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Nikhil Khushalani, MD, on Neoadjuvant and Adjuvant Treatment in CSCC

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Nikhil Khushalani, MD, Vice Chair for the Department of Cutaneous Oncology at Moffitt Cancer Center, reviews advances in the adjuvant and neoadjuvant treatment of cutaneous squamous cell carcinoma (CSCC). He discusses the possibility of de-escalating therapy for patients who respond positively to presurgical agents; how to best select postoperative regimens; and ongoing trials in both spaces. 

References 

  1. Gross ND, Miller DM, Khushalani NI, et al: Neoadjuvant cemiplimab for stage II to IV cutaneous squamous-cell carcinoma. N Eng J Med 387:1557-1568, 2022.
  2. Gross ND, Miller DM, Khushalani NI, et al: Neoadjuvant cemiplimab and surgery for stage II-IV cutaneous squamous-cell carcinoma: Follow-up and survival outcomes of a single-arm, multicentre, phase 2 study. Lancet Oncol 11:1196-1205, 2023.
  3. Breukers SE, Traets JJH, van Dijk SW, et al: Neoadjuvant ipilimumab and nivolumab in resectable cutaneous squamous cell carcinoma: A randomized phase 2 trial. Nature Medicine. October 8, 2025 (early release online).
  4. Ladwa R, Lee JH, McGrath M, et al: Response-adapted surgical and radiotherapy de-escalation in resectable cutaneous squamous cell cancer using pembrolizumab: The De-Squamate study. J Clin Oncol 26:2888-2986, 2025.
  5. Porceddu SV, Bressel M, Poulsen MG, et al: Postoperative concurrent chemoradiotherapy versus postoperative radiotherapy in high-risk cutaneous squamous cell carcinoma of the head and neck: The randomized phase III TROG 05.01 trial. J Clin Oncol 13:1275-1283, 2018.
  6. Rischin D, Porceddu S, Day F, et al: Adjuvant cemiplimab or placebo in high-risk cutaneous squamous-cell carcinoma. N Eng J Med 393:774-785, 2025.
  7. Koyfman SA, Lee JHJ, Mortier L, et al: Phase 3 randomized trial (KEYNOTE-630) of adjuvant pembrolizumab versus placebo for high-risk locally advanced cutaneous squamous cell carcinoma following surgery and radiation. 2025 ASCO Annual Meeting. Abstract 6000. Presented May 31, 2025. 


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