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Cutaneous Squamous Cell Carcinoma (CSCC)NGF-GRACENCT07064330

Next-gen Flow Cytometry to Find Immune Profiles, Treatment Response, and Toxicity Markers in Skin Cancer Patients Treated With Cemiplimab.

An observational study of Cutaneous Squamous Cell Carcinoma (CSCC), run by Instituto de Investigación Biomédica de Salamanca at 1 site in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Cutaneous squamous cell carcinoma (CSCC) is the second most frequent cancer in humans, it exhibits a high tumor mutational burden and is more common in immunocompromised patients, which aimed to explore the impact of immunotherapy in this cancer. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cutaneous Squamous Cell Carcinoma (CSCC)
What is being tested?
Cemiplimab
Type of treatment
Injection or infusion
How many people
30 participants
Where
1 siteSpain
Study dates
17 Jul 2025to Jun 2027
How long will I take part?
24 Months
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Every patient who is going to be treated with cemiplimab is a potential candidate for this study considering the inclusion and exclusion criteria of the registry study, included in SmPC.

  • Inclusion criteria At least 18 years old

Hepatic function:

  1. Total bilirubin ≤1.5x upper limit of normal (ULN) (or ≤3x ULN, if liver metastases).
  2. Patients with Gilbert's Disease and total bilirubin up to 3x ULN may be eligible after communication with and approval from the medical monitor
  3. Transaminases ≤3x ULN (or ≤5x ULN, if liver metastases)
  4. Alkaline phosphatase (ALP) ≤2.5x ULN (or ≤5x ULN, if liver or bone metastases) Renal function: Serum creatinine ≤2x ULN or estimated creatinine clearance >35 mL/min (according the method of Cockcroft and Gault) Creatine phosphokinase (CPK) (also known as CK [creatine kinase]) elevation ≤ grade 2

Bone marrow function:

  1. Hemoglobin ≥9.0 g/dL b. Absolute neutrophil count (ANC) ≥1.5 x 109/L c. Platelet count ≥75 x 109/L Anticipated life expectancy >12 weeks
  • Exclusion criteria:
  1. - Patient who refuses to participate in the study.
  2. Being unsuitable for cemiplimab treatment
  3. Ongoing or recent (within 5 years) evidence of significant autoimmune disease that required treatment with systemic immunosuppressive treatments, which may suggest risk for immune-related adverse events (irAEs). The following are not exclusionary: vitiligo, childhood asthma that has resolved, type 1 diabetes, residual hypothyroidism requiring only hormone replacement, or psoriasis that does not require systemic treatment.
  4. Untreated brain metastasis(es) that may be considered active.
  5. Note in clarification: Patients with previously treated brain metastases may participate provided that the lesion(s) is (are) stable (without evidence of progression for at least 6 weeks on imaging obtained in the screening period), and there is no evidence of new or enlarging brain metastases, and the patients do not require any immunosuppressive doses of systemic corticosteroids for management of brain metastasis(es) within 28 days of the first dose of REGN2810cemiplimab.
  6. Immunosuppressive corticosteroid doses (>10 mg prednisone daily or equivalent) within 4 weeks prior to the first dose of REGN2810cemiplimab
  7. Note in clarification: Patients who require brief courses of steroids (eg, as prophylaxis for imaging studies due to hypersensitivity to contrast agents) are not excluded
  8. Active infection requiring therapy, including positive tests for human immunodeficiency virus (HIV)-1 or HIV-2 serum antibody, hepatitis B virus (HBV), or hepatitis C virus (HCV)
  9. History of pneumonitis within the last 5 years
  10. Any anticancer treatment other than radiation therapy (chemotherapy, targeted systemic therapy, imiquimod, photodynamic therapy), investigational or standard of care, within 30 days of the initial administration of REGN2810 cemiplimab or planned to occur during the study period
  11. History of documented allergic reactions or acute hypersensitivity reaction attributed to antibody treatments
  12. Patients with allergy or hypersensitivity to REGN2810 cemiplimab or to any of the excipients must be excluded.
  13. Patients with a history of solid organ transplant (patients with prior corneal transplants may be allowed to enroll after discussion with and approval from the medical monitor)
  14. Breastfeeding
  15. Positive serum pregnancy test (a false positive pregnancy test, if demonstrated by serial measurements and negative ultrasound, will not be exclusionary, upon communication with and approval from the medical monitor)
  16. Receipt of live vaccines (including attenuated) within 30 days of first study treatment
  17. Women of childbearing potential (WOCBP)*, or sexually active men, who are unwilling to practice highly effective contraception prior to the initial dose/start of the first treatment prior to the start of the first treatment, during the study, and for at least 6 months after the last dose. Optional criteria, depending on the therapy being investigated:
  18. Prior treatment with an agent that blocks the PD-1/PD-L1 pathway (If a study is addressing prior unsuccessful treatment with PD-1/PD-L1 inhibitor, it is suggested to exclude patients who had suffered from ≥grade 3 irAE during previous treatment)
  19. Prior treatment with other systemic immune-modulating agents within fewer than 28 days prior to the first dose of REGN2810cemiplimab. Examples of immune-modulating agents include therapeutic vaccines, cytokine treatments, or agents that target cytotoxic T-lymphocyte antigen 4 (CTLA-4), 4-1BB (CD137), or OX-40.
  20. Note in clarification: Prior treatment with imiquimod or other topical or intralesional immune modulators will not be exclusionary

