Pivekimab Triplet Demonstrates Encouraging CR, Composite CR, and
MRD Negativity Rates; Broad Anti-Leukemia Activity Observed Across
All Molecular Subsets Evaluated
Pivekimab-Containing Triplet Well-Tolerated with Manageable
Safety Profile
Data Support Continued Development of Triplet; Enrollment and
Follow-Up Ongoing
ImmunoGen Inc. (Nasdaq: IMGN), a leader in the expanding field
of antibody-drug conjugates (ADCs) for the treatment of cancer,
today announced new safety and efficacy findings from the newly
diagnosed (ND) cohorts of the Phase 1b/2 study of pivekimab
sunirine (pivekimab) in combination with azacitidine (Vidaza®) and
venetoclax (Venclexta®), (pivekimab triplet) in patients with ND
acute myeloid leukemia (AML). These findings will be presented in a
poster session at the 65th American Society of Hematology (ASH)
Annual Meeting in San Diego, California.
“We are pleased to share these new findings at ASH, which
demonstrate encouraging anti-leukemia activity of the pivekimab
triplet in newly diagnosed AML, a disease in which long-term
survival unfortunately remains limited,” said Naval Daver, MD,
Associate Professor in the Department of Leukemia at The University
of Texas MD Anderson Cancer Center. “The MRD negativity rates,
which are indicative of a deep remission, are particularly
promising in the treated patient population. This encouraging
activity, along with a manageable safety profile, support the
continued evaluation of this novel triplet in this setting.”
PIVEKIMAB SUNIRINE, A CD123-TARGETING ANTIBODY-DRUG
CONJUGATE, IN COMBINATION WITH AZACITIDINE AND VENETOCLAX IN
PATIENTS WITH NEWLY DIAGNOSED ACUTE MYELOID LEUKEMIA Lead
Author: Navel Daver, MD Poster Session: 616 (Acute Myeloid
Leukemias: Investigational Therapies, Excluding Transplantation and
Cellular Immunotherapies: Poster II) Date and Time: Sunday,
December 10, 2023, 6:00-8:00 p.m. PT / 9:00-11:00 p.m. ET
Publication Number: 2906
In the open-label, multicenter, Phase 1b/2 study of pivekimab in
combination with azacitidine and venetoclax in patients with ND
CD123-positive AML, patients received the recommended Phase 2 dose
of pivekimab at 0.045 mg/kg on day 7, azacitidine at 75 mg/m2 daily
on days 1-7, and venetoclax at up to 400 mg for at least 14 days or
up to 28 days, based on cohort assignment, in a 28-day cycle. The
primary endpoints are complete remission (CR) rate, composite CR
rate (CCR [CR+CRh+CRp+CRi]), minimal residual disease (MRD)
negativity rate, and duration of remission. Key secondary endpoints
are safety, pharmacokinetics, and immunogenicity.
Key findings for 50 ND patients (n=25 per cohort) as of
September 29, 2023 (data cut-off) include:
Anti-Leukemia Activity
- In the overall population, CCR rate was 68% (34/50), CR rate
was 54% (27/50), and MRD negativity rate among evaluable patients
achieving CCR was 76% (22/29). MRD was assessed centrally by flow
cytometry with <0.1% considered negative. Response rates and MRD
negativity were numerically comparable between cohorts 1 and 2,
despite differences in the venetoclax schedule.
- In a post hoc subset analysis of patients unfit for intensive
chemotherapy (i.e. patients >75 years of age, and/or with
pre-specified comorbidities) (n=23), CCR rate was 78% (18/23), CR
rate was 61% (14/23), and MRD negativity rate was 79% (11/14).
- In patients known to be TP53wt (n=25), CCR rate was 88%
(22/25), CR rate was 84% (21/25), and MRD negativity rate was 80%
(16/20). CCR and MRD negativity rates, respectively, were high
across other major molecular subsets, including:
- FLT3 (ITD or TKD): 100% (6/6) and 100% (6/6)
- IDH1 mutant: 100% (4/4) and 67% (2/3)
- IDH2 mutant: 100% (6/6) and 83% (5/6)
- NPM1 mutant: 100% (8/8) and 86% (6/7)
- K/NRAS mutant: 50% (3/6) and 67% (2/3)
- TP53 mutant: 50% (7/14) and 50% (3/6)
- Among all MRD negative patients, the median time to MRD
negativity was 1.87 months (range: 0.79-5.16 months).
- Although follow-up duration was short (median 5.2 months),
landmark overall survival estimate at 6 months is 86%.
- The study is continuing to enroll newly diagnosed unfit AML
patients.
Safety
- The triplet displayed a manageable safety profile; no new
safety signals were observed compared to previously reported
data.
- The most common non-hematologic treatment-emergent adverse
events (TEAEs) (all grades [grade 3+]) seen in ≥20% of all patients
were constipation (48% [2%]), peripheral edema (44% [4%]), diarrhea
(40% [2%]), hypophosphatemia (34% [2%]), nausea (32% [4%]),
hypokalemia (28% [4%]), fatigue (24% [6%]), hypotension (24% [2%]),
and pyrexia (24% [0%]). In the overall population:
- Rates of cytopenias were similar to those observed with
azacitidine and venetoclax, with a median neutrophil recovery to
≥500/µL and platelet recovery to ≥50,000/µL by day 34 and day 22,
respectively.
- No veno-occlusive disease, capillary leak syndrome, or
sinusoidal obstruction syndrome were observed.
- Infusion-related reactions (IRRs) occurred in 16% of patients
(0 grade 3+ IRRs).
- Discontinuations due to an adverse event (AE) were 4% (2
patients).
- 30-day mortality was 0%.
- 60-day mortality was 4% (2 patients; due to pneumonia and early
disease progression).
