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ALKS 4230

Phase 3FDA approved 2014

Advanced Solid Tumors | Monoclonal antibody | Oncology |Mural Oncology plc|Trials Updated: May 21, 2025

ALKS 4230 development status

FDA approval Sep 4, 2014 as Keytruda
Approval holderMerck Sharp Dohme
ApplicationBLA125514
Highest phase Phase 3 (NCT05092360)
Phase scored for MURAPhase 1
Registered trials 14 across 10 sponsors since Dec 2015

Label indication KEYTRUDA is a programmed death receptor-1 (PD-1)-blocking antibody indicated: Melanoma for the treatment of patients with unresectable or metastatic melanoma. ( 1.1 ) for the adjuvant treatment of adult and pediatric (12 years and older) patients with Stage IIB, IIC, or III melanoma following complete resection. FDA label

ALKS 4230 target and mechanism

ModalityMonoclonal antibody

Also known as Nemvaleukin alfa, Keytruda, Nemvaleukin

Success Probability

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Market & Valuation

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Trial Design

CONTROLLED
Total Trials4
Total Enrollment451

FDA Designations

No designations recorded

ALKS 4230 clinical trials

ALKS 4230 · 4 trials · 3 indications

Phase 2 1Phase 1 3
NCT04144517A Study of ALKS 4230 (Nemvaleukin Alfa) With Pembrolizumab in Head and Neck CancerSquamous Cell Carcinoma of Head and Neck
COMPLETED14 Analytics
PHASE2COMPLETED
A Study of ALKS 4230 (Nemvaleukin Alfa) With Pembrolizumab in Head and Neck Cancer
Squamous Cell Carcinoma of Head and NeckUnlock trial analytics

Study Endpoints

Primary Endpoints

Overall Response Rate (ORR) Based on RECIST v1.1
From the first dose of study drug until first PD or death, whichever occurred first (up to 49 weeks)

ORR was defined as percentage of participants with complete response (CR) or PR as assessed by investigator based on response evaluation criteria in solid tumors (RECIST) version (v) 1.1. CR was defined as the disappearance of all target and non-target lesions (non-lymph nodes). All pathological lymph nodes (whether target or non-target) must have a reduction in their short axis less than (\<) 10 millimeters (mm). PR was defined as at least a 30 percent (%) decrease in the sum of diameter (SOD) of target lesions, taking as reference the baseline sum diameters. PD was defined as at least 20% increase (including an absolute increase of at least 5 mm) in the SOD of target lesions, taking as reference the smallest sum and/or unequivocal progression of existing non-target lesions and/or appearance of 1 or more new lesions.

Changes in density (cell counts per mm2) of immune cell (including total T cells, CD8+ T cells, CD56+ cells and Treg cells)
From the time of the Patient's pre-treatment biopsy to the time of the Patient's on-treatment biopsy

Changes in density (cell counts per mm2) of immune cell (including total T cells, CD8+ T cells, CD56+ cells and Treg cells) based on immunohistochemistry (IHC) and/or immunofluorescence (IF) in the TME between pretreatment and on-treatment (Cycle 2 Day 8) paired tumor biopsies

Changes in ratios (including T/Treg, CD8+/Treg, CD56+/Treg) based on immunohistochemistry (IHC) and/or immunofluorescence (IF) in the TME between pretreatment and on-treatment (Cycle 2 Day 8) paired tumor biopsies
From the time of the Patient's pre-treatment biopsy to the time of the Patient's on-treatment biopsy
Incidence of dose-limiting toxicity (DLT)
From the first dose through end of dose-limiting toxicity observation period (up to 24 months)
Incidence of Adverse Events (AEs), and identify the RP2D of ALKS 4230 in Part A
From time of initiation of therapy until 30 days after last dose of study drug, assessed up to 24 months

Includes AEs that are both serious and drug-related

Number of subjects experiencing AEs that are both serious and drug-related in Part B
From time of initiation of therapy until 30 days after last dose of study drug, assessed up to 24 months

Includes AEs that are both serious and drug-related

Clinical Activity of combination treatment with ALKS 4230 and pembrolizumab in each Part B tumor type.
From time of therapy until the date of first documented tumor progression, assessed up to 24 months

