On October 10, 2024 Tempest Therapeutics, Inc. (Nasdaq: TPST), a clinical-stage biotechnology company developing first-in-classi targeted and immune-mediated therapeutics to fight cancer, reported an agreement with Roche to advance the evaluation of amezalpat (TPST-1120) in combination with atezolizumab (Tecentriq) and bevacizumab, the current standard of care for unresectable or metastatic hepatocellular carcinoma (HCC), into a pivotal Phase 3 trial for the first-line treatment of unresectable or metastatic hepatocellular carcinoma, a form of liver cancer with high unmet need (Press release, Tempest Therapeutics, OCT 10, 2024, View Source [SID1234647143]).
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Under the agreement, Roche will supply atezolizumab globally and Tempest will sponsor and lead the pivotal study. This agreement builds on a clinical collaboration between the companies pursuant to which amezalpat was combined with atezolizumab and bevacizumab in first-line HCC patients and compared to atezolizumab and bevacizumab alone in a randomized Phase 1b/2 study. Tempest retains all development and commercial rights to amezalpat.
"We’re excited to announce this agreement that supports the advancement of amezalpat into a pivotal study and reinforces both Tempest and Roche’s shared commitment to delivering groundbreaking cancer treatments for patients," said Stephen Brady, president and chief executive officer of Tempest. "Based on the positive Phase 2 data, I believe this combination therapy holds the potential to significantly improve first-line liver cancer treatment, and we look forward to amezalpat moving into this pivotal Phase 3 study."
In June, Tempest reported updated positive survival data from the ongoing global randomized Phase 1b/2 clinical study, demonstrating a six-month improvement in median overall survival (OS) for patients receiving the combination therapy, in comparison to the control arm of atezolizumab and bevacizumab alone in the first-line treatment of patients with unresectable or metastatic HCC. The survival benefit observed in the amezalpat arm was maintained in key subpopulations, as well. These June data build upon previously released data from the primary analysis showing that the amezalpat combination therapy provided clinical benefit regardless of PD-L1 status and in patients with both immune excluded and immune desert tumors. Patients with a mutation in the beta catenin gene had an increased objective response rate and, in the updated data set, a longer median OS, both supported by amezalpat’s purported mechanism of action.
In August, the company held its end-of-phase 2 meeting with the FDA where it reached broad agreement on the Phase 3 study plan, including the amezalpat dose schedule and primary endpoint of OS, which was a positive result from the Phase 2. The FDA also agreed on the statistical plan, including a pre-specified early efficacy analysis that the company currently estimates could shorten the study’s timeline to primary analysis by 8 months.
About the TPST-1120-301 Study
The planned Phase 3 study is a global, blinded, 1:1 randomized study of amezalpat plus atezolizumab and bevacizumab vs. atezolizumab and bevacizumab, the standard of care, in patients with unresectable or metastatic HCC treated in the first line setting. In August 2024, the company received agreement from the FDA on its Phase 3 study design, dose of amezalpat, and the statistical plan, including a pre-specified efficacy analysis that could shorten the time to primary analysis. The company is preparing for the Phase 3 study start in the first quarter of 2025.
About Amezalpat (TPST-1120)
Amezalpat is an oral, small molecule, selective PPAR⍺ antagonist. Data suggest that amezalpat treats cancer by targeting tumor cells directly and by modulating immune suppressive cells and angiogenesis in the tumor microenvironment. In an ongoing global randomized phase 1b/2 study of amezalpat in combination with atezolizumab and bevacizumab in first-line patients with advanced HCC, the amezalpat arm showed clinical superiority across multiple study endpoints, including overall survival in both the overall population and key subpopulations, when compared to atezolizumab and bevacizumab alone, the standard of care. These randomized data were supported by positive results observed in the Phase 1 clinical trial in patients with heavily pretreated advanced solid tumors, including renal cell carcinoma and cholangiocarcinoma.