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DRUG:

evorpacept (ALX148)

i
Other names: ALX148, ALX 148, ALX-148, LGGL-ALX-148
Company:
ALX Oncology
Drug class:
CD47 inhibitor
2ms
Enrollment change • Combination therapy
|
dexamethasone • pomalidomide • Sarclisa (isatuximab-irfc) • evorpacept (ALX148) • Blenrep (belantamab mafodotin-blmf) • SAR439459 • pegenzileukin (SAR444245)
2ms
ZWI-ZW25-204: A Study of Zanidatamab (ZW25) With Evorpacept (ALX148) in Patients With Advanced HER2-expressing Cancer (clinicaltrials.gov)
P1/2, N=52, Active, not recruiting, Jazz Pharmaceuticals | Trial completion date: Apr 2025 --> Sep 2025 | Trial primary completion date: Oct 2024 --> Apr 2025
Trial completion date • Trial primary completion date • Combination therapy • Metastases
|
HER-2 positive • HER-2 overexpression • HER-2 amplification • HER-2 positive + HER-2 overexpression
|
zanidatamab (ZW25) • evorpacept (ALX148)
2ms
A Study of Evorpacept (ALX148) With Cetuximab and Pembrolizumab for Refractory Microsatellite Stable Metastatic Colorectal Cancer (clinicaltrials.gov)
P2, N=80, Active, not recruiting, University of Colorado, Denver | Trial primary completion date: Sep 2024 --> Dec 2024
Trial primary completion date • Combination therapy • Metastases
|
Keytruda (pembrolizumab) • Erbitux (cetuximab) • evorpacept (ALX148)
3ms
Safety and Efficacy of Anti-CD47, ALX148 in Combination With Liposomal Doxorubicin and Pembrolizumab in Recurrent Platinum-resistant Ovarian Cancer (clinicaltrials.gov)
P2, N=31, Recruiting, Haider Mahdi | Trial completion date: Dec 2027 --> Dec 2031 | Trial primary completion date: Sep 2025 --> Sep 2029
Trial completion date • Trial primary completion date • Combination therapy
|
Keytruda (pembrolizumab) • pegylated liposomal doxorubicin • evorpacept (ALX148)
4ms
Targeting the CD47/SIRPα pathway in malignancies: recent progress, difficulties and future perspectives. (PubMed, Front Oncol)
However, a series of setbacks unfolded recently, starting with the July 2023 announcement of discontinuing the phase 3 ENHANCE study on Magrolimab plus Azacitidine for higher-risk myelodysplastic syndromes (MDS). Subsequently, in August 2023, the termination of the ASPEN-02 program, assessing Evorpacept in combination with Azacitidine in MDS patients, was disclosed due to insufficient improvement compared to Azacitidine alone. These setbacks have cast doubt on the feasibility of targeting CD47 in the industry. In this review, we delve into the challenges of developing CD47-SIRPα-targeted drugs, analyze factors contributing to the mentioned setbacks, discuss future perspectives, and explore potential solutions for enhancing CD47-SIRPα-targeted drug development.
