Drugs

Lefitolimod

Lefitolimod

Other Names: MGN1703, dSLIM-30L1, double-stem-loop immunomodulator 30L1 Drug Class: Latency-Reversing Agents Registry Number: 1548439-51-5 (CAS) Chemical Class: Oligonucleotides Organization: Mologen AG Phase of Development: Lefitolimod is in Phase IIa development as an HIV therapeutic.

(Compound details obtained from ChemIDplus Advanced,1 Clinical Infectious Diseases article,2 NCI Drug Dictionary,3 Mologen AG website,4 and EU Clinical Trials Register5)

What is lefitolimod?

What is lefitolimod?

Lefitolimod is an investigational drug that is being studied as part of a strategy to cure HIV infection. Lefitolimod belongs to a general group of HIV drugs called latency-reversing agents. There are different types of latency-reversing agents. Lefitolimod is a type of latency-reversing agent called a toll-like receptor agonist.2

To learn about how investigational drugs are tested during clinical trials, read the AIDSinfo What is an Investigational HIV Drug? and HIV/AIDS Clinical Trials fact sheets.

How do latency-reversing agents work?

How do latency-reversing agents work?

Currently, there is no cure for HIV infection. One of the main obstacles to curing HIV infection is that the virus can remain hidden and inactive (latent) inside certain cells of the immune system (such as resting CD4 cells) for many months or even years. The cells where latent HIV hides are known as the latent HIV reservoir. Because HIV in this latent state is inactive, the immune system cannot detect the virus, and the antiretroviral (ARV) drugs that are used to treat HIV have no effect on it.6,7

Latency-reversing agents work by drawing HIV out of its latent state within resting CD4 cells. Once the latent HIV is reactivated, the CD4 cells that harbor the virus may be more likely to be recognized and killed by the body’s immune system or may be killed by certain HIV therapies, such as those that can enhance the body’s immune response to HIV. Researchers hope that the combined use of lefitolimod and other HIV-fighting strategies, including ongoing antiretroviral therapy (ART), may fully eliminate HIV from the body.7–9 To learn more, see the AIDSinfo What is a Latent HIV Reservoir? fact sheet.

Which clinical trials are studying lefitolimod?

Which clinical trials are studying lefitolimod?

Study Names: TEACH study; NCT02443935
Phase: Ib/IIa
Status: This study has been completed.
Location: Denmark
Purpose: The purpose of this study was to investigate whether lefitolimod could reactivate latent HIV, improve immune responses in participants with HIV, reduce the size of the latent HIV reservoir, and delay the time to a viral rebound after temporarily stopping ART. The study also assessed the safety of lefitolimod.2,10

Study Names: TITAN; 2018-001165-16 (EudraCT)
Phase: IIa
Status: This study is ongoing.
Location: United States and Australia
Purpose: The purpose of this study is to compare three different treatment strategies – lefitolimod combined with the broadly neutralizing antibodies (bNAbs) 3BNC117 and 10-1074, lefitolimod alone, and 3BNC117 plus 10-1074 alone – in delaying the time to viral rebound after temporarily stopping ART.5

For more details on the studies listed above, see the Health Professional version of this drug summary.

What side effects might lefitolimod cause?

What side effects might lefitolimod cause?

One goal of HIV research is to identify new drugs that have fewer side effects. In the TEACH study (NCT02443935) discussed under the previous question, the most commonly reported side effect was mild redness (erythema) around the injection site, which resolved on its own.2,10,11

Because lefitolimod is still being studied, information on possible side effects of the drug is not complete. As testing of lefitolimod continues, additional information on possible side effects will be gathered.

Where can I get more information about clinical trials studying lefitolimod?

Where can I get more information about clinical trials studying lefitolimod?

More information about lefitolimod-related research studies is available from the AIDSinfo database of ClinicalTrials.gov study summaries. Click on the title of any trial in the list to see the ClinicalTrials.gov trial summary and more information about the study.

Some clinical trials may be looking for volunteer participants. Your health care provider can help you decide whether participating in a clinical trial is right for you. For information, visit NIH Clinical Research Trials and You.

References

References

  1. United States National Library of Medicine. ChemIDplus Advanced: Lefitolimod. https://chem.nlm.nih.gov/chemidplus/rn/1548439-51-5. Accessed February 22, 2019.
  2. Vibholm L, Schleimann MH, Højen JF, et al. Short-course Toll-like receptor 9 agonist treatment impacts innate immunity and plasma viremia in individuals with human immunodeficiency virus infection. Clin Infect Dis. 2017;64(12). https://academic.oup.com/cid/article/64/12/1686/3064483. Accessed February 22, 2019.
  3. National Cancer Institute (NCI). NCI Drug Dictionary: TLR9 agonist MGN1703. https://www.cancer.gov/publications/dictionaries/cancer-drug/def/tlr9-agonist-mgn1703. Accessed February 22, 2019.
  4. Mologen AG website. Product pipeline. https://www.mologen.com/en/pipeline. Accessed February 22, 2019.
  5. EU Clinical Trials Register. EudraCT Number: 2018-001165-16; Combining a TLR9 agonist with broadly neutralizing antibodies for reservoir reduction and immunological control of HIV infection: an investigator-initiated randomized, placebo-controlled, Phase IIa trial (TITAN). https://www.clinicaltrialsregister.eu/ctr-search/trial/2018-001165-16/DK. Accessed February 22, 2019.
  6. National Institute of Allergy and Infectious Diseases (NIAID). Bulletin: NIAID invites applications to conduct basic research on HIV persistence: studies key to search for a cure.https://wayback.archive-it.org/6721/20160908184013/http://www.niaid.nih.gov/news/newsreleases/Archive/2009/Pages/HIV_persistence.aspx. Published June 16, 2009. Accessed February 22, 2019.
  7. Siliciano RF, Greene WC. HIV latency. Cold Spring Harb Perspect Med. 2011;1(1):a007096.
  8. Rasmussen TA, Tolstrup M, Winckelmann A, Østergaard L, Søgaard OS. Eliminating the latent HIV reservoir by reactivation strategies. Hum Vaccines Immunother. 2013;9(4):790–799.
  9. National Institute of Allergy and Infectious Diseases (NIAID). Fact sheet, dated March 20, 2017. HIV viral eradication. https://www.niaid.nih.gov/diseases-conditions/hiv-viral-eradication. Accessed February 22, 2019.
  10. University of Aarhus. Toll-like receptor 9 enhancement of antiviral immunity in chronic HIV-1 infection: a Phase 1b/2a trial. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered on April 30, 2015. NLM Identifier: NCT02443935. https://clinicaltrials.gov/ct2/show/NCT02443935. Accessed February 22, 2019.
  11. Vibholm LK, Frattari G, Schleimann MH, et al. Effect of 24 weeks TLR9 agonist therapy on CTL responses and viral rebound during ATI. Poster presented at: Conference on Retroviruses and Opportunistic Infections (CROI): March 4-7, 2018; Boston, MA. Poster 357. http://www.croiconference.org/sites/default/files/posters-2018/1430_Vibholm_357.pdf. Accessed February 22, 2019.

Last Reviewed: February 22, 2019

Print