On July 22, 2019 Spectrum Pharmaceuticals, Inc. (NASDAQ-GS: SPPI), a biopharmaceutical company focused on novel and targeted oncology therapies, reported that it is further expanding its poziotinib clinical program by adding three new cohorts in its cornerstone poziotinib clinical trial, ZENITH20 (Press release, Spectrum Pharmaceuticals, JUL 22, 2019, View Source [SID1234537648]). The ZENITH20 trial is an open-label, multi-center, global phase 2 trial with sites in the U.S., Canada, and Europe, evaluating the impact of poziotinib treatment on non-small cell lung cancer (NSCLC) patients.
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"With increased use of osimertinib as the treatment of first-line NSCLC patients with classical EGFR mutations, the emergence of osimertinib resistance is a growing occurrence in this setting," said Jeffrey Clarke, MD, Assistant Professor of Medicine at Duke University Hospital/Duke Cancer Institute. "One resistance pattern that is emerging is through the development of an additional EGFR mutation and recent pre-clinical publications suggest that poziotinib may be active against EGFR-dependent resistance mechanisms. Exploring the role of poziotinib as an investigational therapeutic option for those patients who fail first-line osimertinib and for those who have de novo atypical mutations is an exciting development and requires clinical confirmation."
Three new cohorts are currently open to patient enrollment in the ZENITH20 trial. Cohort 5 includes previously treated or treatment-naïve NSCLC patients with EGFR or HER2 exon 20 insertion mutations. Cohort 6 includes NSCLC patients with classical EGFR mutations who progressed while on treatment with first-line osimertinib and developed an additional EGFR mutation. Cohort 7 includes NSCLC patients with a variety of less common mutations in EGFR or HER2 exons 18-21 or the extracellular or transmembrane domains. All three new cohorts are now open to enrollment.
"Strong preclinical evidence led to the development of poziotinib in exon 20 mutations. Similarly guided by elegant science, we are expanding the poziotinib program to evaluate its potential in patients with additional difficult to treat mutations in non-small cell lung cancer," said Francois Lebel, M.D., F.R.C.P.C., Chief Medical Officer of Spectrum Pharmaceuticals. "The emergence of osimertinib resistance and the lack of effective treatments for atypical mutations are growing treatment voids that poziotinib may be uniquely suited to fill."
The ZENITH20 trial now consists of seven cohorts of NSCLC patients. Cohorts 1 (EGFR) and 2 (HER2) are in previously-treated NSCLC setting and are fully enrolled. Cohort 3 (EGFR) and 4 (HER2) are in the first-line setting and are currently enrolling patients. Cohorts 1- 4 are each independently powered for a pre-specified statistical hypothesis and the primary endpoint is objective response rate (ORR). Additional endpoints include duration of response (DOR), disease control rate (DCR), progression-free survival (PFS), and safety. Topline results from cohort 1 are expected in Q4 2019.
"Our poziotinib clinical program is aggressive, proactive and designed to provide us with a full understanding of poziotinib’s potential impact on non-small cell lung cancer," said Joe Turgeon, President and CEO of Spectrum Pharmaceuticals. "Thus far, we are pleased with the rapid recruitment and are eagerly awaiting our first topline readout in patients with previously treated EGFR exon 20 insertion mutations in the fourth quarter of this year."
About Poziotinib
Poziotinib is a novel, oral epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI) that inhibits the tyrosine kinase activity of EGFR (HER1) as well as HER2 and HER4. Importantly this leads to the inhibition of the proliferation of tumor cells that overexpress these receptors. Mutations or overexpression/amplification of EGFR family receptors have been associated with a number of different cancers, including non-small cell lung cancer (NSCLC), breast cancer, and gastric cancer.
Spectrum received exclusive license from Hanmi Pharmaceuticals to develop, manufacture, and commercialize poziotinib worldwide, excluding Korea and China. Poziotinib is currently being investigated by Spectrum and Hanmi in several trials in multiple solid tumors.