CHICAGO and RARITAN, N.J., May 30,
2015 /PRNewswire/ -- Data from the Phase 3 CLL3001
(HELIOS) trial demonstrated that the combination of ibrutinib
(IMBRUVICA®) plus bendamustine and rituximab (BR)
reduced the risk of progression or death by 80% and also
significantly improved overall response rate (ORR) versus placebo
plus BR in patients with relapsed or refractory (R/R) chronic
lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL).
Janssen Research & Development, LLC (Janssen) today announced
these data, which will be included today in the official press
program at the American Society of Clinical Oncology (ASCO) Annual
Meeting in Chicago, IL. The data
will also be presented in full by the lead author of the study, Dr.
Asher Chanan-Khan, based at the Mayo
Clinic in Jacksonville, Florida,
in an oral, late-breaking abstract session today during the
Leukemia, Myelodysplasia, and Transplantation track at 2:27 p.m. CT. IMBRUVICA is jointly developed and
commercialized by Janssen Biotech, Inc. and Pharmacyclics LLC.
At a pre-planned interim analysis earlier this year, the
addition of ibrutinib to BR was shown to significantly improve
progression-free survival (PFS; the primary endpoint) and ORR (a
key secondary endpoint) compared with the combination of BR and
placebo. An independent review committee (IRC) recommended HELIOS
be unblinded at that point and patients receiving placebo plus BR
be offered the option to receive ibrutinib as their next
treatment.
"The HELIOS data are particularly exciting, as they demonstrate
that ibrutinib combination therapy improved PFS rates three-fold in
previously treated patients with CLL or SLL, versus
chemo-immunotherapy alone," said Simon
Rule, M.D., Consultant Haematologist, Department of
Haematology, and Head of the Lymphoma Service, Derriford Hospital,
Plymouth, UK, and HELIOS study
investigator. "As clinicians, we have continued to search for safe
and effective options for people who have relapsed or become
refractory to treatment. These results suggest the combination of
ibrutinib, bendamustine and rituximab may be a favorable option for
many patients who have received previous therapy."
HELIOS is a Janssen-sponsored, randomized, double-blind,
placebo-controlled, international, multicenter Phase 3 study
conducted in 21 countries, which evaluated the safety and efficacy
of ibrutinib in combination with BR in 578 patients with relapsed
or refractory CLL/SLL who had received at least one prior therapy.
Patients were randomized to receive either the combination of 420
mg ibrutinib orally once daily and six cycles of BR, or a matching
regimen of placebo orally once daily and six cycles of BR, with
ibrutinib or placebo continued until disease progression or
unacceptable toxicity. The primary endpoint was IRC-assessed PFS
and key secondary endpoints included ORR per IRC, overall survival
(OS), rate of minimal residual disease negative remissions (MRD-
remissions) and safety.
At a median follow-up of 17 months, IRC-assessed PFS was
significantly longer with ibrutinib+BR, compared to placebo+BR
(median not reached vs. 13.3 months; HR: 0.203, 95% CI:
0.150-0.276, P<0.0001). This difference in PFS rates between
study arms was consistent across all subgroups, including high-risk
subgroups. IRC-assessed PFS rates at 18 months were 79% for
patients in the ibrutinib+BR arm, as compared with 24% for patients
in the placebo+BR arm. The IRC-assessed ORR and complete
response/complete response with incomplete marrow recovery (CR/CRi)
rates were 82.7% and 10.4%, respectively, for patients taking
ibrutinib+BR versus 67.8% and 2.8% for people in the placebo+BR
arm. The median OS has not yet been reached at a median follow-up
of 17 months. Overall, ibrutinib reduced the risk of death by 37%
(P=0.06). The OS results are, however, confounded as 90 patients
(31%) in the placebo+BR arm with confirmed progressive disease had
crossed over to receive ibrutinib and no longer received placebo
for the remainder of the trial. The safety profile of ibrutinib+BR
was consistent with the known individual safety profiles for
ibrutinib and BR therapies, respectively. In addition, ibrutinib
had no impact on the ability of BR to be administered, with a
similar number of BR cycles administered in both study arms.
