New Study Highlights Progress in Drug Development Landscape for Lung Cancer

On June 22, 2022 LUNGevity Foundation, the nation’s leading lung cancer-focused nonprofit organization, reported a study analyzing the current global lung cancer drug development landscape (Press release, LUNGevity Foundation, JUN 22, 2022, View Source [SID1234616195]). The manuscript, which was recently published in the Journal of Thoracic Oncology, reveals the impressive progress that has been made in the lung cancer therapy space and points to an increased need for comprehensive biomarker testing at earlier stages of the disease.

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The authors of the report curated a comprehensive list of lung cancer therapeutic entities (TEs) in preclinical development and clinical trials using publicly available sources. Of the TEs identified, the majority are focused on non-small cell lung cancer and are in the clinical trial stage of development. Targeted therapies for major oncogenic driver targets, such as ALK, EGFR, KRAS, and BRAF, also dominate the landscape.

"Lung cancer has been a proving ground for precision medicine, and we’ve seen several improvements in targeted therapies in recent years," said Amy Moore, PhD, vice president of global engagement and patient partnerships at LUNGevity. "However, we need to consider how these new drugs add value to patients and improve outcomes. Having a holistic landscape of these drugs will help drive future innovation in the areas that need it most."

The report found that new treatment approaches are being developed and tested for both non-small cell and small cell lung cancer, including new classes of drugs such as protein degraders. The analysis also indicates that lung cancer treatment will become increasingly biomarker driven, even for immunotherapy regimens. Also, as more targeted therapies and immunotherapies are being developed for early-stage lung cancer, there will be an increased need for biomarker testing to be implemented at earlier stages of the disease.

The analysis also found that, while there are a wide variety of therapies in development for both small cell lung cancer and non-small cell lung cancer, many of the current therapies in development focus on PD-1 inhibition, for which there are already approved drugs. As targeted therapies continue to be developed, it is important to consider whether there will be enough patients to fill clinical trial recruitment needs and whether there will be oversaturation in the market.

"It’s been highly reassuring to see the number of new breakthroughs for lung cancer therapies, especially for early-stage disease. Researchers are working hard to develop new treatment options so that no patient is left behind," said Upal Basu Roy, PhD, MPH, executive director of research at LUNGevity. "This underscores the need for increased and sustained lung cancer research funding to maintain momentum in this space."

The full text of the manuscript can be accessed from the JTO website. This paper complements LUNGevity’s other work to educate patients about lung cancer treatment options, such as the Lung Cancer Patient Gateways, which provide patients with information on FDA-approved therapies, as well as tools to find clinical trials for their specific subtype of cancer.

Novartis Tafinlar + Mekinist receives FDA approval for first tumor-agnostic indication for BRAF V600E solid tumors

On June 22, 2022 Novartis reported the US Food and Drug Administration (FDA) granted accelerated approval for Tafinlar (dabrafenib) + Mekinist (trametinib) for the treatment of adult and pediatric patients 6 years of age and older with unresectable or metastatic solid tumors with BRAF V600E mutation who have progressed following prior treatment and have no satisfactory alternative treatment options1,2 (Press release, Novartis, JUN 22, 2022, View Source;mekinist-receives-fda-approval-for-first-tumor-agnostic-indication-for-braf-v600e-solid-tumors-301573580.html [SID1234616193]). In accordance with the Accelerated Approval Program, continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial(s). Tafinlar + Mekinist is the first and only BRAF/MEK inhibitor to be approved with a tumor-agnostic indication for solid tumors carrying the BRAF V600E mutation, which drives tumor growth in more than 20 different tumor types, and it is the only BRAF/MEK inhibitor approved for use in pediatric patients1,2.

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"The combination of dabrafenib and trametinib demonstrated meaningful efficacy in multiple BRAF-positive tumor types, including in some patients with rare cancers who have no other treatment options available," said principal investigator Dr. Vivek Subbiah, M.D., associate professor of Investigational Cancer Therapeutics and center medical director of the Clinical Center for Targeted Therapy, Division of Cancer Medicine, at The University of Texas MD Anderson Cancer Center in Houston, Texas. "Physicians should consider a BRAF test as a routine diagnostic step that could enable a new option for treating patients with many solid tumors."

