Interestingly in melanoma the combo of ipi and nivo given in the same cycle more or less simultaneously (concurrent arm) resulted in improved ORR but toxicity was significant. The combo of initial ipi with later subsequent nivo infusion (sequenced arm) had half the toxicity but also half the ORR.
Looking at Illuminate-206 for solid tumors (Tilso+ipi+nivo) it is interesting that on clinicaltrials.gov, they have not divulged how the combination of ipi and nivo will be administered. My speculation is that perhaps they will take a sequence approach and take advantage of the tumor specific intratumoral antigen priming/presentation of Tilso with ipi to enhance the initial response then improve the durability of the response by using nivo after the tumor is hot. The hope would be you would then get the benefit of improved ORR (like the concurrent arm) with reduced toxicity (like the sequenced arm).
Undoubtedly BMS is interested in the possibility of using both of their drugs in combinations in multiple solid tumor types if the toxicity can be harnessed. Hopefully that is where Tilso comes in. The mechanisms of Tilso, ipi and nivo all seem to be distinct and perhaps the benefits translatable across multiple tumor types.
BMS should be watching very closely.