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Perets, R.; Bar, J.; Rasco, D.W.; Ahn, M.-J.; Yoh, K.; Kim, D.-W.; Nagrial, A.; Satouchi, M.; Lee, D.H.; Spigel, D.R.; Kotasek, D.; Gutierrez, M.; Niu, J.; Siddiqi, S.; Li, X.; Cyrus, J.; Chackerian, A.; Chain, A.; Altura, R.A.; Cho, B.C.
Annals of oncology, March 2021, 2021-03-00, Volume: 32, Issue: 3Journal Article
Quavonlimab (MK-1308), a novel anti-CTLA-4 antibody, in combination with pembrolizumab was investigated in a phase I study. Dose-escalation (DE) phase: patients with advanced/metastatic solid tumors received an initial flat dose of quavonlimab as monotherapy 25 mg (cohort 1), 75 mg (cohort 2), or 200 mg (cohort 3) followed by four treatments of the same quavonlimab dose plus pembrolizumab every 3 weeks (Q3W). Dose-confirmation phase (DC): patients with stage IIIB/IV non-small-cell lung cancer (NSCLC) received first-line quavonlimab 25 mg Q3W (arm A), 25 mg Q6W (arm B), 75 mg Q6W (arm C), or 75 mg Q3W (arm E) plus pembrolizumab. Primary objectives were safety and tolerability and establishment of the recommended phase II dose (RP2D) of quavonlimab when used with pembrolizumab. Objective response rate (ORR) was a secondary endpoint. Efficacy based on PD-L1 expression, tumor mutational burden (TMB), and changes in circulating CD4+/CD8+ cells were exploratory endpoints. Thirty-nine patients were enrolled in DE n = 14 (cohort 1); n = 17 (cohort 2); n = 8 (cohort 3) and 134 in DC n = 40 (arm A); n = 40 (arm B); n = 40 (arm C); n = 14 (arm E). Maximum-tolerated dose was not reached. Grade 3-5 treatment-related adverse events (AEs; graded according to NCI CTCAE v4.03) occurred in 0%, 23.5%, and 75.0% of patients in DE cohorts 1, 2, and 3, respectively, and 35.0%, 30.0%, 35.0%, and 57.1% of patients in DC arms A, B, C, and E, respectively. Efficacy was observed at all dose levels/schedules in patients with NSCLC. ORRs were 40.0% 95% confidence interval (CI), 24.9-56.7; arm A, 37.5% (95% CI, 22.7-54.2; arm B), 27.5% (95% CI, 14.6-43.9; arm C), and 35.7% (95% CI, 12.8-64.9; arm E). PD-L1 expression and total number of circulating CD4+ cells correlated with ORR. Quavonlimab 25 mg Q6W plus pembrolizumab demonstrated similar efficacy and a better safety profile among all quavonlimab doses/schedules evaluated; this regimen was the chosen RP2D. •Quavonlimab, a novel anti-CTLA-4 antibody, in combination with pembrolizumab was investigated in a first-in-human study.•The combination therapy was safe and tolerable and showed antitumor activity in patients with advanced NSCLC.•Data from this study led to a recommended phase II dose of 25 mg Q6W for quavonlimab when used with pembrolizumab.
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