The FDA approval was based on clinical efficacy and safety demonstrated in three clinical trials. In the Phase II ROAR (Rare Oncology Agnostic Research) basket study and the NCI-MATCH Subprotocol H study, Tafinlar + Mekinist resulted in overall response rates of up to 80% in patients with BRAF V600E solid tumors, including high- and low-grade glioma, biliary tract cancer and certain gynecological and gastrointestinal cancers. An additional study (Study X2101) demonstrated the clinical benefit and acceptable safety profile of Tafinlar + Mekinist in pediatric patients1,2.

"Tackling cancer is complex, which is why it is so important that we continue to follow the science as we pursue meaningful advances and new approaches to treating cancer," said Reshema Kemps-Polanco, Head, Novartis Oncology US. "We are grateful to the patients, and to the multitude of individuals and teams working together to make this latest approval possible as we strive to do more for more people living with cancer."

The safety profile of Tafinlar + Mekinist observed in these studies was consistent with the known safety profile in other approved indications.

BRAF mutations have been identified as drivers of cancer growth across a wide range of solid tumors, including in rare cancer types that can be challenging to study in Phase III trials and often have limited treatment options3,4. BRAF V600E is the most common type of BRAF mutation, accounting for up to 90% of BRAF-mutant cancers3.

Full prescribing information for Tafinlar + Mekinist can be found at
View Source and
View Source

About Tafinlar + Mekinist
The combination of Tafinlar + Mekinist, the worldwide targeted therapy leader in BRAF/MEK-inhibition research and patients reached, may help to slow tumor growth by blocking signals associated with the BRAF and MEK kinases that are implicated in the growth of various types of cancer1-5. Tafinlar + Mekinist has been studied in more than 6,000 BRAF-positive patients in more than 20 ongoing and completed trials, including in pediatric patients 1 year of age and older, and has been prescribed to more than 200,000 patients worldwide5.

Tafinlar + Mekinist is also approved for use in BRAF-positive unresectable or metastatic melanoma, as an adjuvant treatment for BRAF-positive melanoma after surgery, in BRAF-positive metastatic non-small cell lung cancer, and in BRAF-positive anaplastic thyroid cancer1,2. Tafinlar + Mekinist is not indicated for treatment of patients with colorectal cancer or for treatment of patients with wild-type BRAF solid tumors.

Indication and Important Safety Information

TAFINLAR and MEKINIST are prescription medicines that can be used in combination to treat people with a type of skin cancer called melanoma:

that has spread to other parts of the body (metastatic) or cannot be removed by surgery (unresectable), and
that has a certain type of abnormal "BRAF" (V600E or V600K mutation-positive) gene
TAFINLAR and MEKINIST are prescription medicines that can be used in combination to help prevent melanoma that has a certain type of abnormal "BRAF" gene from coming back after the cancer has been removed by surgery.

TAFINLAR and MEKINIST are prescription medicines that can be used in combination to treat a type of lung cancer called non-small cell lung cancer (NSCLC) that has spread to other parts of the body (metastatic NSCLC), and that has a certain type of abnormal "BRAF V600E" gene.

TAFINLAR and MEKINIST are prescription medicines that can be used in combination to treat a type of thyroid cancer called anaplastic thyroid cancer (ATC):

that has spread to other parts of the body and you have no satisfactory treatment options and
that has a certain type of abnormal "BRAF" gene
TAFINLAR and MEKINIST are prescription medicines that can be used in combination to treat solid tumors in adults and children 6 years of age and older:

that cannot be removed by surgery or have spread to other parts of the body, and that have gotten worse (progressed) and you have no satisfactory treatment options and
that have a certain type of abnormal "BRAF" gene
The effectiveness of TAFINLAR and MEKINIST in these patients is based on 2 adult studies and 1 pediatric study that measured 2 types of response to treatment (response rate and duration of response). No clinical information is available to show if these patients treated with TAFINLAR and MEKINIST live longer or if their symptoms improve. Ongoing studies exist to determine how TAFINLAR and MEKINIST works over a longer period.

TAFINLAR, in combination with MEKINIST, is not for use in treating people with colorectal cancer or wild-type BRAF solid tumors. MEKINIST should not be used to treat people who already have received a BRAF inhibitor for treatment of their melanoma and it did not work or is no longer working.

Your health care provider will perform a test to make sure that TAFINLAR and MEKINIST, in combination, are right for you.

It is not known if TAFINLAR used in combination with MEKINIST is safe and effective in children younger than 6 years of age.

TAFINLAR and MEKINIST, in combination, may cause serious side effects such as the risk of new cancers, including both skin cancer and nonskin cancer. Patients should be advised to contact their health care provider immediately for any skin changes, including a new wart, skin sore, or bump that bleeds or does not heal, or a change in the size or color of a mole.

