On October 30, 2023 Deciphera Pharmaceuticals, Inc. (NASDAQ: DCPH), a biopharmaceutical company focused on discovering, developing, and commercializing important new medicines to improve the lives of people with cancer, reported positive top-line results from the MOTION pivotal Phase 3 study of vimseltinib in patients with TGCT not amenable to surgery (Press release, Deciphera Pharmaceuticals, OCT 30, 2023, View Source [SID1234636439]). Vimseltinib is the Company’s investigational, orally administered, potent, and highly selective switch-control kinase inhibitor of CSF1R.
Schedule your 30 min Free 1stOncology Demo!
Discover why more than 1,500 members use 1stOncology™ to excel in:
Early/Late Stage Pipeline Development - Target Scouting - Clinical Biomarkers - Indication Selection & Expansion - BD&L Contacts - Conference Reports - Combinatorial Drug Settings - Companion Diagnostics - Drug Repositioning - First-in-class Analysis - Competitive Analysis - Deals & Licensing
Schedule Your 30 min Free Demo!
"Patients suffering from TGCT are in need of a new treatment option that offers both strong clinical benefit and a well-tolerated safety profile," said Hans Gelderblom, M.D., Ph.D., Chair of the Department of Medical Oncology at Leiden University Medical Center. "TGCT has a significant negative impact on the daily life of patients who face substantial pain, stiffness, and impaired mobility. Success across both the primary and all key secondary endpoints in MOTION underscores vimseltinib’s ability to help TGCT patients feel and function better. The top-line results from MOTION, together with the impressive data announced today from the Phase 1/2 study showing that the response rates with vimseltinib continue to increase over time, and that patients continue to receive long-term clinical benefit as evidenced by the median duration of treatment, demonstrates vimseltinib’s potential to become a best-in-class agent."
"We are excited about the potential for vimseltinib to become our next approved medicine, supporting our continued evolution to a company with multiple marketed products," said Steve Hoerter, President and Chief Executive Officer of Deciphera Pharmaceuticals. "The totality of data shown today demonstrate the potential for vimseltinib to offer a new and differentiated treatment option for patients with TGCT. On behalf of the entire Deciphera team, I would like to thank the patients, their caregivers, and the healthcare professionals who participated in the MOTION and Phase 1/2 studies. We look forward to working with regulatory agencies worldwide as we focus on delivering this important new treatment option to patients with TGCT."
Top-line Results from the MOTION Pivotal Phase 3 Study of Vimseltinib in TGCT
The MOTION pivotal Phase 3 study is a two-part, randomized, double-blind, placebo-controlled study to assess the efficacy and safety of vimseltinib in patients with TGCT not amenable to surgery with no prior anti-CSF1/CSF1R therapy (prior therapy with imatinib or nilotinib allowed). In Part 1, patients (n=123) were randomized two-to-one to receive either 30 mg twice weekly of vimseltinib (n=83) or placebo (n=40) for 24 weeks. The primary endpoint of the study is ORR at Week 25 as measured by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 by blinded independent radiologic review (IRR). The open-label Part 2 portion of MOTION, in which patients from both the vimseltinib and placebo arms receive treatment with vimseltinib, remains ongoing. The results for Part 1 of the study are based on a data cutoff date of August 22, 2023.
The study met its primary endpoint in the intent-to-treat (ITT) population demonstrating statistically significant and clinically meaningful improvement versus placebo in ORR at Week 25 based on IRR per RECIST v1.1. In the ITT population, the ORR at Week 25 was 40% (95% CI: 29%, 51%) for the vimseltinib arm and 0% (95% CI: 0%, 9%) for the placebo arm resulting in a response difference (vimseltinib versus placebo) of 40% (95% CI: 29%, 51%) (p<0.0001).
In addition to meeting the primary endpoint, the study also achieved statistically significant and clinically meaningful improvements versus placebo in all key secondary endpoints assessed at Week 25 including ORR per tumor volume score (TVS), active range of motion (ROM), physical function, stiffness, quality of life, and pain.
In the ITT population, the ORR at Week 25 based on IRR per TVS was 67% (95% CI: 56%, 77%) for the vimseltinib arm and 0% (95% CI: 0%, 9%) for the placebo arm (p<0.0001). Treatment with vimseltinib also demonstrated an improvement in mean change from baseline in active ROM at Week 25 of 18.4% versus a 3.8% improvement for placebo (p=0.0077).
Vimseltinib was well-tolerated and the safety profile in the MOTION study was consistent with previously disclosed data. There was no evidence of cholestatic hepatotoxicity in patients treated with vimseltinib. Patients with treatment-emergent adverse events (TEAEs) leading to treatment discontinuation was 6% in the vimseltinib arm. The table below lists TEAEs >15% in either arm during Part 1 of the study.
