On March 8, 2022 Amgen (NASDAQ: AMGN) reported that new data from across its oncology portfolio and pipeline will be presented at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting from April 8-13 in New Orleans, Louisiana (Press release, Amgen, MAR 8, 2022, View Source [SID1234609659]).
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Long-term outcomes from the CodeBreaK 100 trial of LUMAKRAS (sotorasib), the first and only KRASG12C inhibitor approved for patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), will be shared as a late-breaking oral presentation on Sunday, April 10, 2022 from 3:00 – 5:00 p.m. CST.
Notable data from Amgen’s oncology pipeline includes the first disclosure of preclinical results from AMG 794, a half-life extended (HLE) bispecific T-cell engager (BiTE) molecule targeting Claudin 6 (CLDN6) in NSCLC and epithelial ovarian cancer, and TNB-928b, a T-cell engaging bispecific antibody utilizing a bivalent tumor-selective folate receptor alpha binding arm for the treatment of ovarian cancer.
"Following the approval of LUMAKRAS for KRAS G12C-mutated non-small cell lung cancer in nearly 40 countries around the world, we look forward to sharing the longest follow-up data ever presented with a KRASG12C inhibitor at this year’s AACR (Free AACR Whitepaper) conference, further demonstrating the clinical benefit this transformative therapy can bring to patients," said David M. Reese, M.D., executive vice president of Research and Development at Amgen. "Across our oncology pipeline, we also look forward to sharing emerging early research highlighting how Amgen is advancing the next frontier of innovation in the treatment of cancers."
With the exception of late-breaking research, abstracts are available and can be viewed on the AACR (Free AACR Whitepaper) website.
Abstracts and Presentation Times:
Amgen Sponsored Abstracts
LUMAKRAS
Long-term outcomes with sotorasib in pretreated KRAS p.G12C mutated NSCLC: 2-year analysis of CodeBreaK100
Abstract #7597, Late-Breaking Oral Presentation, Session: Clinical Trials Targeting the DNA Damage Response and KRAS, Sunday, April 10 from 3:00 – 5:00 p.m. CST
LKB1 loss rewires JNK-induced apoptotic protein dynamics through NUAKs and sensitizes KRAS-mutant non-small cell lung cancers to combined KRAS G12C + MCL-1 blockade
Abstract #2150, Oral Presentation, Mini-Symposium, Session: Monday, April 11 from 2:30 – 4.30 p.m. CST
BiTE Platform
AMG 794, a Claudin 6-targeted half-life extended bispecific T-cell engager (HLE BITE) molecule for non-small cell lung cancer and epithelial ovarian cancer
Abstract #5202, E-Poster Virtual Presentation, Session: Clinical Research Excluding Trials – Immuno-Oncology, Friday, April 8 – Wednesday, April 13
Evaluation of a Dual CD123-FLT3 BiTE Molecule Targeting Acute Myeloid Leukemia
Abstract #2900, E-Poster In-Person Presentation, Session: Therapeutic Antibodies 2, Tuesday, April 12 from 9:00-12.30 p.m. CST
Evaluation of a dual-targeting BCMA-CS1 HLE BiTE molecule for multiple myeloma
Abstract #2031, E-Poster Virtual Presentation, Session: Therapeutic Antibodies 1, Friday, April 8 – Wednesday, April 13
MTA-Cooperative PRMT5 Inhibitor
The Discovery and Preclinical Characterization of the MTA Cooperative PRMT5 Inhibitor AM-9747
Abstract #2114, E-Poster In-Person Presentation, Session: Drug Targets, April 11 from 1:30-5:00 p.m. CST
Partner-Led Abstracts
Delta-like ligand 3 immunohistochemical expression landscape in high-grade lung neuroendocrine tumors
Abstract #3690, E-Poster Virtual Presentation, Session: Drug Discovery, Friday, April 8 – Wednesday, April 13
A T-cell engaging bispecific antibody utilizing a bivalent tumor-selective folate receptor alpha binding arm for the treatment of ovarian cancer
Abstract #2904, E-Poster In-Person Presentation, Session: Therapeutic Antibodies 2, Tuesday, April 12 from 9:00-12.30 p.m. CST
About LUMAKRAS/LUMYKRAS (sotorasib)
Amgen took on one of the toughest challenges of the last 40 years in cancer research by developing LUMAKRAS/LUMYKRAS, a KRASG12C inhibitor.1 LUMAKRAS/LUMYKRAS has demonstrated a positive benefit-risk profile with rapid, deep, and durable anticancer activity in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring the KRAS G12C mutation with a once daily oral formulation.2
Amgen is progressing the largest and broadest global KRASG12C inhibitor development program with unparalleled speed and exploring more than 10 sotorasib combination regimens, including triplets, with clinical trial sites spanning five continents. To date, over 4,000 patients around the world have received LUMAKRAS/LUMYKRAS through the clinical development program and commercial use.
In May 2021, LUMAKRAS was the first KRASG12C inhibitor to receive regulatory approval anywhere in the world with its approval in the U.S., under accelerated approval. LUMAKRAS/LUMYKRAS is also approved in the United Arab Emirates, the European Union Switzerland, and Japan, and in Canada and Great Britain under the FDA’s Project Orbis. Through Project Orbis, Amgen also has Marketing Authorization Applications (MAAs) for sotorasib in review in Australia, Brazil, Singapore, and Israel. Additionally, Amgen has submitted MAAs in Turkey, Taiwan, Colombia, Thailand, Mexico, Hong Kong, Saudi Arabia, Argentina, Kuwait and Qatar.
