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Cemiplimab/Peg-Interferon-α in Advanced CSCC

Primary Purpose

Cutaneous Squamous Cell Carcinoma, Squamous Cell Carcinoma, Advanced Squamous Cell Carcinoma

Status
Withdrawn
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cemiplimab-Rwlc
PEG-IFN alfa-2a
Sponsored by
Baptist Health South Florida
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cutaneous Squamous Cell Carcinoma focused on measuring cemiplimab, peg-interferon-alpha

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Provision of signed and dated informed consent form Stated willingness to comply with all study procedures and availability for the duration of the study Participants must have histologically or cytologically confirmed aCSCC Participants who present with unknown primary SCC at the time of diagnosis will be eligible if participants have a plausible primary skin site removed in the past Similarly, participants with neck, parotid or facial lymph nodes biopsy proven SCC with no identifiable mucosal primary would also be eligible Participants must have measurable disease, defined by RECIST v1.1 as at least one lesion that can be accurately measured in at least one dimension of ≥ or equal than 10mm by CT, MRI, positron emission tomography/computed tomography (PET/CT) or ruler/caliper Male or female ≥ 18 years old Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 Participants must have normal organ function as defined below: Absolute neutrophil count ≥ 1,500/mcl Platelets ≥ 75,000 Aspartate transaminase (AST) or alanine aminotransferase (ALT) < 2.5 x upper limit of normal or up to 5x Upper Limit of Normal (ULN) if known to be secondary to liver metastasis Serum creatinine < 1.5 or creatinine clearance ≥ 30 ml/min by either Cockcroft-Gault formula or 24-hour urine collection analysis For females of reproductive potential: pregnancy test must be negative (urine or serum), and use of highly effective contraception (like birth control pills and condoms) prior to screening and agreement to use such a method during study participation For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner Exclusion Criteria: Participants who have had chemotherapy, immunotherapy or targeted therapy within 21 days of protocol treatment initiation, or those who have not recovered to grade 1 CTCAE adverse events due to agents administered ≥ 3 weeks earlier Participants may not be receiving any other investigational agents Pregnancy or lactation Known allergic reactions to components of similar chemical or biologic composition to either cemiplimab or interferon Uncontrolled ongoing illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, myocardial infarction < 30 days, cerebrovascular accident/transient ischemic attack (CVA/TIA) < 30 days, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Any organ transplant participants on immunosuppressive agents Participants with chronic lymphocytic leukemia (CLL) or other hematologic malignancies are allowed as long as they meet all other criteria listed above Patient must not be candidates for curative locoregional treatments Participants with recurrent locoregional disease for who a resection is unacceptably morbid and unlikely to be curative are eligible Participants with autoimmune disease on immunosuppressive therapy Participants with a history of non-infectious pneumonitis

Sites / Locations

  • Miami Cancer Institute at Baptist Health, Inc.

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cemiplimab and Pegylated Interferon-alpha (PEG-IFN-alpha)

Arm Description

Cemiplimab administered at 350 mg intravenous (IV) every three weeks for up to 2 years. PEG-IFN-alpha administered subcutaneously weekly at doses of 45 mcg to 135 mcg for up to 1 year. Exact dosing will depend on when the participant is enrolled in the study and the number of serious adverse effects that have been encountered by previous participants, if any.

Outcomes

Primary Outcome Measures

Total Incidence of Dose Limiting Toxicities (DLTs), Adverse Events (AEs), and Serious Adverse Events (SAEs) Leading to Discontinuation or Death
DLT rate by dose level, frequency distribution of treated participants with AE using the worst common terminology criteria grade. Participants will be counted only (1) once at the preferred term level, (2) once at the system organ class level, and (3) once in the "total participant" row at their worst common terminology criteria grade, regardless of system organ class or preferred term. The DLT window of observation will be during treatment cycle 1 only (i.e., during the first 21-day cycle; adverse events (AEs) meeting the definition of a DLT but occurring after this period will not be considered DLTs). The occurrence of certain toxicities during treatment cycle 1 will be considered a DLT, if assessed by the investigator to be possibly related or related to PEG-IFN-α and/or cemiplimab.

Secondary Outcome Measures

Response Rate (RR)
RR is defined as the proportion of participants whose best overall response is complete (CR) or partial (PR).
Duration of Response (DOR)
DOR is defined as the amount of time from the initiation of study therapy to the first documented disease progression or death due to any cause, whichever occurs first in participants who had achieved CR or PR.
Progression-free Survival (PFS)
PFS is defined as the time from the initiation of study therapy to the first documented disease progression or death due to any cause, whichever occurs first
Overall Survival (OS)
OS is defined as the time from the initiation of study therapy to death due to any cause or date of last follow-up, whichever occurs first.

