Neoadjuvant nivolumab and relatlimab in locally advanced MMR-deficient colon cancer: a phase 2 trial.
Details
Serval ID
serval:BIB_21089C47EC22
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Neoadjuvant nivolumab and relatlimab in locally advanced MMR-deficient colon cancer: a phase 2 trial.
Journal
Nature medicine
ISSN
1546-170X (Electronic)
ISSN-L
1078-8956
Publication state
Published
Issued date
11/2024
Peer-reviewed
Oui
Volume
30
Number
11
Pages
3284-3290
Language
english
Notes
Publication types: Journal Article ; Clinical Trial, Phase II ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Mismatch repair deficiency (dMMR) is found in approximately 15% of non-metastatic colon cancers (CCs) and is characterized by a defective DNA mismatch repair system, resulting in hypermutated and highly immunogenic tumors. Although patients with dMMR CC have limited benefit from chemotherapy, these tumors have been shown to respond exceptionally well to neoadjuvant anti-PD-1 plus anti-CTLA-4, with high rates of pathologic responses. Here, based on data from melanoma studies, we postulated a high efficacy and favorable toxicity profile of anti-PD-1 plus anti-LAG-3. In the NICHE-3 study, a total of 59 patients with locally advanced dMMR CC were treated with two 4-weekly cycles of nivolumab (480 mg) plus relatlimab (480 mg) before surgery. Pathologic response was observed in 57 of 59 (97%; 95% confidence interval (CI): 88-100%) patients, meeting the primary endpoint. Responses included 54 (92%; 95% CI: 81-97%) major pathologic responses (≤10% residual viable tumor) and 40 (68%; 95% CI: 54-79%) pathologic complete responses. With a median follow-up of 8 months (range, 2-19), one patient had recurrence of disease. The treatment displayed an acceptable safety profile, with all-grade and grade 3-4 immune-related adverse events (irAEs) occurring in 80% and 10% of patients, respectively. The most common irAEs were infusion-related reactions (29%), thyroid dysfunction (22%) and fatigue (20%). In conclusion, our results show that neoadjuvant nivolumab/relatlimab induces high rates of pathologic responses and that further investigation of this treatment in larger studies is warranted. These data add to the body of evidence in support of neoadjuvant immunotherapy regimens in dMMR CC. ClinicalTrials.gov identifier: NCT03026140 .
Keywords
Humans, Nivolumab/adverse effects, Nivolumab/therapeutic use, Nivolumab/administration & dosage, Female, Middle Aged, Male, Colonic Neoplasms/drug therapy, Colonic Neoplasms/pathology, Colonic Neoplasms/genetics, Neoadjuvant Therapy, Aged, Adult, DNA Mismatch Repair/genetics, Antibodies, Monoclonal, Humanized/adverse effects, Antibodies, Monoclonal, Humanized/therapeutic use, Antibodies, Monoclonal, Humanized/administration & dosage, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Antineoplastic Combined Chemotherapy Protocols/adverse effects, Aged, 80 and over, Lymphocyte Activation Gene 3 Protein
Pubmed
Web of science
Open Access
Yes
Create date
20/09/2024 15:03
Last modification date
20/11/2024 7:16