1. < Melanoma & Skin Cancer
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Is Cemiplimab, an immunotherapy, effective for basal cell carcinoma?

Posted by martajean @martajean, Jun 21 9:01am

Has anyone out there heard of or had experience with a form of immunotherapy called Cemiplimab?
After having taken the hedgehog-pathway inhibitor vismodegib for six-and-a-half months to treat a large ocular BCC tumor, which I am grateful to say is now gone, there could be errant undetectable microscopic BCC cells that remain in the region behind my eye and could result in yet another recurrence.
I stopped the vismo after 6.5 months due to an accumulation of debilitating side effects. I could resume the chemo treatment, albeit with a modified dosage and schedule, while monitoring side effects, but I've just come across this immunotherapy and am curious to know more about it.
Since traditionally the recommended next step in the eradication of what might remain of the BCC in the region is radiation or proton therapy, which would destroy my eye, I am seeking other alternatives.
I would love to be able to speak to other people who have had this same aggressive, recurring form of BCC in the ocular region. I'd also like to find out about how the immunotherapy has worked for those who have gone that treatment route.

Interested in more discussions like this? Go to the Melanoma & Skin Cancer Support Group.

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louisejewell | @louisejewell | Jun 22 1:01pm

I've been on it Libtayo, for squamous cells that invaded lymph nodules in my neck. It is working in that its eliminated tumors but is still circulating but at low levels in my system. I'm monitored using a blood test called Signatera that compares the tumor that was removed to how much is still in my system. It shows levels that won't be picked up by scans way before they show. The infusions have been easy for me with minimal side effects.

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Susan, Volunteer Mentor | @grammato3 | Jun 22 2:39pm

@martajean Welcome to Mayo Clinic Connect and congratulations on the resolution of your ocular tumor. I see you’ve already gotten one helpful response from someone who has treated with this medication (Libtayo is the brand name) and I’m hopeful others will chime in with their experiences.

In the meantime, here is some information I’ve found on the Mayo site: https://www.mayoclinic.org/drugs-supplements/cemiplimab-rwlc-intravenous-route/description/drg-20444105

Let me know if you decide on this treatment and, if so, when that will start. Best of luck!

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lips702 | @lips702 | Jun 23 11:03am
In reply to @louisejewell "I've been on it Libtayo, for squamous cells that invaded lymph nodules in my neck. It..." + (show)
Profile picture for louisejewell @louisejewell

I've been on it Libtayo, for squamous cells that invaded lymph nodules in my neck. It is working in that its eliminated tumors but is still circulating but at low levels in my system. I'm monitored using a blood test called Signatera that compares the tumor that was removed to how much is still in my system. It shows levels that won't be picked up by scans way before they show. The infusions have been easy for me with minimal side effects.

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@louisejewell
Hello,
I used Libtayo for 9 months and got no relief with my squamous cell carcinoma, no real side effects.
I am currently on a new Immunotherapy called Unloxcyt. I have had 4 infusions and it's already working!!!!
Everyone's body works differently.

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runningy | @runningy | Jun 28 12:15pm

I've had four infusions of Libtayo and about to begin the 5th (double dose) to treat SCC (three lymph nodes removed from my armpit about 3 1/2 months ago. I've tolerated the infusions well with the only side effect being itchy skin from a case of bullous pemphigoid. About to start Dupixent to control that.
I have a PET scan and conference with my oncologist in a few days to assess the effectiveness so far. OHSU tumor board recommended this as a preferred treatment for my cancer and situation. I don't know if it's recommended for BCC. I'll post the prognosis after my next infusion.

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martajean | @martajean | Jun 30 5:32pm
In reply to @runningy "I've had four infusions of Libtayo and about to begin the 5th (double dose) to treat..." + (show)
Profile picture for runningy @runningy

I've had four infusions of Libtayo and about to begin the 5th (double dose) to treat SCC (three lymph nodes removed from my armpit about 3 1/2 months ago. I've tolerated the infusions well with the only side effect being itchy skin from a case of bullous pemphigoid. About to start Dupixent to control that.
I have a PET scan and conference with my oncologist in a few days to assess the effectiveness so far. OHSU tumor board recommended this as a preferred treatment for my cancer and situation. I don't know if it's recommended for BCC. I'll post the prognosis after my next infusion.

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@runningy Thank you for this post. I don't have a tumor board. Apparently my case doesn't justify it? Or is this something a patient has to request? I took Erivedge for seven months to treat a BCC tumor in the orbital of my left eye. It did shrink down the tumor, but there might still be residual cancer cells in the area, even though the PET scan showed no metabolic activity in the area. I had to stop taking Erivedge due to extreme side effects, which is what prompted my curiosity about Libtayo. At this point, radiation is usually the next step. However, radiation would destroy my eye and necessitate its removal. Surgery is scheduled for late October to "clean up" the area where the tumor was located. I'm assuming that I will need to continue to address the likelihood of another recurrence, which also prompted my interest in Libtayo. I am hoping that you will get a positive result!