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Ricardo López, Study Project Manager contact

+34923291200 ext. 55144

uicec.gestion@ibsal.es

Spain1 site, 1 recruiting
  • Complejo Asistencial Universitario de Salamanca

    Salamanca, Salamanca, 37007

    Javier Cañueto, Medical Degree in Dermatology, +34923291200 ext. 55446, jcanueto@usal.es

    Recruiting

Other trials in Spain

About this study

Official title: Next Generation Flow Cytometry for Global Immunological Profile, Response And Toxicity Biomarker Signatures in Cutaneous Squamous Cell Carcinoma Under CEmiplimab Treatment.

Cutaneous squamous cell carcinoma (CSCC) is the second most frequent cancer in humans, it exhibits a high tumor mutational burden and is more common in immunocompromised patients, which aimed to explore the impact of immunotherapy in this cancer. CSCC shows good response to anti-PD1 immunotherapy, and cemiplimab is the first FDA-approved and the only EMA-approved treatment for this tumor. However, 50% of patients won't respond to anti-PD1 and to date there is little evidence on the reasons for such a lack of effectiveness. Also, anti-PD1 immunotherapy is very safe, but some patients will develop adverse events, and anticipating severe adverse events might help in patients' management. The NGF-GRACE project aims to find biomarkers of response and toxicity, both in the blood and the tumor, using advanced technologies. The goal is to move towards more personalized treatments, better select patients, predict side effects, and improve our understanding of the immune system in CSCC.

Read the detailed description

The NGF-GRACE project focuses on identifying biomarkers of response and toxicity in patients with advanced cutaneous squamous cell carcinoma (CSCC) undergoing anti-PD1 treatment, being cemiplimab the unique approved drug in Europe. CSCC, characterized by a high mutational burden and increased risk in immunosuppressed patients, has exhibited significant sensitivity to anti-PD1 immunotherapy. By employing cutting-edge technologies such as Next Generation Flow Cytometry and the BD Rhapsody Single Cell System, the study aims to assess the immunological profile in peripheral blood and in the tumor tissue. The ultimate goal is to advance towards a more individualized therapeutic approach, identifying biomarkers that enhance patient selection, anticipate adverse events, and address knowledge gaps in the CSCC tumor immunology.

Background and Rationale CSCC is a type of skin cancer with one of the highest mutational burdens among solid tumors, making it particularly sensitive to immunotherapy, especially PD-1 blockade. Cemiplimab, an anti-PD-1 antibody, has become the first FDA and EMA-approved treatment for advanced CSCC. However, response rates are variable, with around 50% of patients showing clinical benefit. There is an urgent need to identify predictive biomarkers to guide patient selection, anticipate toxicity, and understand resistance mechanisms.

Study Objectives The main objective is to identify biomarker of response and toxicity to cemiplimab in patients with advanced cutaneous squamous cell carcinoma

Study Design The study will enroll approximately 30 patients with locally advanced or metastatic CSCC who will start cemiplimab treatment. Peripheral blood and tumor samples will be collected. A preliminary phase with 5 patients will define optimal sampling timepoints.

Methods Peripheral blood will be analyzed using Next Generation Flow Cytometry (NGF), applying a custom-designed 40-color antibody panel to characterize innate and adaptive immune cells. Also, soluble biomarkers will be evaluated. Single-cell technologies will be implemented for tumor evaluation.

Endpoints and Data Analysis Clinical response will be measured using RECIST 1.1, and toxicity will follow CTCAE v5.0. Statistical analyses will correlate immune profiles with outcomes using appropriate tests (e.g., chi-square, t-tests, ANOVA, Kaplan-Meier survival analysis).

Ethical Considerations The study complies with the Declaration of Helsinki, GCP, and GDPR. Informed consent is mandatory, and data confidentiality is ensured. Samples and data will only be used for approved research purposes.

Impact The NGF-GRACE project seeks to advance precision immunotherapy in CSCC by identifying predictive biomarkers that can improve patient selection, predict adverse events, and inform new therapeutic strategies. The study's innovative technologies and comprehensive design position it to fill critical knowledge gaps in CSCC immuno-oncology.

Being tested
Cemiplimab
Keywords
Cemiplimab, Rhapsody Single Cell System, Tumor Microenvironment

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CemiplimabDrug

    350 mg IV every 3 weeks as per standard of care. Patients are observed prospectively for biomarkers of response and toxicity during cemiplimab treatment.