Overall Response rate (ORR) will be based on investigator review of radiographic and photographic images

Part A: Number of Participants With Dose-limiting Toxicities (DLTs) Based on Common Terminology Criteria for Adverse Events (CTCAE)
Cycle 1 Day 1 through Cycle 2 Day 15 (Cycle 1 length = 14 days; Cycle 2 length= 21 days)

DLT was defined by any of following events possibly, probably, or definitely related to ALKS 4230: Grade 4 neutrophil count decreased (neutropenia); Febrile neutropenia; CTCAE Grade 4 thrombocytopenia; Thrombocytopenia; Any Grade 3 cardiac or central nervous system toxicity; Liver transaminase elevation higher than 8\*upper limit of normal (ULN) or total bilirubin higher than 6\*ULN; Grade 4 hypoalbuminemia; Fever more than (\>) 40 degree Celsius (°C) sustained for \>24 hours; Hypotension required the use of pressors or prolonged hospitalization (\>48 hours) for hypotension requiring medical intervention; Grade 3 or higher electrolyte abnormalities; Increase in amylase or lipase; Grade 3 or higher nausea, vomiting, or diarrhea; Any other Grade 4 nonhematologic toxicity or any other Grade 3 non-hematologic toxicity; Any other toxicity or adverse event (AE) not defined above that resulted in participant removal from the study or discontinuation of dosing by the Investigator.

Parts A, B, and C: Number of Participants With Treatment-emergent Adverse Events (TEAEs)
From first dose of study drug until 30 days after last dose (up to 10 months for Part A; up to 41.3 months for Part B; up to 51.5 months for Part C)

TEAEs were defined as AEs that were newly occurring or worsening from the time of the first dose of study drug. An AE was any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product.

Parts A, B, and C: Number of Participants With TEAEs by Severity Grading
From first dose of study drug until 30 days after last dose (up to 10 months for Part A; up to 41.3 months for Part B; up to 51.5 months for Part C)

TEAEs were defined as AEs that were newly occurring or worsening from the time of the first dose of study drug. Severity was graded according to the National Cancer Institute (NCI) CTCAE (version 4.03) where, Grade 1: Mild- asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated. Grade 2: Moderate- minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental activities of daily living (ADL) Grade 3: Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL. Grade 4: Life-threatening consequences; urgent intervention indicated. Grade 5: Death related to AE. As planned, Grades 1 and 2 were combined for reporting.

Parts B and C: Overall Response Rate (ORR) Based on Response Evaluation Criteria in Solid Tumors (RECIST) Version (v) 1.1
From first dose of study drug up to 40.3 months for Part B and up to 50.5 months for Part C

ORR rate was defined as the percentage of participants with objective evidence of CR or PR based on RECIST v1.1. Complete Response (CR): Disappearance of all target lesions. Any pathological lymph nodes (whether target or non-target) must have reduction in short axis to less than (\<) 10 millimeters (mm). Partial Response (PR): At least a 30 percent (%) decrease in the sum of diameters of target lesions, taking as reference the baseline sum diameters.

