Phase II studies in second-line SCLC met primary endpoint of overall response Pooled analysis of Phase II trials confirmed cardiac safety profile of Amrubicin
SUMMIT, N.J.--(BUSINESS WIRE)--Aug. 5, 2009--
Celgene Corporation (NASDAQ: CELG) today announced the presentation of
final results from two company-sponsored studies of Amrubicin in
relapsed small cell lung cancer (SCLC) at the 13th World
Conference on Lung Cancer in San Francisco, Calif. The presentations
included safety and efficacy data of two phase II studies of the
next-generation therapy in second-line patients with SCLC both sensitive
and refractory to first-line platinum based chemotherapy, respectively.
A third presentation detailed the results of a pooled cardiac safety
analysis from the phase II studies.
Amrubicin is an anthracyline-like molecule with potent topoisomerase II
inhibition and represents the first solid tumor-focused compound to
complete phase II studies for Celgene.
The first study compared Amrubicin to topotecan, a common and approved
treatment for SCLC, in patients with extensive-disease SCLC who were
sensitive to first-line platinum-based chemotherapy. Dr. Robert Jotte,
of the Rocky Mountain Cancer Centers in Denver, Colo., presented the
results from the trial where patients were randomized to either 40 mg/m2
IV of Amrubicin on days 1-3 of a 21-day cycle (n=50) or topotecan 1.5
mg/m2 IV daily on days 1-5 of a 21-day cycle (n=26). Of the
76 patients enrolled in the study, 72 were treated.
The study demonstrated that the overall response rate (ORR) was
significantly higher in patients treated with Amrubicin (44.0%) compared
to patients treated with topotecan (11.5%) (p=0.005), meeting the
primary endpoint of the study (to demonstrate an Amrubicin ORR of ≥
25%). In addition, the complete response rate was 12% for the Amrubicin
arm compared to 4% for the topotecan arm. Of note, for patients aged 65
years or older, the ORR for patients receiving Amrubicin was 46%
compared to 7% for patients receiving topotecan.
The median overall survival for patients receiving Amrubicin was 9.3
months (95% CI, range 5.8-12.2) compared to 7.7 months for patients
receiving topotecan (95% CI, range 4.5-14.0). Median progression-free
survival was 4.6 months for the Amrubicin arm (95% CI:2.1, 6.1) compared
to 3.3 months for the topotecan arm (95% CI: 2.2., 5.4) and the median
time to progression was 5.6 months for the Amrubicin arm (95% CI: 2.8,
6.9) compared to 3.0 months for the topotecan arm(95% CI: 1.4, 4.4).
In the study, the most common grade 3 or higher adverse events for
patients receiving Amrubicin compared to topotecan were neutropenia
(61.2% vs. 78.3%, respectively), thrombocytopenia (38.8% vs. 60.9%) and
leukopenia (38.8% vs. 39.1%). Dose reductions, primarily due to
reversible myelosuppression, took place in 43% of Amrubicin patients and
44% of topotecan patients. Additionally, 4 patients in the Amrubicin arm
and 1 patient in the topotecan arm died due to neutropenic complications.
In the second presentation, Dr. David S. Ettinger of the Sidney Kimmel
Comprehensive Cancer Center at Johns Hopkins University presented
results from a study of Amrubicin monotherapy in patients with extensive
disease SCLC refractory to first-line platinum-based chemotherapy.
In the study, 75 patients who had no response to first-line chemotherapy
or progression within 3 months of treatment completion were enrolled. Of
these, 69 received 40 mg/m2 IV of Amrubicin on days 1-3 of a 21-day
cycle and treatment continued until disease progression, unacceptable
toxicity or withdrawal.
The ORR was 21.3%, with 1 patient (1.3%) achieving a complete response.
In patients who did not respond to platinum-based first line therapy
(e.g. progressive or stable disease as best response), the ORR was 16%,
and the response in elderly patients (≥ 65 years) was 20% which was
similar to the overall population (21.3%). The median duration of
response was 4.3 months (95% CI: 3.1, 5.8) and the median time to
progression was 3.8 months (95% CI: 2.7, 4.2).
Additionally, median progression free survival for patients in the study
was 3.3 months (95% CI: 2.5, 4.0) and median overall survival was 6.1
months (95% CI: 4.9, 7.2).
In the study, the most commonly occurring grade 3 or higher adverse
events were neutropenia (66.7%), thrombocytopenia (40.6%), leukopenia
(34.8%) and anemia (30.4%). Dose reductions occurred in 38% of patients
and 3 patients experienced fatal serious adverse events that were not
related to disease progression with 1 case considered possibly related
to study treatment.
