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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

和黄医药在中国启动针对 IDH1 和/或 IDH2 突变复发/难治性急性髓系白血病患者的 HMPL-306 RAPHAEL 注册三期试验
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.

中国香港和上海以及新泽西州弗洛勒姆公园,2024 年 5 月 14 日(GLOBE NEWSWIRE)— 和黄医药(中国)有限公司(“和黄医药”)(纳斯达克/AIM: HCM;HKEX: 13)今天宣布已启动一项针对异柠檬酸脱氢酶(“IDH”)突变患者的 HMPL-306 注册性 III 期临床试验 1 或 2 例复发/ 中国的难治性急性髓系白血病(“AML”)。第一位患者于2024年5月11日接受了第一剂疫苗。

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 酶的新型双抑制剂。IDH1和IDH2的突变被认为是某些血液学恶性肿瘤、神经胶质瘤和实体瘤的驱动因素,在急性髓细胞白血病患者中尤其如此。尽管某些IDH抑制剂已在某些市场获准用于急性髓细胞白血病,但细胞质突变体IDH1和线粒体突变体IDH2之间的异构体切换通常会导致对IDH1或IDH2单一抑制剂产生获得性耐药性。通过克服这种获得性耐药性,同时靶向IDH1和IDH2突变可以为癌症患者提供治疗益处。

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 是一项多中心、随机、开放标签、注册的 III 期临床试验,旨在评估 HMPL-306 作为单一疗法对包含 IDH1 和/或 IDH2 突变的复发或难治性急性髓细胞白血病患者的安全性和有效性。总存活率(OS)的主要终点和次要终点,包括无事件存活率(EFS)和完全缓解率(“CR”),将与当前的救助化疗方案进行比较。该公司计划招收约320名患者参加这项注册研究,该研究由北京大学人民医院的首席研究员黄小军教授领导。更多细节可以在clinicaltrials.gov上找到,标识符为 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.

该研究遵循了一项两阶段、开放标签 I 期研究的积极数据,该研究评估了 HMPL-306 在该适应症(NCT04272957)中的安全性、药代动力学、药效学和疗效。2023年6月在欧洲血液学协会大会(“EHA”)上公布了首次人体剂量递增阶段的数据。1 该研究针对50多名患者的剂量扩展阶段的结果表明,推荐的II期剂量的CR率有望在2024年6月的EHA大会上公布。

About IDH and Hematological Malignancies

关于 IDH 和血液系统恶性肿瘤

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 是重要的代谢酶,有助于分解营养物质并为细胞产生能量。当突变时,IDH 会产生一种分子,该分子会改变细胞的基因编程并防止细胞成熟。IDH1或IDH2突变是各种血液和实体瘤的常见基因改变,包括急性髓细胞白血病,约14-20%的患者具有突变IDH基因、骨髓增生异常综合征(MDS)、骨髓增生性肿瘤(MPN)、低度神经胶质瘤和肝内胆管癌。突变体 IDH 亚型切换,无论是从细胞质突变体 IDH1 切换到线粒体突变体 IDH2,反之亦然,都是急性髓细胞白血病和胆管癌中获得性对 IDH 抑制产生耐药的机制。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.

根据美国国家癌症研究所(NCI)的数据,到2023年,美国将有大约20,380例急性髓细胞白血病新发病例,五年相对存活率为31.7% 5。目前,美国食品药品监督管理局(FDA)已经批准了两种用于IDH1突变的药物和一种用于IDH2突变的药物,但尚未批准同时针对IDH1和IDH2突变体的双重抑制剂。据估计,2018年中国有19,700例急性髓细胞白血病新发病例,预计到2030年中国将达到24,200例。6 在中国,一种IDH1抑制剂于2022年获得批准。

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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P539:一项针对包含 IDH1 和/或 2 突变的复发/难治性髓系血液系统恶性肿瘤患者的突变异柠檬酸脱氢酶 (IDH) 1 和 2 的双重抑制剂 HMPL-306 的1期研究。Hemasphere. 2023;7(补充):e86312d3。发布于 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 等人异构切换是获得性抗突变异柠檬酸脱氢酶抑制的机制。Cancer Discov. 2018;8 (12): 1540-1547。doi: 10.1158/2159-8290.cd-18-0877。

4

Delahousse J 等人循环代谢物 D-2-羟基戊二酸对映体是异柠檬酸脱氢酶突变的肝内胆管癌的替代标志物。Eur J Cancer。2018;90:83-91。doi: 10.1016/j.ejca.2017.11.024。

5

资料来源:美国国家癌症研究所 — seer.cancer.gov/statfacts/html/amyl.html。

6

Lin J 等中国急性髓系白血病和骨髓增生异常综合征患者的IDH1和IDH2突变分析。Ann Hematol。2012;91 (4): 519-525. doi: 10.1007/s00277-011-1352-7。

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