Secondary Endpoints

Duration of Response (DOR) Based on RECIST v1.1
From first documented CR or PR until first documentation of PD (up to 49 weeks)
Progression-free Survival (PFS) Based on RECIST v1.1
From the first dose of study drug to date of PD, start of alternate therapy or death, whichever occurred first (up to 49 weeks)
Time to Progression (TTP) Based on RECIST v1.1
From first dose of study drug to the date of the first documentation of PD (up to 49 weeks)
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Group 1: Nemvaleukin 3 mcg/kg + Pembrolizumab 200 mgEXPERIMENTALParticipants with current stable disease (SD) or partial response (PR) (Cohorts 1 and 2) who were not progressing or further demonstrating reductions in tumor size were to receive nemvaleukin alfa 3 microgram per kilogram (mcg/kg), intravenous (IV) infusion, daily from Days 1 to 5 of the first week of each 3-week treatment cycle in combination with pembrolizumab 200 milligram (mg), IV infusion, once, every three weeks (Q3W) on Day 1 of each 21-day cycle until confirmed progression, unacceptable toxicity or met other criteria for discontinuation.
Group 2: Nemvaleukin Alfa 3 mcg/kg + Pembrolizumab 200 mgEXPERIMENTALParticipants with progressive disease (PD) (Cohorts 3 and 4) received nemvaleukin alfa 3 mcg/kg, IV infusion, daily from Days 1 to 5 of the first week of each 3-week treatment cycle in combination with pembrolizumab 200 mg, IV infusion, once, Q3W on Day 1 of each 21-day cycle until confirmed progression, unacceptable toxicity or met other criteria for discontinuation.
Cohort 1: Tumor Microenvironment (TME) Nemvaleukin and PembrolizumabEXPERIMENTALNemvaleukin will be administered via Intravenous (IV) infusion given daily for 5 consecutive days followed by an off-treatment period. Starting on Cycle 3, Day 1 of each cycle, Pembrolizumab will be administered via IV infusion followed by IV infusion of nemvaleukin
Cohort 2 Part A: Less Frequent IV Dosing NemvaleukinEXPERIMENTAL -
Cohort 2 Part B: Less Frequent IV Dosing Nemvaleukin and PembrolizumabEXPERIMENTALThis arm will not open for enrollment.
ALKS 4230EXPERIMENTALAdministered via SC injection once every 7 days or once every 21 days at escalating doses
ALKS 4230 + pembrolizumabEXPERIMENTALALKS 4230 will be administered via SC injection once every 7 or 21 days at escalating doses or at the recommended phase 2 dose and schedule; pembrolizumab will be administered as an intravenous infusion given over 30 minutes; the dose level for pembrolizumab will be 200 mg per the approved label. In December 2020, an RP2D of 3 mg with an administration schedule of q7d was determined for SC ALKS 4230.

Interventions

NameTypeDescription
Nemvaleukin AlfaDRUGNemvaleukin alfa IV infusion.
PembrolizumabDRUGPembrolizumab IV infusion.
ALKS 4230BIOLOGICALSC injection administered in the back of the arm or the abdomen
ALKS 4230 + pembrolizumabDRUGIV infusion of ALKS 4230 over 30 minutes given daily for 5 consecutive days followed by an off-treatment period; pembrolizumab administered IV once with ALKS 4230 on the first day of each cycle
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites7

Inclusion Criteria: * Patients must have histologically or cytopathologically confirmed diagnosis of non-cutaneous squamous cell carcinoma of the head and neck region that is locally advanced and/or recurrent and no longer amenable to local surgical or radiation therapy and/or with evidence of dist...

Countries:United StatesSpainCanadaNetherlandsSouth KoreaTaiwanAustraliaBelgiumPoland
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Competitive Landscape -Other Solid Tumors 10 trials (matched to "Advanced Solid Tumors")

Frequently asked questions about ALKS 4230

What is ALKS 4230 used for in advanced solid tumors?

ALKS 4230, also known as nemvaleukin alfa, is an investigational monoclonal antibody being studied for the treatment of advanced solid tumors. It is in Phase 1 clinical development and has been evaluated in two completed trials enrolling a total of 359 patients with advanced solid tumors.

What does ALKS 4230 target?

ALKS 4230 is a monoclonal antibody designed to target the IL-2 receptor pathway. It is being developed as a cytokine-based therapy for advanced solid tumors, with the goal of modulating immune responses against cancer cells.

Who is developing ALKS 4230?

ALKS 4230 is being developed by Mural Oncology plc, a biopharmaceutical company listed on the stock exchange under the ticker MURA. The company is conducting clinical research on this investigational drug for advanced solid tumors.

What phase is ALKS 4230 in?

ALKS 4230 is in Phase 1 clinical development. It is an investigational drug and has not been approved by regulatory authorities. Two Phase 1 trials have been completed, with no active trials currently ongoing.

What clinical trials is ALKS 4230 in?

ALKS 4230 has been studied in two completed Phase 1 clinical trials: NCT02799095, which enrolled 243 patients with advanced solid tumors, and NCT03861793 (ARTISTRY-2), which enrolled 116 patients and evaluated subcutaneous administration alone and in combination with pembrolizumab.

Is ALKS 4230 the same as nemvaleukin alfa?

Yes, ALKS 4230 is also known as nemvaleukin alfa. Both names refer to the same investigational drug being developed by Mural Oncology for the treatment of advanced solid tumors.