New compelling clinical data from first-ever
Gaucher disease type 3 (GD3) patient and four Gaucher disease type
1 (GD1) patients dosed with investigational AVR-RD-02
Data from first pediatric GD3 patient, the more
severe, progressive form of Gaucher disease, show biochemical
correction and improvement in major refractory element of disease
15 months post gene therapy
Data from first four adult patients dosed in
GD1 clinical trial show important reductions below baseline ERT
levels in liver and spleen volume up to two years post gene
therapy
Following positive feedback from FDA and MHRA,
registrational, global Phase 2/3 clinical trial for GD3 planned for
second half 2023
AVROBIO believes plato® gene therapy platform
is late-stage ready with no major CMC changes anticipated
Gaucher Disease Program Update to be webcast
today starting at 8 a.m. ET
AVROBIO, Inc. (Nasdaq: AVRO), a leading clinical-stage gene
therapy company working to free people from a lifetime of genetic
disease, today announced new interim pharmacokinetic,
pharmacodynamic and clinical efficacy data, showing stabilization
or reversal of multiple clinically relevant measures in five
patients with Gaucher disease after they received a single dose of
AVR-RD-02, an investigational hematopoietic stem cell (HSC) gene
therapy. In addition, following positive discussions with
regulators, AVROBIO plans to initiate a global, registrational
Phase 2/3 clinical trial in Gaucher disease type 3 (GD3) in the
second half of 2023.
Gaucher disease is the largest, most common lysosomal disorder.
Even on enzyme replacement therapy (ERT) – the current standard of
care – people with Gaucher disease type 1 (GD1) typically have a
shortened life expectancy and may experience debilitating symptoms
that significantly reduce their quality of life. GD3 is a more
severe, progressive form of Gaucher disease, which presents with
more widespread systemic manifestations, typically refractory to
standard of care treatment, as well as neurological signs and
symptoms.
“We are thrilled to share new, compelling data from patients
impacted across the spectrum of Gaucher disease, the most common
lysosomal disorder. This includes what we believe to be
transformational data from the first pediatric GD3 patient treated
with an HSC gene therapy, showing complete biochemical correction,
which means both enzyme activity and substrate levels have
normalized post gene therapy. This pharmacodynamic efficacy equates
with improvements in major refractory elements of disease for this
patient, something the child has never experienced on current
standard of care,” said Essra Ridha, M.D., MRCP, FFPM, chief
medical officer at AVROBIO. “Following constructive regulatory
conversations, including with FDA, we are now focused on initiating
a randomized controlled, Phase 2/3 clinical trial for GD3 next
year, the first such trial for a gene therapy, to further evaluate
the benefit-risk profile of AVR-RD-02 in a clinical trial
setting.”
“Additionally, today’s interim data from the ongoing Guard1
clinical trial, our Phase 1/2 trial for GD1, reinforce the
potential clinical impact of HSC gene therapy in this subset of
Gaucher disease, with the first patient dosed now two years post
gene therapy. In our previous update, we shared favorable data
across clinical biomarkers – today, we’re pleased to share new
interim data showing not only sustained pharmacodynamic efficacy,
but also some clinically significant reductions in liver and spleen
volume, demonstrating that our gene therapy is having an impact
above and beyond the standard of care baseline measures,” said
Ridha. “We believe our current GD1 and planned GD3 clinical trials
combined will create a robust data set that will further the
development of this investigational gene therapy and move us ever
closer to bringing a potential one-time treatment option to people
living with Gaucher disease.”
