Cetuximab-based management of metastatic cutaneous squamous cell carcinoma in a heart transplant recipient: A case report and literature review

Background: Solid organ transplant recipients face a higher risk of cutaneous squamous cell carcinoma (cSCC) due to long-term immunosuppression. Managing metastatic cSCC in these patients is challenging because immune checkpoint inhibitors (ICIs) may cause graft rejection. Case Presentation: A 67-year-old male heart transplant recipient developed multiple cSCCs with lung metastases during his illness. After surgery and radiotherapy, disease progression prompted systemic therapy with carboplatin and cetuximab. The patient achieved a complete metabolic response after seven cycles, with no graft rejection or severe side effects. Cetuximab maintenance therapy sustained the response. Conclusion: Cetuximab offers a safe and effective treatment for advanced cSCC in heart transplant recipients, avoiding the risks of ICIs. This case shows that Cetuximab can be a good alternative treatment.