Seven patients with advanced locoregional or metastatic squamous cell carcinoma of the skin were treated with cis-daimminedichloroplatin (cisplatin) and 5fluorouracil(5-FU). Responses were seen in six of seven patients (three partial responses [PR] and three complete responses [CR]). One patient is alive and diseasefree at 2 years. These results indicate that cisplatin and 5-FU is an effective combination regimen that should be used in future clinical trials in squamous cell carcinoma of the skin. Cancer 67:2030-2032,1991.
UTANEOUS SQUAMOUS CELL CARCINOMA is the SeC-C ond most common form of skin cancer.' Ninety percent of these patients are cured by surgery and/or radiation therapy, which appear to be equally effective. Metastasis is uncommon and is seen in only 5% to 10% of patients2; thus, systemic chemotherapy is rarely used in the treatment of this tumor. However, disease that occurs in antecedent scars, mucocutaneous junctions, immunosuppressed patients, and poorly differentiated tumors does metastasi~e,~ both to the regional lymph nodes and systemically, raising the need for systemic therapy. 5-Fluorouracil (5-FU) is an effective topical chemotherapeutic agent for proliferative lesions in the skin, and the activity of 5-FU may relate to the higher thymidylate synthase activity seen in squamous cell carcinoma cell lines.4 Cis-daimminedichloroplatin (cisplatin) has been shown to have activity in squamous cell carcinoma, both in animal models5 and in Phase I1 studies.6 Because the combination of cisplatin and 5-FU is synergistic in a number of in vivo and in vitro tumor models,7 we hypothesized that this regimen would be effective in the treatment of squamous cell carcinoma of the skin.