Clinical activity of fianlimab (REGN3767), a human anti-LAG-3 monoclonal antibody, combined with cemiplimab (anti-PD-1) in patients (pts) with advanced melanoma.

Authors

null

Omid Hamid

The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, Los Angeles, CA

Omid Hamid , Ding Wang , Tae Min Kim , Sang-We Kim , Nehal J. Lakhani , Melissa Lynne Johnson , Roman Groisberg , Kyriakos P. Papadopoulos , John M. Kaczmar , Mark R. Middleton , Alexander I. Spira , Stephen K. Williamson , Guilherme Rabinowits , Rodolfo Gutierrez , Meredith McKean , Shuquan Chen , James Cassidy , Jayakumar Mani , Tasha Nicholle Sims , Glenn Kroog

Organizations

The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, Los Angeles, CA, Henry Ford Hospital, Detroit, MI, Seoul National University Hospital, Seoul, South Korea, University of Ulsan College of Medicine, Seoul, South Korea, START Midwest, Grand Rapids, MI, Sarah Cannon Research Institute/Tennessee Oncology PLLC, Nashville, TN, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, START-San Antonio, San Antonio, TX, MUSC Hollings Cancer Center, Charleston, SC, University of Oxford, Oxford, United Kingdom, US Oncology Research/Virginia Cancer Specialists, Fairfax, VA, University of Kansas Medical Center, Westwood, KS, Miami Cancer Institute/Baptist Health South Florida, Miami, FL, The Angeles Clinical and Research Institute, a Cedars-Sinai Affiliate, Los Angeles, CA, Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN, Regeneron Pharmaceuticals, Inc., Tarrytown, NY

Research Funding

Pharmaceutical/Biotech Company
Regeneron Pharmaceuticals, Inc

Background: Fianlimab and cemiplimab are two high-affinity, fully human, hinge-stabilized IgG4 monoclonal antibodies. In a Phase 1 dose escalation study, fianlimab combined with cemiplimab showed an acceptable safety profile and some clinical activity in pts with advanced malignancies. Here, we present safety and clinical activity data from two expansion cohorts of pts with advanced melanoma (anti–programmed cell death/ligand-1 [anti–PD-(L)1] naïve or experienced) who were treated with fianlimab + cemiplimab and had an opportunity for first on-treatment tumor assessment (cut-off date: Jan 4, 2021). Methods: Pts with advanced melanoma who had no prior anti–PD-(L)1 treatment (naïve) or prior anti–PD-(L)1 treatment within 3 months of screening (experienced) received fianlimab 1600 mg + cemiplimab 350 mg by IV infusion every 3 weeks. Tumor measurements were performed every 6 weeks for the first 24 weeks and subsequently every 9 weeks per RECIST v1.1. Results: 48 pts with advanced melanoma were treated with the combination therapy: 33 were anti–PD-(L)1 naïve and 15 were anti–PD-(L)1 experienced (median age: 69 years vs 59 years; male: 66.7% vs 46.7%; Caucasian: 87.9% vs 60%). The safety profile (including immune-related adverse events [AEs]) of fianlimab + cemiplimab combination therapy was similar to that of anti–PD-1 monotherapy with one exception. The rate of adrenal insufficiency, 8.3% (4/48) of pts, is similar to the rate previously observed with anti–PD-1 + anti–cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) combination therapy but higher than that observed with anti–PD-1 monotherapy. Grade ≥3 treatment-emergent AEs (TEAEs) occurred in 35.4% (17/48) of patients; Grade ≥3 serious TEAEs occurred in 22.9% (11/48) of patients; 8.3% (4/48) of patients discontinued treatment due to a TEAE. The most common TEAEs were fatigue (n = 15, 31.3%) and rash (n = 11, 22.9%). By investigator assessment, objective response rate (includes unconfirmed complete [CR] and partial responses [PR]) was 63.6% (3 CRs and 18 PRs) for anti–PD-(L)1 naïve pts and 13.3% (1 CR and 1 PR) for anti–PD-(L)1 experienced pts. Median progression-free survival and median duration of response for the anti–PD-(L)1 treatment naïve cohort have not been reached. Prognostic clinical markers and tumor biomarkers such as expression of LAG-3, PD-L1, and major histocompatibility complex II are being evaluated. Recruitment is ongoing. Conclusions: The safety profile of fianlimab + cemiplimab is similar to that observed with cemiplimab monotherapy and other anti–PD-1s, with the exception of higher rate of adrenal insufficiency. Fianlimab + cemiplimab combination has shown clinical activity for pts with advanced melanoma that is similar to anti–PD-1 + CTLA-4 combination therapy, but with lower demonstrated rates of TEAEs. Clinical trial information: NCT03005782

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Abstract Details

Meeting

2021 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

NCT03005782

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 9515)

DOI

10.1200/JCO.2021.39.15_suppl.9515

Abstract #

9515

Abstract Disclosures