayos cl&#237;nicos&#44; pero los datos del mundo real siguen siendo limitados&#46; Con el objetivo de evaluar la eficacia de cemiplimab en un entorno cl&#237;nico del mundo real&#44; realizamos un estudio observacional prospectivo de 13 pacientes con cSCC avanzado&#46; Seis pacientes &#40;46&#37;&#41; ten&#237;an enfermedad localmente avanzada&#44; mientras que 7 &#40;54&#37;&#41; ten&#237;an enfermedad metast&#225;sica&#46; Un total de 8 pacientes &#40;62&#37;&#41; respondieron a cemiplimab&#44; 5 &#40;38&#37;&#41; mostraron una respuesta parcial y 3 &#40;23&#37;&#41; mostraron una respuesta completa&#46; Cuatro pacientes con respuesta parcial inicial presentaron una progresi&#243;n de la enfermedad subsiguiente durante el seguimiento&#46; Seis pacientes &#40;46&#37;&#41; desarrollaron efectos secundarios&#44; siendo leve la mayor&#237;a de los mismos &#40;G1&#41;&#46; La supervivencia libre de progresi&#243;n fue de 5&#44;9 meses&#44; con un seguimiento medio de 9 meses&#46; En conclusi&#243;n&#44; cemiplimab demostr&#243; su utilidad en el tratamiento del cSCC avanzado&#44; con unas tasas de respuesta aceptables&#44; un n&#250;mero destacable de respuestas completas y un perfil de seguridad muy bueno&#46;</p></span>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1300
            "Ancho" => 1733
            "Tamanyo" => 332194
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Case 8&#58; advanced cSCC with orbital invasion&#44; clinical perineural invasion&#44; and regional nodal metastases&#46; &#40;A&#8211;C&#41;&#58; clinical pictures of the patient before the start of therapy&#44; after 2 cycles&#44; and after 8 cycles&#44; respectively&#46; In &#40;A&#41;&#44; there is obvious ptosis of the right eyelid because of tumoral perineural invasion&#46; &#40;D&#8211;F&#41;&#58; T2-weighted MRI images before the start of therapy&#44; after 4 cycles&#44; and after 18 cycles&#44; respectively&#46; The large&#44; frontal mass seen in &#40;D&#41; has disappeared completely in &#40;F&#41;&#44; thus showing a complete treatment response&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1307
            "Ancho" => 1740
            "Tamanyo" => 387188
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cases 12 &#40;A&#44; B&#41; and 2 &#40;C&#44; D&#41;&#46; &#40;A&#44; B&#41;&#58; Locally advanced cSCC in the nose of an elderly woman&#46; There is a dramatical reduction of the tumor bulk after only 2 cycles of cemiplimab &#40;B&#41;&#46; &#40;C&#44; D&#41;&#58; Locally advanced cSCC of the left cheek in an elderly man&#46; Before starting therapy&#44; the patient presented a large&#44; ulcerated tumor &#40;C&#41;&#46; After 10 cycles&#44; the patient showed a complete treatment response&#44; with complete clearance of the tumoral mass and secondary maxillary bone exposure&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary tumor location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Metastases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PDL-1 expression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Best response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of cycles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inmunorelated toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Treatment discontinuation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cause of discontinuation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Scalp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade2 Rash&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left cheek&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade1 Asthenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Died from an ischemic stroke &#40;patient with history of a myocardial infarction and a previous ischemic stroke&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Scalp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Right forehead &#40;orbital invasion&#44; clinical perineural invasion&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Strong Positive &#40;90&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complete response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 1 asthenia and dizziness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neck&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 1 dizziness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left hand&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&#59; pleural carcinomatosis&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Strong Positive &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left cheek&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak Positive &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complete response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 1 Diarrhea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sustained complete response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Scalp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lost to follow-up during the COVID-19 pandemic&#44; subsequent tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left leg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Strong Positive &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatologic toxicity &#40;Grade 2 Psoriasis&#59; Grade 1 bullous pemphigoid&#41;Grade 1 Diarrhea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lip&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not studied&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Died from COVID-19 infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial Response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left ear&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No studied&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Main clinical characteristics and treatment ouctomes&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A review of terms used to define cutaneous squamous cell carcinoma with a poor prognosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Ca&#241;ueto"
                            1 => "A&#46; Tejera-Vaquerizo"
                            2 => "P&#46; Redondo"
                            3 => "R&#46; Botella-Estrada"
                            4 => "S&#46; Puig"
                            5 => "O&#46; Sanmartin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2019.06.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2020"
                        "volumen" => "111"
                        "paginaInicial" => "281"
                        "paginaFinal" => "290"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32359704"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines of care for the management of cutaneous squamous cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Alam"
                            1 => "A&#46; Armstrong"
                            2 => "C&#46; Baum"
                            3 => "J&#46;S&#46; Bordeaux"
                            4 => "M&#46; Brown"
                            5 => "K&#46;J&#46; Busam"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2017.10.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2018"
                        "volumen" => "78"
                        "paginaInicial" => "560"
                        "paginaFinal" => "578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29331386"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical treatment of advanced cutaneous squamous-cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;F&#46; Gellrich"
