Aim: Primary analysis from pivotal study, NCT02760498, supported the approval of cemiplimab for patients with metastatic CSCC (mCSCC) or locally advanced CSCC (laCSCC) that is not amenable to curative surgery or curative radiation, collectively referred to as advanced CSCC. The 36-month update demonstrated durable responses and emergence of new objective responses, including complete responses. Safety profile was comparable to other anti-PD-1 agents. We present data upto 43 months follow-up.
Methods: Patients received cemiplimab 3 mg/kg Q2W (Group [G]1, mCSCC; G2, laCSCC) or cemiplimab 350 mg Q3W (G3, mCSCC). Primary endpoint was ORR (CR+PR) per ICR.
Results: 193 patients were enrolled (G1: 59; G2: 78; G3: 56). At data cut-off (October 11, 2020), median duration of follow-up (months [range]) for all patients was 15.7 (0.6–43.2); G1: 18.5 (1.1–41.0); G2: 15.5 (0.8–43.2); G3: 17.3 (0.6–38.5). Overall, ORR by ICR (95% CI) improved to 47.2% (39.9–54.4), with no changes for G1 and G2, but an increase in G3 to 46.4% ([33.0–60.3] vs 42.9% [29.7–56.8] since our last update; including two new CR; 19.6%). Median DOR has not been reached (observed DOR range: 1.9–39.4 months). In responding patients, the estimated proportion of ongoing response (95% CI) at 24 months improved to 72.8% (61.2–81.4) vs 69.4% (55.6–79.6) in our last update. Estimated median Kaplan–Meier PFS (months [95% CI]) for all patients was 18.5 (10.3–31.3); G1: 18.4 (6.8–32.8); G2: 18.5 (11.1–NE); G3: 21.7 (3.6–NE). Median OS by ICR have not been reached. Incidence of immune-related AEs and TEAEs were consistent with previous update. Most common TEAEs by any grade were fatigue (34.7%), diarrhea (27.5%), and nausea (23.8%).
Conclusions: This 43-month follow-up shows incremental improvements in DOR with cemiplimab across all advanced CSCC study groups, and improvements in ORR and complete response rate on the cemiplimab 350 mg Q3W regimen. There were no new safety signals.