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Adam Schoenfeld, Memorial Sloan Kettering Cancer Center, New York, NY, USA 1. Multicenter Phase II Trial Of LN - 145 TIL Cell Therapy Plus Pembrolizumab in Patients With ICI - Na ve Metastatic NSCLC Adam Schoenfeld 1 ; Kai He 2 ; Jason Chesney 3 ; Edward Garon 4 ; Jorge Nieva 5 ; Adrian Sacher 6 ; Sylvia Lee 7 ; Friedrich Graf Finckenstein 8 ; Rana Fiaz 8 ; Melissa Catlett 8 ; Guang Chen 8 ; Viktoria Gontcharova 8 ; Benjamin C. Creelan 9 1 Memorial Sloan Kettering Cancer Center, New York, NY, USA; 2 James Cancer Center, The Ohio State University, Columbus, OH, USA; 3 James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA; 4 University of California Los Angeles, Los Angeles, CA, USA; 5 University of Southern California, Los Angeles, CA, USA; 6 Princess Margaret Cancer Centre, Toronto, Ontario , Canada; 7 Fred Hutchinson Cancer Center, Seattle, WA , USA; 8 Iovance Biotherapeutics, Inc., San Carlos, CA, USA; 9 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
Adam Schoenfeld, Memorial Sloan Kettering Cancer Center, New York, NY, USA 2. IOV - COM - 202 3A: LN - 145 + anti - PD - 1 in ICI - na ve mNSCLC Merging Potent Immunotherapy Modalities 1. Schoenfeld A, et al. J Immunother Cancer 2021;9(Suppl 2):A458. 2. Creelan BC, et al. Nat Med 2021;27(8):1410 - 1418. a Every 8 - 12 hours (3 - 24 hours after completion of LN - 145 infusion). CY, cyclophosphamide; EOA, end of assessment; EOS, end of study; EOT, end of treatment; FLU, fludarabine; GMP, Good Manufactu rin g Practice; ICI, immune checkpoint inhibitor; IL - 2, interleukin - 2; IU, international units; mNSCLC, metastatic non - small cell lung cancer; NMA - LD, non - myeloablative lymphodepletion; PD - 1, programmed cell death protein 1; PD - L1, programmed deat h ligand - 1; TIL, tumor - infiltrating lymphocyte. Screening Enrollment / Tumor Tissue Procurement for LN-145 Manufacturing Single Dose Pembrolizumab (200 mg or 400 mg) NMA - LD Day - 7 to Day - 6: CY (60 mg/kg daily 2 doses) Day - 5 to Day - 1: FLU (25 mg/m 2 daily 5 doses) LN - 145 Infusion Day 0 (1 10 9 to 150 10 9 cells) IL - 2 Day 0 or 1 to Day 3 or 4 6 Doses a (600,000 IU/kg) Pembrolizumab Q3W (200 mg) or Q6W (400 mg) for 24 months Efficacy Follow - up Long - term Follow - up Figure 1. Treatment Regimen and IL - 2 Dosing Methods and Objective IOV - COM - 202 (NCT03645928) is a global, phase 2, multicenter, multicohort open - label study of autologous TIL cell therapy in patients with solid tumors Cohort 3A includes patients with anti - PD - 1/PD - L1 na ve locally advanced or metastatic NSCLC with disease progression We report data for patients in Cohort 3A treated with LN - 145 plus pembrolizumab ( Figure 1 ) GMP Manufacturing (22 days) Assessment Period: Day 0 to EOA EOA EOT EOS Progression or New Therapy Introduction Benefit from front - line ICI chemotherapy in patients with mNSCLC is limited by primary and secondary resistance TIL cell therapy has produced durable objective responses in patients with extensively pretreated mNSCLC 1,2 Integration of TIL cell therapy in front - line regimens may improve long - term benefit
Adam Schoenfeld, Memorial Sloan Kettering Cancer Center, New York, NY, USA 3. Characteristics Cohort 3A (N=19) Median age, y (min, max) 55.4 (35, 68) Never tobacco use, n (%) a 7 (36.8) Median prior lines of systemic therapy by prior therapy subgroup, n (min, max) 1 (0, 4) Treatment - na ve (n=5) b 0 (0, 1) Post - chemotherapy (n=7) c 1 (1, 3) EGFR - mutated post - TKI (n=7) d 2 (1, 4) Nonsquamous histologic cell type, n (%) e 18 (94.7) Driver mutation - positive, n (%) f 13 (68.4) EGFR 7 (36.8) KRAS g 6 (31.6) NTRK 1 (5.3) PD - L1 tumor proportion score, n (%) h <1% 13 (68.4) 1 - 49% 2 (10.5) 50% 4 (21.1) Median number of target and nontarget lesions, n (min, max) 4 (2, 10) Median target lesion SOD, mm (min, max) 61.0 (13, 218) Anatomic site of TTPS, n (%) i Lung 8 (42.1) Lymph node 5 (26.3) Median time from TTPS to LN - 145 infusion, d (min, max) 39.0 (34, 84) Median LN - 145 dose, 10 9 cells (min, max) 23.5 (2.8, 57.6) Table 2. Non - hematologic TEAEs in 30% of Patients