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

Nat Cancer. 2024 Oct;5(10):1459-1464. doi: 10.1038/s43018-024-00818-w. Epub 2024 Aug 26.

Abstract

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antigens, CD*
  • Antigens, Differentiation, T-Lymphocyte
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Dexamethasone* / administration & dosage
  • Dexamethasone* / therapeutic use
  • Female
  • Humans
  • Killer Cells, Natural / drug effects
  • Killer Cells, Natural / immunology
  • Lymphocyte Activation / drug effects
  • Lymphocyte Activation Gene 3 Protein*
  • Male
  • Middle Aged
  • Multiple Myeloma* / drug therapy
  • Multiple Myeloma* / immunology
  • Receptors, Immunologic* / antagonists & inhibitors
  • Thalidomide / administration & dosage
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use
  • Treatment Outcome

Substances

  • TIGIT protein, human
  • Lymphocyte Activation Gene 3 Protein
  • Receptors, Immunologic
  • Lag3 protein, human
  • Dexamethasone
  • Antigens, CD
  • pomalidomide
  • Thalidomide
  • Antigens, Differentiation, T-Lymphocyte
  • CD226 antigen