Published:
Positive SPA Reply From the FDA for TopoTarget's Pivotal Trial With Belinostat in PTCL
COPENHAGEN, Denmark, September 5 /PRNewswire-FirstCall/ -- TopoTarget A/S
(OMX: TOPO) announced that a positive reply from the FDA was received on a
Special Protocol Assessment (SPA) for a phase III trial for belinostat in
PTCL (Peripheral T-Celle Lymphoma). This pivotal trial is to enrol
approximately 120 patients and is to begin in Q4 2008. In June Fast Track
designation was granted for the development of belinostat in this indication
which supports TopoTarget's rapid market entry strategy. There is currently
no standard therapy approved for PTCL.
"This is very good news. We can now move belinostat into a pivotal phase
III. With the SPA in place we have agreed on a design for our pivotal phase
III trial with the FDA which will begin in Q4 of this year. In addition with
the FDA's Fast Track designation received in June for the PTCL indication we
can continue with our strategy of rapid market entry for belinostat in an
area with a high unmet medical need." Said Professor, Peter Buhl Jensen, MD,
CEO of TopoTarget.
Design
The phase III trial is an open-label, multicenter, single arm efficacy
and safety trial in patients with relapsed or refractory peripheral T-cell
lymphoma who have failed at least one prior systemic therapy. Approximately
120 patients (100 evaluable patients) will be enrolled. Patients will be
treated with 1000 mg/m2 belinostat administered as a 30 minute IV infusion on
days 1-5 of every 3-week cycle until there is disease progression or
unmanageable treatment-related toxicities.
Rational
Belinostat is a small molecule class I and II histone deacetylase
inhibitor (HDACi). HDACi's modulate gene expression within tumor cells,
including tumor suppressor genes, leading to G1 and G2/M cell cycle arrest,
induction of apoptosis (programmed cell death), inhibition of angiogenesis,
immune modulation, and promotion of cellular differentiation. Clinical
activity of belinostat has been observed in an ongoing Phase II trial of
belinostat monotherapy in patients with recurrent or refractory cutaneous
(CTCL) or peripheral T-cell lymphoma (PTCL). Efficacy is being analyzed
separately in PTCL and CTCL patients. In 11 patients evaluable for response
in the PTCL arm, 2 durable complete responses (CR) and 4 Stable Diseases (SD)
have been observed as announced at "10th International Conference on
Malignant Lymphoma" in Lugano in June. In both arms of the study, the
objective response rate in the first stage has met the criteria for expansion
to the second stage of a Simon 2-stage design.
Objectives and methods of evaluation The primary study endpoint will be
objective response rate (ORR). Objective response is complete response (CR)
or partial response (PR) based on independent radiology review. Secondary
objectives of the study are to determine: safety of belinostat monotherapy,
time to response, duration of response, time to progression (TTP),
progression-free survival (PFS), one-year progression-free rate, one-year
survival rate and overall survival (OS).
Today's news does not change TopoTarget's full-year financial guidance
for 2008.
Background information
About Periferal T-Cell Lymphomas (PTCL)
PTCL represent approximately 10% of all non-Hodgkin's lymphomas (NHL) in
Western populations and are associated with a poor prognosis. Most patients
with PTCL relapse after initial treatment with cytotoxic agents, and 5-year
survival is less than 30%. T-cell Non Hodkins Lymphomas, to which PTCL
belongs, are associated with a poorer outcome and survival compared to the
B-cell lymphomas. The primary response rate for all PTCL subtypes remains at
less than 60%, with nearly all patients relapsing. Median survival of all
PTCL patients (excluding a few subtypes) is approximately 3-4 years, with a
5-year survival of less than 30%. There are currently no therapies approved
specifically for PTCL. Primary treatment for most subtypes of PTCL remains
anthracycline-based regimens, predominantly the combination of
cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP). With the
exception of ALK-positive ALCL, PTCL subtypes respond poorly to these
regimens. The use of radiotherapy, with or without chemotherapy, is preferred
as front line treatment of extranodal NK/T-cell lymphoma. The majority of
patients with PTCL will relapse after primary therapy. A number of
chemotherapy regimens are used for salvage therapy. However, there is
currently no consensus regarding the optimal treatment approach for PTCL
salvage therapy.
