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Bempegaldesleukin (NKTR-214) plus Nivolumab in Patients with Advanced Solid Tumors: Phase I Dose-Escalation Study of Safety, Efficacy, and Immune Activation (PIVOT-02).

  • Adi Diab
  • , Tannir Nizar M
  • , Salah-Eddine Bentebibel
  • , Patrick Hwu
  • , Vassiliki Papadimitrakopoulou
  • , Cara Haymaker
  • , Kluger Harriet M
  • , Gettinger Scott N
  • , Mario Sznol
  • , Tykodi Scott S
  • , Brendan Curti
  • , Tagliaferri Mary A
  • , Jonathan Zalevsky
  • , Hannah Alison L
  • , Ute Hoch
  • , Sandra Aung
  • , Christie Fanton
  • , Ahsan Rizwan
  • , Ernesto Iacucci
  • , Yijie Liao
  • Chantale Bernatchez, Hurwitz Michael E, Cho Daniel C

    Research output: Contribution to journalArticle

    Abstract

    This single-arm, phase I dose-escalation trial (NCT02983045) evaluated bempeg-a-ldesleukin (NKTR-214/BEMPEG), a CD122-preferential IL2 pathway agonist, plus nivolumab in 38 patients with selected immunotherapy-naïve advanced solid tumors (melanoma, renal cell carcinoma, and non-small cell lung cancer). Three dose-limiting toxicities were reported in 2 of 17 patients during dose escalation [hypotension (n = 1), hyperglycemia (n = 1), metabolic acidosis (n = 1)]. The most common treatment-related adverse events (TRAE) were flu-like symptoms (86.8%), rash (78.9%), fatigue (73.7%), and pruritus (52.6%). Eight patients (21.1%) experienced grade 3/4 TRAEs; there were no treatment-related deaths. Total objective response rate across tumor types and dose cohorts was 59.5% (22/37), with 7 complete responses (18.9%). Cellular and gene expression analysis of longitudinal tumor biopsies revealed increased infiltration, activation, and cytotoxicity of CD8+ T cells, without regulatory T-cell enhancement. At the recommended phase II dose, BEMPEG 0.006 mg/kg plus nivolumab 360 mg every 3 weeks, the combination was well tolerated and demonstrated encouraging clinical activity irrespective of baseline PD-L1 status. SIGNIFICANCE: These data show that BEMPEG can be successfully combined with a checkpoint inhibitor as dual immunotherapy for a range of advanced solid tumors. Efficacy was observed regardless of baseline PD-L1 status and baseline levels of tumor-infiltrating lymphocytes, suggesting therapeutic potential for patients with poor prognostic risk factors for response to PD-1/PD-L1 blockade.

    Original languageUndefined/Unknown
    JournalArticles, Abstracts, and Reports
    StatePublished - May 21 2020

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