Identification

Summary

Cemiplimab is a programmed death receptor-1 blocking antibody used to treat metastatic cutaneous squamous cell carcinoma.

Brand Names
Libtayo
Generic Name
Cemiplimab
DrugBank Accession Number
DB14707
Background

The U.S. Food and Drug Administration (FDA) approved Cemiplimab (Libtayo), manufactured by Regeneron Pharmaceuticals, on September 28, 2018. This is the first FDA approval of a drug specifically for the treatment of advanced cutaneous squamous cell carcinoma (CSCC) 1,4.

Type
Biotech
Groups
Approved, Investigational
Biologic Classification
Protein Based Therapies
Monoclonal antibody (mAb)
Protein Chemical Formula
Not Available
Protein Average Weight
146000.0 Da
Sequences
Not Available
Synonyms
  • Cemiplimab
  • Cemiplimab-rwlc
External IDs
  • REGN-2810
  • REGN2810

Pharmacology

Indication

This drug is a programmed death receptor-1 (PD-1) blocking antibody indicated for the treatment of patients with metastatic cutaneous squamous cell carcinoma (CSCC) or locally advanced CSCC who are not candidates for curative surgery or curative radiation Label,1.

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Avoid life-threatening adverse drug events & improve clinical decision support.
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Pharmacodynamics

Cemiplimab inhibits tumor growth by an immune-mediated mechanism, specifically by the inhibition of the programmed death receptor 1 (PD-1), treating cutaneous squamous cell carcinoma Label, 1, 3.

Mechanism of action

Binding of the programmed death receptor (PD) ligands PD-L1 and PD-L2, to the PD-1 receptor, which is found on T cells, inhibits T-cell proliferation and cytokine production. The upregulation of PD-1 ligands occurs in some tumors and signaling through this pathway may contribute to the inhibition of active T-cell immune surveillance of tumors. Cemiplimab is a recombinant human immunoglobulin G4 (IgG4) monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2 ligands, causing PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response. In mouse tumor models, blocking PD-1 activity resulted in decreased rates of tumor growth Label.

TargetActionsOrganism
AProgrammed cell death protein 1
inhibitor
antibody
Humans
Absorption

After a dose of 350 mg cemiplimab administered intravenously every 3 weeks, median steady-state concentrations (CV%) of cemiplimab ranged between a maximum concentration (Cmax,ss) of 166 mcg/mL (28%) and a minimum concentration (Cmin,ss) of 59 mcg/mL (48%). Steady-state exposure was achieved after approximately 4 months Label.

Volume of distribution

The volume of distribution of cemiplimab at steady state is 5.3 L (25%) Label.

Protein binding

Not Available

Metabolism
Not Available
Route of elimination

Not Available

Half-life

The elimination half-life (CV%) at steady state is 19 days (30%) Label.

Clearance

Cemiplimab clearance (CV%) after the first dose is 0.32 L/day (39%) and decreases over time by 34%, resulting in a steady-state clearance (CLss) (CV%) of 0.21 L/day (39%) Label.

Adverse Effects
Adverseeffects
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Toxicity

The most common adverse reactions (incidence ≥ 20%) were fatigue, rash, and diarrhea in clinical studies Label. Severe and fatal immune-mediated adverse reactions may occur in any organ system or tissue, including the following: immune-mediated pneumonitis, immune-mediated colitis, immune-mediated hepatitis, immune-mediated endocrinopathies, immune-mediated dermatologic adverse reactions, and immune-mediated nephritis and renal dysfunction. Monitor for symptoms and signs of immune-mediated adverse reactions. Regularly perform chemistry panels, including liver and thyroid function, at baseline and periodically during treatment. Withhold or permanently discontinue this drug and administer corticosteroids based on the severity of the reaction. Infusion-related reactions may also occur. Interrupt, decrease the rate of infusion or permanently discontinue based on the severity of the reaction.

