Seattle
Genetics, Inc. (Nasdaq: SGEN) today highlighted multiple ADCETRIS
(brentuximab vedotin) data presentations in frontline and salvage
Hodgkin lymphoma (HL) at the 56th American Society of
Hematology (ASH) Annual Meeting and Exposition taking place in San
Francisco, CA, December 6-9, 2014. ADCETRIS is an antibody-drug
conjugate (ADC) directed to CD30, which is expressed in classical HL and
systemic anaplastic large cell lymphoma (sALCL), a type of T-cell
lymphoma. Data highlighted in oral sessions include encouraging
long-term outcomes from a phase 1 trial evaluating ADCETRIS in
combination with AVD chemotherapy in frontline HL, as well as strong
activity evaluating ADCETRIS combination therapy in second-line HL and
ADCETRIS monotherapy or combination therapy in frontline HL patients age
60 and older. In addition, encouraging data from multiple
investigator-sponsored trials were featured in oral and poster sessions
evaluating ADCETRIS in frontline and salvage HL and in non-Hodgkin
lymphoma settings.
“Our goal is to establish ADCETRIS as the foundation of therapy for
CD30-positive malignancies. The multiple data sets presented at the ASH
annual meeting support that vision, showing encouraging activity
associated with ADCETRIS treatment both as a single-agent and in
combination with other agents for frontline and salvage Hodgkin
lymphoma,” said Clay
B. Siegall, Ph.D., President and Chief Executive Officer of Seattle
Genetics. “Of note, the oral presentation on the three-year long term
follow-up from the phase 1 frontline Hodgkin lymphoma trial,
demonstrating a failure-free survival rate of 92 percent and overall
survival rate of 100 percent with a manageable safety profile, supports
our goal to redefine frontline treatment of Hodgkin lymphoma with the
addition of ADCETRIS. The phase 3 ECHELON-1 trial is evaluating ADCETRIS
in this setting.”
Brentuximab Vedotin Combined with ABVD or AVD for Patients with Newly
Diagnosed Advanced Stage Hodgkin Lymphoma: Long-Term Outcomes (Abstract
#292, oral presentation at 7:45 a.m. PT at the Moscone Center, West
Building, 3009-3011-3022-3024)
This phase 1 trial was conducted to evaluate ADCETRIS plus the
chemotherapy regimen ABVD (Adriamycin, bleomycin, vinblastine and
dacarbazine) or ADCETRIS plus AVD, which removes bleomycin, for the
treatment of newly diagnosed advanced stage HL patients.
Data previously presented from this trial demonstrated that 24 of 25
patients (96 percent) who received ADCETRIS plus AVD achieved a complete
remission and 21 of 22 patients (95 percent) who completed therapy with
ADCETRIS plus ABVD achieved a complete remission. The most common
adverse events of any grade occurring in more than 30 percent of
patients across both treatment regimens were hair loss, constipation,
diarrhea, fatigue, insomnia, nausea, neutropenia, peripheral sensory
neuropathy, fever and vomiting. As previously reported, pulmonary
toxicity was seen in the ADCETRIS plus ABVD cohorts, resulting in a
contraindication for the concomitant administration of ADCETRIS and
bleomycin. No pulmonary toxicity was observed in the ADCETRIS plus AVD
cohort.
Long-term data to be presented in an oral presentation by Joseph
Connors, M.D., BC Cancer Agency, include:
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In the ADCETRIS plus AVD arm, three-year overall survival was 100
percent and three-year failure-free survival was 92 percent. In the
ADCETRIS plus ABVD arm, three-year overall survival was 92 percent and
three-year failure-free survival was 79 percent.
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Patients were followed for a median of 36 months in the ADCETRIS plus
AVD arm and 45 months in the ADCETRIS plus ABVD arm. The longest time
to relapse in either arm was 23 months.
Based on the phase 1 results, the global phase 3 ECHELON-1 trial was
initiated and is currently enrolling patients. This randomized trial is
comparing progression-free survival in patients receiving ADCETRIS in
combination with AVD to patients receiving ABVD alone. Visit www.clinicaltrials.org
for more information about ECHELON-1.
