NIVO + LAG-3 Antibody Succeeds in Advanced Melanoma

This transcript has been edited for clarity.

Hello. I'm Dr Jeffrey Weber. I'm a medical oncologist and deputy director of the Laura and Isaac Perlmutter Cancer Center at New York University Langone Health in New York City. Today I'll be commenting on two studies on melanoma treatment presented at the oral sessions of this year's American Society of Clinical Oncology (ASCO) meeting.

RELATIVITY-047 was a randomized study that included more than 700 patients with previously untreated melanoma. Patients were randomly assigned to receive either relatlimab (RELA), an antibody that blocks the lymphocyte activation gene 3 (LAG-3), plus nivolumab (NIVO) vs NIVO alone. The primary endpoint of this trial was investigator-called progression-free survival (PFS). The secondary endpoints were response rate and overall survival.

This was a well-conducted, well-balanced, randomized phase 3 trial. All of the usual prognostic factors were well matched, including gender, age, performance status, serum LDH, tumor burden, and LAG-3 expression. Previous trials of second-line treatment have shown that a high LAG-3 expression in the tumor was associated with a better response. Overall, 75% of the patients in this study had LAG-3 in more than 1% of the tumor, presumably mostly on infiltrating immune cells, with 25% having LAG-3 in less than 1%, probably meaning that they were essentially LAG-3 negative.