PURPOSE: TIGIT is a co-inhibitory receptor of T cell and natural killer cell activity. Targeting TIGIT with or without PD-1/PD-L1 checkpoint inhibition may enhance anti-tumor immunity. PATIENTS AND METHODS: This Phase 1a/b trial was a first-in-human, open label, multicenter, dose escalation and expansion study in patients with locally advanced or metastatic solid tumors. Using 3+3 design, patients underwent 14-day treatment cycles with anti-TIGIT antibody etigilimab alone (phase 1a; 0.3, 1.0, 3.0, 10.0, 20.0 mg/kg intravenously) or in combination with anti-PD-1 antibody nivolumab (phase 1b; 3.0, 10.0, 20.0 mg/kg etigilimab and 240 mg nivolumab). Primary objective was safety and tolerability. RESULTS: Thirty-three patients were enrolled (Phase 1a, n=23; Phase 1b, n=10). There were no DLTs. MTD for single and combination therapy was not determined; maximum administered dose was 20 mg/kg. The most commonly reported adverse events (AEs) were rash (43.5%), nausea (34.8%) and fatigue (30.4%) in Phase 1a and decreased appetite (50.0%), nausea (50.0%) and rash (40%) in Phase 1b. Six patients experienced Grade {greater than or equal to}3 treatment-related AEs. In phase 1a, 7 patients (30.0%) had stable disease. In Phase 1b, 1 patient had a partial response; 1 patient had prolonged stable disease of nearly 8 months. Median progression-free survival was 56.0 days (Phase 1a) and 57.5 days (Phase 1b). Biomarker correlative analyses demonstrated evidence of clear dose-dependent target engagement by etigilimab. CONCLUSION: Etigilimab had an acceptable safety profile with preliminary evidence of clinical benefit alone and in combination with nivolumab and warrants further investigation in clinical trials.

Author Info: (1) Division of Medical Oncology, Duke University Medical Center niharika.mettu@duke.edu. (2) Hematology/oncology, Stephenson Cancer Center, OUHSC. (3) pRED Oncology, Sarah Cannon

Author Info: (1) Division of Medical Oncology, Duke University Medical Center niharika.mettu@duke.edu. (2) Hematology/oncology, Stephenson Cancer Center, OUHSC. (3) pRED Oncology, Sarah Cannon Research Institute. (4) GI Oncology (Phase 1), Huntsman Cancer Institute. (5) Medicine, Duke Medical Center. (6) Obstetrics and Gynecology, Stephenson Cancer Center, Stephenson Cancer Center at the University of Oklahoma Health Sciences Center/Sarah Cannon Research Institute. (7) OncoMed Pharmaceuticals/Mereo Biopharma. (8) R&D, Mereo Biopharma. (9) Clinical Development, Exelixis Inc. (10) HonorHealth.