LUMAKRAS/LUMYKRAS is also being studied in multiple other solid tumors.3
About Non-Small Cell Lung Cancer and the KRAS G12C Mutation
Lung cancer is the leading cause of cancer-related deaths worldwide, and it accounts for more deaths worldwide than colon cancer, breast cancer and prostate cancer combined.4 Overall survival rates for NSCLC are improving but remain poor for patients with advanced disease and 5-year survival is only 7% for those with metastatic disease.5
KRAS G12C is the most common KRAS mutation in NSCLC.6 About 13% of patients with NSCLC harbor the KRAS G12C mutation.7 Unmet medical need remains high and treatment options are limited for NSCLC patients with the KRAS G12C mutation whose first-line treatment has failed to work or has stopped working. The outcomes with other approved therapies are suboptimal, with a median progression-free survival of approximately 4 months following second-line treatment of KRAS G12C-mutated NSCLC.8
About CodeBreaK
The CodeBreaK clinical development program for Amgen’s drug sotorasib is designed to study patients with an advanced solid tumor with the KRAS G12C mutation and address the longstanding unmet medical need for these cancers.
CodeBreaK 100, the Phase 1 and 2, first-in-human, open-label multicenter study, enrolled patients with KRAS G12C-mutant solid tumors.9 Eligible patients must have received a prior line of systemic anticancer therapy, consistent with their tumor type and stage of disease. The primary endpoint for the Phase 2 study was centrally assessed objective response rate. The Phase 2 trial in NSCLC enrolled 126 patients, 124 of whom had centrally evaluable lesions by RECIST at baseline.2 The Phase 2 trial in colorectal cancer (CRC) is fully enrolled and results have been published.10
CodeBreaK 200, the global Phase 3 randomized active-controlled study comparing sotorasib to docetaxel in KRAS G12C-mutated NSCLC completed enrollment of 345 patients. Eligible patients had previously treated, locally advanced and unresectable or metastatic KRAS G12C-mutated NSCLC. The primary endpoint is progression-free survival and key secondary endpoints include overall survival, objective response rate, and patient-reported outcomes.11
Amgen also has several Phase 1b studies investigating sotorasib monotherapy and sotorasib combination therapy across various advanced solid tumors (CodeBreaK 101) open for enrollment.12 A Phase 2 randomized study will evaluate sotorasib in patients with stage IV KRAS G12C-mutated NSCLC in need of first-line treatment (CodeBreaK 201).13
For information, please visit www.hcp.codebreaktrials.com.
LUMAKRAS (sotorasib) U.S. Indication
LUMAKRAS is indicated for the treatment of adult patients with KRAS G12C-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC), as determined by an FDA-approved test, who have received at least one prior systemic therapy.
This indication is approved under accelerated approval based on overall response rate (ORR) and duration of response (DOR). Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).
LUMAKRAS (sotorasib) Important U.S. Safety Information
Hepatotoxicity
LUMAKRAS can cause hepatotoxicity, which may lead to drug-induced liver injury and hepatitis.
Among 357 patients who received LUMAKRAS in CodeBreaK 100, hepatotoxicity occurred in 1.7% (all grades) and 1.4% (Grade 3). A total of 18% of patients who received LUMAKRAS had increased alanine aminotransferase (ALT)/increased aspartate aminotransferase (AST); 6% were Grade 3 and 0.6% were Grade 4. In addition to dose interruption or reduction, 5% of patients received corticosteroids for the treatment of hepatotoxicity.
Monitor liver function tests (ALT, AST and total bilirubin) prior to the start of LUMAKRAS every 3 weeks for the first 3 months of treatment, then once a month or as clinically indicated, with more frequent testing in patients who develop transaminase and/or bilirubin elevations.
Withhold, dose reduce or permanently discontinue LUMAKRAS based on severity of adverse reaction.
Interstitial Lung Disease (ILD)/Pneumonitis
LUMAKRAS can cause ILD/pneumonitis that can be fatal. Among 357 patients who received LUMAKRAS in CodeBreaK 100, ILD/pneumonitis occurred in 0.8% of patients, all cases were Grade 3 or 4 at onset, and 1 case was fatal. LUMAKRAS was discontinued due to ILD/pneumonitis in 0.6% of patients.
Monitor patients for new or worsening pulmonary symptoms indicative of ILD/pneumonitis (e.g., dyspnea, cough, fever). Immediately withhold LUMAKRAS in patients with suspected ILD/pneumonitis and permanently discontinue LUMAKRAS if no other potential causes of ILD/pneumonitis are identified.
Most Common Adverse Reactions
The most common adverse reactions ≥ 20% were diarrhea, musculoskeletal pain, nausea, fatigue, hepatotoxicity and cough.
Drug Interactions
Advise patients to inform their healthcare provider of all concomitant medications, including prescription medicines, over-the-counter drugs, vitamins, dietary and herbal products.
Inform patients to avoid proton pump inhibitors and H2 receptor antagonists while taking LUMAKRAS.
If coadministration with an acid-reducing agent cannot be avoided, inform patients to take LUMAKRAS 4 hours before or 10 hours after a locally acting antacid.
Please see LUMAKRAS full Prescribing Information.
About BiTE Technology
BiTE (bispecific T-cell engager) technology is a targeted immuno-oncology platform that is designed to engage patient’s own T-cells to any tumor-specific antigen, activating the cytotoxic potential of T-cells to eliminate detectable cancer. The BiTE immuno-oncology platform has the potential to treat different tumor types through tumor-specific antigens. The BiTE platform has a goal of leading to off-the-shelf solutions, which have the potential to make innovative T-cell treatment available to all providers when their patients need it. Amgen is advancing a number of BiTE molecules across a broad range of hematologic malignancies and solid tumors, further investigating BiTE technology with the goal of enhancing patient experience and therapeutic potential.
To learn more about BiTE technology, visit www.AmgenBiTETechnology.com.