AACR 2024 – indolent lymphoma presents fresh CD47 promise

While full data from the surprisingly positive Aspen-06 gastric cancer trial remain the big 2024 catalyst for ALX Oncology’s evorpacept, an investigator-sponsored study has suggested another possible use for this anti-CD47/SIRPα fusion protein. A low-key AACR presentation this week of a phase 1 MD Anderson-sponsored trial saw 15 of 18 relapsed/refractory indolent lymphoma patients go into complete remission. This concerned a combination of evorpacept with Revlimid and Rituxan, an approved combo for indolent B-cell lymphoma. Cross-trial comparisons suggest why the AACR data could hold promise: Revlimid/Rituxan’s registrational Augment study showed a complete response rate of 34%, while ALX’s own Aspen-01 trial, testing evorpacept plus Rituxan, yielded 54%. However, since Aspen-01 data were presented at ASH 2020 neither lymphoma nor haematology has been a major focus for ALX, which instead has turned to solid tumours and scrapped work in AML after disappointments in Aspen-02 and 05. Perhaps the most important message from MD Anderson’s work is that it shows again evorpacept’s potential in combination, though safety will have to be watched: grade 3-4 liver enzyme elevation and neutropenia were respectively seen in 15% and 55% of patients.

Cross-trial comparison in relapsed/refractory indolent (follicular or marginal zone) B-cell non-Hodgkin’s lymphoma

Source: ASCO, ASH & AACR.