A phase I/II study of ANV419, a selective IL-2R-beta-gamma targeted antibody-IL-2 fusion protein, in patients with advanced solid tumors.
Authors: Läubli Heinz , Alonso Guzman , Lopez Juanita Suzanne , Calvo Emiliano , Sanchez Perez Vicky , Di Blasi Daniela , Nair Aswathy , Richter Kirsten , Huber Christoph , Egli Nicole , Mouton Julie , Costanzo Silvio , Katopodis Andreas , Jethwa Schnetzler Sangeeta , Bucher Christoph Marcus , Garralda Elena 
Published: June 2022

e21552

Background: IL-2R agonists that are well tolerated and can selectively enhance immune activation may improve outcomes of patients with cancer. ANV419 is a potent and highly selective IL-2Rβγ binding agonist, consisting of an antibody specific for the IL-2Rα-binding domain of IL-2, fused to native hIL-2. It is currently being investigated in a phase I/II dose finding study in patients with relapsed/refractory advanced solid tumors (ANV419-001). The primary objective of ANV419-001 is to describe the safety and tolerability of ANV419. Methods: ANV419 is administered intravenously over 15 minutes every 2 weeks, without premedication. Thirteen patients with melanoma (cutaneous (n = 3), uveal (n = 2), mucosal (n = 2), choroidal (n = 1)), renal cell carcinoma (n = 1), hepatocellular carcinoma (n = 1), colorectal cancer (n = 1), esophageal adenocarcinoma (n = 1) and adenoid cystic carcinoma (n = 1) have been dosed in six cohorts. Patients received 3mcg/kg (n = 1), 6mcg/kg (n = 1), 12mcg/kg (n = 1), 24mcg/kg (n = 4), 48mcg/kg (n = 3) 72mcg/kg (n = 3) and 108 mcg/kg (ongoing) of ANV419. Results: ANV419 is well tolerated, all related AEs are Grade 1 or Grade 2 and no DLTs have been observed. Most patients experienced chills (G1), with or without low-grade fever (G1), 2-4 hours after post- infusion, which resolved with antipyretic treatment. Two G2 AEs related to ANV419 have been reported in two patients. One patient was reported to have G2 Cytokine Release Syndrome (hypotension (G2), fever (G1), chills (G1)) and one patient experienced transient, self-limiting G2 elevation of liver function tests. Four Serious Adverse Events were reported in three patients (urinary tract infection, lethargy, thoracic pain and abdominal pain), none of which were considered related to ANV419. Pharmacodynamic evaluation on day 4 post-dosing, showed an effector cell selective, dose dependent increase of Ki-67 positive CD8 T cells (2%, 14%, 37%, 62%, 62%, vs. baseline mean (BLM) 2%) and NK cells (30%, 62%, 75%, 85%, 80%, vs BLM 6%) with a dose independent frequency of Ki67+ Tregs ranging from 4% to 25% (BLM 7%) at 3, 6, 12, 24 and 48 mcg/kg doses respectively. At 72mcg/kg mean CD8 T cell and NK proliferation was 70% and 51% respectively, while the mean Treg proliferation increased to 48%. Pharmacokinetic data (including patients treated with up to 24 mcg/kg ANV419) show a dose proportional increase of the ANV419 plasma concentration. The estimated half-life at the 24mcg/kg dose is 17.6 hrs. Four patients continue to receive ANV419. Of the 11 patients who received at least two cycles of ANV419, 4 were assessed to have stable disease. One patient progressed after 24 weeks of confirmed stable disease. Conclusions: Overall, ANV419 is well tolerated and selectively induces expansion and proliferation of CD8 T cells and NK cells, but not Tregs up to a dose of at least 48mcg/kg. Updated data will be shared during the meeting. Clinical trial information: NCT04855929.