A note on fetal toxicity: This drug can cause fetal harm. Advise females of reproductive potential of the potential risk to a fetus and use of effective contraception Label.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbciximabThe risk or severity of adverse effects can be increased when Abciximab is combined with Cemiplimab.
AdalimumabThe risk or severity of adverse effects can be increased when Adalimumab is combined with Cemiplimab.
AducanumabThe risk or severity of adverse effects can be increased when Aducanumab is combined with Cemiplimab.
AlemtuzumabThe risk or severity of adverse effects can be increased when Alemtuzumab is combined with Cemiplimab.
AlirocumabThe risk or severity of adverse effects can be increased when Alirocumab is combined with Cemiplimab.
AmivantamabThe risk or severity of adverse effects can be increased when Cemiplimab is combined with Amivantamab.
AnifrolumabThe risk or severity of adverse effects can be increased when Anifrolumab is combined with Cemiplimab.
AnsuvimabThe risk or severity of adverse effects can be increased when Cemiplimab is combined with Ansuvimab.
Anthrax immune globulin humanThe risk or severity of adverse effects can be increased when Anthrax immune globulin human is combined with Cemiplimab.
Antilymphocyte immunoglobulin (horse)The risk or severity of adverse effects can be increased when Antilymphocyte immunoglobulin (horse) is combined with Cemiplimab.
Interactions
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Food Interactions
No interactions found.

Products

Products2
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
LibtayoSolution250 mg / 5 mLIntravenousSanofi Aventis2019-05-24Not applicableCanada flag
LibtayoInjection, solution, concentrate350 mgIntravenousRegeneron Ireland Designated Activity Company (Dac)2021-01-12Not applicableEU flag
LibtayoInjection50 mg/1mLIntravenousRegeneron Pharmaceuticals, Inc.2018-09-28Not applicableUS flag
LibtayoSolution350 mg / 7 mLIntravenousSanofi Aventis2019-05-24Not applicableCanada flag

Categories

ATC Codes
L01XC33 — Cemiplimab
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
6QVL057INT
CAS number
1801342-60-8

References

General References
  1. 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. [Article]
  2. Authors unspecified: Drug and Device News. P T. 2017 Nov;42(11):665-691. [Article]
  3. Sidaway P: Cemiplimab effective in cutaneous SCC. Nat Rev Clin Oncol. 2018 Aug;15(8):472. doi: 10.1038/s41571-018-0056-5. [Article]
  4. FDA Approves Libtayo [Link]
  5. Libtayo, Regeneron [Link]
RxNav
2058825
Wikipedia
Cemiplimab
FDA label
Download (239 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
3Active Not RecruitingTreatmentNon-Small Cell Lung Carcinoma (NSCLC)2
3Active Not RecruitingTreatmentRecurrent or Metastatic, Platinum-refractory Cervical Cancer / Squamous Cell Carcinoma (SCC)1
3CompletedTreatmentNon-Small Cell Lung Carcinoma (NSCLC)1
3RecruitingTreatmentCutaneous Squamous Cell Carcinoma1
2Active Not RecruitingTreatmentAdvanced Non-Small Cell Lung Carcinoma1
2Active Not RecruitingTreatmentCarcinoma, Basal Cell (BCC)1
2Active Not RecruitingTreatmentCutaneous Squamous Cell Carcinoma1
2CompletedTreatmentCancer, Cancer Nonmelanoma Skin / Head and Neck Carcinoma / Malignant Melanoma of Skin / Sarcomas1
2CompletedTreatmentGlioblastoma Multiforme (GBM)1
2Not Yet RecruitingTreatmentHNSCC / Squamous Cell Carcinoma Head and Neck Cancer (HNSCC) / Squamous Cell Carcinoma of Hypopharynx / Squamous Cell Carcinoma of the Larynx / Squamous Cell Carcinoma of the Oral Cavity1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
InjectionIntravenous50 mg/1mL
Injection, solution, concentrateIntravenous350 mg
Injection, solution, concentrateIntravenous; Parenteral350 MG
SolutionIntravenous250 mg / 5 mL
SolutionIntravenous350 mg / 7 mL
Prices
Not Available
Patents
Not Available

Properties

State
Not Available
Experimental Properties
Not Available

Targets

Drugtargets2
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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Inhibitor
Antibody
General Function
Signal transducer activity
Specific Function
Inhibitory cell surface receptor involved in the regulation of T-cell function during immunity and tolerance. Upon ligand binding, inhibits T-cell effector functions in an antigen-specific manner. ...
Gene Name
PDCD1
Uniprot ID
Q15116
Uniprot Name
Programmed cell death protein 1
Molecular Weight
31646.635 Da
References
  1. 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. [Article]
  2. Authors unspecified: Drug and Device News. P T. 2017 Nov;42(11):665-691. [Article]

Drug created at September 29, 2018 15:41 / Updated at November 28, 2021 11:56