June 2021 – Page 162 – 1stOncology™: Cancer Intelligence Service

Innovent Releases the Phase Ia/Ib Dose-Escalation Trial Results of IBI110 (anti-LAG-3) in Patients with Advanced Solid Tumors at ASCO Annual Meeting 2021

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The phase 1 study of IBI110 is a dose-escalation trial evaluating IBI110, an anti-LAG-3 monoclonal antibody, as a single agent and in combination with sintilimab in patients with advanced solid tumors refractory to standard of care therapy. The study is comprised of Phase Ia, an IBI110 single-drug dose-escalation phase, and Phase Ib, the dose-escalation phase of IBI110 in combination with sintilimab (200mg). At disease progression, cross over from IBI110 monotherapy to combo (IBI110+ sintlilimab) was allowed at the investigators’ discretion. At data cutoff (February 9, 2021), 40 patients were enrolled and received treatment. 22 subjects were assigned in dose groups of 7 (0.01mg/kg~20mg/kg) in Phase Ia, the prespecified dose escalation had been completed and no dose-limited toxicity (DLT) was observed. No adverse event (AE) led to discontinuation of IBI110 or sintilimab and no treatment-related death was reported. In terms of efficacy, a subject with advanced ovarian cancer who progressed on multiple prior systemic therapies achieved partial response after IBI110 monotherapy treatment and was still in the study for more than 6 months. 18 subjects were assigned in dose groups of 5 (0.3mg/kg~5mg/kg) in Phase Ib of IBI110 in combination with sintilimab, the prespecified dose escalation had been completed and no dose-limited toxicity (DLT), adverse events leading to discontinuation or death was observed. At data cutoff (April 26, 2021), three subjects had achieved partial response with an objective response rate of 16.7% (3/18) in phase 1b, demonstrating a synergistic anti-tumor activity of IBI110 and sintilimab.

"The efficacy signal and safety profile we see with IBI110 in this study is exciting," said Dr. Hui Zhou, Senior Vice President of Clinical Development, Innovent Biologics. "The single-drug efficacy demonstrated in the trial suggested a huge anti-tumor potential of this target. As we move ahead with the study, we look forward to greater clinical benefits of IBI110 in combination with sintilimab in patients in this trial. We are committed to innovation and relentless pursuit of breakthroughs for cancer patients. Aside from IBI110, we are also initiating phase 1 clinical trial on IBI323, a LAG-3/PD-L1 bispecific antibody, to fully investigate therapeutic value of LAG-3. "

Professor Caicun Zhou from Shanghai Pulmonary Hospital said: "IBI110’s good safety and preliminary efficacy data support the further exploration of this molecule in a variety of tumor types, including non-small cell lung cancer, small cell lung cancer, melanoma, etc. LAG-3 is the third validated immune-related target after PD-1 and CTLA-4. We look forward to seeing more positive results from the upcoming trials of IBI110."

About the Study

This study is a phase Ia/Ib open label, dose escalation and expansion study to evaluate the safety, tolerability and efficacy of IBI110, an anti-LAG-3 monoclonal antibody, as a single agent and in combination with sintilimab in advanced solid tumors. The study follows a classic 3+3 design. Patients received escalating doses of IBI110 once every 3 weeks in phase Ia and escalating doses of IBI110 in combination with TYVYT (sintilimab injection) 200 mg once every 3 weeks in phase Ib until disease progression, unacceptable toxicity, or withdrawal of consent.

Primary objectives of the trial were to evaluate the safety, tolerability and the antitumor activity of IBI110 monotherapy and in combination with sintilimab.

About LAG-3

Lymphocyte activation gene-3 (LAG-3) (CD223) is a novel 498-amino acid type I transmembrane protein identified on activated human NK and T-cell lines. LAG-3 (CD223) is a potential cancer immunotherapeutic target due to its negative regulatory role on T cells and its capacity, in combination with PD-1, to mediate a state of exhaustion.

