Recent Trends in the Integrated Management of Cutaneous Squamous Cell Carcinoma
Round 1
Reviewer 1 Report
Dear Editors,
Dear author,
the review entitled "Recent trends in integrated management of cutaneous squamous cell carcinoma" by Piyu Parth Naik is well structured and clearly written. Maybe, an outlook for upcoming treatment options and unmet medical needs especially in terms of risk stratification could have improved the underlying work. Nevertheless, it presents concisely recent aspects and concepts of SCC management. Therefore, it is of relevance and should be published.
Author Response
Responding to reviewer’s comments for the manuscript
Date: 16-6-2022
To
Editor and reviewer 1
Dermato
Dear Editor and reviewer 1,
Sub: Responding to reviewer 1’s comments for the manuscript.
Thank you for giving me the opportunity to submit a revised review manuscript titled “Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” to the prestigious “Dermato Journal”. I appreciate the time and effort that you have dedicated to providing your valuable feedback on my manuscript. I am grateful to you for insightful comments on the manuscript. I have incorporated the requested changes to reflect all suggestions provided. I have highlighted the changes within the manuscript with green color ink. Here is a point-by-point response to all comments.
Editor
Comment: An outlook for upcoming treatment options and unmet medical needs especially in terms of risk stratification could have improved the underlying work
Response: Thank you for your valuable comment and suggestion. I have updated the upcoming novel treatment section with new information and references. I have also added the section of unmet medical with addition of contemporary information on risk stratification.
Again, thank you for giving me this opportunity to revise and re-submit this manuscript. I look forward to hearing from you about my manuscript.
Sincerely,
Dr. Piyu Parth Naik,
M.D.(Dermatology), SCE Dermatology (UK), UEMS-European Board of Dermatology & Venereology (UEMS-EBDV)
Specialist dermatologist and medical director,
Department of dermatology, Saudi German hospital, and clinic, Opposite Burj Al Arab, Dubai, United Arab Emirates.
+971503725616
ORCID: 0000-0002-6499-4062
Reviewer 2 Report
The aim of this paper, entitled Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” is evaluated and summarized contemporary knowledge of various management options for cSCC
Given the frequency of this cutaneous neoplasms and the consequent significant impact on daily clinical activity, the topic is of interest. However, the work presents numerous critical issues that require an extensive revision before it can be considered for publication.
The main criticisms are as follows:
In the histopathology section, microscopic features that affect patient prognosis should be specified.
Since this is a review, that may not be aimed exclusively at specialists, I would suggest using a clinical image in addition to the dermoscopic one in reference to the paragraph on diagnosis (Figure 1).
The role of Mohs surgery in the treatment of squamous cell carcinoma is not fully clarified, and therefore should be better discussed and supported by adequate references.
About target therapies, some data on approval times and reimbursement criteria in different countries should be given.
There are few typographical errors that should be corrected.
Author Response
Responding to reviewer 2’s comments for the manuscript
Date: 16-6-2022
To
Editor and reviewer 2
Dermato
Dear Editor and reviewer 2,
Sub: Responding to reviewer 2’s comments for the manuscript.
Thank you for giving me the opportunity to submit a revised review manuscript titled “Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” to the prestigious “Dermato Journal”. I appreciate the time and effort that you have dedicated to providing your valuable feedback on my manuscript. I am grateful to you for insightful comments on the manuscript. I have incorporated the requested changes to reflect all suggestions provided. I have highlighted the changes within the manuscript with green color ink. Here is a point-by-point response to all comments.
Editor
Comment: In the histopathology section, microscopic features that affect patient prognosis should be specified.
Response: Thank you for your valuable comment and suggestion. I have updated the risk stratification section with addition of information on microscopic features that affect patient prognosis. I have also highlighted the features in table 1.
Comment: Since this is a review, that may not be aimed exclusively at specialists, I would suggest using a clinical image in addition to the dermoscopic one in reference to the paragraph on diagnosis (Figure 1).
Response: Thank you for your valuable comment and suggestion. I have added new clinical picture and corresponding dermoscopy image.
