On August 7, 2023 Telix Pharmaceuticals Limited (ASX: TLX, Telix, the Company) reported that first patient has been dosed in a Phase I study of the Company’s investigational therapy TLX101 (4-L-[131I] iodo-phenylalanine, or 131I-IPA) in combination with post-surgical standard of care treatment in patients with newly diagnosed glioblastoma, the most common and aggressive form of primary brain cancer (Press release, Telix Pharmaceuticals, AUG 7, 2023, View Source [SID1234633890]).
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IPAX-2 (ClinicalTrials.gov Identifier: NCT05450744) is a Phase I dose escalation study to confirm safety profile of TLX101 in combination with external beam radiation therapy (EBRT) and temozolomide in front-line glioblastoma. Twelve patients are expected to be recruited to evaluate whether the observed safety and drug interaction profile remains suitable in this setting before progressing to a proof-of-concept Phase II study.
IPAX-2 is being conducted at six sites across Australia, New Zealand and Europe. The study will build on data generated in IPAX-1 (ClinicalTrials.gov Identifier NCT03849105), which reported final results in September 2022.[1] The IPAX-1 study met its primary objective demonstrating safety and tolerability profile of intravenous 131I-IPA administered concurrently with second line EBRT. The study also delivered encouraging preliminary therapeutic effect, demonstrating a median overall survival of 13 months from the initiation of treatment in the recurring setting, or 23 months from initial diagnosis.
Professor Josef Pichler, Kepler University Hospital, Austria and Principal Investigator in the IPAX-2 study said, "Promising efficacy data observed in IPAX-1 clearly warrants further investigation in an earlier setting. We are therefore pleased to be exploring Telix’s glioblastoma therapy candidate in newly diagnosed patients, to accelerate development in this underserved disease area with few effective treatment options."
Dr. Colin Hayward, Telix Chief Medical Officer added, "Commencing this study supports Telix’s goal to expedite new radiopharmaceutical therapies in areas of unmet need. With IPAX-2, we are taking the development of TLX101 into front-line glioblastoma for the first time, and excited to see the potential impact of targeted radiation in patients after initial surgery."
Telix’s investigational positron emission tomography (PET) agent TLX101-CDx (18F-FET) will be used for imaging in the study to identify participants with over-expressed LAT-1 as suitable candidates for 131I-IPA therapy, and to provide baseline and follow up information on tumour response and progression.
In parallel to IPAX-2, TLX101 is being further investigated in the recurrent setting in the investigator-initiated Phase II IPAX-Linz study, which dosed a first patient in November 2022[2] and has now exceeded 70% of the patient enrolment target.
About TLX101
TLX101 (4-L-[131I] iodo-phenylalanine, or 131I-IPA) is one of Telix’s lead therapeutic clinical programs and has been granted orphan drug designation in the United States and Europe for glioblastoma therapy. TLX101 targets a membrane transport protein called L-type amino acid transporter 1 (LAT-1) that is typically highly expressed in glioblastoma. TLX101 is a novel approach that is readily able to pass through the blood-brain barrier, the normal protective barrier that prevents many potential drug candidates entering the brain.
About TLX101-CDx (18F-FET)
18F-FET has been widely used in clinical research settings while recently, new practice guidelines have been developed for the imaging of gliomas using PET with radiolabelled amino acids, of which 18F-FET is a key enabling radiopharmaceutical.[3] 18F-FET targets the amino acid transport system L (LAT) and is therefore highly suitable for use as a complementary diagnostic agent to TLX101. Telix is preparing to file a new drug application for TLX101-CDx with the United States Food and Drug Administration (FDA) during 2023, in preparation for U.S. commercial launch in 2024, pending regulatory approval.