Phase I/Ib, open-label, multicenter, dose-escalation study of the anti-TGF-β monoclonal antibody, NIS793, in combination with spartalizumab in adult patients with advanced tumors

Todd M Bauer, Armando Santoro, Chia-Chi Lin, Ignacio Garrido-Laguna, Markus Joerger, Richard Greil (Co-author), Anna Spreafico, Thomas Yau, Maria-Elisabeth Goebeler, Marie Luise Hütter-Krönke, Antonella Perotti, Pierre-Eric Juif, Darlene Lu, Louise Barys, Viviana Cremasco, Marc Pelletier, Helen Evans, Claire Fabre, Toshikiko Doi

Research output: Contribution to journalOriginal Articlepeer-review

Abstract

BACKGROUND: NIS793 is a human IgG2 monoclonal antibody that binds to transforming growth factor beta (TGF-β). This first-in-human study investigated NIS793 plus spartalizumab treatment in patients with advanced solid tumors.

METHODS: Patients received NIS793 (0.3-1 mg/kg every 3 weeks (Q3W)) monotherapy; following evaluation of two dose levels, dose escalation continued with NIS793 plus spartalizumab (NIS793 0.3-30 mg/kg Q3W and spartalizumab 300 mg Q3W or NIS793 20-30 mg/kg every 2 weeks [Q2W] and spartalizumab 400 mg every 4 weeks (Q4W)). In dose expansion, patients with non-small cell lung cancer (NSCLC) resistant to prior anti-programmed death ligand 1 or patients with microsatellite stable colorectal cancer (MSS-CRC) were treated at the recommended dose for expansion (RDE).

RESULTS: Sixty patients were treated in dose escalation, 11 with NIS793 monotherapy and 49 with NIS793 plus spartalizumab, and 60 patients were treated in dose expansion (MSS-CRC: n=40; NSCLC: n=20). No dose-limiting toxicities were observed. The RDE was established as NIS793 30 mg/kg (2100 mg) and spartalizumab 300 mg Q3W. Overall 54 (49.5%) patients experienced ≥1 treatment-related adverse event, most commonly rash (n=16; 13.3%), pruritus (n=10; 8.3%), and fatigue (n=9; 7.5%). Three partial responses were reported: one in renal cell carcinoma (NIS793 30 mg/kg Q2W plus spartalizumab 400 mg Q4W), and two in the MSS-CRC expansion cohort. Biomarker data showed evidence of target engagement through increased TGF-β/NIS793 complexes and depleted active TGF-β in peripheral blood. Gene expression analyses in tumor biopsies demonstrated decreased TGF-β target genes and signatures and increased immune signatures.

CONCLUSIONS: In patients with advanced solid tumors, proof of mechanism of NIS793 is supported by evidence of target engagement and TGF-β pathway inhibition.

TRIAL REGISTRATION NUMBER: NCT02947165.

Original languageEnglish
JournalJOURNAL FOR IMMUNOTHERAPY OF CANCER
Volume11
Issue number11
DOIs
Publication statusPublished - 29 Nov 2023

Keywords

  • Adult
  • Humans
  • Antibodies, Monoclonal/adverse effects
  • Antineoplastic Agents/therapeutic use
  • Carcinoma, Non-Small-Cell Lung/drug therapy
  • Kidney Neoplasms/drug therapy
  • Lung Neoplasms/drug therapy
  • Transforming Growth Factor beta

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