Updated phase I trial of anti-LAG-3 or anti-CD137 alone and in combination with anti-PD-1 in patients with recurrent GBM.

Authors

null

Michael Lim

The Johns Hopkins Hospital, Baltimore, MD

Michael Lim , Xiaobu Ye , Anna F. Piotrowski , Arati Suvas Desai , Manmeet Singh Ahluwalia , Tobias Walbert , Joy D. Fisher , Serena Desideri , Zineb Belcaid , Christina Jackson , Louis B. Nabors , Patrick Y. Wen , Stuart A. Grossman

Organizations

The Johns Hopkins Hospital, Baltimore, MD, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, Memorial Sloan Kettering Cancer Center, New York, NY, Hospital of the University of Pennsylvania, Philadelphia, PA, Burkhardt Brain Tumor NeuroOncology Center, Neurological Institute, Taussig Center Institute, Cleveland Clinic, Cleveland, OH, Henry Ford Hospital, Detroit, MI, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, Johns Hopkins University SOM, Baltimore, MD, University of Alabama at Birmingham, Birmingham, AL, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore, MD

Research Funding

U.S. National Institutes of Health
Pharmaceutical/Biotech Company

Background: Preclinical GBM data targeting the checkpoint molecules Lag-3 and CD137 have shown promising anti-tumor immune response with resultant improved survival when combined with anti-PD-1. Here we report our experience from a multi-arm safety study in patients with recurrent GBM treated with anti-Lag-3 and anti-CD137. Methods: The Adult Brain Tumor Consortium (ABTC) 1501 trial is a phase I, open label, multicenter, multi-arm dose-finding/safety study of anti-LAG-3 (BMS-986016) or anti-CD137 (BMS-663513) alone and in combination with anti-PD-1 in patients at first recurrence of GBM. The primary objective is to define MTD for the mono and combinational treatment. The major secondary objective is to explore for a signal in efficacy. The key inclusion criteria are adults, first recurrence of GBM following RT+TMZ, TLC≥1000/ul, KPS≥ 60%, stable corticosteroid regimen, measurable disease, and written informed consent. Sequential allocation was used for the treatment assignment at starting dose of 80mg for anti-LAG-3 and 8mg for anti-CD137. Anti-PD-1was given at a flat dose of 240 mg in the combination treatment arms. The 3+3 design is used for the dose finding with a target DLT rate < 33%. Results: to date 44 patients were enrolled into the trial with median age at 57, median KPS at 90. Median treatment cycle was 3 and 39% tumors were MGMT methylated. The highest safe dose for Anti-LAG-3 alone is 800 mg without a DLT. The safe dose for anti-CD137 alone arm is 8mg with 1 DLT, and 2 grade 3 elevated serum ALT at end of cycle 2. Combination arms of Anti-LAG-3 +anti-PD-1 (160 mg/240mg as the highest dose combination) had one DLT (hypertension) and no toxicities were seen in the combination arm of Anti-CD137+Anti-PD-1 (3 mg/240 mg). mOS was 14 months for anti-CD137 alone, 8 months for Anti-Lag-3, and 7 months for Anti-Lag-3 + Anti-PD-1. Correlative data will be discussed. Conclusions: The trial is ongoing. The RP2D is 800mg for anti-LAG-3 as a monotherapy and 8mg for anti-CD137. For the combination arms, 160 mg of Anti-LAG-3 and 240 mg of anti-PD-1 and 3 mg of anti-CD137 and 240 mg antiPD-1 were the RP2D. Clinical trial information: NCT02658981

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Clinical Trial Registration Number

NCT02658981

Citation

J Clin Oncol 37, 2019 (suppl; abstr 2017)

DOI

10.1200/JCO.2019.37.15_suppl.2017

Abstract #

2017

Poster Bd #

206

Abstract Disclosures

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