When TAFINLAR is used in combination with MEKINIST, it can cause serious bleeding problems, especially in the brain or stomach, that can lead to death. Patients should be advised to call their health care provider and get medical help right away if they have any signs of bleeding, including headaches, dizziness, or feeling weak, coughing up blood or blood clots, vomiting blood or their vomit looks like "coffee grounds," or red or black stools that look like tar.

MEKINIST, alone or in combination with TAFINLAR, can cause inflammation of the intestines or tears in the stomach or intestines that can lead to death. Patients should report to their health care provider right away if they have any of the following symptoms: bleeding, diarrhea (loose stools) or more bowel movements than usual, stomach-area (abdomen) pain or tenderness, fever, or nausea.

TAFINLAR, in combination with MEKINIST, can cause blood clots in the arms or legs, which can travel to the lungs and can lead to death. Patients should be advised to get medical help right away if they have the following symptoms: chest pain, sudden shortness of breath or trouble breathing, pain in their legs with or without swelling, swelling in their arms or legs, or a cool or pale arm or leg.

The combination of TAFINLAR and MEKINIST can cause heart problems, including heart failure. A patient’s heart function should be checked before and during treatment. Patients should be advised to call their health care provider right away if they have any of the following signs and symptoms of a heart problem: feeling like their heart is pounding or racing, shortness of breath, swelling of their ankles and feet, or feeling lightheaded.

TAFINLAR, in combination with MEKINIST, can cause severe eye problems that can lead to blindness. Patients should be advised to call their health care provider right away if they get: blurred vision, loss of vision, or other vision changes, seeing color dots, halo (seeing blurred outline around objects), eye pain, swelling, or redness.

TAFINLAR, in combination with MEKINIST, can cause lung or breathing problems. Patients should be advised to tell their health care provider if they have new or worsening symptoms of lung or breathing problems, including shortness of breath or cough.

Fever is common during treatment with TAFINLAR in combination with MEKINIST but may also be serious. In some cases, chills or shaking chills, too much fluid loss (dehydration), low blood pressure, dizziness, or kidney problems may happen with the fever. Patients should be advised to call their health care provider right away if they get a fever.

Rash and other skin reactions are common side effects of TAFINLAR in combination with MEKINIST. In some cases, these rashes and other skin reactions can be severe or serious, may need to be treated in a hospital, or lead to death. Patients should be advised to call their health care provider if they get any of the following symptoms: blisters or peeling of skin, mouth sores, blisters on the lips or around the mouth or eyes, high fever or flu-like symptoms, and/or enlarged lymph nodes.

Some people may develop high blood sugar or worsening diabetes during treatment with TAFINLAR in combination with MEKINIST. For patients who are diabetic, their health care provider should check their blood sugar levels closely during treatment. Their diabetes medicine may need to be changed. Patients should be advised to tell their health care provider if they have increased thirst, urinate more often than normal, or produce an increased amount of urine.

TAFINLAR may cause healthy red blood cells to break down too early in people with glucose-6-phosphate dehydrogenase deficiency. This may lead to a type of anemia called hemolytic anemia, where the body does not have enough healthy red blood cells. Patients should be advised to tell their health care provider if they have yellow skin (jaundice), weakness or dizziness, or shortness of breath.

TAFINLAR, in combination with MEKINIST, can cause new or worsening high blood pressure (hypertension). A patient’s blood pressure should be checked during treatment. Patients should be advised to tell their health care provider if they develop high blood pressure, their blood pressure worsens, or if they have severe headache, lightheadedness, blurry vision, or dizziness.

For women of reproductive potential, TAFINLAR and MEKINIST, in combination, can harm your unborn baby. Your health care provider will do a test to see if you are pregnant before starting treatment with TAFINLAR and MEKINIST in combination. Use effective birth control (contraception) during treatment with TAFINLAR and MEKINIST in combination, and for 4 months after stopping treatment with TAFINLAR and MEKINIST.

Men (including those who have had a vasectomy) should use condoms during sexual intercourse during treatment with TAFINLAR and MEKINIST and for at least 4 months after the last dose of TAFINLAR and MEKINIST.