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Susan, Volunteer Mentor | @grammato3 | Jul 1 10:20am
In reply to @martajean "@runningy Thank you for this post. I don't have a tumor board. Apparently my case doesn't..." + (show)
Profile picture for martajean @martajean

@runningy Thank you for this post. I don't have a tumor board. Apparently my case doesn't justify it? Or is this something a patient has to request? I took Erivedge for seven months to treat a BCC tumor in the orbital of my left eye. It did shrink down the tumor, but there might still be residual cancer cells in the area, even though the PET scan showed no metabolic activity in the area. I had to stop taking Erivedge due to extreme side effects, which is what prompted my curiosity about Libtayo. At this point, radiation is usually the next step. However, radiation would destroy my eye and necessitate its removal. Surgery is scheduled for late October to "clean up" the area where the tumor was located. I'm assuming that I will need to continue to address the likelihood of another recurrence, which also prompted my interest in Libtayo. I am hoping that you will get a positive result!

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@martajean: That's reassuring about the PET scan results. I'm curious to hear what your doctors have had to say about alternatives such as cemiplimab (brand name Libtayo) or immunotherapy. Also, why they or you feel it would be necessary to remove the eye if radiation were to be used. In most cases, radiation is targeted so as to preserve the eye, although vision may possibly be affected. Can you tell me more about your conversations with your provider?

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martajean | @martajean | Jul 1 11:40am
In reply to @grammato3 "@martajean: That's reassuring about the PET scan results. I'm curious to hear what your doctors have..." + (show)
Profile picture for Susan, Volunteer Mentor @grammato3

@martajean: That's reassuring about the PET scan results. I'm curious to hear what your doctors have had to say about alternatives such as cemiplimab (brand name Libtayo) or immunotherapy. Also, why they or you feel it would be necessary to remove the eye if radiation were to be used. In most cases, radiation is targeted so as to preserve the eye, although vision may possibly be affected. Can you tell me more about your conversations with your provider?

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@grammato3 Thank you for your interest. Since the BCC tumor was located in the orbital behind my left eye, targeted radiation or even proton therapy would definitely destroy the lacrimal gland, which would make life with that eye very uncomfortable. Traditional radiation might also damage the cornea of the eye and could result in vision loss. They cannot guarantee that my eye would survive the treatments: 5 treatments per week for 6 to 7 weeks. For now, I'll be having surgery in a few months to repair damage caused by the tumor. If I need to resume chemo thereafter, I'm looking into immunotherapy, since my body is no longer tolerating the Erivedge, with which I had a seven-month run that destroyed the tumor. Of course, there could still be microscopic BCC present, which is why the surgeon will also biopsy the tissue in the location where the tumor was located.

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Susan, Volunteer Mentor | @grammato3 | Jul 1 11:43pm
In reply to @martajean "@grammato3 Thank you for your interest. Since the BCC tumor was located in the orbital behind..." + (show)
Profile picture for martajean @martajean

@grammato3 Thank you for your interest. Since the BCC tumor was located in the orbital behind my left eye, targeted radiation or even proton therapy would definitely destroy the lacrimal gland, which would make life with that eye very uncomfortable. Traditional radiation might also damage the cornea of the eye and could result in vision loss. They cannot guarantee that my eye would survive the treatments: 5 treatments per week for 6 to 7 weeks. For now, I'll be having surgery in a few months to repair damage caused by the tumor. If I need to resume chemo thereafter, I'm looking into immunotherapy, since my body is no longer tolerating the Erivedge, with which I had a seven-month run that destroyed the tumor. Of course, there could still be microscopic BCC present, which is why the surgeon will also biopsy the tissue in the location where the tumor was located.

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@martajean: thank you for that explanation. When the lacrimal gland is involved it definitely can complicate matters. I’m wondering if in a case such as this if combination immunotherapy of Nivolumab/Pembrolizumab would be considered?

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runningy | @runningy | Jul 2 6:48am
In reply to @martajean "@runningy Thank you for this post. I don't have a tumor board. Apparently my case doesn't..." + (show)
Profile picture for martajean @martajean

@runningy Thank you for this post. I don't have a tumor board. Apparently my case doesn't justify it? Or is this something a patient has to request? I took Erivedge for seven months to treat a BCC tumor in the orbital of my left eye. It did shrink down the tumor, but there might still be residual cancer cells in the area, even though the PET scan showed no metabolic activity in the area. I had to stop taking Erivedge due to extreme side effects, which is what prompted my curiosity about Libtayo. At this point, radiation is usually the next step. However, radiation would destroy my eye and necessitate its removal. Surgery is scheduled for late October to "clean up" the area where the tumor was located. I'm assuming that I will need to continue to address the likelihood of another recurrence, which also prompted my interest in Libtayo. I am hoping that you will get a positive result!

Jump to this post

@martajean
Good news: My PET scan showed no spread and just a very small area that might have some residual SCC cells, but could also just be scar tissue from the surgery; no tumors. Probably the best news we could get. I don't anticipate any further surgery or radiation, but the next PET scan at the end of September will be important in making a final decision...

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