Dr. Atlas on the Promise of Up-Front Cemiplimab in Locally Advanced CSCC

Jennifer L. Atlas, MD, a medical oncologist in Hematology and Medical Oncology at Levine Cancer Institute, of Atrium Health, discusses the promise of cemiplimab (Libtayo) in the treatment of patients with locally advanced cutaneous squamous cell carcinoma (CSCC).

In a single-institution, retrospective study, investigators set out to examine the use of cemiplimab in the frontline treatment of patients with locally advanced disease. The primary end point was to determine whether there would be a need for local intervention with surgery and/or radiation.

Two important things to note from this study is that the overall response rate from the cohort was approximately 72% with cemiplimab, which is higher than what has been reported in previous datasets and protocols that have led to agent’s approval, says Atlas. Additionally, in terms of patient baseline characteristics, investigators subcategorized patients into different tumor locations, whether it was extremity, trunk, or head and neck. The vast majority of patients who met the locally advanced criteria were those with disease in the head and neck range that was going to lead to morbid surgeries. However, with cemiplimab, patients were able to avoid those procedures, adds Atlas.

The underlying conclusion was that the up front use of cemiplimab should be considered in some of these patients with locally advanced disease to potentially eliminate the need for disfiguring complex surgeries, especially in those who are on a short course of treatment and seem to be falling into the response category.

These data might lead to a paradigm shift, especially with regard to the order of treatment for some of these patients; this does not mean that surgery or radiation are being eliminated as treatment options. Cemiplimab is just a new approach to add to the mix, concludes Atlas.