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Checking Checkpoint Inhibitor Effectiveness in Immunocompromised Patients With Advanced Skin Cancer

By: Celeste L. Dixon
Posted: Wednesday, August 4, 2021

Patients with advanced cutaneous squamous cell carcinoma who are immunosuppressed and/or immunocompromised appear to tolerate cemiplimab-rwlc as well as other patients with this type of advanced skin cancer who do not have immunologic issues, and it seems to be as effective and safe in them as well. These results emerged from the analysis of an initial cohort of the CASE study and were presented during the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 9547) by Guilherme Rabinowits, MD, of Miami Cancer Institute, and colleagues.

CASE is a prospective, real-world, multicenter, longitudinal study evaluating the effectiveness, safety, quality of life, and survivorship in patients with advanced cutaneous squamous cell carcinoma being treated with cemiplimab. Relatively little is known about how safe and effective cemiplimab and other immune checkpoint inhibitors are in patients who are immunocompromised or immunosuppressed; the reason, in fact, is that generally they tend to be excluded from clinical trials, noted the team.

The responses of 19 patients who fit this category and became CASE enrollees prior to their third cemiplimab dose were assessed by investigators. They found that one patient had a complete response and eight had partial responses, for an overall response rate of 47%. Although 23% of patients experienced immune-related adverse events, none resulted in death, reported Dr. Rabinowits and co-researchers. The median duration of cemiplimab exposure was 14 months, and patients received a 350-mg dose intravenously every 3 weeks.

Immunosuppressed and/or immunocompromised patients are at increased risk for solid tumors and cutaneous malignancies; in this study, patients had had solid organ transplants, autoimmune disorders, or hematologic malignancies. “Further follow-up and additional data would add to our general understanding of [the] safety and effectiveness of anti–PD-1 therapy in immunocompromised and/or immunosuppressed patient populations overall,” noted the investigators.

Disclosure: The study authors’ disclosure information can be found at coi.asco.org.



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