On April 28, 2022 Turning Point Therapeutics, Inc. (NASDAQ: TPTX), a clinical-stage precision oncology company developing next-generation therapies that target genetic drivers of cancer, and Zai Lab (NASDAQ: ZLAB; HKEX: 9688), a patient-focused, innovative, commercial-stage, global biopharmaceutical company, reported topline data for repotrectinib within the China region from the previously disclosed Phase 1/2 TRIDENT-1 study dataset (Press release, Turning Point Therapeutics, APR 28, 2022, View Source [SID1234613165]).
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"We are incredibly pleased with our collaboration with Zai Lab given their strong enrollment into the global TRIDENT-1 study and are happy to share these initial results," said Mohammad Hirmand, M.D., Chief Medical Officer of Turning Point Therapeutics. "We look forward to discussing our global TRIDENT-1 data with the FDA prior to the end of this quarter and presenting detailed study results from the global dataset at a medical conference in the second half of the year."
"With over 800,000 newly diagnosed lung cancer patients every year in China, NSCLC accounts for approximately 85% of the cases, and ROS1 rearrangements occur in 2-3% of patients with advanced NSCLC. The majority of these patients are diagnosed at advanced stages, representing significant unmet medical need," said Alan Sandler, M.D., President and Head of Global Development, Oncology, at Zai Lab. "It is encouraging to see the similar results of the efficacy analyses comparing data from sites in China and globally for repotrectinib, a potential best-in-class drug candidate for patients with ROS1-positive advanced NSCLC. We will continue to work closely with Turning Point to advance this program to help support NSCLC patients in China and around the world."
The primary objective of the TRIDENT-1 study is to determine the cORR based on BICR as assessed by RECIST 1.1. DOR is a key secondary objective of the study. The dataset utilizes a February 11, 2022 data cutoff date. The global safety analysis included 380 treated patients from the pooled Phase 1 and Phase 2 portions of TRIDENT-1 across all cohorts. The global efficacy analyses included pooled patients from Phase 1 across all dose levels with an identified ROS1 fusion by next generation sequencing at baseline and Phase 2 patients. All patients received at least one dose of repotrectinib with at least four months of follow-up, and the majority of responders had at least six months of DOR follow-up.
Topline Efficacy Analyses by BICR
In TKI-naïve patients (EXP-1), in 71 total patients, there was a cORR of 79% across the global trial. Ten of 11 patients responded within China for a cORR of 91% (95% CI: 59,100) and DOR ranged from 3.6+ to 7.5+ months with a median duration of follow-up of 3.7 months.
In patients previously treated with 1 TKI and platinum-based chemotherapy (EXP-2), in 26 total patients, there was a cORR of 42% across the global trial. Two of 3 patients responded within China for a cORR of 67% (95% CI:9,99) and DOR ranged from 3.6+ to 3.7+ months with a median duration of follow-up of 3.7 months.
In patients previously treated with two TKIs without prior chemotherapy (EXP-3), in 18 total patients, there was a cORR of 28% across the global trial. Two of 4 patients responded within China for a cORR of 50% (95% CI: 7,93) and DOR ranged from 1.9+ to 3.4+ months with a median duration of follow-up of 2.6 months.
In patients previously treated with 1 TKI without prior chemotherapy (EXP-4), in 56 total patients, there was a cORR of 36% across the global trial. Four of 11 patients responded within China for a cORR of 36% (95% CI: 11,69) and DOR ranged from 2.0+ to 3.7+ months with a median duration of follow-up of 3.1 months.
Global TRIDENT-1 Topline Safety Analyses
Repotrectinib was generally well tolerated in a total of 380 patients treated globally with a safety and tolerability profile that was consistent with previously reported findings. The most commonly reported treatment emergent adverse event remained dizziness (61% all grade), of which 76% of patients who reported dizziness had a maximum severity of grade 1. The safety profile was comparable among the 287 patients who were treated at the Phase 2 dose.
The TRIDENT-1 study continues to enroll patients globally across the study. As previously guided, Turning Point Therapeutics anticipates discussing the topline BICR data for the ROS1-positive advanced NSCLC cohorts with the U.S. Food and Drug Administration (FDA) at a pre-NDA meeting this quarter. Turning Point Therapeutics plans to present detailed study results, including intracranial activity, from the ROS1-positive advanced NSCLC cohorts of the TRIDENT-1 study, at a medical conference in the second half of 2022.
Zai Lab plans to complete enrollment in the phase 1/2 registrational TRIDENT-1 study and discuss the regulatory pathway with the National Medical Products Administration (NMPA) at a pre-NDA meeting in the fourth quarter of 2022.