Brentuximab Vedotin in Combination with Bendamustine for Patients
with Hodgkin Lymphoma who are Relapsed or Refractory to Frontline Therapy
(Abstract #293, oral presentation at 8:00 a.m. PT at the Moscone
Center, West Building, 3009-3011-3022-3024)
Interim data were presented from an ongoing phase 1/2 single-arm,
open-label clinical trial evaluating the efficacy and tolerability of
ADCETRIS in combination with bendamustine in HL patients who have
relapsed or were refractory to frontline therapy. Current treatment
options in this setting include salvage chemotherapy regimens that
historically have resulted in variable complete remission rates of 19 to
60 percent and are associated with significant toxicities.
The phase 1 study determined the dosing level of bendamustine combined
with ADCETRIS, and assessed safety and tolerability. The phase 2
expansion cohort is evaluating combination treatment of ADCETRIS and
bendamustine to assess best response, duration of response and
progression-free survival. In the trial, ADCETRIS in combination with
bendamustine is administered every three weeks, for up to six cycles,
followed by additional treatment with single-agent ADCETRIS for up to a
total of 16 cycles of therapy. After patients receive at least two
cycles of combination therapy, they have the option to pause treatment
to receive an autologous stem cell transplant (ASCT) and then resume
treatment with single-agent ADCETRIS as consolidation.
Data were reported from 54 patients with a median age of 37 years. The
majority of patients (54 percent) had stage III/IV disease at the time
of initial diagnosis and 37 patients (69 percent) had either primary
refractory disease or had relapsed within one year of frontline therapy.
Interim data from this phase 1/2 trial to be highlighted in an oral
presentation by Ann LaCasce, M.D., Dana-Farber Cancer Institute, include:
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Of 48 patients evaluable for response, 46 patients (96 percent) had an
objective response, including 40 patients (83 percent) with a complete
remission and six patients (13 percent) with a partial remission. One
patient had stable disease and one patient had progressive disease.
The majority of complete remissions (34 of 40 patients) were achieved
after two cycles of combination therapy.
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Median duration of response, progression-free survival and overall
survival had not yet been reached.
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No adverse impact on stem cell mobilization or engraftment was
observed. Thirty-two patients had received an ASCT to date.
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The most common adverse events from combination treatment were
infusion-related reactions (IRRs) which were seen in approximately 50
percent of patients. Approximately 20 percent of IRRs were Grade 3 or
higher. The majority of IRRs occurred within 24 hours of the second
cycle of combination treatment and were considered related to both
therapies. Symptoms associated with IRRs were dyspnea (15 percent),
chills (13 percent) and flushing (13 percent). The trial protocol was
amended to require premedication with corticosteroids and
antihistamines, which decreased the severity of IRRs.
Brentuximab Vedotin Monotherapy and in Combination with Dacarbazine
in Frontline Treatment of Hodgkin Lymphoma in Patients Aged 60 Years and
Above: Interim Results of a Phase 2 Study (Abstract #294, oral
presentation at 8:15 a.m. PT at the Moscone Center, West Building,
3009-3011-3022-3024)
Data were presented from an ongoing phase 2 clinical trial evaluating
ADCETRIS as a single-agent or in combination with dacarbazine as
frontline therapy for HL patients age 60 or older. Interim data were
reported from 27 patients treated with single-agent ADCETRIS and 18
patients treated with the combination of ADCETRIS and dacarbazine. The
median age of patients was 78 years in the single-agent ADCETRIS arm and
72.5 years in the dacarbazine combination arm. A majority of patients in
each arm had stage III/IV disease at the time of diagnosis. The data
will be highlighted in an oral presentation by Andres Forero-Torres,
M.D., University of Alabama at Birmingham.
Data from the single-agent ADCETRIS arm include:
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Of 27 evaluable patients, 25 patients (93 percent) had an objective
response, including 19 patients (70 percent) with a complete remission
and six patients (22 percent) with a partial remission. Two patients
(seven percent) had stable disease.