"Building upon our initial findings in frontline AML presented
last year, these data show broad and consistent response rates in a
larger study population and across major molecular subsets of
interest, including those patients with biological mutations making
them high-risk," said Michael Vasconcelles, MD, ImmunoGen's
Executive Vice President, Research, Development, and Medical
Affairs. "We are pleased with the low early mortality and
manageable safety profile observed, in particular the lack of
prolonged cytopenias. We look forward to continuing to expand our
cohort of newly diagnosed unfit patients to inform the development
path for pivekimab in AML.”
PRECLINICAL POSTERS ImmunoGen is also presenting two
preclinical posters at ASH.
Title: Venetoclax Synergizes with IMGN632, a Novel
CD123-Targeting Antibody Conjugated to a DNA Alkylating Payload, By
Suppressing DNA Damage Response and Potentiating Apoptosis in Acute
Myeloid Leukemia in Vitro Models Presenter: Anna Skwarska Session:
604 (Molecular Pharmacology and Drug Resistance: Myeloid Neoplasms:
Poster III) Date and Time: Monday, December 11, 2023, 6:00-8:00
p.m. PT / 9:00-11:00 p.m. ET Publication Number: 4155
Title: Spatial Response to Pivekimab Sunirine In Vivo in a BPDCN
Model Presenter: Margaux Poussard Session: 604 (Molecular
Pharmacology and Drug Resistance: Myeloid Neoplasms: Poster II)
Date and Time: Sunday, December 10, 2023, 6:00-8:00 p.m. PT /
9:00-11:00 p.m. ET Publication Number: 2791
Additional information can be found at
https://www.hematology.org, including abstracts.
ABOUT PIVEKIMAB SUNIRINE Pivekimab sunirine is a
CD123-targeting ADC in clinical development for hematological
malignancies, including blastic plasmacytoid dendritic cell
neoplasm (BPDCN), acute myeloid leukemia (AML), and other CD123+
hematologic malignancies. Pivekimab is currently being evaluated as
monotherapy for patients with BPDCN and in combination with
azacitidine (Vidaza®) and venetoclax (Venclexta®) for patients with
untreated and relapsed/refractory AML. Pivekimab uses one of
ImmunoGen's novel indolinobenzodiazepine (IGN) payloads, which
alkylate DNA and cause single-strand breaks without crosslinking.
IGNs are designed to have high potency against tumor cells, while
demonstrating less toxicity to normal marrow progenitors than other
DNA-targeting payloads. The European Medicines Agency (EMA) granted
orphan drug designation to pivekimab for the treatment of BPDCN in
June 2020. Pivekimab also holds this designation in the US. In
October 2020, the FDA granted pivekimab Breakthrough Therapy
designation in relapsed/refractory BPDCN.
ABOUT ACUTE MYELOID LEUKEMIA (AML) AML is a cancer of the
bone marrow cells that produce white blood cells. It causes the
marrow to increasingly generate abnormal, immature white blood
cells (blasts) that do not mature into effective infection-fighting
cells. The blasts quickly fill the bone marrow, impacting the
production of normal platelets and red blood cells. The resulting
deficiencies in normal blood cells leave the patient vulnerable to
infections, bleeding problems, and anemia. It is estimated that, in
the US alone, more than 20,000 people will be diagnosed with AML
and more than 11,000 will die from the disease this year.
ABOUT CD123 CD123, the interleukin-3 alpha chain, is
expressed on multiple myeloid and lymphoid cancers including AML,
BPDCN, ALL, chronic myeloid leukemia, and myeloproliferative
neoplasms. With limited expression on normal hematopoietic cells,
rapid internalization, and expression on AML leukemia stem cells,
CD123 is a clinically validated therapeutic target.
ABOUT IMMUNOGEN ImmunoGen is developing the next
generation of antibody-drug conjugates (ADCs) to improve outcomes
for cancer patients. By generating targeted therapies with enhanced
anti-tumor activity and favorable tolerability profiles, we aim to
disrupt the progression of cancer and offer our patients more good
days. We call this our commitment to TARGET A BETTER NOW™.
Learn more about who we are, what we do, and how we do it at
www.immunogen.com.
Vidaza® and Venclexta® are registered trademarks of their
respective owners.
FORWARD-LOOKING STATEMENTS This press release includes
forward-looking statements. These statements include, but are not
limited to, the potential efficacy and safety of pivekimab. Various
factors could cause ImmunoGen's actual results to differ materially
from those discussed or implied in the forward-looking statements,
and you are cautioned not to place undue reliance on these
forward-looking statements, which are current only as of the date
of this release. Factors that could cause future results to differ
materially from such expectations include, but are not limited to:
the timing and outcome of the Company's clinical development
processes; the difficulties inherent in the development of novel
pharmaceuticals, including uncertainties as to the timing, expense,
and results of clinical trials and regulatory processes; and other
factors as set forth in the Company's Annual Report on Form 10-K
filed with the Securities and Exchange Commission on March 1, 2023,
the Company's Quarterly Reports on Form 10-Q filed with the
Securities and Exchange Commission on April 28, 2023 and July 31,
2023 and November 2, 2023, and other reports filed with the
Securities and Exchange Commission. The forward-looking statements
in this press release speak only as of the date of this press
release. ImmunoGen undertakes no obligation to update any
forward-looking statement, whether as a result of new information,
future developments, or otherwise, except as may be required by
applicable law.
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INVESTOR RELATIONS ImmunoGen Anabel Chan 781-895-0600
anabel.chan@immunogen.com MEDIA ImmunoGen Courtney O'Konek
781-895-0600 courtney.okonek@immunogen.com OR FTI Consulting Robert
Stanislaro 212-850-5657 robert.stanislaro@fticonsulting.com
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