Comment: The role of Mohs surgery in the treatment of squamous cell carcinoma is not fully clarified, and therefore should be better discussed and supported by adequate references.
Response: Thank you for your valuable comment and suggestion. I have updated the Mohs surgery section. I have added the post-MMS clinical picture.
Comment: About target therapies, some data on approval times and reimbursement criteria in different countries should be given.
Response: Thank you for your valuable comment and suggestion. I have added this information in the targeted therapy section.
Comment: There are few typographical errors that should be corrected.
Response: Thank you for your valuable comment and suggestion. I have corrected the typographical errors.
Again, thank you for giving me this opportunity to revise and re-submit this manuscript. I look forward to hearing from you about my manuscript.
Sincerely,
Dr. Piyu Parth Naik,
M.D.(Dermatology), SCE Dermatology (UK), UEMS-European Board of Dermatology & Venereology (UEMS-EBDV)
Specialist dermatologist and medical director,
Department of dermatology, Saudi German hospital, and clinic, Opposite Burj Al Arab, Dubai, United Arab Emirates.
+971503725616
ORCID: 0000-0002-6499-4062
Round 2
Reviewer 2 Report
Post-operative clinical picture of MMS is not necessary
Author Response
Responding to reviewer 2’s comment for the manuscript
Date: 17-6-2022
To
Editor and reviewer 2
Dermato
Dear Editor and reviewer 2,
Sub: Responding to reviewer 2’s comment for the manuscript.
Thank you for giving me the opportunity to submit a revised review manuscript titled “Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” to the prestigious “Dermato Journal”. I appreciate the time and effort that you have dedicated to providing your valuable feedback on my manuscript. I am grateful to you for insightful comment on the manuscript. I have incorporated the requested change to reflect all suggestions provided.
Comment: Post-operative clinical picture of MMS is not necessary
Response: Thank you for your valuable comment and suggestion. I have removed the post-operative clinical picture.
Again, thank you for giving me this opportunity to revise and re-submit this manuscript. I look forward to hearing from you about my manuscript.
Sincerely,
Dr. Piyu Parth Naik,
M.D.(Dermatology), SCE Dermatology (UK), UEMS-European Board of Dermatology & Venereology (UEMS-EBDV)
Specialist dermatologist and medical director,
Department of dermatology, Saudi German hospital, and clinic, Opposite Burj Al Arab, Dubai, United Arab Emirates.
+971503725616
ORCID: 0000-0002-6499-4062
This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.
Round 1
Reviewer 1 Report
The manuscript by Piyu Parth Naik, entitled "Recent trends in integrated management of cutaneous squamous cell carcinoma", reports the latest management options for cutaneous squamous cell carcinoma.
Overall, the review manuscript seems to be well organized and referred to the almost latest literature. I found it useful to have a short but quick reference to cSCC management.
Minor: please consider to use cSCC or CSCC. Please explain some abbreviations, such as PFS or NCNN. Also, some English editing should be done ("sumarized", "simplyfy", etc are not correct words).
Author Response
Responding to reviewer’s comments for the manuscript
Dear Editor-in-chief and reviewer 1,
Sub: Responding to reviewer’s comments for the manuscript.
Thank you for giving me the opportunity to submit a revised review manuscript titled “Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” to the prestigious “Dermato Journal”. I appreciate the time and effort that you have dedicated to providing your valuable feedback on my manuscript. I am grateful to you for insightful comments on the manuscript. I have incorporated the requested changes to reflect all suggestions provided. I have highlighted the changes within the manuscript with red color ink. Here is a response to the comment.
REVIEWER 1
Comment:
Please consider to use cSCC or CSCC. Please explain some abbreviations, such as PFS or NCNN. Also, some English editing should be done ("sumarized", "simplyfy", etc are not correct words).
Response:
Thank you for your suggestion. I have modified CSCC to “cSCC” and the same has been followed throughout the manuscript. The English editing has been checked by the author as well as editing team and are corrections are made as per suggestions.
Again, thank you for giving me this opportunity to revise and re-submit this manuscript. I look forward to hearing from you about my manuscript.
