1stOncology™: Cancer Intelligence Service – Page 16316 – 1stOncology is recognized as a Top 10 Global Pharma Analytic Provider

First patient treated in phase I/II trial with IPH2201 in ovarian cancer

On September 28, 2015 Innate Pharma SA (the "Company" – Euronext Paris: FR0010331421 – IPH) reported that the first patient was treated in the Phase I/II trial testing IPH2201, a first-in-class NKG2A checkpoint inhibitor, as a single agent in platinum resistant or sensitive patients with high grade ovarian cancer (Press release, Innate Pharma, SEP 26, 2015, View Source [SID:1234507571]). The trial is sponsored by NCIC Clinical Trials Group and conducted in Canada. Thirty-eight (38) patients are planned to be enrolled.

Schedule your 30 min Free 1stOncology Demo!
Discover why more than 1,500 members use 1stOncology™ to excel in:

Early/Late Stage Pipeline Development - Target Scouting - Clinical Biomarkers - Indication Selection & Expansion - BD&L Contacts - Conference Reports - Combinatorial Drug Settings - Companion Diagnostics - Drug Repositioning - First-in-class Analysis - Competitive Analysis - Deals & Licensing

Schedule Your 30 min Free Demo!

Pierre Dodion, Chief Medical Officer of Innate Pharma, said: "There is evidence to suggest that the immune system plays a key role in ovarian cancer. Furthermore, there is a body of data indicating that ovarian cancers may at least partly escape immune surveillance via expression of HLA-E, the ligand of NKG2A. Once a patient relapses after first line treatment, the disease is ultimately fatal in virtually all cases. In addition, the development of new active agents in ovarian cancer has been slow. We are therefore very enthusiastic to test IPH2201 in patients with such a high medical need".

This is the second out of four trials announced by Innate Pharma, included in the frame of the global co-development and commercialization agreement signed with AstraZeneca for IPH2201 in April 2015. The first trial (IPH2201-201) is an open label Phase II trial testing IPH2201 as a single agent in a pre-operative setting of squamous cell carcinoma of the oral cavity (OCSCC). The first patient was treated at the Charité Comprehensive Cancer Center (CCCC), Berlin, Germany, in December 2014.

As part of Innate’s program, two further trials, testing IPH2201 in combination with ibrutinib in patients with Chronic Lymphocytic Leukemia, and with cetuximab in patients with Head and Neck cancer, will start in 2015. The initial development plan also includes Phase II combination clinical trials with IPH2201 and durvalumab (MEDI4736), an anti-PD-L1 immune checkpoint inhibitor, in solid tumors, which will be performed by AstraZeneca.

Epizyme Announces Updated Tazemetostat Phase 1 Data Showing Clinical Activity in a Broader Range of Adults With INI1-Negative and SMARCA4-Negative Solid Tumors

On September 28, 2015 Epizyme, Inc. (NASDAQ: EPZM) reported results from the ongoing phase 1 trial of tazemetostat, its first-in-class EZH2 inhibitor (Press release, Epizyme, SEP 26, 2015, View Source [SID:1234507562]). The data showed that tazemetostat demonstrated clinical activity in a broader group of patients with INI1-negative and SMARCA4-negative tumors than previously reported, achieved inhibition of EZH2 in tumor tissue, and had an acceptable safety profile when administered as oral monotherapy in adult patients with relapsed or refractory INI1-negative and SMARCA4-negative tumors. The data were presented at the European Cancer Congress 2015 (ECC) in Vienna, Austria by Antoine Italiano, M.D., Ph.D., of the Institut Bergonié in Bordeaux, France. Based on tazemetostat’s clinical activity observed to date and other supportive research, Epizyme will initiate a global phase 2 study in adults and a global phase 1 study in children with INI1-negative tumors and synovial sarcoma in the fourth quarter of 2015.

INI1-negative and SMARCA4-negative tumors, such as rhabdoid tumors and epithelioid sarcoma are serious and debilitating cancers. Approximately 1,400 patients each year in the major global markets develop these tumors1, which have no established standard of care. INI1 and SMARCA4 are critical proteins of the SWI/SNF complex, which oppose the activity of EZH2. Genetic alterations or loss of function of either can result in EZH2-dependent oncogenesis in certain cancer backgrounds, thus rendering these tumors sensitive to EZH2 inhibition.

