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Bempegaldesleukin Plus Nivolumab in First-Line Metastatic Melanoma

  • Adi Diab
  • , Scott S. Tykodi
  • , Gregory A. Daniels
  • , Michele Maio
  • , Brendan D. Curti
  • , Karl D. Lewis
  • , Sekwon Jang
  • , Ewa Kalinka
  • , Igor Puzanov
  • , Alexander I. Spira
  • , Daniel C. Cho
  • , Shanhong Guan
  • , Erika Puente
  • , Tuan Nguyen
  • , Ute Hoch
  • , Sue L. Currie
  • , Wei Lin
  • , Mary A. Tagliaferri
  • , Jonathan Zalevsky
  • , Mario Sznol
  • Michael E. Hurwitz
  • University of Texas MD Anderson Cancer Center
  • University of Washington
  • University of California at San Diego
  • Azienda Ospedaliera Universitaria Senese
  • Translational Molecular Pathology
  • University of Colorado Anschutz Medical Campus
  • Inova Schar Cancer Institute
  • Institute of Polish Mother's Health Center
  • Virginia Cancer Specialists
  • New York University
  • Nektar
  • Yale University

Research output: Contribution to journalArticlepeer-review

71 Scopus citations

Abstract

PURPOSE Therapies that produce deep and durable responses in patients with metastatic melanoma are needed. This phase II cohort from the international, single-arm PIVOT-02 study evaluated the CD122-preferential interleukin-2 pathway agonist bempegaldesleukin (BEMPEG) plus nivolumab (NIVO) in first-line metastatic melanoma. METHODS A total of 41 previously untreated patients with stage III/IV melanoma received BEMPEG 0.006 mg/kg plus NIVO 360 mg once every 3 weeks for # 2 years; 38 were efficacy-evaluable ($ 1 postbaseline scan). Primary end points were safety and objective response rate (blinded independent central review); other end points included progression-free survival, overall survival (OS), and exploratory biomarkers. RESULTS At 29.0 months’ median follow-up, the objective response rate was 52.6% (20 of 38 patients), and the complete response rate was 34.2% (13 of 38 patients). Median change in size of target lesions from baseline was 278.5% (response-evaluable population); 47.4% (18 of 38 patients) experienced complete clearance of target lesions. Median progression-free survival was 30.9 months (95% CI, 5.3 to not estimable). Median OS was not reached; the 24-month OS rate was 77.0% (95% CI, 60.4 to 87.3). Grade 3 and 4 treatment-related and immune-mediated adverse events occurred in 17.1% (7 of 41) and 4.9% (2 of 41) of patients, respectively. Increased polyfunctional responses in CD81 and CD41 T cells were seen in blood after treatment, driven by cytokines with effector functions. Early on-treatment blood biomarkers (CD81 polyfunctional strength difference and eosinophils) correlated with treatment response. CONCLUSION BEMPEG in combination with NIVO was tolerated, with relatively low rates of grade 3 and 4 treatment-related and immune-mediated adverse events. The combination had encouraging antitumor activity in first-line metastatic melanoma, including an extended median progression-free survival. Exploratory analyses associated noninvasive, on-treatment biomarkers with response, before radiologic evidence was observed.

Original languageEnglish
Pages (from-to)2914-2925
Number of pages12
JournalJournal of Clinical Oncology
Volume39
Issue number26
DOIs
StatePublished - Sep 10 2021

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