Sincerely,
Dr. Piyu Parth Naik,
M.D.(Dermatology), SCE Dermatology (UK), UEMS-European Board of Dermatology & Venereology (UEMS-EBDV)
Specialist dermatologist and medical director,
Department of dermatology, Saudi German hospital, and clinic, Opposite Burj Al Arab, Dubai, United Arab Emirates.
+971503725616
ORCID: 0000-0002-6499-4062
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Overall impression: In this narrative review, the author summarizes current treatment options for SCCs. This is not a very novel thing to do, but can provide a good overview. However, the structure of the manuscript is a bit chaotic and more thorough discussion appears necessary.
Specific points:
- Throughout the manuscript, please be consistent with the abbreviation cSCC – decide for either cSCC or CSCC.
- Despite the language editing cited in the acknowledgements, there are some typos and orthographic errors that should be corrected. Some wording is awkward, e.g. “meager” in line 42, “protracted” in line 55, “triggering boulevards” in line 108, “Set IV infusion” in line 265
- Abstract, line 12: “Other drugs have been used […]” Unclear what “other” refers to here, since no drugs were mentioned before, only surgery.
- Introduction:
- This section is very short. Some parts that are currently found in other sections should be moved here to build a more thorough background for the reader.
- The numbers and wording regarding prevalences require careful revision (e.g., development and prediction in lines 24-25, and ten-year survival 90% – this is not what is in the reference [5] that is cited here).
- Histopathologic Subtypes
- Would be helpful to also have the distinction of head and neck SCC here. Worth mentioning risk factors beyond sun-exposure: HCT, immunosuppression, and certain genodermatoses (XP, EB).
- It would be important to cite the latest ASCO classification and include tumor depth, differentiation/invasion.
- Clinical Diagnosis and Secondary Prevention
- Not sure why these two are under one subheading – secondary prevention would make more sense after the therapy?
- Differentiation (line 56) is not clinical appearance, but a histopathologic feature.
- Lines 62-67: This is not helping the article’s aim to review “recent trends in therapy” and could be left out.
- Management
- This section needs an introductory paragraph and a more logical order of the subsections.
- 1.1: Line 77: “Because […]” – The reason that physicians chose surgical excision is not that it is an outpatient procedure, but that it is the most effective option to get rid of the tumor entirely for the vast majority of patients!
- Line 85: “margins of at least 15 mm […]” needs a reference
- I do not agree with the author that Moh’s surgery is the more precise option. Moh’s surgery is only performed in some countries, while other prefer the method of histologically controlled excisions, in which FFPE tissue is assessed within one day and surgery continues, during an inpatient stay. The availability of MMS should be discussed, and also the limitation of reduced validity of frozen sections in contrast to FFPE sections.
- BRAF Inhibitors and cSCC: Lines 102-109 sound more like introduction. Lines 128-142 also is background and doesn’t help the understanding in its current form. I don’t understand why the author starts the section of targeted therapies with a therapy that is not used in SCCs, but appears to increase the risk? Strongly suggest to reorder and rewrite.
- Line 123: “COX-2 drugs” should be “Anti-COX-2 drugs”
- 3. Adjuvant treatment for high-risk patients: Lines 147-148: These sentences don’t fit together, please revise. The section should be moved further to the back.
- 4. Radiation therapy
- Line 161/162: “primary therapeutic option” – does the author really mean therapeutic as stand-alone? I assume neo-adjuvant is meant here. In any case, this needs a reference.
- Lines 164-165: Rethink wording/sentence structure – it is really two things here, 1. Dedication, 2. No histology. Two sentences would be better.
- 5. Immunotherapy
- Lines 171 ff: This has to be carefully revised! The problem is that neoplasms disguise and are not fought by the body’s immune system, and anti-PD-1-antibodies make them accessible to the immune system.
- Line breaks are needed in line 198 before “Cemiplimab” and in line 212 before “The most common […]”.
- Table 1: Please state the date and source of the information
- 4.6. Sentinel lymph node biopsy: This is a diagnostic method, not a therapy, and should be moved. The author mentions T1-T4 stages here, but these have not been explained previously.
