Pharmacodynamic effect of IMCgp100 (TCR–CD3 bispecific) on peripheral cytokines and association with overall survival in patients with advanced melanoma.

Authors

null

Mark R. Middleton

Churchill Hospital, Oxford, United Kingdom

Mark R. Middleton , Neil Matthew Steven , TR Jeffry Evans , Jeffrey R. Infante , Omid Hamid , Alexander Noor Shoushtari , Philippa Gail Corrie , Alan Anthoney , Avinash Gupta , Victoria K Woodcock , Cheryl McAlpine , Mario Sznol

Organizations

Churchill Hospital, Oxford, United Kingdom, University of Birmingham, Birmingham, United Kingdom, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom, Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN, The Angeles Clinic and Research Institute, Los Angeles, CA, Memorial Sloan Kettering Cancer Center, New York, NY, Cambridge Cancer Trials Centre, Cambridge, United Kingdom, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom, The Christie NHS Foundation Trust, Manchester, United Kingdom, Early Phase Clinical Trials Unit, Oxford University NHS Trust, Oxford, United Kingdom, Immunocore, Abingdon, United Kingdom, Yale School of Medicine and Smilow Cancer Center, Yale New Haven Hospital, New Haven, CT

Research Funding

Pharmaceutical/Biotech Company

Background: ImmTAC molecules are unique TCR–anti-CD3 bispecifics that redirect T cells against intracellular antigens. IMCgp100, an ImmTAC targeting melanocyte-expressed gp100 antigen, has demonstrated monotherapy activity in advanced melanoma and can cause rash and cytokine-mediated AEs, hypothesized to be on-target (gp100) or effector (CD3) mediated. A preclinical MoA for T cell bispecifics suggests chemokine CXCL10 redirection of CXCR3+ T cells from blood into antigen-positive tissues; this has not been clinically validated. Methods: 84 HLA-A2+ pts with advanced melanoma (n = 61 cutaneous [CM], n = 19 uveal [UM], n = 4 other) received IMCgp100 (NCT01211262). Serum (n = 40) and PBMC (n = 22) samples were taken pre- and post-infusion to analyze changes in cytokines and circulating T cells. Pre- (n = 16) and post-treatment (n = 11) tumor biopsies were analyzed by IHC for CD3, PD-L1 and gp100 expression; tumor RNA (n = 12) was analyzed for gene expression. Results: IMCgp100 induced a transient increase in IFNg-inducible cytokines, most prominently CXCL10. A greater increase in serum CXCL10 was associated with longer OS (p = 0.0002), tumor shrinkage (p = 0.003), and greater transient reduction in peripheral CXCR3+CD8+ T cells (p = 0.001). Reduction in CXCR3+ CD8+ T cells also trended with longer OS (p = 0.02), and tumor shrinkage (p = 0.03). 3/16 pre-treatment biopsies had < 1% gp100 expression (all progressive disease). 8/11 biopsies post-IMCgp100 had increased CD3+ T cells compared with matched pre-treatment samples (associated with baseline gp100 but not PD-L1 expression). Based on tumor biopsy gene expression analysis, IMCgp100 increased T cell markers, IFNg-inducible and cytotoxicity-related genes. Conclusions: The association of clinical benefit with increased serum CXCL10 and decreased peripheral CXCR3+ T cells supports the MoA of IMCgp100-induced T cell redirection and activation. Tumor biopsy results support IMCgp100 redirection of T cells to antigen-positive tumor. A Phase II trial in CM (NCT02535078), a Phase I/II trial in UM (NCT02570308), and a Pivotal RCT in UM (NCT03070392) are ongoing. Clinical trial information: NCT01211262

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT01211262

Citation

J Clin Oncol 37, 2019 (suppl; abstr 9523)

DOI

10.1200/JCO.2019.37.15_suppl.9523

Abstract #

9523

Poster Bd #

94

Abstract Disclosures