Maplirpacept for the treatment of DLBCL: Mechanism of action and ongoing trials

Maplirpacept is a CD47-binding fusion protein that enhances phagocytosis and antitumor activity.¹ Unlike many other anti-CD47 agents, it binds minimally to red blood cells, reducing the risk of potential complications such as anemia.^1,2

Previously, a phase I dose-escalation and expansion trial of maplirpacept (NCT03530683) investigated the safety of eight doses, ranging from 0.05 to 18 mg/kg weekly, in 42 patients with relapsed or refractory lymphoma.^2,3 As of April 2021, treatment-related adverse events (AEs) occurred in 47% patients; with most AEs being Grade 1 or 2 and reversible.⁴ The most common treatment-related AEs included thrombocytopenia (21%), neutropenia (12%), and anemia and fatigue (both 9%).⁴ At data cut-off (April 12, 2021), objective responses were achieved in nine patients, including two complete responses.⁴ Positive results from this trial have led to further investigation of maplirpacept. Studies are now investigating maplirpacept in combination with various approved agents for lymphoma. Here, we summarize these ongoing studies and the mechanism of action of maplirpacept.

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