MGI PHARMA Summarizes Data Presented at the 2007 American Society of Clinical Oncology (ASCO) Annual Meeting
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MGI PHARMA, INC. (Nasdaq:MOGN), a biopharmaceutical company
focused in oncology and acute care, today provided highlights of data
presentations made during the 2007 American Society of Clinical Oncology
(ASCO) Annual Meeting. Dacogen®
(decitabine) for Injection was the subject of five posters including the
presentation of efficacy data in older patients with acute myelogenous
leukemia (AML) and activity observed in patients with refractory acute
lymphocytic leukemia (ALL). Gliadel®
Wafer (polifeprosan 20 with carmustine implant) was the subject of two
posters with one detailing the impact of multimodal therapy that
included Gliadel implantation, followed by treatment with radiation and
concurrent temozolomide plus rotational chemotherapy, on survival in
patients with primary glioblastoma. A poster discussion provided updated
response and survival data from a randomized phase 2 clinical trial of
Irofulven (MGI 114; hydroxymethylacylfulvene) in hormone refractory
prostate cancer (HRPC) patients who failed docetaxel treatment. In
addition to two posters, Aloxi®
(palonosetron hydrochloride) Injection was the subject of a published
abstract describing study results that differentiate the molecular
interaction of Aloxi with the 5-HT3 receptor.
These data provide new insight into the receptor binding mechanisms that
may explain the enhanced protection from chemotherapy-induced nausea and
vomiting (CINV) observed with Aloxi in clinical trials.
"The data presentations at ASCO demonstrate
our commitment to advancing the discovery of clinical attributes that
distinguish each of the oncology products in our portfolio,”
said Mary Lynne Hedley, Ph.D., Executive Vice President and Chief
Scientific Officer of MGI PHARMA. "We look
forward to advancing the scientific understanding of our product
candidates and the presentation of data at future medical meetings.” Aloxi®
Injection Study Results on Receptor Interactions of Aloxi Versus Other 5-HT3
Receptor Antagonists
The results of studies characterizing the molecular ligand-receptor
interactions of Aloxi and the other 5-HT3
receptor antagonists, ondansetron and granisetron, were reported.
Competitive versus allosteric interactions between these agents and the
5-HT3 receptor were examined in binding
experiments using each unlabeled antagonist in competition with [3H]-antagonist.
Concentrations of [3H]-antagonists
were representative of the probable concentrations of each antagonist at
the receptor site in vivo. Based on a plot of the concentration of
unlabeled antagonist needed to observe half maximal binding (IC50)
as a function of [3H]-antagonist
concentration, Aloxi demonstrated dual action suggesting competitive and
allosteric interactions with the 5-HT3
receptor. In contrast, ondansetron and granisetron exhibited strictly
competitive antagonism. The Aloxi allosteric interaction with the 5-HT3
receptor indicates that it has additional inhibitory potential at the
primary receptor binding site compared to the other 5-HT3
receptor antagonists studied.
Study of a Single Day Combination of Aloxi, Dexamethasone and
Aprepitant in Patients Receiving Moderately Emetogenic
Chemotherapy (MEC) Regimens
The results of a study evaluating the efficacy of Aloxi in combination
with dexamethasone and aprepitant given only on Day 1 for the prevention
of acute and delayed CINV in patients receiving MEC were presented in a
poster session on Saturday, June 2, 2007. Forty-one patients (40 female,
1 male) with solid tumors received a 1-day, 3-drug regimen of
intravenous Aloxi 0.25 mg, oral dexamethasone 20 mg and aprepitant 285
mg prior to their first cycle of chemotherapy. Endpoints of the study
included complete response (no emesis or rescue medication), no emesis,
and no significant nausea (Visual Analogue Score (VAS; 0-100) <25)
on Day 1, during the delayed period of Days 2-5, and during the overall
period of Days 1-5. On Day 1, 100% of patients had no emesis and at
least 95% of patients had no emetic episodes in the delayed and overall
time periods. A complete response was demonstrated in 75% of patients on
Day 1 and in 67% of patients in the delayed time period. Based on VAS,
the majority of patients had no significant nausea in the acute, delayed
or overall phases. The most commonly observed adverse events were
headache and fatigue.