Review • Journal
|
PD-1 (Programmed cell death 1) • SIRPA (Signal Regulatory Protein Alpha)
|
azacitidine • magrolimab (ONO-7913) • evorpacept (ALX148)
4ms
Enrollment closed • Combination therapy • Metastases
|
Keytruda (pembrolizumab) • cisplatin • carboplatin • 5-fluorouracil • evorpacept (ALX148)
4ms
Enrollment closed • Combination therapy • Metastases
|
PD-L1 (Programmed death ligand 1)
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
6ms
Isatuximab in Combination With Novel Agents in RRMM - Master Protocol (clinicaltrials.gov)
P1/2, N=197, Recruiting, Sanofi | Trial completion date: Dec 2027 --> Mar 2028 | Trial primary completion date: Dec 2027 --> Jun 2027
Trial completion date • Trial primary completion date
|
dexamethasone • pomalidomide • Sarclisa (isatuximab-irfc) • evorpacept (ALX148) • Blenrep (belantamab mafodotin-blmf) • SAR439459 • pegenzileukin (SAR444245)
7ms
ZWI-ZW25-204: A Study of Zanidatamab (ZW25) With Evorpacept (ALX148) in Patients With Advanced HER2-expressing Cancer (clinicaltrials.gov)
P1/2, N=52, Active, not recruiting, Jazz Pharmaceuticals | Recruiting --> Active, not recruiting | N=93 --> 52 | Trial primary completion date: Jul 2024 --> Oct 2024
Enrollment closed • Enrollment change • Trial primary completion date • Combination therapy • Metastases
|
HER-2 positive • HER-2 overexpression • HER-2 amplification
|
zanidatamab (ZW25) • evorpacept (ALX148)
8ms
A Study of Evorpacept (ALX148) With Enfortumab Vedotin for Subjects With Urothelial Carcinoma (ASPEN-07) (clinicaltrials.gov)
P1, N=30, Recruiting, ALX Oncology Inc. | Trial primary completion date: Jan 2024 --> Dec 2024
Trial primary completion date • Combination therapy
|
Padcev (enfortumab vedotin-ejfv) • evorpacept (ALX148)
8ms
A Study of Evorpacept (ALX148) in Patients With Advanced Solid Tumors and Lymphoma (ASPEN-01) (clinicaltrials.gov)
P1, N=174, Active, not recruiting, ALX Oncology Inc. | Trial completion date: Feb 2024 --> Dec 2024
Trial completion date • Metastases
|
Keytruda (pembrolizumab) • Herceptin (trastuzumab) • cisplatin • paclitaxel • Rituxan (rituximab) • 5-fluorouracil • Cyramza (ramucirumab) • evorpacept (ALX148)
9ms
Neoadjuvant Immunoradiotherapy With Evorpacept and Pembrolizumab in HPVOPC (Human Papilloma Virus Oropharynx Cancer) (clinicaltrials.gov)
P2, N=29, Recruiting, University of California, San Diego | Not yet recruiting --> Recruiting | Trial primary completion date: Dec 2024 --> Aug 2026
Enrollment open • Trial primary completion date • Combination therapy • Metastases
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
9ms
KEYNOTE-B87: Evorpacept (ALX148) in Combination With Pembrolizumab in Patients With Advanced Head and Neck Squamous Cell Carcinoma (ASPEN-03) (clinicaltrials.gov)
P2, N=183, Recruiting, ALX Oncology Inc. | Trial completion date: Dec 2024 --> Dec 2025 | Trial primary completion date: Dec 2023 --> Dec 2024
Trial completion date • Trial primary completion date • Combination therapy • Metastases
|
PD-L1 (Programmed death ligand 1)
|
PD-L1 expression
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
9ms
KEYNOTE-B88: Evorpacept (ALX148) in Combination With Pembrolizumab and Chemotherapy in Patients With Advanced Head and Neck Squamous Cell Carcinoma (ASPEN-04) (clinicaltrials.gov)
P2, N=168, Recruiting, ALX Oncology Inc. | Trial completion date: Dec 2024 --> Dec 2025 | Trial primary completion date: Dec 2023 --> Dec 2024
Trial completion date • Trial primary completion date • Combination therapy • Metastases
|
Keytruda (pembrolizumab) • cisplatin • carboplatin • 5-fluorouracil • evorpacept (ALX148)
11ms
Isatuximab in Combination With Novel Agents in RRMM - Master Protocol (clinicaltrials.gov)
P1/2, N=197, Recruiting, Sanofi | N=123 --> 197 | Trial completion date: Nov 2028 --> Dec 2027 | Trial primary completion date: Nov 2028 --> Dec 2027
Enrollment change • Trial completion date • Trial primary completion date • Combination therapy
|
pomalidomide • Sarclisa (isatuximab-irfc) • evorpacept (ALX148) • Blenrep (belantamab mafodotin-blmf) • SAR439459 • pegenzileukin (SAR444245)
12ms
Neoadjuvant Immunoradiotherapy With Evorpacept and Pembrolizumab in HPVOPC (Human Papilloma Virus Oropharynx Cancer) (clinicaltrials.gov)
P2, N=29, Not yet recruiting, University of California, San Diego | Initiation date: Aug 2023 --> Dec 2023
Trial initiation date • Combination therapy • Metastases
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
12ms
ZWI-ZW25-204: A Study of Zanidatamab (ZW25) With Evorpacept (ALX148) in Patients With Advanced HER2-expressing Cancer (clinicaltrials.gov)
P1/2, N=93, Recruiting, Jazz Pharmaceuticals | Phase classification: P1b/2 --> P1/2 | Trial completion date: Oct 2024 --> Jan 2025 | Trial primary completion date: Apr 2024 --> Jul 2024
Phase classification • Trial completion date • Trial primary completion date • Combination therapy • Metastases
|
HER-2 positive • HER-2 overexpression • HER-2 amplification
|
zanidatamab (ZW25) • evorpacept (ALX148)
1year
Single-Cell Genomics and Proteomics Reveals Venetoclax-Resistant Monocytic Differentiation of TP53 LOH Clones in TP53 Mutant AML (ASH 2023)
Patients 1 and 3 received treatment with CD47AB (Magrolimab), 5'-Azacitidine (Aza), and Venetoclax (Ven); Patient 2 received IMGN632 (CD123-targeting ADC), Aza and Ven. Patient 4 received p97 Inhibitor CB-5339; Patient 5 received CD47 inhibitor (ALX148), Aza, Ven... This study establishes a genotype-phenotype connection through single-cell proteogenomic profiling of TP53-mutated AML, describing the clonal evolution and immunophenotypic dynamics during treatment while proposing a potential mechanism of resistance.