The most common side effects for patients with metastatic melanoma receiving the combination are pyrexia, nausea, rash, chills, diarrhea, headache, vomiting, hypertension, arthralgia, peripheral edema, and cough. The most common side effects for patients with stage III melanoma as adjuvant therapy receiving the combination are pyrexia, tiredness, nausea, headache, rash, chills, diarrhea, vomiting, arthralgia, and myalgia. The most common side effects for patients with NSCLC receiving the combination are pyrexia, tiredness, nausea, vomiting, diarrhea, dry skin, decreased appetite, edema, rash, chills, hemorrhage, cough, and dyspnea. The most common side effects for adults with solid tumors that cannot be removed by surgery or have spread to other parts of the body who are receiving the combination are fever, tiredness, nausea, rash, chills, headache, bleeding, cough, vomiting, constipation, diarrhea, muscle and or joint aches, and swelling of arms and legs. The most common side effects for children with solid tumors that cannot be removed by surgery or have spread to other parts of the body who are receiving the combination are fever, rash, vomiting, tiredness, dry skin, cough, diarrhea, acne, headache, stomach-area (abdomen) pain, nausea, bleeding, constipation, and skin infection around fingernails or toenails.

Nucleix Expands EU Label Indication of Bladder EpiCheck® to Include the Detection of Primary Bladder Cancer and Detection of Primary and Recurrent Upper Tract Urinary Cancer

On June 22, 2022 Nucleix, a liquid biopsy company revolutionizing cancer treatment by detecting the disease earlier, reported that the company has expanded the European Union (EU) label indication of its Bladder EpiCheck test (Press release, Nucleix, JUN 22, 2022, View Source [SID1234616192]). Bladder EpiCheck detects DNA methylation patterns in urine that are associated with urothelial cancer.

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The technology was initially indicated for use as a non-invasive method for the monitoring of tumor recurrence in conjunction with cystoscopy in patients previously diagnosed with bladder cancer. The current update expands the label indication to also include aiding in the detection of primary bladder cancer and upper tract urothelial carcinoma (UTUC) in patients presenting with hematuria and/or other urinary tract symptoms and/or findings with a suspicion of malignancy, and the detection of recurrent UTUC, in conjunction with standard diagnostic procedures.

Bladder cancer is the fifth most common cancer in Europe with more than 200,000 new cases of the disease diagnosed annually.1 With bladder cancer, patients typically experience symptoms of traces of blood in the urine, called hematuria, though this is not usually visible to the naked eye.2 Up to 30% of adults will experience hematuria at some point in their life, so it is crucial to quickly and non-invasively determine if the symptom is associated with bladder cancer, to ensure a urological workup is conducted immediately.2 Bladder EpiCheck demonstrated 88% sensitivity in detecting the primary high-risk bladder cancer, with a specificity of 98% or more.

"The current workup of hematuria is invasive, costly and usually performed too late, due to delayed referrals to urologists, all the while symptoms can worsen and diagnosis of the disease is delayed when treatment is critical," said Eli Frydman, Ph.D. MBA, President EMEA of Nucleix. "With this expanded label indication and high specificity of Bladder EpiCheck in this population, we’re able to offer a cost-effective, non-invasive approach to triage hematuria patients and help identify bladder cancer early."

Two recently published studies evaluated the performance of Bladder EpiCheck in the detection of primary and recurrent UTUC including 220 patients.3,4 Bladder Epicheck showed high-grade sensitivity of 96-98% and specificity of 81-100% in urine collected from the ureter. One of the studies also reported high-grade sensitivity of 71% and specificity of 81% in bladder urine. In both studies, test sensitivity was higher than cytology.

"Identifying patients with high-grade UTUC early is critical – if missed, the disease can progress to metastases very quickly and the standard treatment, which is the removal of ureter and kidney, can lead to considerable morbidity," said Aharona Shuali, M.D., Vice President of Medical Affairs at Nucleix. "We are encouraged by this expanded label indication because of its potential impact on patients. Bladder EpiCheck delivers highly accurate results in a non-invasive way and could play an important role in the diagnosis and follow-up of this disease, particularly in ruling-out high-grade disease."

About Bladder EpiCheck

Bladder EpiCheck provides patients and clinicians with a simple, objective urine test to detect primary and recurrent bladder and upper urinary tract cancers. The test analyzes subtle disease-specific changes in DNA methylation markers, with sensitivity of 91-96% of high-grade cancers. Bladder EpiCheck demonstrated negative predictive value (NPV) of 99% for high-grade cancer, meaning that when receiving a negative Bladder EpiCheck result, there is 99% chance that no high-grade cancer is present.5 Overall specificity of Bladder EpiCheck is 84%, 81% and 98% for recurrent bladder cancer, UTUC and primary cancers, respectively, ensuring a low rate of false positive results. Bladder EpiCheck is intended for use as a non-invasive method for detection of urinary tract cancers in conjunction with standard methods. Bladder EpiCheck is CE-marked and commercially available in Europe. The test is not available for sale in the United States.

