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Background/Aim: Cutaneous squamous cell carcinoma (SCC) is a common skin cancer with significant morbidity and mortality, particularly in advanced stages. Treatment options for metastatic cutaneous SCC in very elderly patients are limited due to concerns about treatment tolerability and potential adverse effects. Case Report: We report the case of a 90-year-old female patient with metastatic cutaneous SCC who was treated with cemiplimab, a monoclonal antibody (m-Ab) against programmed cell death protein 1 (PD-1), in combination with radiotherapy. The patient received cemiplimab for a limited period, during which time she demonstrated significant clinical improvement without severe adverse events. Radiotherapy was performed as a locoregional treatment with the aim to enhance immunotherapy efficacy. Discussion: This case highlights the feasibility and effectiveness of cemiplimab in very elderly patients with metastatic cutaneous SCC. Despite the common apprehensions regarding the use of immunotherapy in this age group, our patient tolerated cemiplimab well, and the combination with radiotherapy proved beneficial. This suggests that even in very elderly patients, short-term use of cemiplimab, in conjunction with locoregional treatments such as radiotherapy, can be a viable and successful therapeutic approach. Conclusion: Cemiplimab, even in combination with radiotherapy, can be effectively and safely administered to very elderly patients with metastatic cutaneous SCC. This case supports the consideration of immunotherapy, even for a limited duration, as a practical option in the management of advanced cutaneous SCC in elderly patients, expanding the potential treatment strategies for this population. [ABSTRACT FROM AUTHOR]

This article, published in Frontiers in Immunology, discusses the analysis of tumor immune microenvironments and molecular mechanisms in advanced non-small cell lung cancer (NSCLC) to reveal the challenges of immunotherapy. The authors highlight the limitations of immune checkpoint inhibitors (ICIs) and explore strategies to enhance their efficacy, including combination therapy with chemotherapy. The article presents several studies that examine the changes in the tumor microenvironment following treatment with tyrosine kinase inhibitors (TKIs), the role of biomarkers such as Integrin alpha-8 (ITGA8) and proprotein convertase subtilisin/kexin type 9 (PCSK9), the impact of inflammatory cytokines on PD-L1 expression, and the significance of soluble PD-1 (sPD-L1) changes during treatment. The findings emphasize the importance of personalized approaches and ongoing research to overcome the challenges of immunotherapy in NSCLC. [Extracted from the article]