IO biomarker
|
TP53 (Tumor protein P53) • KIT (KIT proto-oncogene, receptor tyrosine kinase) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • CD8 (cluster of differentiation 8) • ETV6 (ETS Variant Transcription Factor 6) • BCL2L1 (BCL2-like 1) • CD123 (Interleukin 3 Receptor Subunit Alpha) • CD33 (CD33 Molecule) • CD34 (CD34 molecule) • CD36 (thrombospondin receptor) • CD14 (CD14 Molecule) • CD68 (CD68 Molecule) • EIF4EBP1 (Eukaryotic translation initiation factor 4E binding protein 1) • ITGAM (Integrin, alpha M) • IL3RA (Interleukin 3 Receptor Subunit Alpha)
|
TP53 mutation • IDH1 R132 • ETV6 mutation • IDH1 R132L
|
Venclexta (venetoclax) • azacitidine • magrolimab (ONO-7913) • evorpacept (ALX148) • pivekimab sunirine (IMGN632) • CB-5339
over1year
KEYNOTE-B87: Evorpacept (ALX148) in Combination With Pembrolizumab in Patients With Advanced Head and Neck Squamous Cell Carcinoma (ASPEN-03) (clinicaltrials.gov)
P2, N=183, Recruiting, ALX Oncology Inc. | Trial completion date: Oct 2024 --> Dec 2024 | Trial primary completion date: Oct 2023 --> Dec 2023
Trial completion date • Trial primary completion date • Combination therapy • Metastases
|
PD-L1 (Programmed death ligand 1)
|
PD-L1 expression
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
over1year
A Study of Evorpacept (ALX148) in Patients With Advanced Solid Tumors and Lymphoma (ASPEN-01) (clinicaltrials.gov)
P1, N=174, Active, not recruiting, ALX Oncology Inc. | Trial completion date: Feb 2023 --> Feb 2024
Trial completion date • Metastases
|
Keytruda (pembrolizumab) • Herceptin (trastuzumab) • cisplatin • paclitaxel • Rituxan (rituximab) • 5-fluorouracil • Cyramza (ramucirumab) • evorpacept (ALX148)
over1year
KEYNOTE-B88: Evorpacept (ALX148) in Combination With Pembrolizumab and Chemotherapy in Patients With Advanced Head and Neck Squamous Cell Carcinoma (ASPEN-04) (clinicaltrials.gov)
P2, N=168, Recruiting, ALX Oncology Inc. | Trial completion date: Oct 2024 --> Dec 2024 | Trial primary completion date: Oct 2023 --> Dec 2023
Trial completion date • Trial primary completion date • Combination therapy • Metastases
|
Keytruda (pembrolizumab) • cisplatin • carboplatin • 5-fluorouracil • evorpacept (ALX148)
2years
Evorpacept (ALX148), a CD47-Blocking Myeloid Checkpoint Inhibitor, in Combination with Azacitidine and Venetoclax in Patients with Acute Myeloid Leukemia (ASPEN-05): Results from Phase 1a Dose Escalation Part (ASH 2022)
The addition of evorpacept to standard dose VEN and AZA for AML was well tolerated with no MTD reached. The maximum administered evorpacept dose was 60 mg/kg Q4W, and preliminary dose-proportional pharmacokinetics was seen along with full CD47 target occupancy in both peripheral blood and bone marrow across all dose levels evaluated. Initial anti-leukemic activity was observed in subjects with both ND and R/R AML (including VEN-naïve and prior VEN-exposed disease).