- 4.7. Systemic treatments for advanced sSCC – why does this come here? These have been covered already. But I like this subheading, because it makes clear that immunotherapies are not for every cSCC, but only for advanced cases.
- Line 251: “curative goal for advanced SCC” – really?
- Lines 255 ff: Repetition to previous section
- Line 263: By “pivotal experiment”, does the author mean a pilot study?
- Line 267 “median duration of response was not reached” – what would that have been and why was it not reached?
- Line 273: EGFR inhibitors: Now these deserve an extra paragraph and some references!
- Line 277 ff, risk stratification: This is helpful and should be more prominently positioned. I would advise to additionally point to special situations/indications, such as immunosuppressed/post-transplant patietns and certain genodermatoses
- Table 2: Is this the author’s original work? If adapted from somewhere, please give the reference.
- Figure 2: Is this the author’s original work? If note, please cite. What do the colors mean and are they all necessary? Abbreviations need to be explained in the legend.
- 5. Conclusion
- Line 284: “An exceptional understanding of the molecular foundations of cSCC has aided the development of novel treatments […]” –this is not really evident from this paper!
- Line 289: “our review” – I thought it is only one author?
Author Response
Responding to reviewer 2’s comments for the manuscript
Dear Editor-in-chief and reviewer 2,
Sub: Responding to reviewer 2’s comments for the manuscript.
Thank you for giving me the opportunity to submit a revised review manuscript titled “Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” to the prestigious “Dermato Journal”. I appreciate the time and effort that you have dedicated to providing your valuable feedback on my manuscript. I am grateful to you for insightful comments on the manuscript. I have incorporated the requested changes to reflect all suggestions provided. I have highlighted the changes within the manuscript with red color ink. Here is a point-by-point response to all comments.
REVIEWER 2
Comment: Throughout the manuscript, please be consistent with the abbreviation cSCC – decide for either cSCC or CSCC.
Response: Thank you for your suggestion. I have modified CSCC to “cSCC” and the same has been followed throughout the manuscript now.
Comment: Despite the language editing cited in the acknowledgments, there are some typos and orthographic errors that should be corrected. Some wording is awkward, e.g., “meager” in line 42, “protracted” in line 55, “triggering boulevards” in line 108, “Set IV infusion” in line 265.
Response: Thank you for your comment. The English editing has been checked by the editing team and the author and corrections are made as per all suggestions and highlighted.
Comment: Abstract, line 12: “Other drugs have been used […]” Unclear what “other” refers to here, since no drugs were mentioned before, only surgery.
Response: Thank you for your comment. This sentence has been rewritten to propagate the message.
Comment:
Introduction:
- This section is very short. Some parts that are currently found in other sections should be moved here to build a more thorough background for the reader.
- The numbers and wording regarding prevalences require careful revision (e.g., development and prediction in lines 24-25, and ten-year survival 90% – this is not what is in the reference [5] that is cited here).
Response: Thank you for your comments and suggestions. The introduction part has been enhanced with more points as per your suggestion. I have edited and correctly cited the reference now.
Comment:
Histopathologic Subtypes
- Would be helpful to also have the distinction of head and neck SCC here. Worth mentioning risk factors beyond sun-exposure: HCT, immunosuppression, and certain genodermatoses (XP, EB).
- It would be important to cite the latest ASCO classification and include tumor depth, differentiation/invasion.
Response: Thank you for your comments and suggestions. I have these details in the revised version.
Comment:
Clinical Diagnosis and Secondary Prevention
- Not sure why these two are under one subheading – secondary prevention would make more sense after the therapy?
- Differentiation (line 56) is not clinical appearance, but a histopathologic feature.
- Lines 62-67: This is not helping the article’s aim to review “recent trends in therapy” and could be left out.
Response: Thank you for your comments and suggestions. Subheading has been rewritten and the suggested lines were removed.
Comment: Management - This section needs an introductory paragraph and a more logical order of the subsections
Response: Thank you for your comment and suggestion. Subsections were checked and restructured.
Comment: Line 77: “Because […]” – The reason that physicians chose surgical excision is not that it is an outpatient procedure, but that it is the most effective option to get rid of the tumor entirely for the vast majority of patients!
