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
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, n (%) | N=80 |
---|---|
Treatment-emergent AEs, any grade / grade ≥3 | 70 (87.5) / 22 (27.5) |
AEs related to AZD2936, any grade / grade ≥3 | 37 (46.3) / 4 (5.0) |
AEs leading to discontinuation | 3 (3.8) |
Response and disease control | Evaluable 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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