Clinical • P1 data • Combination therapy • Checkpoint inhibition
|
TP53 (Tumor protein P53) • DNMT3A (DNA methyltransferase 1) • RUNX1 (RUNX Family Transcription Factor 1) • ASXL1 (ASXL Transcriptional Regulator 1)
|
TP53 mutation • DNMT3A mutation
|
Venclexta (venetoclax) • azacitidine • evorpacept (ALX148)
almost3years
A Study of Evorpacept (ALX148) in Patients With Advanced HER2+ Gastric Cancer (ASPEN-06) (clinicaltrials.gov)
P2/3, N=450, Recruiting, ALX Oncology Inc. | Not yet recruiting --> Recruiting | Initiation date: Aug 2021 --> Jan 2022
Enrollment open • Trial initiation date
|
HER-2 (Human epidermal growth factor receptor 2)
|
HER-2 overexpression
|
Herceptin (trastuzumab) • paclitaxel • Cyramza (ramucirumab) • evorpacept (ALX148)
almost3years
Evorpacept alone and in combination with pembrolizumab or trastuzumab in patients with advanced solid tumours (ASPEN-01): a first-in-human, open-label, multicentre, phase 1 dose-escalation and dose-expansion study. (PubMed, Lancet Oncol)
The safety findings support the use of evorpacept in combination with pembrolizumab or trastuzumab for patients with advanced solid tumours. Preliminary antitumour activity results support future investigation of evorpacept combined with pembrolizumab or trastuzumab in patients with HNSCC, gastric or gastroesophageal junction cancer, and NSCLC.
Clinical • P1 data • Journal • Combination therapy
|
HER-2 (Human epidermal growth factor receptor 2) • SIRPA (Signal Regulatory Protein Alpha)
|
HER-2 positive
|
Keytruda (pembrolizumab) • Herceptin (trastuzumab) • evorpacept (ALX148)
3years
Clinical • Enrollment change • Combination therapy
|
PD-L1 (Programmed death ligand 1)
|
PD-L1 expression
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
3years
Evorpacept (ALX148), a CD47-Blocking Myeloid Checkpoint Inhibitor, in Combination with Azacitidine: A Phase 1 / 2 Study in Patients with Myelodysplastic Syndrome (ASPEN-02) (ASH 2021)
The myeloid checkpoint inhibitor evorpacept was well tolerated in combination with AZA with an initial safety profile similar to that of AZA monotherapy. The evorpacept RP2D in combination with AZA is 60 mg/kg Q4W. Promising initial activity has been observed, with objective responses and hematologic improvement at multiple dose levels in subjects with both ND and R/R MDS, including those with adverse risk features such as TP53 mutation with complex cytogenetics, therapy-related MDS, and prior HMA-failure.
Clinical • Combination therapy • Checkpoint inhibition
|
TP53 (Tumor protein P53)
|
TP53 mutation
|
azacitidine • evorpacept (ALX148)
3years
Zanidatamab in combination with ALX148 in advanced human epidermal growth factor receptor 2 (HER2)‑expressing cancers, including breast cancer: A phase 1b/2, multicenter, open‑label, dose‑finding and cohort‑expansion study (ZWI‑ZW25‑204) (SABCS 2021)
In a Phase 1 study, ALX148 demonstrated antitumor activity when combined with trastuzumab in patients whose disease had progressed on prior HER2‑targeted therapies. Secondary endpoints in Part 2 include disease control rate, clinical benefit rate, duration of response, progression‑free survival, overall survival, safety, pharmacokinetics, and immunogenicity assessments. The study is currently open for enrollment in the United States and may enroll up to 93 patients (NCT: 05027139).
