Spectrum Pharmaceuticals (NasdaqGS: SPPI), a biotechnology company with
fully integrated commercial and drug development operations with a
primary focus in oncology, today announced that various studies on
ZEVALIN® (ibritumomab tiuxetan) for Injection were presented
at the 11th International Conference on Malignant Lymphoma
(ICML), held June 15-18, 2011, in Lugano, Switzerland. The ICML is a
major international scientific conference held every two years and is
focused specifically on lymphomas.
"We are pleased that ZEVALIN continues to be a significant focus of
research in the treatment of lymphoma, both indolent and aggressive
subtypes, and in the autologous transplant setting,” said Rajesh C.
Shrotriya, MD, Chairman, Chief Executive Officer, and President of
Spectrum Pharmaceuticals. "All of the studies presented conclude that
ZEVALIN is a safe and effective treatment option for the treatment of
lymphoma.”
Oral Session – Controversies in Follicular
Lymphomas
ZEVALIN Consolidation vs. Rituximab-Maintenance
in First Remission Follicular Non-Hodgkin’s Lymphoma – The Case for RIT
In an oral discussion on the topic of "Controversies in Follicular
Lymphomas,” Anton Hagenbeek, MD, from the Academic Medical Center in
Amsterdam, Netherlands, and one of the principal investigators of the
FIT Study, which served as the basis for ZEVALIN’s 2009 approval in the
first-line consolidation setting, gave an oral presentation entitled Radio-Immunotherapy
Consolidation vs. Rituximab-Maintenance in First Remission Follicular
Non-Hodgkin’s Lymphoma - The Case for RIT. During his
oral presentation, Dr. Hagenbeek provided a comparative evaluation of
the ECOG 1496 Study, in which newly diagnosed patients with indolent
lymphoma were induced with CVP and responders were subsequently
randomized between rituximab maintenance, once per week for 4 weeks
every 6 months x4; and the FIT trial, where various chemo-induction
regimens were allowed after which partial responders (PR) or complete
responders (CR) were randomized between one infusion of ZEVALIN versus
no further treatment. CR rates after induction chemotherapy were 16%
(ECOG) versus 52% (FIT), increasing to 37% (ECOG) and 87% (FIT), due to
22% and 78%, respectively, of patients in PR converting to CR. With more
than 4 years (ECOG) and 6-½ years (FIT) median follow-up, the median PFS
was prolonged with ZEVALIN by 3 years in both studies, as compared to
controls. In patients achieving a CR after ZEVALIN, the PFS increased
more than 5 years as compared to controls (median PFS >92 months after 1
infusion of ZEVALIN).
"A single infusion of ZEVALIN matched roughly 16 infusions of rituximab
in terms of achieving the same increase in PFS,” said Dr. Hagenbeek. "I
leave it up to the audience to draw conclusions about cost
effectiveness. Thus, in conclusion, RIT represents the most effective
single drug in the treatment of follicular NHL.”
Poster Session – Mantle Cell Lymphoma
Abstract #017 – Phase 2 Study of R-CHOP
followed by 90Y-Ibritumomab
Tiuxetan (ZEVALIN) in Untreated Mantle Cell Lymphoma (MCL):
5-Year
Follow-Up of Eastern Cooperative Oncology Group E1499
M.R. Smith, MD, from the Medical Oncology division of the Fox Chase
Cancer Center in Philadelphia, PA, reported on a study to determine
safety and efficacy of the anti-CD20 radioimmunoconjugate 90Y-ibritumomab
tiuxetan following 4 cycles of R-CHOP induction.
Dr. Smith, et al., concluded that 90Y radioimmunotherapy
(RIT) after R-CHOP x4 in untreated MCL is safe and improves percent of
response and the quality of response. 90Y-RIT consolidation
is applicable to most patients with MCL and met the primary endpoint of
50% prolongation of time to treatment failure (TTF) over that expected
for R-CHOP x6 alone. While there is no apparent plateau in TTF, median
overall survival is not yet reached at 5 years. Overall survival at 3
and 5 year compares favorably with reports using more intensive therapy,
calling into question the need for intensive initial therapy.