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All 27 patients (100 percent) achieved tumor reduction.
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After a median follow-up time of 8.7 months, the median duration of
response was 9.1 months and the median PFS was 10.5 months.
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The median number of treatment cycles was eight.
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The most common adverse events of any grade occurring in 20 percent or
more of patients were peripheral sensory neuropathy, fatigue, nausea,
swelling, diarrhea, decreased appetite and constipation.
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The only Grade 3 adverse events occurring in more than one patient
were peripheral sensory neuropathy (seven patients) and peripheral
motor neuropathy and rash (two patients each). No Grade 4 adverse
events occurred.
Preliminary key findings in the ongoing trial evaluating combination
ADCETRIS and dacarbazine include:
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Of 14 evaluable patients, 13 patients (93 percent) had an objective
response, including four patients (29 percent) with a complete
remission and nine patients (64 percent) with a partial remission.
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All 14 evaluable patients (100 percent) achieved tumor reduction.
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Fifteen of 18 patients (83 percent) were still on treatment at the
time of the analysis.
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The most common Grade 1 and 2 adverse events were peripheral sensory
neuropathy and nausea (33 percent each); diarrhea and constipation (28
percent each); fatigue, hair loss, joint pain and headache (22 percent
each).
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Grade 3 or serious adverse events occurring in one patient each were
colitis and vomiting, hypotension and hyperglycemia.
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The trial is currently enrolling patients to evaluate the combination
of ADCETRIS and bendamustine.
Additional ADCETRIS Data Presentations
Additional investigator-sponsored data presentations evaluating ADCETRIS
in Hodgkin and non-Hodgkin lymphoma include:
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Cost-Effectiveness Assessment of Brentuximab Vedotin to Prevent
Progression Following Autologous Stem Cell Transplant in Hodgkin
Lymphoma in the United States (Abstract #2657, poster presentation by
Joshua Roth, Ph.D., M.H.A., Fred Hutchinson Cancer Research Center, at
6:00 p.m. PT on Sunday, December 7, 2014 at the Moscone Center North
Building, Hall E )
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Brentuximab Vedotin (BV) Plus Rituximab (R) as Frontline Therapy for
Patients (Pts) with Epstein Barr Virus (EBV)+ and/or CD30+ Lymphoma:
Phase I Results of an Ongoing Phase I-II (Abstract #3096, poster
presentation by Mitul Gandhi, M.D., Northwestern University Feinberg
School of Medicine, at 6:00 p.m. PT on Sunday, December 7, 2014)
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Safety and Early Efficacy in an Ongoing Pilot Study of Brentuximab
Vedotin and AVD Chemotherapy Followed By 30 Gray Involved-Site
Radiotherapy for Newly Diagnosed, Early Stage, Unfavorable Risk
Hodgkin Lymphoma (Abstract #3085, poster presentation on Monday,
December 8, 2014)
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A Phase 1-2 Study of Brentuximab Vedotin (BV) and Bendamustine (B) in
Patients with Relapsed or Refractory Hodgkin Lymphoma (HL) and
Anaplastic Large T-Cell Lymphoma (ALCL) (Abstract #3084, poster
presentation on Monday, December 8, 2014)
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Results of a Phase II Trial of Brentuximab Vedotin As First Line
Salvage Therapy in Relapsed/Refractory HL Prior to AHCT (Abstract
#501, oral presentation at 3:15 p.m. PT on Monday, December 8, 2014)
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A Phase 2 Trial of Induction Chemotherapy with ABVD Followed by
Brentuximab Vedotin Consolidation in Patients with Previously
Untreated Non-Bulky Stage I or II Hodgkin Lymphoma (Abstract #4431,
poster presentation on Monday, December 8, 2014)
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Phase II Investigator-Initiated Study of Brentuximab Vedotin in
Mycosis Fungoides or Sézary Syndrome: Final Results Show Significant
Clinical Activity and Suggest Correlation with CD30 Expression
(Abstract #804, oral presentation at 8:45 a.m. PT on Tuesday, December
9, 2014)
ADCETRIS is currently not approved in the frontline, salvage or
combination Hodgkin and non-Hodgkin lymphoma settings or in cutaneous
T-cell lymphoma.