Clinical • P1/2 data • Combination therapy
|
HER-2 (Human epidermal growth factor receptor 2) • SIRPA (Signal Regulatory Protein Alpha)
|
HER-2 positive • HER-2 overexpression • HER-2 expression
|
Herceptin (trastuzumab) • zanidatamab (ZW25) • evorpacept (ALX148)
over3years
Clinical • New P2/3 trial
|
HER-2 (Human epidermal growth factor receptor 2)
|
HER-2 overexpression
|
Herceptin (trastuzumab) • paclitaxel • Cyramza (ramucirumab) • evorpacept (ALX148)
over3years
New P2 trial
|
PD-L1 (Programmed death ligand 1)
|
PD-L1 expression
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
over3years
[VIRTUAL] ASPEN-01: A phase 1 study of ALX148, a CD47 blocker, in combination with trastuzumab, ramucirumab and paclitaxel in patients with second-line HER2-positive advanced gastric or gastroesophageal junction cancer (ESMO-GI 2021)
The RP2D of ALX148 is 15 mg/kg QW in combination. Observed durable responses and initial survival estimates in patients with second-line disease that had progressed upon prior HER2-directed therapy warrants further study of this combination in patients with advanced HER2-positive G/GEJ cancer.
Clinical • P1 data • Combination therapy
|
HER-2 (Human epidermal growth factor receptor 2) • CD47 (CD47 Molecule)
|
HER-2 positive
|
Herceptin (trastuzumab) • paclitaxel • Cyramza (ramucirumab) • evorpacept (ALX148)
over3years
Clinical • Enrollment open • Combination therapy
|
PD-L1 (Programmed death ligand 1)
|
PD-L1 expression
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
almost4years
Clinical • New P2 trial • Combination therapy
|
PD-L1 (Programmed death ligand 1)
|
PD-L1 expression
|
Keytruda (pembrolizumab) • evorpacept (ALX148)
4years
[VIRTUAL] ALX148, a CD47 Blocker, in Combination with Rituximab in Patients with Non-Hodgkin Lymphoma (ASH 2020)
The MTD of ALX148 in combination with rituximab was not reached. Encouraging preliminary activity and favorable PK/PD characteristics in combination with rituximab were observed at all dose levels with greater objective response rates reported at the MAD of 15 mg/kg QW.
Clinical • Combination therapy
|
CD20 (Membrane Spanning 4-Domains A1)
|
CD20 positive
|
Rituxan (rituximab) • evorpacept (ALX148)
4years
[VIRTUAL] ALX148 Enhances the Depth and Durability of Response to Multiple AML Therapies (ASH 2020)
Recently, the combination of azacitidine with venetoclax, a BCL2 inhibitor, has shown increased efficacy compared to azacitidine alone in patients with AML (EHA 2020, #LB2601). Together, these in vitro and in vivo results provide rationale that ALX148 combinations may benefit AML and MDS patients. Clinical trials with ALX148 in patients with MDS (NCT04417517) and AML are currently planned.
IO biomarker
|
TP53 (Tumor protein P53) • FLT3 (Fms-related tyrosine kinase 3)
|
TP53 mutation • FLT3 mutation
|
Venclexta (venetoclax) • azacitidine • evorpacept (ALX148)
over4years
[VIRTUAL] A phase I study of ALX148, a CD47 blocker, in combination with standard anticancer antibodies and chemotherapy regimens in patients with advanced malignancy. (ASCO 2020)
ALX148 enhances innate and adaptive immune responses against cancer and has previously been shown to be well tolerated in combination with the checkpoint inhibitor (CPI), pembrolizumab (P), and trastuzumab (T) in a range of solid tumors (ASCO 2019 #2514)...Pts with ≥2L GC progressed on T+FU+platinum received AT +/- ramucirumab (ram)+paclitaxel (pac)... Initial data suggests ALX148 demonstrates excellent tolerability in combination with anti cancer antibodies and standard chemotherapy. Clinical activity in pts with advanced CPI naïve HNSCC (including PD-L1 negative) and GC compares favorably with historic controls. Final data from AP and AT cohorts and initial data from chemotherapy combination cohorts will be presented.
Clinical • P1 data • Combination therapy • PD(L)-1 Biomarker • IO biomarker
|
HER-2 (Human epidermal growth factor receptor 2) • PD-L1 (Programmed death ligand 1)
|
HER-2 positive
|
Keytruda (pembrolizumab) • Herceptin (trastuzumab) • paclitaxel • Cyramza (ramucirumab) • evorpacept (ALX148) • fluorouracil topical