Figure 2.

The patient whose advanced basal cell carcinoma stabilized on anti-programmed cell death protein-1 (PD-1), then regressed following the addition of anti-lymphocyte activation gene 3 (LAG-3) therapy. (A) the patient received nivolumab (anti-PD-1) over 48 weeks (green) during which he experienced stable disease per Response Evaluation Criteria in Solid Tumors (RECIST) V.1.1. The tumor remained stable in size for 18 weeks after discontinuation of therapy, at which point the patient received nivolumab plus relatlimab (anti-LAG-3; blue). He experienced a partial response 39 weeks later, ongoing at 21.5 months from nivolumab/relatlimab initiation. Dashed lines show a 30% decrease in tumor diameter from baseline during each treatment regimen. Both CT scans (B) and paired pretreatment and on-treatment biopsies stained with H&E (C) demonstrate tumor regression. The high-powered view of the regression area shown for Week 71 shows fibrosis, plasma cells, foamy macrophages and numerous lymphocytes. The LAG-3 immunohistochemistry (IHC) staining performed on the Week 0 (immediate pretreatment) and Week 66 biopsies shows an increase in LAG-3 expression after administration of anti-PD-1 monotherapy prior to anti-PD-1+LAG-3 treatment. The patient went on to demonstrate an objective response to combinatorial therapy. Additional images for LAG-3 expression over the course of therapy are shown in online supplemental figure S3. Some figure elements created with BioRender.com.