Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanoma
Background To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of eftilagimod alpha (efti), a soluble lymphocyte activation gene-3 protein, in combination with the programmed cell death-1 (PD-1) antagonist pembrolizumab.Methods The study was divided into two parts; parts A an...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | Journal for ImmunoTherapy of Cancer |
| Online Access: | https://jitc.bmj.com/content/8/2/e001681.full |
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| author | Christian Mueller Andrew Haydon Victoria Atkinson Prashanth Prithviraj Frederic Triebel Chrystelle Brignone Adnan Khattak Melissa Eastgate Amitesh Roy |
| author_facet | Christian Mueller Andrew Haydon Victoria Atkinson Prashanth Prithviraj Frederic Triebel Chrystelle Brignone Adnan Khattak Melissa Eastgate Amitesh Roy |
| author_sort | Christian Mueller |
| collection | DOAJ |
| description | Background To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of eftilagimod alpha (efti), a soluble lymphocyte activation gene-3 protein, in combination with the programmed cell death-1 (PD-1) antagonist pembrolizumab.Methods The study was divided into two parts; parts A and B, where part A was the dose escalation part and part B was an extension part of the study. Patients with metastatic melanoma were treated with efti plus the standard dose of pembrolizumab. Blood samples were assayed to determine plasma pharmacokinetic parameters, detect efti antibody formation and determine long-lived CD8 T cell responses and associated pharmacodynamic parameters.Results Twenty-four patients with melanoma received pembrolizumab and bi-weekly subcutaneous (s.c.) injections of efti at doses 1 mg, 6 mg or 30 mg/injection for up to 6 months (part A) or 30 mg/injection for up 12 months (part B). No dose-limiting toxicities were reported and the main adverse event for efti was injection site reactions. Sustained systemic exposure to the product was obtained in all patients following s.c. injections of 30 mg dose. Treatment induced an increase in activated CD8 and CD4 T cell counts, and in some of the soluble biomarkers, particularly interferon (IFN)-γ, a Th1 signature cytokine. An overall response rate (ORR) of 33% was observed in patients partly with pembrolizumab-refractory of part A and ORR of 50% was observed in patients with PD-1 naïve of part B.Conclusions Efti was well tolerated in combination with pembrolizumab with encouraging antitumor activity. This warrants further clinical studies of this new combination therapy combining an antigen-presenting cell activator with an immune checkpoint inhibitor. |
| format | Article |
| id | doaj-art-0c55a1f2566c44ba8bca2bd5ddb172f6 |
| institution | Kabale University |
| issn | 2051-1426 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Journal for ImmunoTherapy of Cancer |
| spelling | doaj-art-0c55a1f2566c44ba8bca2bd5ddb172f62024-11-09T20:00:08ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2020-001681Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanomaChristian Mueller0Andrew Haydon1Victoria Atkinson2Prashanth Prithviraj3Frederic Triebel4Chrystelle Brignone5Adnan Khattak6Melissa Eastgate7Amitesh Roy8Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, USADepartment of Medical Oncology, Alfred Hospital, Melbourne, Victoria, Australia3 Princess Alexandra Hospital, Woolloongabba, Queensland, AustraliaAff1 grid.410678.cMedical Oncology, Austin Health Heidelberg Australia10 Research and Development, Immutep SAS, Orsay, France10 Research and Development, Immutep SAS, Orsay, FranceFiona Stanley Hospital, Perth, Western Australia, AustraliaCancer Care Services, Royal Brisbane and Womens Hospital, Herston, Queensland, Australia7 Oncology Research, Flinders Medical Centre, Bedford Park, South Australia, AustraliaBackground To evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of eftilagimod alpha (efti), a soluble lymphocyte activation gene-3 protein, in combination with the programmed cell death-1 (PD-1) antagonist pembrolizumab.Methods The study was divided into two parts; parts A and B, where part A was the dose escalation part and part B was an extension part of the study. Patients with metastatic melanoma were treated with efti plus the standard dose of pembrolizumab. Blood samples were assayed to determine plasma pharmacokinetic parameters, detect efti antibody formation and determine long-lived CD8 T cell responses and associated pharmacodynamic parameters.Results Twenty-four patients with melanoma received pembrolizumab and bi-weekly subcutaneous (s.c.) injections of efti at doses 1 mg, 6 mg or 30 mg/injection for up to 6 months (part A) or 30 mg/injection for up 12 months (part B). No dose-limiting toxicities were reported and the main adverse event for efti was injection site reactions. Sustained systemic exposure to the product was obtained in all patients following s.c. injections of 30 mg dose. Treatment induced an increase in activated CD8 and CD4 T cell counts, and in some of the soluble biomarkers, particularly interferon (IFN)-γ, a Th1 signature cytokine. An overall response rate (ORR) of 33% was observed in patients partly with pembrolizumab-refractory of part A and ORR of 50% was observed in patients with PD-1 naïve of part B.Conclusions Efti was well tolerated in combination with pembrolizumab with encouraging antitumor activity. This warrants further clinical studies of this new combination therapy combining an antigen-presenting cell activator with an immune checkpoint inhibitor.https://jitc.bmj.com/content/8/2/e001681.full |
| spellingShingle | Christian Mueller Andrew Haydon Victoria Atkinson Prashanth Prithviraj Frederic Triebel Chrystelle Brignone Adnan Khattak Melissa Eastgate Amitesh Roy Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanoma Journal for ImmunoTherapy of Cancer |
| title | Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanoma |
| title_full | Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanoma |
| title_fullStr | Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanoma |
| title_full_unstemmed | Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanoma |
| title_short | Eftilagimod alpha, a soluble lymphocyte activation gene-3 (LAG-3) protein plus pembrolizumab in patients with metastatic melanoma |
| title_sort | eftilagimod alpha a soluble lymphocyte activation gene 3 lag 3 protein plus pembrolizumab in patients with metastatic melanoma |
| url | https://jitc.bmj.com/content/8/2/e001681.full |
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