CytRx
Corporation (NASDAQ:CYTR), a biopharmaceutical research and
development company specializing in oncology, today announced it has
received approval from the U.S. Food and Drug Administration (FDA) to
continue dosing patients with aldoxorubicin until disease progression in
a planned pivotal, global Phase 3 clinical trial with aldoxorubicin as a
second-line treatment for soft tissue sarcomas. The clinical trial is
scheduled to begin this quarter. For purposes of the clinical trial,
disease progression is defined as an increase in the size of measurable
tumors by 20% or the development of a new tumor lesion. The following
table sets forth the cumulative dose of doxorubicin in prior and planned
CytRx clinical trials:
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Cumulative Doxorubicin Dose
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Recognized maximum dose associated with cardiac toxicity -
Doxorubicin
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450 mg/m2
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CytRx Phase 2b Clinical Trial – Aldoxorubicin
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1,560 mg/m2
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CytRx Phase 1b/2 Clinical Trial– Aldoxorubicin
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2,080 mg/m2
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CytRx Pharmacokinetics Clinical Trial – Aldoxorubicin
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1600-3200 mg/m2
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CytRx Pivotal Phase 3 Clinical Trial– Aldoxorubicin
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Up to Disease Progression
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The study design under the trial’s Special Protocol Assessment (SPA)
originally called for dosing to be stopped after six treatment cycles.
FDA acceptance of a protocol amendment to include a dose-to-progression
regimen demonstrates the superior cardiac safety thus far of
administrating a cumulative 2,080 mg/m2 dose of aldoxorubicin
as seen in the Company’s recently announced global, Phase 2b clinical
trial results (which is equivalent to 1,560 mg/m2 of
doxorubicin), which is 3.5 times the recognized maximum cumulative dose
of doxorubicin (450 mg/m2) associated with cardiac toxicity
(heart damage).
Sant Chawla, M.D., of the Sarcoma Oncology Center in Santa Monica,
Calif., and principal investigator of the Phase 3 pivotal trial,
commented, “In addition to observing no significant cardiotoxicity of
aldoxorubicin to this point, the FDA’s agreement to extend dosing beyond
six cycles offers the potential to achieve even greater progression-free
survival efficacy results than were demonstrated in CytRx’s recent
highly successful global Phase 2b trial for advanced soft tissue
sarcomas. As the principal investigator for this trial, I can say that
we are very pleased to have the opportunity to provide the maximum
benefits of aldoxorubicin to the patients around the world.”
“Current chemotherapy treatments for soft tissue sarcomas have
demonstrated limited impact, and other potential treatments have
provided no improved benefits in Phase 3 trials,” said CytRx President
and CEO Steven A. Kriegsman. “As such there is a significant need for a
second-line treatment with greater efficacy and reduced or no measurable
cardiac toxicity. This FDA acceptance of extended dosing represents a
potential major breakthrough for CytRx and STS patients throughout the
world.”
The international, open-label pivotal Phase 3 clinical trial will enroll
approximately 400 patients with metastatic, locally advanced or
unresectable soft tissue sarcomas who have either not responded to or
have progressed following treatment with one or more systemic regimens
of non-adjuvant chemotherapies. Trial patients will be randomized 1:1 to
be treated with aldoxorubicin or the investigator’s choice of an
approved chemotherapeutic regimen to include dacarbazine, pazopanib
(Votrient®), gemcitabine plus docetaxel, doxorubicin or ifosfamide, with
up to three comparator regimens to be selected by the investigator at
each clinical site. The clinical trial will be conducted at
approximately 100 clinical sites in the U.S., Europe, Canada, Latin
America and Australia. The primary endpoint of the study is
progression-free survival (PFS), and secondary endpoints include overall
survival and safety.
Review of Results for Phase 2b Trial with Aldoxorubicin as a
First-line Treatment in Advanced Soft Tissue Sarcomas
As initially reported on December 11, 2013, patients treated with
aldoxorubicin demonstrated highly statistically significant clinical
outcomes compared to those receiving standard doxorubicin therapy for
soft tissue sarcomas in both an investigator assessment and a central
lab review. Specifically, both assessments showed an unambiguous 80% to
100% improvement in PFS among patients treated with aldoxorubicin.
In an intent-to-treat analysis, the investigator-assessed median PFS was
8.4 months for aldoxorubicin patients versus 4.7 months for doxorubicin
patients (p=0.0002), while the blinded central lab review indicated that
median PFS for aldoxorubicin patients was 5.7 months versus 2.8 months
for doxorubicin patients (p=0.018). Per investigators, 67.1% of
aldoxorubicin patients had not progressed at 6 months, compared with
36.1% of doxorubicin-treated patients (p=0.005). By blinded central lab
review, 46.8% of aldoxorubicin patients had not progressed at 6 months,
compared with 23.7% of doxorubicin patients (p=0.038).
On January 8, 2014, CytRx reported results of additional analyses that
determined hazard ratios for the primary endpoint of PFS by both
investigators at study sites and by a blinded radiology review performed
at an independent central laboratory. The hazard ratio for
investigator-read scans was 0.37 (95% confidence interval, range of
0.212 to 0.643) (p=0.0004), reflecting a 63% reduction in the risk of
disease progression; and the hazard ratio for central lab scans was 0.59
(95% confidence interval, range of 0.36 to 0.96) (p=0.034), reflecting a
41% reduction in the risk of disease progression. Hazard ratios – the
likelihood that the study endpoint (in this case tumor progression) will
be reached during a given period – are an important measure of the
reliability and uniformity of the absolute data for PFS as presented
above. Hazard ratios where the upper limit is less than 1 indicate that
there is a significant difference between the two study groups.
