A first-in-human phase 1 dose escalation study of spartalizumab (PDR001), an anti-PD-1 antibody, in patients with advanced solid tumors

Aung Naing, Justin F. Gainor, Hans Gelderblom, Patrick M. Forde, Marcus O. Butler, Chia Chi Lin, Sunil Sharma, Maria Ochoa De Olza, Andrea Varga, Matthew Taylor, Jan H.M. Schellens, Hongqian Wu, Haiying Sun, Antonio P. Silva, Jason Faris, Jennifer Mataraza, Scott Cameron, Todd M. Bauer

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    3 Scopus citations

    Abstract

    Background Spartalizumab is a humanized IgG4κ monoclonal antibody that binds programmed death-1 (PD-1) and blocks its interaction with PD-L1 and PD-L2. This phase 1/2 study was designed to assess the safety, pharmacokinetics, and preliminary efficacy of spartalizumab in patients with advanced or metastatic solid tumors. Methods In the phase 1 part of the study, 58 patients received spartalizumab, intravenously, at doses of 1, 3, or 10 mg/kg, administered every 2 weeks (Q2W), or 3 or 5 mg/kg every 4 weeks (Q4W). Results Patients had a wide range of tumor types, most commonly sarcoma (28%) and metastatic renal cell carcinoma (10%); other tumor types were reported in ≤3 patients each. Most patients (93%) had received prior antineoplastic therapy (median three prior lines) and two-thirds of the population had tumor biopsies negative for PD-L1 expression at baseline. The maximum tolerated dose was not reached. The recommended phase 2 doses were selected as 400 mg Q4W or 300 mg Q3W. No dose-limiting toxicities were observed, and adverse events included those typical of other PD-1 antibodies. The most common treatment-related adverse events of any grade were fatigue (22%), diarrhea (17%), pruritus (14%), hypothyroidism (10%), and nausea (10%). Partial responses occurred in two patients (response rate 3.4%); one with atypical carcinoid tumor of the lung and one with anal cancer. Paired tumor biopsies from patients taken at baseline and on treatment suggested an on-treatment increase in CD8+ lymphocyte infiltration in patients with clinical benefit. Conclusions Spartalizumab was well tolerated at all doses tested in patients with previously treated advanced solid tumors. On-treatment immune activation was seen in tumor biopsies; however, limited clinical activity was reported in this heavily pretreated, heterogeneous population. The phase 2 part of this study is ongoing in select tumor types. Trial registration number NCT02404441.

    Original languageEnglish (US)
    Article numbere000530
    JournalJournal for immunotherapy of cancer
    Volume8
    Issue number1
    DOIs
    StatePublished - Mar 15 2020

    Keywords

    • clinical trials as topic
    • immunotherapy
    • programmed cell death 1 receptor

    ASJC Scopus subject areas

    • Immunology and Allergy
    • Immunology
    • Molecular Medicine
    • Oncology
    • Pharmacology
    • Cancer Research

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    Naing, A., Gainor, J. F., Gelderblom, H., Forde, P. M., Butler, M. O., Lin, C. C., Sharma, S., Ochoa De Olza, M., Varga, A., Taylor, M., Schellens, J. H. M., Wu, H., Sun, H., Silva, A. P., Faris, J., Mataraza, J., Cameron, S., & Bauer, T. M. (2020). A first-in-human phase 1 dose escalation study of spartalizumab (PDR001), an anti-PD-1 antibody, in patients with advanced solid tumors. Journal for immunotherapy of cancer, 8(1), [e000530]. https://doi.org/10.1136/jitc-2020-000530