Cemiplimab + RP1 for Advanced Squamous Skin Cancer

(CERPASS Trial)

Not currently recruiting at 82 trial locations

Overseen By Clinical Trials at Replimune

Age: 18+

Sex: Any

Trial Phase: Phase 2

Sponsor: Replimune Inc.

Must not be taking: Anti-herpetics, Immunosuppressives

Disqualifiers: Autoimmune disease, Hepatitis, HIV, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Prior Safety Data This treatment has passed at least one previous human trial

Approved in 4 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effectiveness of cemiplimab alone versus its combination with RP1 (an experimental treatment) for individuals with advanced squamous skin cancer. Researchers aim to determine the response rate among patients receiving these treatments. The trial seeks participants with squamous cell skin cancer that is inoperable or unresponsive to radiation and have at least one measurable and treatable tumor. As a Phase 2 trial, this research focuses on assessing the treatment's efficacy in an initial, smaller group of participants.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you need to use certain antiviral medications or have had specific treatments like PD-1/PD-L1 blockers. It's best to discuss your current medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that cemiplimab is generally safe for people. In studies, most patients experienced manageable side effects such as tiredness or a rash, while serious side effects were rare. When combined with RP1, the safety profile remained similar, with no significant increase in severe side effects. This suggests that using them together does not add much extra risk. Additionally, cemiplimab is already approved for other conditions, which supports its safety. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatments?

Researchers are excited about the combination of Cemiplimab and RP1 for advanced squamous skin cancer because it offers a fresh approach compared to standard treatments like surgery, radiation, or traditional chemotherapy. Unlike other treatments, Cemiplimab is an immunotherapy that works by enhancing the body's immune response to target and destroy cancer cells. When combined with RP1, an oncolytic virus that specifically infects and kills tumor cells, the treatment has the potential to significantly boost anti-cancer effects. This combination could offer a more targeted and effective option with the potential for better outcomes and fewer side effects than current therapies.

What evidence suggests that this trial's treatments could be effective for advanced squamous skin cancer?

Studies have shown that cemiplimab effectively treats cutaneous squamous cell carcinoma, a type of skin cancer. Research indicates it reduces the risk of cancer recurrence or death by 68%. Patients with advanced stages of this cancer have responded positively to the treatment. In this trial, some participants will receive cemiplimab as a single therapy. Researchers are also investigating the combination of cemiplimab with another drug, RP1, in a separate treatment arm to determine if it enhances effectiveness. Early results suggest this combination might improve outcomes. ^{2 5 6 7 8}

Who Is on the Research Team?

Moran Mishal, MD

Principal Investigator

Lead Medical Monitor

Jeannie Hou, MD

Principal Investigator

Secondary Medical Monitor

Are You a Good Fit for This Trial?

This trial is for adults with advanced squamous skin cancer who can't have or don't want surgery/radiotherapy. They should be relatively active (ECOG ≤1), expected to live more than 12 weeks, and able to provide a tumor sample. Not allowed if they've had certain previous treatments, active brain metastases, lung inflammation in the last 5 years, recent vaccines, herpes complications, need anti-herpetic drugs regularly, significant autoimmune disease treated with immunosuppressants within 5 years, or have hepatitis B/C or HIV.

Inclusion Criteria

Anticipated life expectancy >12 weeks

I have at least one tumor that can be measured and treated according to the study.

I agree to provide samples of my tumor for review.

Exclusion Criteria

I haven't had immune therapy for my condition in the last 3 years, except as part of initial treatment.

I do not have active hepatitis B, hepatitis C, or HIV.

I have had serious herpes infections or complications like eye or brain infections.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive cemiplimab monotherapy or cemiplimab in combination with RP1, administered every 3 weeks

12 weeks

4 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Cemiplimab
• RP1

Trial Overview The study compares two approaches: Cemiplimab alone versus combined with RP1 in patients with locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC). The main focus is on how well these treatments shrink tumors according to independent reviews.

How Is the Trial Designed?

