On June 5, 2022 Amgen (NASDAQ:AMGN) and Takeda Pharmaceutical Company (TSE: 4502) reported that new data from the Phase 3 PARADIGM clinical trial of Vectibix (panitumumab) in Japanese patients with previously untreated unresectable wild-type RAS metastatic colorectal cancer (mCRC) are being featured during the June 5 Plenary Session (Abstract #LBA1) of the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting being held in Chicago and online (Press release, Amgen, JUN 5, 2022, View Source [SID1234615558]).

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PARADIGM is a randomized trial conducted in Japan comparing the efficacy and safety of Vectibix plus mFOLFOX6 compared to bevacizumab plus mFOLFOX6 in chemotherapy-naive patients with unresectable advanced mCRC (n=823). This trial was conducted by Takeda. This is the first prospective trial to evaluate treatment options for patients with wild-type RAS mCRC and left-side primary tumor (descending colon, sigmoid colon, and rectum).

"Data from the PARADIGM study demonstrate the superiority of Vectibix over bevacizumab, both with chemotherapy, further establishing this Vectibix combination regimen as a standard of care for first-line treatment of wild-type RAS metastatic colorectal cancer," said David M. Reese, M.D., executive vice president of Research and Development at Amgen. "These study results build on the long history of Vectibix in the treatment of advanced colorectal cancer and reinforce the importance of comprehensive biomarker testing to identify all eligible patients."

The results of the trial showed that the mFOLFOX6 + Vectibix combination provides a statistically significant improvement in overall survival (OS) over the mFOLFOX6 + bevacizumab combination in patients with a left-sided primary tumor or regardless of tumor locations (median OS for left-sided tumors: 37.9 vs. 34.3 months, HR=0.82 [95.798% CI: 0.68-0.99], p=0.031, overall median OS: 36.2 vs. 31.3 months, HR=0.84 [95% CI: 0.72-0.98], p=0.030). The safety profile of Vectibix in this study was similar to clinical study results previously published.

"This is the first prospective Phase 3 study of treatment in patients with wild-type RAS, unresectable metastatic colorectal cancer and left-sided primary tumor," said Dr. Takayuki Yoshino, chief for the Department of Gastrointestinal Oncology, and deputy director at the National Cancer Center Hospital East. "These results provide further evidence of the benefits Vectibix provides for treatment in wild-type RAS, left-sided mCRC."

"These results further our understanding of the value Vectibix plus chemotherapy as a first-line treatment may provide for this patient population," said Takafumi Horii, head of the Japan Oncology BU, Global Oncology Unit at Takeda Pharmaceutical. "We are grateful to the patients, families and physicians in Japan who have contributed to this trial as we strive to deliver new therapeutic options for patients with unmet needs around the world."

For more detailed results of the study, please refer to ASCO (Free ASCO Whitepaper).org.

The PARADIGM Trial

Trial overview

The aim of the trial was to evaluate the efficacy of mFOLFOX6 + bevacizumab versus mFOLFOX6 +
panitumumab in the first-line treatment of
chemotherapy-naive patients with metastatic colorectal cancer and the wild-
type RAS gene (KRAS/NRAS gene).

Trial design

Multicenter, randomized, open label

Number of patients enrolled

823

Primary endpoint

Overall survival (OS)

Secondary endpoints

Progression-free survival (PFS), response rate (RR), duration of response (DOR), curative resection rate, safety

Place of study

Japan

Ancillary study

Analysis of circulating tumor DNA from tumor and blood samples to identify predictors of treatment response and mechanisms of treatment resistance.

About Vectibix (panitumumab)

Vectibix is the first fully human monoclonal anti-EGFR antibody approved by the FDA for the treatment of mCRC. Vectibix was approved in the U.S. in September 2006 as a monotherapy for the treatment of patients with EGFR-expressing mCRC after disease progression after prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy.

In May 2014, the FDA approved Vectibix for use in combination with FOLFOX, as first-line treatment in patients with wild-type KRAS (exon 2) mCRC. With this approval, Vectibix became the first-and-only biologic therapy indicated for use with FOLFOX, one of the most commonly used chemotherapy regimens, in the first-line treatment of mCRC specifically for patients with wild-type KRAS mCRC.

In June 2017, the FDA approved a refined indication for Vectibix for use in in patients with wild-type RAS (defined as wild-type in both KRAS and NRAS as determined by an FDA-approved test for this use) mCRC.

