On October 19, 2015 Galectin Therapeutics, Inc. (Nasdaq: GALT), the leading developer of therapeutics that target galectin proteins to treat fibrosis and cancer, reported that Providence Cancer Center has filed an Investigational New Drug (IND) application with the U.S. Food and Drug Administration (FDA) to study GR-MD-02 in combination with Keytruda (pembrolizumab), an immune checkpoint inhibitor, in a Phase 1b study of patients with advanced refractory metastatic melanoma (Filing, 8-K, Galectin Therapeutics, OCT 19, 2015, View Source [SID:1234507733]). GR-MD-02 binds to and inhibits galectin proteins, predominantly galectin-3 (Gal-3). Galectin will provide GR-MD-02 to the investigators, who are funding the costs of this study.

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The IND filing was prompted by findings from preclinical studies led by tumor immunology expert William L. Redmond, Ph.D. of the Providence Cancer Center’s Earle A. Chiles Research Institute. That study found that GR-MD-02 increased tumor shrinkage and enhanced survival in immune competent mice with multiple types of cancers when combined with one of the immune checkpoint inhibitors, anti-CTLA-4 or anti-PD-1. Pembrolizumab (anti-PD-1) was approved by the FDA in September 2014 to treat patients whose melanoma had progressed after treatment with Yervoy (ipilimumab) or targeted therapy in melanomas that have a BRAF mutation. GR-MD-02 is also the subject of an ongoing Phase 1b study in combination with Yervoy in patients with malignant melanoma, also by Providence Cancer Center. Details of the study design can be found at clinicaltrials.gov: here

"This proposed study will be the second involving a checkpoint inhibitor in combination with GR-MD-02, and we are very pleased to reach this milestone with the investigators at the Portland Cancer Center," said Peter G. Traber, M.D., president, chief executive officer and chief medical officer of Galectin Therapeutics. "Preclinical data show that GR-MD-02 holds potential to increase the effectiveness of other therapies and represents a promising approach to enhance cancer immunotherapy."

Pending FDA review of the IND, the Phase 1b study will be conducted by the Providence Cancer Center under principal investigator Brendan D. Curti, M.D., director of the Providence Biotherapy Program. Providence Cancer Center researchers have been leaders in immunotherapy research and translational clinical trials in melanoma and other cancers.

"Clinical research has shown that therapeutic combinations involving checkpoint inhibitors have improved outcomes in patient survival. The Phase 1b study will determine if GR-MD-02 enhances the probability of melanoma response with pembrolizumab by inducing proliferation, activation and memory function of CD8+ T cells," said Dr. Curti. "The combination of GR-MD-02 and pembrolizumab has a strong scientific rationale based on Dr. Redmond’s laboratory work. This study represents a novel approach for patients with metastatic melanoma and complements our similar study of GR-MD-02 in combination with Yervoy."

Study Design
The proposed Phase 1b study is expected to enroll 16 to 22 patients with advanced melanoma whose disease has progressed after treatment with ipilimumab and/or BRAF-targeted therapy in melanomas with a BRAF mutation, and is designed to determine a safe dose of GR-MD-02 in combination with the approved dose of pembrolizumab (2 mg/kg). The study will employ a 3+3 Phase 1 design with dose escalation of GR-MD-02 beginning with 2 mg/kg in the first cohort and increasing to 8 mg/kg, depending on toxicity. In addition to monitoring for toxicity and clinical response, blood samples will be obtained to assess immunologic measures relevant to galectin biology and pembrolizumab T-cell checkpoint inhibition. Galectin Therapeutics will supply researchers with supporting analysis of the pharmacokinetics of GR-MD-02 and the right to reference the Company’s open IND on GR-MD-02.
Yervoy is a registered trademark of Bristol-Myers Squibb. Keytruda is a registered trademark of Merck.

