ESTRO 2025 - Abstract Book

S1092

Clinical – Head & neck

ESTRO 2025

3673

Poster Discussion Preliminary results of the CRASCH study: cemiplimab and radiotherapy for cutaneous squamous cell carcinoma of the head and neck Emma D'Ippolito 1 , Ida D'Onofrio 1,2 , Anna Maria Merlotti 3 , Elisa D'Angelo 4 , Alessia Di Rito 5 , Viola Salvestrini 6 , Valerio Nardone 1 , Giuseppe Fanetti 7 , Maria Ausilia Teriaca 8 , Federica Gherardi 9 , Lavinia Spinelli 3 , Carla Pisani 10 , Paola De Franco 11 , Alessia Reali 12 , Annalisa Nardone 13 , Pasqualina D'Urso 14 , Francesca De Felice 15 , Laura Maffioletti 16 , Pierluigi Bonomo 6 1 Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy. 2 Unit of Radiation Oncology, , Ospedale del Mare, ASL Napoli 1 Centro, Naples, Italy. 3 Radiation Oncology Department, Santa Croce and Carle Hospital, Cuneo, Italy. 4 Radiation Oncology Department, Bellaria Hospital, AUSL of Bologna, Bologna, Italy. 5 Radiation Oncology Unit, Ospedale Monsignor Raffaele Dimiccoli, Barletta, Italy. 6 Radiation Oncology Unit, Careggi University Hospital, Florence, Italy. 7 Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy. 8 Department of Radiotherapy and Radiosurgery, Humanitas Research Center-IRCCS, Rozzano (MI), Italy. 9 Radiotherapy Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Naples, Italy. 10 Division of Radiation Oncology, University Hospital "Maggiore della Carità", Novara, Italy. 11 Radiation Oncology Unit, Dipartimento di Oncoematologia, Ospedale Vito Fazzi, Lecce, Italy. 12 Radiation Oncology Department, Michele and Pietro Ferrero Hospital, Verduno, Italy. 13 Unità Operativa Complessa di Radioterapia, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy. 14 Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy. 15 Radiation Oncology, AOU Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, "Sapienza" University of Rome, Rome, Italy. 16 Department of Oncology and Hematology-Radiation Oncology Unit, Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII (ASST-PG23), Bergamo, Italy Purpose/Objective: The CRASCH study evaluates the real-world combination of cemiplimab (CEMI) and radiotherapy (RT) in the treatment of cutaneous squamous cell carcinoma of the head and neck (cHNSCC). Given the challenges in managing these often elderly and comorbid patients, this analysis aims to assess the clinical impact of treatment sequencing on efficacy and safety. The current literature contains few studies with limited patient cohorts, highlighting the need for more data to guide clinical practice [1-5]. The study aims to provide insights into local control, toxicity, and overall survival (OS) to guide future treatment and optimize strategies. Material/Methods: The CRASCH is an Italian multicenter retrospective study analyzing data from patients with stage II-IV cHNSCC treated between 2019 and 2024. Patients were divided into two cohorts: Group 1 received RT first (adjuvant to surgery or with radical purpose), followed by CEMI within 12 months due to disease progression. Group 2 started with CEMI and underwent RT during treatment for consolidation (after best response) or salvage purposes. Collected data included patient demographics, RT parameters, tumor response (RECIST 1.1), and toxicity profiles (CTCAE 5.0). Data collection is ongoing, and final results will further refine treatment recommendations. Group 1 (n= 32) received a median RT dose of 51 Gy (range: 25-70 Gy). At a median follow-up of 29 months, 9 patients had recurrences, 3 of which occurred within the RT field. The median OS was 45 months (95% CI: ±11). Group 2 (n= 40) received a median RT dose of 39 Gy (range: 20-70 Gy). Local control was achieved in 29 patients (72.5%) at 4 months post-RT. At a median follow-up of 22 months, 11 patients experiencing recurrence (6 in-field). The median OS was 42 months (95% CI: ±8). Toxicities were manageable, with CEMI-related skin effects observed in 22% of Group 1 and 27.5% of Group 2, and pneumonitis reported in 5% of Group 2. Additionally, one case of G3 acute mucositis was reported in Group 1 and one case of G3 dermatitis in Group 2, both related to RT Results: A total of 72 patients (median age: 78, ECOG 0-1: 78%) were included.