                            1 => "S&#46; H&#252;ning"
                            2 => "S&#46; Beissert"
                            3 => "T&#46; Eigentler"
                            4 => "E&#46; Stockfleth"
                            5 => "R&#46; Gutzmer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.16024"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol"
                        "fecha" => "2019"
                        "volumen" => "33"
                        "paginaInicial" => "38"
                        "paginaFinal" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31833610"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative efficacy of cemiplimab versus other systemic treatments for advanced cutaneous squamous cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Keeping"
                            1 => "Y&#46; Xu"
                            2 => "C&#46;-I&#46; Chen"
                            3 => "S&#46; Cope"
                            4 => "A&#46; Mojebi"
                            5 => "A&#46; Kuznik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Future Oncol"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European interdisciplinary guideline on invasive squamous cell carcinoma of the skin&#58; Part 2&#46; Treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Stratigos"
                            1 => "C&#46; Garbe"
                            2 => "C&#46; Dessinioti"
                            3 => "C&#46; Lebbe"
                            4 => "V&#46; Bataille"
                            5 => "L&#46; Bastholt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2020.01.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2020"
                        "volumen" => "128"
                        "paginaInicial" => "83"
                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32113942"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical outcomes among unresectable&#44; locally advanced&#44; and metastatic cutaneous squamous cell carcinoma patients treated with systemic therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;L&#46; Cowey"
                            1 => "N&#46;J&#46; Robert"
                            2 => "J&#46;L&#46; Espirito"
                            3 => "K&#46; Davies"
                            4 => "J&#46; Frytak"
                            5 => "I&#46; Lowy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cam4.3146"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Med"
                        "fecha" => "2020"
                        "volumen" => "9"
                        "paginaInicial" => "7381"
                        "paginaFinal" => "7387"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32578965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Phase 2 study of cemiplimab in patients with metastatic cutaneous squamous cell carcinoma&#58; primary analysis of fixed-dosing&#44; long-term outcome of weight-based dosing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Rischin"
                            1 => "M&#46;R&#46; Migden"
                            2 => "A&#46;M&#46; Lim"
                            3 => "C&#46;D&#46; Schmults"
                            4 => "N&#46;I&#46; Khushalani"
                            5 => "B&#46;G&#46;M&#46; Hughes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "J Immunother Cancer"
                        "fecha" => "2020"
                        "paginaInicial" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cemiplimab in locally advanced cutaneous squamous cell carcinoma&#58; results from an open-label&#44; phase 2&#44; single-arm trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Migden"
                            1 => "N&#46;I&#46; Khushalani"
                            2 => "A&#46;L&#46;S&#46; Chang"
                            3 => "K&#46;D&#46; Lewis"
                            4 => "C&#46;D&#46; Schmults"
                            5 => "L&#46; Hernandez-Aya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1470-2045(19)30728-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Oncol"
                        "fecha" => "2020"
                        "volumen" => "21"
                        "paginaInicial" => "294"
                        "paginaFinal" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31952975"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "PD-1 blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Migden"
                            1 => "D&#46; Rischin"
                            2 => "C&#46;D&#46; Schmults"
                            3 => "A&#46; Guminski"
                            4 => "A&#46; Hauschild"
                            5 => "K&#46;D&#46; Lewis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2018"
                        "paginaInicial" => "341"
                        "paginaFinal" => "351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real-world outcomes treating patients with advanced cutaneous squamous cell carcinoma with immune checkpoint inhibitors &#40;CPI&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;J&#46; Hanna"
                            1 => "E&#46;S&#46; Ruiz"
                            2 => "N&#46;R&#46; LeBoeuf"
                            3 => "M&#46; Thakuria"
                            4 => "C&#46;D&#46; Schmults"
                            5 => "J&#46;A&#46; Decaprio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41416-020-01044-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Cancer"
                        "fecha" => "2020"
                        "volumen" => "123"
                        "paginaInicial" => "1535"
                        "paginaFinal" => "1542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32868898"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Programmed cell death protein 1 inhibitors in advanced cutaneous squamous cell carcinoma&#58; real-world data of a retrospective&#44; multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Salzmann"
                            1 => "U&#46; Leiter"
                            2 => "C&#46; Loquai"
                            3 => "L&#46; Zimmer"
                            4 => "S&#46; Ugurel"
                            5 => "R&#46; Gutzmer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2020.07.029"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2020"
                        "volumen" => "138"
                        "paginaInicial" => "125"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32882466"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00017310/0000011300000006/v1_202206190516/S0001731022001661/v1_202206190516/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "83192"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Comunicaciones Breves"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011300000006/v1_202206190516/S0001731022001661/v1_202206190516/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022001661?idApp=UINPBA000044"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Brief Communication
Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma: Real-World Experience in a Monographic Oncology Center
Cemiplimab en el carcinoma de células escamosas cutáneo avanzado: experiencia del mundo real en un centro oncológico monográfico
E. Ríos-Viñuelaa,
Corresponding author
elisariosvi@hotmail.com

Corresponding author.