Response: Thank you for your comment and suggestion. The changes have been made as per your suggestion
Comment: “margins of at least 15 mm […]” needs a reference.
Response: Thank you for your comment and suggestion. Reference has been added.
Comment: I do not agree with the author that Moh’s surgery is the more precise option. Moh’s surgery is only performed in some countries, while other prefer the method of histologically controlled excisions, in which FFPE tissue is assessed within one day and surgery continues, during an inpatient stay. The availability of MMS should be discussed, and also the limitation of reduced validity of frozen sections in contrast to FFPE sections.
Response: Thank you for your comments and suggestions. The advantages of MMS and limitations of FFPE have been added.
Comment: BRAF Inhibitors and cSCC: Lines 102-109 sound more like introduction. Lines 128-142 also is background and doesn’t help the understanding in its current form. I don’t understand why the author starts the section of targeted therapies with a therapy that is not used in SCCs, but appears to increase the risk? Strongly suggest to reorder and rewrite.
Response: Thank you for your comments and suggestions. Restructured and rewritten as per your suggestion.
Comment: Line 123: “COX-2 drugs” should be “Anti-COX-2 drugs”
Response: Thank you for pointing this out. I have corrected this sentence.
Comment: Adjuvant treatment for high-risk patients: Lines 147-148: These sentences don’t fit together, please revise. The section should be moved further to the back.
Response: Thank you for your comment and suggestion. Moved as per your suggestion.
Comment: Line 161/162: “primary therapeutic option” – does the author really mean therapeutic as stand-alone? I assume neo-adjuvant is meant here. In any case, this needs a reference.
Response: Thank you for your comment and suggestion. Reference has been added.
Comment: Lines 164-165: Rethink wording/sentence structure – it is really two things here, 1. Dedication, 2. No histology. Two sentences would be better.
Response: Thank you for your comment and suggestion. The sentence was rewritten as per your suggestion.
Comment: Lines 171 ff: This has to be carefully revised! The problem is that neoplasms disguise and are not fought by the body’s immune system, and anti-PD-1-antibodies make them accessible to the immune system.
Response: Thank you for your comment and suggestion. The lines were revised and rewritten.
Comment: Line breaks are needed in line 198 before “Cemiplimab” and in line 212 before “The most common […]”.
Response: Thank you for your comment and suggestion. The paragraphs were broken as per your suggestion.
Comment: Table 1: Please state the date and source of the information
Response: Thank you for your comment and suggestion. I have cited the detail now.
Comment: Sentinel lymph node biopsy: This is a diagnostic method, not a therapy, and should be moved. The author mentions T1-T4 stages here, but these have not been explained previously.
Response: Thank you for your comment and suggestion. Explained and the paragraph was moved to diagnostic section as per your suggestion.
Comment: Systemic treatments for advanced sSCC – why does this come here? These have been covered already. But I like this subheading, because it makes clear that immunotherapies are not for every cSCC, but only for advanced cases.
Response: Thank you for your comments.
Comment: Line 251: “curative goal for advanced SCC” – really?
Response: The author aims at describing it as a goal for curing cSCC and hence, the same has been mentioned.
Comment: Lines 255 ff: Repetition to the previous section
Response: Thank you for your comment and suggestion. I have removed the repeated section.
Comment: Line 263: By “pivotal experiment”, does the author mean a pilot study?
Response: Thank you for your comment. The author describes it as a pivotal experiment, as per the citation referred.
Comment: Line 267 “median duration of response was not reached” – what would that have been and why was it not reached?
Response: Thank you for your comment. The reason has been explained as per referred article.
Comment: Line 273: EGFR inhibitors: Now these deserve an extra paragraph and some references!
Response: Thank you for your comment and suggestion. I have added.
Comment: Line 277 ff, risk stratification: This is helpful and should be more prominently positioned. I would advise to additionally point to special situations/indications, such as immunosuppressed/post-transplant patients and certain genodermatoses.
Response: Thank you for your comment and suggestion The risk stratification has been made prominent by providing separate sub-heading. Points related to immunosuppression and genodermatoses risk stratification are added and highlighted as per suggestion.
