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Haematologica. 2025;110(9):2102-2112.

Evorpacept plus rituximab for the treatment of relapsed or refractory non-Hodgkin lymphoma: results from the phase I ASPEN-01 study.

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제1저자 김태민 · 교신저자 Sophia S Randolph

소속 (7)
  1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul.
  2. START Midwest, Grand Rapids, MI.
  3. Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA.
  4. University of Colorado Cancer Center, Aurora, CO.
  5. ALX Oncology Inc., South San Francisco, CA.
  6. ALX Oncology Inc., South San Francisco, CA. info@alxoncology.com.
  7. Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul.

Abstract

CD47 overexpression has been associated with tumor cell survival. We present the safety, pharmacokinetics, pharmacodynamics, and preliminary anti-tumor activity of evorpacept, a novel fusion protein comprising a high-affinity CD47-SIRPα immune checkpoint inhibitor to promote tumor cell phagocytosis and inactive Fc domain to spare healthy cells, plus rituximab in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL) from the phase I ASPEN-01 study. Thirty-three patients received intravenous evorpacept (10 mg/kg [N=22] or 15 mg/kg [N=11] once weekly) until disease progression, in combination with fixed-duration intravenous rituximab (375 mg/m2 once weekly for 4 weeks, then every 4 weeks for 8 months). Evorpacept plus rituximab was well tolerated, with no dose-limiting toxicities; no maximum tolerated dose was identified. The most common treatment-related adverse events (TRAE) were rash (24.2%) and fatigue (15.2%); most TRAE (70.0%) were mild-to-moderate in severity. Four (12.1%) patients reported grade 3 TRAE: anemia, neutropenia, decreased neutrophil count, increased alanine aminotransferase, decreased lymphocyte count, and decreased platelet count (1 of each). Two (6.1%) patients experienced grade 4 TRAE (neutropenia, decreased neutrophil count). Six (18.2%) patients experienced serious AE (not treatment-related): asthma, dyspnea, respiratory failure, gastrointestinal infection, pneumonia, cardiac failure, and disease progression (1 of each). Two (6.1%) deaths occurred (not treatment-related). Pharmacokinetics/ pharmacodynamics were consistent with previous studies, with complete CD47 target occupancy (≥85%) achieved at both doses. In response-evaluable patients (N=32), objective response rate was 50.0% (95% confidence interval: 33.1-69.8%). The safety, tolerability, and promising anti-tumor activity of evorpacept plus rituximab support continued evaluation of this combination in NHL (clinicaltrials gov. Identifier: NCT03013218).

Figures

Figure 1.
Figure 1. Mean serum concentration-time profiles after the first evorpacept infusion. QW: once weekly; SD: standard deviation.
Figure 2.
Figure 2. Tumor response data (best overall response). Best percentage change from baseline in measurable lesion size (sum of product [mm]). Baseline is defined as the last measurement before treatment initiation. *Denotes ≥80% increase from baseline. (A) Data for evorpacept 10 mg/kg plus rituximab (2 patients - 1 with metabolic complete response, 1 with rapidly progressive disease - are not represented). (B) Data for evorpacept 15 mg/kg plus rituximab. (C) Data for aggressive and indolent non-Hodgkin lymphoma (NHL) subtypes for evorpacept 10 mg/kg plus rituximab. (D) Data for aggressive and indolent NHL subtypes for evorpacept 15 mg/kg plus rituximab. CR: complete response; PD: progressive disease; PR: partial response; QW: once weekly; SD: stable disease.
Figure 3.
Figure 3. Mean CD47 target occupancy over time. Mean percentages of CD47 target occupancy are shown for each dose of evorpacept (10 and 15 mg/kg). (A) Mean CD47 target occupancy among CD4+ T lymphocytes. (B) Mean CD47 target occupancy among erythrocytes. QW: once weekly; SD: standard deviation.
Figure 4.
Figure 4. Tumor-infiltrating cell profiles. Baseline data for intratumoral CD8, CD68, and CD163 positivity versus tumor response following treatment with evorpacept plus rituximab. Percentages of (A) CD8+ cells, (B) CD68+ cells, and (C) CD163+ cells.

그림 출처: PubMed Central 공개 논문 (PMC12399940)

그 밖의 정보
출판 형태
Journal Article, Clinical Trial, Phase I, Multicenter Study, Research Support, Non-U.S. Gov't
저널
Haematologica · eISSN 1592-8721
전자 출판
2025-04-10
MeSH
Humans · Male · Rituximab / administration & dosage / adverse effects · Female · Middle Aged · Aged · Antineoplastic Combined Chemotherapy Protocols* / therapeutic use / adverse effects · Adult · Lymphoma, Non-Hodgkin* / drug therapy / pathology / mortality · Recombinant Fusion Proteins / administration & dosage / adverse effects / pharmacokinetics · Treatment Outcome · Aged, 80 and over · Drug Resistance, Neoplasm
Substances
Rituximab · Recombinant Fusion Proteins
데이터
ClinicalTrials.gov: NCT03013218
참고문헌
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