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Active, not recruitingNCT05553834Updated Apr 13, 2026

PCSK9 Inhibitor and PD-1 Inhibitor in Patients With Metastatic, Refractory To Prior Anti PD-1 Non-small Cell Lung

A Phase 2 interventional study of Alirocumab and Cemiplimab in Non-small Cell Lung Cancer (NSCLC), sponsored by Duke University. Active, not recruiting at 2 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-13.

Sponsored by Duke University · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
60
Allocation
Not applicable
Ages
18 Years and older
Sex
All
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Study summary

PCSK9 mediates immune checkpoint blockade resistance by downregulating tumor cell surface MHC class 1 molecules. This study will evaluate if combining the anti-PCSK9 antibody alirocumab with the anti-PD-1 antibody cemiplimab can generate anti-tumor activity and clinical responses in patients with metastatic lung cancer who have progressed on first line immune checkpoint blockade therapy.

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Conditions studied

  • Non-small Cell Lung Cancer (NSCLC)
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In context

Carcinoma, Non-Small-Cell Lung

6,488 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,632 are open to participants now.

This study's planned enrollment of 60 is close to the median of 62 across 5,213 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

Duke University is the lead sponsor of 2,025 studies on the registry; 275 are open to participants now.

Of its 194 completed or terminated interventional studies of FDA-regulated products, 159 (82%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Histologically documented recurrent and/or metastatic non-small cell lung cancer
  • Progression after prior PD-1 directed therapy (as monotherapy or in combination with chemotherapy and/or anti-CTLA4, or anti-VEGF agents) - defined as investigator assessed progression from prior treatment
  • If molecularly altered NSCLC including EGFR, ALK, ROS1, MET exon 14, RET, BRAF, NTRK, progression on prior targeted therapy is required
  • Measurable disease by RECIST 1.1
  • ECOG Performance Status 0 or 1
  • Signed written informed consent
  • Minimum of 4 weeks from any other experimental anti-cancer therapies or prior PD-1 treatment
  • Meet all the laboratory criteria per protocol

Exclusion criteria

Exclusion Criteria:

  • Prior treatment with PCSK9 inhibitors
  • Cardiac issues including MI, uncontrolled arrhythmia, symptomatic angina pectoris, active ischemia, or cardiac failure not controlled by medications.
  • Uncontrolled diabetes mellitus, defined as HbA1c > 10
  • Major surgery less than 4 weeks prior to study enrollment
  • Another malignant condition diagnosed within 3 years of study enrollment
  • Intolerance to prior PD-1/L1 treatment including discontinuation for severe or recurrent severe toxicity (including myocarditis or other myocardiotoxity, encephalitis, colitis, diarrhea, pancreatitis, hypo/hyperthyroidism, hypopituitarism, adrenal insufficiency, rash, autonomic neuropathy, myasthenia gravis, Guillain-Barre, myositis/polymyositis, hepatitis, Type 1 Diabetes, thrombocytopenia) or developed an immune checkpoint blockade related immune adverse event that was refractory to steroids and required additional systemic immunosuppressive medication.
  • Known history of HIV seropositivity or known acquired immunodeficiency syndrome (AIDS)
  • Additional exclusion criterion as per listed in the protocol
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Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Alirocumab and Cemiplimab

    Combination of anti-PCSK9 antibody alirocumab with the anti-PD-1 antibody cemiplimab

    Combination Product: Alirocumab and Cemiplimab

Interventions

  • Combination productAlirocumab and Cemiplimab

    Combination of PCSK9 inhibitor Alirocumab 150mg SC q2weeks and PD-I inhibitor Cemiplimab 350mg IV q3 weeks

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What researchers measure

Primary outcomes

  1. Response rate associated with combination of alirocumab and cemiplimab

    Ascertain the response rate associated with alirocumab and cemiplimab, with 95% confidence intervals. Response rate is defined as the proportion of treated subjects with a complete or partial response per RECIST 1.1 criteria. All patients who receive at least one dose of alirocumab and cemiplimab will be considered for the primary outcome analysis

    Time frame: Day 1 of treatment until the date of first documented progression or date of death, whichever comes first, assessed up to 110 weeks per RECIST 1.1

Secondary outcomes

  1. Safety and tolerability of the combination regimen

    Toxicity analysis will be performed on a continual basis following CTC V 5.0 criteria

    Time frame: Day 1 of treatment until 30 days post last dose

  2. Progression Free Survival

    Progression Free Survival will be assessed utilizing RECIST 1.1 criteria

    Time frame: Day 1 of treatment until the date of first documented progression or date of death, whichever comes first, assessed up to 110 weeks

  3. Overall survival

    Patients will be followed till death or off study due to any other reason

    Time frame: Day 1 of treatment until death or off study due to any other reason whichever comes first, assessed up to 110 weeks

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Study locations

2 sites
  • Moffitt Cancer Center
    Tampa, Florida 33612, United States
  • Duke University
    Durham, North Carolina 27705, United States
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References and documents

Publications

  • Oduah EI, Zhang T, Jung SH, Stinchcombe TE, Ready N, Crawford J, Clarke JM, Gray JE, Antonia SJ. Alirocumab plus cemiplimab in advanced immuno-refractory metastatic non-small cell lung cancer: an ongoing multi-center phase II study. Future Oncol. 2026 Apr;22(9):1065-1072. doi: 10.1080/14796694.2026.2648863. Epub 2026 Apr 6. PubMed 41940540 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05553834
Lead sponsor
Duke University
Collaborators
Regeneron Pharmaceuticals
Responsible party
Sponsor
First posted
Sep 23, 2022
Start date
May 16, 2023
Primary completion
Sep 16, 2025
Completion
Nov 1, 2026 (estimated)
Last update
Apr 13, 2026

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

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