Comment: Table 2: Is this the author’s original work? If adapted from somewhere, please give the reference.
Response: Thank you for pointing this out. I have adapted this figure from reference number 103. I have added the reference in figure 2 ligand.
Comment: Figure 2: Is this the author’s original work? If note, please cite. What do the colors mean and are they all necessary? Abbreviations need to be explained in the legend.
Response: Thank you for pointing this out. I have adapted this figure from reference number 103. I have added the abbreviations in figure 2 ligand. Colors do not signify anything and added to develop photographic memory in readers.
Comment: Line 284: “An exceptional understanding of the molecular foundations of cSCC has aided the development of novel treatments […]” –this is not really evident from this paper!
Response: Thank you for pointing this out. I have edited this line.
Comment: Line 289: “our review” – I thought it is only one author?
Response: Thank you for pointing this out. I have edited this line.
Again, thank you for giving me this opportunity to revise and re-submit this manuscript. I look forward to hearing from you about my manuscript.
Sincerely,
Dr. Piyu Parth Naik,
M.D.(Dermatology), SCE Dermatology (UK), UEMS-European Board of Dermatology & Venereology (UEMS-EBDV)
Specialist dermatologist and medical director,
Department of dermatology, Saudi German hospital, and clinic, Opposite Burj Al Arab, Dubai, United Arab Emirates.
+971503725616
ORCID: 0000-0002-6499-4062
Author Response File: Author Response.pdf
Reviewer 3 Report
This is a review paper on the current treatment of cutaneous squamous cell carcinoma (SCC). Overall the paper is well written. I would like to raise the following minor concerns.
1, Table 1. Listed drugs are not for immunotherapy, but for target therapy.
2, Brief discussion on potential use of other target therapies and antibody-drug conjugates will be interesting.
3, Figure 2. Is this an authors' opinion? If not, refer to the original article.
Author Response
Responding to reviewer 3’s comments for the manuscript
Dear Editor-in-chief and reviewer 3,
Sub: Responding to reviewer 3’s comments for the manuscript.
Thank you for giving me the opportunity to submit a revised review manuscript titled “Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” to the prestigious “Dermato Journal”. I appreciate the time and effort that you have dedicated to providing your valuable feedback on my manuscript. I am grateful to you for insightful comments on the manuscript. I have incorporated the requested changes to reflect all suggestions provided. I have highlighted the changes within the manuscript with red color ink. Here is a point-by-point response to the comments.
REVIEWER 3
Comment: Table 1. Listed drugs are not for immunotherapy, but for target therapy.
Response: Modified as per your suggestion.
Comment: Brief discussion on potential use of other target therapies and antibody-drug conjugates will be interesting.
Response: Thank you for your suggestion. Few lines on the antibody-drug conjugates were added.
Comment: Figure 2. Is this an authors' opinion? If not, refer to the original article.
Response: Thank you for pointing this out. I have adapted this figure from reference number 103. I have cited the reference in figure 2 ligand.
Sincerely,
Dr. Piyu Parth Naik,
M.D.(Dermatology), SCE Dermatology (UK), UEMS-European Board of Dermatology & Venereology (UEMS-EBDV)
Specialist dermatologist and medical director,
Department of dermatology, Saudi German hospital, and clinic, Opposite Burj Al Arab, Dubai, United Arab Emirates.
+971503725616
ORCID: 0000-0002-6499-4062
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
Unfortunately, the revision did, if at all, only marginally improve this paper. The detailed comments and errors pointed out where only in part, superficially, or poorly addressed and corrected. As a reader looking for an overview on cSCC treatment, I would be confused after reading this paper and wouldn’t have gained a concept on what to do and what is in the pipeline.