About TYVYT (sintilimab Injection)

TYVYT (sintilimab injection) is an innovative PD-1 inhibitor with global quality standards jointly developed by Innovent and Lilly. Sintilimab is a type of immunoglobulin G4 monoclonal antibody, which binds to PD-1 molecules on the surface of T-cells, blocks the PD-1 / PD-Ligand 1 (PD-L1) pathway, and reactivates T-cells to kill cancer cells. Innovent is currently conducting more than 20 clinical studies of sintilimab to evaluate its safety and efficacy in a wide variety of cancer indications, including more than 10 registrational or pivotal clinical trials.

In China, TYVYT (sintilimab Injection) has been approved for two indications, including:

The treatment of relapsed or refractory classic Hodgkin’s lymphoma after two lines or later of systemic chemotherapy
In combination with pemetrexed and platinum chemotherapy, for the first-line treatment of nonsquamous non-small cell lung cancer
In combination with gemcitabine and platinum chemotherapy, for the first-line treatment of squamous non-small cell lung cancer
Additionally, Innovent currently has regulatory submissions under review in China for TYVYT (sintilimab Injection):

In combination with BYVASDA (bevacizumab injection) for the first-line treatment of hepatocellular carcinoma
The second-line treatment of squamous non-small cell lung cancer
In May 2021, the U.S. FDA accepted for review the Biologics License Application (BLA) for sintilimab in combination with pemetrexed and platinum chemotherapy for the first-line treatment of nonsquamous non-small cell lung cancer.

TYVYT (sintilimab Injection) was included in China’s National Reimbursement Drug List (NRDL) in 2019 as the first PD-1 inhibitor and the only PD-1 included in the list in that year.

Innovent and AnHeart Release Preliminary Results from the Phase II TRUST Trial of Taletrectinib in ROS1 Fusion Positive NSCLC at the ASCO 2021 Annual Meeting

On June 6, 2021 Innovent Biologics, Inc. ("Innovent", HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of cancer, metabolic, autoimmune and other major diseases, together with AnHeart Therapeutics Co., Ltd ("AnHeart"), a clinical stage oncology company focused on underserved patients in global markets, reported a presentation of a scientific poster entitled "Preliminary results from TRUST: A phase II clinical study to investigate Taletrectinib in treating patients with ROS1 fusion positive non-small cell lung cancer (NSCLC)" which summarizes initial data from its ongoing trial of taletrectinib (NCT04395677) at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) 2021 Annual Meeting (Press release, Innovent Biologics, JUN 6, 2021, View Source [SID1234583621]).

As of the data cut-off date of April 8, 2021, there were 15 crizotinib treatment-naïve patients and 5 crizotinib pre-treated patients, who had been confirmed to be ROS1 fusion positive and assessed at least twice by investigators. The results were as follows:

In the crizotinib treatment-naïve patients (n=15), the overall response rate (ORR) was 93% (14/15) and the disease control rate (DCR) was 93% (14/15);
In the crizotinib pre-treated patients (n=5), the ORR was 60% (3/5); and the DCR was 100% (5/5). ROS1 G2032R resistant mutations were identified in three of the five patients and all three patients experienced tumor regressions; and
Taletrectinib has shown a manageable safety profile characterized primarily by gastrointestinal adverse events, with reversible increases of aspartate aminotransferase (AST) and alanine aminotransferase (ALT).
"These safety and efficacy data for taletrectinib are very promising for ROS1 fusion positive lung cancer patients," said Dr. Caicun Zhou, director of the Department of Oncology, Shanghai Pulmonary Hospital. "Responses appear particularly impressive in crizotinib treatment-naïve patients, and while the number of crizotinib pre-treated patients is limited, thus far all five patients continue to benefit from the drug."

"We are glad to see the study result of Taletrectinib can be presented at ASCO (Free ASCO Whitepaper) meeting, the most authoritative clinical oncology conference", said Dr. Hui Zhou, Senior Vice President of Clinical Development, Innovent Biologics, "In China, ROS1 positive fusion patients have limited treatment choices at present. More new drugs are needed to develop for clinical application. Taletrectinib has shown good efficacy and safety results, which offers hope to patients with ROS1 fusion positive non-small cell lung cancer."

