Posted: Monday, November 21, 2022
First-line treatment with the soluble LAG-3 protein eftilagimod alpha plus pembrolizumab appears to be safe and active in patients with metastatic non–small cell lung cancer (NSCLC) unselected for PD-L1, according to a study presented at the 2022 Society for Immunotherapy of Cancer (SITC) Annual Meeting (Abstract LBA 1470) and published in the Journal for ImmunoTherapy of Cancer. Based on these results from the phase II TACTI-002 trial, Wade T. Iams, MD, of the Vanderbilt Ingram Cancer Center, Nashville, and colleagues proposed this combination may warrant late-stage clinical investigation.
Between March 2019 and November 2021, a total of 114 patients were administered 30 mg of subcutaneous eftilagimod alpha every other week for eight cycles prior to receiving this agent every 3 weeks for up to 1 year with 200 mg of intravenous pembrolizumab every 3 weeks for up to 2 years. Follow-up data were provided for a median of 13 months.
A total of 9.6% of patients discontinued treatment because of related adverse events. Dyspnea (35%), asthenia (33%), decreased appetite (25%), cough (25%), anemia (23%), fatigue (21%), pruritus (21%), constipation (18%), nausea (17%), hemoptysis (16%), and diarrhea (16%) were the most frequently reported adverse events.
According to the immune Response Evaluation Criteria in Solid Tumors (RECIST), the objective response rate was 39.5%, and the median duration of progression-free survival was 6.9 months. Responses were reported in all PD-L1 subgroups. The objective response rates were 37.5% and 38.9% in patients with squamous and nonsquamous carcinomas, respectively, according to the immune RECIST. The median duration of response was 21.6 months. Results based on the RECIST version 1.1 criteria were found to be comparable. The investigators reported early and sustained increases in the circulating CXCL-10 and interferon-gamma levels.
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