, P. Álvarezb, J. Laverniab, C. Serra-Guilléna, C. Requenaa, E. Berniaa, A. Diagoc, B. Llombarta, O. Sanmartína
a Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
b Department of Oncology, Instituto Valenciano de Oncología, Valencia, Spain
c Department of Dermatology, Hospital Universitario Miguel Servet, Zaragoza, Spain
Read
5428
Times
was read the article
1687
Total PDF
3741
Total HTML
Share statistics
 array:25 [
  "pii" => "S0001731022001661"
  "issn" => "00017310"
  "doi" => "10.1016/j.ad.2021.04.011"
  "estado" => "S300"
  "fechaPublicacion" => "2022-06-01"
  "aid" => "2955"
  "copyright" => "AEDV"
  "copyrightAnyo" => "2022"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2022;113:610-5"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0001731022003404"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2022.05.001"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "3041"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2022;113:T610-T615"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Comunicaci&#243;n breve</span>"
      "titulo" => " Cemiplimab en el carcinoma de c&#233;lulas escamosas cut&#225;neo avanzado&#58; experiencia del mundo real en un centro oncol&#243;gico monogr&#225;fico"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "T610"
          "paginaFinal" => "T615"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma&#58; Real-World Experience in a Monographic Oncology Center"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1300
              "Ancho" => 1733
              "Tamanyo" => 332696
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Caso 8&#58; cSCC avanzado con invasi&#243;n orbital&#44; invasi&#243;n perineural cl&#237;nica&#44; y met&#225;stasis ganglionares regionales&#46; &#40;A-C&#41;&#58; fotograf&#237;as cl&#237;nicas del paciente antes de iniciar la terapia&#44; tras 2 ciclos&#44; y tras 8 ciclos&#44; respectivamente&#46; En &#40;A&#41;&#44; existe ptosis obvia del p&#225;rpado derecho debido a la invasi&#243;n perineural tumoral&#46; &#40;D-F&#41;&#58; im&#225;genes de RM ponderadas en T2 antes de iniciar la terapia&#44; tras 4 ciclos&#44; y tras 18 ciclos&#44; respectivamente&#46; La masa grande frontal observada en &#40;D&#41; ha desaparecido completamente en &#40;F&#41; lo cual refleja&#44; por tanto&#44; la respuesta completa al tratamiento&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "E&#46; R&#237;os-Vi&#241;uela, P&#46; &#193;lvarez, J&#46; Lavernia, C&#46; Serra-Guill&#233;n, C&#46; Requena, E&#46; Bernia, A&#46; Diago, B&#46; Llombart, O&#46; Sanmart&#237;n"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "R&#237;os-Vi&#241;uela"
            ]
            1 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "&#193;lvarez"
            ]
            2 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Lavernia"
            ]
            3 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Serra-Guill&#233;n"
            ]
            4 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Requena"
            ]
            5 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Bernia"
            ]
            6 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Diago"
            ]
            7 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Llombart"
            ]
            8 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Sanmart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022003404?idApp=UINPBA000044"
    "url" => "/00017310/0000011300000006/v1_202206190516/S0001731022003404/v1_202206190516/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S000173102200415X"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2022.01.040"
    "estado" => "S300"
    "fechaPublicacion" => "2022-06-01"
    "aid" => "3056"
    "copyright" => "AEDV"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "pgl"
    "cita" => "Actas Dermosifiliogr. 2022;113:T583-T609"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Consensus Document</span>"
      "titulo" => " Practical Update of the Guidelines Published by the Psoriasis Group of the Spanish Academy of Dermatology and Venereology &#40;GPs&#41; on the Treatment of Psoriasis With Biologic Agents&#58; Part 2&#8212;Management of Special Populations&#44; Patients With Comorbid Conditions&#44; and Risk"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "T583"
          "paginaFinal" => "T609"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Actualizaci&#243;n pr&#225;ctica de las recomendaciones del Grupo de Psoriasis de la Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a &#40;GPS&#41; para el tratamiento de la psoriasis con terapia biol&#243;gica&#46; Parte 2 &#171;Manejo de poblaciones especiales&#44; pacientes con comorbilidad y gesti&#243;n del riesgo&#187;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1010
              "Ancho" => 2925
              "Tamanyo" => 201671
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Efficacy of biologic drugs &#40;including biosimilars and new-generation synthetic molecules&#41; in psoriatic arthritis according to phase III randomized controlled trials&#46;<a class="elsevierStyleCrossRef" href="#bib1315"><span class="elsevierStyleSup">80</span></a> TNF indicates tumor necrosis factors&#59; IL&#44; interleukin&#59; ADA&#44; adalimumab&#59; ETN&#44; etanercept&#59; IFX&#44; infliximab&#59; CER&#44; certolizumab pegol&#59; UST&#44; ustekinumab&#59; BRO&#44; brodalumab&#59; SEC&#44; secukinumab&#59; IXE&#44; ixekizumab&#59; BIME&#44; bimekizumab&#59; GUS&#44; guselkumab&#59; IL&#44; interleukin&#59; PsA&#44; psoriatic arthritis&#59; RIS&#44; risankizumab&#59; TIL&#44; tildrakizumab&#46;</p> <p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Colors&#46; Dark green means that the domain was the primary endpoint of a completed phase III trial designed to assess that domain&#59; light green&#44; that the domain was the secondary endpoint in a completed phase III trial&#59; dark blue&#44; that the domain is the primary endpoint in an ongoing phase III trial with phase II results available&#59; and light blue&#44; that the domain is a secondary endpoint in an ongoing phase III trial with phase II results available&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">&#43; efficacious&#59; &#8722; not efficacious&#59; &#43;&#63; few data or data not published in indexed journals&#59;&#63;&#63; No data available&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">a</span> Approved for axial spondyloarthritis &#40;ankylosing spondylitis&#47;nonradiographic axial spondyloarthritis&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib1540"><span class="elsevierStyleSup">125</span></a></p> <p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">b</span> Not approved for psoriatic arthritis&#59; phase III RCT discontinued by sponsor&#46;</p> <p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">c</span> Not approved for psoriatic arthritis&#59; phase III RCT underway&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;M&#46; Carrascosa, L&#46; Puig, I&#46;B&#46; Romero, L&#46; Salgado-Boquete, E&#46; del Alc&#225;zar, J&#46;J&#46;A&#46; Lencina, D&#46; Moreno, P&#46; de la Cueva"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Carrascosa"