"Our team is highly focused on completing patient enrollment for this phase II TRUST trial in Q3 2021," said Bing Yan, MD, co-founder and chief medical officer of AnHeart. "These data from the TRUST trial have built a solid foundation for our upcoming global trials of taletrectinib and will support us in seeking regulatory approvals of talectrectinib in China and globally. We sincerely thank the patients, their families and investigators in the TRUST trial and look forward to bringing taletrectinib to all ROS1 fusion positive patients in the near future upon approval."

About Taletrectinib

Taletrectinib is an investigational next-generation tyrosine kinase inhibitor (TKI) designed to effectively target ROS1 and NTRK fusion mutations with potential to treat TKI-naïve or pre-treated patients. ROS1 rearrangement is estimated to be an oncogenic driver in approximately 2 to 3 percent of patients with advanced NSCLC, and NTRK rearrangement is estimated to be an oncogenic driver in approximately 0.5 percent of patients with other advanced solid tumors. More information about the ongoing TRUST (Taletrectinib ROS1 LUng STudy) trial and the basket trial in NTRK fusion positive solid tumors of taletrectinib may be found by searching clinical trial identifiers NCT04395677 and NCT04617054, respectively at View Source

On 1 June 2021, Innovent and Anheart announced an exclusive license agreement for the co-development and commercialization of AnHeart’s lead drug candidate, taletrectinib – a next-generation tyrosine kinase inhibitor (TKI) designed to effectively target ROS1 and NTRK – in Greater China, including mainland China, Hong Kong, Macau and Taiwan.

Innovent and HUTCHMED Release Phase 1b preliminary Results of TYVYT (Sintilimab Injection) plus Fruquintinib as a Third Line Treatment for Advanced Colorectal Cancer at ASCO Annual Meeting 2021

This is a Phase 1b dose escalation and dose expansion study to evaluate the tolerability, safety and preliminary efficacy of sintilimab plus fruquintinib, and to determine the recommended phase 2 dose (RP2D). 44 CRC patients that had failed at least 2 previous lines of therapy containing fluoropyrimidine, oxaliplatin or irinotecan were enrolled. They received either 5mg-intermittent or 3mg-continous dosage (n=22, each). The objective response rate (ORR) was 22.7% (10/44, 95% CI: 11.5-37.8%) with 27.3% (6/22, 95% CI: 10.7-50.2%) in the 5mg-intermittent group and 18.2% (4/22, 95% CI: 5.2-40.3%) in the 3mg-continuous group. With a median follow-up time of 11.3 (range: 9.8-11.7) months, the Kaplan-Meier estimated median progression free survival (PFS) was 5.6 (95% CI:4.3-7.5) months among all 44 patients, with 6.9 (95% CI:5.4-8.3) months for the 5mg-intermittent group and 4.2 (95% CI:2.9-9.5) months for the 3mg-continuous group. The safety for this combination therapy was controllable.

Dr. Hui Zhou, Senior Vice President of Clinical Development, Innovent Biologics, said, "The preliminary results were very encouraging, which have given us a very promising efficacy signal that TYVYT (sintilimab injection) in combination with ELUNATE (fruquintinib) could be used as a third-line treatment for advanced CRC with microsatellite stability. These results would warrant further investigation in a larger population. This study also underscores our commitment to provide innovative treatment options to patients with cancer."

Dr. Weiguo Su, Chief Scientific Officer of HUTCHMED, said, "Fruquintinib’s clean profile led us to evaluate this sintilimab combination in many different tumor types, with this favorable safety profile further highlighted by the combination’s RP2Ds similarity to their monotherapy RP2D. This CRC data at RP2D is promising, showing median PFS at nearly double what was demonstrated under monotherapy. We are exploring next steps in bringing this novel therapy to cancer patients."

About Colorectal Cancer

Colorectal cancer is one of the most common malignancies in the world with relatively high morbidity and mortality. With the improvement of living conditions, the incidence of CRC in China has been increasing in recent years. Surgery is the major treatment for early stage CRC, but a large proportion of patients who have received surgery would develop relapse or distant metastasis, and die from disease progression. More than 95% of advanced CRCs are microsatellite stable, with very limited efficacy of immunotherapy and large unmet clinical needs.