About Metastatic Melanoma
Melanoma, the most dangerous form of skin cancer, is one of the most widespread cancers among young adults. Metastatic melanoma occurs when the cancer cells spread (or metastasize) through the lymph nodes to other parts of the body. The liver, lungs, bones and brain are most often affected by these metastases. The American Cancer Society estimates that there were more than 76,000 new diagnoses and 9,100 deaths from melanoma in the United States in 2012.

On October 19, 2015 DelMar Pharmaceuticals, Inc. (OTCQX: DMPI) ("DelMar" and the "Company"), a biopharmaceutical company focused on the development and commercialization of new cancer therapies, reported that yesterday it presented positive preclinical data demonstrating the promising potential of its lead product candidate VAL-083 (dianhydrogalactitol) as a treatment for ovarian cancer (Press release, DelMar Pharmaceuticals, OCT 19, 2015, View Source [SID:1234507732]).

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The Company presented data from its collaboration with researchers at MD Anderson Cancer Center in a poster entitled, "A Comparison of the Mechanisms and Cytotoxic Activity of Dianhydrogalactitol (VAL-083) to Cisplatin in Ovarian Tumor Models Harboring Wild-type and Mutant p53," at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) Advances in Ovarian Cancer Research: Exploiting Vulnerabilities Conference.

The data demonstrate the effectiveness of VAL-083 against cisplatin-resistant ovarian cancers and raise the potential for VAL-083 as a treatment for ovarian cancers as a single-agent against platinum-resistant tumors or in combination with platinum-based chemotherapeutic regimens.

VAL-083 is a bi-functional alkylating agent, whose cytotoxic activity is due to the formation of DNA cross links at the N7 position of guanine. Unlike platinum-based chemotherapies such as cisplatin, carboplatin and oxaliplatin, which predominantly form intrastrand DNA cross-links, VAL-083 is believed to derive its anti-cancer activity via interstrand DNA cross-links, which leads to a distinct downstream of biological events within the tumor leading to apoptosis and cancer cell death. In prior NCI-sponsored clinical studies, VAL-083 demonstrated clinical activity against a range of tumor types, including ovarian cancer.

"These data represent another success in our strategy to leverage VAL-083’s historical clinical data with contemporary biological research to address significant unmet medical needs in the modern treatment of cancer," stated Jeffrey Bacha, president & CEO of DelMar Pharmaceuticals.

"Onset of drug resistance is a major factor limiting the clinical utility of platinum-based therapeutic regimens. Such regimens form the basis of ovarian cancer treatment and produce an initial 70% response rate. Unfortunately, many patients experience relapse as their cancer becomes resistant to currently available chemotherapy. The average duration of survival after recurrence of ovarian cancer is about 12 to 18 months with fewer than one in ten patients surviving beyond five years following standard salvage chemotherapy treatment," added Mr. Bacha. "We believe that these data, coupled with evidence of historical clinical activity against ovarian cancer, represent the promise of VAL-083 to address a major modern unmet medical need by providing a potential new treatment option for ovarian cancer patients whose tumors exhibit resistance to platinum-based therapy."

Platinum drug resistance is normally ascribed to several mechanisms. The current study investigated the activity of VAL-083 in multiple ovarian cancer models including both cisplatin-sensitive (A2780); and cisplatin-resistant (2780CP-16, OVCAR-10, Hey and OVCA-433) phenotypes in vitro. The data support the potential of VAL-083 to circumvent drug-resistance in the treatment of ovarian cancer.

DelMar previously reported that the combination of VAL-083 and cisplatin demonstrated significant super-additivity (p<0.05) in animal models of non-small cell lung cancer (NSCLC) and synergy (CI < 1) in vitro.

Mr. Bacha continued, "We have a growing body of evidence indicating that, in comparison to platinum-based chemotherapy, the anti-cancer mechanism of VAL-083 is less dependent on, or independent of, wild-type p53. The current ovarian study provides additional proof that there is a lack of cross-resistance between cisplatin and VAL-083 further suggesting distinct modes of action for the two drugs. Importantly, the non-overlapping mechanisms of action support the potential of VAL-083 in the treatment of platinum-resistant cancers as well as the potential for therapeutic benefit in combining VAL-083 with platinum-based chemotherapy regimens."