Group I: Cemiplimab in combination with RP1 Experimental Treatment 2 Interventions

Cemiplimab administered intravenously every 3 weeks in combination with RP1 administered as an intratumoral injection every 3 weeks

Group II: Cemiplimab Active Control 1 Intervention

Cemiplimab administered intravenously as a single therapy every 3 weeks

Cemiplimab is already approved in European Union, United States, Canada, Brazil for the following indications:

Approved in European Union as Libtayo for:

• Cutaneous squamous cell carcinoma (CSCC)
• Non-small cell lung cancer (NSCLC)

Approved in United States as Libtayo for:

• Cutaneous squamous cell carcinoma (CSCC)
• Basal cell carcinoma (BCC)
• Non-small cell lung cancer (NSCLC)

Approved in Canada as Libtayo for:

• Cutaneous squamous cell carcinoma (CSCC)
• Non-small cell lung cancer (NSCLC)

Approved in Brazil as Libtayo for:

• Cutaneous squamous cell carcinoma (CSCC)

Who Is Running the Clinical Trial?

Replimune Inc.

Lead Sponsor

Trials

16

Recruited

1,700+

Regeneron Pharmaceuticals

Industry Sponsor

Trials

690

Recruited

948,000+

Founded

1988

Headquarters

Tarrytown, USA

Known For

Precision medicine

Top Products

Dupixent, EYLEA, Libtayo, Praluent

Leonard Schleifer

Regeneron Pharmaceuticals

Chief Executive Officer since 1988

MD and PhD in Medicine

George Yancopoulos

Regeneron Pharmaceuticals

Chief Medical Officer since 1997

MD from Harvard Medical School

Published Research Related to This Trial

Cemiplimab, a PD-1 targeting monoclonal antibody, demonstrated an objective response rate of 45.5% in a real-life study of 33 patients with advanced cutaneous squamous cell carcinoma, confirming its efficacy as a treatment option.

The addition of radiotherapy to cemiplimab resulted in a quicker response time, with a median duration of response of 5.5 months compared to 3 months for cemiplimab alone, and did not increase adverse events, indicating a safe and effective combination therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Real-Life Study of the Benefit of Concomitant Radiotherapy with Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma (cSCC): A Retrospective Cohort Study. Bailly-Caillé, B., Kottler, D., Morello, R., et al.[2023]

Cemiplimab, a PD-1 inhibitor, shows significant improvements in overall survival (OS) and progression-free survival (PFS) compared to EGFR inhibitors and pembrolizumab, with hazard ratios indicating a strong benefit.

In comparison to platinum-based chemotherapy, cemiplimab also demonstrated superior efficacy in improving overall survival for patients with advanced cutaneous squamous cell carcinoma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparative efficacy of cemiplimab versus other systemic treatments for advanced cutaneous squamous cell carcinoma. Keeping, S., Xu, Y., Chen, CI., et al.[2021]

Cemiplimab, an antibody treatment for locally advanced and metastatic cutaneous squamous cell carcinoma, shows promising efficacy with objective response rates between 32% and 77%, indicating it is a viable option for patients who cannot undergo surgery or radiation.

The treatment is generally safe and well-tolerated, with only 9.8% of patients experiencing adverse events severe enough to stop therapy, although there is a 3% risk of treatment-related death due to immune-mediated side effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cemiplimab for the Treatment of Advanced Cutaneous Squamous Cell Carcinoma: Appropriate Patient Selection and Perspectives. Mager, L., Gardeen, S., Carr, DR., et al.[2023]

Cemiplimab is the first FDA-approved treatment for patients with advanced cutaneous squamous cell carcinoma (CSCC) who cannot undergo curative surgery or radiation, demonstrating rapid and substantial antitumor efficacy in phase II clinical trials.

The treatment has an acceptable safety profile, with low rates of treatment discontinuation (7%) and death (3%), although current recommendations are based mainly on phase II data due to the lack of an approved comparator agent.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cemiplimab in advanced cutaneous squamous cell carcinoma. Naik, PP.[2022]

Cemiplimab demonstrated significant antitumor activity in patients with locally advanced cutaneous squamous cell carcinoma, with 44% of the 78 patients showing an objective response, including 13% achieving a complete response.

The treatment had an acceptable safety profile, with 44% of patients experiencing grade 3-4 adverse events, the most common being hypertension and pneumonia, and one treatment-related death due to aspiration pneumonia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial. Migden, MR., Khushalani, NI., Chang, ALS., et al.[2021]

Cemiplimab-rwlc (Libtayo) is an FDA-approved immunotherapy for advanced cutaneous squamous cell carcinoma (CSCC) that works by blocking the PD-1 receptor, enhancing the immune system's ability to fight tumors.