INDICATION AND LIMITATION OF USE

Vectibix is indicated for the treatment of patients with wild-type RAS (defined as wild-type in both KRAS and NRAS as determined by an FDA-approved test for this use) metastatic colorectal cancer (mCRC): as first-line therapy in combination with FOLFOX, and as monotherapy following disease progression after prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy.

Limitation of Use: Vectibix is not indicated for the treatment of patients with RAS mutant mCRC or for whom RAS mutation status is unknown.

IMPORTANT SAFETY INFORMATION

BOXED WARNING: DERMATOLOGIC TOXICITY

Dermatologic Toxicity: Dermatologic toxicities occurred in 90% of patients and were severe (NCI-CTC grade 3 and higher) in 15% of patients receiving Vectibix monotherapy [see Dosage and Administration (2.3), Warnings and Precautions (5.1), and Adverse Reactions (6.1)].

In Study 20020408, dermatologic toxicities occurred in 90% of patients and were severe (NCI-CTC grade 3 and higher) in 15% of patients with mCRC receiving Vectibix. The clinical manifestations included, but were not limited to, acneiform dermatitis, pruritus, erythema, rash, skin exfoliation, paronychia, dry skin, and skin fissures.
Monitor patients who develop dermatologic or soft tissue toxicities while receiving Vectibix for the development of inflammatory or infectious sequelae. Life-threatening and fatal infectious complications including necrotizing fasciitis, abscesses, and sepsis have been observed in patients treated with Vectibix. Life-threatening and fatal bullous mucocutaneous disease with blisters, erosions, and skin sloughing has also been observed in patients treated with Vectibix. It could not be determined whether these mucocutaneous adverse reactions were directly related to EGFR inhibition or to idiosyncratic immune- related effects (e.g., Stevens Johnson syndrome or toxic epidermal necrolysis). Withhold or discontinue Vectibix for dermatologic or soft tissue toxicity associated with severe or life-threatening inflammatory or infectious complications. Dose modifications for Vectibix concerning dermatologic toxicity are provided in the product labeling.
Vectibix is not indicated for the treatment of patients with colorectal cancer that harbor somatic RAS mutations in exon 2 (codons 12 and 13), exon 3 (codons 59 and 61), and exon 4 (codons 117 and 146) of either KRAS or NRAS and hereafter is referred to as "RAS."
Retrospective subset analyses across several randomized clinical trials were conducted to investigate the role of RAS mutations on the clinical effects of anti-EGFR-directed monoclonal antibodies (panitumumab or cetuximab). Anti-EGFR antibodies in patients with tumors containing RAS mutations resulted in exposing those patients to anti-EGFR related adverse reactions without clinical benefit from these agents. Additionally, in Study 20050203, 272 patients with RAS-mutant mCRC tumors received Vectibix in combination with FOLFOX and 276 patients received FOLFOX alone. In an exploratory subgroup analysis, OS was shorter (HR = 1.21, 95% CI: 1.01-1.45) in patients with RAS-mutant mCRC who received Vectibix and FOLFOX versus FOLFOX alone.
Progressively decreasing serum magnesium levels leading to severe (grade 3-4) hypomagnesemia occurred in up to 7% (in Study 20080763) of patients across clinical trials. Monitor patients for hypomagnesemia and hypocalcemia prior to initiating Vectibix treatment, periodically during Vectibix treatment, and for up to 8 weeks after the completion of treatment. Other electrolyte disturbances, including hypokalemia, have also been observed. Replete magnesium and other electrolytes as appropriate.
In Study 20020408, 4% of patients experienced infusion reactions and 1% of patients experienced severe infusion reactions (NCI-CTC grade 3-4). Infusion reactions, manifesting as fever, chills, dyspnea, bronchospasm, and hypotension, can occur following Vectibix administration. Fatal infusion reactions occurred in postmarketing experience. Terminate the infusion for severe infusion reactions.
Severe diarrhea and dehydration, leading to acute renal failure and other complications, have been observed in patients treated with Vectibix in combination with chemotherapy.
Fatal and nonfatal cases of interstitial lung disease (ILD) (1%) and pulmonary fibrosis have been observed in patients treated with Vectibix. Pulmonary fibrosis occurred in less than 1% (2/1467) of patients enrolled in clinical studies of Vectibix. In the event of acute onset or worsening of pulmonary symptoms interrupt Vectibix therapy. Discontinue Vectibix therapy if ILD is confirmed.
In patients with a history of interstitial pneumonitis or pulmonary fibrosis, or evidence of interstitial pneumonitis or pulmonary fibrosis, the benefits of therapy with Vectibix versus the risk of pulmonary complications must be carefully considered.
Exposure to sunlight can exacerbate dermatologic toxicity. Advise patients to wear sunscreen and hats and limit sun exposure while receiving Vectibix.
Keratitis and ulcerative keratitis, known risk factors for corneal perforation, have been reported with Vectibix use. Monitor for evidence of keratitis or ulcerative keratitis. Interrupt or discontinue Vectibix for acute or worsening keratitis.
In an interim analysis of an open-label, multicenter, randomized clinical trial in the first-line setting in patients with mCRC, the addition of Vectibix to the combination of bevacizumab and chemotherapy resulted in decreased OS and increased incidence of NCI-CTC grade 3-5 (87% vs 72%) adverse reactions. NCI-CTC grade 3-4 adverse reactions occurring at a higher rate in Vectibix-treated patients included rash/acneiform dermatitis (26% vs 1%), diarrhea (23% vs 12%), dehydration (16% vs 5%), primarily occurring in patients with diarrhea, hypokalemia (10% vs 4%), stomatitis/mucositis (4% vs < 1%), and hypomagnesemia (4% vs 0).
NCI-CTC grade 3-5 pulmonary embolism occurred at a higher rate in Vectibix-treated patients (7% vs 3%) and included fatal events in three (< 1%) Vectibix-treated patients. As a result of the toxicities experienced, patients randomized to Vectibix, bevacizumab, and chemotherapy received a lower mean relative dose intensity of each chemotherapeutic agent (oxaliplatin, irinotecan, bolus 5-FU, and/or infusional 5-FU) over the first 24 weeks on study compared with those randomized to bevacizumab and chemotherapy.
Vectibix can cause fetal harm when administered to a pregnant woman. Advise pregnant women and females of reproductive potential of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment, and for at least 2 months after the last dose of Vectibix.
In monotherapy, the most commonly reported adverse reactions (≥ 20%) in patients with Vectibix were skin rash with variable presentations, paronychia, fatigue, nausea, and diarrhea.
The most commonly reported adverse reactions (≥ 20%) with Vectibix + FOLFOX were diarrhea, stomatitis, mucosal inflammation, asthenia, paronychia, anorexia, hypomagnesemia, hypokalemia, rash, acneiform dermatitis, pruritus, and dry skin. The most common serious adverse reactions (≥ 2% difference between treatment arms) were diarrhea and dehydration.
To see the Vectibix Prescribing Information, including Boxed Warning visit www.vectibix.com.