"INI1-negative tumors represent a group of devastating diseases with a very poor prognosis even for patients who can undergo a complete surgical resection. Tazemetostat has induced objective responses that are durable for some patients and has an excellent safety profile," said Dr. Italiano. "Our data provide evidence that potentially changes the landscape of clinical research in this group of tumors and could improve the treatment paradigm for these traditionally refractory diseases."

"We are excited by these data, which show clinical activity in patients with INI1-negative and SMARCA4-negative tumors. These results are consistent with preclinical data that demonstrate the important role of EZH2 in INI1- and SMARCA4-negative tumors such as malignant rhabdoid tumors where median survival after relapse is approximately nine months," said Peter Ho, M.D., Ph.D., Chief Medical Officer, Epizyme. "We are now turning our attention to initiating global registration-supporting clinical trials in adults and children with these aggressive tumors, for which new treatments are needed."

In total, 30 patients with solid tumors were enrolled into this ongoing phase 1 study, including eight patients in a food effect sub-study. Of these 30 patients, eight had INI1-negative tumors, comprised of five with malignant rhabdoid tumors and three with epithelioid sarcomas (ES). Additionally, three patients had SMARCA4-negative tumors including two patients with malignant rhabdoid tumor of the ovary, also referred to as small cell carcinoma of the ovary hypercalcemic type (SCCOHT), and one patient with thoracic sarcoma. Nineteen patients had other solid tumors that were not characterized by INI1 or SMARCA4 loss, including three patients with synovial sarcomas.

Synovial sarcomas occur in approximately 1,800 patients each year in the major markets. Synovial sarcomas are INI1-deficient rather than INI1-negative. A fusion protein that is characteristic for synovial sarcoma displaces INI1 from the SWI/SNF complex. Displacement of INI1 confers dependence of these tumors on EZH2, and hence sensitivity to an EZH2 inhibitor in preclinical models.

In addition to the 30 patients with solid tumors, 21 patients with advanced Non-Hodgkin Lymphoma (NHL) were also enrolled into this ongoing phase 1 study, and the safety data from the ECC update presentation includes these patients. The data cutoff for this presentation was August 31, 2015.

Summary of Results

A total of 11 patients with INI1-negative or SMARCA4-negative tumors have been treated. The tumor histology of these patients includes MRT, MRTO, ES and thoracic sarcoma. Nine of these 11 patients have been treated at or above the recommended phase 2 dose of 800 mg twice daily.

Six of the 11 patients experienced a reduction in tumor size as best response, with four patients experiencing tumor reduction of over 30%.

Of five patients with an INI1-negative malignant rhabdoid tumor, one patient achieved a complete response (CR) at week eight and remains on study and in CR through week 65.

Of three patients with SMARCA4-negative tumors, two patients have malignant rhabdoid tumor of the ovary. One MRTO patient achieved a PR at week 8 and remains on study through week 25. A second MRTO patient remains on study with stable disease (SD) through week 26.

Of three patients with an INI1-negative epithelioid sarcoma, one patient achieved a PR of short duration and remains on study with SD through week 25. The second patient remains on study with SD through week 24.
Clinical activity was not observed in the 19 patients with other tumors, including the three patients with synovial sarcomas.
Inhibition of EZH2, as measured by post-treatment H3K27 trimethylation compared to baseline, was observed in tumor tissue of INI1-negative patients as assessed by immunohistochemistry.

The majority of adverse events observed in the study were grade 1 or grade 2 within the entire population of 51 patients with NHL and solid tumors. The most frequent adverse events regardless of attribution were asthenia, decreased appetite, thrombocytopenia, nausea, dyspnea, anemia and constipation. Five grade 3 or greater treatment-related adverse events have been observed including one each of: thrombocytopenia, neutropenia, hypertension, liver function test elevation and decreased appetite.

Solid tumor patients enrolled in this study had been heavily pre-treated, with over half of patients having received three or more prior anti-cancer therapies.

