Updated safety phase I trial of anti-LAG-3 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 , 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, Johns Hopkins University School of Medicine, Baltimore, MD, Hospital of the University of Pennsylvania, Philadelphia, PA, Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Taussig Cancer Institute and Cleveland Clinic, Cleveland, OH, Henry Ford Cancer Institute, Henry Ford University, Detroit, MI, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, 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

Other Government Agency
NCI - ABTC, BMS for correlative studies

Background: Preclinical GBM data targeting the checkpoint molecule Lag-3 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 in combination with anti-PD-1. Methods: A phase I, open label, multicenter, multi-arm dose-finding/safety study of anti-LAG-3 (BMS-986016) alone or in combination with anti-PD-1 in patients at first recurrence of GBM was carried out in The Adult Brain Tumor Consortium (ABTC) (1501). The primary objectives were safety and to define MTD (DLT rate < 33%) for both the mono and combination arms. The major secondary objective was efficacy. The key inclusion criteria were: adults with first recurrence of GBM following RT+TMZ, TLC≥1000/ul, KPS≥ 60%, on a stable corticosteroid regimen, measurable disease, and written informed consent. Three pre specified dose levels of anti-Lag-3 at 80mg, 160mg, and 800mg were tested. Anti-PD-1was given at a flat dose of 240 mg in combination with anti-LAG-3 at 80 mg and 160 mg. Results: To date, the phase I portion of study completed its accrual and 33 patients were enrolled into the anti-LAG-3 alone or in combination with anti-PD-1 arms. The median age and KPS was 56 and 90 respectively. 39% tumors were MGMT methylated and the median treatment cycle was 3. The highest safe dose for Anti-LAG-3 alone is 800 mg without a DLT. Two DLT were observed in combination arms of Anti-LAG-3 +anti-PD-1 (80 mg/240mg), a grade 3 muscle weakness and a grade 4 edema. Three DLTs were observed in the higher Anti-LAG-3 + anti-PD-1 group (160 mg/240mg): grade 3 hypertension, syncope, and edema. 80% of the DLTs occurred after cycle 2 of the treatment. The estimated overall mOS was 8 months. Seven (44%) patients in the combination arm are still alive and 3 out of the 7 are living beyond 20 months suggesting a subset benefit. Conclusions: The phase I part of trial has completed enrollment. The MTD is 800mg for anti-LAG-3 as a monotherapy. For the combination arms, 160 mg of Anti-LAG-3 and 240 mg of anti-PD-1 was the MTD. DLTs were late onset events. Clinical trial information: NCT02658981.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

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 38: 2020 (suppl; abstr 2512)

DOI

10.1200/JCO.2020.38.15_suppl.2512

Abstract #

2512

Poster Bd #

3

Abstract Disclosures