{"entity":{"id":"lag3-adjuvant-caution","kind":"pairing","name":"Caution: LAG-3 blockade outside active disease","aka":[],"tldr":"LAG-3 blockers helped in measurable melanoma with one drug pairing, but failed as adjuvant therapy and with a different PD-1 partner.","summary":"This caution notes that LAG-3 blockade in melanoma has succeeded in only one setting: relatlimab with nivolumab in unresectable, measurable disease, as shown in RELATIVITY-047. The same pairing failed as adjuvant therapy in RELATIVITY-098, and the alternative LAG-3 antibody fianlimab with cemiplimab failed in a first-line phase 3 reported in 2026. LAG-3 is expressed on exhausted T cells inside tumours, so without tumour present, or with different antibody properties and comparators, the effect may vanish. Two negative phase 3 trials against one positive one mean the benefit cannot be assumed to transfer to the adjuvant setting or to a different PD-1 partner.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT03470922: RELATIVITY-047","url":"https://clinicaltrials.gov/study/NCT03470922"},{"label":"ClinicalTrials.gov NCT05002569: RELATIVITY-098","url":"https://clinicaltrials.gov/study/NCT05002569"}],"tags":[],"related":[],"cancers":["melanoma"],"sections":[],"technologies":[],"targets":["lag3"],"drugs":["relatlimab-nivolumab","fianlimab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["relativity-047","relativity-098","fianlimab-phase3-melanoma"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"relatlimab-nivolumab","b":"fianlimab","rationale":"LAG-3 is expressed on exhausted T cells inside tumours; without tumour, or with different antibody properties and comparators, the effect may vanish.","evidence":"Two negative phase 3 trials versus one positive.","pairingType":"caution"},"route":"/pairings/lag3-adjuvant-caution/","neighbours":{"cancer":[{"id":"melanoma","kind":"cancer","name":"Melanoma","route":"/cancers/melanoma/"}],"target":[{"id":"lag3","kind":"target","name":"LAG-3","route":"/targets/lag3/"}],"drug":[{"id":"fianlimab","kind":"drug","name":"Fianlimab","route":"/drugs/fianlimab/"},{"id":"relatlimab-nivolumab","kind":"drug","name":"Relatlimab + nivolumab","route":"/drugs/relatlimab-nivolumab/"}],"trial":[{"id":"fianlimab-phase3-melanoma","kind":"trial","name":"Fianlimab + cemiplimab phase 3 (first-line melanoma)","route":"/trials/fianlimab-phase3-melanoma/"},{"id":"relativity-047","kind":"trial","name":"RELATIVITY-047","route":"/trials/relativity-047/"},{"id":"relativity-098","kind":"trial","name":"RELATIVITY-098","route":"/trials/relativity-098/"}]}}