Poster Session – Autologous Transplant
Poster #256 – Upfront Consolidation with
Targeted Intensification Utilizing Yttrium-90 Ibritumomab Tiuxetan
(ZEVALIN) and High Dose Therapy in Poor Prognosis Patients with Diffuse
Large B-Cell Lymphoma – Z-BEAM 2 Study
In a poster session on transplantation, Christophe Fruchart, MD, from
the Centre Francois Baclesse, in Caen, France, described a Phase 2 trial
that evaluated the safety and efficacy of standard-dose 90Y ibritumomab
tiuxetan (ZEVALIN) combined with high-dose BEAM (Z-BEAM) after first
line treatment in patients under 65 years of age with poor prognosis
DLBCL.
The role of high dose therapy (HDT) and autologous stem cell
transplantation (ASCT) as a first line therapy in poor risk patients
with DLBCL is still discussed. The addition of ZEVALIN to HDT regimen
has been preliminarily tested in refractory or relapsed B-cell
lymphomas. Overall studies have shown that this approach offered minimal
additional toxicity compared with chemotherapy alone and had also
yielded good efficacy.
Dr. Fruchart, et al., concluded that in selected patients with poor
prognosis factors, adding ZEVALIN to high-dose BEAM is safe without an
increase in transplant-related toxicity or delayed engraftment. Rate of
progression free survival is encouraging and warrants a randomized study.
Poster Session – Autologous Transplant
Abstract #254 – Minimum Tolerable Interval of 90Yttrium
Ibritumomab-Tiuxetan (ZEVALIN) to Autologous Stem Cell Transplantation
After High-Dose Chemotherapy with Carmustin, Etoposide, Cytarabine,
Melphalan is 10 days. First Results From DSHNHL Esc Z-BEAM Trial for
Relapsed or Refractory Aggressive B-NHL
J. Hasenkamp, MD, from the Hematology and Oncology Division of the
University Medicine Goettingen, in Goettingen, Germany, presented a
poster reporting on the interval for ZEVALIN administration when
combined with autologous transplantation. Previously it was reported
that high-dose therapy (HDT) and autologous stem cell transplantation
(ASCT) is significantly less effective in patients with aggressive
B-cell lymphoma if first-line therapy included rituximab (Gisselbrecht
et al. JCO 2010). Combining BEAM with radioimmunotherapy (ZEVALIN) is a
promising option to enhance the efficacy of the high-dose regimen.
ZEVALIN (0.4 mCi/kg body weight) at day -10 before ASCT was determined
as minimum tolerated interval of radioimmunotherapy to ASCT after BEAM.
Median follow-up is 18 months. Three-year PFS and OS is 59% and 73%,
respectively. Z-BEAM followed by ASCT was safe and feasible and results
in a high response rate in rituximab pretreated patients with aggressive
B-cell lymphoma. Extended studies at the maximum tolerated dose are
warranted.
Abstract #257 – Significant Improvement in
Overall Survival in High-Risk Aggressive B Cell Non-Hodgkin’s Lymphoma
After 90Yttrium
Ibritumomab Tiuxetan-Beam Followed by Autologous Stem Cell
Transplantation
M. Wondergerm, MD, from the Hematology division of the VU University
Medical Center in Amsterdam, Netherlands, presented a poster stating
high dose chemotherapy followed by autologous stem cell transplantation
(AuSCT) induces long term disease free survival in 50-60% of patients
with diffuse large B cell lymphoma (DLBCL) after rituximab containing
(re-) induction therapy. Adding 90Yttrium ibritumomab
tiuxetan prior to the BEAM conditioning regimen has proven to be
feasible and shows promising results with respect to disease free and
overall survival in high risk DLBCL patients. At the VU University
Medical center, rituximab was added to (re-) induction therapy starting
July 2001. From 2006 they started to add 90Yttrium
ibritumomab tiuxetan (ZEVALIN) to BEAM (Z-BEAM) in DLBCL patients. In
this retrospective analysis they compare outcome after Z-BEAM with
outcome after BEAM, both followed by AuSCT.
Dr. Wondergerm, et al., concluded that adding 90Yttrium
ibritumomab tiuxetan to the BEAM conditioning regimen preceding AuSCT
leads to a significant improvement in overall survival in relapsed,
refractory or transformed NHL patients. Addition of 90Yttrium
ibritumomab tiuxetan did not result in decreased bone marrow reserve or
non haematological long term sequelae enabling treatment of relapse
including allogeneic SCT.
