Dana-Farber's Dr. Robert Haddad says research shows the combination of a PD1 with anti-LAG3 +/- anti-TIM3 does not improve outcomes in metastatic disease, raising the question of whether to look at this combo earlier, in the neoadjuvant setting.
In this trial, we enrolled patients with recurrent metastatic head and neck cancer being treated in the first line recurrent metastatic disease. They needed to have a CPS of one or more. And in this trial, we did assess the level of LAC 3 and the level of CPS. So the combination was a PD1 with a LAC 3 and a TIM 3. We compared the results of the anti-PD1 with the anti-LAC 3. And the results of the anti-PD1 with the combination of two other drugs, the Lac 3 and the TI 3. The primary endpoint of this trial is progression free survival. For that endpoint, we did not observe a meaningful difference in the progression free survival between the PD1 and the PD1 plus like 3. And when we compared the results of the PD1 to the triplet, also we did not find a meaningful difference in the progression free survival. Also assessing the response rate, the response rate was 20% with the PD1 antibody alone. And when we added the LAC 3, that number increased by 10% to 30%. And the same thing happened when we compared the PD1 with the triplet. So the results of this trial essentially are telling us that the combination of a PD1 with a LAC 3, or a PD1 with a LaC3 and a TIM 3 did not improve outcome in patients with recurring metastatic disease. These results add to the body of evidence we have currently with this combination that the combination of a PD1 inhibitor with the LAC3 and TIM 3 is not improving outcome in patients with recurrent metastatic disease. This is not the first trial to show this, but it asks. The other data we have with these combinations and really raises the question whether this is the best setting to test these agents or whether there is a room to look at these agents earlier in the disease process, such as, for example, neoadjuvant immunotherapy in head and neck cancer patients. Thank you.
