Ifinatamab Deruxtecan Demonstrated Clinically Meaningful Response Rates in Patients with Extensive-Stage Small Cell Lung Cancer in IDeate-Lung01 Phase 2 Trial
- An objective response rate of 48.2% was observed with ifinatamab deruxtecan in these previously treated patients
- Discussions with global regulatory authorities underway
Ifinatamab deruxtecan is a specifically engineered, potential first-in-class B7-H3 directed DXd antibody drug conjugate (ADC) discovered by
SCLC is aggressive and progresses rapidly to the distant metastatic stage, which has a low five-year survival rate.1,2 While conventional standard of care treatments for patients with advanced SCLC may help improve outcomes, there is a need for additional subsequent treatment approaches.3,4,5,6
In
Response was assessed in patients
In a subset of patients (n=32) receiving ifinatamab deruxtecan as a second-line treatment, a confirmed ORR of 56.3% (95% CI: 37.7–73.6) was observed as assessed by BICR. Eighteen PRs and 13 cases of SD were seen in this subset of patients. A median DOR of 7.2 months (95% CI: 3.6–NE) and a DCR of 96.9% (95% CI: 83.8–99.9) were observed. Median PFS of 5.6 months (95% CI: 3.9–8.1) and median OS of 12.0 months (95% CI: 7.3–19.1) were seen.
In a subset of patients (n=105) receiving ifinatamab deruxtecan in a third-line and beyond setting, a confirmed ORR of 45.7% (95% CI: 36.0–55.7) with three CRs, 45 PRs and 41 cases of SD were seen. A DCR of 84.8% (95% CI: 76.4–91.0) was observed in these patients.
In an exploratory analysis, an intracranial ORR of 46.2% (95% CI: 33.7–59.0) was observed by CNS RECIST v1.1 in a subset of patients (n=65) with brain metastases at baseline. A full subgroup analysis (2760MO) will be presented at 2025
“Patients with extensive-stage small cell lung cancer have an extremely poor prognosis despite current standard of care treatment options,” said
The safety profile observed in IDeate-Lung01 was consistent with that seen for ifinatamab deruxtecan in the phase 1 trial with no new safety signals identified. Grade 3 or higher treatment-related adverse events (TRAEs) occurred in 36.5% of patients. The most common (>10%) grade 3 or higher TRAEs were neutropenia (13.9%), lymphopenia (12.4%), and anemia (10.2%). Seventeen patients (12.4%) had confirmed treatment-related interstitial lung disease (ILD)/pneumonitis as determined by an independent adjudication committee. The majority of ILD/pneumonitis events were low grade, with 11 grade 1 or 2 (8.0%), four grade 3 (2.9%), and two grade 5 (1.5%) ILD/pneumonitis events observed as of the data cutoff of
“In these primary results from IDeate-Lung01, ifinatamab deruxtecan produced clinically meaningful responses in patients with previously treated extensive-stage small cell lung cancer,” said
“Small cell lung cancer is the second most common type of lung cancer globally, with 15 percent of patients impacted by this particularly devastating form of the disease,” said
A majority of patients (54.7%) in IDeate-Lung01 received a median of two prior lines of treatment, including immunotherapy (81%), topoisomerase I inhibitor (32.1%), lurbinectedin (21.2%), amrubicin (8.8%) and DLL3-targeting T-cell engager (8.0%). As of the data cutoff, the median treatment duration was 4.8 months (range: 0.7–22.7) and 14 patients remain on treatment.