Phase 3 Results of Aloxi in Pediatric Patients
The results of a phase 3, multicenter, randomized, double-blind study to
assess the safety, efficacy and pharmacokinetics of single intravenous
doses of Aloxi in pediatric patients were presented in a poster session
on Sunday, June 3, 2007. Sixty patients (2-17 years of age) were
randomized to receive either 3 mcg/kg or 10 mcg/kg with a maximum total
dose of 0.25 mg and 0.75mg, respectively, prior to moderately (n=21) or
highly (n=39) emetogenic chemotherapy. Twelve additional patients, age
28 days-23 months, were studied in open-label design at the same doses.
The majority of patients had received previous chemotherapy. Day 1
complete response (CR: no emetic episodes and no rescue medication)
rates of 37.1% (CI, 22.0-55.1%) and 54.1% (CI, 37.1-70.2%) were reported
in the 3 mcg/kg (n=35) and 10 mcg/kg (n=37) groups, respectively. The
percentage of patients who were emesis-free was numerically higher in
the 10 mcg/kg group; however, as with CR, these differences were
primarily seen in children < 2 years. A
numerically higher proportion of patients (aged 6-17 years) with no
nausea was also observed in the 10 mcg/kg group. Both doses showed a
similar time to treatment failure (time to first emetic episode and/or
first administration of rescue medication). The pharmacokinetic data
show that total body clearance and volume of distribution of Aloxi
increased with age-related body weight, as expected. The long half-life
(21-37 hours) of Aloxi in this pediatric population was consistent with
that in adults. There were no cardiac safety concerns or serious
treatment related adverse events.
Dacogen®
for Injection Study of Response to Dacogen in Older Patients Diagnosed with Acute
Myelogenous Leukemia (AML)
The impact of Dacogen on the survival of older patients with AML was
presented in a poster discussion on Monday, June 4, 2007. A total of 33
patients meeting the WHO definition of AML ( =20%
bone marrow blasts) who had been treated with Dacogen as front-line
therapy on either the randomized Phase 3 study in patients with
myelodysplastic syndromes, or on two consecutive studies of Dacogen,
alone or in combination with valproic acid were evaluated
retrospectively. Response to therapy was assessed by the International
Working Group criteria. In the 33 patients treated with intravenous
Dacogen (100-150 mg/m2/course), an overall
response rate ranging from 50-57% was observed across the three clinical
trials with complete and partial response rates of 24% and 6%,
respectively, and hematologic improvement and marrow complete response
rates of 15% and 6%, respectively. The median survival for the Dacogen
treated patients was 12.6 months, the median duration of response was
8.8 months, and 1- and 2-year survival rates were 51% and 26%,
respectively. Regardless of blast percentage, cytogenetics, or age,
responses were observed in all risk groups. Additionally, the survival
of the Dacogen treated group compared favorably to that of 330 patients
with AML (over 60 years of age) given standard induction therapy
containing cytarabine and treated in the same time-period.
Non-hematologic adverse events included myocardial infarction, dyspnea,
hyperbilirubinemia, dehydration, syncope, headache, and hypokalemia.
Phase 1 Study of Dacogen in Patients with Relapsed or Refractory
Acute Lymphocytic Leukemia (ALL)
Interim results of two consecutive phase 1 studies designed to evaluate
the dose, toxicity, biologic response, and preliminary clinical response
of Dacogen alone and in combination with hyperCVAD, in patients with
relapsed/refractory ALL were presented on Saturday, June 2, 2007.
Patients were treated with intravenous Dacogen administered daily for
five days every other week (starting at 100 mg/m2
per course) with 7 of 13 patients subsequently retreated with Dacogen
(starting at 25 mg/m2 per course) and given
hyperCVAD every three to four weeks. Both agents were started on Day 1.
Two patients had complete bone marrow response on Dacogen alone with one
of these patients also having a complete response except for platelets
(CRp) with subsequent hyperCVAD therapy. Two additional patients who
also received combination therapy had a complete response (CR). One of
the responding patients received a successful allogeneic stem cell
transplant. Correlative studies on patient peripheral blood samples
demonstrated hypomethylation and hematological control. No significant
Grade 3 or Grade 4 drug related non-hematological toxicities were
observed.
