- Luke, Jason;
- Patel, Manish;
- Blumenschein, George;
- Hamilton, Erika;
- Chmielowski, Bartosz;
- Ulahannan, Susanna;
- Connolly, Roisin;
- Santa-Maria, Cesar;
- Wang, Jie;
- Bahadur, Shakeela;
- Weickhardt, Andrew;
- Asch, Adam;
- Mallesara, Girish;
- Clingan, Philip;
- Dlugosz-Danecka, Monika;
- Tomaszewska-Kiecana, Monika;
- Pylypenko, Halyna;
- Hamad, Nada;
- Kindler, Hedy;
- Sumrow, Bradley;
- Kaminker, Patrick;
- Chen, Francine;
- Zhang, Xiaoyu;
- Shah, Kalpana;
- Smith, Douglas;
- De Costa, Anushka;
- Li, Jonathan;
- Li, Hua;
- Sun, Jichao;
- Moore, Paul
Tebotelimab, a bispecific PD-1×LAG-3 DART molecule that blocks both PD-1 and LAG-3, was investigated for clinical safety and activity in a phase 1 dose-escalation and cohort-expansion clinical trial in patients with solid tumors or hematologic malignancies and disease progression on previous treatment. Primary endpoints were safety and maximum tolerated dose of tebotelimab when administered as a single agent (n = 269) or in combination with the anti-HER2 antibody margetuximab (n = 84). Secondary endpoints included anti-tumor activity. In patients with advanced cancer treated with tebotelimab monotherapy, 68% (184/269) experienced treatment-related adverse events (TRAEs; 22% were grade ≥3). No maximum tolerated dose was defined; the recommended phase 2 dose (RP2D) was 600 mg once every 2 weeks. There were tumor decreases in 34% (59/172) of response-evaluable patients in the dose-escalation cohorts, with objective responses in multiple solid tumor types, including PD-1-refractory disease, and in LAG-3+ non-Hodgkin lymphomas, including CAR-T refractory disease. To enhance potential anti-tumor responses, we tested margetuximab plus tebotelimab. In patients with HER2+ tumors treated with tebotelimab plus margetuximab, 74% (62/84) had TRAEs (17% were grade ≥3). The RP2D was 600 mg once every 3 weeks. The confirmed objective response rate in these patients was 19% (14/72), including responses in patients typically not responsive to anti-HER2/anti-PD-1 combination therapy. ClinicalTrials.gov identifier: NCT03219268 .