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Clinical response and pathway-specific correlates following TIGIT–LAG3 blockade in myeloma: the MyCheckpoint randomized clinical trial

  • Shambavi Richard,
  • Alexander M. Lesokhin,
  • Barry Paul,
  • Jonathan L. Kaufman,
  • Matthew Pianko,
  • Noa Biran,
  • Ravi Vij,
  • Deon B. Doxie,
  • Maryam I. Azeem,
  • Mercedes Martillo,
  • Katie Wozniak,
  • Hearn J. Cho,
  • Kavita M. Dhodapkar,
  • Madhav V. Dhodapkar

摘要

Persons with myeloma were randomized to receive an anti-TIGIT (T cell immunoreceptor) or anti-LAG3 (lymphocyte activation gene) antibody followed by combination with pomalidomide and dexamethasone (NCT04150965). Primary and secondary endpoints were safety and efficacy, respectively. Therapy was well tolerated without dose-limiting toxicity. Durable clinical responses were observed in both the anti-TIGIT(three of six participants) and the anti-LAG3 (two of six participants) arms. Anti-LAG3 responders had higher naive cluster of differentiation 4 (CD4)-positive T cells and lower programmed cell death protein 1-positive effector T cells. Anti-TIGIT responders had higher CD226 expression, natural killer cell activation and lower CD112 expression. These data demonstrate the clinical activity of TIGIT–LAG3 blockade and identify pathway-specific response correlates in myeloma.