Real-Life Study of the Benefit of Concomitant Radiotherapy with Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma (cSCC): A Retrospective Cohort Study

Abstract

Background: Cemiplimab is a monoclonal antibody targeting the PD-1, and phase II trials have shown its efficacy in the treatment of advanced cutaneous squamous cell carcinoma in patients who are not candidates for curative surgery or radiation therapy as a first- or later-line treatment. A synergistic antitumoral response has been demonstrated with concurrent radiotherapy and PD1-immunotherapy. However, no real-life study has demonstrated this effect in advanced cutaneous squamous cell carcinoma. Methods: We conducted a real-life retrospective cohort study to investigate the benefit of concomitant therapy in 33 patients treated with cemiplimab at the University Hospital of Caen, alone (C group) or concomitant to radiotherapy (C/RT group). Our primary objectives were to evaluate the best overall response and objective response rate. Our secondary objectives were the disease control rate, median time to response, progression-free survival, overall survival, clinical benefit of radiotherapy, and safety data. After stopping cemiplimab administration, we performed a follow-up of our patients and performed a descriptive study. Results: We reported an objective response rate of 45.5%, including 47.6% in the cemiplimab group versus 41.6% in the concomitant group. The addition of radiotherapy to cemiplimab enables an earlier clinico-radiological response, with a median duration of 5.5 months in the cemiplimab group versus 3 months in the concomitant therapy group. The response to treatment was prolonged despite discontinuation of cemiplimab, with 91.6% (n = 11/12) and 83.3% (n = 10/12) patients in complete or partial remission at 6 months and 1 year after cessation of cemiplimab and no switch to another oncological treatment, respectively. Radiation therapy also provided a therapeutic effect in 83.3% of the patients in the concomitant group, without increasing the occurrence of adverse events. Conclusions: Our study confirms the efficacy of cemiplimab and radiotherapy in the management of advanced cutaneous squamous cell carcinoma. Concomitant therapy permitted to obtain an earlier radiological response, a beneficial local therapeutic effect of radiotherapy, without any safety alert.

Cemiplimab for the Treatment of Advanced Cutaneous Squamous Cell Carcinoma: Appropriate Patient Selection and Perspectives

“…However, the combination therapy group demonstrated an earlier radiologic disease response, with a median duration of 3 months (versus 5.5 months in the monotherapy group) and a prolonged treatment response even after discontinuation of PD-1 blockade. 26 …”

“…However, the combination therapy group demonstrated an earlier radiologic disease response, with a median duration of 3 months (versus 5.5 months in the monotherapy group) and a prolonged treatment response even after discontinuation of PD-1 blockade. 26 Several studies evaluated unique scenarios, such as the use of cemiplimab to treat periorbital CSCC, CSCC with large caliber PNI, and CSCC in SOTRs. For periorbital CSCC, treatment with cemiplimab resulted in response rates between 82% and 100% and negated the need for orbital exenteration in most cases.…”

Monoclonal antibodies for the treatment of squamous cell carcinoma: A literature review

“…In this study, the observed objective response rate was 47.6 in Cemiplimab consumption versus 41.6 in combined treatment. The simultaneous use of radiotherapy and Cemiplimab (3 months) caused a faster clinical‐radiological response than the use of Cemiplimab alone (5.5 months) 157 …”

“…The simultaneous use of radiotherapy and Cemiplimab (3 months) caused a faster clinical‐radiological response than the use of Cemiplimab alone (5.5 months). 157 …”

A Retrospective Study of Cemiplimab Effectiveness in Elderly Patients with Squamous Cell Carcinoma of the Skin: Insights from a Real-Life Scenario

“…Cemiplimab, a monoclonal antibody targeting the programmed death 1 (PD-1) receptor, has exhibited substantial potential in the management of advanced SCC [ 5 ]. However, the real-world effectiveness of this therapeutic agent, especially within distinct patient populations and varied clinical scenarios, remains a subject of paramount interest [ 6 ].…”