On June 6, 2022 ImmunityBio, Inc. (NASDAQ: IBRX), a leading clinical-stage immunotherapy company, reported new positive data from the company’s pivotal Phase 2/3 trial for BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) carcinoma in situ (QUILT 3032) and Phase 2 trial in advanced pancreatic cancer (QUILT 88) (Press release, ImmunityBio, JUN 6, 2022, View Source [SID1234615616]). The results, which were presented during the 2022 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting, demonstrate the strong and diverse growth of ImmunityBio’s immunotherapy platform that includes an IL-15 superagonist (N-803), adenovirus vaccine platform, and engineered off-the-shelf natural killer (NK) cell therapy. Together with the company’s self-amplifying RNA and yeast platforms, and Toll receptor activators, along with clinical progress across a range of highly challenging cancer types and commercial-scale manufacturing capabilities, ImmunityBio believes that it is well positioned to change the paradigm of care in cancer and infectious disease.
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"The theme at this year’s ASCO (Free ASCO Whitepaper) conference finally is about combination therapy and immunotherapy. We have been focused on this approach for the past decade and the trial results we presented at this year’s ASCO (Free ASCO Whitepaper) conference are validation that the approach of harnessing the patient’s immune system with a combination of NK and T-cell activation has clinical benefit," said Patrick Soon-Shiong, M.D., Executive Chairman and Global Chief Scientific and Medical Officer at ImmunityBio. "We have, at risk, made the investments to build GMP commercial-scale manufacturing for our platforms and are now positioned to launch QUILT trials in earlier first-line, neoadjuvant and even preventative settings."
The data demonstrate a potential new option for BCG-unresponsive non-muscle invasive bladder cancer patients who were treated with Bacillus Calmette-Guérin (BCG) plus N-803 (Anktiva) and the doubling of historic overall survival rates in patients with advanced pancreatic cancer who were treated with the Nant Cancer Vaccine, N-803 (Anktiva, IL-15 cytokine fusion protein), and off-the-shelf PDL1-targeted high-affinity NK cell (PDL1 t-haNK) infusion.
"Collectively, bladder cancer and pancreatic cancer claim more than half a million lives globally each year, with many patients failing to respond to the current standards of care," said Sandeep Bobby Reddy, M.D., Chief Medical Officer at ImmunityBio. "In dozens of studies, we have shown that N-803 proliferates NK and T cells and thus serves as an enhancing secondary boost, augmenting the immunological response when given in combination with BCG or a checkpoint inhibitor. This mechanism of action of inducing trained innate immune memory, through the combination of N-803 and a prime, contributes we believe to the compelling results we’re seeing in these important trials."
The study results presented at ASCO (Free ASCO Whitepaper) are summarized below:
QUILT 3032 BCG-unresponsive NMIBC CIS (Cohort A)
In an oral presentation on June 3, 2022, Principal Investigator Karim Chamie, M.D., Associate Professor of Urology at UCLA, presented the final clinical results of pivotal trial of IL-15RαFc superagonist N-803 with BCG in BCG-unresponsive CIS and papillary non-muscle-invasive bladder cancer (Abstract #4508).
Link to video presentation on ecancer.org:
Excellent safety and tolerability profile of N-803 + BCG for CIS
1% treatment-related SAEs
0% immune-related AEs
0% grade 4 and 5 AE
71% Complete remission (CR) rate at anytime
26.6 months median durable complete remission
96% Avoidance of bladder cancer progression at 24 months in responders
91% Avoidance of cystectomy at 24 months in responders
100% Bladder cancer-specific overall survival at 24 months
Favorable & familiar dosing schedule with activity localized to the bladder
QUILT 3.032 is an open-label, three cohort, multicenter Phase 2/3 study of intravesical BCG plus N-803 in patients with BCG-unresponsive high-grade NMIBC (NCT03022825) and was opened in 2017. The primary endpoint for Cohort A of this Phase 2/3 study is incidence of complete response (CR) of CIS at any time. The U.S. Food and Drug Administration (FDA) previously granted N-803 Breakthrough Therapy and Fast Track designations when used in combination with Bacillus Calmette-Guerin (BCG) for the treatment of BCG-unresponsive NMIBC CIS. On May 23, 2022, ImmunityBio announced that it had submitted a Biologics License Application (BLA) to the FDA for N-803 plus BCG for the treatment of BCG-unresponsive non-muscle invasive bladder cancer (NMIBC) carcinoma in situ (CIS) with or without Ta or T1 disease.
QUILT 88 Pancreatic Cancer
The study results were presented on June 4, 2022 by the Principal Investigator Dr. Tara Seery of Hoag Cancer Center in a poster session titled Phase 2 clinical trial of DAMP inducers combined with IL15 superagonist, N-803, and anti–PD-L1 NK cell therapy more than doubles historical overall survival in patients with third- to sixth-line advanced pancreatic cancer (Abstract #4147, Poster #132).
Nant Cancer Vaccine (NCV) more than doubled median OS versus historical OS (Manax ASCO (Free ASCO Whitepaper) GI 2019) of 3 months after >2L
Median overall survival in 3rd line subjects (n=34) was 6.2 months (95% CI: 4.9, 9.8)
Overall survival for ITT population (N=78) of 3rd, 4th and 5th line is 5.8 months (95% CI: 4.0, 6.9)
Treatment-related (TR) SAEs were uncommon (6%), no TR deaths were reported
All treatments were performed as outpatient
Treatment ongoing for 25 patients
"For the first time, we are seeing clinical efficacy of immunotherapy in pancreatic cancer. Lung, Kidney, Head and Neck cancer, melanoma and many other cancers have been successfully treated with immunotherapy, but pancreatic cancer has been left behind in the revolution. Now, with ImmunityBio’s combination immunotherapy there is renewed hope for patients with this dreaded disease," said Dr. Seery. "We are hopeful to be able to present similar results at future ASCO (Free ASCO Whitepaper) conferences in the other cohorts of this trial in which we continue to enroll patients."
QUILT 88 is a Phase 2, randomized, three-cohort, open-label study evaluating the comparative efficacy and overall safety of standard-of-care chemotherapy versus low-dose chemotherapy in combination with PD-L1 t-haNK, N-803, and aldoxorubicin in subjects with locally advanced or metastatic pancreatic cancer (NCT04390399). Each treatment setting, as well as each first- and second-line or later maintenance treatment, will be evaluated independently as Cohorts A, B, and C, respectively, with Cohorts A and B having independent experimental and control arms. The study is expected to enroll 328 subjects across all three cohorts (63 of 80 participants are currently enrolled in Cohort C, third-line or greater). The primary objective of Cohorts A and B is progression-free survival (PFS) per RECIST V1.1, and the objective of Cohort C is overall survival (OS). Secondary objectives include initial safety and additional efficacy measures, including overall response rate (ORR), complete response (CR) rate, durability of response (DoR), disease control rate (DCR), and overall survival (OS).
Currently, four trial sites have been activated: Hoag Memorial Hospital Presbyterian in Orange County, Calif., The Chan Soon-Shiong Institute for Medicine in Los Angeles County, Calif., Avera McKennan Hospital and University Health Center in Sioux Falls, South Dakota, which serves patients in the tri-state area (Iowa, Nebraska and South Dakota); and Astera Cancer Care, East Brunswick, N.J.