Poster Session – Positron Emission Tomography
Abstract #216 – Discriminatory Power of the 111Indium
Scan (111In)
in the Prediction of Altered Biodistribution of Radio-Immunoconjugate in
the 90-Yttrium
Ibritumomab Tiuxetan (ZEVALIN) Therapeutic Regimen:
Meta-Analysis
of Five Clinical Trials and 9 Years of Clinical Experience in 45
Countries
Jelle Kylstra, MD, Clinical Development, Spectrum Pharmaceuticals,
discussed in a poster data supporting the removal of the bioscan
requirement.
At the time of regulatory approval of Y-90 ibritumomab tiuxetan (ZEVALIN®),
3 countries (USA, Switzerland, Japan) required labeling specifying that
an Indium–111 (111In) scan be performed 7-9 days before the
therapeutic dose, to guard against the hypothetical risk that altered
bio-distribution (AB) of the immunoconjugate could cause unintended
end-organ damage; 42 other countries (incl. EU, Canada) approved ZEVALIN
without requiring the 111In scan.
Methods:
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Establishment of the false positive and true positive rate (positive
predictive value) of the 111In scan in predicting AB with
data from 5 clinical trials that had supported the approval of
ZEVALIN in follicular lymphoma. Trials had subjected scans to both
local and secondary (central) review.
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2)
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Comparison of safety surveillance data from countries that do versus
countries that do not require the 111In scan as part of
the ZEVALIN therapeutic regimen.
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In 5 clinical trials, 11 of 253 scans (4.3%) showed AB based on local
review. In only 3 of these patients, the local finding of AB was
confirmed in central review. Of patients with 111-In scans reviewed by a
trained reader in central review, 3/233 (1.3%) were found to have true
AB and 7/233 (3%) were found to have had a false positive local judgment
of AB. Three patients with true AB on central review who had proceeded
with 90-Y Z treatment based on a scan result locally judged normal,
showed safety and efficacy outcomes within the range of those shown by
other patients on study. Comparison of post-marketing safety databases
between countries with (USA, CH, JP) and without (Rest of World) 111-In
requirement showed no differences in the general pattern of safety
signals reported, with respectively 3% and 4% of patients reporting
grade III/IV bone marrow suppressive states, and anaphylactoid responses
reported at 0.3% in both geographic clusters.
Dr. Kylstra, et al., concluded that the 111-In scan shows poor
discriminatory power in identifying cases of AB. Analysis of safety
results of patients treated with 90-Y Z despite true AB does not
indicate that removal of the 111-In requirement from the ZEVALIN
labeling in countries currently requiring it would constitute a safety
risk.
Poster Session – New Drug Combinations
Abstract #113 – Short Course Fludarabine,
Mitoxantrone, Rituximab Followed by 90Y-Ibritumomab
Tiuxetan in Untreated Intermediate/High-Risk Follicular Lymphoma: A
Phase II Trial
P.L. Zinzani, MD, from the Institute of Haematology and Medical Oncology
from the University of Bologna, Italy, presented a poster describing the
use of ZEVALIN in combination with fludarabine, mitoxantrone and
rituximab (FMR) for the treatment of untreated intermediate/high-risk
follicular lymphoma in a Phase 2 clinical trial.
An innovative approach combining induction chemotherapy and subsequent
consolidation with 90Yttrium-ibritumomab-tiuxetan (90Y-IT)
has been upgraded by shortening the chemotherapy duration and by
insertion of rituximab, in untreated follicular non-Hodgkin’s lymphoma
(NHL).
Dr. Zinzani, et al., concluded that this study has established the
feasibility, tolerability, and efficacy of a regimen composed by a short
FMR induction with a 90Y-IT consolidation in untreated
intermediate/high-risk follicular NHL patients.
About ZEVALIN® and the
ZEVALIN Therapeutic Regimen
ZEVALIN (ibritumomab tiuxetan), injection for intravenous use is
indicated for the treatment of patients with previously untreated
follicular non-Hodgkin’s Lymphoma (NHL), who achieve a partial or
complete response to first-line chemotherapy. ZEVALIN is also indicated
for the treatment of patients with relapsed or refractory, low-grade or
follicular B-cell non-Hodgkin's lymphoma.
