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HUTCHMED Initiates the RAPHAEL Registrational Phase III Trial of HMPL-306 for Patients With IDH1- And/or IDH2-Mutated Relapsed/Refractory Acute Myeloid Leukemia in China

HUTCHMED Initiates the RAPHAEL Registrational Phase III Trial of HMPL-306 for Patients With IDH1- And/or IDH2-Mutated Relapsed/Refractory Acute Myeloid Leukemia in China

和黃醫藥在中國啓動針對 IDH1 和/或 IDH2 突變復發/難治性急性髓系白血病患者的 HMPL-306 RAPHAEL 註冊三期試驗
GlobeNewswire ·  05/13 20:00

HONG KONG and SHANGHAI, China and FLORHAM PARK, N.J., May  14, 2024  (GLOBE NEWSWIRE) -- HUTCHMED (China) Limited ("HUTCHMED") (Nasdaq/AIM:HCM; HKEX:13) today announces that it has initiated a registrational Phase III clinical trial of HMPL-306 in patients with mutated isocitrate dehydrogenase ("IDH") 1 or 2 relapsed / refractory acute myeloid leukemia ("AML") in China. The first patient received their first dose on May 11, 2024.

中國香港和上海以及新澤西州弗洛勒姆公園,2024 年 5 月 14 日(GLOBE NEWSWIRE)— 和黃醫藥(中國)有限公司(“和黃醫藥”)(納斯達克/AIM: HCM;HKEX: 13)今天宣佈已啓動一項針對異檸檬酸脫氫酶(“IDH”)突變患者的 HMPL-306 註冊性 III 期臨床試驗 1 或 2 例復發/ 中國的難治性急性髓系白血病(“AML”)。第一位患者於2024年5月11日接受了第一劑疫苗。

HMPL-306 is a novel dual-inhibitor of IDH1 and IDH2 enzymes. Mutations of IDH1 and IDH2 have been implicated as drivers of certain hematological malignancies, gliomas and solid tumors, particularly among AML patients. Although some IDH inhibitors have been approved in certain markets for AML, isoform switching between the cytoplasmic mutant IDH1 and mitochondrial mutant IDH2 often leads to acquired resistance to single inhibitors of IDH1 or IDH2. Targeting both IDH1 and IDH2 mutations may provide therapeutic benefits in cancer patients by overcoming this acquired resistance.

HMPL-306 是 IDH1 和 IDH2 酶的新型雙抑制劑。IDH1和IDH2的突變被認爲是某些血液學惡性腫瘤、神經膠質瘤和實體瘤的驅動因素,在急性髓細胞白血病患者中尤其如此。儘管某些IDH抑制劑已在某些市場獲准用於急性髓細胞白血病,但細胞質突變體IDH1和線粒體突變體IDH2之間的異構體切換通常會導致對IDH1或IDH2單一抑制劑產生獲得性耐藥性。通過克服這種獲得性耐藥性,同時靶向IDH1和IDH2突變可以爲癌症患者提供治療益處。

RAPHAEL is a multicenter, randomized, open-label, registrational Phase III clinical trial designed to evaluate the safety and efficacy of HMPL-306 as a monotherapy in patients with relapsed or refractory AML harboring IDH1 and/or IDH2 mutations. The primary endpoint of overall survival (OS) and the secondary endpoints, including event-free survival (EFS) and complete remission ("CR") rate, will be tested in comparison with current salvage chemotherapy regimens. The Company is looking to enroll approximately 320 patients for this registrational study, which is being led by principal investigator Prof Xiaojun Huang of Peking University People's Hospital. Additional details may be found at clinicaltrials.gov, using identifier NCT06387069.

RAPHAEL 是一項多中心、隨機、開放標籤、註冊的 III 期臨床試驗,旨在評估 HMPL-306 作爲單一療法對包含 IDH1 和/或 IDH2 突變的復發或難治性急性髓細胞白血病患者的安全性和有效性。總存活率(OS)的主要終點和次要終點,包括無事件存活率(EFS)和完全緩解率(“CR”),將與當前的救助化療方案進行比較。該公司計劃招收約320名患者參加這項註冊研究,該研究由北京大學人民醫院的首席研究員黃小軍教授領導。更多細節可以在clinicaltrials.gov上找到,標識符爲 NCT06387069。

The study follows positive data from a two-stage, open-label Phase I study evaluating the safety, pharmacokinetics, pharmacodynamics and efficacy of HMPL-306 in this indication (NCT04272957). The first-in-human dose-escalation stage data was presented at the European Hematology Association Congress ("EHA") in June 2023.1 Results of the dose expansion stage of the study in over 50 patients demonstrated promising CR rates at the recommended Phase II dose are expected to be presented at the EHA Congress in June 2024.