About TYVYT (Sintilimab Injection)

In China, TYVYT (sintilimab Injection) has been approved for two indications, including:

TYVYT (sintilimab Injection) was included in China’s National Reimbursement Drug List (NRDL) in 2019 as the first PD-1 inhibitor and the only PD-1 included in the list in that year..

About ELUNATE (fruquintinib)

Fruquintinib is a highly selective and potent oral inhibitor of VEGFRs –1, –2 and –3. VEGFR inhibitors play a pivotal role in blocking tumor angiogenesis. Fruquintinib was designed to improve kinase selectivity to minimize off-target toxicities, improve tolerability and provide more consistent target coverage. The generally good tolerability in patients to date, along with fruquintinib’s low potential for drug-drug interaction based on preclinical assessment, suggests that it may also be highly suitable for combinations with other anti-cancer therapies.

Fruquintinib was approved for marketing by the NMPA in September 2018 and is marketed under the brand name ELUNATE in China. ELUNATE is for the treatment of patients with metastatic CRC that have been previously treated with fluoropyrimidine, oxaliplatin and irinotecan, including those who have previously received anti-VEGF therapy and/or anti-EGFR therapy (RAS wild type).

HUTCHMED retains all rights to fruquintinib outside of China. In China, HUTCHMED is partnered with Eli Lilly and Company and is responsible for development and execution of all on-the-ground medical detailing, promotion and local and regional marketing.

Innovent Releases Phase 1 Results of Pemigatinib in Chinese Patients with Advanced Solid Tumors at ASCO Annual Meeting 2021

This is a Phase 1 study to evaluate the pharmacokinetic (PK), pharmacodynamic (PD) and safety of pemigatinib in Chinese patients (pts) with advanced malignancy. Moreover, potential efficacy of pemigatinib was explored in a broad spectrum of fibroblast growth factor receptor (FGFR) alteration in variety of cancer types. 12 patients with 5 different cancer types (colorectal cancer, gastric cancer, cholangiocarcinoma, esophageal carcinoma and breast cancer) and FGF/FGFR1-3 alterations were enrolled. All the subjects were failed to prior standard therapy. As of Jan 31, 2021, all patients received at least once treatment, the safety was controllable with the most common treatment related adverse events (TRAE) of hyperphosphatemia, decreased appetite and diarrhea. Two patients reported ≥ grade 3 TRAEs, which were hyponatremia and proteinuria. There were no TEAEs leading to death or treatment discontinuation. Among 11 efficacy evaluable patients, 2 of them had partial responses (PR) as evaluated by investigators with 1 cholagiocarcinoma harboring FGFR2 point mutation (p.F276C) and the other esophageal carcinoma carrying FGFR1 mutation (p.A354V). 3 patients had a best overall response of stable disease (SD). The objective response rate (ORR) was 16.7% (95%CI: 2–48%) and disease control rate was 41.7% (95%CI: 15–72%).

Professor Yi Ba from Tianjin Medical University Cancer Institute and Hospital said," Pemigatinib had an acceptable and manageable toxicity in Chinese patients with advanced malignancy. A significant implication of the data is that it extended the population that potentially benefit from pemigatinib other than FGFR2 fusion/rearrangement."

"Several FGFR inhibitors are being in clinical stage" said Dr. Hui Zhou, Senior Vice President of Clinical Development, Innovent Biologics. "Innovent has multiple clinical trials of pemigatinib for the treatment of cholangiocarcinoma and other types of tumors. Currently we are preparing the New Drug Application (NDA) of pemigatinib in China. We presented the data at the ASCO (Free ASCO Whitepaper) Annual Meeting, which highlighted our capability of small molecules. In the future, we will conduct in-depth clinical development of pemigatnib to explore its treatment in other indications. We are looking forward to providing innovative therapies for more cancer patients in the future."

About Pemazyre (pemigatinib)

In April 2020, the U.S. Food and Drug Administration (FDA) approved Incyte’s Pemazyre (pemigatinib), a selective, oral inhibitor of FGFR isoforms 1, 2 and 3, for the treatment of adults with previously treated, unresectable locally advanced or metastatic cholangiocarcinoma with a fibroblast growth factor receptor 2 (FGFR2) fusion or rearrangement as detected by an FDA-approved test. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s).