From the experience with this first revision, I feel it is wasted energy to list all the items that need further revision here in detail, as already in the first round they were not addressed. In brief: The manuscript requires heavy restructuring and editing (order of sections, uniformity in subheadings and their hierarchy). Especially the order of systemic therapies doesn’t make sense – start with what is approved and then go to experimental ones as an outlook (the sonic-hedgehog inhibitor section doesn’t even mention a drug or compound underway?!), and then lots of the information is misleading, repetitive, and appears under different subheadings (e.g. pembrolizumab). Still, cetuximab as one of the few approved systemic medications does not have a section and heading. The therapeutic approaches that the author deems as preventative should be labeled as such; consider grouping these. In several parts, the text still lacks references. Many of the critic with missing/wrong information and sentences remains.
Line 124/125: “These clinical practice guidelines offer evidence-based therapy and management advice for patients with cSCC.” I hope the author is not talking about his/her review – this is not a GCP, and needs a lot of work before it can provide helpful advice for patients.
Regarding the Table 1: Has this been updated by the author – it is from 2020?
Regarding Figure 1: Now the author has given a reference for this, and says it is an adaption. I looked at the original figure and I find the flowchart there is very different, and recommendations differ as well.
Author Response
Responding to reviewer 2’s comments for the manuscript
Date: 16-5-2022
To
Editor-in-Chief and reviewer 2
Dermato
Dear Editor-in-chief and reviewer 2,
Sub: Responding to reviewer 2’s comments for the manuscript.
Thank you for giving me the opportunity to re-submit a revised review manuscript titled “Recent Trends in Integrated Management of Cutaneous Squamous Cell Carcinoma” to the prestigious “Dermato Journal”. I appreciate the time and effort that you have dedicated to providing your valuable feedback on my manuscript. I am grateful to you for insightful comments on the manuscript. I have incorporated the requested changes to reflect all suggestions provided. I have highlighted the changes within the manuscript with red color ink. Here is a point-by-point response to all comments.
REVIEWER 2
Comment: The manuscript requires heavy restructuring and editing (order of sections, uniformity in subheadings and their hierarchy).
Response: Thank you for your valuable comment and suggestion. The manuscript has been restructured and heavily edited for flow and grammar. The hierarchy has been modified for uniformity.
Comment: Especially the order of systemic therapies doesn’t make sense – start with what is approved and then go to experimental ones as an outlook (the sonic-hedgehog inhibitor section doesn’t even mention a drug or compound underway?!), and then lots of the information is misleading, repetitive, and appears under different subheadings (e.g. pembrolizumab).
Response: Thank you for your valuable comments and suggestions. The manuscript has been restructured and heavily edited for flow and grammar. The hierarchy has been modified for uniformity. The sonic-hedgehog inhibitor section been updated. Approved medication has been added.
Comment: Still, cetuximab as one of the few approved systemic medications does not have a section and heading. The therapeutic approaches that the author deems as preventative should be labeled as such; consider grouping these. In several parts, the text still lacks references. Many of the critic with missing/wrong information and sentences remains.
Response: Thank you for your comments and suggestions. I have added the new section for cetuximab – EGFR inhibitor. New references have been added and the sentences have been checked.
Comment: Line 124/125: “These clinical practice guidelines offer evidence-based therapy and management advice for patients with cSCC.” I hope the author is not talking about his/her review – this is not a GCP, and needs a lot of work before it can provide helpful advice for patients. Response: Thank you for your comments and suggestions. The lines have been removed as per your suggestion.
Comment: Regarding the Table 1: Has this been updated by the author – it is from 2020?
Response: Thank you for your comment. I have removed the table.
Comment: Regarding Figure 1: Now the author has given a reference for this, and says it is an adaption. I looked at the original figure and I find the flowchart there is very different, and recommendations differ as well.
Response: Thank you for your comment. I have removed the figure.
Again, thank you for giving me this opportunity to revise and re-submit this manuscript. I look forward to hearing from you about my manuscript.
Sincerely,
Dr. Piyu Parth Naik,
M.D.(Dermatology), SCE Dermatology (UK), UEMS-European Board of Dermatology & Venereology (UEMS-EBDV)
Specialist dermatologist and medical director,
Department of dermatology, Saudi German hospital, and clinic, Opposite Burj Al Arab, Dubai, United Arab Emirates.
+971503725616
ORCID: 0000-0002-6499-4062
Author Response File: Author Response.pdf