HIGHLIGHTS OF DELMAR’S PRESENTATION

VAL-083 demonstrated cytotoxic activity in all tested ovarian cancer cell lines, including cisplatin-resistant cell lines, in vitro;
VAL-083 is significantly less dependent on wild-type p53 for its activity than both cisplatin and oxaliplatin, and appears to have a distinct mode of action;
VAL-083 exhibits significantly different cytotoxic-related cell-signaling patterns against resistant tumor phenotypes in comparison to platinum-based chemotherapy, in vitro;
VAL-083 displays significant synergy with cisplatin in vitro; and
Taken together, these results support VAL-083 as a viable treatment option for ovarian cancer patients failing platinum-based therapy, and suggests a potential benefit of a VAL-083 + platinum combination therapy.

SUMMARY

VAL-083 activity in five wild-type p53 ovarian cancer cell lines
The activity of VAL-083 was examined in five ovarian cancer cell lines: including one cisplatin-sensitive (A2780), and four cisplatin-resistant (2780CP-16, OVCAR-10, Hey and OVCA-433) tumors in vitro. The relative tumor-killing effect (IC50) was compared in cisplatin-sensitive versus cisplatin-resistant cell-lines. VAL-083 maintained significantly greater cytotoxic activity in comparison to cisplatin. These results demonstrate a lack of significant cross-resistance between cisplatin and VAL-083, further suggesting distinct modes of action for VAL-083.

Limited dependence of VAL-083 on p53 status
The dependence on p53 status was investigated in isogenic models with (HCT-116p53-/-) or without (HCT-116p53+/+) p53 knockout. Loss of p53 increased resistance to cisplatin and oxaliplatin by 3- and 6-fold, respectively, whereas the increase in resistance to VAL-083 was <2-fold. These data suggest that the cytotoxic a mechanism of VAL-083 that is much less dependent on, or independent of, p53.

VAL-083 signaling is distinct from platinum-based chemotherapy in drug-resistant ovarian tumors
Resistance to platinum-based chemotherapy can also arise in tumors bearing wild-type (non-mutant) p53 due to other factors effecting p53 function, such failure to induce downstream regulation of checkpoint proteins or activation via phosphorylation of p53 itself. VAL-083 and cisplatin demonstrate similar effects on p53 induction and activation via phosphorylation and CHK2-related p21 induction in p53 wild-type cisplatin-sensitive (A2780) ovarian cancer cells. However, in cisplatin-resistant (2780CP-16) ovarian cancer cells, only VAL-083 caused significant activation of p53 and p21, and induced greater Ser-15 and Ser-20 phosphorylation of p53, all of which are hallmarks of cytotoxic DNA damage. This further supports the conclusion of distinct modes of action for VAL-083 versus platinum-based chemotherapy and activity against platinum-resistant cancer phenotypes.

Combination of VAL-083 with platinum-based chemotherapy in p53 mutant H1975 NSCLC
The combination of VAL-083 with either cisplatin or oxaliplatin in the human H1975 model demonstrated significant super-additivity (p<0.05) and synergy (CI<1). These results suggest non-overlapping mechanism of action between the platinum drugs and VAL-083, and support the potential for synergistic benefit for a combination of VAL-083 and platinum-based therapies in the treatment of cisplatin resistant cancers.

The Company’s poster presentation from AACR (Free AACR Whitepaper) Advances in Ovarian Cancer Research and other VAL-083 posters and scientific publications may be found on DelMar’s website under View Source

On October 19, 2015 Curis, Inc. (NASDAQ:CRIS), a biotechnology company focused on the development and commercialization of innovative drug candidates for the treatment of human cancers, reported the expansion of its pipeline with the addition of two programs, the first of which is an oral, small molecule immune checkpoint antagonist targeting programmed death ligand-1 (PD-L1) and V-domain Ig suppressor of T cell activation (VISTA), and the second is focused on inhibitors of Interleukin-1 receptor-associated kinase 4 (IRAK4) (Press release, Curis, OCT 19, 2015, View Source [SID:1234507731]).

