A First-in-Human Study and Biomarker Analysis of NKTR-214, a Novel IL2Rβγ-Biased Cytokine, in Patients with Advanced or Metastatic Solid Tumors.
Salah-Eddine BentebibelMichael E HurwitzChantale BernatchezCara L HaymakerCourtney W HudgensHarriet M KlugerMichael T TetzlaffMary A TagliaferriJonathan ZalevskyUte HochChristie FantonSandra AungPatrick HwuBrendan D CurtiNizar M TannirMario SznolAdi DiabPublished in: Cancer discovery (2019)
NKTR-214 (bempegaldesleukin) is a novel IL2 pathway agonist, designed to provide sustained signaling through heterodimeric IL2 receptor βγ to drive increased proliferation and activation of CD8+ T and natural killer cells without unwanted expansion of T regulatory cells (Treg) in the tumor microenvironment. In this first-in-human multicenter phase I study, NKTR-214 administered as an outpatient regimen was well tolerated and showed clinical activity including tumor shrinkage and durable disease stabilization in heavily pretreated patients. Immune activation and increased numbers of immune cells were observed in the periphery across all doses and cycles with no loss of NKTR-214 activity with repeated administration. On-treatment tumor biopsies demonstrated that NKTR-214 promoted immune cell increase with limited increase of Tregs. Transcriptional analysis of tumor biopsies showed that NKTR-214 engaged the IL2 receptor pathway and significantly increased genes associated with an effector phenotype. Based on safety and pharmacodynamic markers, the recommended phase II dose was determined to be 0.006 mg/kg every three weeks. SIGNIFICANCE: We believe that IL2- and IL2 pathway-targeted agents such as NKTR-214 are key components to an optimal immunotherapy treatment algorithm. Based on its biological activity and tolerability, NKTR-214 is being studied with approved immuno-oncology agents including checkpoint inhibitors.See related commentary by Sullivan, p. 694.This article is highlighted in the In This Issue feature, p. 681.
Keyphrases
- phase ii
- endothelial cells
- clinical trial
- end stage renal disease
- small cell lung cancer
- open label
- gene expression
- natural killer cells
- randomized controlled trial
- transcription factor
- ejection fraction
- deep learning
- dna damage
- induced pluripotent stem cells
- chronic kidney disease
- cell proliferation
- dendritic cells
- oxidative stress
- cancer therapy
- immune response
- signaling pathway
- double blind
- binding protein
- peritoneal dialysis
- placebo controlled
- combination therapy
- replacement therapy