About ADCETRIS
ADCETRIS (brentuximab vedotin) is an ADC comprising an anti-CD30
monoclonal antibody attached by a protease-cleavable linker to a
microtubule disrupting agent, monomethyl auristatin E (MMAE), utilizing
Seattle Genetics’ proprietary technology. The ADC employs a linker
system that is designed to be stable in the bloodstream and release MMAE
upon internalization into CD30-expressing tumor cells.
ADCETRIS for intravenous injection received accelerated approval from
the U.S. Food and Drug Administration and approval with conditions from
Health Canada for two indications: (1) the treatment of patients with HL
after failure of ASCT or after failure of at least two prior multi-agent
chemotherapy regimens in patients who are not ASCT candidates, and (2)
the treatment of patients with sALCL after failure of at least one prior
multi-agent chemotherapy regimen. The indications for ADCETRIS are based
on response rate. There are no data available demonstrating improvement
in patient-reported outcomes or survival with ADCETRIS.
ADCETRIS was granted conditional marketing authorization by the European
Commission in October 2012 for two indications: (1) for the treatment of
adult patients with relapsed or refractory CD30-positive HL following
ASCT, or following at least two prior therapies when ASCT or multi-agent
chemotherapy is not a treatment option, and (2) the treatment of adult
patients with relapsed or refractory sALCL. ADCETRIS has received
marketing authorization by regulatory authorities in 45 countries. See
important safety information below.
Seattle Genetics and Takeda are jointly developing ADCETRIS. Under the
terms of the collaboration agreement, Seattle Genetics has U.S. and
Canadian commercialization rights and Takeda has rights to commercialize
ADCETRIS in the rest of the world. Seattle Genetics and Takeda are
funding joint development costs for ADCETRIS on a 50:50 basis, except in
Japan where Takeda will be solely responsible for development costs.
About Seattle Genetics
Seattle Genetics is a biotechnology company focused on the development
and commercialization of innovative antibody-based therapies for the
treatment of cancer. Seattle Genetics is leading the field in developing
antibody-drug conjugates (ADCs), a technology designed to harness the
targeting ability of antibodies to deliver cell-killing agents directly
to cancer cells. The company’s lead product, ADCETRIS®
(brentuximab vedotin) is an ADC that, in collaboration with Takeda
Pharmaceutical Company Limited, is commercially available for two
indications in more than 45 countries, including the U.S., Canada, Japan
and members of the European Union. Additionally, ADCETRIS is being
evaluated broadly in more than 30 ongoing clinical trials. Seattle
Genetics is also advancing a robust pipeline of clinical-stage ADC
programs, including SGN-CD19A, SGN-CD33A, SGN-LIV1A, SGN-CD70A, ASG-22ME
and ASG-15ME. Seattle Genetics has collaborations for its ADC technology
with a number of leading biotechnology and pharmaceutical companies,
including AbbVie, Agensys (an affiliate of Astellas), Bayer, Genentech,
GlaxoSmithKline and Pfizer. More information can be found at www.seattlegenetics.com.
ADCETRIS (brentuximab vedotin) U.S. Important Safety Information
BOXED WARNING
Progressive multifocal leukoencephalopathy (PML): JC virus infection
resulting in PML and death can occur in patients receiving ADCETRIS.
Contraindication:
Concomitant use of ADCETRIS and bleomycin is contraindicated due to
pulmonary toxicity.
Warnings and Precautions:
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Peripheral neuropathy: ADCETRIS treatment causes a peripheral
neuropathy that is predominantly sensory. Cases of peripheral motor
neuropathy have also been reported. ADCETRIS-induced peripheral
neuropathy is cumulative. Monitor patients for symptoms of neuropathy,
such as hypoesthesia, hyperesthesia, paresthesia, discomfort, a
burning sensation, neuropathic pain or weakness and institute dose
modifications accordingly.