CytRx also reported that a Kaplan-Meier analysis of the trial results,
which describes the time it takes for tumors to progress in individual
patients, showed significant improvement in patients treated with
aldoxorubicin versus patients treated with doxorubicin.
About Soft Tissue Sarcoma
Soft tissue sarcoma is a cancer occurring in muscle, fat, blood vessels,
tendons, fibrous tissues and connective tissue, and can arise anywhere
in the body at any age. According to the American Cancer Society, there
are approximately 50 types of soft tissue sarcomas. In 2013 more than
11,400 new cases were diagnosed in the U.S. and approximately 4,400
Americans died from this disease. In addition, approximately 40,000 new
cases and 13,000 deaths in the U.S. and Europe are part of a growing
underserved market.
About Aldoxorubicin
The widely used chemotherapeutic agent doxorubicin is delivered
systemically and is highly toxic, which limits its dose to a level below
its maximum therapeutic benefit. Doxorubicin also is associated with
many side effects, especially the potential for damage to heart muscle
at cumulative doses greater than 450 mg/m2. Aldoxorubicin
combines doxorubicin with a novel single-molecule linker that binds
directly and specifically to circulating albumin, the most plentiful
protein in the bloodstream. Protein-hungry tumors concentrate albumin,
thus increasing the delivery of the linker molecule with the attached
doxorubicin to tumor sites. In the acidic environment of the tumor, but
not the neutral environment of healthy tissues, doxorubicin is released.
This allows for greater doses (3½ to 4 times) of doxorubicin to be
administered while reducing its toxic side effects. In studies thus far
there has been no evidence of clinically significant effects of
aldoxorubicin on heart muscle, even at cumulative doses of drug well in
excess of 2 g/m2.
About CytRx Corporation
CytRx Corporation is a biopharmaceutical research and development
company specializing in oncology. CytRx currently is focused on the
clinical development of aldoxorubicin (formerly known as INNO-206), its
improved version of the widely used chemotherapeutic agent doxorubicin.
CytRx has completed a global Phase 2b clinical trial with aldoxorubicin
as a first-line therapy for soft tissue sarcomas, a Phase 1b/2 clinical
trial primarily in the same indication, a Phase 1b study of
aldoxorubicin in combination with doxorubicin in patients with advanced
solid tumors and a Phase 1b pharmacokinetics clinical trial in patients
with metastatic solid tumors. CytRx plans to initiate under a special
protocol assessment a pivotal Phase 3 global trial with aldoxorubicin as
a therapy for patients with soft tissue sarcomas whose tumors have
progressed following treatment with chemotherapy. CytRx has initiated a
Phase 2 clinical trial with aldoxorubicin in patients with late-stage
glioblastoma (brain cancer), and plans to initiate a Phase 2 clinical
trial in HIV-related Kaposi’s sarcoma. CytRx plans to expand its
pipeline of oncology candidates based on a linker platform technology
that can be utilized with multiple chemotherapeutic agents and may allow
for greater concentration of drug at tumor sites. CytRx also has rights
to two additional drug candidates, tamibarotene and bafetinib. CytRx
completed its evaluation of bafetinib in the ENABLE Phase 2 clinical
trial in high-risk B-cell chronic lymphocytic leukemia (B-CLL), and
plans to seek a partner for further development of bafetinib. For more
information about CytRx Corporation, visit www.cytrx.com.
Forward-Looking Statements
This press release contains forward-looking statements within the
meaning of Section 21E of the Securities Exchange Act of 1934, as
amended. Such statements involve risks and uncertainties that could
cause actual events or results to differ materially from the events or
results described in the forward-looking statements, including risks
relating to the outcome, timing and results of CytRx's clinical trials,
the risk that the results of any future human testing of aldoxorubicin,
including the final data from the Phase 2b clinical testing of
aldoxorubicin as a first-line treatment in patients with metastatic,
locally advanced or unresectable soft tissue sarcomas who have not been
previously treated with any chemotherapy, or the Phase 3 clinical trial
with aldoxorubicin as a second-line treatment for advanced soft tissue
sarcomas, might not produce objective response or safety results similar
to the data described in this press release, risks related to CytRx's
ability to manufacture its drug candidates in a timely fashion,
cost-effectively or in commercial quantities in compliance with
stringent regulatory requirements, risks related to CytRx's need for
additional capital or strategic partnerships to fund its ongoing working
capital needs and development efforts, including the Phase 3 clinical
development of aldoxorubicin, and the risks and uncertainties described
in the most recent annual and quarterly reports filed by CytRx with the
Securities and Exchange Commission and current reports filed since the
date of CytRx's most recent annual report. All forward-looking
statements are based upon information available to CytRx on the date the
statements are first published. CytRx undertakes no obligation to
publicly update or revise any forward-looking statements, whether as a
result of new information, future events or otherwise.
Copyright Business Wire 2014