Full Information

First Posted
February 6, 2023
Last Updated
August 7, 2023
Sponsor
Baptist Health South Florida
Collaborators
Regeneron Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT05729139
Brief Title
Cemiplimab/Peg-Interferon-α in Advanced CSCC
Official Title
Cemiplimab/PEG-Interferon-α Combination for Advanced Cutaneous Squamous Cell Carcinoma (aCSCC)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Withdrawn
Why Stopped
PI is leaving institution prior to study opening for accrual.
Study Start Date
July 2023 (Anticipated)
Primary Completion Date
July 2026 (Anticipated)
Study Completion Date
July 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baptist Health South Florida
Collaborators
Regeneron Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary purpose of this research study is to test the safety and possible harms of cemiplimab/peg-interferon-alpha, when it is given to participants at different dose levels. The researchers want to find out what effects (good and bad) cemiplimab/Peg-Interferon has on participants with advanced cutaneous squamous cell carcinoma (aCSCC) so that they can find the best dose to treat aCSCC and reduce side effects as much as possible.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cutaneous Squamous Cell Carcinoma, Squamous Cell Carcinoma, Advanced Squamous Cell Carcinoma
Keywords
cemiplimab, peg-interferon-alpha

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cemiplimab and Pegylated Interferon-alpha (PEG-IFN-alpha)
Arm Type
Experimental
Arm Description
Cemiplimab administered at 350 mg intravenous (IV) every three weeks for up to 2 years. PEG-IFN-alpha administered subcutaneously weekly at doses of 45 mcg to 135 mcg for up to 1 year. Exact dosing will depend on when the participant is enrolled in the study and the number of serious adverse effects that have been encountered by previous participants, if any.
Intervention Type
Drug
Intervention Name(s)
Cemiplimab-Rwlc
Other Intervention Name(s)
Libtayo
Intervention Description
350 mg via IV infusion over 30 minutes every 3 weeks for up to two years
Intervention Type
Drug
Intervention Name(s)
PEG-IFN alfa-2a
Other Intervention Name(s)
PEGASYS
Intervention Description
Self-administered by the participant via subcutaneous injection in the abdomen or thigh weekly for up to one year. Participants will receive one of three doses: Dose level 0: 45 mcg Dose level 1: 90 mcg Dose level 2: 135 mcg Dose level 0 is considered the starting dose and sequential cohorts of three participants will be treated with escalated doses until the maximum tolerated dose is established.
Primary Outcome Measure Information:
Title
Total Incidence of Dose Limiting Toxicities (DLTs), Adverse Events (AEs), and Serious Adverse Events (SAEs) Leading to Discontinuation or Death
Description
DLT rate by dose level, frequency distribution of treated participants with AE using the worst common terminology criteria grade. Participants will be counted only (1) once at the preferred term level, (2) once at the system organ class level, and (3) once in the "total participant" row at their worst common terminology criteria grade, regardless of system organ class or preferred term. The DLT window of observation will be during treatment cycle 1 only (i.e., during the first 21-day cycle; adverse events (AEs) meeting the definition of a DLT but occurring after this period will not be considered DLTs). The occurrence of certain toxicities during treatment cycle 1 will be considered a DLT, if assessed by the investigator to be possibly related or related to PEG-IFN-α and/or cemiplimab.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Response Rate (RR)
Description
RR is defined as the proportion of participants whose best overall response is complete (CR) or partial (PR).
Time Frame
2 years
Title
Duration of Response (DOR)
Description
DOR is defined as the amount of time from the initiation of study therapy to the first documented disease progression or death due to any cause, whichever occurs first in participants who had achieved CR or PR.
Time Frame
2 years
Title
Progression-free Survival (PFS)
Description
PFS is defined as the time from the initiation of study therapy to the first documented disease progression or death due to any cause, whichever occurs first
Time Frame
2 years
Title
Overall Survival (OS)
Description