About Colorectal Cancer

Colorectal cancer is the second most common cancer in women worldwide and the third most common cancer in men. Approximately 1.2 million cases of colorectal cancer are expected to occur globally. With more than 630,000 deaths worldwide per year, it is the third leading cause of cancer-related death in the Western world. The highest incidence rates are found in Japan, North America, parts of Europe, New Zealand, and Australia, and rates are low in Africa and Southeast Asia.[1] Using molecular approaches to identify unique genetic signatures in mCRC has the potential to help improve treatment outcomes.[2]

About Amgen Oncology

At Amgen Oncology, our mission to serve patients drives all that we do. That’s why we’re relentlessly focused on accelerating the delivery of medicines that have the potential to empower all angles of care and transform lives of people with cancer.

For the last four decades, we have been dedicated to discovering the firsts that matter in oncology and to finding ways to reduce the burden of cancer. Building on our heritage, Amgen continues to advance the largest pipeline in the Company’s history, moving with great speed to advance those innovations for the patients who need them.

On June 5, 2022 Innovent Biologics, Inc. ("Innovent") (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of oncology, autoimmune, metabolic, ophthalmology and other major diseases, reported that clinical data of IBI110 (anti-LAG-3 monoclonal antibody) from three clinical trials will be presented at the 2022 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting, held June 3-7, 2022 (Press release, Innova Therapeutics, JUN 5, 2022, View Source [SID1234615591]). This includes clinical data from a Phase Ia/Ib clinical study and preliminary results from two Phase Ib Proof-of-Concept (PoC) clinical studies for the treatment of advanced squamous non-small cell lung cancer (sqNSCLC) and advanced gastric cancer (GC).