Clinical trials have shown that cemiplimab is effective in treating CSCC, although common side effects and safety issues were noted, highlighting the need for ongoing research to improve treatment outcomes and reduce toxicity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cemiplimab-rwlc as first and only treatment for advanced cutaneous squamous cell carcinoma. Ahmed, SR., Petersen, E., Patel, R., et al.[2019]

Cemiplimab (Libtayo®) is the first approved immunotherapy for patients with locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC) who cannot undergo surgery or radiotherapy, showing a clinically significant objective response rate in the phase II EMPOWER-CSCC 1 trial.

The treatment has a durable effect, with the median duration of response and overall survival not yet reached, and it has an acceptable safety profile, with manageable immune-related adverse events.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cemiplimab: A Review in Advanced Cutaneous Squamous Cell Carcinoma. Lee, A., Duggan, S., Deeks, ED.[2020]

Cemiplimab demonstrated a significant objective response rate of 46.1% in patients with advanced cutaneous squamous cell carcinoma (CSCC), with complete response rates of 20.3% for metastatic CSCC and 12.8% for locally advanced CSCC, indicating its efficacy as a treatment option.

Patients experienced durable improvements in quality of life and pain control, with significant enhancements observed as early as the second treatment cycle, highlighting the treatment's positive impact on overall well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Integrated analysis of a phase 2 study of cemiplimab in advanced cutaneous squamous cell carcinoma: extended follow-up of outcomes and quality of life analysis. Rischin, D., Khushalani, NI., Schmults, CD., et al.[2022]

Cemiplimab is a PD-1 monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, which is crucial for enhancing the immune response against cancer cells.

In September 2018, cemiplimab received FDA approval for treating patients with metastatic or locally advanced cutaneous squamous cell carcinoma who cannot undergo curative surgery or radiation, marking a significant advancement in cancer treatment options.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cemiplimab: First Global Approval. Markham, A., Duggan, S.[2023]

Citations

1. oncologynewscentral.com oncologynewscentral.com/drugs/info/fda-approves-cemiplimab-for-cutaneous-squamous-cell-carcinoma

FDA Approves Cemiplimab for Cutaneous Squamous Cell ... ... RP1 in combination with nivolumab can bring substantial benefit to advanced melanoma patients.” The application was based on the results of ...

2. newsroom.regeneron.com newsroom.regeneron.com/news-releases/news-release-details/libtayor-cemiplimab-phase-3-data-adjuvant-treatment-post

Libtayo® (cemiplimab) Phase 3 Data in the Adjuvant ... Libtayo demonstrated a 68% reduction in the risk of disease recurrence or death, the primary endpoint of the trial (p<0.0001).

3. ascopubs.org ascopubs.org/doi/10.1200/JCO.2025.43.16_suppl.TPS9600

A phase 1, open-label, dose expansion cohort of the ... This phase 1 clinical trial is designed to combine tolododekin alfa and cemiplimab to determine tolerability and initial biologic and clinical activity.

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40869427/

Efficacy of Neoadjuvant Cemiplimab Treatment for ... Despite more research still being needed to confirm its long-term benefits and the effects of the drug's use outside of clinical trials, there ...

5. fda.gov fda.gov/drugs/drug-approvals-and-databases/fda-approves-cemiplimab-rwlc-metastatic-or-locally-advanced-cutaneous-squamous-cell-carcinoma

Cemiplimab-rwlc for cutaneous squamous cell carcinoma Response rates and durability results were consistent across the advanced CSCC subtypes. For patients with locally advanced CSCC ...

6. clinicaltrials.eu clinicaltrials.eu/trial/study-of-cemiplimab-alone-and-with-rp1-for-patients-with-advanced-skin-squamous-cell-carcinoma/

Study of Cemiplimab Alone and with RP1 for Patients ... This clinical trial investigates the effects of Cemiplimab, alone and in combination with RP1, on patients with Advanced Cutaneous Squamous ...

7. clinicaltrials.ucsd.edu clinicaltrials.ucsd.edu/trial/NCT04050436

Cemiplimab Alone and Combined With RP1 in Treating ... A randomized, controlled, open-label, Phase 2 study of cemiplimab as a single agent and in combination with RP1 in patients with advanced cutaneous squamous ...

8. clin.larvol.com clin.larvol.com/trial-detail/NCT04050436

Study Evaluating Cemiplimab Alone and Combined With ... The CERPASS clinical trial was a global, randomized study enrolling 211 patients randomized 2 to 1 to receive RP1 plus cemiplimab versus cemiplimab standard of ...