j Table 3. Grade 3/4 Hematologic Lab Abnormalities Data cutoff: 26 June 2023 Patients were largely PD - L1 - negative , with high burden of disease ( Table 1 ) TEAEs were consistent with the underlying disease and the known safety profiles of non - myeloablative lymphodepletion and IL - 2 ( Table 2; Table 3 ) No Grade 5 TEAE was reported Preferred Term, n (%) Cohort 3A (N=19) Any grade Grade 3/4 Pyrexia 15 (78.9) 1 (5.3) Hypoxia 14 (73.7) 11 (57.9) Chills 13 (68.4) 0 Dyspnea 12 (63.2) 4 (21.1) Fatigue 10 (52.6) 3 (15.8) Cough 9 (47.4) 0 Diarrhea 9 (47.4) 0 Hypotension 9 (47.4) 3 (15.8) Nausea 9 (47.4) 1 (5.3) Febrile neutropenia 8 (42.1) 8 (42.1) Hypoalbuminemia 8 (42.1) 1 (5.3) Sinus tachycardia 8 (42.1) 0 Hypophosphatemia 7 (36.8) 6 (31.6) Hypertension 7 (36.8) 2 (10.5) Peripheral edema 7 (36.8) 1 (5.3) Constipation 6 (31.6) 0 Hyponatremia 6 (31.6) 2 (10.5) Hyperglycemia 6 (31.6) 1 (5.3) Maculopapular rash 6 (31.6) 0 Musculoskeletal chest pain 6 (31.6) 0 Table 1. Baseline Patient and Disease Characteristics Preferred Term, n (%) Cohort 3A (N=19) Grade 3/4 Neutropenia 19 (100) Leukopenia 19 (100) Lymphopenia 19 (100) Thrombocytopenia 17 (89.5) Anemia 15 (78.9) Results: Baseline Demographics and Safety Data Majority of Patients Were PD - L1 - Negative With High Disease Burden a 12 patients (63.2%) were former smokers. b ICI - na ve patients who are treatment na ve in metastatic setting (n=5); 1 patient received neoadjuvant chemotherapy. c ICI - na ve patients who received prior chemotherapy (n=7). d ICI - na ve EGFR - mutated patients who received prior TKI therapy (n=7). e 1 patient (5.3%) had squamous cell carcinoma. f Genes assessed include BRAF , EGFR , ALK , ROS1 , KRAS , and NTRK ; some patients did not have all genes assessed. g 1 patient had a KRAS G12C mutation. h As adjudicated between site - reported and central - laboratory data; 8 of the patients with PD - L1 - negative disease were EGFR wild - type. i 6 patients (26.3%) had other site, including bone, liver, skin/subcutaneous, buttock, post chest wall, and pleura (n=1 each). j Per CTCAE v4.03; TEAEs include AEs that occur from the earlier of the first dose of pembrolizumab or LN - 145 infusion, up to 30 days after the later of the last dose of pembrolizumab or LN - 145 infusion or start of a new anticancer therapy. AE, adverse event; IL - 2, interleukin 2; PD - L1, programmed death ligand - 1; SOD, sum of diameters; TEAE, treatment - emergent advers e event; TKI, tyrosine kinase inhibitor; TTPS, tumor tissue procurement surgery.
Adam Schoenfeld, Memorial Sloan Kettering Cancer Center, New York, NY, USA 4. Median study follow - up was 18.2 months 76.5% of patients experienced reduction in tumor burden ( Figure 2 ) ORR was 42.1% ( Table 4 ); ORRs by prior therapy were: Treatment - na ve: 80.0% (4/5) Post - chemotherapy: 42.9% (3/7) EGFR - mutated post - TKI: 14.3% (1/7) Treatment - na ve or post - chemotherapy: 58.3% (7/12) Best Overall Response Cohort 3A (N=19) n/N % (95% CI) ORR 8/19 42.1 (20.3, 66.5) DCR 15/19 78.9 (54.4, 93.9) CR 2/19 10.5 PR 6/19 31.6 SD 7/19 36.8 PD 2/19 10.5 NE 2/19 10.5 Table 4. Best Overall Response Results: Clinical Efficacy in ICI - na ve mNSCLC Responses (RECIST v1.1) Observed Independent of PD - L1 Status PD - L1 status (%) as adjudicated between site - reported and central - laboratory data. CR, complete response; DCR, disease control rate; ICI, immune checkpoint inhibitor; mNSCLC , metastatic non - small cell lung cancer; NE, non - evaluable; ORR, objective response rate; PD - L1, programmed death ligand - 1; PD, progressive disease; PR, partial response; SD, stable disease; SOD, sum of diameters; TKI, tyrosine kinase inhibitor. Figure 2. Best Percentage Change from Baseline in Target Lesion SOD for Evaluable Patients ORR (95% CI): 80.0% (28.4%, 99.5%) ORR (95% CI): 14.3% (0.4%, 57.9%) 100 80 60 40 20 0 - 20 - 40 - 60 - 80 - 100 Treatment - na ve Post - chemotherapy EGFR - mutated post - TKI 50 50* <1* 50* 50* <1* <1* <1* <1* <1* <1* <1* <1* 1 - 49* <1* <1* 1 - 49* % Change from Baseline Best Overall Response PD PR SD CR ORR (95% CI): 42.9% (9.9%, 81.6%)