            ]
            1 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Puig"
            ]
            2 => array:2 [
              "nombre" => "I&#46;B&#46;"
              "apellidos" => "Romero"
            ]
            3 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Salgado-Boquete"
            ]
            4 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "del Alc&#225;zar"
            ]
            5 => array:2 [
              "nombre" => "J&#46;J&#46;A&#46;"
              "apellidos" => "Lencina"
            ]
            6 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Moreno"
            ]
            7 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "de la Cueva"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173102200415X?idApp=UINPBA000044"
    "url" => "/00017310/0000011300000006/v1_202206190516/S000173102200415X/v1_202206190516/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S0001731022003404"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2022.05.001"
      "estado" => "S300"
      "fechaPublicacion" => "2022-06-01"
      "aid" => "3041"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2022;113:T610-T615"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Comunicaci&#243;n breve</span>"
        "titulo" => " Cemiplimab en el carcinoma de c&#233;lulas escamosas cut&#225;neo avanzado&#58; experiencia del mundo real en un centro oncol&#243;gico monogr&#225;fico"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "T610"
            "paginaFinal" => "T615"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma&#58; Real-World Experience in a Monographic Oncology Center"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1300
                "Ancho" => 1733
                "Tamanyo" => 332696
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Caso 8&#58; cSCC avanzado con invasi&#243;n orbital&#44; invasi&#243;n perineural cl&#237;nica&#44; y met&#225;stasis ganglionares regionales&#46; &#40;A-C&#41;&#58; fotograf&#237;as cl&#237;nicas del paciente antes de iniciar la terapia&#44; tras 2 ciclos&#44; y tras 8 ciclos&#44; respectivamente&#46; En &#40;A&#41;&#44; existe ptosis obvia del p&#225;rpado derecho debido a la invasi&#243;n perineural tumoral&#46; &#40;D-F&#41;&#58; im&#225;genes de RM ponderadas en T2 antes de iniciar la terapia&#44; tras 4 ciclos&#44; y tras 18 ciclos&#44; respectivamente&#46; La masa grande frontal observada en &#40;D&#41; ha desaparecido completamente en &#40;F&#41; lo cual refleja&#44; por tanto&#44; la respuesta completa al tratamiento&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "E&#46; R&#237;os-Vi&#241;uela, P&#46; &#193;lvarez, J&#46; Lavernia, C&#46; Serra-Guill&#233;n, C&#46; Requena, E&#46; Bernia, A&#46; Diago, B&#46; Llombart, O&#46; Sanmart&#237;n"
            "autores" => array:9 [
              0 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "R&#237;os-Vi&#241;uela"
              ]
              1 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "&#193;lvarez"
              ]
              2 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Lavernia"
              ]
              3 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Serra-Guill&#233;n"
              ]
              4 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Requena"
              ]
              5 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Bernia"
              ]
              6 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Diago"
              ]
              7 => array:2 [
                "nombre" => "B&#46;"
                "apellidos" => "Llombart"
              ]
              8 => array:2 [
                "nombre" => "O&#46;"
                "apellidos" => "Sanmart&#237;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022003404?idApp=UINPBA000044"
      "url" => "/00017310/0000011300000006/v1_202206190516/S0001731022003404/v1_202206190516/es/main.assets"
    ]
  ]
  "en" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Brief Communication</span>"
    "titulo" => "Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma&#58; Real-World Experience in a Monographic Oncology Center"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "610"
        "paginaFinal" => "615"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "E&#46; R&#237;os-Vi&#241;uela, P&#46; &#193;lvarez, J&#46; Lavernia, C&#46; Serra-Guill&#233;n, C&#46; Requena, E&#46; Bernia, A&#46; Diago, B&#46; Llombart, O&#46; Sanmart&#237;n"
        "autores" => array:9 [
          0 => array:4 [
            "nombre" => "E&#46;"
            "apellidos" => "R&#237;os-Vi&#241;uela"
            "email" => array:1 [
              0 => "elisariosvi@hotmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "P&#46;"
            "apellidos" => "&#193;lvarez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Lavernia"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Serra-Guill&#233;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Requena"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Bernia"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Diago"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "B&#46;"
            "apellidos" => "Llombart"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "O&#46;"
            "apellidos" => "Sanmart&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Department of Dermatology&#44; Instituto Valenciano de Oncolog&#237;a&#44; Valencia&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Oncology&#44; Instituto Valenciano de Oncolog&#237;a&#44; Valencia&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Department of Dermatology&#44; Hospital Universitario Miguel Servet&#44; Zaragoza&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Cemiplimab en el carcinoma de c&#233;lulas escamosas cut&#225;neo avanzado&#58; experiencia del mundo real en un centro oncol&#243;gico monogr&#225;fico"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1300
            "Ancho" => 1733
            "Tamanyo" => 332194
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Case 8&#58; advanced cSCC with orbital invasion&#44; clinical perineural invasion&#44; and regional nodal metastases&#46; &#40;A&#8211;C&#41;&#58; clinical pictures of the patient before the start of therapy&#44; after 2 cycles&#44; and after 8 cycles&#44; respectively&#46; In &#40;A&#41;&#44; there is obvious ptosis of the right eyelid because of tumoral perineural invasion&#46; &#40;D&#8211;F&#41;&#58; T2-weighted MRI images before the start of therapy&#44; after 4 cycles&#44; and after 18 cycles&#44; respectively&#46; The large&#44; frontal mass seen in &#40;D&#41; has disappeared completely in &#40;F&#41;&#44; thus showing a complete treatment response&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous squamous cell carcinoma &#40;cSCC&#41; is the second most common cutaneous neoplasm&#44; and its incidence has increased in the last decades&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#44;2</span></a> Most cases of cSCC carry a good prognosis and can be treated with complete surgical excision&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#44;3</span></a> However&#44; a small percentage of cases fall within the category of advanced cSCC&#44; which is