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IBI110 (anti-LAG-3 mAb) as a single agent or in combination with sintilimab (anti-PD-1 mAb) in patients with advanced solid tumors: updated results from the Phase Ia/Ib dose-escalation study

Poster Presentation, Abstract #: 2650

This is a first-in-human, Phase Ia/Ib study of IBI110 in patients with advanced solid tumors, including Phase Ia IBI110 monotherapy and Phase Ib combination therapy of IBI110 and sintilimab. The highlights for the study results were as follows:

39 patients with advanced solid tumors who failed standard of care therapy were treated with IBI110 (≥ 3 mg/kg) in combination with sintilimab and received at least 1 post-baseline tumor assessment. 6 patients achieved partial response (PR); the objective response rate (ORR) was 15.4% and the disease control rate (DCR) was 64.1%.
31 patients with advanced NSCLC who failed standard of care, and 6 patients achieved PR; the ORR and DCR were 19.4% and 74.2%, respectively.
For safety results, no dose limiting toxicity (DLT) was observed in either Phase Ia or Ib dose escalation. In Phase Ib dose escalation, treatment-related adverse events (TRAEs) occurred in 75.6% (34/45) patients, most of which were grade 1-2, and the most common TRAEs were aspartate aminotransferase increased (28.9%), anemia (24.4%) and alanine aminotransferase increased (22.2%).
Efficacy and safety of IBI110 (anti-LAG-3 mAb) in combination with sintilimab (anti-PD-1 mAb) in first-line advanced squamous non-small cell lung cancer (sqNSCLC): initial results from a Phase Ib study

Abstract #: e21145

In this Phase Ib study, the efficacy and safety of IBI110 in combination with sintilimab as first-line therapy for advanced sqNSCLC was evaluated.

20 untreated advanced sqNSCLC patients received 200 mg IBI110 combined with sintilimab and chemotherapy and received at least 1 post-baseline tumor assessment. As of the data cutoff date of Jan 20, 2022, 16 patients achieved PR, the ORR was 80%. The study is still ongoing and will continue to monitor depth of response overtime.
For safety results, the most common TRAEs ≥ grade 3 were neutrophil count decreased (30%) and white blood cell count decreased (20%). Immune-related AEs occurred in 11 patients (55%) and most were grade 1-2. There were no treatment-related deaths or TRAEs led to treatment discontinuation.
IBI110 alone or plus sintilimab indicate a manageable safety profile andpromising antitumor activity from the preliminary data. The study is ongoing with the clinical data in squamous NSCLC is continuing to mature and will be presented in the future.
Efficacy and safety of IBI110 in combination with sintilimab in first-line advanced HER2-negative gastric cancer or gastroesophageal junction cancer: preliminary results from a Phase Ib study

Abstract #: e16097

In this Phase Ib study, the efficacy and safety of IBI110 in combination with sintilimab as first-line therapy for advanced GC was evaluated.

15 untreated advanced GC patients received 200 mg IBI110 combined with sintilimab and chemotherapy and received at least 1 post-baseline tumor assessment. At the cut-off date of January 20, 2022, 9 patients achieved PR; the ORR and DCR were 60% and 100%, respectively. Up to the press release date, the ORR reached 76.5% and most patients were still in treatment.
The most common TRAEs ≥ grade 3 were neutrophil count decreased (11.1%), platelet count decreased (11.1%) and hepatic function abnormal (11.1%). Immune-mediated AEs occurred in 7 pts (38.9%). One patient discontinued treatment due to coronary artery disease. There were no treatment-related deaths.
Professor Caicun Zhou, Shanghai Pulmonary Hospital, stated: "Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death worldwide, of which non-small cell lung cancer accounts for about 80%. In recent years, PD-1/PD-L1 inhibitors have shown promising efficacy in non-small cell lung cancer. However, persistent response to immune checkpoint inhibitor monotherapy remains a challenge in clinical practice. IBI110 plus sintilimab indicate a manageable safety profile and promising antitumor activity in untreated squamous non-small cell lung cancer patients. The ORR reached 80%, suggesting that it is worth further exploring the safety and efficacy of IBI110 combination therapy in this indication."

Professor Nong Xu, The First Affiliated Hospital, School of Medicine, Zhejiang University, stated: "Immune checkpoint inhibitors have shown good efficacy in a variety of tumors, but clinical challenges still remain. A key part of the mechanism of action is the synergistic inhibition of LAG-3 and PD-1 could have the potential to enhance the immune response and inhibit tumor growth. We are encouraged by the results we’ve seen to date in this study and the potential of this medicine."

