Sponsor: Gilead Sciences (industry)
Phase: 2
Start date: Feb. 18, 2025
Planned enrollment: 100
Zimberelimab, also known as WBP-3055, GLS-010, or AB122, is a fully human anti-PD-1 monoclonal antibody developed for the treatment of various cancers. It has been evaluated in multiple clinical trials, demonstrating efficacy and safety across different malignancies.
Zimberelimab targets the programmed death-1 (PD-1) receptor, a checkpoint protein on T cells that, when engaged by its ligands, inhibits T-cell activation. By blocking PD-1, zimberelimab enhances the immune system's ability to detect and destroy cancer cells.
Relapsed or Refractory Classical Hodgkin Lymphoma (R/R cHL):
In the Phase II YH-S001-04 trial, 75 patients with R/R cHL received zimberelimab 240 mg every two weeks. With a median follow-up of 38 months, the objective response rate (ORR) was 91.6% (95% CI, 83.8-95.9). The median progression-free survival (PFS) was 23.6 months, and the 3-year overall survival (OS) rate was 94.0% (95% CI, 85.9-97.4). (pubmed.ncbi.nlm.nih.gov)
Recurrent or Metastatic Cervical Cancer (R/M CC):
A pivotal Phase II study (YH-S001-05) evaluated zimberelimab monotherapy in 90 patients with R/M CC. The ORR was 27.8%, with 5.6% achieving complete remission and 22.2% partial remission. The median PFS was 3.7 months, and the median OS was 16.8 months. (pipelinereview.com)
Advanced Cervical Cancer Post-ICI Therapy:
In a Phase II trial, 30 patients with advanced cervical cancer who had progressed after prior immune checkpoint inhibitor (ICI) therapy received zimberelimab combined with lenvatinib. The ORR was 33.3%, with a disease control rate of 96.7%. The median PFS was 7.1 months. (trial.medpath.com)
Third-Line Metastatic Colorectal Cancer (mCRC):
The ARC-9 Phase 1b/2 study assessed the combination of etrumadenant, zimberelimab, FOLFOX chemotherapy, and bevacizumab (EZFB) in 75 patients with third-line mCRC. The median OS was 19.7 months, compared to 9.5 months for the control group receiving regorafenib. The median PFS was 6.2 months versus 2.1 months, respectively. The confirmed ORR was 17.3% for EZFB, compared to 2.7% for regorafenib. (stocktitan.net)
Across clinical trials, zimberelimab has demonstrated a favorable safety profile. In the YH-S001-04 trial for R/R cHL, no serious adverse events with an incidence greater than 5% were reported. (pubmed.ncbi.nlm.nih.gov) In the ARC-9 study for third-line mCRC, the EZFB regimen had a safety profile consistent with the known profiles of each individual component, without unexpected toxicities. A higher percentage of patients treated with regorafenib (17%) had treatment-emergent adverse events leading to discontinuation compared to those treated with EZFB (5%). (stocktitan.net)
Last updated: Apr 2025
Domvanalimab, also known as AB-154 or GS-0154, is an investigational monoclonal antibody targeting the TIGIT (T-cell immunoreceptor with Ig and ITIM domains) pathway. It is being developed to enhance anti-tumor immune responses, particularly in combination with other immunotherapies, for the treatment of various cancers.
Domvanalimab is an Fc-silent anti-TIGIT antibody designed to block the TIGIT receptor on T cells and natural killer (NK) cells. By inhibiting TIGIT, domvanalimab aims to restore and enhance the immune system's ability to detect and destroy cancer cells. The Fc-silent design minimizes potential depletion of TIGIT-expressing immune cells, potentially reducing adverse effects associated with Fc-mediated effector functions.
Upper Gastrointestinal (GI) Cancers:
In a Phase 2 study evaluating domvanalimab in combination with zimberelimab (an anti-PD-1 antibody) and chemotherapy as a first-line treatment for upper GI cancers, the regimen demonstrated promising efficacy:
12-month PFS rate: 57.6% (95% CI: 41.7, 73.5)
Objective Response Rate (ORR):
Non-Small Cell Lung Cancer (NSCLC):
In the Phase 2 ARC-7 study, domvanalimab combined with zimberelimab showed improved outcomes compared to zimberelimab monotherapy in patients with PD-L1-high NSCLC:
Hazard Ratio: 0.67 (95% CI: 0.40, 1.13)
Objective Response Rate (ORR):
The domvanalimab-containing regimens have been generally well-tolerated:
Last updated: Apr 2025
Goal: Evaluate the efficacy and safety of adding the anti-TIGIT antibody domvanalimab to the anti–PD-1 antibody zimberelimab plus platinum-taxane chemotherapy, compared with zimberelimab plus the same chemotherapy backbone, in first-line recurrent or metastatic head and neck squamous cell carcinoma (HNSCC).