Ikonisys Announces the First Sale of the Ikoniscope20 Solution Including the Newly Added Reagents to Comprehensive Urology

On June 22, 2022 Ikonisys SA (Code ISIN: FR00140048X2 / Mnémonique: ALIKO) (Paris:ALIKO), a company specializing in the early and accurate detection of cancer with a unique fully-automated solution for medical diagnostic labs, reported the first sale of an Ikoniscope20 digital fluorescence microscope solution together with its optimized reagents (Press release, Ikonisys, JUN 22, 2022, View Source [SID1234616190]).

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As announced during the IPO of Ikonisys, the primary initial focus of the commercialization strategy for the United States is to convert current customers into Ikoniscope20 users. An active user of Ikonisys’ former Ikoniscope Gen1 platform up to today, Comprehensive Urology has decided to upgrade its system to the Ikoniscope20 and at the same time to utilize the optimized reagents provided by Ikonisys to perform its bladder cancer molecular diagnosis.

Ikonisys’ business model is to sell a fully integrated solution comprising hardware, software and consumables. Reagents, needed to perform each single test, are an essential part of the molecular diagnostics market. Ikonisys is offering clients optimized reagents at a competitive rate, ensuring greater performance with the ikoniscope20.

The Ikoniscope20 combined with Ikonisys’ FISH probes will automate early bladder cancer diagnosis, allowing Comprehensive Urology to perform several thousand tests per year.

Ellipses Announces FDA Clearance of IND Application for EP0031 for Patients With Advanced RET-altered Malignancies

On June 22, 2022 Ellipses Pharma ("Ellipses"), a global drug development company focused on accelerating the development of cancer medicines and treatments through an innovative drug development model, reported that the U.S. Food and Drug Administration (FDA) has cleared the company’s Investigational New Drug (IND) application for EP0031, a next generation selective RET inhibitor (SRI) (Press release, Ellipses Pharma, JUN 22, 2022, View Source [SID1234616189]).

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Developed in partnership with Sichuan Kelun-Biotech Pharmaceutical Co., Ltd (Kelun-Biotech), EP0031 (known as A400 when in conjunction with Kelun-Biotech’s ongoing regional development) is a next generation SRI under development for the treatment of RET-altered cancers, with the first trials to focus on thyroid and non-small cell lung cancer. Kelun-Biotech has already commenced a clinical trial of EP0031 (A400) in China, which is progressing rapidly towards the dose expansion stage.

Approval of the IND is a significant step in the initiation of a global, modular Phase 1/2 trial to evaluate the safety, tolerability and efficacy of EP0031 in patients with advanced RET-altered cancers including patients who have not received prior treatment with first generation SRIs. The trial will include sites across the US and Europe and the first patient is anticipated to enter the dose escalation part of the trial in Q3 2022. Further regulatory submissions in the UK and EU are anticipated shortly to support the initiation of the trial in countries outside of the US.

Dr Rajan Jethwa, Chief Executive Officer & Founder of Ellipses, commented:
"EP0031 offers the potential for a promising new treatment option that seeks to address some of the issues with first generation SRIs. Next generation SRIs offer the potential to expand the armamentarium against RET-driven cancers and further improve patient outcomes. This IND marks another important step for Ellipses. Our strategy is to advance the most promising cancer treatments to the clinic as soon as possible, and the clearance of this IND will allow us to rapidly move forward with our planned clinical trial of EP0031."

ENDS

About EP0031 (A400)
EP0031 is a potent next generation SRI with broad activity against common RET fusions and mutations, including solvent front resistance mutations. Therefore, EP0031 (A400) may overcome resistance mechanisms to first generation SRIs. In preclinical studies, EP0031 (A400) demonstrated favourable inhibitory activity against key RET kinases in-vitro and in-vivo. EP0031 (A400) also demonstrated good penetration of the blood brain barrier in animal models. An IND application for EP0031 (A400) was approved by China’s National Medicinal Products Administration (NMPA) in June 2021 and a Phase 1/2 trial is ongoing in China. In March 2021, Kelun-Biotech granted Ellipses an exclusive license for EP0031 (A400) in certain territories including the US and Europe, with Kelun-Biotech retaining certain rights in Greater China and part of the Asia-Pacific region.