Name of the Procedure:

Injection, cemiplimab-rwlc, 1 mg (HCPCS Code: J9119)

Summary

Cemiplimab-rwlc is a type of cancer treatment known as immunotherapy. It involves the injection of a medication called cemiplimab-rwlc, which helps the body's immune system fight certain types of cancer. This specific treatment uses the monoclonal antibody cemiplimab to target and inhibit the PD-1 pathway, a protein that restricts the immune system's ability to attack cancer cells.

Purpose

Cemiplimab-rwlc is used to treat specific types of skin cancer, including metastatic cutaneous squamous cell carcinoma (CSCC) and locally advanced CSCC that cannot be treated with surgery or radiation. The goal is to enhance the patient's immune response against cancer cells, aiming to shrink tumors and control disease progression.

Indications

• Metastatic cutaneous squamous cell carcinoma (CSCC)
• Locally advanced cutaneous squamous cell carcinoma (CSCC) unsuitable for surgery or radiation therapy
• Patients who have not responded to or are not candidates for other treatments

Preparation

• Patients may be advised to avoid certain medications before the procedure and discuss their full medical history, including any autoimmune diseases and infections.
• Blood tests and imaging studies may be conducted to assess the patient's overall health and the extent of the cancer.

Procedure Description

1. The healthcare provider administers cemiplimab-rwlc intravenously (IV).
2. The procedure begins with the insertion of an IV line into the patient's vein, typically in the arm.
3. Cemiplimab-rwlc is infused slowly into the bloodstream over 30 minutes.
4. The patient is monitored throughout the infusion for any signs of adverse reactions.

Duration

The infusion of cemiplimab-rwlc typically takes about 30 minutes.

Setting

The procedure is performed in a healthcare setting, such as a hospital, outpatient clinic, or specialized infusion center.

Personnel

• Oncologist or hematologist
• Infusion nurse
• Supporting medical staff, including pharmacists and lab technicians

Risks and Complications

• Common: fatigue, rash, diarrhea, nausea, itching
• Rare: severe immune-mediated reactions (e.g., pneumonitis, colitis, hepatitis, endocrinopathies)
• Management of severe reactions may involve discontinuation of treatment and administration of corticosteroids or other immune-suppressive medications.

Benefits

• Potential tumor shrinkage
• Improved disease control and survival rates
• Enhanced quality of life by potentially reducing symptoms associated with advanced cancer

Recovery

• Post-infusion monitoring to manage and document any immediate reactions
• Patients can usually return to normal activities shortly after the infusion
• Regular follow-up appointments with the healthcare team to monitor cancer progression and manage any side effects

Alternatives

• Surgery for resectable tumors
• Radiation therapy for local control
• Chemotherapy
• Other immune checkpoint inhibitors
• Pros and cons of alternatives vary based on individual patient factors and the type and stage of cancer. Some treatments may have different side effects or efficacy rates.

Patient Experience

• Patients may experience mild discomfort from the IV placement.
• During the infusion, patients generally sit or lie comfortably while being monitored.
• Side effects vary, but many patients report feeling tired afterward. Pain management and comfort measures are available to address any discomfort during and after the procedure. Regular consultation with the healthcare team can help manage any ongoing symptoms or complications.