Patients: Adults with histologically/cytologically confirmed recurrent or metastatic HNSCC of the oral cavity, oropharynx, hypopharynx, or larynx, incurable by local therapy, no prior systemic therapy for r/m disease (allowed if relapse >6 months after curative-intent platinum for locoregionally advanced disease), at least one RECIST v1.1 measurable lesion, available tumor tissue for central testing, ECOG 0–1, and known HPV/p16 status for oropharyngeal primaries. Key exclusions include nasopharyngeal and non-HNSCC locations, disease suitable for curative local therapy, relapse ≤6 months after curative-intent platinum, prior PD-1/PD-L1 or TIGIT inhibitors, active ILD/pneumonitis or significant autoimmune disease requiring systemic therapy, active CNS metastases, unresolved ≥Grade 2 toxicities, and recent major surgery, anticancer therapy, investigational drugs, or radiation within protocol-defined windows.
Design: Phase 2, randomized, multicenter platform study with an initial substudy (Substudy-01) in first-line r/m HNSCC; allocation is randomized between two experimental regimens. Approximately 100 participants will be enrolled in Substudy-01. Future substudies may add additional combinations or populations in a staggered manner.
Treatments: Arm A: Domvanalimab + zimberelimab + paclitaxel/carboplatin. Arm B: Zimberelimab + paclitaxel/carboplatin. Zimberelimab is a human IgG4 PD-1 inhibitor that blocks PD-1/PD-L1/PD-L2 interactions to restore antitumor T-cell activity; it has demonstrated antitumor activity across tumor types and has regulatory approvals in China for certain indications, with a safety profile typical of PD-1 inhibitors. Domvanalimab is an Fc-silent humanized IgG1 antibody targeting TIGIT to relieve inhibitory signaling on immune cells while minimizing Fc-mediated depletion of regulatory T cells; in Phase 2 settings (e.g., NSCLC ARC-7), domvanalimab combined with zimberelimab improved response rates and reduced risk of progression versus PD-1 monotherapy, and has shown encouraging activity with chemotherapy in upper GI cancers, with a manageable safety profile.
Outcomes: Primary endpoints: Objective response rate per RECIST v1.1 and progression-free survival. Key secondary endpoints: Disease control rate, duration of response, time to progression, PFS at 6 months, overall survival, OS at 6 and 12 months, and safety including treatment-emergent adverse events and clinical laboratory abnormalities. Assessments use investigator RECIST v1.1 with follow-up up to 36 months; safety monitoring extends to 24 months plus 100 days after last dose for certain endpoints.
Burden on patient: Moderate. Participants will receive IV immunotherapy combined with platinum-taxane chemotherapy, requiring frequent infusion visits, routine safety labs, and serial imaging consistent with first-line r/m HNSCC standards. Additional burdens include submission of tumor tissue for central testing and regular adverse event monitoring typical of checkpoint inhibitor plus chemotherapy regimens. No intensive pharmacokinetic sampling or mandated serial biopsies are indicated, which limits extra procedures beyond standard-of-care imaging and labs, but combination therapy infusions and monitoring schedules still necessitate regular travel and clinic time.
Key Inclusion Criteria:
* Histologically or cytologically confirmed r/m squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, and larynx that is considered incurable by local therapies.
* No prior systemic therapy for r/m HNSCC. Individuals who had disease progression or recurrence more than 6 months after the last dose of curative intent systemic platinum-containing therapy for locoregionally advanced disease are eligible.
* At least 1 measurable lesion by computed tomography or magnetic resonance imaging that qualifies as a RECIST v1.1 target lesion at baseline.
* Have adequate tumor tissue samples preferably from lesions not irradiated prior to biopsy (acceptable from irradiated lesions if disease progression has been demonstrated in such lesions) to submit for central testing.
* Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.
* Known results from human papillomavirus (HPV) status test (p16 expression) for oropharyngeal carcinoma defined as p16 testing.
