Partial Hold on MacroGenics’ Gynecologic Cancer Therapy

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FDA has placed a partial clinical hold on a MacroGenics Phase 2 (LINNET) trial of its investigational immunotherapy lorigerlimab, halting enrollment of new patients while allowing those already in the study to continue treatment. MacroGenics says the agency action followed the company’s recent decision to temporarily pause enrollment after a series of serious safety events in the study, which is evaluating lorigerlimab in patients with gynecologic cancers.

The safety concerns involved four patients treated at a dose of 6 mg/kg every three weeks. Reported events included two cases of Grade 4 thrombocytopenia, one case of Grade 4 myocarditis, and one case of Grade 4 neutropenia accompanied by septic shock, according to the company, adding that the latter resulted in a Grade 5 event (patient death).

To date, 41 participants have received the 6 mg/kg dose across the platinum-resistant ovarian cancer and clear cell gynecologic cancer cohorts, it says. Under the partial clinical hold, no new patients may be enrolled until FDA lifts the restriction. However, patients currently participating in the trial may continue receiving lorigerlimab.

Lorigerlimab is described as an investigational bispecific DART molecule designed to simultaneously target PD-1 and CTLA-4, two immune checkpoint proteins involved in regulating immune responses against tumors. Dual checkpoint inhibition has shown clinical activity in several cancers but is also associated with increased immune-related toxicities.

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