人类淋巴细胞活化基因-3 (LAG-3)单克隆抗体 Fianlimab 与西米普利单抗联合治疗晚期黑色素瘤的 I 期研究。

IF 42.1 1区 医学 Q1 ONCOLOGY
Journal of Clinical Oncology Pub Date : 2024-08-20 Epub Date: 2024-06-20 DOI:10.1200/JCO.23.02172
Omid Hamid, Karl D Lewis, Amy Weise, Meredith McKean, Kyriakos P Papadopoulos, John Crown, Tae Min Kim, Dae Ho Lee, Sajeve S Thomas, Janice Mehnert, John Kaczmar, Nehal J Lakhani, Kevin B Kim, Mark R Middleton, Guilherme Rabinowits, Alexander I Spira, Melinda Yushak, Inderjit Mehmi, Fang Fang, Shuquan Chen, Jayakumar Mani, Vladimir Jankovic, Fang Wang, Nathalie Fiaschi, Laura Brennan, Anne Paccaly, Sheila Masinde, Mark Salvati, Matthew G Fury, Glenn Kroog, Israel Lowy, Giuseppe Gullo
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引用次数: 0

摘要

目的:淋巴细胞活化基因-3(LAG-3)和PD-1受体的联锁疗法可为晚期黑色素瘤患者带来显著的临床疗效。Fianlimab 和 cemiplimab 是高亲和力的人类铰链稳定 IgG4 单克隆抗体,分别靶向 LAG-3 和 PD-1。我们报告了fianlimab和cemiplimab对包括晚期黑色素瘤在内的多种恶性肿瘤的安全性和有效性的首次人体I期研究结果:晚期黑色素瘤患者有资格加入四个队列:三个队列针对未接受过抗PD-1治疗的患者,一个队列针对曾在晚期疾病环境中接受过抗PD-1治疗的患者。患者接受fianlimab 1600毫克和cemiplimab 350毫克静脉注射治疗,每3周一次,最长51周,如有临床指征,可选择延长51周。主要终点是根据RECIST 1.1标准得出的客观反应率(ORR):抗PD-1无效黑色素瘤患者的ORR为63%(队列6;n=40;中位随访20.8个月),全身治疗无效黑色素瘤患者的ORR为63%(队列15;n=40;11.5个月),既往接受过新辅助治疗的黑色素瘤患者的ORR为56%(队列16;n=18,9.7个月)。联合组群(6 + 15 + 16)的中位随访时间为 12.6 个月,ORR 为 61.2%,中位无进展生存期 (mPFS) 为 13.3 个月(95% CI,7.5 到未估计 [NE])。既往接受过抗PD-1辅助治疗的患者(n = 13)的ORR为61.5%,中位无进展生存期为12个月(95% CI,1.4至NE)。既往接受过抗PD-1治疗的晚期患者(n = 15)的ORR为13.3%,mPFS为1.5个月(95% CI,1.3至7.7)。分别有44%和22%的患者观察到治疗突发不良事件和治疗相关不良事件≥3级(G3)。除了肾上腺功能不全的发生率增加(12%-G1-4,4%-G3-4)外,没有记录到新的安全性信号:目前的研究结果表明,fianlimab/cemiplimab联合疗法对晚期黑色素瘤患者(包括既往接受过抗PD-1治疗的患者)具有良好的获益-风险预测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Phase I Study of Fianlimab, a Human Lymphocyte Activation Gene-3 (LAG-3) Monoclonal Antibody, in Combination With Cemiplimab in Advanced Melanoma.

Purpose: Coblockade of lymphocyte activation gene-3 (LAG-3) and PD-1 receptors could provide significant clinical benefit for patients with advanced melanoma. Fianlimab and cemiplimab are high-affinity, human, hinge-stabilized IgG4 monoclonal antibodies, targeting LAG-3 and PD-1, respectively. We report results from a first-in-human phase-I study of fianlimab and cemiplimab safety and efficacy in various malignancies including advanced melanoma.

Methods: Patients with advanced melanoma were eligible for enrollment into four cohorts: three for patients without and one for patients with previous anti-PD-1 therapy in the advanced disease setting. Patients were treated with fianlimab 1,600 mg and cemiplimab 350 mg intravenously once every 3 weeks for up to 51 weeks, with an optional additional 51 weeks if clinically indicated. The primary end point was objective response rate (ORR) per RECIST 1.1 criteria.

Results: ORRs were 63% for patients with anti-PD-1-naïve melanoma (cohort-6; n = 40; median follow-up 20.8 months), 63% for patients with systemic treatment-naïve melanoma (cohort-15; n = 40; 11.5 months), and 56% for patients with previous neo/adjuvant treatment melanoma (cohort-16; n = 18, 9.7 months). At a median follow-up of 12.6 months for the combined cohorts (6 + 15 + 16), the ORR was 61.2% and the median progression-free survival (mPFS) 13.3 months (95% CI, 7.5 to not estimated [NE]). In patients (n = 13) with previous anti-PD-1 adjuvant therapy, ORR was 61.5% and mPFS 12 months (95% CI, 1.4 to NE). ORR in patients with previous anti-PD-1 therapy for advanced disease (n = 15) was 13.3% and mPFS 1.5 months (95% CI, 1.3 to 7.7). Treatment-emergent and treatment-related adverse events ≥grade 3 (G3) were observed in 44% and 22% of patients, respectively. Except for increased incidence of adrenal insufficiency (12%-G1-4, 4%-G3-4), no new safety signals were recorded.

Conclusion: The current results show a promising benefit-risk profile of fianlimab/cemiplimab combination for patients with advanced melanoma, including those with previous anti-PD-1 therapy in the adjuvant, but not advanced, setting.

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来源期刊
Journal of Clinical Oncology
Journal of Clinical Oncology 医学-肿瘤学
CiteScore
41.20
自引率
2.20%
发文量
8215
审稿时长
2 months
期刊介绍: The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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