QL1706(抗 PD-1 IgG4/CTLA-4 抗体)联合或不联合贝伐珠单抗化疗治疗晚期非小细胞肺癌:一项多队列、II 期研究。

QL1706 (anti-PD-1 IgG4/CTLA-4 antibody) plus chemotherapy with or without bevacizumab in advanced non-small cell lung cancer: a multi-cohort, phase II study.

机构信息

Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, No. 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, China.

Department of Medicine, Qilu Pharmaceutical Co., Ltd., Jinan, China.

出版信息

Signal Transduct Target Ther. 2024 Jan 29;9(1):23. doi: 10.1038/s41392-023-01731-x.

Abstract

First-line chemoimmunotherapy (with or without bevacizumab) has improved outcomes in advanced non-small cell lung cancer (NSCLC). Here, this open-label, multi-cohort phase II study (NCT05329025) was done to investigate the safety and efficacy of QL1706 (a single bifunctional MabPair product against PD-1 and CTLA-4) and chemotherapy with or without bevacizumab in this population. Patients were enrolled into five different cohorts based on genotype (cohorts 1-4, epidermal growth factor receptor [EGFR] wild-type; cohort 5, EGFR-mutant and progressed on EGFR-tyrosine kinase inhibitors [TKIs]). Between June 11, 2021 and December 29, 2021, 91 patients were enrolled. Most frequent treatment-related adverse events (TRAEs) included decreased appetite (60 [65.9%]), anemia (60 [65.9%]), infusion-related reactions (48 [52.7%]), and pruritus (44 [48.4%]). Grade ≥ 3 TRAEs occurred in 30 (33.0%) patients. Twenty-seven (45%) patients with wild-type EGFR achieved partial response (PR) (objective response rate [ORR] = 45%) and had a median progression-free survival (mPFS) of 6.8 months (95% CI: 5.2-9.7). For 31 patients harboring mutated EGFR, 17 (54.8%) achieved PR (ORR = 54.8%), with an mPFS of 8.5 months (95% CI: 5.72-not evaluable). Overall, QL1706 plus chemotherapy, regardless of having bevacizumab, was generally tolerable and had promising antitumor activity for EGFR wild-type advanced NSCLC in first-line setting. Moreover, QL1706 plus chemotherapy and bevacizumab showed favorable antitumor activity for patients who had EGFR mutated NSCLC but failed in TKI therapy, demonstrating a potential for treating this population.

摘要

一线化疗免疫治疗(联合或不联合贝伐珠单抗)已改善晚期非小细胞肺癌(NSCLC)的预后。在此,进行了这项开放标签、多队列 2 期研究(NCT05329025),旨在研究 QL1706(一种针对 PD-1 和 CTLA-4 的单分子双功能 mabPair 产品)联合或不联合贝伐珠单抗与化疗在该人群中的安全性和疗效。根据基因型(队列 1-4,表皮生长因子受体 [EGFR] 野生型;队列 5,EGFR 突变型且对 EGFR 酪氨酸激酶抑制剂 [TKI] 治疗进展),将患者纳入五个不同队列。2021 年 6 月 11 日至 2021 年 12 月 29 日期间,共纳入 91 例患者。最常见的治疗相关不良事件(TRAEs)包括食欲下降(60 [65.9%])、贫血(60 [65.9%])、输注相关反应(48 [52.7%])和瘙痒(44 [48.4%])。30 例(33.0%)患者发生≥3 级 TRAE。27 例(45%)野生型 EGFR 患者获得部分缓解(PR)(客观缓解率 [ORR] = 45%),中位无进展生存期(mPFS)为 6.8 个月(95%CI:5.2-9.7)。对于 31 例 EGFR 突变患者,17 例(54.8%)获得 PR(ORR = 54.8%),mPFS 为 8.5 个月(95%CI:5.72-不可评估)。总的来说,QL1706 联合化疗,无论是否联合贝伐珠单抗,在一线治疗中对野生型晚期 NSCLC 均具有良好的耐受性和抗肿瘤活性。此外,QL1706 联合化疗和贝伐珠单抗对 EGFR 突变型 NSCLC 但 TKI 治疗失败的患者显示出良好的抗肿瘤活性,为治疗该人群提供了可能。

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