New Ipilimumab Survival Data in Patients with Metastatic Melanoma Presented at American Society of Clinical Oncology Annual Meeting
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Bristol-Myers Squibb Company (NYSE:
BMY) and Medarex, Inc. (NASDAQ:
MEDX) today announced preliminary survival data for ipilimumab (10 mg/kg
monotherapy), an investigational oncology immunotherapy, in
previously-treated patients with advanced metastatic melanoma.
Results of three Phase 2 studies (008, 022 and 007) and one Phase 1/2
study (MDX010-15), presented at the 44th Annual
Meeting of the American Society of Clinical Oncology, showed:
One-year projected survival rate of 46.7 percent and median overall
survival of 10.2 months in patients who had progressed while on or
after receiving standard treatment (Study 008, Abstract #9021);
One-year projected survival rate of 53.4 percent and median overall
survival of 14.6 months in patients who were previously treated,
relapsed or failed to respond to experimental treatment or were unable
to tolerate currently approved therapies (Study 022, Abstract #9025);
One-year projected survival rate of 59.1 percent in treatment-naïve
patients and patients previously treated with therapy other than
ipilimumab—at the time of analysis, the
median overall survival had not been reached (Study 007, Abstract #
9010); and
Two-year projected survival rate of 30 percent and median overall
survival of 13.4 months in heavily pre-treated melanoma patients
(Study MDX010-15, Abstract #3018).
The median follow-up for survival in studies 008, 022 and 007 was 9.5,
8.9 and 10.9 months, respectively. The median follow-up for survival in
study MDX010-15 was 15.5 months.
"Prolonging survival is the ultimate goal of
any cancer treatment,” said Steven J. O’Day,
M.D., Chief of Research and Director of the Melanoma Program at The
Angeles Clinic and Research Institute, California. "These
ipilimumab studies are particularly important when you consider that the
recent medical literature reports median overall survival of six to nine
months and a one-year survival rate of 25 to 35 percent for patients
with Stage III or Stage IV metastatic melanoma. The ipilimumab data
offer further insight into the potential role of harnessing the immune
system to fight cancer.”
The four studies enrolled a total of 510 patients with Stage III
or Stage IV metastatic melanoma treated with 10 mg/kg ipilimumab
therapy. Approximately half of the patients in each of the trials had
stage M1c disease, which indicates that melanoma metastases have spread
to internal organs. M1c disease can also be associated with an elevated
level of serum LDH and is typically indicative of the worst prognosis.
Overall survival, one-year survival rates, disease control rate, stable
disease and other measurements of anti-tumor activity and patterns of
responses were secondary endpoints in studies 008, 022 and 007.
Long-term survival data from study MDX010-015 was collected in a
separate follow-up study (MDX010-28).
Additional data presented from studies 008, 022 and 007, which further
demonstrated the potential clinical activity of ipilimumab at the 10
mg/kg dosing regimen, included:
A statistically significant relationship between increased response
rate and increased dose (p=0.0015) in study 022, favoring the 10 mg/kg
regimen, as determined by independent radiology review (IRC); and
Disease control rates (proportion of patients with complete responses,
partial responses or stable disease) of 27.1 percent (42 of 155), 29.2
percent (21 of 72) and 35.1 percent (20 of 57) across studies 008, 022
and 007, respectively.
Investigators also discussed unique patterns of response observed in
studies 008, 022 and 007, which suggested that conventional criteria for
classifying short-term response and tumor progression may not accurately
capture the clinical activity observed with ipilimumab. For example, an
exploratory analysis utilizing endpoints that assessed total tumor
burden showed that some patients who received 10 mg/kg of ipilimumab can
initially demonstrate progression of the target lesion or new lesions
but subsequently go on to achieve responses. In these patients, both the
initial lesion and new lesions shrank in size or resolved with
additional follow-up. The resulting response rates observed by the
investigators using the exploratory analyses may correlate better with
the survival data presented (Abstracts #3008 and #3020).
"Ipilimumab involves immune activation that
begins early and builds an immune response over time,”
said F. Steven Hodi, M.D., Clinical Director of the Melanoma Program at
Dana-Farber Cancer Institute. "The ipilimumab
data observed show patterns of response that are different from
conventional chemotherapy and underscore the need for criteria that more
accurately describe clinical activity and long-term benefit.”
Safety results from the four studies were generally consistent with data
from previously reported clinical trials of ipilimumab. The most common
immune-related adverse events (greater than five percent) were rash,
diarrhea and hepatitis, as well as endocrinopathies (four percent). The
high-grade (3/4) immune-related adverse event rate was approximately 20
to 40 percent in patients who received 10 mg/kg of ipilimumab. The
adverse events were generally manageable and reversible within days or
weeks with the use of systemic steroids and established treatment
guidelines in the majority of patients.
About the Studies
The four studies enrolled patients across North America, Europe, South
America and Africa and included:
A Phase 2 open-label, single arm trial (008) evaluating overall
response rate in 155 patients who progressed while on or after
receiving standard treatment;
A Phase 2 randomized, double-blind trial (022) evaluating the efficacy
of three dose levels of ipilimumab in 217 patients who were previously
treated, relapsed or failed to respond to experimental treatment or
were unable to tolerate currently approved therapies; and
A Phase 2 randomized, double-blind trial (007) in 115 patients
comparing the safety of ipilimumab, with prophylactic oral budesonide
or placebo (primarily evaluating the rate of grade 2+ diarrhea).
