Incyte Corporation (Nasdaq:INCY) announced today that it has reached
agreement with the U.S. Food and Drug Administration (FDA) regarding a
Special Protocol Assessment (SPA) on the design of a pivotal Phase III
trial for its lead JAK1/JAK2 Inhibitor, INCB18424, in patients with
primary myelofibrosis (PMF), post-polycythemia vera myelofibrosis
(PPV-MF) or post-essential thrombocythemia myelofibrosis (PET-MF). The
SPA provides agreement that the study design and planned analysis of the
Phase III trial adequately address objectives in support of a regulatory
submission.
COMFORT-I (COntrolled MyeloFibrosis Study with ORal
JAK Inhibitor Treatment), is a double-blind, placebo-controlled
Phase III trial comparing the efficacy and safety of INCB18424 to
placebo in approximately 240 patients with PMF, PPV-MF or PET-MF.
COMFORT-I is expected to begin in August. COMFORT-II, a second Phase III
trial being conducted in Europe, began patient enrollment in July.
Paul A. Friedman, M.D., Incyte’s President and CEO, stated,
"Finalization of the SPA is an important achievement and we look forward
to initiating COMFORT-I as quickly as possible in over 90 clinical sites
in the U.S., Canada and Australia. The primary endpoint of COMFORT-I is
the proportion of patients achieving a 35% or greater reduction in
spleen volume as compared to patients receiving placebo. Key secondary
endpoints include measuring the duration of the 35% or greater reduction
in spleen volume among the patients initially randomized to INCB18424,
and the proportion of patients who achieve a 50% or greater reduction in
symptoms as measured by a modified version of the Myelofibrosis Symptom
Assessment Form.”
Richard Levy, M.D., Incyte’s Executive Vice President, Chief Drug
Development and Medical Officer, stated, "Based on our current estimates
for patient recruitment of COMFORT-I, and assuming that results from the
trial are positive, we anticipate filing the New Drug Application for
INCB18424’s use in MF in late 2010 or early 2011.”
Srdan Verstovsek, M.D., Ph.D., Associate Professor, Leukemia Department,
Myeloproliferative Disorders Program Leader, University of Texas M.D.
Anderson Cancer Center, and the principal investigator for COMFORT-I
stated, "Initiation of the Phase III registration trials for INCB18424’s
use in myelofibrosis marks an important step forward in developing a new
effective treatment for this under-served disease. Importantly, the
primary and secondary endpoints in COMFORT-I and COMFORT-II are
clinically relevant features of the disease that both physicians and
patients are currently unable to overcome. I am optimistic that over
time, the results from the INCB18424 myelofibrosis Phase III program
will lead to important insights regarding the disease itself and the
long-term value of treatment with a JAK1/JAK2 inhibitor.”
COMFORT-I Trial
Overall Design: COMFORT-I (also referred to as
INCB18424-351) is
a randomized (1:1), double-blind Phase III
study comparing the efficacy and safety of INCB18424 to placebo in
approximately 240 patients with PMF, PPV-MF or PET-MF. To be eligible
for the study, patients must have a palpated spleen length of 5 cm or
greater and be classified as intermediate 2 or high risk according to
the International Working Group (IWG) criteria (Cervantes et al, 2008).
Primary Efficacy Endpoint: Proportion of patients
achieving = 35% reduction in spleen volume from baseline to week 24 as
measured by MRI (or CT scan in applicable subjects).
Key Secondary Efficacy Endpoints: Durability of a = 35%
reduction from baseline in spleen volume among patients initially
randomized to receive INCB18424 and the proportion of patients achieving
a = 50% reduction in their total symptom score from baseline to week 24
as measured by the modified Myelofibrosis Symptom Assessment Form
(MFSAF) diary.
Duration of Trial: The double-blind portion of COMFORT-I
is 24 weeks. Data are scheduled to be analyzed when the last patient has
completed 24 weeks of treatment with either INCB18424 or placebo and at
least 50% of patients remaining in the study have completed 36 weeks of
treatment.
COMFORT-I is scheduled to continue until either INCB18424 receives
marketing approval or when the last randomized patient remaining in the
study has completed week 144 (36 months).
Cross Over From Placebo to INCB18424: When the last
randomized subject has received 24 weeks of treatment with placebo, and
at least 50% of patients remaining in the study have completed 36 weeks
of treatment, and the primary data analysis is complete, the study is
scheduled to be unblinded, and eligible patients randomized to placebo
will have the opportunity to cross over and begin receiving INCB18424
open label. If a patient treated with placebo meets certain
pre-determined criteria, he or she may be eligible to cross over and
receive treatment with INCB18424 prior to week 24.
