IMPORT-201 (IMP-MEL): A phase 1 first-in-human dose finding/randomized phase 2 study of a novel iNKT agonist IMM60 and pembrolizumab for advanced melanoma and metastatic non-small cell lung cancer (NSCLC).

Authors

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Nicholas Coupe

Oxford University Hospital, Oxford, United Kingdom

Nicholas Coupe , David J. James Pinato , Justin P. Fairchild , Desa Rae Electa Pastore , Steven Innaimo , David Thompson , Uzi Gileadi , Robert A. Kramer , Ian B. Walters , Mark R. Middleton

Organizations

Oxford University Hospital, Oxford, United Kingdom, Department of Surgery and Cancer, Imperial College, London, United Kingdom, Portage Biotech, Westport, CT, Oncology Clinical Trials Office, University of Oxford, Oxford, United Kingdom, Oxford University, Oxford, United Kingdom, Department of Oncology, University of Oxford, Oxford, United Kingdom

Research Funding

Pharmaceutical/Biotech Company
Portage Biotech/iOx Therapeutics

Background: Invariant natural killer T-cells (iNKTs) share features of NK-like cells and T-cells, playing a role in both innate and adaptive immune responses. The importance of this relatively rare lymphocyte subset has generated interest due to its dual ability to have a direct cytotoxic effect on CD1d expressing tumors as well as to induce long-lasting antitumor CD8 T cell responses mediated by cross-priming and licensing of dendritic cells. While many current clinical approaches involve the use of allogeneic iNKT cells, here we describe initial clinical studies with IMM60, a synthetically derived agonist of iNKT cells formulated in a liposome (PORT-2). In preclinical studies, IMM60 treatment results in maturation of DCs and B cells and a potent stimulation of iNKT cell-derived IFN-g. In murine efficacy studies, IMM60 demonstrated monotherapy activity in multiple PD-1 resistant models (e.g., B16-F10), as well as upregulation of PD-L1 expression on cancer cells and re-sensitization to PD-1 inhibition. Methods: The IMPORT-201 trial is a multicenter, international expansion of an open-label first-in-human phase I/II investigator initiated study (IMP-MEL). Ph 1 is currently enrolling patients with NSCLC or melanoma. IMM60-containing liposomes are administered IV Q3W at 3 escalating dose levels for 6 doses as monotherapy or with pembrolizumab 200mg Q3W. The Ph I portion of the study seeks to establish the recommended Ph 2 dose of IMM60 alone and in combination with pembrolizumab. The Ph 2 evaluates IMM60 monotherapy, PD-1 monotherapy, and the combination. Results: Eight patients with melanoma (n=4) or NSCLC (n=4) have been enrolled in the IMM60 monotherapy dose cohorts. These patients were heavily pretreated, having a median of 3.5 prior therapies (range 2-7). One patient with NSCLC has been enrolled to the IMM60 + pembrolizumab combination cohort. IMM60 was well tolerated with no treatment-related SAEs or G3-5 AEs, and no MTD was determined. The most common related AE is G1-2 fatigue, reported in 2 patients. In the monotherapy cohort, a preliminary review of individual target lesions showed 2 lesions that completely resolved, 1 lesion with 69% decrease in size, 10 lesions that were stable, and 6 lesions with >20% increase in size. Serum biomarker analysis demonstrated evidence of iNKT and NK activation, as well as increases in dendritic and CD86+ B cells. Pharmacokinetics demonstrate dose proportionality with a terminal half-life of ~8 hours. Conclusions: IMM60 is well tolerated as monotherapy and in combination with pembrolizumab at the doses tested. These data show that a single agent iNKT agonist can be safely administered in a heavily pre-treated population and initiate immune activation. The combination with pembrolizumab is ongoing, and updated results of the Ph 1 portion of the study will be reported. Clinical trial information: NCT05709821.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Developmental Therapeutics—Immunotherapy

Track

Developmental Therapeutics—Immunotherapy

Sub Track

New Targets and New Technologies (IO)

Clinical Trial Registration Number

NCT05709821

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr 2575)

DOI

10.1200/JCO.2023.41.16_suppl.2575

Abstract #

2575

Poster Bd #

417

Abstract Disclosures