Study Design
The data presented at ECC are from the ongoing first-in-human phase 1 trial of tazemetostat in adults with relapsed or refractory B-cell lymphomas or advanced solid tumors. The primary objective of the study was to determine the recommended phase 2 dose. Secondary endpoints included safety, pharmacokinetics, pharmacodynamics and tumor response evaluated every eight weeks.
Tazemetostat is administered orally twice daily. Five cohorts were studied in the dose escalation phase: 100 mg, 200 mg, 400 mg, 800 mg and 1600 mg; and two cohorts, 800 mg and 1600 mg, were evaluated in the dose expansion phase. Patients enrolled into the food effects sub-study received tazemetostat at 400 mg.

Expanded Tazemetostat Phase 1 and Phase 2 Plans
A planned phase 2 trial studying tazemetostat in adult patients with INI1-negative solid tumors or synovial sarcoma is expected to begin in the fourth quarter of 2015. A phase 1 dose escalation study in pediatric patients with INI1-deficient solid tumors is also expected to start in the fourth quarter of 2015. The INI1-deficient tumor studies will enroll subjects in the U.S., EU and Australia.

Epizyme is already enrolling patients into an international five-arm, multi-center, phase 2 study that will assess the safety and efficacy of tazemetostat in patients with relapsed or refractory NHL, stratified by cell of origin and EZH2 mutation status.

The company plans to initiate additional trials of tazemetostat, including:

A combination study of tazemetostat with R-CHOP in patients with diffuse large B-cell lymphoma (DLBCL), including higher risk front-line patients. R-CHOP, which represents the current first-line regimen for patients with DLBCL, is comprised of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone.
A combination study of tazemetostat with a B-cell signaling agent or other emerging targeted therapy for B-cell lymphomas.
About EZH2 in Cancer
EZH2 is a histone methyltransferase (HMT) that is increasingly understood to play a potentially oncogenic role in a number of cancers. These include non-Hodgkin lymphomas, rhabdoid tumors and other INI1-deficient cancers such as epithelioid sarcomas and synovial sarcoma as well as a range of other solid tumors.

About Tazemetostat
Epizyme is developing tazemetostat for the treatment of non-Hodgkin lymphoma patients and patients with INI1-deficient solid tumors. Tazemetostat is a first-in-class small molecule inhibitor of EZH2 created by Epizyme using its proprietary product platform. In many human cancers, aberrant EZH2 enzyme activity results in misregulation of genes that control cell proliferation resulting in the rapid and unconstrained growth of tumor cells. Tazemetostat is the WHO International Non-Proprietary Name (INN) for EPZ-6438.

Additional information about this program, including clinical trial information, may be found here: View Source

VARGATEF® plus docetaxel significantly reduced tumour burden in lung cancer patients with advanced adenocarcinoma compared to docetaxel alone

On September 28, 2015 Boehringer Ingelheim reported at the European Cancer Congress (ECC) in Vienna, Austria, further data to support the efficacy of VARGATEF (nintedanib*) in combination with docetaxel for the treatment of advanced non-small cell lung cancer (NSCLC) with adenocarcinoma histology (Press release, Boehringer Ingelheim, SEP 26, 2015, View Source [SID:1234507557]). Further analysis of the data from the pivotal LUME-Lung 1 trial showed that after first-line chemotherapy adenocarcinoma patients receiving VARGATEF plus docetaxel had a significantly reduced rate of tumour growth over time, compared to patients receiving docetaxel alone.1 At the time of treatment initiation, the average tumour size of the 658 adenocarcinoma patients who took part in the trial was 82.5mm (diameter). After six months of treatment, the adenocarcinoma patients receiving VARGATEF plus docetaxel experienced about 10% less tumour growth over time (9.7mm), compared to those receiving placebo plus docetaxel (tumour size at 6 months: 98.4mm placebo plus docetaxel vs 88.7mm nintedanib plus docetaxel).1

Advanced adenocarcinoma patients with the poorest prognosis received an even more pronounced benefit from VARGATEF plus docetaxel, compared to docetaxel alone, after first-line chemotherapy:

