PO.CT01.01 · 临床试验

Global first-in-human (FiH) monotherapy dose escalation trial of BAY2862789, a diacylglycerol kinase alpha (DGKalpha) selective intra-cellular T cell checkpoint inhibitor in solid tumors

编号 CT131 展板 23 🕑 4/20 02:00–05:00 📍 Section 51 主讲 Shirish Madhav Gadgeel, Unknown
分会场 Phase 0 and First-in-Human Phase I Clinical Trials
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作者与单位 Authors & Affiliations

Ravit Geva1, Ofra Maimon2, Aaron Hansen3, Jeong Eun Kim4, Javier Garcia-Corbacho5, Enriqueta Felip6, Sook Hee Hong7, Kyriakos Papadopoulos8, Guru Sonpavde9, Alexandre Desjonqueres10, Yulin Li11, Christoph Mancao12, Jochen Schulze12, Stephen Ducray12, Andrea Frohwann10, Lidia Sacchetto10, Huijuan Su13, Laura Hunt14, Stefanie Reif10, David A. Schaer15, Helge Roider10, Leila Khoja10, Shirish Madhav Gadgeel16, Tae Min Kim17

1Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel,2Hadassah Hebrew University Hospital Ein Kerem, Ein Kerem, Israel,3Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada,4Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Republic of,5Hospital Clinic de Barcelona, Barcelona, Spain,6Vall d’Hebron University Hospital (HUVH), Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain,7The Catholic University of Korea-Seoul St. Mary's Hospital, Seoul, Korea, Republic of,8START Cancer Center, San Antonio, TX,9AdventHealth Medical Group, Orlando, FL,10Bayer AG, Berlin, Germany,11Bayer HealthCare Pharmaceuticals, Whippany, NJ,12Bayer AG, Basel, Switzerland,13Bayer, Beijing, China,14Bayer PLC, Reading, United Kingdom,15Bayer, Whippany, NJ,16Henry Ford Cancer Center, Detroit, MI,17Seoul National University Hospital, Seoul, Korea, Republic of

摘要 Abstract

Background: The limited ability of a patient's immune system to recognize tumor mutations as foreign antigens is a key constraint on the effectiveness of immunotherapies to improve anti-cancer immunity. DGKalpha is an isoform of DGK in T cells, that like DGKζ acts as an intra-cellular immune checkpoint to down-modulate the strength of T cell receptor signaling through phosphorylation of the critical secondary messenger diacylglycerol. Preclinically, inhibition of DGKalpha with the specific inhibitor BAY2862789 results in enhanced T cell function as monotherapy and in combination with immunomodulatory agents leading to increased anti-tumor effects in vitro and in vivo murine models, albeit to a lesser degree than DGKζ inhibition. Methods: A FiH trial (NCT05858164) of BAY2862789 was performed using a keyboard design for dose escalation (DE) in patients with solid tumors, with an additional parallel biomarker cohort (BC) of select tumor types, to evaluate safety (MTD/MAD), pharmacokinetics and pharmacodynamics (PD) and to determine a recommended dose for expansion (RDE). BAY2862789 was administered orally in continuous 21-day cycles until disease progression or treatment discontinuation. Here we report results of the first selective DGKalpha inhibitor global FiH study.  Results: Thirty-nine patients were dosed: N=27 DE, and N=12 BC (NSCLC=9, GOJ N=2 and CRC N=1). Baseline characteristics were 46% female (N=18) with age range 21-84 years and ECOG 0 (N=15), ECOG 1 (N=24). Three dosages were tested in 5 cohorts. Patients received between 1-16 cycles in total. Plasma concentrations of BAY2862789 were in the predicted pharmacologically active exposure range in all cohorts. Percentage worst grade TEAEs and TRAEs G1/2 were 51% and 79%; ≥ Grade 3 were 24% and 18% respectively. The most common TRAEs (>15% of patients) were Nausea, (79% G1-2, 3% G3), Dizziness (72% G1-2, 3% G3), Vomiting (59% G1-2, 3% G3), and Diarrhea (21% G1-2, 3% G3). Possible immune-related AEs were observed in 5 patients including raised CK G4 and myositis G2, myalgia G1, Hyperthyroidism G1, Hypothyroidism G2, erythema/pruritus G1. Two separate DLTs were observed (hypertension G3, dizziness G3). TRAE leading to dose modification or discontinuation occurred in 26% and 5% of patients, respectively. Despite plasma concentrations higher than in vitro EC80 in all patients, no consistent evidence of peripheral T cell activation (Ki67+) was observed. No measurable increase in intra-tumor T cells was seen in evaluable paired biopsies (N=5). The overall disease control rate was 43.6% with no RECIST 1.1 response observed. Conclusions: At tested doses, treatment with BAY2862789 was tolerable. Whilst MAD and RDE were determined, analyses of PD biomarkers suggest that specific inhibition of DGKalpha as a monotherapy is clinically insufficient to effectively modulate anti-tumor immunity.
利益披露 Disclosure
R. Geva, None.. O. Maimon, None.. A. Hansen, None.. J. Kim, None.. J. Garcia-Corbacho, None.. E. Felip, None.. S. Hong, None.. K. Papadopoulos, None.. G. Sonpavde, None. A. Desjonqueres, Bayer Employment. Y. Li, Bayer Employment. C. Mancao, Bayer Employment. J. Schulze, Bayer Employment. S. Ducray, Bayer Employment. A. Frohwann, Bayer Employment. L. Sacchetto, Bayer Employment. H. Su, Bayer Employment. L. Hunt, None. S. Reif, Bayer Employment. D. A. Schaer, Bayer Employment. H. Roider, Bayer Employment. L. Khoja, None. S. Gadgeel, Astra-Zeneca Other, Consultant; Ad Board. Genentech/Roche Other, Consultant. Pfizer Other, Consultant. Bayer Other, Consultant. Regeneron Other, Consultant. Daichii Other, Consultant. Astellas Other, Consultant. Boehringer-Ingelheim Other, Consultant. Ellipses Other, Consultant. Amgen Other, Consultant. BMS Other, Consultant. Gilead Other, Consultant. J&J Other, Consultant. Arrivent Other, Manuscript support. T. Kim, None.

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