logo
logo
Sign in

LAG-3 antibody drug R&D boom

avatar
Jerry Carter

 

On March 19, Bristol-Myers Squibb (BMS) announced that its dual immunotherapy combination Opdualag had received accelerated marketing approval from the FDA. Opdualag therapy is a fixed-dose combination of Relatlimab (anti-LAG3) and Nivolumab (anti-PD1) for the treatment of adult and pediatric patients 12 years of age and older with unresectable or metastatic melanoma, making LAG-3 the third immune checkpoint in the clinic after PD-1 and CTLA-4.

 

Lymphocyte-activation gene 3 (LAG-3), also known as CD233, is a type I transmembrane protein expressed mainly in activated T cells, NK cells, B cells, and plasma cell-like DCs. Oncology and autoimmune diseases (rheumatoid arthritis, multiple sclerosis) are currently among the clinical pipeline indications for LAG-3 which acts as an immunomodulator in a variety of tumors, including leukemia, non-small cell lung cancer, colon cancer, pancreatic cancer, and head and neck cell cancer. As an important member of tumor immunotherapy, LAG-3 antibodies have large future market potential.

 

The membrane protein encoded by the LAG3 gene contains four immunoglobulin superfamily structural domains that are very similar to CD4 in terms of structure and chromosomal localization, but it binds with higher affinity to MHCII (major histocompatibility complex class II molecule) and negatively regulates T cell function.

 

The main mechanism of action of LAG-3

* Bind to Galectin-3 and LSECtin, which affect T cell function.

* Elevated plasma levels of FGL1 in tumor patients are associated with poor prognosis and resistance to PD-1 inhibitors. Block FGL1-LAG-3 interaction to enhance the anti-tumor effect.

 

The combined therapy of CTLA-4 and PD-1/PD-L1 is well established. The LAG-3/PD-1 combination must not only outperform PD-1 alone, but inevitably also has to contest with CTLA-4/PD-1 combinations.

 

Results from the phase II/III study of RELATIVITY-047 (CA224-047) showed that in 714 patients with previously untreated metastatic or unresectable melanoma treated with Relatlimab in combination with Opdivo, compared to Opdivo monotherapy, the median progression-free survival (mPFS) in the former was 10.1 months compared to 4.6 months in the latter. The 12-month PFS rate was 47.7% in the Relatlimab-Opdivo group compared with 36.0% in the Opdivo group.

 

Relatlimab outperformed CTLA-4 monoclonal antibody Ipilimumab in terms of safety. 59% of patients treated with Ipilimumab + Opdivo experienced serious or life-threatening side effects, compared to a grade 3 or 4 Relatlimab treatment-related adverse event rate of only 18.9%.

 

There are currently 50+ drugs in the pipeline that target LAG-3, and the development of a LAG-3 immune checkpoint inhibitor is set to take off again with the approval of Relatlimab.

collect
0
avatar
Jerry Carter
guide
Zupyak is the world’s largest content marketing community, with over 400 000 members and 3 million articles. Explore and get your content discovered.
Read more