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News
A new phase 3 trial is testing whether adding a LAG-3 inhibitor to standard chemoimmunotherapy can beat pembrolizumab-based treatment in nonsquamous NSCLC. The RELATIVITY-1093 trial targets patients with PD-L1 expression of 1%–49%—a group that often loses responses quickly. Early phase 2 data showed promising response rates and manageable toxicity, fueling optimism for a practice-changing result.
A new phase 3 trial is betting that tackling immunotherapy resistance early—rather than waiting for disease progression—could meaningfully extend survival for patients with nonsquamous non-small cell lung cancer (NSCLC). The RELATIVITY-1093 trial is enrolling ~1,000 patients to compare nivolumab plus relatlimab (Opdualag) and chemotherapy against the current standard of pembrolizumab plus chemotherapy. The trial zeros in on patients with PD-L1 expression of 1%–49%, a population that responds inconsistently to existing regimens and represents a significant unmet need.
The rationale stems from phase 2 RELATIVITY-104 data, which showed that adding relatlimab to nivolumab and chemotherapy produced notably better outcomes in nonsquamous, PD-L1-positive patients. The dual blockade approach targets T-cell exhaustion through two complementary pathways—PD-1 and LAG-3—with the goal of generating more durable immune responses. Importantly, toxicity profiles were similar between arms in the earlier trial, easing concerns about added side effects.
By the Numbers
Why it matters: Most NSCLC patients on today's standard of care don't reach the 5-year survival mark. If RELATIVITY-1093 delivers a meaningful OS benefit, it could redefine frontline treatment for a large subset of lung cancer patients—and shift how oncologists think about addressing immune resistance from day one.
