INO-5401 and INO-9012 delivered intramuscularly (IM) with electroporation (EP) in combination with cemiplimab (REGN2810) in newly diagnosed glioblastoma (GBM): Interim results.

Authors

null

David A. Reardon

Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA

David A. Reardon , Steven Brem , Arati Suvas Desai , Stephen Joseph Bagley , Sylvia Christine Kurz , Macarena Ines De La Fuente , Seema Nagpal , Mary Roberta Welch , Adilia Hormigo , Nicholas Carroll , Sarah K Bartra , Patricia Campbell , Kamalnayan Bhatt , Israel Lowy , Jean Boyer , Kimberly Kraynyak , Matthew P Morrow , Trevor McMullan , David B. Weiner , Jeffrey Skolnik

Organizations

Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, University of Pennsylvania, Philadelphia, PA, Hospital of the University of Pennsylvania, Philadelphia, PA, Abramson Cancer Center, Philadelphia, PA, NYU Langone Health, New York, NY, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, Stanford University, Stanford, CA, Montefiore Medical Center, New York, NY, Icahn School of Medicine at Mount Sinai, New York, NY, Inovio Pharmaceuticals, Plymouth Meeting, PA, Inovio, Plymouth Meeting, PA, Inovio Pharmaceuticals, Inc., Plymouth, PA, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, Inovio, San Diego, CA, Inovio Pharmaceuticals, Inc., Blue Bell, PA, Inovio Pharmaceuticals, Inc., Collegeville, PA, The Wistar Institute, Philadelphia, PA

Research Funding

Pharmaceutical/Biotech Company
Inovio

Background: Novel T cell-enabling therapies, in combination with checkpoint inhibition, may improve OS in GBM. INO-5401 (synthetic DNA plasmids encoding for hTERT, WT-1 and PSMA), plus INO-9012 (synthetic DNA plasmid encoding IL-12), with the PD-1 checkpoint inhibitor cemiplimab, is given to patients with newly-diagnosed GBM to evaluate tolerability, efficacy and immunogenicity of the combination. Methods: Phase I/II, single arm, 2 cohort study (A: MGMT unmethylated, B: MGMT methylated). The primary endpoint is safety; efficacy and immunogenicity are secondary. Nine mg INO-5401 plus 1 mg INO-9012 (every 3 weeks for 4 doses, then Q9W) is given with EP by CELLECTRA 2000 with cemiplimab (350 mg IV Q3W). RT is given as 40 Gy over 3 weeks. TMZ is given with radiation (all patients), followed by maintenance (Cohort B only). Results: Fifty two subjects were enrolled: 32 in Cohort A; 20 in Cohort B. 35% women and 90% white. Median age 60 years (range 19-78 years). Common Grade ≥3 AEs reported were: platelet count decreased (11.5%), tumor inflammation (7.7%), seizure (7.7%), ALT increased (7.7%), lymphocyte count decreased (7.7.%). One Grade 5 unrelated event of urosepsis was reported. Of 69 SAEs reported there was only 1 related to the combination therapy, Grade 1 pyrexia. 48% of subjects reported irAEs, most frequently ALT increased (9.6%), AST increased (7.7%), diarrhea (7.7%), pyrexia (7.7%) and tumor inflammation (7.7%). 71% of the reported SAEs and irAEs occurred within the first 12 weeks of treatment. OS at 12 months was 84.4% (95% CI 67.2, 94.7) in Cohort A; Cohort B will be presented at ASCO. ELISpot assessments demonstrated T cell responses to INO-5401. Flow cytometry demonstrated evidence of activated INO-5401-specific CD8+T cells with lytic potential (CD38+Prf+GrzA+) when compared with baseline, post-treatment in the majority of patients assayed. Conclusions: INO-5401 + INO-9012 in combination with cemiplimab and RT/TMZ has an acceptable safety profile, is immunogenic and may show a survival advantage in patients with newly-diagnosed GBM. OS18 data will be presented later this year. Clinical trial information: NCT03491683.

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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

NCT03491683

Citation

J Clin Oncol 38: 2020 (suppl; abstr 2514)

DOI

10.1200/JCO.2020.38.15_suppl.2514

Abstract #

2514

Poster Bd #

5

Abstract Disclosures