Relatlimab (previously known as BMS-986016) is a cancer immunotherapy being developed by Bristol-Myers Squibb (BMS). The treatment has already shown benefit in melanoma patients and is also being tested in other cancers.
Immunotherapies use the body’s own immune system to fight cancer, instead of directly attacking cancer cells.
How relatlimab works
Relatlimab is an anti-LAG-3 antibody, which means that it binds to and inhibits LAG-3, a protein present on the surface of specialized immune cells called T-cells.
LAG-3 is an immune checkpoint protein whose job is to control the response, activation, and growth of T-cells that fight cancer cells, ensuring that the immune system does not attack healthy cells.
Some tumor cells have found a way to use these checkpoints for their own benefit, applying a brake on T-cells to avoid being detected and attacked.
When relatlimab binds to LAG-3 on T-cells, this process essentially releases those brakes, and stimulates T-cells to attack cancer cells. This way, the immune system is again able to work as intended against cancer, reducing tumor growth.
Relatlimab in clinical trials
Relatlimab is being investigated, alone and in combination with other treatments, in several types of cancer.
A Phase 1/2 study (NCT01968109) is investigating the safety, tolerability, and effectiveness of relatlimab with and without Opdivo (nivolumab), another immunotherapy produced by BMS, to treat various solid tumors.
Initial results from this study in patients with advanced melanoma, a type of skin cancer, were presented at the 2017 meeting of the American Society of Clinical Oncology (ASCO) and at the European Society for Medical Oncology (ESMO) 2017 Congress.
They showed, in 68 melanoma patients who did not respond to or became resistant to other immunotherapies, that the combination of relatlimab and Opdivo was well-tolerated and effective. Overall, 11.5 percent of patients responded to treatment. One achieved a complete response, six had partial responses, and 23 others had stable disease. Responses were 3.5 fold more likely in patients who were producing LAG-3.
However, the side effects of this combined treatment resulted in 10 percent of patients dropping out of the study.
The study is still recruiting in the U.S., Australia, Europe, Canada, Japan, and the U.K. to further evaluate the combination treatment in patients with melanoma and other solid tumors.
Other studies of relatlimab are ongoing and also recruiting participants.
A Phase 1/2 study (NCT02061761) that started in February 2014 is investigating the safety of relatlimab in hematologic cancers, which form in the blood or immune system. This study is currently recruiting in the U.S. and Canada.
Another Phase 1 study (NCT02658981) that started in August 2016 is recruiting in the U.S. to evaluate relatlimab alone or in combination with Opdivo in patients with glioblastoma, a type of cancer of the nervous system.
Phase 2 studies are also ongoing to test relatlimab in patients with cancers of the kidneys (NCT02996110), stomach (NCT02935634), lungs (NCT02750514), and colon (NCT02060188).