Characterization of liver function tests (LFTs) following tebentafusp (tebe) in previously treated (2L+) metastatic uveal melanoma (mUM) patients (pts).

Authors

null

Takami Sato

Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA

Takami Sato , Richard D. Carvajal , Joseph J. Sacco , Alexander Noor Shoushtari , Jessica Cecile Hassel , Alexandra Ikeguchi , Leonel Fernando Hernandez-Aya , Paul Nathan , Matthew Rioth , Omid Hamid , Josep M. Piulats , Jason J. Luke , Douglas Buckner Johnson , Serge Leyvraz , Enrique Espinosa , Shaad Essa Abdullah , Daniel Sum , Sarah Lockwood , Patricia Mendez , Marcus O. Butler

Organizations

Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, Department of Medicine, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, Clatterbridge Cancer Centre, Merseyside, United Kingdom, Memorial Sloan Kettering Cancer Center, New York, NY, Department of Dermatology and National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany, University of Oklahoma Medical Center, Oklahoma City, OK, University of Michigain Health System, Ann Arbor, MI, Mount Vernon Cancer Centre, London, United Kingdom, University of Colorado Cancer Center, Aurora, CO, The Angeles Clinic and Research Institute, Los Angeles, CA, Instituto Català de Oncologia, Hospital Duran i Reynals, L’Hospitalet de Llobregat, Hospitalet De Llobregat, Spain, UPMC Hillman Cancer Center, Pittsburgh, PA, Vanderbilt University Medical Center, Nashville, TN, Charite-Universitätsmedizin Berlin, Berlin, Germany, Department of Medical Oncology, La Paz University Hospital, Madrid, Spain, Immunocore, Abingdon, United Kingdom, Pivotal Statistics Ltd, Macclesfield, United Kingdom, Tumor Immunotherapy Program, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada

Research Funding

Pharmaceutical/Biotech Company
Immunocore

Background: Tebe is a bispecific gp100-targeted T cell receptor fusion protein that can redirect polyclonal T cells to target gp100+ cells leading to T cell activation and release of inflammatory mediators. Hepatocytes do not express gp100 and tebe did not redirect T cells against normal hepatocytes in preclinical in vitro studies. However, since most mUM pts have liver metastases, tebe may result in secondary effects from localized tumor-related inflammation. Here we describe LFT kinetics and outcomes for pts in the IMCgp100-102 study (NCT02570308). Methods: 127 HLA-A*02:01+ pts with 2L+ mUM received tebe, administered weekly at the RP2D following intra-patient dose escalation (C1D1: 20μg; C1D8: 30μg; C1D15+: 68μg). Pts were eligible if ALT/AST ≤ 3 x ULN and bilirubin ≤ 1.5 x ULN. LFTs were measured at baseline (BL) and weekly prior to each dose using local laboratories. AE grading was based on CTCAE v4.03. This analysis was conducted on the primary analysis snapshot dated 04Jun20. Results: At BL,125/127 (98%) pts had ALT/AST ≤ grade(G)1 and 122/127 (96%) had liver metastasis. 68/127 (54%) had an increase in post-BL grade for ALT, AST or both. Of these 48/68 (71%) increased to G1, 9/68 (13%) to G2, 7/68 (10%) to G3, and 4/68 (6%) to G4. 67 of these 68 pts (99%) had liver metastasis and most had largest liver metastasis > 3cm (38 pts > 3 cm, 29 pts < 3cm and 1 pt without). ALT/AST increases occurred early in treatment in 36/68 (53%) including at Dose 1 (12/68; 18%), Dose 2 (10/68; 15%), or Dose 3 (14/68; 21%). In the other 32/68 pts (47%), ALT/AST increases occurred at or after Dose 4 (4-65), and most of these events (21/32; 66%) were associated temporally with increase in size of liver metastases. Among the 11 pts with G3/4 ALT/AST increases post-BL, most pts experienced these events early (Doses 1-3) (8/11; 73%) and in the context of either increase in size of liver metastases / disease progression or biliary obstruction (9/11; 82%). Most pts, 60/68 (88%), continued treatment despite an increase in ALT/AST grade. Among 8 pts who discontinued treatment, 3 were due to disease progression and 3 were due to adverse events. Median time for ALT/AST to return to BL was 9 days and there were no temporal increases in albumin or INR. Conclusions: Approximately 1/2 of tebe treated pts experienced an increase in post-BL CTCAE grade for ALT/AST. Among these pts, most ALT/AST increases were mild. Most of the pts with G3/4 ALT/AST increase (9/11) were explained by increase in size of liver metastases or biliary obstruction. Increase in LFT are not unusual at time of disease progression in mUM given high frequency of liver metastases. In summary, ALT/AST increases occurred early in about half of the pts, were generally self-limiting, permitted treatment to continue, and did not appear to impact liver synthetic function (INR/Albumin). Clinical trial information: NCT02570308

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT02570308

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr e21513)

DOI

10.1200/JCO.2021.39.15_suppl.e21513

Abstract #

e21513

Abstract Disclosures