Loading
Adding an antibody against a second immune brake, LAG-3, to nivolumab delayed progression in advanced melanoma compared with nivolumab alone, with far fewer serious side effects than the ipilimumab combination.
Double-blind phase 3 trial of 714 patients with untreated advanced melanoma randomised to a fixed-dose combination of relatlimab (anti-LAG-3) and nivolumab or nivolumab alone. Primary endpoint was PFS by blinded review.
Median PFS was 10.1 vs 4.6 months (HR 0.75). Grade 3-4 treatment-related adverse events were 18.9% vs 9.7%, much lower than the roughly 55-59% seen with nivolumab plus ipilimumab. It validated LAG-3 as the third checkpoint target after CTLA-4 and PD-1, led to FDA approval of the combination (Opdualag) in 2022, and provided a gentler dual-checkpoint option.
Patients with newly diagnosed advanced melanoma have a dual-checkpoint option that improves on nivolumab alone with only a modest increase in serious side effects, making it attractive for those unable to tolerate or unwilling to risk the toxicity of ipilimumab. It did not prove superior survival, and it has not been compared with nivolumab plus ipilimumab, which remains preferred for patients with brain metastases or other high-risk features. LAG-3 is now an established target under study in many other cancers.
Shares RELATIVITY-047, Relatlimab + nivolumab, CheckMate 067, LAG-3.
Shares Relatlimab + nivolumab, Advanced melanoma (unresectable stage III and stage IV), Bristol Myers Squibb, Nivolumab.
Shares Relatlimab + nivolumab, CheckMate 067, LAG-3, Bristol Myers Squibb.
Shares Relatlimab + nivolumab, Bristol Myers Squibb, Nivolumab, Melanoma.
Shares CheckMate 067, Advanced melanoma (unresectable stage III and stage IV), Nivolumab, PD-1.
Shares Lines of therapy, Too many combinations to test, Progression-free survival (PFS), Overall survival (OS).
Shares RELATIVITY-047, Relatlimab + nivolumab, LAG-3, Melanoma.
Shares Hussein A. Tawbi, Relatlimab + nivolumab, LAG-3, Nivolumab.