Summary of IDeate-Lung01 Results |
|||
Efficacy Measure |
Ifinatamab Deruxtecan 12 mg/kg |
||
Total Population (N=137) |
Second-Line Subset (n=32) |
Third-Line Plus and Beyond Subset (n=105) |
|
Confirmed ORR, % (95% CI) |
48.2% (39.6–56.9) |
56.3% (37.7–73.6) |
45.7% (36.0–55.7) |
CR, n (%) |
3 (2.2%) |
0 |
3 (2.9%) |
PR, n (%) |
63 (46.0%) |
18 (56.3%) |
45 (42.9%) |
SD, n (%) |
54 (39.4%) |
13 (40.6%) |
41 (39.0%) |
DCR (95% CI), % |
87.6% (80.9–92.6) |
96.9% (83.8–99.9) |
84.8% (76.4–91.0) |
DOR, median (95% CI), months |
5.3 months (4.0–6.5) |
7.2 months (3.6–NE) |
4.3 months (3.7–5.8) |
TTR, median (95% CI), months |
1.4 months (1.0–8.1) |
1.4 months (1.2–4.0) |
N/A |
PFS, median (95% CI), months |
4.9 months (4.2-5.5) |
5.6 months (3.9–8.1) |
N/A |
OS, median (95% CI), months |
10.3 months (9.1-13.3) |
12.0 months (7.3–19.1) |
N/A |
CR, complete response; DCR, disease control rate; DOR, duration of response; N/A, not available; NE, not evaluable; ORR, objective response rate; OS, overall survival; PR, partial response; PFS, progression-free survival; SD, stable disease; TTR, time to response |
About IDeate-Lung01
IDeate-Lung01 is a global, multicenter, randomized, open-label, two-part phase 2 trial evaluating the safety and efficacy of ifinatamab deruxtecan in patients with ES-SCLC previously treated with at least one prior line of platinum-based chemotherapy and a maximum of three prior lines of therapy. Patients with asymptomatic brain metastases (untreated or previously treated) were eligible to participate.
In the first part of the trial (dose optimization), patients were randomized 1:1 to receive ifinatamab deruxtecan (8 or 12 mg/kg) given intravenously once every three weeks. In the second part of the trial (dose expansion), patients received ifinatamab deruxtecan (12 mg/kg) intravenously at the same dosing interval.
The primary endpoint is ORR as assessed by BICR per RECIST v1.1. Secondary endpoints included DOR, PFS, DCR, TTR, OS, pharmacokinetics and safety. Intracranial ORR was assessed by BICR as an exploratory analysis.
IDeate-Lung01 enrolled 187 patients in
About Small Cell Lung Cancer
More than 2.48 million lung cancer cases were diagnosed globally in 2022.7 Small cell lung cancer (SCLC) is the second most common type of lung cancer, accounting for approximately 15% of cases.8 SCLC is aggressive and progresses rapidly to the distant metastatic stage, which has a low five-year survival rate.1,2 While conventional standard of care treatments for patients with advanced SCLC may help improve outcomes, there is a need for additional subsequent treatment approaches.3,4,5,6
About B7-H3
B7-H3 is a transmembrane protein that belongs to the B7 family of proteins, which bind to the CD28 family of receptors that includes PD-1.9,10 B7-H3 is overexpressed in a wide range of cancer types, including SCLC, and its overexpression has been shown to correlate with poor prognosis, making B7-H3 a promising therapeutic target.11,12,13,14 There are currently no B7-H3 directed medicines approved for the treatment of any cancer.
About Ifinatamab Deruxtecan
Ifinatamab deruxtecan is an investigational potential first-in-class B7-H3 directed ADC. Designed using Daiichi Sankyo’s proprietary DXd ADC Technology, ifinatamab deruxtecan is comprised of a humanized anti-B7-H3 IgG1 monoclonal antibody attached to a number of topoisomerase I inhibitor payloads (an exatecan derivative, DXd) via tetrapeptide-based cleavable linkers.
Ifinatamab deruxtecan was granted Breakthrough Therapy Designation by the
Ifinatamab deruxtecan has been granted orphan drug designation by the
About the Ifinatamab Deruxtecan Clinical Development Program
A comprehensive global clinical development program is underway evaluating the efficacy and safety of ifinatamab deruxtecan monotherapy and in combination with other cancer medicines across multiple cancers.