"HELIOS represents the first read-out of a Phase 3 study
evaluating ibrutinib in combination with standard
chemo-immunotherapy. The data demonstrate the potential benefits of
ibrutinib when combined with standard therapy for people with
previously treated CLL or SLL," said Sen Zhuang, M.D., Ph.D., Vice
President, Oncology Clinical Research, Janssen. "Notably, this is
the second Phase 3 trial to demonstrate ibrutinib significantly
delays progression for previously treated patients with these
diseases."
The most common all-grade adverse events (AEs ≥20%) in the
HELIOS trial were neutropenia (58.2% in the ibrutinib+BR arm vs.
54.7% in the placebo+BR arm), nausea (36.9% vs. 35.2%), diarrhea
(35.5% vs. 23.7%), thrombocytopenia (30.7% vs. 24.4%), pyrexia
(24.7% vs. 22%), anemia (22.6% vs. 28.9%) and fatigue (21.6% vs.
22.6%). The most common Grade 3/4 AEs (≥15%) were neutropenia
(53.7% vs. 50.5%) and thrombocytopenia (15% in both arms). Higher
rates of Grade 1/2 bleeding such as hematoma (8% vs. 1%), contusion
(7.7% vs. 3.1%), epistaxis (5.9% vs. 3.1%), ecchymosis (3.1% vs.
0.7%) and petechiae (2.8% vs. 0.3%) were observed in patients
taking ibrutinib+BR versus those in the placebo+ BR arm. Rates of
major hemorrhage (defined as serious or Grade 3 or greater events)
were 3.8% (11 cases) and 1.7% (5 cases), respectively. Few patients
had Grade 3/4 atrial fibrillation (8 cases or 2.8% and 2 cases or
0.7%), with most patients having a history of prior atrial
fibrillation or cardiac risk factors. Overall, 14.2% of patients in
the ibrutinib arm discontinued due to AEs, as compared to 11.8% of
patients in the placebo arm. The rates of other malignancies
reported during treatment and follow-up were similar in each arm
(8.4% in patients taking ibrutinib+BR vs. 8% in patients taking
placebo+BR)
A full study report for HELIOS is being prepared and planned to
be submitted to health authorities for future labeling
considerations. A manuscript is also planned for submission for
potential publication in a peer-reviewed journal. For additional
study information, visit ClinicalTrials.gov.
About IMBRUVICA®
(ibrutinib)
IMBRUVICA was one of the first therapies to
receive U.S. approval after having received the FDA's Breakthrough
Therapy Designation. IMBRUVICA works by blocking a specific protein
called Bruton's tyrosine kinase (BTK).1 The BTK protein
transmits important signals that tell B cells to mature and produce
antibodies and is needed by specific cancer cells to multiply and
spread.1,2 IMBRUVICA targets and blocks BTK, inhibiting
cancer cell survival and spread.1 For more information,
visit www.IMBRUVICA.com.
Additional Information about IMBRUVICA®
INDICATIONS
IMBRUVICA® is indicated to treat people
with:
- Mantle cell lymphoma (MCL) who have received at least one prior
therapy
- Accelerated approval was granted for this indication based on
overall response rate. Continued approval for this indication may
be contingent upon verification of clinical benefit in confirmatory
trials.
- Chronic lymphocytic leukemia (CLL) who have received at least
one prior therapy
- Chronic lymphocytic leukemia (CLL) with 17p deletion
- Waldenstrom's macroglobulinemia (WM)
IMPORTANT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
Hemorrhage - Fatal bleeding events have occurred in
patients treated with IMBRUVICA®. Grade 3
or higher bleeding events (subdural hematoma, gastrointestinal
bleeding, hematuria, and post-procedural hemorrhage) have occurred
in up to 6% of patients. Bleeding events of any grade, including
bruising and petechiae, occurred in approximately half of patients
treated with IMBRUVICA®.
The mechanism for the bleeding events is not well
understood. IMBRUVICA® may increase
the risk of hemorrhage in patients receiving antiplatelet or
anticoagulant therapies. Consider the benefit-risk of withholding
IMBRUVICA® for at least 3 to 7 days pre and
post-surgery depending upon the type of surgery and the risk of
bleeding.
