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Iparomlimab (QL1604) in patients with microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) unresectable or metastatic solid tumors: a pivotal, single-arm, multicenter, phase II trial
Journal of Hematology & Oncology ( IF 29.5 ) Pub Date : 2024-11-11 , DOI: 10.1186/s13045-024-01627-5
Feng Bi, Jian Dong, Chuan Jin, Zuoxing Niu, Wenhui Yang, Yifu He, Dajun Yu, Meili Sun, Teng Wang, Xianli Yin, Ruixing Zhang, Kehe Chen, Keming Wang, Zhiwu Wang, Wei Li, Zhongtao Zhang, Hangyu Zhang, Qunyi Guo, Xin Wang, Lei Han, Xizhi Zhang, Wei Shen, Liangming Zhang, Jieer Ying, Miao Wu, Weiguo Hu, Zeng Li, Xiaofen Li, Wenlei Feng, Baihui Zhang, Lingyan Li, Xiaoyan Kang, Weijian Guo

Though several anti-PD-1/PD-L1 antibodies approved for monotherapy in microsatellite instability-high or mismatch repair-deficient unresectable/metastatic solid tumors, novel immunotherapy with better anti-tumor activity is needed in clinic. In this single-arm, multicenter, pivotal, phase II study, patients received iparomlimab (a novel humanized anti-PD-1 mAb, 200 mg or 3 mg/kg for patients with body weight < 40 kg, IV, Q3W) until disease progression, intolerable toxicities, withdrawal of consent, death, or up to 2 years. The primary endpoint was objective response rate (ORR) assessed by independent radiological review committee (IRRC). Totally, 120 patients were enrolled, of whom 60 patients failed from prior standard therapy, were enrolled in the full analysis set (FAS). As of Jan 20, 2024, the confirmed ORR per IRRC in FAS were 50.0% (30/60; 95% CI 36.8–63.2%) patients, including 4 (6.7%) complete response (CR) and 26 (43.3%) partial response (PR). In colorectal cancer (CRC) patients in FAS, the ORR reached 57.9% (22/38; 95% CI 40.8–73.7%) per IRRC, with 3 (7.9%) CR and 19 (50.0%) PR. Furtherly, the ORRs in liver metastatic or non-liver metastatic CRC patients were 52.9% (9/17, 95% CI 27.8–77.0%) vs 61.9% (13/21, 95% CI 38.4%–81.9%). The incidence of TRAE was 90.8% (any grade) and 20.8% (grade ≥ 3). Immune-related adverse events occurred in 33.3% (any grade) and 5.0% (grade ≥ 3) of patients. No iparomlimab-related death occurred. Iparomlimab presented encouraging antitumor activity with durable response and tolerable safety profile. Trial registration ClinicalTrials.gov Identifier: NCT04326829.

中文翻译:


Iparomlimab (QL1604) 治疗微卫星不稳定性高 (MSI-H) 或错配修复缺陷 (dMMR) 不可切除或转移性实体瘤患者:一项关键性、单臂、多中心、II 期试验



尽管几种抗 PD-1/PD-L1 抗体被批准用于微卫星不稳定性高或错配修复缺陷的不可切除/转移性实体瘤的单药治疗,但临床需要具有更好抗肿瘤活性的新型免疫疗法。在这项单臂、多中心、关键的 II 期研究中,患者接受 iparomlimab(一种新型人源化抗 PD-1 mAb,200 mg 或 3 mg/kg,用于体重 < 40 kg,IV,Q3W 的患者)直至疾病进展、无法耐受的毒性、撤回同意、死亡或长达 2 年。主要终点是由独立放射学审查委员会 (IRRC) 评估的客观缓解率 (ORR)。共有 120 名患者入组,其中 60 名既往标准治疗失败的患者被纳入完整分析集 (FAS)。截至 2024 年 1 月 20 日,FAS 中每个 IRRC 确认的 ORR 为 50.0% (30/60;95% CI 36.8-63.2%) 患者,包括 4 例 (6.7%) 完全缓解 (CR) 和 26 例 (43.3%) 部分缓解 (PR)。在 FAS 的结直肠癌 (CRC) 患者中,每个 IRRC 的 ORR 达到 57.9% (22/38;95% CI 40.8-73.7%),其中 3 个 (7.9%) CR 和 19 个 (50.0%) PR。此外,肝转移性或非肝转移性 CRC 患者的 ORR 为 52.9% (9/17,95% CI 27.8-77.0%) 对 61.9% (13/21,95% CI 38.4%-81.9%)。TRAE 的发生率为 90.8% (任何级别) 和 20.8% (≥ 3 级)。免疫相关不良事件发生在 33.3% (任何级别) 和 5.0% (≥ 3 级) 的患者中。未发生 iparomlimab 相关死亡。Iparomlimab 表现出令人鼓舞的抗肿瘤活性,具有持久的反应和可耐受的安全性。试验注册 ClinicalTrials.gov 标识符:NCT04326829。
更新日期:2024-11-11
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