defined as a tumor that is surgically unresectable&#44; that is not susceptible to curative radiation therapy&#44; and&#47;or that has developed nodal or visceral metastases&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#44;4</span></a> Management of patients with advanced cSCC is often challenging&#44; and until recently the choice of systemic medications was limited and of modest efficacy&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3&#8211;6</span></a> Of late&#44; however&#44; there is increasing evidence on the efficacy of immunotherapy in cSCC&#46; Cemiplimab &#40;an anti-PD1 monoclonal antibody&#41; is the first immunotherapeutic agent approved for the treatment of metastatic or locally advanced cSCC&#44; and it has demonstrated substantial antitumor activity with an acceptable safety profile in clinical trials&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">7&#8211;9</span></a> Evidence from real-world studies with cemiplimab is still scarce&#44; and consists mainly on single case reports&#44; with only two recent retrospective studies of patients treated with several PD-1 inhibitors &#40;including cemiplimab&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">10&#44;11</span></a> In the present study we report the clinical outcomes of 13 patients with advanced cSCC treated with cemiplimab&#46; The main outcome measurement was treatment response&#46; Secondary objectives were to evaluate treatment-related adverse events &#40;AEs&#41; and progression-free survival &#40;PFS&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">A prospective observational study was performed&#44; including 13 patients treated with cemiplimab at Fundaci&#243;n Instituto Valenciano de Oncolog&#237;a between April 2019 and November 2020 &#40;6 with locally advanced disease&#44; 7 with nodal or visceral metastatic disease&#41;&#46; Treatment was administered intravenously at the approved dose of 350<span class="elsevierStyleHsp" style=""></span>mg every 3 weeks&#46; A partial response &#40;PR&#41; was defined as a reduction of &#8805;20&#37; of the clinical and&#47;or radiological diameter&#44; and a complete response &#40;CR&#41; as the complete clinical and radiological disappearance of the tumor&#46; Progression was defined as an increase of the tumoral bulk of &#8805;10&#37;&#46; Stable disease did not meet criteria for either progression or complete or partial responses&#46; Patients with disease progression received up to 6 cemiplimab cycles before treatment discontinuation&#46; All patients were followed jointly both by the Oncology and Dermatology departments&#44; and underwent a thorough physical exam and clinical interview prior to each infusion&#44; as well as control laboratory tests including a complete blood cell count and a basic biochemistry panel &#40;electrolytes&#44; liver and kidney function and lactate dehydrogenase levels&#41;&#46; Control clinical pictures were carried out every 6-9 weeks by the Dermatology department&#46; Control imaging studies were performed with variable periodicity&#58; to confirm clinical treatment responses&#44; to assess disease progression&#44; and to verify response maintenance&#46; PDL-1 expression was studied in histological samples of 11 cases&#46; A descriptive statistical analysis was performed with the program IBM-SPSS 25&#46;0&#46; This study was approved by the institutional review board of Fundaci&#243;n Instituto Valenciano de Oncolog&#237;a&#44; and informed consent was obtained from patients or their families following the procedures established by the ethics committee at our hospital&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0015" class="elsevierStylePara elsevierViewall">A total of 13 patients were included in this study&#46; All but one patient were men&#44; and most of them elderly &#40;median age 81&#44; range 56&#8211;91&#41;&#46; The main clinical characteristics and treatment outcomes are depicted in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Patients received a median of 6 cycles of cemiplimab &#40;range 1&#8211;23&#41;&#46; Overall&#44; 8 cases &#40;62&#37;&#41; responded to cemiplimab after a median of 2 cycles &#40;range 2-4&#41;&#46; Three patients &#40;23&#37;&#41; showed a complete response and 5 &#40;38&#37;&#41; a PR&#46; Responding patients received a median of 9 treatment cycles&#46; All but one patient with an initial PR presented subsequent disease progression&#44; leading to drug discontinuation&#46; One of the patients with a CR &#40;case 2&#41; died of unrelated causes while still receiving cemiplimab&#46; In case 8&#44; cemiplimab was suspended after 11 cycles &#40;5 cycles after achieving a complete radiological response&#41;&#44; with no progression to date&#46; Finally&#44; the last patient with a CR &#40;case 4&#41; is still receiving cemiplimab &#40;23 cycles to date&#41;&#58; because of the high-risk location of the tumor&#44; treatment discontinuation seemed too risky&#46; PFS for responding patients was 5&#46;9 months &#40;range 1&#46;9-15&#46;5&#41;&#46; Five patients showed no response to treatment &#40;one of whom was lost to follow-up after receiving only one treatment cycle&#41;&#46; The median follow-up was 9 months &#40;range 3&#46;5-16&#41;&#46; Regarding treatment-related toxicity&#44; 6 patients &#40;46&#37;&#41; developed AEs&#46; Most of them were mild &#40;G1&#41;&#44; and none of the patients in our series presented a serious or lethal adverse reaction&#46; No patients discontinued treatment due to AEs&#46; The most common side effects were fatigue&#44; dizziness and diarrhea &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Finally&#44; PD1-L expression was measured in 11 cases&#44; with a median value of 10&#37; &#40;range 1&#8211;90&#37;&#41;&#46; PD1-L expression did not appear to be related to treatment response&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Cemiplimab demonstrated substantial antitumor activity in the clinical trials that lead to its approval&#44; with an objective response rate of almost 50&#37; in the treatment of locally advanced and metastatic cSCC&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">7&#8211;9</span></a> In our series&#44; we observed a remarkably high rate of CR &#40;23&#37;&#41;&#44; with a higher overall response rate &#40;RR&#41; as compared to clinical trials &#40;62&#37;&#41;&#46; Data from the previous two other real-world studies differ&#58; Hanna et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> found a lower overall RR as compared to clinical trials &#40;31&#46;5&#37;&#41;&#44; while Salzmann et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> reported a higher RR &#40;58&#46;7&#37;&#41;&#46; Experience with pembrolizumab and nivolumab is more limited&#44; but preliminary results show very similar RR than those of cemiplimab&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">10&#44;11</span></a> It is still unclear why some patients show extraordinary responses to immunotherapy&#44; and others do not respond at all&#46; Focus has been placed in the role of PD-L1 expression and in the presence of TILs&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> Surprisingly&#44; the available data suggests that treatment response does not