Abstract 1885P
Background
Pexa-vec (PV) is an oncolytic and immunotherapeutic vaccinia virus engineered to express GM-CSF. The REN026 study assessed the antitumor activity and safety of intravenous (IV) or intratumoral(IT) PV in combination with cemiplimab (REGN2810, anti-PD-1 inhibitor) in patients with metastatic or unresectable renal cell carcinoma (RCC).
Methods
The study enrolled 89 patients with measurable histologically or cytologically confirmed metastatic or unresectable RCC, randomly assigned to one of four study arms. Patients who were treatment-naive to immune check point inhibitors (ICIs) with accessible tumors were randomized into Arm A (IT PV and cemiplimab) or Arm B (cemiplimab monotherapy, upon disease progression PV (IT) was added. Patients who were treatment-naïve to ICIs with non-accessible tumors were assigned to Arm C with IV PV, and those with prior treatment with ICIs were assigned to Arm D with IV PV. PV was given IT (Arms A and B) administered every 2 weeks or IV (Arms C and D) weekly for 3 or 4 treatments as 1× 109 pfu. Cemiplimab IV infusion (all arms) was administered every 3 weeks, at a dose of 350 mg.
Results
Between June 2018 and October 2022, 89 patients were assigned to the study arms as follows: 15 in Arm A, 16 in Arm B, 30 in Arm C, and 28 in Arm D. The median number of prior systemic regimens in the metastatic setting was 1 (0-4) in Arms A, B, and C and 3 (1-5) in Arm D. With the median follow-up of 22.2 months, efficacy outcomes are shown in table. The most common treatment-related adverse event was pyrexia, with a Grade ≥ 3 of 13.3% in Arm A, 0% in Arm B,0% in Arm C, and 3.6% in Arm D. No Grade 5 events occurred in any of the study arms. Table: 1885P
Summary of efficacy results
A (n=15) | B (n=16) | C (n=30) | D (n=28) | |
IT | IV | |||
ORR (95% CI)-% | 13.3 (1.7-40.5) | 12.5 (1.6-38.4) | 23.3 (9.9-42.3) | 17.9 (6.1-36.9) |
DCR (95% CI)-% | 60.0 (32.3-83.7) | 56.2 (29.9-80.3) | 60.0 (40.6-77.3) | 67.9 (47.7-84.1) |
PFS median (mo) (80% CI) | 4.3 (3.3-6.3) | 5.6 (2.1-NA) | 4.8 (4.4-8.3) | 6.4 (3.6-12.3) |
OS median (mo) (80% CI) | 22.0 (22.0-NE) | 20.8 (19.5-NE) | 25.1 (22.7-NE) | 18.5 (14.8-NE) |
Median duration of response (range,months) | 6.1 (3.7-8.5) | 7.7 (4.1-11.3) | 10.4 (5.5-24.1) | 8.5 (1.1-11.3) |
Conclusions
The combination immunotherapy of IV PV and cemiplimab demonstrated an acceptable safety profile and encouraging efficacy of ORR and survival with durable responses in patients with metastatic or unresectable RCC, regardless of previous ICI treatment.
Clinical trial identification
NCT03294083.
Editorial acknowledgement
Acknowledgments: None
Legal entity responsible for the study
SillaJen Inc.
Funding
SillaJen Inc
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1756P - Vizcan: A Swedish population-based study to address cancer outcomes using an interactive platform
Presenter: Anders Berglund
Session: Poster session 23
1757P - A real-world evaluation of the effectiveness of thermogram along with clinical breast examination in community-based breast cancer screening program
Presenter: Rahul Ravind
Session: Poster session 23
1758P - Body composition meets precision medicine: The prognostic value of sarcopenia in patients (pt) treated with Molecularly Targeted Agents (MTA)
Presenter: Cinta Hierro
Session: Poster session 23
1760P - Systematic review of quality of life (QoL) inclusion among endpoints, reporting and impact of QoL results in phase III non-inferiority trials of systemic treatments in oncology
Presenter: Jessica Paparo
Session: Poster session 23
1761P - Incidence of herpes zoster in cancer patients in Europe: A systematic review
Presenter: Inga Posiuniene
Session: Poster session 23
1762P - Are published data up-to-date? Analysis of time to publication in major oncological journals
Presenter: Pawel Sobczuk
Session: Poster session 23
1763P - The challenge for Cancer Trials Ireland (CTI) to sponsor NCI and non-EU sponsored trials in the EU
Presenter: Eibhlin Mulroe
Session: Poster session 23
1886P - Pembrolizumab and denosumab in clear cell renal cell carcinoma (ccRCC): A phase II trial (KeyPAD, ANZUP1601)
Presenter: Craig Gedye
Session: Poster session 23
1887P - Adjuvant everolimus (EVE) in patients (pts) with completely resected very high-risk renal cell cancer (RCC) and clear cell histology: Results from the phase III SWOG S0931 (EVEREST) trial
Presenter: Primo Lara
Session: Poster session 23
1888P - 24-month follow up of durvalumab and savolitinib combination in MET-driven clear cell and non-clear cell renal cancer
Presenter: Francesca Jackson-Spence
Session: Poster session 23