Gliadel®
Wafer Retrospective Data on the Overall Survival of Patients with
Glioblastoma Treated with Gliadel Wafer Implantation as Part of
Multimodal Therapy
The results of a retrospective analysis to assess the survival of
patients treated with rotational multi-agent chemotherapy compared to
those who received chemotherapy together with Gliadel Wafer were
presented in a poster discussion on Monday June 4, 2007. Eighty-five
patients with primary glioblastoma multiforme received surgery with
(n=36) or without (n=49) Gliadel implantation followed by radiotherapy
and concurrent temozolomide (TMZ) plus one year of adjuvant rotational
multi-agent chemotherapy (lomustine (CCNU), TMZ, and irinotecan),
consisting of two cycles of each agent. After a median follow-up of 132
weeks, the group that received Gliadel had an extended median survival
of 89.4 weeks (95% CI, 65.1-8) compared to
72.7 weeks (95% CI, 57.7-84.3) for patients who did not receive Gliadel.
One- and 2- year survival rates were also increased with the addition of
Gliadel (81% vs. 67% and 44% vs. 27%, respectively). A Cox proportional
hazards model accounting for the effects of the Recursive Partitioning
Analysis (RPA) class was performed, and the effect of Gliadel treatment
on survival was found to approach significance (p<0.055).
Adverse events were similar in patients treated with or without Gliadel
and included thrombocytopenia, leukopenia, seizures, fatigue, and
gastrointestinal.
Irofulven Results of a Randomized Phase 2 Trial of Irofulven in Hormone
Refractory Prostate Cancer (HRPC) Patients who Failed First-line
Docetaxel Treatment
Updated results of a randomized, 3-arm phase 2 study of irofulven +
prednisone ± capecitabine compared to
mitoxantrone + prednisone in patients with HRPC were presented in a
poster discussion on Saturday, June 2, 2007. A total of 137
patients with documented resistance to first-line treatment with
docetaxel were stratified by presence or absence of disease related
pain at study entry and assigned to treatment in a 2:2:1 manner (i.e.
4/5 patients received an irofulven-containing regimen). Although the
study was not designed for a statistical comparison of survival, there
was a consistent trend toward increased survival in the irofulven arms
vs. mitoxantrone over the entire study period and through last
follow-up. The observed median overall survival was 10.6 months for
patients treated with irofulven + prednisone, 9.4 months for irofulven +
capecitabine + prednisone, and 7.3 months for mitoxantrone + prednisone.
Similarly, patients with disease-related pain at baseline receiving
irofulven + prednisone had a median survival of 8 months vs. 5.5 months
for those patients receiving mitoxantrone + prednisone. PSA response was
noted in 22% of patients receiving irofulven + capecitabine + prednisone
and in 10% of patients treated with irofulven + prednisone. No PSA
responses were observed following treatment with mitoxantrone +
prednisone. Treatment related toxicity including Grade 3-4
myelosuppression was manageable in all 3 arms. These results support
further study of irofulven in this setting.
Additional Abstracts Presented at the 2007 ASCO Annual Meeting Abstract # 7080 "Changing the treatment paradigm
for patients with MDS: how the development of therapeutics influences
population-based care in community oncology –
the Georgia Cancer Specialists Outcomes Database experience” Abstract # 7088 "Phase II trial of decitabine in
myelofibrosis with myeloid metaplasia” Abstract # 9565 "Decitabine (DAC) in combination
with doxorubicin (DOX) and cyclophosphamide (CTX) in relapsed
neuroblastoma (NBL): A Children’s Oncology
Group Study” Abstract # 2036 "Phase II trial of Gliadel plus
O6-benzylguanine (O6-BG) for patients with recurrent glioblastoma
multiforme” Abstract #34157 "A retrospective safety and
efficacy analysis of combination therapy for GBM using temozolomide,
external beam radiation (EBRT), and Gliadel Wafers” About Aloxi®
Injection
Aloxi is approved for the prevention of acute nausea and vomiting
associated with initial and repeat courses of moderately and highly
emetogenic cancer chemotherapy and for the prevention of delayed nausea
and vomiting associated with initial and repeat courses of moderately
emetogenic cancer chemotherapy. Aloxi is the first and only 5-HT3
receptor antagonist to be indicated for the prevention of delayed
chemotherapy-induced nausea and vomiting (CINV) caused by moderately
emetogenic cancer chemotherapy. In clinical trials, the most common
adverse reactions related to Aloxi were headache (9%) and constipation
(5%). Aloxi is contraindicated in patients known to have
hypersensitivity to the drug or any of its components. Please see the
Aloxi package insert, available at www.mgipharma.com and www.aloxi.com,
for important additional details.
