01.06.2008 13:00:00
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Updated Data from Ongoing Phase 3 Trials Support the Continued Study of Vectibix(R) (panitumumab) in Combination with Standard Chemotherapy
Amgen (NASDAQ:AMGN) today announced updated interim pooled, blinded,
safety results from two Phase 3 trials evaluating Vectibix®
(panitumumab) in combination with standard chemotherapy in earlier lines
of metastatic colorectal cancer (mCRC). Updated data from these trials,
as well as the first prospective trial evaluating the impact of the
clinical biomarker KRAS on Vectibix efficacy in combination with
chemotherapy, were presented at the 2008 American Society of Clinical
Oncology’s (ASCO) Annual Meeting in Chicago.
"The data being generated from a number of
our ongoing trials in various settings of colorectal cancer continue to
inform us about the safety of Vectibix in combination with standard
chemotherapy,” said Roger M. Perlmutter,
M.D., Ph.D., executive vice president of Research and Development at
Amgen. "Our data regarding the importance of
KRAS mutation status emphasize the significance of this biomarker in
developing individualized therapy for colorectal cancer.” PRIME (203) Study
The "PRIME” or
20050203 study is a global, Phase 3 trial investigating Vectibix in
combination with FOLFOX chemotherapy as first-line treatment for mCRC
among wild-type KRAS and all randomized patients. Final
enrollment was completed in February 2008 with a total of 1,183 patients.
Pooled safety data from a planned interim analysis, conducted by an
independent Data Monitoring Committee (DMC), of 903 patients (455
Vectibix plus FOLFOX; 448 FOLFOX only), of which 99 percent received at
least one cycle of therapy, showed the following pooled grade 3/4
adverse events: neutropenia (28 percent), diarrhea (11 percent), fatigue
(4 percent), nausea (3 percent), dehydration (3 percent) and
hypomagnesaemia, pulmonary embolism, febrile neutropenia and deep vein
thrombosis (2 percent, respectively). Fifty-six percent of the pooled
patient population had skin and subcutaneous tissue system organ class
(SOC) events of any grade; 10 percent grade 3 and less than one percent
grade 4. Based upon this interim safety analysis, the DMC recommended
that the PRIME study continue per protocol.
Patients enrolled in this study were randomized to receive either 6.0
mg/kg of Vectibix and FOLFOX once every two weeks (Q2W) or FOLFOX alone
Q2W. The primary endpoint is progression-free survival (PFS). Other
endpoints include overall survival, objective response rate, time to
progression, duration of response and safety.
All study endpoints will be investigated by patients’ KRAS mutational status in both treatment arms as a biomarker for
Vectibix activity in combination with FOLFOX chemotherapy as first-line
treatment for mCRC.
181 Study
The 20050181 ("181”)
study is a global, Phase 3 trial investigating Vectibix in combination
with FOLFIRI chemotherapy as second-line treatment for patients with
mCRC assessed according to KRAS mutational status. The 181 study
final enrollment was completed in March 2008 with a total of 1,187
patients.
Pooled safety data from a planned interim analysis, conducted by the
independent DMC, of 1,097 patients (548 Vectibix plus FOLFIRI; 549
FOLFIRI only), of which 99.6 percent received at least one cycle of
therapy, showed the following pooled grade 3/4 adverse events:
neutropenia (17 percent), diarrhea (10 percent), fatigue (5 percent),
nausea, dehydration, pulmonary embolism, febrile neutropenia (2 percent,
respectively), and hypomagnaesemia and deep vein thrombosis (1 percent,
respectively). Sixty-three percent of the pooled patient population had
skin and subcutaneous tissue SOC events of any grade; 15 percent grade 3
and less than one percent grade four. Based upon this interim safety
analysis, the DMC recommended that the 181 study continue per protocol.
Patients were randomized to receive either 6.0 mg/kg of Vectibix and
FOLFIRI Q2W or FOLFIRI Q2W alone. The co-primary endpoints are
progression-free survival and overall survival. Other endpoints include
objective response rate, time to progression, duration of response and
safety.
All study endpoints will be investigated by patients’ KRAS mutational status in both treatment arms as a biomarker for
Vectibix activity in combination with FOLFIRI chemotherapy as
second-line treatment for mCRC.