seem to be related to PD-L1 expression&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> Our series further supports these findings&#44; with patients with complete responses showing very variable levels pf PD-L1 expression&#46; Optimal treatment duration is still unclear&#44; and there is not enough evidence to determine how long therapy should be maintained after an objective response has been achieved&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">5&#44;10&#44;11</span></a> It seems&#44; however&#44; that patients responding to therapy induce a long-term response &#40;especially those with complete responses&#41;&#44; with few patients subsequently progressing&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> In our series&#44; this was not the case for patients with partial responses&#44; as all but one of them presented subsequent disease progression in spite of continuing therapy&#46; In patients with a complete response&#44; the decision to continue treatment was made based on their risk profile&#46; In case 5&#44; the high-risk location of the tumor and the fear to a potentially fatal disease recurrence prevented treatment discontinuation&#46; In case 8&#44; because of the tumor&#39;s low-risk location &#40;potentially susceptible to surgical treatment in case of recurrence&#41; we decided to discontinue treatment&#44; with no signs of disease progression during follow-up&#46; In this series of primarily elderly patients&#44; cemiplimab demonstrated a very good safety profile&#44; without any serious treatment-related AEs and without any treatment discontinuation due to intolerable AEs &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The most common AEs were similar to those reported in previous studies&#46; Nevertheless&#44; all patients receiving cemiplimab should be monitored for potential side effects&#44; as these could be severe or even lethal&#46; In summary&#44; cemiplimab showed evident antitumor activity&#44; albeit response rates were lower than previously reported in clinical trials&#46; In this case series&#44; the number of complete responses&#44; and the drug&#39;s good tolerability profile were significant&#46; The main limitations of this study are the small number of patients included and the relatively short follow-up &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Cemiplimab has proved to be effective in the treatment of advanced cSCC in real-world clinical practice&#46; Although preliminary data have yielded lower response rates than previously reported in clinical trials&#44; its significant antitumor activity and its good tolerability place it as one of the first-line therapies for advanced cSCC&#46; Further investigation is needed to define additional treatment approaches &#40;such as adjuvant and neo-adjuvant immunotherapy&#41; and to determine patient profiles that can predict the probability of treatment response&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conflict of interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres1736582"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1532013"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1736581"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1532014"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0030"
          "titulo" => "Conflict of interests"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1532013"
          "palabras" => array:5 [
            0 => "Advanced cutaneous squamous cell carcinoma"
            1 => "Metastatic squamous cell carcinoma"
            2 => "Locally-advanced squamous cell carcinoma"
            3 => "Cemiplimab"
            4 => "PD-1 inhibitors"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1532014"
          "palabras" => array:5 [
            0 => "Carcinoma de c&#233;lulas escamosas cut&#225;neo"
            1 => "C&#225;ncer escamoso metast&#225;sico"
            2 => "Carcinoma de c&#233;lulas escamosas localmente avanzado"
            3 => "Cemiplimab"
            4 => "Inhibidores PD-1"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Management of advanced cSCC is challenging&#44; and many available systemic medications have modest efficacy&#46; Cemiplimab has demonstrated efficacy in the treatment of advanced cSCC in clinical trials&#44; but real-world data are still limited&#46; With the objective of evaluating the efficacy of cemiplimab in a real-world clinical setting&#44; we conducted a prospective observational study of 13 patients with advanced cSCC&#46; Six patients &#40;46&#37;&#41; had locally advanced disease&#44; while 7 &#40;54&#37;&#41; had metastatic disease&#46; A total of 8 patients &#40;62&#37;&#41; responded to cemiplimab&#46; Five &#40;38&#37;&#41; showed a partial response&#44; while 3 &#40;23&#37;&#41; showed a complete response&#46; Four patients with an initial partial response presented subsequent disease progression during follow-up&#46; Six patients &#40;46&#37;&#41; developed AEs&#44; most of which were mild &#40;G1&#41;&#46; PFS was 5&#46;9 months&#44; with a median follow-up was 9 months&#46; In conclusion&#44; cemiplimab demonstrated its utility in the treatment of advanced cSCC&#44; with acceptable response rates&#44; a remarkable number of complete responses&#44; and a very good safety profile&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El manejo del carcinoma de c&#233;lulas escamosas cut&#225;neo &#40;cSCC&#41; avanzado es complicado&#44; siendo modesta la eficacia de muchos de los f&#225;rmacos sist&#233;micos disponibles&#46; Cemiplimab ha demostrado su eficacia en el tratamiento del cSCC avanzado en ensayos cl&#237;nicos&#44; pero los datos del mundo real siguen siendo limitados&#46; Con el objetivo de evaluar la eficacia de cemiplimab en un entorno cl&#237;nico del mundo real&#44; realizamos un estudio observacional prospectivo de 13 pacientes con cSCC avanzado&#46; Seis pacientes &#40;46&#37;&#41; ten&#237;an enfermedad localmente avanzada&#44; mientras que 7 &#40;54&#37;&#41; ten&#237;an enfermedad metast&#225;sica&#46; Un total de 8 pacientes &#40;62&#37;&#41; respondieron a cemiplimab&#44; 5 &#40;38&#37;&#41; mostraron una respuesta parcial y 3 &#40;23&#37;&#41; mostraron una respuesta completa&#46; Cuatro pacientes con respuesta parcial inicial presentaron una progresi&#243;n de la enfermedad subsiguiente durante el seguimiento&#46; Seis pacientes &#40;46&#37;&#41; desarrollaron efectos secundarios&#44; siendo leve la mayor&#237;a de los mismos &#40;G1&#41;&#46; La supervivencia libre de progresi&#243;n fue de 5&#44;9 meses&#44; con un seguimiento medio de 9 meses&#46; En conclusi&#243;n&#44; cemiplimab demostr&#243; su utilidad en el tratamiento del cSCC avanzado&#44; con unas tasas de respuesta aceptables&#44; un n&#250;mero destacable de respuestas completas y un perfil de seguridad muy bueno&#46;</p></span>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1300
            "Ancho" => 1733
            "Tamanyo" => 332194