Infections - Fatal and non-fatal infections have occurred
with IMBRUVICA® therapy. Grade 3 or greater
infections occurred in 14% to 26% of patients. Cases of progressive
multifocal leukoencephalopathy (PML) have occurred in patients
treated with IMBRUVICA®. Monitor patients
for fever and infections and evaluate promptly.
Cytopenias - Treatment-emergent Grade 3 or 4 cytopenias
including neutropenia (range, 19 to 29%), thrombocytopenia (range,
5 to 17%), and anemia (range, 0 to 9%) occurred in patients treated
with IMBRUVICA®. Monitor complete blood
counts monthly.
Atrial Fibrillation - Atrial fibrillation and atrial
flutter (range, 6 to 9%) have occurred in patients treated with
IMBRUVICA®, particularly in patients with
cardiac risk factors, acute infections, and a previous history of
atrial fibrillation. Periodically monitor patients clinically for
atrial fibrillation. Patients who develop arrhythmic symptoms
(e.g., palpitations, lightheadedness) or new-onset dyspnea should
have an ECG performed. If atrial fibrillation persists, consider
the risks and benefits of IMBRUVICA®
treatment and dose modification.
Second Primary Malignancies - Other malignancies (range,
5 to 14%) including non-skin carcinomas (range, 1 to 3%) have
occurred in patients treated with
IMBRUVICA®. The most frequent second
primary malignancy was non-melanoma skin cancer (range, 4 to
11%).
Tumor Lysis Syndrome - Tumor lysis syndrome has been
reported with IMBRUVICA® therapy. Monitor
patients closely and take appropriate precautions in patients at
risk for tumor lysis syndrome (e.g., high tumor burden).
Embryo-Fetal Toxicity - Based on findings in animals,
IMBRUVICA® can cause fetal harm when
administered to a pregnant woman. Advise women to avoid becoming
pregnant while taking IMBRUVICA®. If this
drug is used during pregnancy or if the patient becomes pregnant
while taking this drug, the patient should be apprised of the
potential hazard to a fetus.
ADVERSE REACTIONS
The most common adverse reactions (≥25%) in patients with B-cell
malignancies (MCL, CLL, WM) were thrombocytopenia* (57%, 52%, 43%),
neutropenia* (47%, 51%, 44%), diarrhea (51%, 48%, 37%), anemia*
(41%, 36%, 13%), fatigue (41%, 28%, 21%), musculoskeletal pain
(37%, 28%**, NA***), bruising (30%, 12%**, 16%**), nausea (31%,
26%, 21%), upper respiratory tract infection (34%, 16%, 19%), and
rash (25%, 24%**, 22%**).
*Based on adverse reactions and/or laboratory measurements
(noted as platelets, neutrophils, or hemoglobin decreased).
**Includes multiple ADR terms.
***Not applicable; no associated ADRs.
The most common Grade 3 or 4 non-hematological adverse reactions
(≥5%) in MCL patients were pneumonia (7%), abdominal pain (5%),
atrial fibrillation (5%), diarrhea (5%), fatigue (5%), and skin
infections (5%).
Approximately 6% (CLL), 14% (MCL), and 11% (WM) of patients had
a dose reduction due to adverse events.
Approximately 5% (CLL), 9% (MCL), and 6% (WM) of patients
discontinued due to adverse events. Most frequent adverse events
leading to discontinuation were infections, subdural hematomas, and
diarrhea in CLL patients and subdural hematoma (1.8%) in MCL
patients.
DRUG INTERACTIONS
CYP3A Inhibitors - Avoid co-administration with strong
and moderate CYP3A inhibitors. If a moderate CYP3A inhibitor must
be used, reduce the IMBRUVICA® dose.
CYP3A Inducers - Avoid co-administration with strong
CYP3A inducers.
SPECIFIC POPULATIONS
Hepatic Impairment - Avoid use in patients with moderate
or severe baseline hepatic impairment. In patients with mild
impairment, reduce IMBRUVICA® dose.
