Eganelisib, a First-in-Class PI3Kγ Inhibitor, in Patients with Advanced Solid Tumors: Results of the Phase 1/1b MARIO-1 Trial

Authors

David S Hong
Michael Postow
Bartosz Chmielowski
Ryan Sullivan
Amita Patnaik
Ezra E W Cohen
Geoffrey Shapiro
Conor Steuer
Martin Gutierrez
Heather Yeckes-Rodin
Robert Ilaria
Brenda O'Connell
Joanna Peng
Guangbin Peng
Nora Zizlsperger
Anthony Tolcher
Jedd D Wolchok

Publication Date

6-13-2023

Journal

Clinical Cancer Research

Abstract

Purpose: Eganelisib (IPI-549) is a first-in-class, orally administered, highly selective PI3Kγ inhibitor with antitumor activity alone and in combination with programmed cell death protein 1/ligand 1 (PD-1/PD-L1) inhibitors in preclinical studies. This phase 1/1b first-in-human, MAcrophage Reprogramming in Immuno-Oncology-1 (NCT02637531) study evaluated the safety and tolerability of once-daily eganelisib as monotherapy and in combination with nivolumab in patients with solid tumors.

Patients and methods: Dose-escalation cohorts received eganelisib 10-60 mg as monotherapy (n = 39) and 20-40 mg when combined with nivolumab (n = 180). Primary endpoints included incidence of dose-limiting toxicities (DLT) and adverse events (AE).

Results: The most common treatment-related grade ≥3 toxicities with monotherapy were increased alanine aminotransferase (ALT; 18%), aspartate aminotransferase (AST; 18%), and alkaline phosphatase (5%). No DLTs occurred in the first 28 days; however, toxicities meeting DLT criteria (mostly grade 3 reversible hepatic enzyme elevations) occurred with eganelisib 60 mg in later treatment cycles. In combination, the most common treatment-related grade ≥3 toxicities were increased AST (13%) and increased ALT and rash (10%). Treatment-related serious AEs occurred in 5% of monotherapy patients (grade 4 bilirubin and hepatic enzyme increases in one patient each) and 13% in combination (pyrexia, rash, cytokine release syndrome, and infusion-related reaction in ≥2 patients each). Antitumor activity was observed in combination, including patients who had progressed on PD-1/PD-L1 inhibitors.

Conclusions: On the basis of the observed safety profile, eganelisib doses of 30 and 40 mg once daily in combination with PD-1/PD-L1 inhibitors were chosen for phase 2 study.

Keywords

Humans, Nivolumab, Antibodies, Monoclonal, Humanized, Programmed Cell Death 1 Receptor, Immune Checkpoint Inhibitors, Neoplasms, Angiogenesis Inhibitors, Antineoplastic Combined Chemotherapy Protocols

DOI

10.1158/1078-0432.CCR-22-3313

PMID

37000164

PMCID

PMC10388696

PubMedCentral® Posted Date

12-13-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes