Oncoimmunology Research Unit, Navarrabiomed-Fundación Miguel Servet, Universidad Pública de Navarra (UPNA), Hospital Universitario de Navarra (HUN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31001 Pamplona, Spain.
Division of Gene Therapy and Regulation of Gene Expression, Cima Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdISNA), 31001 Pamplona, Spain.
Cells. 2022 Jul 30;11(15):2351. doi: 10.3390/cells11152351.
Immune checkpoint inhibitors (ICIs) have revolutionized medical practice in oncology since the FDA approval of the first ICI 11 years ago. In light of this, Lymphocyte-Activation Gene 3 (LAG-3) is one of the most important next-generation immune checkpoint molecules, playing a similar role as Programmed cell Death protein 1 (PD-1) and Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4). 19 LAG-3 targeting molecules are being evaluated at 108 clinical trials which are demonstrating positive results, including promising bispecific molecules targeting LAG-3 simultaneously with other ICIs. Recently, a new dual anti-PD-1 (Nivolumab) and anti-LAG-3 (Relatimab) treatment developed by Bristol Myers Squibb (Opdualag), was approved by the Food and Drug Administration (FDA) as the first LAG-3 blocking antibody combination for unresectable or metastatic melanoma. This novel immunotherapy combination more than doubled median progression-free survival (PFS) when compared to nivolumab monotherapy (10.1 months versus 4.6 months). Here, we analyze the large clinical trial responsible for this historical approval (RELATIVITY-047), and discuss the preclinical and clinical developments that led to its jump into clinical practice. We will also summarize results achieved by other LAG-3 targeting molecules with promising anti-tumor activities currently under clinical development in phases I, I/II, II, and III. Opdualag will boost the entry of more LAG-3 targeting molecules into clinical practice, supporting the accumulating evidence highlighting the pivotal role of LAG-3 in cancer.
免疫检查点抑制剂(ICIs)自 11 年前 FDA 批准首个 ICI 以来,彻底改变了肿瘤学的医学实践。鉴于此,淋巴细胞激活基因 3(LAG-3)是下一代最重要的免疫检查点分子之一,其作用类似于程序性细胞死亡蛋白 1(PD-1)和细胞毒性 T 淋巴细胞抗原 4(CTLA-4)。目前有 108 项临床试验正在评估 19 种针对 LAG-3 的靶向分子,这些试验均取得了积极成果,包括同时针对 LAG-3 和其他 ICI 的有前途的双特异性分子。最近,百时美施贵宝(Bristol Myers Squibb)开发的一种新型双抗 PD-1(Nivolumab)和抗 LAG-3(Relatimab)药物(Opdualag)被食品和药物管理局(FDA)批准用于治疗不可切除或转移性黑色素瘤,这是首个 LAG-3 阻断抗体联合疗法。与 nivolumab 单药治疗相比,该新型免疫疗法联合用药使中位无进展生存期(PFS)延长一倍以上(10.1 个月比 4.6 个月)。在此,我们分析了促成这一历史性批准的大型临床试验(RELATIVITY-047),并讨论了导致其进入临床实践的临床前和临床进展。我们还将总结目前在 I、I/II、II 和 III 期临床试验中具有有前途的抗肿瘤活性的其他靶向 LAG-3 的分子所取得的结果。Opdualag 将推动更多靶向 LAG-3 的分子进入临床实践,为不断积累的证据提供支持,这些证据强调了 LAG-3 在癌症中的关键作用。