Please see full Prescribing Information:
http://www.imbruvica.com/downloads/Prescribing_Information.pdf
About Chronic Lymphocytic Leukemia
Chronic Lymphocytic
Leukemia (CLL) is a slow-growing blood cancer that most commonly
arises from B cells, a type of white blood cell (lymphocyte) that
originates in the bone marrow.3,4 CLL is predominantly a
disease of the elderly, with a median age of 71 at
diagnosis.3
About Janssen Research & Development, LLC
At
Janssen, we are dedicated to addressing and solving some of the
most important unmet medical needs of our time in oncology,
immunology, neuroscience, infectious diseases and vaccines, and
cardiovascular and metabolic diseases. Driven by our commitment to
patients, we develop innovative products, services and healthcare
solutions to help people throughout the world. Janssen Research
& Development, LLC; Janssen Products, LP; and Janssen Biotech,
Inc. are part of the Janssen Pharmaceutical Companies of Johnson
& Johnson. Please visit http://www.janssenrnd.com for more
information.
Janssen in Oncology
In oncology, our goal is to
fundamentally alter the way cancer is understood, diagnosed and
managed, reinforcing our commitment to the patients who inspire us.
In looking to find innovative ways to address the cancer challenge,
our primary efforts focus on several treatment and prevention
solutions. These include a focus on hematologic malignancies,
prostate cancer and lung cancer; cancer interception with the goal
of developing products that interrupt the carcinogenic process;
biomarkers that may help guide targeted, individualized use of our
therapies; as well as safe and effective identification and
treatment of early changes in the tumor microenvironment. Please
visit oncology.janssenrnd.com.
Cautions Concerning Forward-Looking Statements
This
press release contains "forward-looking statements" as defined in
the Private Securities Litigation Reform Act of 1995 regarding
product development. The reader is cautioned not to rely on these
forward-looking statements. These statements are based on current
expectations of future events. If underlying assumptions prove
inaccurate or known or unknown risks or uncertainties materialize,
actual results could vary materially from the expectations and
projections of Janssen Research & Development, LLC and/or
Johnson & Johnson. Risks and uncertainties include, but are not
limited to: challenges and uncertainties inherent in new product
development, including the uncertainty of clinical success and of
obtaining regulatory approvals; competition, including
technological advances, new products and patents attained by
competitors; challenges to patents; changes to applicable laws and
regulations, including global health care reforms; and trends
toward health care cost containment. A further list and description
of these risks, uncertainties and other factors can be found in
Johnson & Johnson's Annual Report on Form 10-K for the fiscal
year ended December 28, 2014,
including in Exhibit 99 thereto, and the company's subsequent
filings with the Securities and Exchange Commission. Copies of
these filings are available online at www.sec.gov, www.jnj.com or
on request from Johnson & Johnson. None of the Janssen
Pharmaceutical Companies or Johnson & Johnson undertakes to
update any forward-looking statement as a result of new information
or future events or developments.
References:
1 IMBRUVICA Prescribing Information, January 2015
2 Genetics Home Reference. Isolated growth hormone
deficiency. Available at:
http://ghr.nlm.nih.gov/condition/isolated-growth-hormone-deficiency.
Accessed May 2015.
3 American Cancer Society. Detailed guide: what is
chronic lymphocytic leukemia. Available from:
http://www.cancer.org/acs/groups/cid/documents/webcontent/003111-pdf.pdf.
Accessed May 2015.
4 Shaffer AL, Rosenwald A, Staudt LM. Lymphoid
malignancies: the dark side of B-cell differentiation. Nat Rev
Immunol. 2002;2(12):920-932.
Media Inquiries:
Kellie
McLaughlin
Phone: 1-908-927-7477
Mobile: 1-609-468-8356
Satu Kaarina Glawe
Mobile: +49 172 294 6264
Investor Relations:
Lesley
Fishman
Phone: 1-732-524-3922
U.S. Medical Inquiries:
Pharmacyclics Medical
Information:
1-877-877-3536
To view the original version on PR Newswire,
visit:http://www.prnewswire.com/news-releases/ibrutinib-imbruvica-helios-interim-analysis-study-data-show-significant-reductions-in-risk-of-progression-or-death-in-patients-with-previously-treated-chronic-lymphocytic-leukemia-300091188.html
SOURCE Janssen Research & Development, LLC