Adenocarcinoma patients whose disease progressed within nine months of starting first-line chemotherapy (T<9) received a 16.8mm reduction in tumour size over time after six months (tumour size at baseline 88.3mm; tumour size at 6 months: 114.6mm placebo plus docetaxel vs 97.8mm nintedanib plus docetaxel; difference in growth over time of 13%)
Adenocarcinoma patients who had continuously progressed during first-line therapy (PD-FLT) experienced a 19.7mm reduction in tumour size over time after six months (tumour size at baseline 98.1mm; tumour size at 6 months: 124.7mm placebo plus docetaxel vs 105mm nintedanib plus docetaxel; a difference in growth over time of 15%)

Professor Martin Reck, lead investigator of the LUME-Lung 1 trial said, "The reduction in tumour burden seen in adenocarcinoma patients receiving nintedanib plus docetaxel is very encouraging and it is particularly positive to see the additional benefit for those patients who progress quickly when receiving first-line therapy as they often have the poorest prognosis. Tumour burden is commonly associated with clinical outcomes and as such is a relevant and valuable measurement. These latest data add to our wealth of knowledge and reiterate the efficacy of nintedanib which has previously been shown to extend overall survival to over one year for this difficult to treat cancer."

The Phase III LUME-Lung 1 trial randomised 1,314 patients with stage IIIB/IV recurrent NSCLC to receive either VARGATEF plus docetaxel or placebo plus docetaxel (1:1).2 Tumour growth was evaluated in a planned post-hoc analysis using all available tumour measurements. Mixed-effects models were employed to measure the relationship between time from treatment initiation and tumour size (measured as the sum of longest diameter of target lesions [SLD]).1

Dr Mehdi Shahidi, Medical Head, Solid Tumour Oncology, Boehringer Ingelheim commented, "The announcement of the latest data from the LUME-Lung 1 trial further illustrates how VARGATEF in combination with docetaxel can potentially improve the lives of lung cancer sufferers following its EU approval in 2014. We have a long-term commitment to discovering novel and innovative treatments to better the lives of patients with different types of cancer and look forward to bringing further advances in the future."

VARGATEF in combination with docetaxel was approved in the EU in 2014 for use by adult patients with locally advanced, metastatic or locally recurrent NSCLC of adenocarcinoma tumour histology after first-line chemotherapy. The LUME-Lung 1 study demonstrated the efficacy and safety of the treatment:2

VARGATEF plus docetaxel significantly prolonged progression-free survival compared to docetaxel alone for patients with adenocarcinoma (PFS: primary endpoint; 4.0 vs 2.8 months)
VARGATEF plus docetaxel significantly extended overall survival to beyond one year for patients with adenocarcinoma, compared to docetaxel alone (OS: key secondary endpoint; 12.6 vs 10.3 months)
VARGATEF plus docetaxel enabled one in four patients with adenocarcinoma to live for at least two years after first-line chemotherapy

VARGATEF in combination with docetaxel demonstrated a familiar and generally manageable side-effect profile without further compromising patients’ overall, health-related, quality of life compared to docetaxel alone. The most common adverse events for patients taking docetaxel vs VARGATEF plus docetaxel included: nausea 18% vs 24%; vomiting 9% vs 17%; diarrhoea 22% vs 42% and elevated liver enzymes 8% vs 29%.

Adenocarcinoma is the most common type of lung cancer and the majority of patients are diagnosed in an advanced stage.3 Most patients will experience disease progression during or after first-line chemotherapy and there is a significant need for new, effective second-line treatments.2,3

ECC 2015: GIOTRIF® (afatinib) demonstrates superior survival compared to Tarceva® (erlotinib) for patients with previously treated advanced squamous cell carcinoma of the lung, independent of EGFR mutation status

