On July 30, 2024 BioNTech SE (Nasdaq: BNTX, "BioNTech" or "the Company") reported positive topline data from the ongoing Phase 2 clinical trial (EudraCT No.: 2020-002195-12; NCT04526899) in patients with unresectable stage III or IV melanoma whose disease had progressed following anti-PD-(L)1-containing treatment (Press release, BioNTech, JUL 30, 2024, View Source [SID1234645149]). The randomized trial evaluates the clinical activity and safety of the investigational mRNA cancer immunotherapy BNT111 in combination with Libtayo (cemiplimab), an anti-PD-1 monoclonal antibody being developed by Regeneron, and assesses the two single agents alone.
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The trial met its primary efficacy outcome measure, demonstrating a statistically significant improvement in ORR in patients treated with BNT111 in combination with cemiplimab as compared to historical control in this indication and treatment setting. Both randomized monotherapy arms showed clinical activity. The ORR in the cemiplimab monotherapy arm was in line with the historical control of anti-PD-(L)1 or anti-CTLA-4 treatments in this patient group. The treatment was well tolerated and the safety profile of BNT111 in combination with cemiplimab in this trial was consistent with previous clinical trials assessing BNT111 in combination with anti-PD-(L)1-containing treatments. The Phase 2 trial will continue as planned to further assess the secondary endpoints, which were not mature at the time of the primary analysis.
"These Phase 2 results mark a significant step towards our vision of personalized cancer medicine. We envision mRNA as a centerpiece in future treatment paradigms for cancer, helping to address unmet medical needs, such as for patients with anti-PD-(L)1 refractory or resistant melanoma," said Prof. Özlem Türeci, M.D., Chief Medical Officer and Co-Founder at BioNTech. "These data are a proof of concept for us in three dimensions: First, for our decade-long improved mRNA cancer vaccine technology that uses uridine mRNA chemistry, a non-coding backbone that is engineered for optimal translational performance and our proprietary lipoplex formulation for delivery. Second, for our computational approaches for selecting suitable tumor antigens for our cancer indication-specific FixVac platform candidates. Third, for our strategy to combine synergistic modalities, in this case BNT111 with an established immune checkpoint treatment."
BioNTech and Regeneron plan to present data from this trial at a forthcoming medical conference. Further, the companies also intend to submit these data for publication in a peer reviewed scientific journal.
BNT111 is based on BioNTech’s fully owned FixVac platform that utilizes a fixed combination of four mRNA-encoded, tumor-associated antigens designed to trigger an innate and tumor-antigen-specific immune response against cancer cells expressing one or more of the respective tumor antigens. In 2021, BNT111 in combination with cemiplimab received Fast Track designation by the FDA for the treatment of anti-PD-1-refractory/relapsed, unresectable Stage III or IV melanoma. In the same year, the FDA granted Orphan Drug designation for BNT111 the treatment of stage IIB through IV melanoma.
About BioNTech’s oncology mRNA platforms
BioNTech has developed a range of mRNA platforms to establish a novel class of therapeutics and vaccines aimed at improving the health of people worldwide. In oncology, BioNTech utilizes five mRNA platforms. Each platform is designed with the aim to address unique challenges in oncology. BioNTech’s fully owned FixVac (Fix Combination Vaccine) platform candidates target specific cancer indications focusing on tumor-associated antigens which are shared by many cancer patients, while iNeST (Individualized Neoantigen Specific Immunotherapy) platform candidates are personalized immunotherapies tailored to the patient’s individual tumor profile. Both platforms utilize BioNTech’s proprietary optimized uridine mRNA ("uRNA") technology and the lipoplex ("LPX") delivery technology that the scientific founders and the researchers at BioNTech have pioneered over decades of scientific discoveries and technological advancements. These technologies are optimized for immunotherapy applications aiming to boost the immunostimulatory effect of the investigational immunotherapies and to trigger targeted immune responses against cancer cells expressing one or more of the respective encoded tumor antigens. Currently, six programs based on the Company’s FixVac and iNeST platforms are being evaluated in randomized Phase 2 trials in various solid tumor indications.
In addition to the FixVac and iNeST platforms, BioNTech is leveraging mRNA to deliver the building plan for targeted antibody, cytokine or immunomodulating protein approaches directly to the patient based on the Company’s RiboMab, RiboCytokine and Intratumoral Immunotherapy platforms aiming to help the body to produce its own therapeutic.
About advanced melanoma
Melanoma is amongst the leading causes of cancer-related deaths globally, responsible for roughly 58,000 deaths yearly. 1 Anti-PD-1 refractory/relapsed unresectable Stage III or IV melanoma is an aggressive form of melanoma, which remains particularly lethal. Current standard of care includes checkpoint inhibitor therapies that substantially improve the life expectancy of patients with melanoma.2,3 Despite advances in treatment, a high proportion of patients exhibit resistance to approved therapies, leading to limited options for those who progress on targeted or immunotherapy.4 The 5-year survival rate for patients with distant metastatic melanoma is approximately 35%.5 This underscores the significant unmet medical need.
About BNT111
BNT111 is an mRNA-based off-the-shelf cancer immunotherapy candidate for intravenous administration encoding a fixed set of four non-mutated melanoma-associated antigens (NY-ESO-1, MAGE-A3, tyrosinase, and TPTE) delivered as uridine mRNA-lipoplex formulation. Over 90% of patients with cutaneous melanomas express at least one of these antigens.6 Data of the Lipo-MERIT Phase 1 clinical trial have shown that BNT111 alone or in combination with blockade of the checkpoint inhibitor PD-1 induces novel antigen-specific anti-tumor immune responses and enhances pre-existing immune responses against the encoded melanoma-associated antigens in checkpoint inhibitor-experienced patients with unresectable melanoma.7 Further, these data have shown that the candidate can prime and activate T cells against the vaccine antigens that persisted for more than one year under continuous monthly vaccination.7 BNT111 is one of three clinical-stage FixVac product candidates within BioNTech’s development pipeline. The candidate is currently being evaluated in a Phase 2 clinical trial in combination with cemiplimab, in patients with anti-PD-1 refractory/relapsed unresectable Stage III or IV melanoma.
About the BNT111-01 trial
The BNT111-01 trial (EudraCT No.: 2020-002195-12; NCT04526899) is an open-label, randomized Phase 2 trial evaluating the efficacy of BNT111 and cemiplimab and the contribution of the single components in patients with anti-PD-1/PD-L1-refractory or relapsed, unresectable Stage III or IV cutaneous melanoma. Conducted across approximately 60 sites in 7 countries, this multi-site trial aims to demonstrate anti-tumor activity and ORR of the combination therapy as well as each agent alone. Additional endpoints include duration of response (DOR), disease control rate (DCR), overall survival (OS), safety, and tolerability. Patients were randomized in a 2:1:1 ratio to Arm 1 (BNT111 + cemiplimab), Arm 2 (BNT111 monotherapy), and Arm 3 (cemiplimab monotherapy), with up to 24 months of active treatment. More information on this trial can be found at clinicaltrials.gov or www.clinicaltrialsregister.eu.