ASCO 2021 | Clinical activity of fianlimab, an anti-LAG-3 mAb combined with cemiplimab in advanced melanoma
Omid Hamid, MD, The Angeles Clinic and Research Institute, Los Angeles, CA, presents the safety and clinical activity data of a Phase I study evaluating fianlimab, an anti-LAG-3 monoclonal antibody (mAb) and cemiplimab in patients with advanced melanoma. The safety profile of fianlimab and cemiplimab was similar to that observed with cemiplimab monotherapy and the combination was associated with similar clinical activity to anti-PD-1/CTLA-4 approaches but with a more manageable safety profile. This interview took place at the American Society of Clinical Oncology (ASCO) 2021 Virtual Meeting.
Transcript (edited for clarity)
This is an abstract of the clinical activity of fianlimab, which is a anti-LAG-3 monoclonal antibody combined with cemiplimab, which is an anti-PD -1 antibody in patients with advanced melanoma. I think in melanoma there’s going to be a huge focus on LAG-3 as a target. ASCO was the one of the first places where Paulo Acierto showed that you can reinvigorate T-cells by giving LAG-3 along with PD-1 and restoring immune function...
This is an abstract of the clinical activity of fianlimab, which is a anti-LAG-3 monoclonal antibody combined with cemiplimab, which is an anti-PD -1 antibody in patients with advanced melanoma. I think in melanoma there’s going to be a huge focus on LAG-3 as a target. ASCO was the one of the first places where Paulo Acierto showed that you can reinvigorate T-cells by giving LAG-3 along with PD-1 and restoring immune function. These are first-line and second-line trials. This trial with fianlimab allowed patients who were previously treated and patients who are therapeutically naive. What we see here are response rates of 63% for anti-PD-1, PD-L1 naive patients. And also 13.3% for patients who are PD-1 experienced. This is in line with what we’ve seen in other second-line, but the first-line data is important. Response rates around 60% are in line with what we’ve seen with PD-1, CTLA-4 combinations. The caveat here is these responses are durable, similar to other combinations, but the toxicity is less than what we’ve seen with anti-PD-1, anti-CTLA-4.
I think as we go forward drugs like fianlimab and the targeting of LAG-3 are going to have a huge place in melanoma and then move into the care of other solid tumors and slowly try to answer the question of what’s our first-line therapy? What do we give for patients who have recurred after adjuvant PD-1? What about our patients who are frailer and cannot tolerate a 55% grade three or four toxicity? So 2021 features this abstract with fianlimab, but also the RELATIVITY-047 trial looking at first-line versus nivolumab of LAG-3 and nivolumab.
And also an abstract that I think more of us will be focused on is the neoadjuvant data that’s going to be presented with LAG-3 PD-1 in patients with melanoma. This abstract shows high pathologic complete response rates and low toxicity. So slowly you’ll see LAG-3 coming into therapeutic regimens for melanoma and other solid tumors. We have clinical trials now looking at not just combinations with PD-1, but triplets with anti-LAG, anti-TIM, and anti-PD1 in refractory population patients. So this’ll be an ASCO that focuses on LAG-3 therapy and this poster of fianlimab and cemiplimab in patients with advanced melanoma will be a major part of that story.
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