Skin Flashcards
What are the most important history for skin cancer?
Immunosuppression - more aggressive, can influence treatment field
Previous skin cancer history
What are the 5 types of BCC?
Superficial
Nodular
Why is Morpheic type BCC more aggressive?
What is Gorelin’s syndrome?
What are difficult area to treat ?
Eye lids
Pre-tibial region of leg
Tendon of hands
Lacriminal gland
What is the C-POST trial evaluating?
The adjuvant immunotherapy trial evaluating Siniplimab (anti-PD-1) vs. placebo after surgery and post-operative radiotherapy for high-risk cutaneous squamous cell carcinoma (CSCC)
C-POST stands for TROG 17.11
What was the rationale behind the C-POST trial?
No proven systemic therapy had previously shown benefit in this setting, and anti-PD-1 therapies showed strong activity in recurrent/metastatic CSCC
The hypothesis was that adjuvant Siniplimab could improve disease-free survival (DFS)
What was the primary endpoint of the C-POST trial?
Disease-Free Survival (DFS)
Secondary endpoints included overall survival, freedom from loco-regional and distant recurrence, second primary tumors, and safety/tolerability
What were the high-risk criteria for patients in the C-POST trial?
- Nodal disease with ≥20mm node & extracapsular extension
- ≥3 lymph nodes involved
- In-transit metastases
- Clinical or radiologic main nerve perineural invasion
- T4 tumors
- Recurrent disease with additional risk factors
What was the randomization process in the C-POST trial?
Patients were randomized to 1 year of Siniplimab or placebo
Patients who relapsed could receive Siniplimab in Part 2
How many patients were enrolled in the C-POST trial?
415 patients
Enrollment was initially planned for 112 patients but was delayed due to COVID-19
What percentage of participants in the C-POST trial were contributed by TROG?
43%
This contribution came from 24 TROG sites
What was the significant result regarding recurrence risk from the C-POST trial?
68% reduction in recurrence risk (Hazard Ratio: 0.32)
This was based on the primary endpoint being met
What was the median follow-up duration for the C-POST trial?
24 months
What was the treatment-related discontinuation rate in the Siniplimab arm?
10%
This was compared to 1.5% in the placebo group
What ongoing review is being conducted as part of the C-POST trial?
Retrospective review of 20% of radiation plans to analyze patterns of practice and potential correlations with outcomes
This review is led by Sandro Porceddu
What are the future plans for the C-POST trial results?
Planned mid-year presentation at a major oncology conference with simultaneous high-impact journal publication
What conclusion can be drawn from the C-POST trial?
The trial demonstrated a significant DFS benefit for adjuvant Siniplimab in high-risk CSCC, supporting its potential role as a new standard of care in this population