In Japan, Pemazyre is approved for the treatment of patients with unresectable biliary tract cancer with a FGFR2 fusion gene, worsening after cancer chemotherapy. In Europe, Pemazyre is approved for the treatment of adults with locally advanced or metastatic cholangiocarcinoma with a FGFR2 fusion or rearrangement that have progressed after at least one prior line of systemic therapy. Pemazyre is marketed by Incyte in the United States, Europe and Japan.

In December 2018, Innovent and Incyte entered into a strategic collaboration for three clinical-stage product candidates discovered and developed by Incyte, including pemigatinib (FGFR1/2/3 inhibitor). Under the terms of the agreement, Innovent has received the rights to develop and commercialize the three assets in Mainland China, Hong Kong, Macau and Taiwan.

Pemazyre is a trademark of Incyte Corporation.

OriginCell Therapeutics Presents Positive Results of GPC3 CAR-T in HCC Trial at the 2021 ASCO Annual Meeting

On June 6, 2021 OriginCell Therapeutics (Shanghai) Co., Ltd. ("OriginCell"), together with Lishui Central Hospital affiliated to Zhejiang University and Shanghai Changzheng Hospital, reported the updated data from the on-going trial of Ori-CAR-001, a GPC3 CAR-T cell therapy for the treatment of relapsed/refractory hepatocellular carcinoma (HCC), at the 2021 annual meeting of American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) (Press release, Shanghai OriginCell Therapeutics, JUN 6, 2021, View Source [SID1234583618]). Preliminary results from the study show promising safety and efficacy of Ori-CAR-001 in patients with GPC3-positive relapsed/refractory HCC.

(PRNewsfoto/Yuanqi Biological Technology (Shanghai) Co., Ltd.)(PRNewsfoto/Yuanqi Biological Technology (Shanghai) Co., Ltd.)
Session type: Poster Session
Abstract Title: An armored GPC3-directed CAR-T for refractory or relapsed hepatocellular carcinoma in China: A phase I trial
Date and time: 06/04/2021, 9:00 AM (EDT)
Abstract ID: 4095
Link: View Source

A breakthrough Cell Therapy against Solid Tumors

As of March 10, 2021, a total of 11 patients were enrolled into this study. All subjects had advanced HCC and had failed prior lines of treatment including chemotherapy, TACE, and targeted therapies. All subjects had BCLC stage C (late stage) HCC except for one subject with stage B (mid stage). All subjects had multiple lesions, of which 6 (54%) had distant metastasis. Two subjects dropped out early and were not evaluable. Among the 9 evaluable subjects, 4 achieved partial response (PR), 3 achieved stable disease (SD), and 2 had disease progression (PD). The objective response rate was 44.4%, and the disease control rate reached 77.8%. A partial response lasting for more than 6 months was observed in Subject 007 at the time of data cutoff, whose tumor volume was reduced by more than 80% one month post cell therapy infusion. (As of June 2021, this subject had exceeded 8 months of disease control, follow-up is still ongoing). Good tumor response was also seen in Subject 012, who has advanced and diffuse massive HCC and joined the study after failing in radiotherapy, targeted drug and 12 times of TACE.

Barcelona Clinic Liver Cancer (BCLC) is a liver cancer staging system developed by the European Association for the Study of Liver, to help assess patients’ conditions, select the right therapies for the right patients, and predict patients’ prognosis. The BCLC system classifies HCC mainly as stages of 0, A, A1,A2,A3,A4, B, C,and D.

On day 28 post infusion with CAR-T cells, the target tumor lesion decreased from 133mm in diameter at baseline to 9mm, a reduction of more than 93%. Currently, the subject is being evaluated for month 3 post CAR-T cell infusion, MRI scan showed near complete tumor response. In addition, AFP level (alpha-fetoprotein, a specific tumor marker for primary liver cancer) decreased from a baseline value of >80,000/ng/ml to 1148.9 ng/ml on month 1, and to 746.7 ng/ml at month 3 post infusion (normal range <40ng/ml), demonstrating significant preliminary efficacy of Ori-CAR-001 in patients with advanced HCC.

