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A recent phase 1b clinical trial investigated the use of pegilodecakin in combination with anti-PD-1 monoclonal antibodies nivolumab or pembrolizumab. The combination showed a “favourable” response in patients with non-small cell lung cancer and kidney cancer.
Pegilodecakin works by stimulating the survival, proliferation and “killing” potential of CD8+ T cells, which can recognise and destroy cancer cells. Pegilodecakin complements the action of anti-PD1 monoclonal antibodies, such as nivolumab and pembrolizumab, when given in combination.
One hundred and eleven pre-treated patients were randomised in the phase 1b trial: renal cell carcinoma (34%), melanoma (33%), non-small cell lung cancer (31%), triple-negative breast cancer (less than 1%) and bladder cancer (less than 1%). Patients were separated into two groups — 53 received pegilodecakin plus pembrolizumab and 58 received pegilodecakin plus nivolumab. Tumours shrunk in 43% of patients with non-small cell lung cancer and 40% of patients with kidney cancer. In the patients with melanoma, only 10% saw a reduction.
The most common side effects were anaemia, fatigue, low blood platelet counts and high triglycerides (a type of fat found in the blood that provides the body with energy).
“The activity of pegilodecakin in combination with anti-PD-1 monoclonal antibodies introduces a new class of drugs to the treatment of advanced solid tumours,” said Dr Aung Naing from The University of Texas MD Anderson in Houston. “Future randomised trials hopefully will determine the tolerability and clinical benefits of pegilodecakin as a single agent and in combinations in a range of cancers.” He continued, “Pegilodecakin with anti-PD-1 monoclonal antibodies had a manageable toxicity profile and promising anti-tumour activity.”