Background CD47 is an immune checkpoint that binds to signal regulatory protein alpha (SIRPα) and delivers a "do not eat" signal to suppress macrophage phagocytosis. Tumor cells frequently overexpress CD47… Click to show full abstract
Background CD47 is an immune checkpoint that binds to signal regulatory protein alpha (SIRPα) and delivers a "do not eat" signal to suppress macrophage phagocytosis. Tumor cells frequently overexpress CD47 to evade macrophage-mediated destruction. TTI-621 (SIRPαFc) is an immune checkpoint inhibitor consisting of the CD47 binding domain of human SIRPα linked to the Fc region of human IgG1 designed to both: 1) block the CD47 "do not eat" signal, and 2) engage macrophage Fcγ receptors with IgG1 Fc to enhance phagocytosis and antitumor activity. Methods A phase 1, open-label, multicenter study is ongoing to evaluate the activity of weekly IV infusions of TTI-621 in multiple cohorts of adult patients (pts) with relapsed or refractory malignancies. Eligible pts are those who have progressed on standard anticancer therapy (including rituximab for pts with B-cell lymphomas), or those for whom no other approved therapy exists (NCT02663518). This data disclosure comprises all consecutively enrolled pts with diffuse large B-cell lymphoma (DLBCL) who received, at a minimum, 0.2 mg/kg/week TTI-621 monotherapy or 0.1 mg/kg TTI-621 in combination with 375 mg/m2/week rituximab for 8 weeks, after which TTI-621 monotherapy was permitted. Results As of June 1, 2017, 14 evaluable pts with DLBCL (7M/7F, age 42-72 years) have been enrolled and treated: 6 pts received TTI-621 monotherapy and 8 pts received TTI-621 plus rituximab. The number of prior systemic therapies ranged from 2 to 13; 6 pts had received prior autograft. Weekly outpatient treatments have been well tolerated. Mild-to-moderate infusion-related reactions were experienced by 9 pts following the first dose of TTI-621. Transient, dose-dependent decreases in platelets and leukocytes were generally without clinical sequelae. Objective responses were observed for 5/14 pts (36%): 1/6 pts treated with TTI-621 monotherapy and 4/8 pts treated with TTI-621 plus rituximab. Two pts attained complete responses (CR). One CR occurred in a pt treated with TTI-621 monotherapy who remains in continued CR at 20+ weeks. The second CR was in a pt treated with TTI-621 plus rituximab who remains in continued CR at 12+ weeks. Conclusions Weekly IV dosing employing TTI-621 to block the CD47 "do not eat" signal as monotherapy or in combination with rituximab was well tolerated. Treatment was associated with preliminary and promising anti-tumor activity in pts with advanced DLBCL as evidenced by 2 CRs and 3 PRs among 14 pts. Disclosures Ansell: Bristol-Myers Squibb: Research Funding; Affimed: Research Funding; Merck: Research Funding; Celldex: Research Funding; Seattle Genetics: Research Funding. Flinn: Genentech: Research Funding; Janssen: Research Funding; Janssen: Research Funding; Acerta: Research Funding; AbbVie Company: Research Funding; Seattle Genetics: Research Funding; KITE: Research Funding; Verastem: Research Funding; Curis: Research Funding; Infinity: Research Funding; TG Therapeutics: Research Funding; Agios: Research Funding; Beigene: Research Funding; Forty Seven: Research Funding; Pfizer: Research Funding; Merck: Research Funding; Pharmacyclics: Research Funding; Incyte: Research Funding; Gilead: Research Funding; Novartis: Research Funding; Constellation: Research Funding; Celgene: Research Funding; Pharmacyclics LLC: Research Funding; Takeda: Research Funding; Portola: Research Funding; Trillium: Research Funding; Calithera: Research Funding. O9Connor: Celgene: Honoraria, Research Funding; Trillium Therapeutics: Research Funding. Advani: Pfizer: Consultancy; Takeda/ Millenium: Research Funding. Percival: FLXbio: Research Funding. Johnson: Trillium Therapeutics: Employment. Catalano: Trillium Therapeutics: Employment; Apotex Inc.: Employment. Irwin: Hoffmann La Roche: Employment, Equity Ownership; Trillium Therapeutics: Employment, Equity Ownership. Petrova: Trillium Therapeutics: Employment, Equity Ownership. Uger: Trillium Therapeutics: Employment, Equity Ownership, Patents & Royalties. Sievers: Trillium Therapeutics: Employment, Equity Ownership. Chen: Genentech: Speakers Bureau; Merck: Consultancy, Speakers Bureau; Seattle Genetics: Consultancy, Research Funding, Speakers Bureau; Bristol-Myers Squibb: Consultancy, Research Funding; Pfizer: Consultancy; Pharmacyclics: Consultancy, Research Funding; Affimed: Research Funding.
               
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