About Dacogen®
For Injection
Dacogen is approved by the U.S Food and Drug Administration for the
treatment of patients with myelodysplastic syndromes (MDS) including
previously treated and untreated, de novo and secondary MDS of all
French-American-British (FAB) subtypes (refractory anemia, refractory
anemia with ringed sideroblasts, refractory anemia with excess blasts,
refractory anemia with excess blasts in transformation, and chronic
myelomonocytic leukemia), and Intermediate-1, Intermediate-2, and
High-Risk International Prognostic Scoring System (IPSS) groups. Dacogen
may cause fetal harm when administered to a pregnant woman. Women of
childbearing potential should be advised to avoid becoming pregnant
while using Dacogen. Men should be advised not to father a child while
receiving treatment with Dacogen and for 2 months afterwards. In
clinical trials, the most commonly occurring adverse reactions included
neutropenia (90%), thrombocytopenia (89%), anemia (82%), pyrexia (53%),
fatigue (48%), nausea (42%), cough (40%), petechiae (39%), constipation
(35%), and diarrhea (34%). Please visit www.mgipharma.com or
www.dacogen.com for full prescribing information.
About Gliadel®
Wafer
Gliadel is a biodegradable wafer containing the chemotherapy agent
carmustine, or BCNU, and is indicated in newly diagnosed patients with
high-grade malignant glioma as an adjunct to surgery and radiation.
Gliadel is also indicated in recurrent glioblastoma multiforme patients
as an adjunct to surgery. As a Gliadel Wafer dissolves, BCNU is
delivered directly to the site once occupied by the tumor. Side effects
that have been reported in patients receiving Gliadel include seizures,
intracranial infections, abnormal wound healing, and brain edema
(swelling). Although these events may result as a consequence of brain
surgery (craniotomy) without Gliadel, they may occur more frequently
when Gliadel is used. In clinical studies, the most common side effects
that occurred more often in patients receiving Gliadel than in patients
receiving placebo, included pain and abnormal wound healing. Please
visit www.gliadel.com for full prescribing information.
About MGI PHARMA
MGI PHARMA, INC. is a biopharmaceutical company focused in oncology and
acute care that acquires, researches, develops and commercializes
proprietary products that address the unmet needs of patients. MGI
PHARMA markets Aloxi® (palonosetron
hydrochloride) Injection, Dacogen®
(decitabine) for Injection and Gliadel® Wafer
(polifeprosan 20 with carmustine implant) in the United States. MGI
PHARMA directly markets its products in the U.S. and collaborates with
partners to reach international markets. For more information, please
visit www.mgipharma.com.
This news release contains certain "forward-looking”
statements within the meaning of the Private Securities Litigation
Reform Act of 1995. These statements are typically preceded by
words such as "believes,” "expects,” "anticipates,” "intends,” "will,” "may,” "should,”
or similar expressions. These forward-looking statements are not
guarantees of MGI PHARMA’s future performance
and involve a number of risks and uncertainties that may cause actual
results to differ materially from the results discussed in these
statements. Factors that might cause MGI PHARMA's results to
differ materially from those expressed or implied by such
forward-looking statements include, but are not limited to, the ability
of MGI PHARMA to continue to increase sales of its marketed products,
the ability to successfully commercialize Saforis™
/ the ability for MGI PHARMA to respond to the FDA’s
approvable letter, the successful completion of clinical trials for the
Company’s other product candidates, and other
risks and uncertainties detailed from time to time in MGI PHARMA’s filings with the Securities and Exchange Commission including its
most recently filed Form 10-K and Form 10-Q. MGI PHARMA undertakes
no duty to update any of these forward-looking statements.