About the Modified Myelofibrosis Symptom Assessment Form (MFSAF)
Diary:
A modified Myelofibrosis Symptom Assessment Form diary will be used to
measure symptoms in COMFORT-I. The MFSAF diary was developed from work
conducted by Ruben Mesa, M.D., Professor of Medicine, Mayo Clinic
Arizona, et al to measure quality of life and symptomatic response to
treatment in myelofibrosis: (Leukemia Research, Volume 33, Issue
9, Pages 1199-1203).
Dr. Mesa stated, "Quality of life in patients with myelofibrosis is
severely compromised by debilitating symptoms including fatigue, night
sweats, fever, weight loss, pruritus, and symptoms from frequently
massive hepatosplenomegaly. Using an international internet-based survey
of 458 patients with MF, we created a 20-item instrument, Myelofibrosis
Symptom Assessment Form, which measured the symptoms reported by greater
than 10% of MF patients. The results we generated from the survey were
highly correlated with other validated instruments in cancer patients
and judged comprehensive and understandable by patients. It is very
gratifying to see the modified MFSAF being used in the INCB18424
COMFORT-I Phase III program.”
COMFORT-II Trial
COMFORT-II (also referred to as INCB18424-352) is a second Phase III
trial being conducted in Europe. It is an open-label study designed to
evaluate the efficacy, safety and tolerability of INCB18424 as compared
to the best-available therapy in 150 patients with PMF, PPV-MF or
PET-MF. COMFORT-II is expected to involve approximately 70 clinical
sites in 10 European countries: Belgium, Austria, France, Italy,
Germany, Sweden, the Netherlands, Spain, Switzerland and the U.K. The
primary efficacy endpoint
in COMFORT–II is the proportion of
patients achieving at least 35% reduction in spleen volume from baseline
to week 48. Enrollment in COMFORT II began in July of this year.
About Myelofibrosis
Myelofibrosis is a serious neoplastic condition for which there are no
approved therapies in the U.S. It is characterized by varying degrees of
bone marrow failure, splenic enlargement and debilitating constitutional
symptoms resulting in a significant loss in quality of life and reduced
life-span. Myelofibrosis is part of a related group of hematological
neoplasms called myeloproliferative disorders that includes
myelofibrosis, polycythemia vera and essential thrombocythemia.
Approximately 10 to 20% of patients with polycythemia vera and essential
thrombocythemia progress to myelofibrosis. Myelofibrosis can also
develop without a prior history of polycythemia vera and essential
thrombocythemia.
About Special Protocol Assessments
The SPA is a process that allows for official FDA evaluation of the
clinical protocols of a Phase III clinical trial intended to form the
primary basis for an efficacy claim and provides trial sponsors with a
binding written agreement that the design and analysis of the trial are
adequate to support a marketing application submission if the trial is
performed according to the SPA. Final marketing approval depends on the
results of efficacy, the adverse event profile and on an evaluation of
the benefit/risk of treatment demonstrated in the Phase III trials. The
SPA agreement may only be changed through a written agreement between
the sponsor and the FDA, or if the FDA becomes aware of a substantial
scientific issue essential to product efficacy or safety. For more
information on Special Protocol Assessment, please visit: http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm080571.pdf
About Incyte
Incyte Corporation is a Wilmington, Delaware-based drug discovery and
development company focused on developing proprietary small molecule
drugs for oncology, inflammation and diabetes. Incyte’s most advanced
compound, INCB18424, is in Phase III development for myelofibrosis. For
additional information on Incyte, visit the Company's website at www.incyte.com.
Forward-Looking Statements
Except for the historical information contained herein, the matters set
forth in this press release, including statements with respect to
the anticipated completion of the Phase III clinical trial in patients
with myelofibrosis and timing of filing of a New Drug Application for
INCB18424 assuming positive results are received, the expected times to
begin enrollment of patients in COMFORT-I, the expected number of
clinical sites and patients for COMFORT-I and the expected number of
clinical sites and countries for COMFORT-II, are all forward-looking
statements within the meaning of the "safe harbor" provisions of the
Private Securities Litigation Reform Act of 1995. These forward-looking
statements are subject to risks and uncertainties that may cause actual
results to differ materially, including the high degree of risk and
uncertainty associated with drug development and clinical trials, the
uncertainty of the regulatory approval processes, uncertainty regarding
the timing of commencement of the COMFORT-I trial, Incyte's ability to
enroll a sufficient number of patients for the COMFORT-I and COMFORT-II
clinical trials in a timely manner or at all, unanticipated developments
in the efficacy or safety of INCB18424, and other risks detailed from
time to time in Incyte's filings with the Securities and Exchange
Commission, including its Quarterly Report on Form 10-Q for the quarter
ended March 31, 2009. Incyte disclaims any intent or obligation to
update these forward-looking statements.
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