First-line chemoimmunotherapy in metastatic breast carcinoma: combination of paclitaxel and IMP321 (LAG-3Ig) enhances immune responses and antitumor activity

转移性乳腺癌的一线化学免疫疗法:紫杉醇与IMP321(LAG-3Ig)联合用药可增强免疫反应和抗肿瘤活性

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作者:Chrystelle Brignone, Maya Gutierrez, Fawzia Mefti, Etienne Brain, Rosana Jarcau, Frédérique Cvitkovic, Nabil Bousetta, Jacques Medioni, Joseph Gligorov, Caroline Grygar, Manon Marcu, Frédéric Triebel

Background

IMP321 is a recombinant soluble LAG-3Ig fusion protein that binds to MHC class II with high avidity and mediates APC and then antigen-experienced memory CD8+ T cell activation. We report clinical and biological

Conclusions

The absence of toxicity and the demonstration of activity strongly support the future development of this agent for clinical use in combined first-line regimens.

Methods

MBC patients were administered one dose of IMP321 s.c. every two weeks for a total of 24 weeks (12 injections). The repeated single doses were administered the day after chemotherapy at D2 and D16 of the 28-day cycles of paclitaxel (80 mg/m2 at D1, D8 and D15, for 6 cycles). Blood samples were taken 13 days after the sixth and the twelfth IMP321 injections to determine sustained APC, NK and memory CD8 T cell responses.

Results

Thirty MBC patients received IMP321 in three cohorts (doses: 0.25, 1.25 and 6.25 mg). IMP321 induced both a sustained increase in the number and activation of APC (monocytes and dendritic cells) and an increase in the percentage of NK and long-lived cytotoxic effector-memory CD8 T cells. Clinical benefit was observed for 90% of patients with only 3 progressors at 6 months. Also, the objective tumor response rate of 50% compared favorably to the 25% rate reported in the historical control group. Conclusions: The absence of toxicity and the demonstration of activity strongly support the future development of this agent for clinical use in combined first-line regimens.

Trial registration

ClinicalTrials.gov NCT00349934.

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