Study groups in NCT07064330
Study groupRoleWhat they receive
Observational CohortAll enrolled patients will receive cemiplimab as part of standard clinical care for advanced cutaneous squamous cell carcinoma (CSCC). Cemiplimab is not assigned by the study but is administered as per physician's decision in routine practice.
Receives: Drug: Cemiplimab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Biomarker signature associated with cemiplimab response

    Identification of peripheral blood and tumor immune biomarkers (cellular and soluble) that correlate with objective response to cemiplimab. Immune biomarkers to be reported include:

    1. Peripheral blood biomarkers (cellular and soluble):
    • Cellular biomarkers include: CD4⁺, CD8⁺ and T cells, B and plasma cells, NK cells, monocytes, dendritic cells and other myeloid populations, functional and checkpoint markers (e.g. PD-1, HLA-DR).
    • Soluble biomarkers (cytokines and chemokines): IL-2, IL-6, IL-10, IFN-γ, TNF-α, Chemokines (CXCL9, CXCL10, CCL2, and CCL5).
    1. Tumor tissue biomarkers (single-cell multi-omics):
    • Cellular biomarkers: CD3, CD4, CD8, CD11c, CD14, CD16, CD19, CD25, CD27, CD28, CD45RA, CD56, CD62L, CD127, CD134, CD137, CD161, CD183, CD185, CD186, CD196, CD197, CD272, CD278, CD279, CD357, CD366, HLA-DR, IgD and IdM.
    • Transcriptomic biomarkers:

    Single-cell transcriptome data (WTA library) will be generated to explore gene expression profiles associated with immune response.

    Measured: Up to 6 months from treatment initiation

  2. Best Overall Response (BOR)

    Proportion of patients with complete response (CR) or partial response (PR) according to RECIST v1.1 criteria, as assessed during cemiplimab treatment.

    Measured: From baseline to end of treatment (up to 12 months)

  3. Immune-related toxicity rate

    Descripción: Incidence and severity of immune-related adverse events (irAEs) according to CTCAE v5.0, and their association with baseline immune profiles.

    Measured: From first infusion until 90 days after last dose of cemiplimab

Secondary outcomes (5)
  1. Progression-Free Survival (PFS)

    Time from cemiplimab initiation to disease progression or death from any cause.

    Measured: Up to 18 months

  2. Overall Survival (OS)

    Time from cemiplimab initiation to death from any cause.

    Measured: Up to 24 months

  3. Analysis of transcriptomic and proteomic immune profiling of tumor-infiltrating cells

    Single-cell analysis of tumor samples before and during treatment, identifying profiles associated with response or resistance.

    Measured: From pre-treatment biopsy to post-infusion sample (up to 3 months)

  4. Correlation between tumor and blood immune biomarkers

    Association between immune signatures in peripheral blood and those found in the tumor microenvironment. Immune biomarkers to be reported include: 1. Peripheral blood biomarkers (cellular and soluble): - Cellular biomarkers include: CD4⁺, CD8⁺ and T cells, B and plasma cells, NK cells, monocytes, dendritic cells and other myeloid populations, functional and checkpoint markers (e.g. PD-1, HLA-DR). - Soluble biomarkers (cytokines and chemokines): IL-2, IL-6, IL-10, IFN-γ, TNF-α, Chemokines (CXCL9, CXCL10, CCL2, and CCL5). 2. Tumor tissue biomarkers (single-cell multi-omics): - Cellular biomarkers: CD3, CD4, CD8, CD11c, CD14, CD16, CD19, CD25, CD27, CD28, CD45RA, CD56, CD62L, CD127, CD134, CD137, CD161, CD183, CD185, CD186, CD196, CD197, CD272, CD278, CD279, CD357, CD366, HLA-DR, IgD and IdM. - Transcriptomic biomarkers: Single-cell transcriptome data (WTA library) will be generated to explore gene expression profiles associated with immune response.

    Measured: Up to 6 months

  5. Treatment discontinuation due to toxicity

    Rate and reasons for cemiplimab discontinuation related to adverse events.

    Measured: From first dose to end of treatment (up to 12 months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Jul 2025
  2. Study start17 Jul 2025
  3. Primary completionJun 2027 (estimated)
  4. Study completionJun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
30 participants (estimated)
Target duration
24 Months
IDs, dates and publications
ClinicalTrials.gov ID
NCT07064330
Sponsor's protocol ID
NGF-GRACE Study
Other IDs
E.O. 24/841
Acronym
NGF-GRACE
Status last verified
Sep 2025
First submitted
25 Jun 2025
Last updated
10 Sep 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data (IPD) that underlie the results reported in future publications (after de-identification) will be made available upon reasonable request. This includes data related to baseline characteristics, treatment administration, toxicity, tumor response, survival outcomes, and quality of life assessments

Questions about this trial

What is this clinical trial studying?

An observational study of Cutaneous Squamous Cell Carcinoma (CSCC), run by Instituto de Investigación Biomédica de Salamanca at 1 site in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 10 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Ricardo López, Study Project Manager (+34923291200 ext. 55144, uicec.gestion@ibsal.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Biomarker signature associated with cemiplimab response (time frame: Up to 6 months from treatment initiation). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Sep 2025.

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