ARC-10: A phase 3 study to evaluate zimberelimab + domvanalimab versus pembrolizumab in front-line, PD-L1-high, locally advanced or metastatic non–small-cell lung cancer.

Authors

null

Christos Chouaid

Centre Hospitalier Intercommunal de Créteil, Créteil, France

Christos Chouaid , Gwo Fuang Ho , Yotsawaj Runglodvatana , Xian He , Christoph Matthias Ahlers , Debbie Pomponio , Trever Todd , Thao Dang , Jarushka Naidoo

Organizations

Centre Hospitalier Intercommunal de Créteil, Créteil, France, University Malaya Medical Centre, Kuala Lumpur, Malaysia, Vajira Hospital, Bangkok, Thailand, Arcus Biosciences, Inc., Hayward, CA, Arcus Biosciences, Hayward, CA, Gilead Sciences, Inc., Foster City, CA, Beaumont Hospital and RCSI University of Health Sciences, Dublin, Ireland

Research Funding

Pharmaceutical/Biotech Company
Arcus Biosciences

Background: Despite improvements in the management of locally advanced or metastatic non–small cell lung cancer (NSCLC) from programmed cell death/ligand protein 1 (PD-[L]1) inhibition, there remains an unmet need for improved treatment options. PD-L1 expression is a known biomarker of response to anti–PD-L1 therapies in metastatic NSCLC. The combination of PD-1 inhibition with inhibition of the immunosuppressive T cell Immunoglobulin and ITIM domain (TIGIT) pathway is associated with improved response and prolonged progression-free survival in patients with advanced NSCLC. Domvanalimab (dom) is an Fc-silent humanized IgG1 monoclonal antibody (mAb) that blocks TIGIT, thereby reducing immunosuppression of T/natural killer (NK) cells and promoting antitumor activity. Zimberelimab (zim) is an mAb that binds to PD-1 on T/NK cells, preventing PD-L1-mediated immunosuppressive effects and resulting in tumor cell death. This phase 3 study will investigate the efficacy and safety of combination therapy with dom + zim compared with pembrolizumab monotherapy in patients with PD-L1-high NSCLC. Methods: ARC-10 (NCT04736173) is a global, phase 3, randomized, multicenter, open-label study. Eligible patients are adults with histologically confirmed, treatment-naive, locally advanced or metastatic, squamous or non-squamous NSCLC with ≥1 measurable lesion(s) per Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, high expression of PD-L1 (tumor cells [TC] ≥50%), and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Patients must not have genomic tumor aberrations for which targeted therapies are approved and available (eg, EGFR, ALK, ROS, BRAF, NTRK). Approximately 600 patients will be randomized 1:1 to receive combination therapy with dom + zim (dom 1200 mg intravenous [IV] once every 3 weeks [Q3W] + zim 360 mg IV Q3W) or pembrolizumab monotherapy (200 mg IV Q3W) for 21-day cycles until disease progression, intolerance, or a maximum of 35 cycles. Randomization will be stratified by ECOG performance status (0 vs 1), geographical region (Asia vs non-Asia), and histology (squamous vs non-squamous). The primary efficacy endpoint is overall survival. Secondary efficacy endpoints include blinded independent central review of progression-free survival and confirmed overall response rate according to RECIST v1.1. Safety endpoints include the presence of treatment-emergent adverse events and laboratory parameters. Health-related quality of life will be assessed by measuring the time to first symptom deterioration in the NSCLC-Symptom Assessment Questionnaire total score. Study recruitment is planned in Asia, North and South America, Africa, and Europe. Clinical trial information: NCT04736173.

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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

NCT04736173

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr TPS9148)

DOI

10.1200/JCO.2023.41.16_suppl.TPS9148

Abstract #

TPS9148

Poster Bd #

131b

Abstract Disclosures