nab-Paclitaxel Plus Gemcitabine Versus Gemcitabine in Patients with Metastatic Pancreatic Adenocarcinoma: Canadian Subgroup Analysis of the Phase 3 MPACT Trial.

The phase III MPACT trial in patients with metastatic pancreatic cancer (MPC) demonstrated superior efficacy of nab-paclitaxel (nab-P) plus gemcitabine (Gem) compared with Gem monotherapy, including the primary endpoint of overall survival (OS; median 8.7 vs. 6.6 months; hazard ratio [HR] 0.72; P < 0.001). A significant treatment difference favoring nab-P + Gem over Gem was observed for OS in patients treated in North America. The majority of patients were from the US (88%) with only 12% from Canada. Healthcare systems and treatment patterns are different between the 2 countries, and there is limited published information on outcomes of Canadian patients treated with first-line nab-P + Gem. This analysis evaluated efficacy and safety outcomes in Canadian patients in the MPACT trial.
Treatment-naive patients with MPC (N = 861) received either nab-P 125 mg/m(2) + Gem 1000 mg/m(2) on days 1, 8, and 15 every 4 weeks or Gem 1000 mg/m(2) weekly for the first 7 of 8 weeks (cycle 1) and then on days 1, 8, and 15 every 4 weeks (cycle ≥2).
The MPACT trial enrolled 63 patients in Canada. Baseline characteristics were well balanced and comparable with those of the intent-to-treat population. Both OS (median 11.9 vs. 7.1 months; HR 0.76; P = 0.373) and progression-free survival (median 7.2 vs. 5.2 months; HR 0.65; P = 0.224) were numerically longer and overall response rate (27% vs. 17%; P = 0.312) was numerically higher with nab-P + Gem vs. Gem. The most common grade ≥3 adverse events with nab-P + Gem vs. Gem were neutropenia (22% vs. 10%), fatigue (34% vs. 33%), and neuropathy (25% vs. 0%).
This subanalysis confirmed that nab-P + Gem is an efficacious treatment option and has a manageable safety profile in patients with MPC treated in Canada.
ClinicalTrials.gov identifier, NCT00844649.
Celgene Corporation, Summit, NJ, USA.

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!


Safety and Tolerability of Empagliflozin in Patients with Type 2 Diabetes.

The aim of this analysis was to establish the safety profile and tolerability of empagliflozin in patients with type 2 diabetes mellitus (T2DM) according to pooled data from several clinical trials.
Pooled data were analyzed from patients with T2DM treated with placebo (n = 3695), empagliflozin 10 mg (n = 3806), or empagliflozin 25 mg (n = 4782) in 17 randomized, Phase I, II, and III clinical trials plus 6 extension studies. Adverse events (AEs) were assessed descriptively in patients who took ≥1 dose of the study drug. AE incidence rates per 100 patient-years were calculated to adjust for differences in drug exposure across trials.
Total exposure was 3254, 3840, and 5649 patient-years in the placebo, empagliflozin 10 mg, and empagliflozin 25 mg groups, respectively. The incidence of any AEs, AEs leading to treatment discontinuation, severe AEs, and serious AEs was no higher in patients treated with empagliflozin than with placebo. Empagliflozin was not associated with an increased risk of hypoglycemia versus placebo, except in patients on background sulfonylurea and/or insulin. The incidence of events consistent with urinary tract infection was similar across treatment groups (9.4-11.3/100 patient-years); 0.4%, 0.2%, and 0.3% of patients in the placebo, empagliflozin 10 mg, and empagliflozin 25 mg groups, respectively, had urinary tract infections that required or prolonged hospitalization. The incidence of events consistent with genital infection was higher in patients treated with empagliflozin (4.7 and 5.0/100 patient-years for empagliflozin 10 and 25 mg, respectively) than placebo (1.3/100 patient-years), but only 0.1%, 0.1%, and <0.1% in the placebo, empagliflozin 10 mg, and empagliflozin 25 mg groups, respectively, had genital infections that required or prolonged hospitalization. The incidence of AEs consistent with volume depletion was similar with placebo, empagliflozin 10 mg, and empagliflozin 25 mg (1.6, 1.5, and 1.3/100 patient-years, respectively) and was higher with empagliflozin 25 mg than placebo or empagliflozin 10 mg in patients aged >75 years (4.4 vs 2.3 and 2.5/100 patient-years, respectively). The incidences of bone fractures, malignancies, decreased renal function, hepatic injury, venous thromboembolic events, and diabetic ketoacidosis were low and similar across the treatment groups.
In this predefined analysis that was based on >9000 patient-years’ exposure to empagliflozin, empagliflozin 10 mg, and empagliflozin 25 mg were well tolerated in patients with T2DM.
Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

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!