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The additions to the pipeline come through the Company’s exercise of its options under a collaboration agreement with Aurigene announced earlier this year. In the area of immuno-oncology, Curis exercised its option to exclusively license a first-in-class oral, small molecule antagonist designated as CA-170 that targets PD-L1 and VISTA, which function as negative checkpoint regulators of immune activation. CA-170 was selected from the broad PD-L1 antagonist program that the companies have been engaged in since the collaboration was established in January 2015.

Curis also exercised its option to exclusively license a program of orally available small molecule inhibitors of IRAK4 kinase. IRAK4 is a serine/ threonine kinase involved in the regulation of innate immune responses and also plays an important role in certain hematologic cancers. IRAK4 is inappropriately activated, and drives pro-survival and cytokine mediated pathways in cancers such as activated B cell-diffuse large B cell lymphoma (ABC-DLBCL), an aggressive form of lymphoma with poor prognosis. Targeting IRAK4 has potential therapeutic implications in both cancer and cytokine-driven inflammatory and autoimmune diseases.

The exercise of options for the PD-L1/VISTA and IRAK4 programs resulted in an aggregate one-time payment of $6 million by Curis to Aurigene in exchange for an exclusive, royalty-bearing license to develop, manufacture and commercialize compounds from the programs, including the development candidate, CA-170 and products containing such compounds, anywhere in the world with the exception of India and Russia, where Aurigene will hold an exclusive, royalty-free, fully paid license to commercialize such compounds.

Additionally, Curis has selected a second preclinical program within the immuno-oncology collaboration with Aurigene that is focused on evaluating small molecule antagonists with dual PD-L1 and T-cell immunoglobulin and mucin domain containing protein-3 (TIM-3) targeting properties. TIM-3 is an inhibitory checkpoint molecule that plays an important role in immune suppression and is co-expressed with programmed cell death-1 (PD-1) receptors on highly exhausted cytotoxic T cells in tumor tissues as well as expressed on certain regulatory T cells.

Curis expects that Aurigene scientists will present data from the PD-L1/VISTA immuno-oncology and the IRAK4 programs at the AACR (Free AACR Whitepaper)-NCI-EORTC AACR-NCI-EORTC (Free AACR-NCI-EORTC Whitepaper) International Conference on Molecular Targets and Cancer Therapeutics (EORTC-NCI-AACR) (Free ASGCT Whitepaper) (Free EORTC-NCI-AACR Whitepaper), which will take place Nov. 5-9 in Boston.

"We are pleased with the progress in our collaboration with Aurigene and the small molecule candidates emerging from the PD-L1 antagonist program," said Ali Fattaey, Ph.D., Curis’ President and CEO. "Based on its preclinical profile in multiple in vitro and in vivo activity and safety models, we have selected CA-170 as our clinical candidate. By targeting both PD-L1 and VISTA with CA-170, we potentially have the opportunity to address exhausted T cells as well as other inhibitory immune cells such as myeloid derived suppressor cells or MDSCs, in the tumor microenvironment with one drug candidate. We believe that this property of targeting two unique checkpoint regulators provides CA-170 with the potential to not only address, but potentially expand beyond tumors with PD-L1 overexpression or those that may have relapsed after PD-1/ PD-L1 targeting therapies. Development of CA-170 is a priority for Curis, and we and Aurigene are working diligently to complete the required IND-enabling studies in the coming months. We expect to file an IND and initiate Phase 1 clinical testing of CA-170 during the first half of 2016. We also expect to file an IND for development of the IRAK4 inhibitor within the first half of 2016."

Dr. Fattaey continued, "We are also encouraged with the progress in our second immuno-oncology program that is generating small molecules targeting PD-L1 and TIM3, which may provide for additional opportunities to relieve the inhibitory effects of multiple immune checkpoints on exhausted T cells using our small molecule antagonist approach."

