On June 26, 2017 TG Therapeutics, Inc. (NASDAQ:TGTX), reported clinical data from two triple combination therapy trials using TGR-1202 (umbralisib), the Company’s oral, next generation PI3K delta inhibitor and TG-1101 (ublituximab), the Company’s novel glycoengineered anti-CD20 monoclonal antibody, as the backbone of the combinations (Press release, TG Therapeutics, JUN 26, 2017, View Source [SID1234519689]). The data presentations include a recap of the data from the combination of TGR-1202, TG-1101, and ibrutinib, as well as from the triple combination of TGR-1202, TG-1101, and bendamustine. Data from these trials were presented this past weekend at the 22nd European Hematology Association (EHA) (Free EHA Whitepaper) Annual Congress in Madrid, Spain. These data sets were presented earlier this month at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) annual meeting and/or at the 14th International Conference on Malignant Lymphoma (ICML).

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Highlights from the presentations include the following:

Oral Presentation: Chemo-free triplet combination of TGR-1202, ublituximab, and ibrutinib is well tolerated and highly active in patients with advanced CLL and NHL

This oral presentation includes data from patients with Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL) and Non-Hodgkin’s Lymphoma (NHL) treated with the triple combination of TGR-1202, TG-1101, and ibrutinib. All patients were relapsed or refractory to prior therapy, except 3 CLL patients who were treatment naïve. Three cohorts each for CLL/SLL and NHL were evaluated with TGR-1202 dose escalation starting with doses of 400 mg (cohort 1), followed by 600 mg (cohort 2) and 800 mg (cohort 3), in combination with TG-1101 at 900 mg and ibrutinib daily at 420 mg (CLL) and 560 mg (NHL).

Safety & Tolerability
Thirty-eight (38) patients were evaluable for safety (20 CLL/SLL patients, and 18 NHL patients). The triple combination appeared to be well tolerated in all patients, with neutropenia (32% all grades, 18% Grade 3/4) and pneumonia (18% all grades, 11% Grade 3/4), being the only Grade 3/4 AEs in > 10% of patients. Of the 38 patients treated to date, only two AEs (sepsis and pneumonia) led to treatment discontinuation. Median time on study was 11.1 months (range 0.4 – 30+ months) with 81% of patients on study > 6 months.

Clinical Activity
Clinical activity was observed at all dose levels with 36 of 38 patients evaluable for efficacy (19 CLL/SLL patients, and 17 NHL patients), with 2 patients having discontinued prior to first efficacy assessment (1 pneumonia, and 1 investigator discretion).

CLL/SLL Efficacy highlights include:

100% (19 of 19) Overall Response Rate (ORR), including a 32% Complete Response (CR) rate observed in patients with CLL/SLL (4 of 6 CR’s pending bone marrow confirmation)

50% of the CLL patients had a 17p and/or 11q deletion

3 CLL patients had prior BTK and/or PI3Kδ inhibitor therapy, including one patient refractory to both idelalisib and ibrutinib who attained a complete response (ongoing for 1.5+ years)
NHL Efficacy highlights include:

Response Rates observed in patients with NHL:
100% (2 of 2) ORR, including one CR in patients with Marginal Zone Lymphoma (MZL)
100% (4 of 4) ORR, including 50% CR rate in patients with Mantle Cell Lymphoma (MCL)
80% (4 of 5) ORR, including 20% CR rate in patients with Follicular Lymphoma (FL)
17% (1 of 6) ORR in patients with Diffuse Large B-cell Lymphoma (DLBCL)

FL patients were heavily pretreated including 2 with prior Autologous Stem Cell Transplant (ASCT), 1 refractory to prior ibrutinib, and 1 with 5 prior lines of rituximab based therapy

DLBCL patients had a median of 4 prior therapies, and 4 of 6 were of non-GCB subtype
Poster Presentation: Combination of TGR-1202, Ublituximab, and Bendamustine is safe and highly active in patients with advanced DLBCL and Follicular Lymphoma

This poster presentation includes data from patients with relapsed or refractory Diffuse Large B-Cell Lymphoma (DLBCL) or Follicular Lymphoma (FL) treated with the triple combination of TGR-1202 (umbralisib), TG-1101 (ublituximab), and bendamustine. Thirty-three patients were evaluable for safety of which 24 were evaluable for efficacy (9 patients were note evaluable; 7 were too early to evaluate and 2 patients were off study prior to an efficacy assessment: 1 non-related adverse event (AE) and 1 investigator decision). The triple combination appears well tolerated with no discontinuations for a treatment related AE. No events of pneumonitis and no Grade 3/4 transaminitis were reported. Twenty-one patients (64%) were refractory to prior treatment. Mean time on study was approximately 6 months.

Efficacy highlights from this poster include:

100% (4 of 4) ORR, including a 50% CR rate, observed in patients with relapsed DLBCL

50% (6 of 12) ORR, including a 42% CR rate, observed in patients with refractory DLBCL with durable CR and PR responses observed (PR on-going for > 16+ months)

88% (7 of 8) ORR, including a 50% CR rate, observed in patients with relapsed or refractory FL
PRESENTATION DETAILS:

The above referenced presentations are available on the Publications page, located within the Pipeline section, of the Company’s website at www.tgtherapeutics.com/publications.cfm.