On September 28, 2015 Boehringer Ingelheim reported at the European Cancer Congress (ECC) in Vienna, Austria, new data from the Phase III LUX-Lung 8 trial which further highlights the benefits of afatinib* compared to erlotinib for the treatment of patients with previously treated advanced SCC of the lung (Press release, Boehringer Ingelheim, SEP 26, 2015, View Source [SID:1234507556]).2 Data from the trial showed that treatment with afatinib resulted in superior progression-free survival (PFS) and superior overall survival (OS) compared to erlotinib in this patient population.2 These improved survival outcomes observed with afatinib were not driven by the presence of EGFR mutations, according to a new analysis presented at ECC.2 Furthermore, a higher number patients treated with afatinib in the LUX-Lung 8 trial reported improvements in overall health and quality of life, as well as improvements in some lung cancer-related symptoms, compared to those treated with erlotinib.3

LUX-Lung 8 clinical trial investigator Glen D. Goss, M.D., Director of Clinical and Translational Research, The Ottawa Hospital Cancer Center, University of Ottawa, Canada, commented: "These latest data not only demonstrate benefits of afatinib compared to erlotinib for patients with SCC of the lung, but also suggest that afatinib is an effective treatment option for a broad group of patients and not just those whose tumours harbour EGFR mutations. We know that dysregulation of ErbB receptors plays a role in the underlying mechanisms of SCC of the lung and the fact that afatinib targets this family of receptors rather than only EGFR, may explain why it offered additional benefits for this patient population."

Afatinib is an oral, once daily targeted treatment which works by irreversibly blocking the ErbB family of receptors. Unlike other targeted treatments such as erlotinib which are reversible and specifically target EGFR (ErbB1), afatinib aims to provide a sustained, selective and complete ErbB Family Blockade. The Phase III LUX-Lung 8 trial compared afatinib to erlotinib in patients with advanced SCC of the lung progressing after treatment with first-line platinum-based chemotherapy. Data from the trial showed that treatment with afatinib resulted in superior PFS, reducing the risk of cancer progression by 19%, and superior OS, reducing the risk of death by 19% compared to erlotinib in this patient population.1,2 The PFS and OS advantages observed with afatinib compared to erlotinib were independent of the EGFR mutation status of the tumours analysed from this trial.2

Further data presented at ECC confirm the efficacy of afatinib observed in the LUX-Lung 8 trial was associated with improvements in patient reported outcomes.3 More patients had improved overall health-related quality-of-life (36% vs 28%, p=0•041), cough (43% vs 35%, p=0•029) and dyspnoea (51% vs 44%, p=0•061) with afatinib than with erlotinib.3 The rate of severe adverse events in the LUX-Lung 8 trial was similar between the two treatment arms with differences observed in the incidence of certain side effects.1 A higher incidence of severe diarrhoea and stomatitis (mouth sores) was observed with afatinib compared to erlotinib (grade 3 diarrhoea: 10% vs 2%; grade 3 stomatitis: 4% vs 0%), while a higher incidence of severe rash/acne was reported with erlotinib compared to afatinib (grade 3 rash/acne: 10% vs 6%).1 Diarrhoea occurring in patients treated with afatinib was manageable.3

Dr. Mehdi Shahidi, Medical Head, Solid Tumour Oncology, Boehringer Ingelheim commented: "We are pleased to present these data at ECC 2015 which confirm that the advantages of afatinib, compared to erlotinib, are not limited to patients with squamous cell lung cancer whose tumours expressed EGFR mutations, which are rare in this disease. The LUX-Lung 8 trial shows that treatment with afatinib versus erlotinib not only leads to improved survival outcomes but also offered patients an improved quality of life. Afatinib is under review by both the FDA and EMA for the treatment of SCC of the lung and we look forward to working with regulatory authorities in the hope of making this much needed new treatment option available to patients."

Afatinib is currently approved in more than 60 countries for the first-line treatment of specific types of EGFR mutation-positive non-small cell lung cancer (NSCLC) (under brand names: GIOTRIF / GILOTRIF). Both the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have recently accepted filing applications for afatinib for the treatment of patients with advanced SCC of the lung progressing after treatment with first-line chemotherapy, based on the positive PFS and OS data from the LUX-Lung 8 trial. Afatinib has also been granted orphan drug designation by the FDA – a status given to a product intended for the treatment of a rare disease or condition.

