Article
作者: Zheng, Pan ; Fawole, Adewale ; He, Kun ; Wenger, Michael ; Kayali, Fadi ; Song, Shiling ; Wu, Long ; Li, Tianhong ; Efuni, Sergey ; Li, Luchun ; Park, Keon-Uk ; Yang, Bin ; Zhang, Jiliang ; Pan, Pinhua ; Wu, Lin ; Wang, Qiong ; Socinski, Mark A ; Singh, Preet ; Wu, Yi-Long ; Liu, Zhi-Gang ; Liu, Yang ; Yu, Xinmin ; Lee, Ki Hyeong ; Chen, Hua-Jun ; Yu, Yan ; Hamm, John ; Şahin, Uğur ; Leddon, Jennifer L ; Shpyro, Svetlana ; Balaraman, Rama ; Wang, Xicheng ; Cho, Byoung Chul ; Jain, Vikram ; He, Kai ; Davarifar, Ardalan ; Beardsley, Andrew ; Sun, Meili ; Lee, Youngjoo ; Huang, Yanjing
Abstract:
PRESERVE-003 is a two-stage phase 3 trial evaluating gotistobart (BNT316/ONC-392), a novel pH-sensitive anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4) antibody that selectively depletes regulatory T cells within the tumor microenvironment, in patients with metastatic squamous non-small cell lung cancer (sqNSCLC) without actionable genomic alterations who progressed on programmed cell death protein/programmed death ligand 1 inhibitor/platinum-based chemotherapy—a population with a poor prognosis. Here we report on stage 1, which aimed to confirm the dose and assess the preliminary efficacy (primary outcome: overall survival; secondary outcomes: progression‑free survival, objective response rate and duration of response) and safety of gotistobart compared to docetaxel. Patients with sqNSCLC were randomized (1:1) to gotistobart (6 mg kg
−1
with two 10 mg kg
−1
loading doses every 3 weeks (
N
= 45)) or docetaxel (75 mg m
−2
every 3 weeks (
N
= 42)). After a median follow-up of 14.5 months, median overall survival was not reached with gotistobart (95% confidence interval (CI) 9.3 to not evaluable) versus 10.0 months (95% CI 6.2 to 11.9 months) with docetaxel (hazard ratio 0.46, 95% CI 0.25 to 0.84, nominal two-sided
P
= 0.0102). Safety was manageable, with grade ≥3 treatment-related adverse events in 42% and 49% of patients receiving gotistobart and docetaxel, respectively. Stage 1 results suggest that gotistobart monotherapy can provide clinically meaningful benefit for patients with programmed cell death protein/programmed death ligand 1-resistant and chemotherapy-resistant metastatic sqNSCLC. ClinicalTrials.gov identifier:
NCT05671510
.