The development of the Company’s immuno-oncology programs will be led by David Tuck, M.D., the Company’s Vice President, Clinical and Translational Sciences. Dr. Tuck joined Curis from EMD Serono in May 2015, where he served as Senior Medical Director in the Oncology Translational Innovation program. Prior to that, Dr. Tuck was employed by Bristol-Myers Squibb Global Oncology Research in the role of Translational Physician for ipilimumab, with a primary focus on external development of immune checkpoint inhibitors in solid tumors and hematological malignancies. Dr. Tuck was previously an Associate Professor at Yale University and Associate Director of the Yale Cancer Center. Dr. Tuck earned his Medical Degree at the University of Vermont School of Medicine and is board certified in internal medicine, medical oncology and hematology.

Dr. Tuck said, "I am excited to lead the development of our immuno-oncology drug candidates and believe that oral, small molecule checkpoint inhibitors may provide a favorable drug profile to better address immune-related adverse events and the potential for combination with other therapies in a convenient manner for patients."

On October 19, 2015 Varian Medical Systems reported that researchers working with the TrueBeam system from Varian Medical Systems (NYSE: VAR) have reported on breakthrough research that capitalizes on the unique capabilities of this advanced platform to deliver much more concentrated doses of radiation to tumors to potentially achieve better outcomes in the fight against cancer (Press release, InfiMed, OCT 19, 2015, View Source [SID:1234507730]).

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The four pi (4π) non-coplanar approach to treatment exploits specific capabilities of the TrueBeam platform to deliver more compact radiation doses that can fully saturate a targeted tumor and "fall off" sharply outside the target zone, minimizing and, where necessary, even eliminating dose to specific organs requiring more protection. It was outlined by Varian consultant Patrick Kupelian, MD, professor of radiation oncology and vice-chair of clinical operations and clinical research at the University of California, Los Angeles (UCLA) via video presentation in front of some 700 radiation oncology professionals who attended Varian’s Users Meeting here on Saturday.

"We believe this approach could enable High Definition Radiotherapy (HDRT)—the next big advance in radiation oncology, rivaling the development of IMRT in the 1990s, IGRT and volumetric modulated arc therapy (VMAT) in the 2000s, and linac-based radiosurgery in more recent years, in terms of importance to the field and potential impact on patients," said Kolleen Kennedy, president of Varian Oncology Systems. "It has the potential to vastly simplify how advanced treatments like stereotactic radiosurgery are planned and delivered, and may make it possible for more facilities to offer these precise, efficient forms of treatment to more patients. We anticipate that a high definition approach could make image-guided radiosurgery a mainstream offering, for clinical and also for economic reasons."

Varian’s vision for High Definition Radiotherapy also involves facilitating the use of different imaging modalities as required, both during the planning stage and for image-guidance during treatment. "We’re developing a comprehensive ecosystem around the TrueBeam machine that will enable clinicians to use CT, cone-beam CT, MR, and/or PET images for treatment planning, image guidance, and even for adaptation—whatever is best for each individual patient," Kennedy said.

Research at UCLA Shows the Potential of High Definition Radiotherapy
Kupelian and his colleagues at UCLA have been testing software that optimizes a treatment using automated delivery of non-coplanar beam angles (i.e. angles of approach that are not in a single plane, but that converge on the tumor from many different directions). This allows the clinician to develop a treatment plan that increases the amount of normal organ sparing, and that misses specific areas, such as the heart, or the brain stem, or the spinal cord, altogether.

The UCLA team has published about their work creating treatment plans for lung tumors, demonstrating that, compared with conventional IMRT plans, 4π non-coplanar approaches could significantly reduce the amount of dose going to the heart, esophagus, trachea/bronchus tree, spinal cord, and healthy lung tissues.1 Another published study compared non-coplanar plans with VMAT plans for liver cancer, finding that the former could offer significant improvements in dose conformality and normal organ sparing.2

"UCLA radiation oncology has launched a prospective clinical trial, with Varian support, to test the safety and clinical flow of High Definition Radiotherapy," said Ke Sheng, PhD, medical physicist who, with his colleague Daniel Low, PhD, developed the 4π algorithm being studied at UCLA. "Five patients have now been treated under the protocol, using treatment plans that spared more critical tissues than would have been possible using conventional IMRT."