A Phase 1/2 trial (MDX010-15) evaluating the efficacy of the 10 mg/kg
dosing regimen in 23 highly-refractory melanoma patients treated with
ipilimumab.
The primary endpoint of studies 008 and 022 was best overall response
rate and the primary endpoint of study 007 was to compare the safety of
ipilimumab with or without prophylactic oral budesonide. Top-line
results from these studies were previously announced. The primary
endpoint of study MDX010-15 was to determine the safety and
pharmacokinetic profile of single and multiple doses of ipilimumab.
About Ipilimumab
Ipilimumab is a fully human antibody that binds to CTLA-4 (cytotoxic T
lymphocyte-associated antigen 4), a molecule on T-cells that plays a
critical role in regulating natural immune responses. The absence or
presence of CTLA-4 can augment or suppress the immune system’s
T-cell response in fighting disease. Ipilimumab is designed to block the
activity of CTLA-4, thereby sustaining an active immune response in its
attack on cancer cells.
About Advanced Melanoma
Melanoma is a form of skin cancer characterized by the uncontrolled
growth of pigment-producing cells (melanocytes) located in the skin. As
with many cancers, it is more difficult to treat once the disease has
spread beyond the skin to other parts of the body by way of the
bloodstream or the lymphatic system (metastatic disease). Melanoma
accounts for about three percent of skin cancer cases, but it causes
most skin cancer deaths. The American Cancer Society estimates that in
2008 there will be 62,480 new cases of melanoma in the U.S., and about
8,420 people will die of this disease.
About Medarex
Medarex is a biopharmaceutical company focused on the discovery,
development and potential commercialization of fully human
antibody-based therapeutics to treat life-threatening and debilitating
diseases, including cancer, inflammation, autoimmune disorders and
infectious diseases. Medarex applies its UltiMAb®
technology and product development and clinical manufacturing experience
to generate, support and potentially commercialize a broad range of
fully human antibody product candidates for itself and its partners.
More than 40 of these therapeutic product candidates derived from
Medarex technology are in human clinical testing or have had INDs
submitted for such trials, with seven of the most advanced product
candidates currently in Phase 3 clinical trials or the subject of
regulatory applications for marketing authorization. Medarex is
committed to building value by developing a diverse pipeline of antibody
products to address the world's unmet healthcare needs. For more
information about Medarex, visit its Web site at www.medarex.com.
Except for the historical information presented herein, matters
discussed herein may constitute forward-looking statements, as defined
in the Private Securities Litigation Reform Act of 1995, that are
subject to certain risks and uncertainties that could cause actual
results to differ materially from any future results, performance or
achievements expressed or implied by such statements. Statements that
are not historical facts, including statements preceded by, followed by,
or that include the words; "potential"; "may"; or similar statements are
forward-looking statements. Medarex disclaims, however, any intent or
obligation to update these forward-looking statements. These risks and
uncertainties include whether the actual results in the clinical studies
described above will differ materially from results in future use of
ipilimumab, whether development of ipilimumab will be successful,
whether the clinical studies described in this release will support the
filing of a BLA with the FDA, or whether, if a BLA is filed with the
FDA, it will be filed in the timeframe developed by the parties or will
receive regulatory approval, as well as risks detailed from time to time
in Medarex's public disclosure filings with the U.S. Securities and
Exchange Commission (SEC), including its Annual Report on Form 10-K for
the fiscal year ended December 31, 2007 and its quarterly reports on
Form 10-Q. There can be no assurance that such development efforts will
succeed or that other developed products will receive required
regulatory clearance or that, even if such regulatory clearance were
received, such products would ultimately achieve commercial success.
Copies of Medarex's public disclosure filings are available from its
investor relations department.
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to extend and enhance human life. For more information, visit www.bms.com.
This press release contains "forward-looking statements" as that term is
defined in the Private Securities Litigation Reform Act of 1995,
regarding the research and development of ipilimumab. Such
forward-looking statements are based on current expectations and involve
inherent risks and uncertainties, including factors that could delay,
divert or change any of them, and could cause actual outcomes and
results to differ materially from current expectations. No
forward-looking statement can be guaranteed. Among other risks, there
can be no guarantee that the development of ipilimumab will be
successful or that the clinical studies described in this release will
support the filing of a Biological License Application (BLA) with the
U.S. Food and Drug Administration (FDA). Furthermore, there can be no
assurances that if a BLA is filed with the FDA, that it will be filed in
the timeframe developed by the parties or that such BLA will receive
regulatory approval. There can be no assurances that if approved,
ipilimumab will be commercially successful. Forward-looking statements
in the press release should be evaluated together with the many
uncertainties that affect Bristol-Myers Squibb's business, particularly
those identified in the cautionary factors discussion in Bristol-Myers
Squibb's Annual Report on Form 10-K for the year ended December 31,
2007, its Quarterly Reports on Form 10-Q, and Current Reports on Form
8-K. Bristol-Myers Squibb undertakes no obligation to publicly update
any forward-looking statement, whether as a result of new information,
future events, or otherwise.