On October 8, 2019 Adlai Nortye Ltd. ("Adlai Nortye" or "the Company"), a global clinical-stage biopharmaceutical company dedicated to discovery, development and commercialization of new and effective drugs with a focus on Oncology, reported at the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) 2019 Congress the first results from a phase 1b neoadjuvant study of AN0025 (previously known as E7046), an investigational, potentially first in class oral EP4 antagonist (Press release, Adlai Nortye Biopharma, OCT 8, 2019, View Source [SID1234540107]).
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Researchers presented results from two dose levels of AN0025 in combination with the standard of care for locally advanced rectal cancer where primary resection without chemoradiotherapy is unlikely to achieve clear margins as defined by MRI. Twenty-eight high-risk patients were enrolled with 14 patients in the 250 mg cohort and 14 patients in the 500mg cohort; 25 patients were eligible for assessment. No DLT were observed in any patients. Complete clinical responses have led to 5/25 patients being managed by a watch-and-wait approach, in those who had surgery, 4/15 had pCR with 12 of these patients having clear resection margins.
The study showed that AN0025 was well tolerated in combination with chemoradiation as well as to radiotherapy followed by consolidation chemotherapy. The preliminary efficacy demonstrated encouraging clinical results in locally advanced rectal cancer.
"There is a tremendous need for new treatment strategies in rectal cancer, especially in patients with high-risk of relapse enrolled in this study. With nearly 40% of patients not requiring surgery or achieving a complete pathological response in the post-surgical specimen in this study, AN0025 in combination with the standard pre-operative treatment warrants further development. The excellent toxicity profile of this novel immunotherapy and potential combination with both conventionally fractionated radiochemotherapy or short course irradiation with consolidating chemotherapy make this strategy feasible worldwide." said lead author Dr. Lucjan Wyrwicz, MD, PhD, Department of Oncology and Radiotherapy, M. Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland.
He added: "My patients are more and more often asking for organ preservation in rectal cancer and for many of them only a complete clinical response without any surgery is the desired outcome of treatment."
Commenting on the findings, Dr. Theodore S. Hong, MD, Director, Gastrointestinal Service, Associate Clinical Director, Department of Radiation Oncology, Massachusetts General Hospital, Co-Leader, Gastrointestinal Malignancies Program, Dana-Farber/Harvard Cancer Center, Professor of Radiation Oncology, Harvard Medical School, said "Given the unique mechanism of action and strong preclinical rationale, combined with the excellent tolerability and encouraging results, further study of AN0025 in preoperative therapy for rectal cancer are warranted. One question remains if there is a benefit to continuous exposure with AN0025 with FOLFOX followed by chemoradiation with AN0025 in a total neoadjuvant therapy (TNT) paradigm. Further evaluation in randomized trials is eagerly awaited." Dr. Hong was also an investigator in the study.
"We are very encouraged by these results and plan to move AN0025 plus chemoradiotherapy into a randomized confirmatory trial without delay" said Dr. Lars Birgerson, Chief Development Officer of Adlai Nortye. "We believe that the EP4 class, where AN0025 is a leading compound, holds considerable promise in combination with multiple treatments including check point inhibitors for a multitude of solid tumors."
About AN0025
AN0025 (previously E7046) is an investigational, potentially first in class oral EP4 antagonist that is believed to prevent the binding of prostaglandin E2 to its EP4 to change the immunosuppressive character of the tumor microenvironment. Based on preliminary results, it is well tolerated in patients with solid tumors.