On January 25, 2018 Trovagene, Inc. (NASDAQ: TROV), a clinical-stage precision medicine biotechnology company, engaged in the development of targeted cancer therapies, reported the initiation of its Phase 2 clinical trial, evaluating the combination of PCM-075 and abiraterone acetate (Zytiga – Johnson & Johnson), in patients with metastatic Castration-Resistant Prostate Cancer (mCRPC) (Press release, Trovagene, JAN 25, 2018, View Source [SID1234523575]). This clinical trial is called UNITE, "A Phase 2 Study to Understand the Novel Combination of PCM-075 and Abiraterone and the Opportunity to Improve Treatment and Extend Response in Patients with Metastatic Castration-Resistant Prostate Cancer." The study will enroll 25 patients with mCRPC who are showing early signs of disease progression while on abiraterone/prednisone therapy and will evaluate the proportion of patients achieving disease control after 12 weeks of study treatment.
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"Initiation of the UNITE trial in mCRPC marks an important milestone in the clinical development of PCM-075 and builds upon the promising data from our completed and published Phase 1 trial in metastatic solid tumor cancers, as well as preclinical data demonstrating significant synergy for the combination of PCM-075 and abiraterone in CRPC tumor cells," said Bill Welch, Chief Executive Officer of Trovagene. "We are excited to be working with leading prostate cancer specialists and the Harvard Medical Institutions to conduct this trial and believe that the highly synergistic combination of PCM-075 and Zytiga has the potential to address the medical need to extend the benefit of response to treatment in patients with mCRPC."
Trovagene filed its Phase 2 metastatic Castration-Resistant Prostate Cancer protocol to the FDA and its active solid tumor IND in December, 2017. The Company successfully passed the 30-day FDA review period and has selected PRA Health Sciences as the Clinical Research Organization (CRO) to facilitate the trial.
About the Phase 2 mCRPC Clinical Study
In the UNITE multi-center, open-label, Phase 2 trial, the combination of PCM-075 with the standard dose of abiraterone and prednisone, all administered orally, will be evaluated to determine the proportion of patients achieving disease control after 12 weeks of study treatment. Disease control is defined by the lack of Prostate Specific Antigen (PSA) progression in patients who are showing signs of early progressive disease (rise in PSA, but minimally symptomatic or asymptomatic) while currently receiving androgen deprivation therapy (ADT) plus abiraterone and prednisone.
The Phase 2 UNITE trial will enroll 25 patients with metastatic Castration-Resistant Prostate Cancer showing signs of disease progression demonstrated by two rising PSA values separated by at least one week, while on abiraterone/prednisone therapy. The follow-up of patients will occur approximately every six weeks until disease progression in patients with stable disease, or better at the end of treatment assessments.
The Phase 2 trial also includes the following secondary observation endpoints:
The effects of PCM-075 in combination with abiraterone and prednisone on time to PSA progression in subjects with mCRPC;
The effects of PCM-075 in combination with abiraterone and prednisone on time to radiographic progression, based on the Prostate Cancer Working Group 3 (PCWG3) guidelines; and
The effects of PCM-075 in combination with abiraterone and prednisone on radiographic response (per Response Evaluation Criteria in Solid Tumors [RECIST] 1.1 criteria) in subjects with mCRPC and measurable disease.
About PCM-075
PCM-075 is a highly-selective adenosine triphosphate (ATP) competitive inhibitor of the serine/threonine polo-like-kinase 1 (PLK 1) enzyme, which is over-expressed in multiple hematologic and solid tumor cancers. Studies have shown that inhibition of polo-like-kinases can lead to tumor cell death, including a Phase 2 study in Acute Myeloid Leukemia (AML) where response rates up to 31% were observed when used in conjunction with a standard therapy for AML (low-dose cytarabine-LDAC) versus treatment with LDAC alone with a 13.3% response rate. A Phase 1 open-label, dose escalation safety study of PCM-075 has been completed in patients with advanced metastatic solid tumor cancers, and published in Investigational New Drugs.
PCM-075 only targets PLK1 isoform (not PLK2 or PLK3), is oral, has a 24-hour drug half-life with reversible on-target hematologic toxicities. Trovagene believes that targeting only PLK1 with reversible on-target activity and an improved dose/scheduling protocol can significantly improve on the long-term outcome observed in previous studies with a PLK inhibitor in AML.
PCM-075 has demonstrated synergy in preclinical studies with over 10 chemotherapeutic and target agents used in hematologic and solid tumor cancers, including Zytiga (abiraterone), FLT3 and HDAC inhibitors, taxanes, and cytotoxins. Trovagene believes the combination of its targeted PLK-1 inhibitor, PCM-075, with other compounds has the potential for improved clinical efficacy in Castration-Resistant Prostate Cancer (CRPC), Acute Myeloid Leukemia (AML), Non-Hodgkin Lymphoma (NHL), Triple Negative Breast Cancer (TNBC) and Adrenocortical Carcinoma (ACC).
About Castration-Resistant Prostate Cancer (CRPC)
Castration-Resistant Prostate Cancer (CRPC) is defined by disease progression despite androgen-deprivation therapy (ADT) and may present as one or any combination of a continuous rise in serum levels of prostate-specific antigen (PSA), progression of pre-existing disease, or appearance of new metastases. Prognosis is associated with several factors, including performance status, presence of bone pain, extent of disease on bone scan, and serum levels of alkaline phosphatase. Bone metastases occur in 90% of men with CPRC and can produce significant morbidity, including pain, pathologic fractures, spinal cord compression, and bone marrow failure. Paraneoplastic effects are also common, including anemia, weight loss, fatigue, hypercoagulability, and increased susceptibility to infection. Institution of treatment and the choice of systemic or local therapy depend on a number of factors.