A Phase 1 Study of AGEN1181, an Fc-Engineered Anti-CTLA-4 Monoclonal Antibody as Monotherapy and in Combination With AGEN2034 (Balstilimab), an Anti-PD-1 Monoclonal Antibody, in Subjects With Advanced Cancer

Trial ID # NCT03860272
Phase I
Drug Class Immunotherapy: Checkpoint Inhibitors/CTLA-4
Drug Name Botensilimab
Alternate Drug Names AGEN1181, anti-CTLA-4 monoclonal antibody AGEN1181
Drugs in Trial Balstilimab, Botensilimab
Eligible Participant

Platinum resistant ovarian cancer

Patients Enrolled

24; median 4 prior therapies (1-8); 19 HGS, 1 carcinosarcoma, 2 CCOC, 2 mixed CCOC/endometrioid

Therapy Setting

Recurrence

Study Design

Open-Label, Non-randomized

Endpoints

ORR, DCR, evaluated per RECIST

Efficacy

Bot:
ORR: 11.1% (1CR, 3PR, 1 OC w/ SD for 18 months on Bot monotherapy then PR on combo, n=36)
Bot+Bal:
ORR: 33% (1CR, 7PR - 6 HGS, 1 CCOC, 1 mixed CCOC/endometrioid); DCR: 67% (1CR, 7PR, 8SD - 6 HGS, 1 carcinosarcoma, 1 mixed CCOC/endometrioid) 

Clinically Significant Adverse Events

Serious AE:
Grade 3-4 AE: overall (33%); diarrhea/colitis (21%)

Conclusion

Botenlisimab alone or in combination with balstilimab demonstrates clinical activity in platinum resistant OC. Activity is seen both in patients with the low and high affinity FcγRIIIA alleles, unlike first generation anti-CTLA-4 molecules that generally benefit only those patients who express the high affinity allele

Reference

Wilky B et al. BOTENSILIMAB, A NOVEL INNATE/ADAPTIVE IMMUNE ACTIVATOR, PLUS OR MINUS BALSTILIMAB (ANTI-PD-1) IN “COLD” AND I-O REFRACTORY METASTATIC SOLID TUMORS SITC (2022) abstract 778
https://www.clearityfoundation.org/wp-content/uploads/2023/02/SITC-2022-Botensilimab-abstract.pdf

Wilky et al. Slide from presentation
https://www.clearityfoundation.org/wp-content/uploads/2023/02/SITC-2022-BotensilimabBalstilimab-slide.pdf

Bockorny B et al. Botensilimab, a novel innate/adaptive immune activator, plus balstilimab (anti-PD-1) in patients with recurrent platinum refractory/resistant ovarian cancer. SGO (2023) abstract 2
https://www.clearityfoundation.org/wp-content/uploads/2023/10/Botensilimab-and-bastilimab-SGO-2023.pdf

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