Adam Schoenfeld, Memorial Sloan Kettering Cancer Center, New York, NY, USA 5. Results: Clinical Efficacy in ICI - na ve mNSCLC Durable Responses Were Observed a As adjudicated between site - reported and central - laboratory data. b The following genes were tested: BRAF , EGFR , ALK , ROS1 , KRAS , and NTRK . c Patient received prior neoadjuvant chemoradiotherapy. d ROS1 , NTRK not assessed. e NTRK not assessed. BOR, best overall response; CR, complete response; ICI, immune checkpoint inhibitor; mNSCLC, metastatic non - small cell lung canc er; PD - L1, programmed death ligand - 1; PR, partial response; SOD, sum of diameters; TKI, tyrosine kinase inhibitor; TPS, tumor proportion score. Figure 3. Time to Response, Duration of Response, and Time on Efficacy Assessment for Confirmed Responders (PR or Better) 4 responses occurred in 8 patients with EGFR wild - type, PD - L1 - negative disease (50%) ( Figure 3 ) Responses deepened over time in a subgroup of patients ( Figure 4 ) Figure 4. Percentage Change from Baseline in Target Lesion SOD CR PR SD PD 3A - 16 (PD) 3A - 03 (PD) 3A - 15 (SD) 3A - 19 (SD) 3A - 18 (SD) 3A - 05 (SD) 3A - 07 (SD) 3A - 08 (SD) 3A - 01 (SD) 3A - 04 (PR) 3A - 11 (PR) 3A - 17 (PR) 3A - 02 (PR) 3A - 10 (PR) 3A - 09 (PR) 3A - 14 (CR) 3A - 13 (CR) Baseline Day 42 Day 84 Day 126 Month 6 Month 9 Month 12 Month 15 Month 18 Visit - 100 - 80 - 60 - 40 - 20 0 20 40 60 80 Percentage Change Best Response Subgroup Pt PD - L1 TPS (%) a Mutation Status b BOR on Study Treatment - na ve 3A - 02 c <1 None detected PR 3A - 04 50 KRAS G12V mutated PR 3A - 17 50 KRAS G12V mutated PR 3A - 10 50 None detected PR Post - chemotherapy 3A - 11 <1 None detected d PR 3A - 13 <1 None detected e CR 3A - 09 <1 NTRK gene fusion PR EGFR - mutated post - TKI 3A - 14 1 - 49 EGFR mutated CR 0 Time (Months) Since LN - 145 Infusion 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 Ongoing on Study CR start PR start Progression Pembrolizumab
Adam Schoenfeld, Memorial Sloan Kettering Cancer Center, New York, NY, USA 6. Clones from the infused TIL product persisted similarly in responders and nonresponders ( Figure 5 ) * Bars represent standard error. TCR, T - cell receptor; TIL, tumor - infiltrating lymphocyte. Figure 5. Persistence of Infused TIL* Infused TCR Clonotypes Over Time and Cell Dose Infused TIL Persist in Peripheral Blood and Cell Dose Did Not Differ By Response Total cell dose infused was similar among responders and nonresponders ( Figure 6 ) Figure 6. Total Cell Dose Time % TCR Repertoire Pre - Infusion Day 4 0 50 100 Day 42 Nonresponder Responder Total Dose (billion) 0 20 40 60 p = 0.62
In patients with ICI - na ve mNSCLC, activity of LN - 145 plus pembrolizumab was greater than what has previously been reported for LN-145 monotherapy or pembrolizumab alone and was not limited by PD - L1 TPS Overall, the ORR was 42.1% Treatment - na ve: 80.0% (4/5) Post - chemotherapy: 42.9% (3/7) EGFR - mutated post - TKI: 14.3% (1/7) Treatment - na ve or post - chemotherapy: 58.3% (7/12) EGFR wild - type, PD - L1 - negative disease: 50.0% (4/8) No new safety signals were observed with pembrolizumab addition to the LN-145 regimen Durable and deepening responses (up to 15.4 months and ongoing) were observed and TIL clones persisted after infusion No difference was observed in cell dose infused for responders and nonresponders These results support further clinical investigation of LN - 145 in ICI - na ve mNSCLC and inform design of a phase 3 study of LN - 14 5 added to front - line standard of care therapy for patients with mNSCLC Adam Schoenfeld, Memorial Sloan Kettering Cancer Center, New York, NY, USA 7. ICI, immune checkpoint inhibitor; mNSCLC, metastatic non - small cell lung cancer; ORR, objective response rate; PD - L1, programmed death ligand - 1; TKI, tyrosine kinase inhibitor; TPS, tumor proportion score. Trial Conclusions TIL Cell Therapy Activity May Be Independent of PD - L1 Status in ICI - na ve mNSCLC Copies of this presentation obtained through QR (Quick Response) and/or text key codes are for personal use only and may not be reproduced without written permission of the authors.