NCI sponsored, ECOG-ACRIN Phase 3 Study
of Leukine in Combination with Ipilimumab and Nivolumab in Front
Line Treatment of Melanoma Heads to Last Stages of
Enrollment
LEXINGTON, Mass., April 18,
2024 /PRNewswire/ -- Partner Therapeutics, Inc. (PTx)
announced publication of a comprehensive review by Dougan et
al.1 in Cancers summarizing the mechanistic
rationale and pre-clinical and clinical data regarding the use of
Leukine (sargramostim; glycosylated, yeast-derived recombinant
human granulocyte-macrophage colony-stimulating factor [rhu
GM-CSF]) to manage gastrointestinal (GI) immune-related adverse
events (irAEs) for patients taking immune checkpoint inhibitors
(ICIs) for the treatment of cancer. Leukine is not FDA approved for
treatment of irAEs or melanoma.
The authors describe the mechanisms underlying GI irAEs and
their similarities to inflammatory bowel disease and review the
available clinical data supporting a potential role for Leukine in
both settings. In the prospective, randomized study E1608, Hodi and
colleagues2 observed that advanced melanoma patients who
received Leukine plus ipilimumab had a reduction in GI irAEs
(p=0.05) (see figure below) as well as a significant improvement in
overall survival (p=0.01) compared to those who received ipilimumab
alone.
"Immune checkpoint inhibitors have meaningfully improved
prognoses for cancer patients in a number of cancers," said
Michael Dougan MD, PhD, Associate
Professor of Medicine at Massachusetts General Hospital.
"Unfortunately, these drugs also can cause the immune system to
attack healthy cells creating unwanted GI side effects including
some that lead to discontinuation of treatment and more severe
outcomes. The potential Leukine has shown in mitigating GI irAEs
and improving patient outcomes, including survival, are
encouraging."
Ongoing Phase 3 Study of Leukine with Ipilimumab and
Nivolumab in Front Line Metastatic Melanoma
Leukine continues to be studied in combination with ICIs to
assess differences in the rate of serious adverse events as well as
its impact on overall survival.
EA6141 (NCT02339571) is a randomized, controlled phase 2/3 study
of Leukine in combination with ipilimumab and nivolumab for the
front line treatment of patients with unresectable stage III or
stage IV melanoma that is sponsored by the National Cancer
Institute (NCI) and being conducted by ECOG-ACRIN Cancer Research
Group.3 It is led by Study Chair F. Stephen Hodi Jr., MD, Director of the Center
for Immuno-Oncology at Dana-Farber Cancer Institute, and Study
Co-Chair Ahmad A. Tarhini, MD, PhD,
Professor of Oncologic Sciences and Director of Cutaneous and
Clinical Translational Research at H. Lee Moffitt Cancer Center and
Research Institute. Both are members of the ECOG-ACRIN Melanoma
Committee.
"The phase 2 portion of study EA6141 was completed previously,
and after a successful planned interim analysis, advanced to the
phase 3 portion, which is now in the last stages of enrollment,"
said Dr. Hodi in a recent statement. "The primary objective is to
compare the overall survival rates of patients who receive
nivolumab/ipilimumab/rhu GM-CSF versus those who receive only
nivolumab/ipilimumab."
REFERENCES
- Dougan M, Nguyen LH, Buchbinder EI, Lazarus HM. Sargramostim
for Prophylactic Management of Gastrointestinal Immune-Related
Adverse Events of Immune Checkpoint Inhibitor Therapy for
Cancer. Cancers. 2024; 16(3):501.
doi.org/10.3390/cancers16030501
- Hodi FS, Lee S, McDermott DF, et al. Ipilimumab Plus
Sargramostim vs Ipilimumab Alone for Treatment of Metastatic
Melanoma: A Randomized Clinical Trial. JAMA. 2014;
312(17):1744-1753. doi:10.1001/jama.2014.13943
- National Cancer Institute. A Phase II/III Trial
of Nivolumab, ipilimumab, and GM-CSF in patients with advanced
melanoma. Available
at: https://clinicaltrials.gov/ct2/show/NCT02339571. NLM
identifier: NCT02339571. Accessed April 16, 2024.
ABOUT MELANOMA
Melanoma is the most aggressive form of
skin cancer and rates of melanoma have been rising for the past 30
years. The American Cancer Society estimates 96,480 new melanoma
cases will be diagnosed in the US and 7,230 people will die from
the disease in 2019. The FDA grants orphan drug designation to
promote the development of promising treatments for conditions that
affect 200,000 or fewer U.S. patients annually.
ABOUT LEUKINE
LEUKINE (sargramostim) is a glycosylated recombinant human
granulocyte-macrophage colony-stimulating factor (rhu GM-CSF)
produced by recombinant DNA technology in yeast. The product is
commercially available in the United
States and accessible through a named patient program
operated by Tanner Pharma Group outside of the United States.