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Case 8&#58; advanced cSCC with orbital invasion&#44; clinical perineural invasion&#44; and regional nodal metastases&#46; &#40;A&#8211;C&#41;&#58; clinical pictures of the patient before the start of therapy&#44; after 2 cycles&#44; and after 8 cycles&#44; respectively&#46; In &#40;A&#41;&#44; there is obvious ptosis of the right eyelid because of tumoral perineural invasion&#46; &#40;D&#8211;F&#41;&#58; T2-weighted MRI images before the start of therapy&#44; after 4 cycles&#44; and after 18 cycles&#44; respectively&#46; The large&#44; frontal mass seen in &#40;D&#41; has disappeared completely in &#40;F&#41;&#44; thus showing a complete treatment response&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1307
            "Ancho" => 1740
            "Tamanyo" => 387188
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Cases 12 &#40;A&#44; B&#41; and 2 &#40;C&#44; D&#41;&#46; &#40;A&#44; B&#41;&#58; Locally advanced cSCC in the nose of an elderly woman&#46; There is a dramatical reduction of the tumor bulk after only 2 cycles of cemiplimab &#40;B&#41;&#46; &#40;C&#44; D&#41;&#58; Locally advanced cSCC of the left cheek in an elderly man&#46; Before starting therapy&#44; the patient presented a large&#44; ulcerated tumor &#40;C&#41;&#46; After 10 cycles&#44; the patient showed a complete treatment response&#44; with complete clearance of the tumoral mass and secondary maxillary bone exposure&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary tumor location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Metastases&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PDL-1 expression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Best response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of cycles&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inmunorelated toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Treatment discontinuation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cause of discontinuation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Scalp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade2 Rash&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left cheek&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade1 Asthenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Died from an ischemic stroke &#40;patient with history of a myocardial infarction and a previous ischemic stroke&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Scalp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Right forehead &#40;orbital invasion&#44; clinical perineural invasion&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Strong Positive &#40;90&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complete response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 1 asthenia and dizziness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neck&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 1 dizziness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left hand&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&#59; pleural carcinomatosis&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Strong Positive &#40;60&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left cheek&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak Positive &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complete response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Grade 1 Diarrhea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sustained complete response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Scalp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lost to follow-up during the COVID-19 pandemic&#44; subsequent tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left leg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Strong Positive &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatologic toxicity &#40;Grade 2 Psoriasis&#59; Grade 1 bullous pemphigoid&#41;Grade 1 Diarrhea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lip&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not studied&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Died from COVID-19 infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weak positive &#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Partial Response&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NO&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patient 13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Left ear&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional lymph nodes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No studied&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Progressive disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No reported toxicity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">YES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tumor progression&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Main clinical characteristics and treatment ouctomes&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A review of terms used to define cutaneous squamous cell carcinoma with a poor prognosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Ca&#241;ueto"
                            1 => "A&#46; Tejera-Vaquerizo"
                            2 => "P&#46; Redondo"
                            3 => "R&#46; Botella-Estrada"
                            4 => "S&#46; Puig"
                            5 => "O&#46; Sanmartin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2019.06.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2020"
                        "volumen" => "111"
                        "paginaInicial" => "281"
                        "paginaFinal" => "290"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32359704"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines of care for the management of cutaneous squamous cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Alam"
                            1 => "A&#46; Armstrong"
                            2 => "C&#46; Baum"
                            3 => "J&#46;S&#46; Bordeaux"
                            4 => "M&#46; Brown"
                            5 => "K&#46;J&#46; Busam"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2017.10.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2018"
                        "volumen" => "78"
                        "paginaInicial" => "560"
                        "paginaFinal" => "578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29331386"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Medical treatment of advanced cutaneous squamous-cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46;F&#46; Gellrich"
                            1 => "S&#46; H&#252;ning"
                            2 => "S&#46; Beissert"
                            3 => "T&#46; Eigentler"
                            4 => "E&#46; Stockfleth"
                            5 => "R&#46; Gutzmer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.16024"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol"
                        "fecha" => "2019"
                        "volumen" => "33"
                        "paginaInicial" => "38"
                        "paginaFinal" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31833610"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative efficacy of cemiplimab versus other systemic treatments for advanced cutaneous squamous cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Keeping"
                            1 => "Y&#46; Xu"
