Ipsen and Servier announced preliminary data from the Phase 1/2 study of the investigational use of liposomal irinotecan (ONIVYDE) in combination with 5- fluorouracil/leucovorin (5-FU/LV) and oxaliplatin (OX) in study patients with previously untreated metastatic pancreatic ductal adenocarcinoma cancer (PDAC) at the ESMO 21st World Congress on Gastrointestinal Cancer in Barcelona, Spain, 3–6 July 2019.
The results, which were presented as a short oral presentation, included preliminary safety and efficacy data from an ongoing multicenter, open-label, dose-escalation study, which aims to determine the maximum tolerated dose and the recommended dose to be used in future clinical studies.
“Pancreatic cancer is aggressive and difficult to treat. With most patients going undiagnosed until the disease has spread and the prognosis is poor, some physicians may be reluctant to consider novel treatment options,” said Zev Wainberg, M.D., lead investigator and associate professor of medicine, University of California Los Angeles. “It’s critical that physicians have more treatment options for their patients, particularly in the first line of therapy.”
“ONIVYDE is the first and only FDA and EMA approved second-line treatment for metastatic pancreatic cancer following gemcitabine-based therapy, and the initial data presented today provides a first look into the use of this investigational therapy earlier in the treatment sequence,” said Yan Moore, M.D., Ipsen’s Senior Vice President, Head of Oncology Therapeutic Area. “We look forward to further analyses of these early data, with the aim of evolving the standard of care in metastatic pancreatic cancer.”
“It is vitally important to advance the research of new treatment approaches for pancreatic cancer patients, a goal Servier shares with Ipsen,” said Patrick Therasse, Head of Servier Research and Development Oncology.
ONIVYDE is a topoisomerase inhibitor indicated in combination with 5-FU/LV for metastatic pancreatic cancer after disease progression following gemcitabine-based therapy. The ongoing Phase 1/2, open-label trial (NCT02551991) was designed to assess the safety, tolerability and dose-limiting toxicities (DLTs) of the study drug, liposomal irinotecan, in combination with 5-FU/LV and OX, known as NAPOX, for the first-line treatment of study participants with metastatic pancreatic cancer. Secondary objectives were to assess clinical efficacy, defined by overall response rate (ORR), disease control rate (DCR) and best overall response (BOR). Preliminary analyses of median progression-free survival and median overall survival were not mature enough for evaluation.
As of the 19 February 2019 data cut off, a total of 56 study patients (median age = 58 (39-76) years) were enrolled and dosed at 15 sites across the US, Spain and Australia. The interim analysis was conducted after all study participants in the four dose exploration cohorts had completed their second scheduled tumor evaluation at 16 weeks. Study participants from the Part 1A–cohort B (n=7) dose exploration phase and study participants from the Part 1B–dose expansion phase (n=25) received the selected dose level of liposomal irinotecan 50 mg/m2 [free-base equivalent; FBE], LV 400 mg/m2, 5-FU 2400 mg/m2, and OX 60 mg/m2. These 32 patients made up the pooled population (PP) analysis (n=29 mPDAC; n=3 locally advanced pancreatic PDAC).
- No reported Grade 3 or higher fatigue or peripheral neuropathy.
- One study participant in the Part 1A–cohort B dose exploration phase reported a DLT (febrile neutropenia).
- Treatment emergent adverse events (TEAEs) Grade 3 or higher were reported by 20 of 32 study patients in the 50/60 PP and included: neutropenia (n=9); febrile neutropenia (n=4); hypokalemia (n=4); diarrhea (n=3); nausea (n=3); anemia (n=2); vomiting (n=2).
- Four study patients in the 50/60 PP reported TEAEs leading to discontinuation (n=4/32), with 23 study patients requiring dose adjustment due to AEs.
- At data cut-off, 15/32 study patients in the 50/60 PP remained on treatment.
- BOR (Best Overall Response) was: one complete response (CR; study participant diagnosed with locally advanced Stage III disease), 10 partial responses (PR) in 31.3% (10/32) and 15 stable diseases (SD) in 46.9% (15/32) (sum of CR+PR+SD = 81.3%).
- 71.9% (23/32) of study patients in the 50/60 PP achieved disease control at 16 weeks.
- Overall, 34% of study patients had a response.
Source: Company Press Release