Economic Analysis of Panitumumab Compared With Cetuximab in Patients With Wild-Type KRAS Metastatic Colorectal Cancer That Progressed After Standard Chemotherapy.

In this analysis, we compared costs and explored the cost-effectiveness of subsequent-line treatment with cetuximab or panitumumab in patients with wild-type KRAS (exon 2) metastatic colorectal cancer (mCRC) after previous chemotherapy treatment failure. Data were used from ASPECCT (A Study of Panitumumab Efficacy and Safety Compared to Cetuximab in Patients With KRAS Wild-Type Metastatic Colorectal Cancer), a Phase III, head-to-head randomized noninferiority study comparing the efficacy and safety of panitumumab and cetuximab in this population.
A decision-analytic model was developed to perform a cost-minimization analysis and a semi-Markov model was created to evaluate the cost-effectiveness of panitumumab monotherapy versus cetuximab monotherapy in chemotherapy-resistant wild-type KRAS (exon 2) mCRC. The cost-minimization model assumed equivalent efficacy (progression-free survival) based on data from ASPECCT. The cost-effectiveness analysis was conducted with the full information (uncertainty) from ASPECCT. Both analyses were conducted from a US third-party payer perspective and calculated average anti-epidermal growth factor receptor doses from ASPECCT. Costs associated with drug acquisition, treatment administration (every 2 weeks for panitumumab, weekly for cetuximab), and incidence of infusion reactions were estimated in both models. The cost-effectiveness model also included physician visits, disease progression monitoring, best supportive care, and end-of-life costs and utility weights estimated from EuroQol 5-Dimension questionnaire responses from ASPECCT.
The cost-minimization model results demonstrated lower projected costs for patients who received panitumumab versus cetuximab, with a projected cost savings of $9468 (16.5%) per panitumumab-treated patient. In the cost-effectiveness model, the incremental cost per quality-adjusted life-year gained revealed panitumumab to be less costly, with marginally better outcomes than cetuximab.
These economic analyses comparing panitumumab and cetuximab in chemorefractory wild-type KRAS (exon 2) mCRC suggest benefits in favor of panitumumab. ClinicalTrials.gov identifier: NCT01001377.
Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

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!


Purinylpyridinylamino-based DFG-in/αC-helix-out B-Raf inhibitors: Applying mutant versus wild-type B-Raf selectivity indices for compound profiling.

One of the challenges for targeting B-Raf(V600E) with small molecule inhibitors had been achieving adequate selectivity over the wild-type protein B-Raf(WT), as inhibition of the latter has been associated with hyperplasia in normal tissues. Recent studies suggest that B-Raf inhibitors inducing the ‘DFG-in/αC-helix-out’ conformation (Type IIB) likely will exhibit improved selectivity for B-Raf(V600E). To explore this hypothesis, we transformed Type IIA inhibitor (1) into a series of Type IIB inhibitors (sulfonamides and sulfamides 4-6) and examined the SAR. Three selectivity indices were introduced to facilitate the analyses: the B-Raf(V600E)/B-Raf(WT) biochemical ((b)S), cellular ((c)S) selectivity, and the phospho-ERK activation ((p)A). Our data indicates that α-branched sulfonamides and sulfamides show higher selectivities than the linear derivatives. We rationalized this finding based on analysis of structural information from the literature and provided evidence for a monomeric B-Raf-inhibitor complex previously hypothesized to be responsible for the desired B-Raf(V600E) selectivity.
Copyright © 2016 Elsevier Ltd. All rights reserved.

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!


Roche reports solid sales growth in the first quarter of 2016

On April 19, 2016 Roche reported solid sales growth in the first quarter of 2016 (Press release, Hoffmann-La Roche , APR 18, 2016, View Source [SID:1234511052]).

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!

