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BMS-986299(一种 NLRP3 激动剂)作为单药及与 nivolumab 和 ipilimumab 联合治疗晚期实体瘤患者的 I 期研究

英文原题:Phase I study of BMS-986299, an NLRP3 agonist, as monotherapy and in combination with nivolumab and ipilimumab in patients with advanced solid tumors.

查看英文原题

Phase I study of BMS-986299, an NLRP3 agonist, as monotherapy and in combination with nivolumab and ipilimumab in patients with advanced solid tumors.

PubMed 2025/01/16(内容时间) J Immunother Cancer Q1 · IF 11.7(JCR 2025)

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研究概要

BMS-986299 联合免疫检查点抑制剂在特定癌症类型中显示出可控的毒性、良好的耐受性和有前景的抗肿瘤活性。

研究思路结论见上方概要

BMS-986299 是一种首创的、含 NOD-、LRR- 和 pyrin 结构域的 3(NLRP3)炎症小体激动剂,可增强适应性免疫和 T 细胞记忆反应。

这是一项I期研究(NCT03444753),评估了瘤内注射BMS-986299单药治疗(1A部分)以及与nivolumab和ipilimumab联合治疗(1B部分)在晚期实体瘤中的安全性和耐受性。此处报告的是单中心结果。

共纳入36例患者,其中乳腺癌(31%)、结直肠癌(17%)和头颈癌(14%)为较常见的入组癌种。大多数患者(58%)既往接受过免疫治疗。治疗耐受性良好,最常见的治疗相关不良事件为G1-G2发热(70%)、中性粒细胞增多(36%)和白细胞增多(33%),另有1例G4间质性肾炎、1例G3肝毒性和G3结肠炎。瘤内BMS-986299单药治疗导致全身暴露呈剂量依赖性增加,同时肿瘤CTLs(67%)、CD4+ TILs(63%)增加,并且在剂量高于2000 µg时血清IL-1B、G-CSF和IL-6显著增加两倍以上。BMS-986299全身暴露与G-CSF和IL-6的全身细胞因子升高呈正相关。在BMS-986299单药治疗队列中未观察到抗肿瘤活性。然而,在联合治疗队列(BMS-986299+nivolumab+ipilimumab)中,总体客观缓解率为10%,在TNBC、激素受体阳性、人表皮生长因子受体2阴性乳腺癌和皮肤鳞状细胞癌中观察到确认的PR。

展开英文摘要原文

BMS-986299 is a first-in-class, NOD-, LRR-, and pyrin-domain containing-3 (NLRP3) inflammasome agonist enhancing adaptive immune and T-cell memory responses.

This was a phase-I (NCT03444753) study that assessed the safety and tolerability of intra-tumoral BMS-986299 monotherapy (part 1A) and in combination (part 1B) with nivolumab, and ipilimumab in advanced solid tumors. Reported here are single-center results.

36 patients were enrolled, with breast (31%), colorectal (17%), and head and neck (14%) being the more commonly enrolled cancers. Most patients (58%) had received prior immunotherapy. Therapy was well-tolerated, with G1-G2 fever (70%), neutrophilia (36%), and leukocytosis (33%) being the most common treatment-related adverse events with one case of G4 interstitial nephritis and one case of G3 hepatotoxicity and G3 colitis. Intratumoral BMS-986299 monotherapy resulted in dose-dependent increases in systemic exposure with increase in tumor CTLs (67%), CD4+ TILs (63%), along with notable above twofold increases in serum IL-1B, G-CSF and IL-6 at doses above 2000 µg. Systemic BMS-986299 exposure was positively associated with systemic cytokine elevation for G-CSF and IL-6. No antitumor activity was noted in BMS-986299 monotherapy cohort. However, in the combination therapy cohort (BMS-986299+nivolumab+ipilimumab), overall objective response rate was 10%, with confirmed PRs observed in TNBC, hormone receptor-positive, human epidermal growth factor receptor 2 negative breast cancer, and cutaneous squamous cell carcinoma.

BMS-986299 in combination with immune checkpoint inhibitors demonstrated manageable toxicities, good tolerability, and promising antitumor activity in certain cancer types. TRIAL REGISTRATION NUMBER: NCT03444753.

论文信息

作者
Nelson BE、O'Brien S、Sheth RA、Hong DS、Naing A、Zhang X、Xu A、Hamuro L
第一作者单位
Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.United States
通讯作者单位
Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA spihapau@mdanderson.org.United States
文献类型
I 期临床试验
期刊
Journal for immunotherapy of cancer2025 Jan 16
原文标识
PubMed 39824531 · DOI 10.1136/jitc-2024-010013