On February 21, 2024 Lutris Pharma, a clinical stage biopharmaceutical company focused on improving anti-cancer therapies by reducing dose limiting side effects, reported the publication of data from its phase 1/2 trial of lead compound, LUT014, a topically applied, novel B-Raf inhibitor, for the treatment of radiation-induced dermatitis (RD) in patients with breast cancer (Press release, Lutris Pharma, FEB 21, 2024, View Source [SID1234640348]). The data were published in the peer-reviewed, JAAD International, in an article entitled, "A Topical BRAF Inhibitor (LUT014) For Treatment of Radiodermatitis Among Women with Breast Cancer."
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"Our data suggest that LUT014 can be safely administered, with no serious adverse events (AEs) observed in either the open-label or randomized parts of the study," stated Benjamin W. Corn, M.D., Chief Medical Officer of Lutris Pharma. "In part 1 of the trial, by day 28, 6 of 8 (75%) of enrolled patients who developed grade 2 dermatitis at baseline, achieved complete resolution. Additionally, all 8 women in part 2 achieved treatment success, compared to 73% in the placebo arm, illustrating that a positive efficacy signal may be associated with this compound. Importantly, the results support the need for further study of LUT014 in this radiation-induced dermatitis indication, especially since several expert professional bodies such as the Oncologic Nursing Society (ONS), the American Society of Radiation Oncology (ASTRO) and the Multinational Association of Supportive Care in Cancer (MASCC) recently concluded that there is currently no standard treatment for radiation dermatitis."
"Publication of the impressive results from our phase 1/2 trial in breast cancer patients with RD in such a highly regarded peer reviewed journal, one of the main scientific/educational arms of the American Academy of Dermatology; the largest and most influential professional organization of dermatologists in the U.S. & Canada, is a testament to the potential of LUT014 to improve patients’ quality of life while accelerating their recovery from RD," added Noa Shelach, Ph.D., Chief Executive Officer of Lutris Pharma. "Given that the majority of women with breast cancer will develop some form of RD, and that there remains a clinically meaningful, unmet medical need, with no current, effective treatment options, we believe LUT014 may be able to effectively treat this patient population."
The phase 1/2 trial included an open-label part 1, followed by a double-blind placebo-controlled part 2. Part 1 results showed that, of the eight enrolled patients who developed grade 2 RD at baseline, 75% (6/8) had complete resolution, improving to grade 0 dermatitis, and 100% of patients had RD of 1 or 0 as assessed by the Common Terminology Criteria for Adverse Events (CTAE) after 28 days of daily, topically applied LUT014 gel. All of the patients derived benefit in quality of life by day 28 as assessed by the validated, self-reporting Dermatology Life Quality Index (DLQI) questionnaire, with seven of eight patients experiencing no or small effect of the dermatitis on their respective quality of life after the treatment course. The primary endpoint of the open-label part 1 was the incidence of Treatment-Emergent Adverse Events as assessed by CTAE at 12 weeks and the data showed that LUT014 was well tolerated, no severe or serious adverse events occurred, and no adverse events were associated with discontinuation of the study drug. These data were deemed to be sufficiently intriguing to trigger the randomized part of this phase 1/2 trial.
The randomized, double-blind, placebo-controlled part two of the phase 1/2 study enrolled a total of 20 patients and was designed to evaluate the efficacy of topically administered LUT014 in breast cancer patients with RD. Patients were randomized in a 1:1 ratio to receive either topically administered LUT014 or placebo for 28 days, followed by a 2-month follow-up period.
The primary endpoint of the double blinded part 2 of the phase 1/2 trial was the change in severity of radiation dermatitis, based on a validated self-reporting DLQI questionnaire at 14 days, as measured by improvement of at least 5 points on the DLQI at day 14, and was achieved by all eight women treated with LUT014, in comparison to 73% of the placebo arm at the same juncture. Improvement in the DLQI score at day 7 was 30%. Furthermore, 75% of patients in the intervention-arm showed improvement from grade 2 to grade 1 as early as day 7, in comparison to 55% of those assigned to the control arm. Moreover, 50% of the women assigned to the treatment arm experienced complete recovery at Day 21, versus 27% of those receiving only placebo (p=0.3765). Overall, four out of eight (50%) subjects had recovered completely in the LUT014 Gel group while four out of 11 (36%) subjects had recovered completely in the placebo group by the end of the study (Day 28) (p=0.6577). None of these differences reached conventional levels of statistical significance, however, this small study was not powered to show such differences. The mean and the median of the time to recovery were shorter in the LUT014 Gel group than in the placebo group: 30.5 vs. 46.6 days and 21.0 vs. 54.0 days, respectively.
For more information about this clinical trial, please visit: www.clinicaltrials.gov, NCT04261387.
About LUT014
LUT014 is a novel B-Raf inhibitor which is applied topically on the skin. When the B-Raf protein is mutated, as is the case in some human cancers such as melanoma cancer, blocking this pathway leads to apoptosis of the cells and tumor shrinkage. However, when the same pathway is blocked in normal, non-mutated cells, the opposite happens: the MAPK pathway is activated, and cells start growing. This phenomenon is recognized as the paradoxical effect of B-Raf Inhibitors. LUT014 harnesses the paradoxical effect of B-Raf Inhibitors in order to enhance cell proliferation and balance cell destruction, typical to radiation dermatitis.
About Radiation Dermatitis
Radiation therapy results in ionization events that lead to damage of cellular macromolecules, including double-stranded DNA breaks. Within the epidermis, this DNA damage disrupts the normal proliferation and differentiation of basal keratinocytes, depleting the differentiated epidermal keratinocytes and ultimately resulting in the loss of the protective barrier provided by the skin. This, combined with DNA damage disruption within the dermis, which results in a complex sequence of effects including an immune response cascade, leads to the symptomology associated with radiation dermatitis, which can dramatically diminish a patient’s quality of life.
There is currently no FDA-approved drug whose labelled indication is for the prevention or treatment of radiation-induced dermatitis. Rather, patients are merely treated with supportive cutaneous care. The current treatment options – which have a weak evidence base — have included topical steroids, non-steroidal anti-inflammatory topicals, and hyaluronic acid derivatives. To date, none has been definitively proved efficacious.