A soluble LAG-3 protein (eftilagimod alpha) and an anti-PD-L1 antibody (avelumab) tested in a phase I trial: a new combination in immuno-oncology.

LAG-3 protein anti-PD-L1 eftilagimod alpha metastatic solid tumors

Journal

ESMO open
ISSN: 2059-7029
Titre abrégé: ESMO Open
Pays: England
ID NLM: 101690685

Informations de publication

Date de publication:
10 2023
Historique:
received: 26 06 2023
revised: 28 07 2023
accepted: 31 07 2023
medline: 30 10 2023
pubmed: 25 9 2023
entrez: 24 9 2023
Statut: ppublish

Résumé

Eftilagimod alpha (efti) is a major histocompatibility complex class II agonist activating antigen-presenting cells which leads to greater systemic type 1 T helper response and more cytotoxic CD8+ T-cell activation. This phase I trial evaluated the administration of efti, a soluble lymphocyte activation gene-3 (LAG-3) protein, combined with the anti-programmed death-ligand 1 (PD-L1) antibody avelumab in advanced solid tumors. Patients with heavily pretreated metastatic solid tumors received intravenous avelumab (800 mg) combined with subcutaneously administered efti (6 or 30 mg) for up to 12 cycles, followed by avelumab monotherapy. The primary endpoint was the assessment of the recommended phase II dose (RP2D) of efti in combination with avelumab. Twelve patients with different tumor entities were enrolled (six patients in each cohort). During treatment, no dose-limiting toxicities occurred, and the severity of most adverse events was grade 1 or 2. In total, nine serious adverse events were documented, resulting in a fatal outcome in two cases, but none of them were assessed to be treatment related. Five patients (42%) achieved partial response. The median progression-free survival was 1.96 months and the median overall survival was not reached, with a 12-month survival rate of 75%. Subcutaneously administered efti plus avelumab was well tolerated, and efti of 30 mg was determined to be RP2D. The activity is promising and warrants further investigation in future phase II trials.

Sections du résumé

BACKGROUND
Eftilagimod alpha (efti) is a major histocompatibility complex class II agonist activating antigen-presenting cells which leads to greater systemic type 1 T helper response and more cytotoxic CD8+ T-cell activation. This phase I trial evaluated the administration of efti, a soluble lymphocyte activation gene-3 (LAG-3) protein, combined with the anti-programmed death-ligand 1 (PD-L1) antibody avelumab in advanced solid tumors.
PATIENTS AND METHODS
Patients with heavily pretreated metastatic solid tumors received intravenous avelumab (800 mg) combined with subcutaneously administered efti (6 or 30 mg) for up to 12 cycles, followed by avelumab monotherapy. The primary endpoint was the assessment of the recommended phase II dose (RP2D) of efti in combination with avelumab.
RESULTS
Twelve patients with different tumor entities were enrolled (six patients in each cohort). During treatment, no dose-limiting toxicities occurred, and the severity of most adverse events was grade 1 or 2. In total, nine serious adverse events were documented, resulting in a fatal outcome in two cases, but none of them were assessed to be treatment related. Five patients (42%) achieved partial response. The median progression-free survival was 1.96 months and the median overall survival was not reached, with a 12-month survival rate of 75%.
CONCLUSION
Subcutaneously administered efti plus avelumab was well tolerated, and efti of 30 mg was determined to be RP2D. The activity is promising and warrants further investigation in future phase II trials.

Identifiants

pubmed: 37742484
pii: S2059-7029(23)00858-X
doi: 10.1016/j.esmoop.2023.101623
pmc: PMC10594027
pii:
doi:

Substances chimiques

avelumab KXG2PJ551I
CD274 protein, human 0
B7-H1 Antigen 0
Antibodies, Monoclonal 0

Types de publication

Clinical Trial, Phase I Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

101623

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

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Auteurs

S-E Al-Batran (SE)

UCT-University Cancer Center, Hospital Northwest, Frankfurt am Main; Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main. Electronic address: albatran@ikf-khnw.de.

D W Mueller (DW)

Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main.

M-R Rafiyan (MR)

Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main.

D Kiselicki (D)

Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main.

A Atmaca (A)

Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main.

T Habibzada (T)

UCT-University Cancer Center, Hospital Northwest, Frankfurt am Main.

C Mueller (C)

Immutep GmbH, Berlin, Germany.

C Brignone (C)

Immutep SAS, Saint-Aubin, France.

F Triebel (F)

Immutep SAS, Saint-Aubin, France.

M Loose (M)

Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main.

M Schaaf (M)

Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main.

D Sookthai (D)

Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main.

R Eickhoff (R)

Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main.

E Jaeger (E)

Department of Oncology and Hematology, Hospital Northwest, Frankfurt am Main.

T O Goetze (TO)

UCT-University Cancer Center, Hospital Northwest, Frankfurt am Main; Institute of Clinical Cancer Research IKF at Hospital Northwest, Frankfurt am Main.

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