Good Safety Profile

Ori-CAR-001 CAR-T infusion demonstrated good safety and tolerability in 11 patients. Cytokine release syndrome (CRS) was observed in 9 patients (7 cases grade 1-2 and 2 cases grade 4), which were resolved after treatment with steroids and tocilizumab. No neurotoxicity was observed.

Regarding the results from this exploratory study, Professor Ji Jiansong, principal investigator of Lishui Central hospital, who is also Chief scientist of the National Key R&D Program, director of Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research of Zhejiang China, said, "There is currently no effective treatment for relapsed/refractory hepatocellular carcinoma. Many challenges such as the tumor micro environment is difficult to overcome and have limited the therapeutic effects of cell therapy in solid tumors. However, Ori-CAR-001, developed by OriginCell Therapeutics, has managed to achieve an objective response rate of 44% and a disease control rate of 77% in patients with relapsed/refractory HCC, demonstrating a level of safety and anti-tumor activity that cannot be achieved by currently available drugs. Given its preliminary promising efficacy and safety data, we are confident in the future development prospects of Ori-CAR-001 and will continue our research studies. We take great pride and hope Ori-CAR-001 will one day become a new treatment option for patients with advanced HCC.

Dr. He Xiaowen, co-founder and chief scientific officer of OriginCell Therapeutics, said, " Although Immuno-cell therapies have produced remarkable clinical responses in hematological tumors, they have limited efficacy against solid tumors. OrginCell will continue to explore the broader unmet needs in this space, with the hope to bring more effective immuno-cell therapies to clinicians and patients with advanced stage cancer."

About Ori-CAR-001

Ori-CAR-001 is a next generation autologous chimeric antigen receptor T cell therapy targeting GPC3 for the treatment of refractory/ relapsed hepatocellular carcinoma (HCC). The construct of Ori-CAR-001 is comprised of humanized anti-GPC3 scFv, a CD8-derived hinge region, a transmembrane domain linked to 4-1BB co-stimulatory domain, a CD3z intracellular signaling domain, and Ori2 components simultaneously expressed through T2A. Compared with conventional CAR-T cells, Ori-CAR-001 has significantly higher proportion of memory stem T cells, which may translate to improved expansion and persistence in the body, thereby increasing their anti-tumor activity.

It is worth noting that, in addition to the preliminary safety and efficacy data of Ori-CAR-001 presented at 2021 ASCO (Free ASCO Whitepaper) annual meeting, OriginCell and study investigators also carried out translational medicine studies, in which the mode of administration, dosing, PK/PD, and biomarkers were explored. This will futher promote the application and development of cell therapy for solid tumors.

OriginCell will plan more clinical development programs to further explore Ori-CAR-001’s potential based on existing data, and the Investigational New Drug (IND) application with the National Medical Products Administration (NPMA) is currently in progress.

About ASCO (Free ASCO Whitepaper)

With more than 40,000 members from more than 100 countries, the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) is the world’s leading academic organization for physicians and oncology professionals caring for people with cancer. Its mission is to prevent cancer and improve cancer care, and promote the translation of research findings into clinical practice. By providing access to a global network of oncology expertise, the ASCO (Free ASCO Whitepaper) annual meeting is recognized as the world’s most influential academic congress in the field of oncology.

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Month: June 2021

Innovent Releases the Phase Ia/Ib Dose-Escalation Trial Results of IBI110 (anti-LAG-3) in Patients with Advanced Solid Tumors at ASCO Annual Meeting 2021

Innovent and AnHeart Release Preliminary Results from the Phase II TRUST Trial of Taletrectinib in ROS1 Fusion Positive NSCLC at the ASCO 2021 Annual Meeting

Innovent and HUTCHMED Release Phase 1b preliminary Results of TYVYT (Sintilimab Injection) plus Fruquintinib as a Third Line Treatment for Advanced Colorectal Cancer at ASCO Annual Meeting 2021

Innovent Releases Phase 1 Results of Pemigatinib in Chinese Patients with Advanced Solid Tumors at ASCO Annual Meeting 2021

OriginCell Therapeutics Presents Positive Results of GPC3 CAR-T in HCC Trial at the 2021 ASCO Annual Meeting