"Our vision is to enable High Definition Radiotherapy by commercializing the sophisticated software and hardware enhancements that can enable these types of non-coplanar treatments to be implemented using the TrueBeam system," said Kennedy. "The key is the ability to move the treatment couch—with the patient on it—while the treatment machine is rotating around the patient to achieve a dramatic increase in the number of beam angles used to attack the tumor. The dynamically shaped beams will then converge on the tumor from many different directions, providing more options for avoiding critical areas of the patient’s body."

"Many of the elements needed for high-definition radiotherapy are present in the TrueBeam system today," Kennedy added. "We are working with clinical research partners around the world to further define and deliver the toolkit that will make it possible to plan and deliver these very sophisticated treatments safely, efficiently and accurately. Enabling high definition radiotherapy is a big focus right now, and it’s one of the more important developments our customers can expect from our R&D pipeline in the future."

On October 19, 2015 Eisai Co., Ltd. (Headquarters: Tokyo, CEO: Haruo Naito, "Eisai") reported that the results of a Phase II clinical trial (Study 205)(1) of its in-house developed novel anticancer agent Lenvima (lenvatinib mesylate, "lenvatinib") in advanced or metastatic renal cell carcinoma have been published in the online version of The Lancet Oncology(1), a leading clinical oncology research journal that is highly regarded worldwide (Press release, Eisai, OCT 19, 2015, View Source [SID:1234507729]).

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Study 205 was a Phase II clinical trial to compare the safety and efficacy among three groups including a combination of lenvatinib (18 mg) plus everolimus (5 mg), lenvatinib alone (24 mg) and everolimus alone (10 mg) in advanced or metastatic renal cell carcinoma following one prior vascular endothelial growth factor-targeted therapy. From the results of the study, the combination of lenvatinib plus everolimus group demonstrated a significant extension in progression free survival (PFS), the study’s primary endpoint, compared to the everolimus alone group. Additionally, the lenvatinib alone group demonstrated an extension in PFS compared to the everolimus alone group. Both the lenvatinib plus everolimus group and the lenvatinib alone group showed an improvement in objective response rate compared to the everolimus alone group. The most common treatment-emergent adverse events (TEAE) reported in the lenvatinib plus everolimus group were diarrhea, decreased appetite and fatigue. The most common TEAEs of Grade 3 or higher included diarrhea, hypertension and fatigue.

Renal cell carcinoma comprises more than 90% of all malignancies of the kidney.(2) For advanced or metastatic renal cell carcinoma that is difficult to treat with surgery, the standard treatment method is molecular targeted drug therapy, however with low 5-year survival rates, this remains a disease with significant unmet medical needs. According to the results of Study 205, the combination of lenvatinib plus everolimus showed superior PFS over everolimus alone, which is recommended by the National Comprehensive Cancer Network (NCCN) guidelines as a 2nd-line therapy for advanced or metastatic renal cell carcinoma.

Lenvatinib has received a breakthrough therapy designation from the U.S. Food and Drug Administration (FDA) for the potential indication of advanced and/or metastatic renal cell carcinoma. Eisai has shared the results of Study 205 with the U.S. FDA and the European Medicines Agency to discuss further steps regarding potential submission strategies for an indication covering renal cell carcinoma, and Eisai intends to have similar discussions with the regulatory authorities in Japan as well. Currently lenvatinib has been launched in the United States, Japan and Europe indicated for refractory thyroid cancer, and clinical trials of the agent in various types of cancer such as hepatocellular carcinoma are also underway.

Eisai is committed to exploring the potential clinical benefits of lenvatinib in order to further contribute to patients with cancer and their families.

