Neoadjuvant and adjuvant therapy for locally advanced cutaneous squamous cell carcinoma

Neoadjuvant and adjuvant treatment strategies are promising approaches to enhance outcomes in locally advanced, resectable cutaneous squamous cell carcinoma (LACSCC). This review summarizes key studies of neoadjuvant, adjuvant, and combination therapies to guide clinical practice in treatment of LACSCC. The clinical trials and real-world studies reviewed in this study collectively demonstrate that neoadjuvant strategies for LACSCC, especially with immune checkpoint inhibitors, yielded high pathological response rates, improved survival, reduced treatment side effects, and decreased surgical morbidity. Adjuvant immunotherapy also has recently been shown to also provide a substantial benefit in specific LACSCC tumors, often in combination with radiation therapy. Moreover, adaptive neoadjuvant therapies could enable treatment de-escalation and even avoidance of surgery altogether, while achieving high durable response rates.