Phase I Trial of M7824 (MSB0011359C), a Bifunctional Fusion Protein Targeting PD-L1 and TGFβ, in Advanced Solid Tumors.

Abstract

Purpose: M7824 (MSB0011359C) is an innovative first-in-class bifunctional fusion protein composed of a mAb against programmed death ligand 1 (PD-L1) fused to a TGFβ "trap."Experimental Design: In the 3+3 dose-escalation component of this phase I study (NCT02517398), eligible patients with advanced solid tumors received M7824 at 1, 3, 10, or 20 mg/kg once every 2 weeks until confirmed progression, unacceptable toxicity, or trial withdrawal; in addition, a cohort received an initial 0.3 mg/kg dose to evaluate pharmacokinetics/pharmacodynamics, followed by 10 mg/kg dosing. The primary objective is to determine the safety and maximum tolerated dose (MTD); secondary objectives include pharmacokinetics, immunogenicity, and best overall response.Results: Nineteen heavily pretreated patients with ECOG 0-1 have received M7824. Grade ≥3 treatment-related adverse events occurred in four patients (skin infection secondary to localized bullous pemphigoid, asymptomatic lipase increase, colitis with associated anemia, and gastroparesis with hypokalemia). The MTD was not reached. M7824 saturated peripheral PD-L1 and sequestered any released plasma TGFβ1, -β2, and -β3 throughout the dosing period at >1 mg/kg. There were signs of efficacy across all dose levels, including one ongoing confirmed complete response (cervical cancer), two durable confirmed partial responses (PR; pancreatic cancer; anal cancer), one near-PR (cervical cancer), and two cases of prolonged stable disease in patients with growing disease at study entry (pancreatic cancer; carcinoid).Conclusions: M7824 has a manageable safety profile in patients with heavily pretreated advanced solid tumors. Early signs of efficacy are encouraging, and multiple expansion cohorts are ongoing in a range of tumors. Clin Cancer Res; 24(6); 1287-95. ©2018 AACR.

• Authors: Julius Strauss, Christopher R Heery, Jeffrey Schlom, Ravi A Madan, Liang Cao, Zhigang Kang, Elizabeth Lamping, Jennifer L Marté, Renee N Donahue, Italia Grenga, Lisa Cordes, Olaf Christensen, Lisa Mahnke, Christoph Helwig, James L Gulley
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 24 Issue 6 Pg. 1287-1295 (03 15 2018) ISSN: 1557-3265 [Electronic] United States
• PMID: 29298798 (Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: ©2018 American Association for Cancer Research.

Chemical References

• Antibodies, Bispecific
• Antineoplastic Agents, Immunological
• B7-H1 Antigen
• CD274 protein, human
• Transforming Growth Factor beta

Topics

• Adult
• Aged
• Antibodies, Bispecific (pharmacology, therapeutic use)
• Antineoplastic Agents, Immunological (pharmacology, therapeutic use)
• B7-H1 Antigen (antagonists & inhibitors)
• Combined Modality Therapy
• Female
• Humans
• Male
• Middle Aged
• Molecular Targeted Therapy (adverse effects, methods)
• Neoplasm Metastasis
• Neoplasm Staging
• Neoplasms (drug therapy, metabolism, mortality, pathology)
• Retreatment
• Transforming Growth Factor beta (antagonists & inhibitors)
• Treatment Outcome