Group sales up 4%1 at constant exchange rates, 5% in Swiss francs

Pharmaceuticals Division sales increase 4%, driven by oncology and immunology medicines

Diagnostics Division sales grow 5%, led by immunodiagnostic product demand

US FDA grants priority review for investigational cancer immunotherapy medicine atezolizumab in bladder and lung cancer and breakthrough therapy designation for ocrelizumab in multiple sclerosis

Outlook for 2016 confirmed
Key figures January – March

In millions of CHF
As % of sales
% change

2016 2015 2016 2015 At CER In CHF
Group Sales 12,414 11,833 100 100 +4 +5
Pharmaceuticals Division 9,800 9,322 79 79 +4 +5
– United States 4,716 4,392 38 37 +3 +7
– Europe 2,319 2,178 19 18 +5 +6
– Japan 853 763 7 6 +4 +12
– International* 1,912 1,989 15 18 +4 -4
Diagnostics Division 2,614 2,511 21 21 +5 +4
* Asia–Pacific, EEMEA (Eastern Europe, Middle East, Africa), Latin America, Canada, Others

Roche CEO Severin Schwan said: "We have started the year with solid growth in both our Pharmaceuticals and Diagnostics Divisions. The marketing applications of important investigational medicines are well underway. The FDA granted priority review for atezolizumab in two indications and breakthrough therapy designation for ocrelizumab in primary progressive multiple sclerosis. Overall, we are on track to meet our full-year targets for 2016."

Group
In the first quarter of 2016, Group sales rose 4% to CHF 12.4 billion. Sales in the Pharmaceuticals Division were up 4% to CHF 9.8 billion with Europe growing 5%, driven by Perjeta, MabThera and RoActemra. Pharmaceuticals sales in the US increased 3%, led by Esbriet, Xolair and HER2-positive breast cancer medicines. The recently launched medicines Cotellic in skin cancer and Alecensa in lung cancer have had a good start. In the US, sales of Tamiflu and Lucentis declined. The main growth contributors in the International region (+4%) were Avastin, MabThera and Herceptin; this growth was partly offset by lower Pegasys sales due to competition from a new generation of treatments. In Japan, sales rose 4% driven by Avastin, HER2 medicines and Alecensa.

In Diagnostics, sales grew 5% to CHF 2.6 billion, driven primarily by strong growth in Asia-Pacific (+16%) and Latin America (+21%). In Europe, the Middle East, and Africa (EMEA) sales increased 1% while they remained stable in North America and declined by 3% in Japan. Strong growth was recorded for the immunodiagnostic, molecular and tissue diagnostics businesses. Diabetes Care sales were impacted by challenging market conditions, especially in North America.

Portfolio progress
In March and April respectively, Roche’s lead investigational cancer immunotherapy medicine atezolizumab was granted priority review by the FDA for marketing applications in two indications, advanced bladder cancer and non-small cell lung cancer (NSCLC). Both filings were submitted under FDA breakthrough therapy designations and are based on pivotal phase II data. Atezolizumab is being investigated in a broad phase III clinical programme in solid and hematologic cancers.

The FDA granted breakthrough therapy designation (BTD) for ocrelizumab in primary progressive multiple sclerosis in February. Ocrelizumab is the first investigational medicine to receive BTD in multiple sclerosis. Since 2013, the FDA has granted BTDs for 12 indications of Roche medicines. Roche plans to file ocrelizumab for both relapsing and primary progressive multiple sclerosis in the first half of 2016.

In March, Roche provided an update on two identical phase III studies of lebrikizumab in people with severe asthma. While one study met its primary clinical endpoint, the second did not achieve statistical significance. Roche is analysing the data to help determine next steps in the asthma programme.

In April, the FDA granted Venclexta (venetoclax) accelerated approval for people with a hard-to-treat type of chronic lymphocytic leukemia. Venclexta is the first approved medicine designed to help restore a process in which cells self-destruct by selectively blocking a protein called BCL-2. Venclexta is being jointly developed with AbbVie.

In February, Roche received US approval for Gazyva for the treatment of people with relapsed or rituximab-refractory follicular lymphoma, the most common type of indolent non-Hodgkin lymphoma (NHL), based on phase III results. European approvals are expected later this year. Gazyva is being studied in a large clinical programme in NHL, and phase III data in diffuse large B cell lymphoma, an aggressive type of NHL, are expected later this year.