Preferred Term n (%)
Vimseltinib
(n=83)
Placebo
(n=39)1
All Grades
Grade 3/4
All Grades
Grade 3/4
Periorbital edema^
37 (45%)
3 (4%)
5 (13%)
0
Fatigue ^
27 (33%)
0
6 (15%)
0
Face edema^
26 (31%)
1 (1%)
3 (8%)
0
Pruritus^
24 (29%)
2 (2%)
3 (8%)
0
Headache^
23 (28%)
1 (1%)
10 (26%)
0
Asthenia^
22 (27%)
1 (1%)
9 (23%)
1 (3%)
Nausea ^
21 (25%)
0
8 (21%)
1 (3%)
CPK increased
20 (24%)
8 (10%)
0
0
AST increased
19 (23%)
0
1 (3%)
0
Arthralgia ^
16 (19%)
0
6 (15%)
1 (3%)
Rash ^
16 (19%)
0
2 (5%)
0
Rash maculo-papular^
16 (19%)
1 (1%)
0
0
Edema peripheral ^
15 (18%)
0
3 (8%)
0
Hypertension
14 (17%)
4 (5%)
4 (10%)
1 (3%)
Diarrhea
10 (12%)
0
8 (21%)
1 (3%)
(1) Does not include one patient randomized to placebo that did not receive study drug.
TEAE incidence is based on maximum grades per CTCAE v5.0. The only Grade 4 adverse events were CPK Increased observed in two patients. TEAEs leading to dose interruption were 44 (53%) and dose reduction 35 (42%). ^ Denotes adverse events without Grade 4 criteria per CTCAE v5.0.
The Company expects to submit a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for vimseltinib for the treatment of patients with TGCT in the second quarter of 2024 and a Marketing Authorisation Application (MAA) to the European Medicines Agency in the third quarter of 2024.
Additional efficacy and safety results from Part 1 of the MOTION study are expected to be presented at an upcoming medical meeting.
Updated Results from the Phase 1/2 Study of Vimseltinib in TGCT
The Company also announced today updated results from the Phase 1/2 open-label, multicenter study evaluating the safety and efficacy of vimseltinib in patients with TGCT, which will be presented at the Connective Tissue Oncology Society 2023 Annual Meeting in Dublin, Ireland on November 1-4, 2023.
As of the June 27, 2023 cutoff date, 97 patients were enrolled in the study as follows:
Phase 1: 32 patients enrolled in three cohorts across multiple doses.
Phase 2: 65 patients enrolled in two cohorts at the recommended Phase 2 dose of 30 mg twice weekly: Cohort A (n=46) in TGCT patients with no prior anti-CSF1/CSF1R therapy (prior therapy with imatinib or nilotinib allowed); and Cohort B (n=19) in TGCT patients with prior anti-CSF1/CSF1R therapy (prior therapy with imatinib or nilotinib alone not eligible).
Antitumor Activity and Treatment Duration:
93 patients were evaluable for efficacy by RECIST v1.1 at the data cutoff date; response data is based on IRR summarized as follows:
Phase 1
(n=32)
Phase 2 Cohort A
(n=45)
Phase 2 Cohort B
(n=16)
Best ORR per RECIST v1.1 by IRR (%)
72%
64%
(38% at Week 25)
44%
Median Duration of Response
(months) (Range)
NR (3.8+, 45.2+)
NR (0.03+, 25.4+)
NR (4.0+, 21.0+)
Median Treatment Duration
(months) (Range)
25.1 (0.7, 46.9)
21.0 (0.2, 30.3)
7.3 (0.7, 27.4)
Patients Active on Treatment at Cutoff Date (%)
47%
48%
74%
NR: Not Reached by Kaplan-Meier analysis.
In addition, updated data from Cohorts A and B of the Phase 2 study demonstrate that patients experienced clinically meaningful symptomatic benefit at Week 25 across multiple secondary efficacy measures including best ORR per TVS (Cohort A), active range of motion, physical function, stiffness, and pain.
Safety and Tolerability
Treatment with vimseltinib was well-tolerated in patients with TGCT and consistent with previously disclosed data.
There was no evidence of cholestatic hepatotoxicity.
Treatment discontinuation due to TEAEs occurred in 9% of patients.
Results from the Phase 1 portion of the study are being presented in an oral presentation, titled "Safety and Efficacy Updates from a Phase 1 Study of Vimseltinib in Patients with Tenosynovial Giant Cell Tumor." Results from Cohorts A and B of the Phase 2 portion of the study are being presented in two poster presentations, titled "Safety, Efficacy, and Patient-Reported Outcomes with Vimseltinib in Patients with Tenosynovial Giant Cell Tumor Who Received No Prior Anti-Colony-Stimulating Factor 1 Therapy: Ongoing Phase 2 Update" and "Safety, Efficacy, and Patient-Reported Outcomes with Vimseltinib in Patients with Tenosynovial Giant Cell Tumor Who Received Prior Anti-Colony-Stimulating Factor 1 Therapy: Ongoing Phase 2 Update." The presentations are available on the Company’s website at www.deciphera.com/presentations-publications.
Conference Call and Webcast
Deciphera will host a conference call and webcast to discuss this announcement today, October 30, 2023, at 8:00 AM ET. The conference call may be accessed via this link: https://register.vevent.com/register/BIc2885b197da74145bfc30deb5fb11858. A live webcast of the conference call will be available in the "Events and Presentations" page in the "Investors & News" section of the Company’s website at View Source A replay will be available on the Company’s website approximately two hours after the conference call and will be available for 30 days following the call.