Immunotherapy for Advanced Basal Cell Carcinoma of the Skin

Immunotherapy is the use of medicines to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively. Some types of immunotherapy can be used to treat people with advanced basal cell carcinoma (BCC), also known as basal cell skin cancer.

Immune checkpoint inhibitors

Just as it’s important that immune cells in the body get activated to fight infections and cancer, it’s also important that they turn off when they are no longer needed. Checkpoint proteins on immune cells act as brakes to slow down immune cell attacks.

Cancer cells sometimes use these checkpoints to keep from being attacked by the immune system.

Drugs that target these checkpoint proteins, called checkpoint inhibitors, can help restore the immune response against the cancer cells.

PD-1 inhibitor

Cemiplimab (Libtayo) is a drug that targets PD-1, a checkpoint protein on immune cells called T cells. By blocking PD-1, this drug can boost the immune response against cancer cells.

Cemiplimab can be used to treat advanced BCC in people who are no longer being helped by or can’t take targeted drugs called hedgehog pathway inhibitors.

This drug is given as an infusion into a vein (IV), typically every 3 weeks.

This drug hasn’t been studied in people with weakened immune systems, such as people who take medicines for autoimmune diseases or who have had an organ transplant, so the balance between benefits and risks in these people isn’t clear.

Possible side effects

Common side effects of cemiplimab can include:

• Feeling tired
• Diarrhea
• Skin rash
• Nausea
• Constipation
• Bone or joint pain
• Loss of appetite

Other, more serious side effects occur less often.

Infusion reactions: Some people might have an infusion reaction while getting this drug. This is like an allergic reaction and can include fever, chills, flushing of the face, rash, itchy skin, wheezing, and trouble breathing.

Autoimmune reactions: This drug works by removing one of the safeguards on the body’s immune system. Sometimes the immune system starts attacking other parts of the body, which can cause serious or even life-threatening problems in the lungs, intestines, liver, hormone-making glands, kidneys, or other organs.

It’s very important to report any new side effects to your healthcare team right away. If serious side effects do occur, treatment might need to be stopped and you might get high doses of corticosteroids to suppress your immune system.