On November 30, 2023 Protara Therapeutics, Inc. (Nasdaq: TARA), a clinical-stage company developing transformative therapies for the treatment of cancer and rare diseases, reported additional encouraging data from the Phase 1a dose-escalation component of its ongoing ADVANCED-1 clinical trial of TARA-002, the Company’s investigational cell-based therapy, for the treatment of patients with high-grade non-muscle invasive bladder cancer (NMIBC) (Press release, Protara Therapeutics, NOV 30, 2023, View Source [SID1234638069]). In addition, the study design for its ADVANCED-2 trial will be presented. The data will be featured during a poster session at the 24th Annual Meeting of the Society of Urologic Oncology (SUO) being held in Washington, D.C. from November 28, 2023 through December 1, 2023.
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"We are pleased to share additional data from the ADVANCED-1 trial which continue to support the potential for TARA-002 to provide a meaningful benefit to patients with NMIBC," said Jesse Shefferman, Chief Executive Officer of Protara Therapeutics. "We look forward to reporting preliminary results from the expansion portion of the ADVANCED-1 trial of TARA-002, which we expect in the first half of 2024, and remain focused on continuing to execute on the totality of our NMIBC program, including the ongoing ADVANCED-2 trial."
Study Results
TARA-002 was generally well tolerated at all three dose levels evaluated in the trial, and no dose limiting toxicities were observed. While a maximum tolerated dose was not determined, the Company has selected the 40KE1 dose for use in subsequent clinical trials.
The majority of reported adverse events were Grades 1 and 2 across all dose levels, and treatment-related adverse events, as assessed by study investigators, were in line with typical responses to bacterial immunopotentiation, and included fatigue, headache, fever, and chills. The most common urinary symptoms were urinary urgency, urinary frequency, urinary tract pain/burning, incomplete emptying, and bladder spasm. Most bladder irritations resolved soon after administration or in a few hours to a few days.
A total of nine patients were enrolled in the study, including three patients with carcinoma in situ (CIS) who reached the three-month efficacy assessment. Of those three patients with CIS, one heavily pre-treated Bacillus Calmette-Guérin (BCG)-unresponsive patient achieved a complete response (CR) at the 20KE dose, and tumor regression was observed in the other two patients.
New results from six patients with high-grade, non-invasive papillary (HGTa) tumors showed five of six patients with high-grade recurrence free survival (HGRFS) at week 12. The patient who did not achieve HGRFS was dosed at 10KE, the lowest dose of TARA-002 offered in the trial.
The Company remains on track to report preliminary results from the expansion portion of the ADVANCED-1 trial in the first half of 2024.
Supported by data from the Phase 1a study, the Company commenced ADVANCED-2 (NCT05951179), a Phase 2 open-label trial evaluating intravesical TARA-002 in up to 102 NMIBC patients with CIS (± Ta/T1) who are BCG-naïve (n=27) and BCG-unresponsive (n=75). Trial subjects received an induction with or without a reinduction course of six weekly intravesical instillations of TARA-002, followed by a maintenance course of three weekly installations every three months in the BCG-unresponsive cohort. Additional details on the trial design will be featured in a Trial in Progress poster at the SUO meeting.
A copy of the SUO posters will be available in the Events and Presentations section of the Company’s website: View Source
About Non-Muscle Invasive Bladder Cancer (NMIBC)
Bladder cancer is the sixth most common cancer in the U.S., with NMIBC representing approximately 80% of bladder cancer diagnoses. NMIBC is cancer found in the tissue that lines the inner surface of the bladder that has not spread into the bladder muscle. Approximately 65,000 patients are diagnosed with NMIBC in the U.S. each year.
About TARA-002
TARA-002 is an investigational cell therapy in development for the treatment of NMIBC and of LMs, for which it has been granted Rare Pediatric Disease Designation by the U.S. Food and Drug Administration. TARA-002 was developed from the same master cell bank of genetically distinct group A Streptococcus pyogenes as OK-432, a broad immunopotentiator marketed as Picibanil in Japan and approved in Taiwan by Chugai Pharmaceutical Co., Ltd. Protara has successfully shown manufacturing comparability between TARA-002 and OK-432.
When TARA-002 is administered, it is hypothesized that innate and adaptive immune cells within the cyst or tumor are activated and produce a strong immune cascade. Neutrophils, monocytes, and lymphocytes infiltrate the abnormal cells and various cytokines, including interleukins IL-2, IL-6, IL-8, IL-10, IL-12, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha are secreted by immune cells to induce a strong inflammatory reaction and destroy the abnormal cells.