PRECEPT
The single-arm PRECEPT study (n=109) was designed to prospectively
evaluate the efficacy of Vectibix when combined with the chemotherapy
regimen FOLFIRI, according to KRAS status, in patients with
metastatic disease which had progressed following first-line treatment
with an oxaliplatin-based chemotherapy regimen plus bevacizumab.
Data from this interim efficacy analysis (n=64 wild-type KRAS,
n=45 mutant KRAS) showed that patients with wild-type KRAS
had longer PFS (median: 26 weeks wild-type versus 16 weeks mutant KRAS)
and time to treatment failure (median: 20 weeks wild-type versus 15
weeks mutant KRAS). Overall response rates were similar in this
interim analysis. In line with other EGFr-inhibitor class data in
combination with chemotherapy, the addition of Vectibix to FOLFIRI was
tolerable. Vectibix-related serious adverse events (grade 3 or higher)
were observed in 15 patients, or 13 percent of the 115 patients included
in the safety analysis. The most frequently reported serious adverse
events were neutropenia (23 percent), skin-related toxicity (19 percent)
and diarrhea (13 percent).
"These data are the first to measure the
potential impact of KRAS status in combination treatment with
Vectibix and chemotherapy, and add to the growing body of evidence that
help validate KRAS as a potential patient selection biomarker for
anti-EGFr therapy,” said Allen Cohn, M.D.,
Rocky Mountain Cancer Center, U.S. Oncology, Denver, Colorado. "KRAS
mutational status ranks among one of the most important scientific
advances in colorectal cancer and has the potential to redefine how
these patients are currently treated.” About Vectibix
Vectibix is the EGFr-inhibitor of choice in the treatment of advanced
colorectal cancer patients who have failed standard chemotherapy due to
its demonstrated efficacy, safety and convenient Q2W dosing schedule.
In the United States (U.S.), Vectibix is indicated for the treatment of
patients with EGFr-expressing mCRC after disease progression on, or
following fluoropyrimidine-, oxaliplatin- and irinotecan-containing
chemotherapy regimens. The effectiveness of Vectibix for the treatment
of EGFr-expressing, metastatic colorectal carcinoma is based on
progression-free survival. Currently no data are available that
demonstrate an improvement in disease-related symptoms or increased
survival with Vectibix.
In the European Union (EU), Vectibix is approved as monotherapy for the
treatment of patients with EGFr-expressing mCRC with non-mutated
(wild-type) KRAS genes after failure of standard chemotherapy
regimens.
Important Product Safety Information
Dermatologic toxicities, related to Vectibix blockade of EGF binding and
subsequent inhibition of EGF receptor-mediated signaling pathways,
included but were not limited to dermatitis acneiform, pruritus,
erythema, rash, skin exfoliation, paronychia, dry skin, and skin
fissures. Dermatologic toxicities were reported in 89 percent of
patients treated with Vectibix and were severe in 12 percent of
patients. Severe dermatologic toxicities were complicated by infection,
including sepsis, septic death, and abscesses requiring incisions and
drainage. Vectibix may need to be withheld or discontinued for severe
dermatologic toxicities.
Severe infusion reactions occurred with Vectibix in approximately one
percent of patients. Severe infusion reactions were identified as
anaphylactic reactions, bronchospasm, fever, chills and hypotension.
Although fatal infusion reactions have not been reported with Vectibix,
they have occurred with other monoclonal antibody products. Severe
infusion reactions require stopping the infusion and possibly
permanently discontinuing Vectibix, depending on the severity and/or
persistence of the reaction.
About Amgen
Amgen discovers, develops, manufactures and delivers innovative human
therapeutics. A biotechnology pioneer since 1980, Amgen was one of the
first companies to realize the new science’s
promise by bringing safe and effective medicines from lab, to
manufacturing plant, to patient. Amgen therapeutics have changed the
practice of medicine, helping millions of people around the world in the
fight against cancer, kidney disease, rheumatoid arthritis and other
serious illnesses. With a deep and broad pipeline of potential new
medicines, Amgen remains committed to advancing science to dramatically
improve people’s lives. To learn more about
our pioneering science and our vital medicines, visit www.amgen.com.
Forward-Looking Statements
This news release contains forward-looking statements that are based on
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and are subject to a number of risks, uncertainties and assumptions that
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