On November 17, 2022 Ayala Pharmaceuticals, Inc. (Nasdaq: AYLA), a clinical-stage oncology company focused on developing and commercializing small molecule therapeutics for patients suffering from rare tumors and aggressive cancers, reported a poster presentation highlighting interim results from the Phase 2 segment / Part A of the RINGSIDE Pivotal Phase 2/3 clinical trial in desmoid tumors at the Connective Tissue Oncology Society (CTOS) 2022 Annual Meeting, taking place in-person November 16-19 in Vancouver, Canada (Press release, Ayala Pharmaceuticals, NOV 17, 2022, View Source [SID1234624193]).
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The ongoing RINGSIDE Pivotal Phase 2/3 clinical trial is evaluating the investigational new drug AL102, a potent, selective, oral gamma-secretase inhibitor. Positive interim results from the Phase 2 segment of this study were previously presented at ESMO (Free ESMO Whitepaper) 2022.
"We are pleased to update the positive interim data from RINGSIDE with the oncology community at this year’s CTOS meeting, which is the largest gathering of connective tissue oncologists worldwide," said Roni Mamluk, PhD, President and CEO of Ayala. "This poster highlights the efficacy demonstrated at the 1.2 mg dose that was selected for the Phase 3 segment of the study, with responses seen as early as 16 weeks that deepened over time. AL102 was generally well tolerated with a manageable safety profile."
Details of the poster presentation are as follows:
Abstract Title: Initial Results of RINGSIDE, a Phase 2/3 Trial of AL102 for the Treatment of Desmoid Tumors
Abstract Number: 2206585
Session Title: Sarcoma of the Year: Desmoid Fibromatosis
Session Date and Time: Thursday, November 17, 2022, 5 PM-7 PM PST
Poster Highlights:
Desmoid tumor is an invasive proliferative disease of the connective tissue characterized by a variable and often unpredictable clinical course with no FDA-approved therapies.
AL102 is a potent, orally available, selective gamma-secretase inhibitor being evaluated in the RINGSIDE Pivotal Phase 2/3 trial in desmoid tumors.
The Phase 2 segment of the study enrolled 42 patients which were dosed in AL102 monotherapy cohorts of 1.2 mg (daily), 2mg (2 days on, 5 days off), or 4mg (2 days on, 5 days off).
The activity of AL102 was measured by the change in tumor volume (central MRI readings) and response (per RECIST 1.1) as determined by blinded independent central review. At the data cut-off (July 14, 2022), 28 patients were evaluable for tumor volume and 29 were evaluable for RECIST with a scan at baseline and at least one additional scan at week 16.
12 patients had at least 2 MRI scans at data cut-off and were evaluable for efficacy.
First partial response (PR) was observed at week 16 and three additional PRs were observed over the follow-up period: two at week 28 and one at week 40.
3 out of 4 PRs were observed at the 1.2 mg once-daily dose that was selected for the Phase 3 segment of the study.
AL102 was generally well tolerated at all doses, with low rates of grade 3, and no grade 4 or 5 adverse events. Adverse events were consistent with mechanism of action of GSIs.
Adverse events leading to discontinuation were all Grade 1 – 3 and occurred within 3 months of treatment initiation
Adverse events related to ovarian dysfunction was observed in 22% of women of childbearing potential (N=23), and were all Grade 1 or 2
1.2 mg once daily was selected as the dose to advance into the Phase 3 portion of RINGSIDE.
Enrolment has begun in the Phase 3 segment of RINGSIDE, the randomized portion of the study Patients are also being enrolled in an open-label extension study.
About the RINGSIDE study
The RINGSIDE pivotal Phase 2/3 study is a randomized global multi-center trial. The Phase 2 segment of the study evaluated the efficacy, safety, tolerability, and tumor volume by MRI after 16 weeks of AL102 in patients with desmoid tumors. It enrolled 42 patients and evaluated 3 doses of AL102. Patients who participated in the Phase 2 segment of the study are eligible to enroll into an open-label extension study at the selected dose of 1.2 mg daily, and long-term efficacy and safety will be monitored.
The Phase 3 segment of the study has been initiated. This is a double-blind, placebo-controlled segment enrolling up to 156 patients with progressive disease that compares AL102 at 1.2 mg once daily to placebo. The primary endpoint for the Phase 3 segment is progression-free survival (PFS), with secondary endpoints including objective response rate (ORR), duration of response (DOR), tumor volume reduction, and patient-reported Quality of Life (QOL) measures. For more information on the RINGSIDE Phase 2/3 study with AL102 for the treatment of desmoid tumors, please visit ClinicalTrials.gov and reference Identifier NCT04871282 (RINGSIDE).
About Desmoid Tumors
Desmoid tumors also called aggressive fibromatosis or desmoid-type fibromatosis, are rare connective tissue tumors that typically arise in the upper and lower extremities, abdominal wall, head and neck area, mesenteric root, and chest wall with the potential to arise in additional parts of the body. Desmoid tumors do not metastasize, but often aggressively infiltrate neurovascular structures and vital organs. People living with desmoid tumors are often limited in their daily life due to chronic pain, functional deficits, general decrease in their quality of life and organ dysfunction. Desmoid tumors have an annual incidence of approximately 1,700 patients in the United States and typically occur in patients between the ages of 15 and 60 years. They are most commonly diagnosed in young adults between 30-40 years of age and are more prevalent in females. Today, surgery is no longer regarded as the cornerstone treatment of desmoid tumors due to a high rate of recurrence post-surgery and there are currently no FDA-approved systemic therapies for the treatment of unresectable, recurrent, or progressive desmoid tumors.