該研究遵循了一項兩階段、開放標籤 I 期研究的積極數據,該研究評估了 HMPL-306 在該適應症(NCT04272957)中的安全性、藥代動力學、藥效學和療效。2023年6月在歐洲血液學協會大會(“EHA”)上公佈了首次人體劑量遞增階段的數據。1 該研究針對50多名患者的劑量擴展階段的結果表明,推薦的II期劑量的CR率有望在2024年6月的EHA大會上公佈。

About IDH and Hematological Malignancies

關於 IDH 和血液系統惡性腫瘤

IDHs are critical metabolic enzymes that help to break down nutrients and generate energy for cells. When mutated, IDH creates a molecule that alters the cell's genetic programming and prevents cells from maturing. IDH1 or IDH2 mutations are common genetic alterations in various types of blood and solid tumors, including AML with approximately 14-20% of patients having mutant IDH genes, myelodysplastic syndrome (MDS), myeloproliferative neoplasms (MPNs), low-grade glioma and intrahepatic cholangiocarcinoma. Mutant IDH isoform switching, either from cytoplasmic mutant IDH1 to mitochondrial mutant IDH2, or vice versa, is a mechanism of acquired resistance to IDH inhibition in AML and cholangiocarcinoma.2,3,4

IDH 是重要的代謝酶,有助於分解營養物質併爲細胞產生能量。當突變時,IDH 會產生一種分子,該分子會改變細胞的基因編程並防止細胞成熟。IDH1或IDH2突變是各種血液和實體瘤的常見基因改變,包括急性髓細胞白血病,約14-20%的患者具有突變IDH基因、骨髓增生異常綜合徵(MDS)、骨髓增生性腫瘤(MPN)、低度神經膠質瘤和肝內膽管癌。突變體 IDH 亞型切換,無論是從細胞質突變體 IDH1 切換到線粒體突變體 IDH2,反之亦然,都是急性髓細胞白血病和膽管癌中獲得性對 IDH 抑制產生耐藥的機制。2,3,4

According to the National Cancer Institute (NCI), there will be approximately 20,380 new cases of AML in the U.S. in 2023 and the five-year relative survival rate is 31.7%5. Currently, the U.S. Food and Drug Administration (FDA) has approved two drugs for IDH1 mutation and one drug for IDH2 mutation, but no dual inhibitor targeting both IDH1 and IDH2 mutants has been approved. There were an estimated 19,700 new cases of AML in China in 2018 and is estimated to reach 24,200 in China in 2030.6 In China one IDH1 inhibitor was approved in 2022.

根據美國國家癌症研究所(NCI)的數據,到2023年,美國將有大約20,380例急性髓細胞白血病新發病例,五年相對存活率爲31.7% 5。目前,美國食品藥品監督管理局(FDA)已經批准了兩種用於IDH1突變的藥物和一種用於IDH2突變的藥物,但尚未批准同時針對IDH1和IDH2突變體的雙重抑制劑。據估計,2018年中國有19,700例急性髓細胞白血病新發病例,預計到2030年中國將達到24,200例。6 在中國,一種IDH1抑制劑於2022年獲得批准。

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REFERENCES

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引用

1

Hu L et al. P539: A Phase 1 Study of HMPL-306, a Dual Inhibitor of Mutant Isocitrate Dehydrogenase (IDH) 1 and 2, in Patients with Relapsed/Refractory Myeloid Hematological Malignancies Harboring IDH1 and/or 2 Mutations. Hemasphere. 2023;7(Suppl):e86312d3. Published 2023 Aug 8. doi:10.1097/01.HS9.0000969064.86312.d3.

2

S Choe S et al. Blood 2019;134(Supplement_1):545. doi:10.1182/blood-2019-122671.

3

Harding JJ et al. Isoform Switching as a Mechanism of Acquired Resistance to Mutant Isocitrate Dehydrogenase Inhibition. Cancer Discov. 2018;8(12):1540-1547. doi:10.1158/2159-8290.CD-18-0877.

4

Delahousse J et al. Circulating oncometabolite D-2-hydroxyglutarate enantiomer is a surrogate marker of isocitrate dehydrogenase-mutated intrahepatic cholangiocarcinomas. Eur J Cancer. 2018;90:83-91. doi:10.1016/j.ejca.2017.11.024.

5

Source: National Cancer Institute – seer.cancer.gov/statfacts/html/amyl.html.

6

Lin J et al. IDH1 and IDH2 mutation analysis in Chinese patients with acute myeloid leukemia and myelodysplastic syndrome. Ann Hematol. 2012;91(4):519-525. doi:10.1007/s00277-011-1352-7.

1

Hu L 等人P539:一項針對包含 IDH1 和/或 2 突變的復發/難治性髓系血液系統惡性腫瘤患者的突變異檸檬酸脫氫酶 (IDH) 1 和 2 的雙重抑制劑 HMPL-306 的1期研究。Hemasphere. 2023;7(補充):e86312d3。發佈於 2023 年 8 月 8 日。doi: 10.1097/01.hs9.0000969064.86312.d3。

2

S Choe S 等人Blood 2019;134(Supplement_1):545. doi: 10.1182/blood-2019-122671。

3

哈丁 JJ 等人異構切換是獲得性抗突變異檸檬酸脫氫酶抑制的機制。Cancer Discov. 2018;8 (12): 1540-1547。doi: 10.1158/2159-8290.cd-18-0877。

4

Delahousse J 等人循環代謝物 D-2-羥基戊二酸對映體是異檸檬酸脫氫酶突變的肝內膽管癌的替代標誌物。Eur J Cancer。2018;90:83-91。doi: 10.1016/j.ejca.2017.11.024。

5

資料來源:美國國家癌症研究所 — seer.cancer.gov/statfacts/html/amyl.html。

6

Lin J 等中國急性髓系白血病和骨髓增生異常綜合徵患者的IDH1和IDH2突變分析。Ann Hematol。2012;91 (4): 519-525. doi: 10.1007/s00277-011-1352-7。

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