                            2 => "C&#46;-I&#46; Chen"
                            3 => "S&#46; Cope"
                            4 => "A&#46; Mojebi"
                            5 => "A&#46; Kuznik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Future Oncol"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European interdisciplinary guideline on invasive squamous cell carcinoma of the skin&#58; Part 2&#46; Treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Stratigos"
                            1 => "C&#46; Garbe"
                            2 => "C&#46; Dessinioti"
                            3 => "C&#46; Lebbe"
                            4 => "V&#46; Bataille"
                            5 => "L&#46; Bastholt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2020.01.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2020"
                        "volumen" => "128"
                        "paginaInicial" => "83"
                        "paginaFinal" => "102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32113942"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical outcomes among unresectable&#44; locally advanced&#44; and metastatic cutaneous squamous cell carcinoma patients treated with systemic therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;L&#46; Cowey"
                            1 => "N&#46;J&#46; Robert"
                            2 => "J&#46;L&#46; Espirito"
                            3 => "K&#46; Davies"
                            4 => "J&#46; Frytak"
                            5 => "I&#46; Lowy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/cam4.3146"
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer Med"
                        "fecha" => "2020"
                        "volumen" => "9"
                        "paginaInicial" => "7381"
                        "paginaFinal" => "7387"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32578965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Phase 2 study of cemiplimab in patients with metastatic cutaneous squamous cell carcinoma&#58; primary analysis of fixed-dosing&#44; long-term outcome of weight-based dosing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Rischin"
                            1 => "M&#46;R&#46; Migden"
                            2 => "A&#46;M&#46; Lim"
                            3 => "C&#46;D&#46; Schmults"
                            4 => "N&#46;I&#46; Khushalani"
                            5 => "B&#46;G&#46;M&#46; Hughes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "J Immunother Cancer"
                        "fecha" => "2020"
                        "paginaInicial" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cemiplimab in locally advanced cutaneous squamous cell carcinoma&#58; results from an open-label&#44; phase 2&#44; single-arm trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Migden"
                            1 => "N&#46;I&#46; Khushalani"
                            2 => "A&#46;L&#46;S&#46; Chang"
                            3 => "K&#46;D&#46; Lewis"
                            4 => "C&#46;D&#46; Schmults"
                            5 => "L&#46; Hernandez-Aya"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1470-2045(19)30728-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet Oncol"
                        "fecha" => "2020"
                        "volumen" => "21"
                        "paginaInicial" => "294"
                        "paginaFinal" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31952975"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "PD-1 blockade with cemiplimab in advanced cutaneous squamous-cell carcinoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Migden"
                            1 => "D&#46; Rischin"
                            2 => "C&#46;D&#46; Schmults"
                            3 => "A&#46; Guminski"
                            4 => "A&#46; Hauschild"
                            5 => "K&#46;D&#46; Lewis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2018"
                        "paginaInicial" => "341"
                        "paginaFinal" => "351"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real-world outcomes treating patients with advanced cutaneous squamous cell carcinoma with immune checkpoint inhibitors &#40;CPI&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;J&#46; Hanna"
                            1 => "E&#46;S&#46; Ruiz"
                            2 => "N&#46;R&#46; LeBoeuf"
                            3 => "M&#46; Thakuria"
                            4 => "C&#46;D&#46; Schmults"
                            5 => "J&#46;A&#46; Decaprio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41416-020-01044-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Cancer"
                        "fecha" => "2020"
                        "volumen" => "123"
                        "paginaInicial" => "1535"
                        "paginaFinal" => "1542"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32868898"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Programmed cell death protein 1 inhibitors in advanced cutaneous squamous cell carcinoma&#58; real-world data of a retrospective&#44; multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Salzmann"
                            1 => "U&#46; Leiter"
                            2 => "C&#46; Loquai"
                            3 => "L&#46; Zimmer"
                            4 => "S&#46; Ugurel"
                            5 => "R&#46; Gutzmer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2020.07.029"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2020"
                        "volumen" => "138"
                        "paginaInicial" => "125"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32882466"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00017310/0000011300000006/v1_202206190516/S0001731022001661/v1_202206190516/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "83192"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Comunicaciones Breves"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011300000006/v1_202206190516/S0001731022001661/v1_202206190516/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022001661?idApp=UINPBA000044"
]
Article information
ISSN: 00017310
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 4 0 4
2024 October 117 93 210
2024 September 145 36 181
2024 August 163 76 239
2024 July 127 47 174
2024 June 135 51 186
2024 May 133 44 177
2024 April 115 46 161
2024 March 136 60 196
2024 February 103 41 144
2024 January 131 47 178
2023 December 100 25 125
2023 November 98 40 138
2023 October 103 36 139
2023 September 130 27 157
2023 August 101 22 123
2023 July 110 55 165
2023 June 114 34 148
2023 May 128 44 172
2023 April 78 33 111
2023 March 105 49 154
2023 February 73 39 112
2023 January 95 62 157
2022 December 120 66 186
2022 November 109 68 177
2022 October 146 65 211
2022 September 73 67 140
2022 August 117 58 175
2022 July 179 71 250
2022 June 167 70 237
2022 May 136 66 202
2022 April 65 59 124
2022 March 85 90 175
Show all

Follow this link to access the full text of the article

Idiomas
Actas Dermo-Sifiliográficas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?