Key Exclusion Criteria:
* Individuals with nasopharyngeal cancer (any histology), squamous cell carcinoma of unknown primary tumors, skin (cutaneous squamous cell carcinoma), paranasal sinuses, and salivary gland.
* Have disease that is suitable for any local therapies with curative intent.
* Individuals who had disease progression or recurrence within 6 months after the last dose of curative intent systemic platinum-containing therapy for locoregionally advanced disease.
* Have a history of (noninfectious) pneumonitis/interstitial lung disease that required steroids or has current pneumonitis/interstitial lung disease.
* Have an active autoimmune disease that required systemic treatment in the past 2 years. (ie, with use of disease-modifying agents, corticosteroids, or immunosuppressive drugs). Replacement therapy (eg, thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency) is not considered a form of systemic treatment.
* Prior treatment with any of the following within the specific time frame prior to the first dose of study drug:
* Major surgery for any cause or significant traumatic injury within 4 weeks prior to the first dose of study drug. Individuals must have recovered adequately from the toxicity and/or complications from the intervention prior to starting study drug.
* Any noninvestigational anticancer therapy (chemotherapy, biologic therapy, targeted therapy, hormone therapy, or immunotherapy, etc) within 4 weeks prior to the first dose of study drug. Concurrent use for noncancer related condition (eg, hormone replacement therapy) is acceptable.
* Any investigational drugs (drugs not marketed for any indication) within 4 weeks or 5 half-lives (whichever is longer) prior to the first dose of study drug.
* Radiation therapy within 2 weeks prior to the first dose of study drug. Individuals must have recovered to Grade ≤ 1 from all radiation-related toxicities, not requiring corticosteroid, and have not experienced radiation pneumonitis.
* Received prior treatment with any anti-PD-1/PD-L1, anti-TIGIT, or other immune checkpoint inhibitors.
* Currently receiving chronic systemic steroids (\> 10 mg/day prednisone or its equivalent). Use of topical, inhalational, intranasal, intraocular steroids, and use as premedication for hypersensitivity reactions (eg, IV contrast allergy) are permitted.
* Any unresolved toxicity (Grade ≥ 2) per National Cancer Institute Common Terminology Criteria for Adverse Events v5.0 from prior anticancer therapy or surgical intervention, with the exception of alopecia, vitiligo, and the laboratory toxicities if the laboratory thresholds defined in the inclusion criteria are met. Individuals with Grade ≤ 2 neuropathy are eligible for this study.
* Have an active second malignancy or have had an active second malignancy within 3 years prior to enrollment.
* Have known active central nervous system (CNS) metastases. Individuals with previously treated brain metastases may participate provided they have stable CNS disease for at least 4 weeks prior to enrollment and all neurologic symptoms have returned to baseline, have no evidence of new or enlarging brain metastasis and are not requiring use of steroid for at least 14 days prior to the first dose of study drugs.
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Melbourne, Victoria, 3004, Australia
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Status: Recruiting
Clayton, Victoria, 3168, Australia
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Status: Recruiting
Kurralta Park, 5037, Australia
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Sydney, 2145, Australia
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Status: Recruiting
Nanning, 530012, China
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Status: Recruiting
Wuhan, 430030, China
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Status: Recruiting
Shanghai, 200120, China
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Status: Recruiting
Chengdu, 610040, China
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Status: Recruiting
Hangzhou, 310005, China
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Status: Recruiting
Pessac, 33604, France
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Status: Recruiting
Milan, 20133, Italy
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Status: Recruiting
Napoli, 80131, Italy
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Status: Recruiting
Sarawak, 93586, Malaysia
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Status: Recruiting
Seville, 41013, Spain
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Status: Recruiting
Taichung, 40402, Taiwan
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Status: Recruiting
Taoyuan District, 33308, Taiwan
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Status: Recruiting
Taipei, 11217, Taiwan
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Status: Recruiting
Kaohsiung City, 80756, Taiwan
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Status: Recruiting
Kaohsiung City, 833, Taiwan
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Status: Recruiting
Taipei, 100229, Taiwan
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Status: Recruiting
London, SW10 9NH, United Kingdom
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Status: Recruiting
London, EC1A 7BE, United Kingdom
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Status: Recruiting
St Louis, Missouri, 63110, United States
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Status: Recruiting
Nashville, Tennessee, 37203, United States
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Status: Recruiting
Houston, Texas, 77030, United States
No email / No phone
Status: Recruiting