Dr. Hui Zhou, Senior Vice President of Innovent, stated: "We are pleased to present our clinical development updates at the 2022 ASCO (Free ASCO Whitepaper) Meeting. IBI110 in combination with sintilimab demonstrated encouraging efficacy and safety data in sqNSCLC and GC. We will continue to update on PoC data readout for IBI110 in treatment areas such as lung cancer and plan to initiate subsequent pivotal clinical studies. As immunotherapy moves into the next era, we are actively advancing the development of next-generation immune checkpoint inhibitors, among which IBI110 represents a high-potential LAG-3 asset, and we hope it could benefit more patients in need soon."

To learn more about Innovent’s R&D updates and activities at 2022 ASCO (Free ASCO Whitepaper), please visit View Source

About IBI110

IBI110 is an IgG4κ recombinant human anti-LAG-3 monoclonal antibody independently developed by Innovent Biologics (Suzhou). Based on the mechanism of action and preclinical data of IBI110, it is assumed that IBI110 can inhibit the immune checkpoint signaling to achieve anti-tumor effect, which may further improve the efficacy of immunotherapy, overcome the primary drug resistance, and overcome the drug resistance after anti-PD-1 /PD-L1 monoclonal antibody treatment. Based on the urgent clinical needs, Innovent Biologics has carried out clinical studies to explore PK/PD characteristics of IBI110 single drug and combined with sintilimab in human body as well as its efficacy and safety in various advanced tumors. This is the first in human clinical study of IBI110.

On June 5, 2022 Innovent Biologics, Inc. ("Innovent") (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high quality medicines for the treatment of oncology, autoimmune, metabolic, ophthalmology and other major diseases, reported the preliminary data of IBI351 (GFH925) (KRASG12C inhibitor) from dose escalation portion of a phase I clinical trial (NCT05005234) at the 2022 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting (Press release, Innovent Biologics, JUN 5, 2022, View Source [SID1234615592]).

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Phase I dose-escalation study of IBI351 (GFH925) monotherapy in patients with advanced solid tumors

Poster Presentation, Abstract #: 3110

IBI351(GFH925) is a novel, irreversible covalent inhibitor of KRASG12C mutation. The NCT05005234 study presented was a first-in-human study conducted in China to evaluate the safety, tolerability and efficacy of IBI351 monotherapy in patients with advanced solid tumors who failed or intolerant to standard of care treatment. As data cutoff (15 April 2022), 31 subjects were enrolled in the study, including 25 patients with non-small cell lung cancer, 5 colorectal cancer and 1 pancreatic cancer. Approximately 30% patients received 3 lines or above prior systemic anticancer therapy. The highlights of the study results were as follows:

Of 21 patients (including 16 non-small cell lung cancer and 5 colorectal cancer) having at least 1 tumor assessment per RECISTv1.1, 9 achieved PR, with investigator assessed ORR 42.9% and DCR 81%.
Of 12 patients with NSCLC treated at/above doses of 700mg once daily, 6 achieved PR, with investigator assessed ORR 50% and DCR 83.3%.
Of 5 CRC patients, 2 achieved PR, with investigator assessed ORR 40% and DCR 60%.
As data cutoff, IBI351 was well tolerated. No DLT was reported and MTD was not reached. Treatment-related adverse events (TRAEs) occurred in 93.5% (29/31) patients and the most common TRAEs were anemia, transferase increased, bilirubin increased, vomiting and diarrhea. The majority of the TRAEs were grade 1-2 with 12.9% (4/31) of patients reporting grade 3 TRAEs. There were no grade 4-5 TRAEs or TRAEs led to treatment discontinuation.
Favorable safety and tolerability and promising antitumor activity of IBI351 monotherapy were observed in previously-treated advanced non-small cell lung cancer and colorectal cancer harboring KRASG12C mutation. As data cutoff, dose escalation is still ongoing. More data will be presented at the future medical meeting.