About the
About the ADC Portfolio of
The Daiichi Sankyo ADC portfolio consists of seven ADCs in clinical development crafted from two distinct ADC technology platforms discovered in-house by
The ADC platform furthest in clinical development is Daiichi Sankyo’s DXd ADC Technology where each ADC consists of a monoclonal antibody attached to a number of topoisomerase I inhibitor payloads (an exatecan derivative, DXd) via tetrapeptide-based cleavable linkers. The DXd ADC portfolio currently consists of ENHERTU®, a HER2 directed ADC, and DATROWAY®, a TROP2 directed ADC, which are being jointly developed and commercialized globally with AstraZeneca. Patritumab deruxtecan (HER3-DXd), a HER3 directed ADC, ifinatamab deruxtecan (I-DXd), a B7-H3 directed ADC, and raludotatug deruxtecan (R-DXd), a CDH6 directed ADC, are being jointly developed and commercialized globally with
The second Daiichi Sankyo ADC platform consists of a monoclonal antibody attached to a modified pyrrolobenzodiazepine (PBD) payload. DS-9606, a CLDN6 directed PBD ADC, is the first of several planned ADCs in clinical development utilizing this platform.
Ifinatamab deruxtecan, patritumab deruxtecan, raludotatug deruxtecan, DS-3939 and DS-9606 are investigational medicines that have not been approved for any indication in any country. Safety and efficacy have not been established.
About
Merck’s Focus on Cancer
Every day, we follow the science as we work to discover innovations that can help patients, no matter what stage of cancer they have. As a leading oncology company, we are pursuing research where scientific opportunity and medical need converge, underpinned by our diverse pipeline of more than 25 novel mechanisms. With one of the largest clinical development programs across more than 30 tumor types, we strive to advance breakthrough science that will shape the future of oncology. By addressing barriers to clinical trial participation, screening and treatment, we work with urgency to reduce disparities and help ensure patients have access to high-quality cancer care. Our unwavering commitment is what will bring us closer to our goal of bringing life to more patients with cancer. For more information, visit www.merck.com/research/oncology.
About
At
Forward-Looking Statement of
This news release of
Risks and uncertainties include but are not limited to, general industry conditions and competition; general economic factors, including interest rate and currency exchange rate fluctuations; the impact of pharmaceutical industry regulation and health care legislation in
The company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future events or otherwise. Additional factors that could cause results to differ materially from those described in the forward-looking statements can be found in the company’s Annual Report on Form 10-K for the year ended
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References:
- Rudin CM, et al. Nat Rev Dis Primers. 2021;7(1):3.
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National Cancer Institute . SEER Explorer. Small cell carcinoma of the Lung and Bronchus: 5-year Relative Survival. AccessedAugust 2025 . -
American Cancer Society . Treatment Choices for Small Cell Lung Cancer, by Stage. AccessedAugust 2025 . - Liu SV, et al. J Clin Oncol. 2021;39(6):619-30.
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Paz-Ares L , et al. ESMO Open. 2022;7(2):100408. -
von Pawel J , et al. J Clin Oncol. 2014; 32:4012-4019. -
World Health Organization .International Agency for Research on Cancer .U.S. Cancer Fact Sheet. AccessedAugust 2025 . - Schabath MB, et al. Cancer Epidemiol Biomarkers Prev. 2019 Oct;28(10):1563-1579.
- Zhao B, et al. J Hematol Oncol. 2022;15(1):153.
- Janakiram M, et al. Immunol Rev. 2017;276(1):26-39.
- Qiu M-j, et al. Front. Oncol. 2021;11:600238.
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Picarda E, et al.
Clin Cancer Res . 2016;22(14):3425-3431. - Bendell JC, et al. J Clin Oncol. 2020;39(15 suppl 1). Abstract TPS3646.
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Clin Cancer Res . 2021;27(5):1227-1235.
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