Phase II Study Evaluating Cemiplimab Alone or Combined with Fianlimab or REGN7075 in Adults With Colorectal Cancer After Surgery and Chemotherapy
Led by NSABP Foundation Inc · Updated on 2026-06-12
79
Participants Needed
9
Research Sites
6 weeks
Total Duration
AI-Summary
What this Trial Is About
Researchers are evaluating if immunotherapies alone or combined with other drugs can delay or prevent colorectal cancer from returning in patients who test positive for circulating tumor DNA ctDNA after their treatment. The study focuses on patients with colorectal cancer who have minimal residual disease following surgery and chemotherapy. The immunotherapies being studied are cemiplimab, fianlimab, and REGN7075, which work by activating the immune system to target and destroy cancer cells.
Participants will receive one of three treatments cemiplimab alone, cemiplimab combined with fianlimab, or cemiplimab combined with REGN7075. Treatments are given intravenously with specific dosing amounts e.g., cemiplimab 350 mg. Eligible patients must have confirmed ctDNA positivity from commercial assays and will have confirmation via a special trial assay. Treatment starts after enrollment, with patients assigned to one of the treatment groups in a parallel design.
During the study, participants will have regular assessments including ctDNA testing to monitor clearance and sustainability of clearance over periods ranging from 12 weeks up to 3 years. Researchers will also track recurrence-free survival and safety, including monitoring for toxicities during the treatment and up to 60 days after. Blood tests and imaging will be used to ensure patients meet criteria and to evaluate treatment effects. The total participation may last several years, with ongoing follow-up to observe outcomes.
CONDITIONS
Brief Title
A Phase II Platform Study to Evaluate Treatment With Cemiplimab Monotherapy or Cemiplimab Plus Fianlimab or Other Novel Combinations in Patients With Colorectal Cancer With Minimal Residual Disease Following Definitive Surgery and Chemotherapy (EMPIRE)
Research Team
D
Department of Site and Study Management (DSSM)
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This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
Factors
Cemiplimab‑based investigational regimen
Current standard surveillance
What this option involves
Cemiplimab alone or combined with fianlimab or REGN7075 given after surgery and chemotherapy in patients with ctDNA‑positive MSS colorectal cancer.
Patients with MSS colorectal cancer and ctDNA‑positivity after standard therapy are usually observed without additional adjuvant immunotherapy.
Primary aim
Clearance of ctDNA (minimal residual disease) at 12 weeks post‑treatment.
Surveillance to monitor for radiographic recurrence over time without further adjuvant intervention.
Evidence maturity
Early‑phase proof‑of‑concept; ctDNA clearance and recurrence outcomes are investigational.
Established as current management pathway for this patient group.
Limitations or uncertainties
Single‑arm design with small sample size; unknown longest‑term survival benefit and generalizability.
Surveillance does not actively eliminate minimal residual disease and may miss early intervention opportunities.
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
Patients must be 18 years or older.
Signed informed consent according to federal and institutional guidelines.
ECOG performance status of 0 or 1.
Confirmed stage II/III colon or rectal cancer, or oligometastatic stage IV colorectal adenocarcinoma.
No definitive evidence of untreated metastatic disease by CT scan.
Complete (R0) resection of primary tumor and resection or ablation of oligometastatic disease if present.
At least 3 months of standard systemic chemotherapy completed.
ctDNA-positive by assay within 2 weeks to 12 months after completing curative therapy.
Tumor status confirmed as microsatellite stable (MSS) or proficient mismatch repair (pMMR).
Adequate liver function: total bilirubin ≤1.5 x ULN; AST and ALT ≤3.0 x ULN with stable values if elevated.
Creatinine ≤1.5 x ULN or creatinine clearance ≥40 mL/min.
Prior chemotherapy toxicities less than Grade 2 unless stable.
No evidence of opportunistic infections.
Negative pregnancy test if of childbearing potential.
Agree to use effective contraception during and for 6 months after study therapy.
You will not qualify if you...
Colon cancer types other than adenocarcinoma.
MSI-high (dMMR) tumors.
Anti-cancer therapy or radiation within 4 weeks before study therapy or recent immune-related adverse events.
Active or latent tuberculosis not treated.
Untreated or uncontrolled infections needing systemic therapy.
Systemic autoimmune disease requiring immunosuppressive therapy (except certain mild or controlled conditions).
Ongoing systemic steroid therapy that cannot be stopped (except low-dose replacement).
Live vaccine within 30 days before entry.
Active or chronic hepatitis B or C infection unless treated and cured.
History of allogeneic organ or bone marrow transplant.
Certain cardiovascular diseases including recent heart failure, heart attack, stroke, myocarditis, or elevated troponin levels.
Active inflammatory bowel disease.
Major surgery within 28 days before entry.
Other recent malignancies unless disease-free for specified periods.
Psychiatric or addictive disorders interfering with study requirements.
Pregnancy or breastfeeding.
Use of investigational agents within 28 days before study therapy.
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Treatment
Duration - Up to 12 weeks
Participants receive one of the study treatments: cemiplimab alone, cemiplimab with fianlimab, or cemiplimab with REGN7075, given intravenously.
Follow-up
Duration - Up to 3 years
Participants are monitored with regular blood tests and assessments for up to 3 years to track clearance of circulating tumor DNA, cancer recurrence, and safety after treatment ends.
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NON_RANDOMIZED
Model
PARALLEL
Primary Purpose
OTHER
Number of Arms
3
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Published Research Related To This Trial
EMPIRE (NSABP FC-13): a biomarker-driven phase II platform trial evaluating cemiplimab-based immunotherapy in microsatellite-stable colorectal cancer with ctDNA-defined minimal residual disease.