Professor Yi-Long Wu from Guangdong Lung Cancer Institute, Guangdong Provincial People’s Hospital, stated: "KRASG12C mutation occurs in about 2~4% of non-small cell lung cancer and 2.5% of colorectal cancer in China, and no KRASG12C inhibitor was approved yet in China. IBI351 is a novel, irreversible covalent inhibitor of KRASG12C mutation. The preliminary data shows the favorable safety and promising activity of IBI351 (GFH925) monotherapy in KRAS G12C mutated advanced solid tumor. We look forward to more positive clinical data from this study. "

Dr. Hui Zhou, Senior Vice President of Innovent, stated: "We are pleased to present our clinical development updates at the 2022 ASCO (Free ASCO Whitepaper), and that IBI351 monotherapy demonstrated encouraging efficacy and safety data in phase I dose-escalation study. We are working to advancing into late stage clinical development to explore the potential of IBI351 in monotherapy and combo-therapy. We hope to benefit more cancer patients as we are exploring next-generation immunotherapies."

To learn more about Innovent’s R&D updates and activities at 2022 ASCO (Free ASCO Whitepaper), please visit View Source

About IBI351/GFH925 (KRASG12C Inhibitor)

Discovered by GenFleet Therapeutics, GFH925 (Innovent R&D code: IBI351) is a novel, orally active, potent KRASG12C inhibitor designed to effectively target the GTP/GDP exchange, an essential step in pathway activation, by modifying the cysteine residue of KRASG12C protein covalently and irreversibly. Preclinical cysteine selectivity studies demonstrated high selectivity of IBI351 towards G12C. Subsequently, IBI351 effectively inhibits the downstream signal pathway to induce tumor cells’ apoptosis and cell cycle arrest. In September 2021, Innovent and GenFleet Therapeutics entered into an exclusive license agreement for the development and commercialization of IBI351 in China (including mainland China, Hong Kong, Macau and Taiwan) with additional option-in rights for global development and commercialization.

On June 4, 2022 Agendia, Inc., a commercial-stage company focused on improving outcomes for breast cancer patients worldwide by providing physicians and patients with next-generation diagnostic and information solutions to inform optimized treatment decision-making, reported it will share findings in a poster discussion debuting initial data from its ImPrint test, a 53-gene signature in development, at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting (ASCO) (Free ASCO Whitepaper) 2022 (Press release, Agendia, JUN 4, 2022, View Source [SID1234615576]).

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The poster discussion, titled The ImPrint immune signature identifies high risk early breast cancer patients who may benefit from PD1 checkpoint inhibition in I-SPY2 [Kuilman, M., et al.], draws from the neoadjuvant biomarker-rich I-SPY2 trial, which established a new benchmark for the efficacy of Phase 2 clinical trials and is widely regarded as the pioneer of the platform trial. In this study, whole transcriptome data collected by Agendia was assessed from patients who had high risk early breast cancer who received immunotherapy (IO). The goal was to migrate the I-SPY2 findings into a robust clinical-grade signature – a biomarker that had not previously existed in early stage breast cancer – to predict sensitivity to IO drugs that target PD-1/PDL-1, a cell pathway that, when overexpressed, allows many breast tumors to escape destruction by the immune system.

Importantly, results showed that in the development phase, the gene-expression biomarker ImPrint met this task and had the potential to predict pathologic complete response (pCR) to PD-1/PDL-1 checkpoint inhibitors with high sensitivity and specificity, especially in ER+ breast cancer which represents a large population of women who may benefit.

"We are incredibly encouraged by the data we are sharing with regard to the ImPrint Test, which is currently in development," said Annuska Glas, Senior Vice President Research and Development and Innovation at Agendia. "ImPrint appears very effective in identifying a subset of HR+HER2- patients who could benefit from IO. We are also interested in the signature’s ability to identify tumors with an immune active phenotype denoted by the enrichment of several immune-related pathways. This kind of information is not currently available to a broad range of patients with breast cancer, and while we are in the research use only stage, we look forward to continuing validation to ensure ImPrint is in physicians’ hands as soon as possible."

The effect of these findings on patients is potentially significant, ultimately having the potential to impact outcomes. The data shared at ASCO (Free ASCO Whitepaper) 2022 point to the RUO ImPrint Test’s ability to find those who will benefit from a PD-1/PDL-1 treatment as initial therapy, regardless of receptor subtype, providing the information needed to define more specific treatment planning soon after diagnosis.

"There has been a substantial increase of novel IO drugs in many types of diseases, which are astoundingly effective in some cases but not a panacea for all. This had led to the urgent need for biomarkers to identify which patients may benefit from them," said Midas M. Kuilman, Research and Development, Agendia NV, Amsterdam and first author on the poster. "We see this signature as addressing an unmet need as various predictive biomarkers have been developed, but none have consistently predicted efficacy. Here, we see that ImPrint appears to predict with high sensitivity and specificity in both discovery and validation sets – it’s an incredibly promising set of data and we look forward to validating it in the I-SPY 2.2 trial."