LEUKINE is indicated:
- To shorten time to neutrophil recovery and to reduce the
incidence of severe and life-threatening infections and infections
resulting in death following induction chemotherapy in adult
patients 55 years and older with acute myeloid leukemia (AML).
- For the mobilization of hematopoietic progenitor cells into
peripheral blood for collection by leukapheresis and autologous
transplantation in adult patients.
- For the acceleration of myeloid reconstitution following
autologous bone marrow or peripheral blood progenitor cell
transplantation in adult and pediatric patients 2 years of age and
older.
- For the acceleration of myeloid reconstitution following
allogeneic bone marrow transplantation in adult and pediatric
patients 2 years of age and older.
- For treatment of delayed neutrophil recovery or graft failure
after autologous or allogeneic bone marrow transplantation in adult
and pediatric patients 2 years of age and older.
- To increase survival in adult and pediatric patients from birth
to 17 years of age acutely exposed to myelosuppressive doses of
radiation (Hematopoietic Syndrome of Acute Radiation Syndrome
[H-ARS]).
Important Safety Information for Leukine (sargramostim)
Contraindications
- Do not administer LEUKINE to patients with a history of
serious allergic reaction, including anaphylaxis, to human
granulocyte-macrophage colony-stimulating factor, sargramostim,
yeast-derived products, or any other component of LEUKINE.
Warnings and Precautions
- Serious hypersensitivity reactions, including anaphylactic
reactions, have been reported with LEUKINE. If a serious allergic
or anaphylactic reaction occurs, immediately discontinue LEUKINE
therapy, and institute medical management. Discontinue LEUKINE
permanently for patients with serious allergic reactions.
- LEUKINE can cause infusion-related reactions that may be
characterized by respiratory distress, hypoxia, flushing,
hypotension, syncope, and/or tachycardia. Observe closely during
infusion, particularly in patients with preexisting lung disease;
dose adjustment or discontinuation may be needed.
- LEUKINE should not be administered simultaneously with or
within 24 hours preceding cytotoxic chemotherapy or radiotherapy or
within 24 hours following chemotherapy.
- Edema, capillary leak syndrome, and pleural or pericardial
effusions have been reported in patients after LEUKINE
administration. LEUKINE should be used with caution in patients
with preexisting fluid retention, pulmonary infiltrates, or
congestive heart failure. Such patients should be monitored.
- Supraventricular arrhythmia has been reported in uncontrolled
studies during LEUKINE administration, particularly in patients
with a history of cardiac arrhythmia. Use LEUKINE with caution in
patients with preexisting cardiac disease.
- If absolute neutrophil count (ANC) > 20,000 cells/mm3 or if
white blood cell (WBC) counts > 50,000/mm3, LEUKINE
administration should be interrupted, or the dose reduced by half.
Monitor complete blood counts (CBC) with differential twice per
week.
- Discontinue LEUKINE therapy if tumor progression, particularly
in myeloid malignancies, is detected during LEUKINE treatment.
- Treatment with LEUKINE may induce neutralizing anti-drug
antibodies. Use LEUKINE for the shortest duration needed.
- Avoid administration of solutions containing benzyl alcohol
(including LEUKINE for injection reconstituted with Bacteriostatic
Water for Injection, USP [0.9 % benzyl alcohol]) to neonates and
low birth weight infants.
Drug Interactions
- Avoid the concomitant use of LEUKINE and products that
induce myeloproliferation. Monitor for clinical and laboratory
signs of excess myeloproliferative effects.
Adverse Reactions
Adverse events occurring in >10% of patients receiving LEUKINE
in controlled clinical trials and reported at a higher frequency
than in placebo patients are:
- In recipients of autologous bone marrow transplantation
(BMT)–asthenia, malaise, diarrhea, rash, peripheral edema, urinary
tract disorder
- In recipients of allogeneic BMT–abdominal pain, chills, chest
pain, diarrhea, nausea, vomiting, hematemesis, dysphagia, GI
hemorrhage, pruritus, bone pain, arthralgia, eye hemorrhage,
hypertension, tachycardia, bilirubinemia, hyperglycemia, increased
creatinine, hypomagnesemia, edema, pharyngitis, epistaxis, dyspnea,
insomnia, anxiety, high glucose, low albumin
- In patients with AML–fever, weight loss, nausea, vomiting,
anorexia, skin reactions, metabolic laboratory abnormalities,
edema
ABOUT PARTNER THERAPEUTICS
Partner Therapeutics, Inc. (PTx), an integrated biotechnology
company, focuses on development and commercialization of late-stage
therapeutics to improve health outcomes in treatment of cancer and
other serious diseases. The company believes in delivering products
and supporting medical teams with the purpose of achieving superior
outcomes for patients and their families.
Visit www.partnertx.com.
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