I-Mab Presents Positive Givastomig Phase 1b Dose Escalation Data in Combination with Immunochemotherapy in Patients with 1L Gastric Cancers at ESMO GI 2025
Data show confirmed ORR of 83% (10/12) at doses selected for ongoing expansion study
Median follow-up of 9.0 months as of the updated data cutoff
Responses observed in patients with low PD-L1 and/or CLDN18.2 expression
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The Phase 1b data (NCT04900818) show a confirmed objective response rate (ORR) of 71% across all doses (12/17), and 83% (10/12) at doses selected for the ongoing dose expansion study (8 mg/kg and 12 mg/kg). Responses occurred in tumors with low levels of PD-L1 expression and/or Claudin 18.2 (CLDN18.2) expression, with favorable overall tolerability. There were no Grade 3 or greater events for nausea and vomiting, and only one Grade 3 TRAE for increased liver enzymes. The data are based on the results of the dose escalation part of a Phase 1b study evaluating the givastomig combination as first line therapy (1L) in patients with Claudin 18.2-positive gastric cancers (≥1+ IHC staining intensity in ≥1% of tumor cells). The primary endpoint is safety. The study enrolled only patients in the
“The positive Phase 1b combination data presented at ESMO GI bolster our confidence in givastomig’s potential to be a best-in-class Claudin 18.2 directed therapy. Givastomig has been well tolerated when combined with immuno-oncology and chemotherapy, has shown a high objective response rate, with rapid onset and durable responses that have deepened over time, supported by consistent pharmacokinetic data and soluble 4-1BB induction,” said
“I am encouraged by the response rates, as well as the deepening of responses over time, demonstrated by the givastomig combination regimen in the Phase 1b dose escalation study that we presented today at ESMO GI. Despite approved therapies, targeted treatment options for gastric cancers continue to be limited. While the data are early, givastomig combination therapy demonstrates a high response rate across Claudin 18.2 and PD-L1 expression levels,” said Samuel J Klempner, MD, Associate Professor of Medicine at
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Givastomig Phase 1b Dose Escalation Data Summary in 1L Gastric Cancers
17 advanced metastatic gastric cancer patients were treated with givastomig across the 5 mg/kg (n=5), 8 mg/kg (n=6), and 12 mg/kg (n=6) dose levels as of the
May 15, 2025 data cutoff. All patients were efficacy evaluable
Patient Characteristics:
The 17 patients enrolled in the study were treatment naïve metastatic gastric, esophageal or gastroesophageal adenocarcinomas
Patients were HER2-negative, Claudin 18.2-positive (defined as ≥1+ IHC staining intensity in ≥1% of tumor cells), regardless of PD-L1 expression levels
All patients were enrolled at sites within
the United States
Efficacy Results:
Confirmed Objective Response Rates (ORRs):
71% of patients (12/17) achieved a partial response (PR) per RECIST v1.1
5 mg/kg (2/5)
8 mg/kg (5/6)
12 mg/kg (5/6)
At the doses selected for dose expansion (8 and 12 mg/kg), 83% (10/12) of patients achieved PRs
80% of patients (4/5) with CLDN18.2 expression below 75% (CLDN-Low) achieved a PR. The CLDN-Low response rate increased to 100% of patients (3/3) in the doses selected for expansion (8 and 12 mg/kg)
The disease control rate (DCR) was 100% across the three dose levels
Dose-dependent pharmacokinetics (PK) were observed, similar to monotherapy PK
Patients also experienced a dose dependent induction of soluble 4-1BB, a positive indicator of T cell activation and engagement
| ORR: % (n) | All (n=17) | Cohorts Chosen for Expansion (8 and 12 mg/kg) (n=12) |
| PD-L1 | ||
| Any | 71 (12/17) | 83 (10/12) |
| ≥5 | 82 (9/11) | 89 (8/9) |
| <5 | 50 (3/6) | 67 (2/3) |
| ≥1 | 73 (11/15) | 82 (9/11) |
| <1 | 50 (1/2) | 100 (1/1) |
| CLDN18.2 | ||
| ≥75 | 67 (8/12) | 78 (7/9) |
| <75 | 80 (4/5) | 100 (3/3) |
| ORR: % (n) | PD-L1 ≥ 5 | PD-L1 < 5 |
| CLDN18.2 ≥ 75 | 80 (8/10) | 0 (0/2) |
| CLDN18.2 < 75 | 100 (1/1) | 75 (3/4) |
Durability:
8 of 17 patients remained on study treatment and the longest treatment duration was 13.3 months as of the data cutoff
Median follow-up was 9.0 months across all dose levels as of the data cutoff
Safety:
Treatment-related adverse events (TRAEs) leading to discontinuation of any treatment were 12% (two patients), five patients had progressive disease, two patients withdrew from the study for social reasons
No dose limiting toxicities (DLT) were observed and a maximum tolerated dose (MTD) was not reached
Common TRAEs (≥10% of patients) were generally Grade 1 or Grade 2 including nausea, vomiting, infusion related reaction, fatigue, decreased appetite, diarrhea, abdominal pain, chills, dyspepsia and gastritis
Grade 3 TRAEs attributed to givastomig were rare, with single cases of abdominal pain, ALT/AST increases, gastritis, and infusion related reaction
Four cases of Grade 3 and two cases of Grade 4 treatment-related neutropenia were observed driven by an early restriction on prophylaxis use of G-CSF, which has been subsequently lifted. The neutropenia cases were primarily attributed to mFOLFOX6 in the 8 mg/kg cohorts
No Grade 5 TRAEs were reported
About Givastomig
Givastomig (TJ033721 / ABL111) is a bispecific antibody targeting Claudin 18.2 (CLDN18.2)-positive tumor cells. It conditionally activates T cells through the 4-1BB signaling pathway in the tumor microenvironment where CLDN18.2 is expressed. Givastomig is being developed for first line (1L) metastatic gastric cancers, with further potential in other solid tumors. In Phase 1 trials, givastomig has shown promising anti-tumor activity attributable to a potential synergistic effect of proximal interaction between CLDN18.2 on tumor cells and 4-1BB on T cells in the tumor microenvironment, while minimizing toxicities commonly seen with other 4-1BB agents.
An ongoing Phase 1b study is evaluating givastomig for the treatment of gastric cancer in the 1L setting in combination with standard of care, nivolumab (an anti-PD-1 checkpoint inhibitor) plus chemotherapy, in dose escalation and dose expansion cohorts. Dose escalation is complete, and enrollment in the first dose expansion cohort (n=20) finished ahead of schedule. Enrollment continues to progress ahead of schedule in the second dose expansion cohort (n=20). The study builds on positive Phase 1 monotherapy data.
Givastomig is being jointly developed through a global partnership with ABL Bio, in which I-Mab is the lead party and shares worldwide rights, excluding Greater China and South Korea, equally with ABL Bio.
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Source: I-Mab Biopharma