Redefining Breast Cancer Care in Post-Neoadjuvant Settings

Another poster, presented by Agendia in partnership with investigators from Cedars-Sinai Medical Center, Los Angeles, looks at matched tumors pre- and post-neoadjuvant chemotherapy analyzed by both MammaPrint and BluePrint to report differential gene expression and pathway analyses in the tumors that may help distinguish different responses. The poster, titled Identification of transcriptional changes with MammaPrint and BluePrint in early-stage breast cancer after neoadjuvant chemotherapy [Chung, A., et al.], found a more robust transcriptional change in tumors that remain MammaPrint High Risk between pre- and post-neoadjuvant chemotherapy. While these tumors remained High Risk, they also had many changes in gene expression pre- and post-neoadjuvant chemotherapy, unlocking clues to resistance and inspiring further research.

The study also found that tumors which changed from MammaPrint High Risk to MammaPrint Low Risk post-therapy had an activated immune response that may be a biomarker for therapy response and improved outcomes based on it.

Taken together, these posters represent Agendia’s continuous dedication to producing and evolving products that lead to insights across the breast cancer care continuum, from initial diagnosis to tailored treatment guidance.

In addition, Agendia will be presenting six posters and a second poster discussion centered on its revolutionary FLEX Trial, which is accelerating impactful data generation aimed at redefining cancer care. Its patient-centric design and national network of participating sites is backed by Agendia’s infrastructure, allowing its investigator-initiated sub-studies to produce important results that have the potential to drive science forward.

Agendia will be sharing updates throughout the conference on its Twitter, Facebook and LinkedIn pages.

On June 4, 2022 Curis, Inc. (NASDAQ: CRIS), a biotechnology company focused on the development of innovative therapeutics for the treatment of cancer, reported the presentation of encouraging clinical data from both the TakeAim Lymphoma and TakeAim Leukemia studies at the 2022 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting currently taking place in Chicago and online until June 7, 2022 (Press release, Curis, JUN 4, 2022, View Source [SID1234615562]).

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"We are excited to share data with the oncology community from our TakeAim Lymphoma and TakeAim Leukemia studies at ASCO (Free ASCO Whitepaper), including the first release of clinical data investigating the use of emavusertib in combination with ibrutinib in patients with Non-Hodgkin’s Lymphoma," said James Dentzer, President and Chief Executive Officer of Curis. "These data demonstrate encouraging signs of anti-cancer activity, including a complete response in a primary CNS lymphoma patient who had prior treatment with ibrutinib. We also presented a poster with data from the TakeAim Leukemia study, previously disclosed in a January 2022 press release, demonstrating emavusertib’s encouraging monotherapy activity in patients with relapsed or refractory (R/R) acute myeloid leukemia (AML) or high-risk myelodysplastic syndrome (MDS)."

"In addition to the data from Curis’s studies, there are presentations at the meeting this year by our collaborators at Washington University and the University of Florida, which help more fully explore emavusertib’s use in tumor types outside of the company’s current focus in hematologic malignancies," said Robert Martell, M.D., Ph.D., Head of Research and Development.

TakeAim Lymphoma:
The TakeAim Lymphoma study is a Phase 1/2 open-label, dose escalation, dose expansion clinical trial investigating emavusertib as monotherapy and in combination with ibrutinib in patients with R/R hematologic malignancies, such as non-Hodgkins’s lymphoma and other B cell malignancies. The poster presentation (#7575) made by Dr. Grzegorz Nowakowski, Division of Hematology, Mayo Clinic-Minnesota, today at ASCO (Free ASCO Whitepaper) includes clinical data from a May 6, 2022 data cutoff, on 13 patients who received the combination, 9 of whom had post-baseline response assessments and were evaluable for response.

Key findings in patients treated with the combination included:

The combination appeared to be well tolerated
No dose-limiting toxicities (DLTs) at 200mg of emavusertib; 2 DLTs observed at 300mg (stomatitis and syncope)
8 of 9 evaluable patients experienced reduction in tumor burden, including:
2 complete responses (CR) (primary CNS lymphoma and mantle cell lymphoma)
2 partial responses (PR) (chronic lymphocytic leukemia and mantle cell lymphoma)
One of the CRs was in a patient who had received prior treatment with ibrutinib, suggesting that the combination may be able to overcome ibrutinib resistance
Next steps for the TakeAim Lymphoma study include further dose expansion in order to determine the Recommended Phase 2 Dose for the combination.