1. About lenvatinib mesylate (product name: Lenvima) Lenvatinib is an orally administered multiple receptor tyrosine kinase (RTK) inhibitor with a novel binding mode that selectively inhibits the kinase activities of vascular endothelial growth factor (VEGF) receptors (VEGFR1, VEGFR2 and VEGFR3) and fibroblast growth factor (FGF) receptors (FGFR1, FGFR2, FGFR3 and FGFR4) in addition to other proangiogenic and oncogenic pathway-related RTKs (including the platelet-derived growth factor (PDGF) receptor PDGFRalpha; KIT; and RET) involved in tumor proliferation. Lenvatinib has been confirmed through X-ray co-crystal structural analysis to demonstrate a new binding mode (Type V) to VEGFR2, and exhibits rapid binding to the target molecule and potent inhibition of kinase activity, according to kinetic analysis.(3)
Currently, Eisai has obtained approval for lenvatinib in the United States, Japan, Europe and Korea indicated for the treatment of refractory thyroid cancer. In addition, lenvatinib is undergoing regulatory review throughout the world including in Asia, Canada, Russia, Australia, Brazil and Mexico. Meanwhile, Eisai is conducting a global Phase III study of lenvatinib in hepatocellular carcinoma as well as Phase II studies of lenvatinib in several other tumor types such as endometrial carcinoma and non-small cell lung cancer. Furthermore, lenvatinib was granted Orphan Drug Designation by regulatory authorities in the United States, Japan and Europe for refractory thyroid cancer.

2. About Study 205(1)
Study 205 was a multicenter, randomized, open-label study of lenvatinib (18 mg) in combination with the anticancer agent everolimus (5 mg), lenvatinib alone (24 mg), and everolimus alone (10 mg) in patients with advanced or metastatic renal cell carcinoma following one prior VEGF-targeted therapy, and was conducted in Europe and the United States. 153 patients were randomized in a 1:1:1 ratio to one of three treatment arms to compare the safety and efficacy of these three regimens.
From the results of the study, the combination of lenvatinib plus everolimus group demonstrated a significant extension in the study’s primary endpoint of progression free survival (PFS) compared to the everolimus alone group (median PFS for the lenvatinib plus everolimus group: 14.6 months vs median PFS for the everolimus alone group: 5.5 months; Hazard Ratio (HR) 0.40 [95% CI: 0.24-0.68], p

Additionally, median PFS for the lenvatinib alone group was 7.4 months, demonstrating an extension in PFS compared to the everolimus alone group (HR: 0.61 [95% CI: 0.38-0.98]). The study also assessed objective response rate (ORR) and overall survival (OS) as secondary endpoints. Regarding ORR, both the lenvatinib plus everolimus group and the lenvatinib alone group showed an improvement in ORR compared to the everolimus alone group (lenvatinib plus everolimus: 43%, lenvatinib alone: 27%, everolimus alone: 6%). Furthermore, regarding OS, an updated analysis carried out in December 2014 suggested that lenvatinib plus everolimus extends OS compared to everolimus alone (HR 0.51 [95% CI=0.30-0.88]). The most common treatment-emergent adverse events (TEAE) reported in the lenvatinib plus everolimus group were diarrhea, decreased appetite and fatigue. The most common TEAEs of Grade 3 or higher (Common Terminology Criteria for Adverse Events) included diarrhea, hypertension and fatigue.

3. About Renal Cell Carcinoma
The number of patients with renal cancer was estimated to be approximately 338,000 worldwide, including approximately 58,000 in the United States, 17,000 in Japan and 115,000 in Europe.(4) Renal cell carcinoma comprises more than 90% of all malignancies of the kidney,(2) and occurs when malignant cells are found in the lining of the tubules of the kidney. The incidence of renal cell carcinoma in people aged in their late 50s is rising, and is more likely to affect men than women. For advanced or metastatic renal cell carcinoma that is difficult to treat with surgery, the standard treatment method is molecular targeted drug therapy, however with low 5-year survival rates, this remains a disease with significant unmet medical needs.
4. About The Lancet Oncology Highly regarded worldwide, The Lancet Oncology is an influential medical journal specialized in the field of oncology.