OS is defined as the time from the initiation of study therapy to death due to any cause or date of last follow-up, whichever occurs first.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provision of signed and dated informed consent form Stated willingness to comply with all study procedures and availability for the duration of the study Participants must have histologically or cytologically confirmed aCSCC Participants who present with unknown primary SCC at the time of diagnosis will be eligible if participants have a plausible primary skin site removed in the past Similarly, participants with neck, parotid or facial lymph nodes biopsy proven SCC with no identifiable mucosal primary would also be eligible Participants must have measurable disease, defined by RECIST v1.1 as at least one lesion that can be accurately measured in at least one dimension of ≥ or equal than 10mm by CT, MRI, positron emission tomography/computed tomography (PET/CT) or ruler/caliper Male or female ≥ 18 years old Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 Participants must have normal organ function as defined below: Absolute neutrophil count ≥ 1,500/mcl Platelets ≥ 75,000 Aspartate transaminase (AST) or alanine aminotransferase (ALT) < 2.5 x upper limit of normal or up to 5x Upper Limit of Normal (ULN) if known to be secondary to liver metastasis Serum creatinine < 1.5 or creatinine clearance ≥ 30 ml/min by either Cockcroft-Gault formula or 24-hour urine collection analysis For females of reproductive potential: pregnancy test must be negative (urine or serum), and use of highly effective contraception (like birth control pills and condoms) prior to screening and agreement to use such a method during study participation For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner Exclusion Criteria: Participants who have had chemotherapy, immunotherapy or targeted therapy within 21 days of protocol treatment initiation, or those who have not recovered to grade 1 CTCAE adverse events due to agents administered ≥ 3 weeks earlier Participants may not be receiving any other investigational agents Pregnancy or lactation Known allergic reactions to components of similar chemical or biologic composition to either cemiplimab or interferon Uncontrolled ongoing illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, myocardial infarction < 30 days, cerebrovascular accident/transient ischemic attack (CVA/TIA) < 30 days, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Any organ transplant participants on immunosuppressive agents Participants with chronic lymphocytic leukemia (CLL) or other hematologic malignancies are allowed as long as they meet all other criteria listed above Patient must not be candidates for curative locoregional treatments Participants with recurrent locoregional disease for who a resection is unacceptably morbid and unlikely to be curative are eligible Participants with autoimmune disease on immunosuppressive therapy Participants with a history of non-infectious pneumonitis
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Guilherme Rabinowits, M.D.
Organizational Affiliation
Miami Cancer Institute at Baptist Health, Inc.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Miami Cancer Institute at Baptist Health, Inc.
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29863979
Citation
Migden MR, Rischin D, Schmults CD, Guminski A, Hauschild A, Lewis KD, Chung CH, Hernandez-Aya L, Lim AM, Chang ALS, Rabinowits G, Thai AA, Dunn LA, Hughes BGM, Khushalani NI, Modi B, Schadendorf D, Gao B, Seebach F, Li S, Li J, Mathias M, Booth J, Mohan K, Stankevich E, Babiker HM, Brana I, Gil-Martin M, Homsi J, Johnson ML, Moreno V, Niu J, Owonikoko TK, Papadopoulos KP, Yancopoulos GD, Lowy I, Fury MG. PD-1 Blockade with Cemiplimab in Advanced Cutaneous Squamous-Cell Carcinoma. N Engl J Med. 2018 Jul 26;379(4):341-351. doi: 10.1056/NEJMoa1805131. Epub 2018 Jun 4.
Results Reference
background
Citation
Regeneron Pharmaceuticals. LIBTAYO® (cemiplimab-rwlc) [Package Insert] Tarrytown. NY: Regeneron Pharmaceuticals; 2018.
Results Reference
background
PubMed Identifier
2229497
Citation
Cornell RC, Greenway HT, Tucker SB, Edwards L, Ashworth S, Vance JC, Tanner DJ, Taylor EL, Smiles KA, Peets EA. Intralesional interferon therapy for basal cell carcinoma. J Am Acad Dermatol. 1990 Oct;23(4 Pt 1):694-700. doi: 10.1016/0190-9622(90)70276-n.
Results Reference
background
PubMed Identifier
1444502
Citation
Edwards L, Berman B, Rapini RP, Whiting DA, Tyring S, Greenway HT Jr, Eyre SP, Tanner DJ, Taylor EL, Peets E, et al. Treatment of cutaneous squamous cell carcinomas by intralesional interferon alfa-2b therapy. Arch Dermatol. 1992 Nov;128(11):1486-9.
Results Reference
background
PubMed Identifier
14692941
Citation
Kim KH, Yavel RM, Gross VL, Brody N. Intralesional interferon alpha-2b in the treatment of basal cell carcinoma and squamous cell carcinoma: revisited. Dermatol Surg. 2004 Jan;30(1):116-20. doi: 10.1111/j.1524-4725.2004.30020.x.
Results Reference
background
PubMed Identifier
16713458
Citation
Tucker SB, Polasek JW, Perri AJ, Goldsmith EA. Long-term follow-up of basal cell carcinomas treated with perilesional interferon alfa 2b as monotherapy. J Am Acad Dermatol. 2006 Jun;54(6):1033-8. doi: 10.1016/j.jaad.2006.02.035.
Results Reference
background
Links:
URL
http://cancer.baptisthealth.net/
Description
Miami Cancer Institute

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Cemiplimab/Peg-Interferon-α in Advanced CSCC

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