TakeAim Leukemia:
The TakeAim Leukemia study is a Phase 1/2 dose escalation and dose expansion study examining emavusertib use as both monotherapy and in combination with azacitidine or venetoclax in patients with R/R AML or high risk MDS. The poster presentation (#7016) made by Dr. Guillermo Garcia-Manero, Chief of the Section of Myelodysplastic Syndromes within the Department of Leukemia at The University of Texas MD Anderson Cancer Center, today at ASCO (Free ASCO Whitepaper), include clinical data from a December 16, 2021 data cutoff for the 49 patients who had been treated with emavusertib in monotherapy as of that date.

Key safety findings included:

Emavusertib was well-tolerated across multiple dose levels, including at the Recommended Phase 2 Dose of 300 mg BID
No dose-limiting myelosuppression observed
No cumulative toxicities observed
These attributes of emavusertib’s emerging safety profile may provide an advantage compared to current standard of care therapies in monotherapy and may also make emavusertib an attractive candidate for addition to combination therapy regimens.

Key tumor assessment findings included:

Collaborator Studies:
In patients with spliceosome-mutated R/R AML:
CR/CRh rate of 40% (2 out of 5 patients) (CRh=complete response with partial hematologic recovery)
Both patients who achieved CR/CRh have been on study > 6 months and achieved negative MRD (minimal residual disease) status
Consistent tumor burden reduction observed, 4 out of 5 patients achieved blast reduction, 3 of whom by ≥ 50%
In patients with spliceosome-mutated R/R MDS:
Objective response rate of 57% (4 out of 7 patients)
One of the patients who achieved a marrow CR (mCR) proceeded to stem cell transplant after 1 cycle
Consistent tumor burden reduction observed, with 4 out of 6 patients with elevated baseline blast counts achieving ≥ 50% reduction in blast counts
In patients with FLT3-mutated R/R AML:
CR rate of 33% (1 out of 3 patients)
2 out of 3 patients showed eradication of FLT3 mutation following treatment, indicating potential for disease modification with emavusertib
Consistent tumor burden reduction observed with 2 out of 3 patients with elevated blast counts achieving ≥ 50% reduction in blast counts
Being presented today (#TPS4168) is work in gastric cancer by Dr. Kian-Huat Lim’s team at Washington University School of Medicine. Based on compelling preclinical work, Dr. Lim and his team have developed a clinical study exploring combination of emavusertib (CA-4948) in combination with FOLFOX chemotherapy plus nivolumab or pembrolizumab. Preclinically, it has been established that chemotherapy resistance can be driven by TLR9 activation and IRAK4 dependent activation of pro-survival NF-kB signaling. Inhibition of IRAK4 has been shown to block this signaling, and to reduce tumor desmoplasia along with revitalization of intratumoral T-cells, setting the stage for combination with immune checkpoint inhibitors. This study is active, but not yet recruiting.

Being presented tomorrow (#2011), June 5, is preclinical work from Dr. Duane Mitchell’s team at the University of Florida, which investigated emavusertib (CA-4948) in melanoma brain metastasis where IRAK4-dependent signaling is known to be high. Emavusertib exposure in the brain and in brain tumors achieved therapeutically relevant levels, resulted in substantial reduction of B16.F10 tumor volume and prolonged survival of the mice.

About Emavusertib (CA-4948)
Emavusertib is an IRAK4 kinase inhibitor and IRAK4 plays an essential role in the toll-like receptor (TLR) and interleukin-1 receptor (IL-1R) signaling pathways, which are frequently dysregulated in patients with cancer. TLRs and the IL-1R family signal through the adaptor protein MYD88, which results in the assembly and activation of IRAK4, initiating a signaling cascade that induces cytokine and survival factor expression mediated by the NF-κB protein complex. Additionally, third parties have recently discovered that the long form of IRAK4 (IRAK4-L) is oncogenic and preferentially expressed in over half of patients with AML and MDS. The overexpression of IRAK4-L is believed to be driven by a variety of factors, including specific spliceosome mutation such as SF3B1 and U2AF1. In addition to inhibiting IRAK4, emavusertib was also designed to inhibit FLT3, a known oncologic driver, which may provide additional benefit in patients with AML and MDS.