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Infusion reactions: Infusion-related reactions, including anaphylaxis,
have occurred with ADCETRIS. Monitor patients during infusion. If an
infusion reaction occurs, interrupt the infusion and institute
appropriate medical management. If anaphylaxis occurs, immediately and
permanently discontinue the infusion and administer appropriate
medical therapy.
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Hematologic toxicities: Grade 3 or 4 anemia, thrombocytopenia and
prolonged (≥1 week) severe neutropenia can occur with ADCETRIS.
Febrile neutropenia has been reported with ADCETRIS. Monitor complete
blood counts prior to each dose of ADCETRIS and consider more frequent
monitoring for patients with Grade 3 or 4 neutropenia. Closely monitor
patients for fever. If Grade 3 or 4 neutropenia develops, manage by
G-CSF support, dose delays, reductions or discontinuation.
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Serious infections and opportunistic infections: Infections such as
pneumonia, bacteremia and sepsis/septic shock (including fatal
outcomes) have been reported in patients treated with ADCETRIS.
Closely monitor patients during treatment for the emergence of
possible bacterial, fungal or viral infections.
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Tumor lysis syndrome: Closely monitor patients with rapidly
proliferating tumor and high tumor burden.
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Progressive multifocal leukoencephalopathy (PML): JC virus infection
resulting in PML and death has been reported in ADCETRIS-treated
patients. In addition to ADCETRIS therapy, other possible contributory
factors include prior therapies and underlying disease that may cause
immunosuppression. Consider the diagnosis of PML in any patient
presenting with new-onset signs and symptoms of central nervous system
abnormalities. Evaluation of PML includes, but is not limited to,
consultation with a neurologist, brain MRI, and lumbar puncture or
brain biopsy. Hold ADCETRIS if PML is suspected and discontinue
ADCETRIS if PML is confirmed.
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Stevens-Johnson syndrome (SJS): SJS has been reported with ADCETRIS.
If SJS occurs, discontinue ADCETRIS and administer appropriate medical
therapy.
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Embryo-fetal toxicity: Fetal harm can occur. Advise pregnant women of
the potential hazard to the fetus.
Adverse Reactions:
ADCETRIS was studied as monotherapy in 160 patients in two Phase 2
trials. Across both trials, the most common adverse reactions (≥20%),
regardless of causality, were neutropenia, peripheral sensory
neuropathy, fatigue, nausea, anemia, upper respiratory tract infection,
diarrhea, pyrexia, rash, thrombocytopenia, cough and vomiting.
Drug Interactions:
Concomitant use of strong CYP3A4 inhibitors or inducers, or P-gp
inhibitors, has the potential to affect the exposure to MMAE.
Use in Specific Populations:
MMAE exposure is increased in patients with hepatic impairment and
severe renal impairment. Closely monitor these patients for adverse
reactions.
For additional important safety information, including Boxed WARNING,
please see the full U.S. prescribing information for ADCETRIS at www.seattlegenetics.com
or www.ADCETRIS.com.
Certain of the statements made in this press release are forward
looking, such as those, among others, relating to our goal to establish
ADCETRIS as the foundation of therapy for a broad array of CD30-positive
malignancies. Actual results or developments may differ materially from
those projected or implied in these forward-looking statements. Factors
that may cause such a difference include risks that data resulting from
these additional trials with ADCETRIS will not support approvals in any
of the studied indications. In addition, as our other drug candidates or
those of our collaborators advance in clinical trials, adverse events
may occur which affect the future development of those drug candidates
and possibly other compounds using similar technology, including
ADCETRIS. More information about the risks and uncertainties faced by
Seattle Genetics is contained in the company’s 10-Q for the quarter
ended September 30, 2014 filed with the Securities and Exchange
Commission. Seattle Genetics disclaims any intention or obligation to
update or revise any forward-looking statements, whether as a result of
new information, future events or otherwise.
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