Astra keeps pushing on with rilvegostomig

Despite various TIGIT blow-ups, AstraZeneca continues to believe in its anti-TIGIT x PD-1 MAb rilvegostomig, with yet another phase 3 trial about to begin, according to a recent listing on clinicaltrials.gov. Like the ongoing Artemide-Lung02 and 03 trials, the new Artemide-Lung04 will be in first-line NSCLC; unlike these studies it will recruit across squamous and non-squamous disease. The earlier trials are also evaluating chemo combos in patients with PD-L1 expression at 1% or higher, while Artemide-Lung04 will test monotherapy in PD-L1-high patients – expression levels aren’t specified, but are presumably ≥50%. A benchmark here comes from the phase 1/2 Artemide-01 trial, which at last year’s World Lung meeting showed a 62% ORR (including unconfirmed responses) with a 750mg rilvegostomig dose in checkpoint inhibitor-naive PD-L1 ≥50% expressers. Astra appears to be covering all the bases in first-line NSCLC, but the omens aren’t good: Merck recently scrapped its TIGIT contender vibostolimab after it flunked the first-line Keyvibe-003 and Keyvibe-007 lung cancer trials; this news followed the final flop for Roche’s Skyscraper-01 trial of tiragolumab. Astra must believe that rilvegostomig is different, but the onus is on the company to prove this.

Phase 3 trials of rilvegostomig

Source: OncologyPipeline & clinicaltrials.gov.