Powderly John D, Gutierrez Martin E, Balmanoukian Ani S, Hoyle Paul E, Dong Zhiwan, Cheng Lulu, Chen Xuejun, Janik John E, Bourayou Nawel, Hamid Omid
Carolina BioOncology Institute, Huntersville, NC 28078, United States.
Hackensack University Medical Center, Hackensack, NJ 07601, United States.
Oncologist. 2025 Jul 4;30(7). doi: 10.1093/oncolo/oyaf136.
Immune checkpoint receptor lymphocyte-activation gene 3 (LAG-3) is an activation marker for CD4+ and CD8+ T cells. Prolonged LAG-3 expression downregulates T-cell activation; therefore, LAG-3 blockade may restore antitumor immune response. INCAGN02385 is a humanized monoclonal LAG-3-targeting antibody. This first-in-human phase I study evaluated INCAGN02385 for advanced/metastatic solid tumors.
In this dose escalation study, patients with select immunogenic advanced or metastatic solid tumors received a single INCAGN02385 infusion (25 mg to 750 mg) every 2 weeks (Q2W). Objectives included evaluation of safety/tolerability, maximum tolerated dose (MTD) (primary), pharmacokinetics (PK), antitumor activity (secondary).
Twenty-two patients were enrolled and treated. Sixty-four percent had received ≥ 3 lines of systemic therapy. Sixty-eight percent had received prior immune checkpoint inhibitor (ICI) therapy; anti-programmed death protein-1/anti-programmed death ligand-1, 68%, anti-cytotoxic T-lymphocyte-associated protein-4 therapy, 18%. No dose-limiting toxicities occurred, and an MTD was not reached. Sixteen patients (73%) experienced treatment-related adverse events (TRAEs), most frequently fatigue (n = 7). Except for one grade 3 lymphopenia TRAE, all were grade 1/2 severity. Two patients experienced sponsor-assessed immune-related AEs (pneumonitis, peripheral sensory neuropathy [n = 1] patient each). INCAGN02385 PK parameters were dose proportional across all doses evaluated. Six patients achieved stable disease lasting ≥ 56 days (range, 57-413 days).
INCAGN02385 exhibited linear PK and preliminary evidence of disease control in this heavily pretreated population, consistent with other LAG-3-targeting monotherapies. A 350-mg Q2W dose was selected for phase II studies that will focus on combinations of INCAGN02385 with other ICIs.
免疫检查点受体淋巴细胞激活基因3(LAG-3)是CD4+和CD8+T细胞的激活标志物。LAG-3的长期表达会下调T细胞激活;因此,阻断LAG-3可能恢复抗肿瘤免疫反应。INCAGN02385是一种人源化抗LAG-3单克隆抗体。这项首次人体I期研究评估了INCAGN02385用于晚期/转移性实体瘤的疗效。
在这项剂量递增研究中,患有特定免疫原性晚期或转移性实体瘤的患者每2周接受一次INCAGN02385单次输注(25mg至750mg)。研究目的包括评估安全性/耐受性、最大耐受剂量(MTD)(主要目的)、药代动力学(PK)、抗肿瘤活性(次要目的)。
22名患者入组并接受治疗。64%的患者接受过≥3线全身治疗。68%的患者接受过既往免疫检查点抑制剂(ICI)治疗;抗程序性死亡蛋白1/抗程序性死亡配体1治疗,68%;抗细胞毒性T淋巴细胞相关蛋白4治疗,18%。未发生剂量限制性毒性,未达到MTD。16名患者(73%)发生治疗相关不良事件(TRAEs),最常见的是疲劳(n = 7)。除1例3级淋巴细胞减少TRAEs外,其余均为1/2级严重程度。2名患者发生申办方评估的免疫相关AE(肺炎、外周感觉神经病变各1例)。在所有评估剂量下,INCAGN02385的PK参数与剂量成比例。6名患者疾病稳定持续≥56天(范围,57 - 413天)。
在这个经过大量预处理的人群中,INCAGN02385表现出线性PK和疾病控制的初步证据,这与其他抗LAG-3单药疗法一致。为II期研究选择了每2周350mg的剂量,该研究将聚焦于INCAGN02385与其他ICI的联合应用。