ASCO 2021: LAG-3 Protein Plus Pembrolizumab Under Study in Metastatic Lung Cancer
Posted: Wednesday, June 30, 2021
Timothy Dudley Clay, DMSc, of St. John of God Hospital, Perth, Australia, and colleagues conducted a phase II study of eftilagimod alpha—a soluble LAG-3 protein—and pembrolizumab as a first-line treatment for metastatic non–small cell lung carcinoma (NSCLC). Presented during the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting, the study authors reported that this combination therapy is not only safe, but demonstrates antitumor activity across all PD-L1 levels (Abstract 9046).
The investigators focused on 36 patients with untreated, advanced NSCLC who were unselected for PD-L1 expression. Eftilagimod alpha was administered at 30 mg every 2 weeks for eight cycles, then every 3 weeks for nine cycles, along with 200 mg of pembrolizumab every 3 weeks.
The median patient age was 69 years, with a majority (69%) being male; participants received a median of 7.0 pembrolizumab and 11.5 eftilagimod alpha administrations. Eastern Cooperative Oncology Group performance status was 0 in 42% of participants, and the remaining 58% had a performance status of 1. Nonsquamous and squamous NSCLC affected 58% and 42% of individuals, respectively, with 95% experiencing metastatic disease.
A tumor proportion score (TPS) of at least 50% was recorded in 36% of patients across all PD-L1 subgroups. Across different PD-L1 subgroups, however, the objective response rates were 27% for individuals with a TPS less than 1%, 39% for patients with a score from 1% to 50%, and 54% for those with a of 50% or greater. Although median overall survival was not reached, the median progression-free survival was 8.2 months.
The most frequent treatment-emergent adverse events were asthenia (47%), decreased appetite (36%), cough (36%), dyspnea (32%), pruritus (31%), fatigue (28%), anemia (25%), constipation (25%) diarrhea (25%), and back pain (22%). Treatment was discontinued in two patients due to grade 3 alanine and aspartate transaminase increase and grade 4 immune-mediated hepatitis.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.