ZEVALIN is a CD20-directed radiotherapeutic antibody. The ZEVALIN
therapeutic regimen consists of three components: rituximab, Indium-111
(In-111) radiolabeled ZEVALIN for imaging, and Yttrium-90 (Y-90)
radiolabeled ZEVALIN for therapy. The ZEVALIN therapeutic regimen is a
form of cancer therapy called radioimmunotherapy. Radioimmunotherapy
(RIT) is an innovative form of cancer treatment with a mechanism of
action that is different from traditional chemotherapy. RIT builds on
the combined effect of a targeted biologic monoclonal antibody augmented
with the therapeutic effects of a beta-emitting radioisotope.
Important ZEVALIN® Safety
Information
Deaths have occurred within 24 hours of rituximab infusion, an essential
component of the ZEVALIN therapeutic regimen. These fatalities were
associated with hypoxia, pulmonary infiltrates, acute respiratory
distress syndrome, myocardial infarction, ventricular fibrillation, or
cardiogenic shock. Most (80%) fatalities occurred with the first
rituximab infusion. ZEVALIN administration results in severe and
prolonged cytopenias in most patients. Severe cutaneous and
mucocutaneous reactions, some fatal, can occur with the ZEVALIN
therapeutic regimen.
Please see full Prescribing Information, including Boxed WARNINGS, for
ZEVALIN and rituximab. Full prescribing information can be found at www.ZEVALIN.com.
About Spectrum Pharmaceuticals, Inc.
Spectrum Pharmaceuticals is a biotechnology company with fully
integrated commercial and drug development operations with a primary
focus in oncology. The Company’s strategy is comprised of acquiring,
developing and commercializing a broad and diverse pipeline of
late-stage clinical and commercial products. The Company markets two
oncology drugs, FUSILEV and ZEVALIN, and has two drugs, apaziquone and
belinostat, in late stage development along with a diversified pipeline
of novel drug candidates. The Company has assembled an integrated
in-house scientific team, including clinical development, medical
research, regulatory affairs, biostatistics and data management,
formulation development, and has established a commercial infrastructure
for the marketing of its drug products. The Company also leverages the
expertise of its worldwide partners to assist in the execution of its
strategy. For more information, please visit the Company’s website at www.sppirx.com.
Forward-looking statement – This press release may contain
forward-looking statements regarding future events and the future
performance of Spectrum Pharmaceuticals that involve risks and
uncertainties that could cause actual results to differ materially.
These statements are based on management’s current beliefs and
expectations.
These statements include but are not limited to
statements that relate to our business and its future, including certain
company milestones, Spectrum's ability to identify, acquire, develop and
commercialize a broad and diverse pipeline of late-stage clinical and
commercial products, leveraging the expertise of partners and employees,
around the world to assist us in the execution of our strategy, and any
statements that relate to the intent, belief, plans or expectations of
Spectrum or its management, or that are not a statement of historical
fact. Risks that could cause actual results to differ include the
possibility that our existing and new drug candidates may not prove safe
or effective, the possibility that our existing and new drug candidates
may not receive approval from the FDA, and other regulatory agencies in
a timely manner or at all, the possibility that our existing and new
drug candidates, if approved, may not be more effective, safer or more
cost efficient than competing drugs, the possibility that our efforts to
acquire or in-license and develop additional drug candidates may fail,
our lack of revenues, our limited marketing experience, our dependence
on third parties for clinical trials, manufacturing, distribution and
quality control and other risks that are described in further detail in
the Company's reports filed with the Securities and Exchange Commission.
We do not plan to update any such forward-looking statements and
expressly disclaim any duty to update the information contained in this
press release except as required by law.
SPECTRUM PHARMACEUTICALS, INC. ®, ZEVALIN®,
and FUSILEV® are registered trademarks of
Spectrum Pharmaceuticals, Inc.
REDEFINING CANCER CARE™ and the
Spectrum Pharmaceuticals logos are trademarks owned by Spectrum
Pharmaceuticals, Inc.
© 2011 Spectrum Pharmaceuticals, Inc. All Rights
Reserved