About Belinostat
Belinostat is a promising small molecule HDAC inhibitor being
investigated for its role in the treatment of a wide range of solid tumors
and hematologic malignancies either as a single-agent, or in combination with
other active anti-cancer agents, including carboplatin, paclitaxel,
cis-retinoic acid, azacitidine and Velcade(R) (bortezomib) for injection.
HDAC inhibitors represent a new mechanistic class of anti-cancer therapeutics
that target HDAC enzymes, and have been shown to arrest growth of cancer
cells (including drug resistant subtypes); induce apoptosis, or programmed
cell death; promote differentiation; inhibit angiogenesis; and sensitize
cancer cells to overcome drug resistance when used in combination with other
anti-cancer agents. Intravenous belinostat is currently being evaluated in
multiple clinical trials as a potential treatment for cutaneous and
peripheral T-cell lymphomas, B-cell lymphomas, AML, mesothelioma, soft tissue
sarcoma, MDS, and liver, colorectal, and ovarian cancers, either alone or in
combination with anti- cancer therapies. An oral formulation of belinostat is
also being evaluated in a Phase I clinical trial for patients with advanced
solid tumors. Several trials in the belinostat program are conducted under a
Clinical Trail Agreement (CTA) under which the NCI sponsors clinical trials
to investigate belinostat for the treatment of various cancers, both as a
single-agent and in combination chemotherapy regimens. In May 2005,
TopoTarget announced the signing of a Cooperative Research and Development
Agreement (CRADA) with the NCI to conduct preclinical and nonclinical studies
on belinostat in order to better understand its anti-tumor activity and to
provide supporting information for clinical trials.
About TopoTarget
TopoTarget (OMX: TOPO) is an international biotech company headquartered
inDenmark, dedicated to finding ''Answers for Cancer'' and developing
improved cancer therapies. The company is founded and run by clinical cancer
specialists and combines years of hands-on clinical experience with in-depth
understanding of the molecular mechanisms of cancer. Focus lies on highly
predictive cancer models and key cancer targets (including HDACi, NAD+, mTOR,
FasLigand and topoisomerase II inhibitors). TopoTarget has a broad cllinical
pipeline with 9 products in development, including belinostat which has shown
proof of concept as monotherapy in treating haematological malignancies and
positive results in solid tumours where it can be used in combination with
full doses of chemotherapy. The company's first marketed product
Savene(R)/Totect(R) was approved by EMEA in 2006 and the FDA in 2007 and is
marketed by TopoTarget's own sales force inEurope and the US. For more
information, please refer to http://www.topotarget.com.
TopoTarget Safe Harbour Statement
This announcement may contain forward-looking statements, including
statements about our expectations of the progression of our preclinical and
clinical pipeline including the timing for commencement and completion of
clinical trials and with respect to cash burn guidance. Such statements are
based on management's current expectations and are subject to a number of
risks and uncertainties that could cause actual results to differ materially
from those described in the forward-looking statements. TopoTarget cautions
investors that there can be no assurance that actual results or business
conditions will not differ materially from those projected or suggested in
such forward-looking statements as a result of various factors, including,
but not limited to, the following: The risk that any one or more of the drug
development programs of TopoTarget will not proceed as planned for technical,
scientific or commercial reasons or due to patient enrolment issues or based
on new information from non-clinical or clinical studies or from other
sources; the success of competing products and technologies; technological
uncertainty and product development risks; uncertainty of additional funding;
TopoTarget's history of incurring losses and the uncertainty of achieving
profitability; TopoTarget's stage of development as a biopharmaceutical
company; government regulation; patent infringement claims against
TopoTarget's products, processes and technologies; the ability to protect
TopoTarget's patents and proprietary rights; uncertainties relating to
commercialization rights; and product liability expo-sure; We disclaim any
intention or obligation to update or revise any forward-looking statements,
whether as a result of new information, future events, or otherwise, unless
required by law.
SOURCE TopoTarget
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