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Therapeutic potential of targeting LAG-3 in cancer
Diwakar Davar1, Ana Carrizosa Anderson2, Ivan Diaz-Padilla3
1Department of Medicine, UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania, USA davard@upmc.edu.
Abstract:
Immune checkpoint inhibitors targeting negative regulatory checkpoints including programmed death-1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 have produced significant improvements in progression-free survival (PFS) and overall survival in multiple solid tumors. Lymphocyte activation gene 3 (LAG-3) is an inhibitory receptor that is highly expressed by exhausted T cells. Dual blockade of LAG-3 and PD-1 with monoclonal antibodies relatlimab and nivolumab has improved PFS in advanced melanoma, leading to Food and Drug Administration approval for this indication. Concurrently, enthusiasm for targeting LAG-3 has been tempered by negative results in multiple indications, although novel approaches including LAG-3-directed bispecifics tebotelimab continue to demonstrate promise. In this review, we discuss the current understanding of LAG-3 in regulating antitumor immunity and the ongoing state of clinical development of LAG-3-directed agents in cancer.
Insights
Immune checkpoint inhibitors like PD-1 and LAG-3 show promise in cancer treatment. Dual blockade of Lymphocyte Activation Gene 3 (LAG-3) and PD-1 has improved survival in advanced melanoma.
Area of Science:
- Immunology
- Oncology
- Cancer Research
Background:
- Immune checkpoint inhibitors targeting programmed death-1 (PD-1) and cytotoxic T-lymphocyte-associated protein 4 have improved survival in various solid tumors.
- Lymphocyte activation gene 3 (LAG-3) is an inhibitory receptor found on exhausted T cells, playing a role in regulating anti-tumor immunity.
Purpose of the Study:
- To review the current understanding of LAG-3's role in anti-tumor immunity.
- To summarize the clinical development status of LAG-3-directed agents in cancer therapy.
Main Methods:
- Literature review of preclinical and clinical studies on LAG-3.
- Analysis of clinical trial data for LAG-3 inhibitors in various cancer types.
Main Results:
- Dual blockade of LAG-3 and PD-1 with relatlimab and nivolumab demonstrated improved progression-free survival (PFS) in advanced melanoma, leading to FDA approval.
- Despite some negative trial outcomes, novel LAG-3-directed therapies, such as bispecific antibodies, continue to show potential.
Conclusions:
- LAG-3 is a significant target for immuno-oncology, with dual blockade showing clinical benefit in specific cancers.
- Ongoing research and novel therapeutic strategies are crucial for maximizing the potential of LAG-3 inhibition in cancer treatment.
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