Aduro Biotech Announces Phase 1b Mesothelioma Trial Featured in Spotlight Poster at ESMO/ECC

On September 26, 2015 Aduro Biotech, Inc. (Nasdaq:ADRO) reported the presentation of updated, interim safety and efficacy data from an ongoing Phase 1b clinical trial of its novel immunotherapy, CRS-207, in combination with standard of care chemotherapy in patients with unresectable malignant pleural mesothelioma (MPM) (Press release, Aduro BioTech, SEP 26, 2015, View Source;p=RssLanding&cat=news&id=2090581 [SID:1234507554]). Of the 34 evaluable patients, disease control was observed in 94% (32/34), including 59% (20/34) with partial responses and 35% (12/34) experiencing stable disease following treatment with CRS-207 and chemotherapy. Of note, in three patients who had tumor biopsies completed, biomarker analysis data available at the time of the presentation showed in all three patients a consistent and marked recruitment of immune cells, including CD8+ T-cells, dendritic cells and natural killer cells, following treatment with CRS-207.

The results were presented by Raffit Hassan, M.D., co-chief of the Thoracic and GI Oncology Branch at the National Cancer Institute, in a spotlight poster presentation (abstract #515/P249) at the 40TH European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper)/18TH European Cancer Congress (ECC) being held September 25-29, 2015 in Vienna, Austria.

"The data in this trial continue to be impressive in the front-line treatment of mesothelioma," said Dr. Hassan. "We are encouraged by the high disease control rate in patients treated with this combination and will continue to evaluate and track the durability of the responses, which are ongoing."

Dirk G. Brockstedt, Ph.D., senior vice president of Research and Development at Aduro added, "Our new immunohistochemistry biomarker data is interesting as it is supports our hypothesis that the tumor microenvironment is altered by our immunotherapy. These data show an increase of tumor-attacking immune cells recruited and deployed where they are needed most. We look forward to presenting final results from this trial with additional biomarker data in 2016. As previously announced, based on the compelling data thus far, we plan to advance the combination regimen with CRS-207 and chemotherapy into a pivotal Phase 3 clinical trial in the front-line setting."

At the time of the ESMO (Free ESMO Whitepaper) presentation, the multi-center Phase 1b study had completed enrollment with 38 patients who were chemotherapy-naïve, with unresectable MPM, good performance status (ECOG 0 or 1) and adequate organ function. Under the trial design, eligible patients received two treatments with CRS-207 two weeks apart, followed by up to six cycles of standard of care pemetrexed and cisplatin chemotherapy three weeks apart and two CRS-207 treatments three weeks apart. Clinically stable patients receive CRS-207 maintenance courses every eight weeks and are followed until disease progression. Objectives of the study are safety, immunogenicity, objective tumor responses and tumor marker kinetics.

Median duration of response was 5.3 months (95% CI: 4.7 – 16.7 months) and median progression free survival was 8.5 months (95% CI: 6.9 – 10.8 months). No treatment-related serious adverse events or unexpected toxicities were observed. Treatment, follow-up and immune response evaluations are ongoing.

About Malignant Pleural Mesothelioma

Mesothelioma is a form of cancer that affects the smooth layer of mesothelial cells that surround the chest, lungs, heart and abdomen. Malignant pleural mesothelioma (MPM), which affects the thin balloon-shaped lining of the lungs, is the most common form of this disease and accounts for approximately 3,000 cases a year in the United States. MPM is an aggressive disease with a poor prognosis. Most MPM patients are not candidates for surgical resection. Based on prior studies, expected median time to progression is 5.7 months and median overall survival is 12.1 months with combination pemetrexed and cisplatin chemotherapy. The tumor-associated antigen mesothelin is overexpressed on the majority of mesothelioma tumors.

About CRS-207

CRS-207 is one of a family of product candidates based on Aduro’s live-attenuated, double-deleted (LADD) Listeria monocytogenes immunotherapy platform that induces a potent innate and T cell-mediated adaptive immune response. CRS-207 has been engineered to express the tumor-associated antigen mesothelin, which is over-expressed in many cancers including mesothelioma and pancreatic, non-small cell lung, ovarian, endometrial and gastric cancers.