“Advances in small cell lung cancer are particularly relevant as there
have been few new options for patients in recent years,” said Dr.
Ettinger. “The data presented today show that Amrubicin is an active
compound with a manageable safety profile in an area of significant
unmet need. We look forward to the results of future studies in this
disease with this drug.”
In the final presentation, Dr. David Spigel of the Sarah Cannon Research
Institute in Nashville, Tenn. described data from a pooled study of the
two phase II studies, attempting to confirm the cardiac safety profile
of Amrubicin through an analysis of decreases in left-ventricular
ejection fraction (LVEF). LVEF is a measure of cardiac contractility,
measuring the fraction of blood pumped out of the left ventricle with
each heart beat. One of the main disadvantages of the use of
anthracyclines is the increased risk of heart damage and reduced LVEF
with cumulative doses exceeding 450 mg/m2.
The pooled analysis evaluated 117 patients treated with Amrubicin across
the two trials. In the study, 115 patients had a baseline LVEF
percentage recorded (median 60%: range 50-85) and were evaluated based
on changes in LVEF level from this mark, as well as according to
cumulative Amrubicin dosing range.
The study demonstrated minimal changes in LVEF percentage from the
baseline, and the median LVEF figures were similar across all cumulative
dosing ranges, including patients who received a cumulative dose >1000
mg/m2 of Amrubicin (n=16), where the median change in LVEF
from the baseline was 2%.
In the pooled study, cardio specific grade 3 or higher adverse events
were acute myocardial infarction (n=2), atrial fibrillation (n=2) and
atrial flutter (n=1). No treatment-related cardiac mortalities occurred
on the study.
“The data from these studies are encouraging as they demonstrate that
Amrubicin compares favorably to both historical data and currently
utilized therapies across multiple patient groups, including elderly
patients and those with poor prognostic factors,” said Dr. Jotte.
“Additionally, these data suggest that Amrubicin has an improved
cardiotoxicity profile compared to traditional anthracyclines. We
believe these results warrant further study of Amrubicin in this hard to
treat area of disease.”
About Amrubicin
Amrubicin is a third-generation, synthetic anthracycline analogue that
has demonstrated substantial clinical efficacy in the treatment of small
cell lung cancer. Amrubicin is a potent topoisomerase II inhibitor and
is being studied as a single agent and in combination with anti-cancer
therapies for a variety of solid tumors, including lung and breast
cancers.
Amrubicin is currently approved and marketed in Japan for the treatment
of both small cell lung cancer and non-small cell lung cancer by Nippon
Kayaku, a Japanese pharmaceutical firm focused on oncology, which
licensed Japanese marketing rights from Dainippon Sumitomo Pharma Co.,
Ltd. (DSP), the original developer of the therapy. DSP also licensed the
North American and European Union rights of Amrubicin to Pharmion
Corporation, which was acquired by Celgene Corporation in 2008.
About Small Cell Lung Cancer
Small cell lung cancer is a disease in which malignant cells form in the
tissues of the lung, and which occurs almost exclusively in people who
smoke. While small cell lung cancer constitutes approximately 15 percent
of all lung cancers, SCLC tends to be more aggressive and fast growing
than the more common non-small cell lung cancer. Of the estimated 65,000
patients diagnosed with SCLC each year in the US and EU, approximately
60 percent of patients have extensive disease at diagnosis, and the
remaining 40 percent present with localized, or limited stage, disease.
About Celgene
Celgene Corporation, headquartered in Summit, New Jersey, is an
integrated global pharmaceutical company engaged primarily in the
discovery, development and commercialization of innovative therapies for
the treatment of cancer and inflammatory diseases through gene and
protein regulation. For more information, please visit the Company's
website at www.celgene.com.
This release contains forward-looking statements which are subject to
known and unknown risks, delays, uncertainties and other factors not
under the Company's control, which may cause actual results, performance
or achievements of the Company to be materially different from the
results, performance or other expectations expressed or implied by these
forward-looking statements. These factors include results of current or
pending research and development activities, actions by the FDA and
other regulatory authorities, and other factors described in the
Company's filings with the Securities and Exchange Commission such as
our 10K, 10Q and 8K reports.
Source: Celgene Corporation
Celgene Corporation
David Gryska, 908-673-9059
Senior Vice
President and
Chief Financial Officer
or
Brian P. Gill,
908-673-9530
Vice President
Corporate Communications