Safety, pharmacokinetics (PK), pharmacodynamics (PD) and preliminary efficacy of AZD2936, a bispecific antibody targeting PD-1 and TIGIT, in checkpoint inhibitor (CPI)-experienced advanced/metastatic non-small-cell lung cancer (NSCLC): First report of ARTEMIDE-01.

Authors

Kristoffer Staal Rohrberg

Kristoffer Staal Rohrberg

University Hospital of Copenhagen, Copenhagen, Denmark

Kristoffer Staal Rohrberg , Mariana Brandão , Eduardo Castanon Alvarez , Enriqueta Felip , Eelke Hiddo Gort , T.Jeroen Jeroen Nicolaas Hiltermann , Hiroki Izumi , Dong-Wan Kim , Sang-We Kim , Luis G. Paz-Ares , Benjamin J. Solomon , Laurie Steinbusch , Els Wauters , Tatsuya Yoshida , Huifang Chen , Andrew Goldwin , Yu Jiang , Ikbel Achour , Moritz Wolfgang Drachsler , Byoung Chul Cho

Organizations

University Hospital of Copenhagen, Copenhagen, Denmark, Jules Bordet Institute, Brussels, Belgium, Clínica Universidad de Navarra Pamplona, Madrid, Spain, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain, UMC Utrecht, Utrecht, Netherlands, University Medical Center Groningen, University of Groningen, Groningen, Netherlands, National Cancer Center Hospital East, Kashiwa, Japan, Seoul National University Hospital, Seoul, South Korea, Asan Medical Center, Seoul, South Korea, Hospital Universitario 12 De Octubre, Madrid, Spain, Peter MacCallum Cancer Centre, Melbourne, Australia, Leiden University Medical Center, Leiden, Netherlands, Universitair Ziekenhuis Leuven, Leuven, Belgium, National Cancer Center Hospital, Tokyo, Japan, AstraZeneca, Boston, MA, AstraZeneca, Cambridge, United Kingdom, AstraZeneca, Gaithersburg, MD, Yonsei Cancer Center, Seoul, Korea, Republic of (South)

Research Funding

Pharmaceutical/Biotech Company
AstraZeneca

Background: PD-1 and TIGIT are implicated in cancer-related T cell immunosuppression. AZD2936 is a bispecific, humanized IgG1 (triple-mutated to minimize Fc effector function) targeting PD-1 and TIGIT. It has demonstrated encouraging activity compared to both anti-PD-1 and anti-PD-1/-TIGIT combinations in murine models. We report data from dose escalation (Part A) and an expansion cohort (Part B) of the first-in-human study ARTEMIDE-01 (NCT04995523). Methods: This open-label, multicenter study enrolled pts with advanced NSCLC who had prior CPI treatment and a PD-L1 tumor proportion score ≥1%. Part A evaluated doses of 70–1500 mg IV Q3W; Part B evaluated the recommended phase 2 dose (RP2D). Primary endpoints included safety, tolerability, dose-limiting toxicities (DLTs) and preliminary efficacy. Secondary endpoints included PK and PD, defined as percentage PD-1 and TIGIT receptor occupancy (RO). Results: As of Dec 5, 2022, 80 pts were enrolled (Part A, n=48; Part B, n=32). Pts were 62.5% male, median age 63.5 years; 72.5% had adenocarcinoma, 23.8% had squamous cell carcinoma; 96.3% had metastatic disease; and 22.5% had brain metastases. They had a median of 2 prior regimens. Median duration of therapy was 11 wks. AZD2936 was well tolerated with no DLTs. In total, 46.3% of pts had treatment-related adverse events (TRAEs), all grade 1–3; the most common were pruritus, rash and lipase increased (6.3% each). Serious TRAEs occurred in 3 pts (3.8%): immune system disorder, acute hepatitis and fatigue (n=1 each). AZD2936 systemic exposure increased in a near dose-proportional manner. Doses of ≥210 mg achieved ~90% PD-1 and TIGIT RO in peripheral T cells. The RP2D was determined to be 750 mg Q3W based on safety, preliminary efficacy, PK/PD and modeling analysis predicting intratumoral RO. Among 76 evaluable pts, 3 had a partial response and 30 had stable disease (Table). Time to response was 1.9–4.0 mos and duration of response was 2.1–6.4 mos. Conclusions: In this interim analysis, AZD2936 showed an acceptable safety profile and preliminary antitumor activity in pts with advanced/metastatic NSCLC previously treated with standard therapy including CPIs. Further exploration of AZD2936 in CPI-naïve NSCLC pts, including a randomized dose optimization cohort is ongoing. Clinical trial information: NCT04995523.

Safety and preliminary antitumor efficacy of AZD2936.

Safety, n (%)N=80
Treatment-emergent AEs, any grade / grade ≥370 (87.5) / 22 (27.5)
AEs related to AZD2936, any grade / grade ≥337 (46.3) / 4 (5.0)
AEs leading to discontinuation3 (3.8)
Response and disease controlEvaluable pts (n=76)
Overall response rate, % (95% CI)3.9 (0.8, 11.1)
Partial response, n (%)3 (3.9)
Stable disease, n (%)30 (39.5)
Disease control at 9 weeks, n (%)33 (43.4)
Disease control at 27 weeks, n (%)11 (14.5)

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lung Cancer—Non-Small Cell Metastatic

Track

Lung Cancer

Sub Track

Metastatic Non–Small Cell Lung Cancer

Clinical Trial Registration Number

NCT04995523

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 9050)

DOI

10.1200/JCO.2023.41.16_suppl.9050

Abstract #

9050

Poster Bd #

38

Abstract Disclosures