Phase 2 trial of neoadjuvant relatlimab plus nivolumab for resectable melanoma

The combination of relatlimab (anti-LAG-3) and nivolumab (anti-PD-1) improves progression-free survival over nivolumab monotherapy in patients with unresectable advanced melanoma (RELATIVITY-047). A phase 2 study at MD Anderson Cancer Center (Houston, TX) and Memorial Sloan Kettering Cancer Center (New York, NY) evaluated neoadjuvant relatlimab plus nivolumab for resectable clinical stage III or oligometastatic stage IV melanoma. The figure shows that two neoadjuvant doses of the combination resulted in 57% pathological complete response rate and 70% overall pathological response rate. No grade 3-4 immune related adverse events were observed in the neoadjuvant setting. After surgery patients received ten doses of adjuvant combination therapy. The 1- and 2-year recurrence-free survival rate was 100% and 92% for patients with any pathologic response, compared to 88% and 55% for patients who did not have pathologic response. The authors conclude that neoadjuvant relatlimab plus nivolumab induces a high pCR rate, with favorable safety compared to other combination immunotherapy regimens.