AVR-RD-02 for GD3: First pediatric patient dosed with
investigational AVR-RD-02
- An 11-year-old patient was dosed at the University of
Manchester, U.K., on a named patient basis
- Fifteen months post gene therapy, the patient has normalized
peripheral glucocerebrosidase (GCase) enzyme activity and plasma
chitotriosidase, a marker of activated macrophages, and remains off
enzyme replacement therapy (ERT) and substrate reduction therapy
(SRT)
- Patient’s albumin levels increased 33% eight months post gene
therapy, reflecting improvements in lymphadenopathy and
enteropathy. This patient was previously refractory to maximal and
multimodal medical therapy, including ERT, SRT, enteral steroids,
dietary restrictions and intermittent albumin infusions
- Additionally, the patient did not develop any new lesions on
MRI assessments post gene therapy, on a background of rapidly
developing lesions, and had no clinically detectable change in
neurological status or new neurological manifestations 15 months
post gene therapy
- Safety data from this patient indicate no adverse events (AEs)
related to drug product. All AEs observed were related to
myeloablative conditioning, stem cell mobilization, underlying
disease or pre-existing conditions
AVR-RD-02 for GD1: Clinically meaningful reductions in
organomegaly and improvements from baseline ERT levels in plasma
lyso-Gb1 and chitotriosidase activity
- All four adult GD1 patients in the Guard1 clinical trial who
have been infused with investigational AVR-RD-02 to date saw
sustained engraftment with vector copy numbers (VCN) between 0.54
to 0.86 per diploid genome 14 weeks to two years post gene therapy,
and reconstitution of GCase enzyme activity both in plasma and
peripheral blood leukocytes within the normal range
- Glucosylsphingosine (lyso-Gb1) decreased 21% to 70% (21%, 21%,
30% and 70%, respectively) below ERT baseline levels for all four
patients 12 weeks to two years post gene therapy. A downstream
metabolic product of glucocerebroside, lyso-Gb1, is considered a
sensitive and specific biomarker used for disease monitoring
- The metabolite chitotriosidase was reduced in the two patients
with evaluable samples to date, reflecting a reduction in
macrophage activation and inflammation. Patient 1's chitotriosidase
level has almost completely normalized, declining from a high of
145.8 µmol/L/h prior to gene therapy treatment to 42.4 µmol/L/h
(≤38.1 µmol/L/h is considered normal range) two years post gene
therapy. Patient 2, who was in the normal range before gene therapy
treatment, still decreased from 24.3 µmol/L/h at baseline to 19.2
µmol/L/h at week 52
- Importantly, three of the four patients dosed demonstrate a
reduction in liver and spleen volume below their own ERT baseline.
Patient 4 is not yet out far enough post gene therapy to be scanned
for liver or spleen volume
- Patient 1 data showed a clinically significant 24% reduction in
liver volume at 104 weeks post gene therapy (patient underwent a
splenectomy during childhood)
- Patient 2 data showed a clinically significant 11% reduction in
liver volume and 23% reduction in spleen volume at 52 weeks post
gene therapy
- Patient 3 data showed a 4% reduction in liver volume and a 19%
reduction in spleen volume, at 26 weeks post gene therapy
- Safety data from the four patients dosed to date indicate no
AEs related to drug product. All AEs observed were related to
myeloablative conditioning, stem cell mobilization, underlying
disease or pre-existing conditions. The majority of AEs were mild
or moderate and resolved without clinical sequelae. Additionally,
hemoglobin and platelet levels, a core feature of successful
Gaucher disease treatment, remain in normal range following gene
therapy
- The ongoing Guard1 clinical trial (NCT04145037) is a
multinational, open-label study to assess the safety and efficacy
of investigational AVR-RD-02 in approximately eight to 16
participants (male or female) who are ≥18 and ≤50 years of age with
a confirmed diagnosis of GD1
Planning first ever, randomized controlled clinical trial for
GD3 in 2023
- AVROBIO plans to initiate a Phase 2/3 pediatric clinical trial
for investigational AVR-RD-02 in GD3 in the second half of 2023,
following constructive meetings with the U.S. Food and Drug
Administration (FDA) and U.K. Medicines and Healthcare products
Regulatory Agency (MHRA)
- Global, open label, parallel-arm and randomized controlled
clinical trial designed to evaluate the efficacy and safety of
investigational AVR-RD-02. The trial is expected to include
approximately 40 GD3 participants (male or female) who will be
randomized 1:1 to receive HSC gene therapy or continue to receive
standard of care ERT. Following the observation period, eligible
participants who received ERT can cross over into the active arm
and receive HSC gene therapy
- Planned primary efficacy endpoint is a novel, multi-domain
endpoint to reflect the systemic and heterogeneous nature of
Gaucher disease, including ataxia (impaired coordination),
breathing ability and liver and spleen volume. A key secondary
efficacy measure will examine substrate levels in cerebrospinal
fluid (CSF), which reflects the impact of the HSC gene therapy in
the central nervous system
- Overall, data from both the Guard1 and planned global Phase 2/3
GD3 clinical trials are expected to further development of this
investigational gene therapy, leveraging the similar underlying
pathophysiology for both types of Gaucher disease.
“AVROBIO is transitioning into a late-stage company in 2023,
targeting indications with large, pre-identified patient
populations and with attractive commercial opportunities,” added
AVROBIO President and Chief Executive Officer Geoff MacKay. “We
look forward to this next stage in our journey, as we continue to
work every day toward our shared purpose of freeing patients from a
lifetime of genetic disease.”
AVROBIO believes its plato® gene therapy platform is late
stage-trial ready, with no major CMC changes anticipated
plato®, AVROBIO’s end-to-end solution covering vector design and
production, drug product manufacturing and analytics, has received
feedback from multiple regulatory agencies and no major chemistry,
manufacturing and controls (CMC) changes are anticipated as the
company enters late-stage clinical trials.
New data showed consistent quality attributes across the Gaucher
disease drug product, including purity, percent transduction, VCN,
as well as potency. Additionally, the company reinforced its
commitment to vector safety and showcased favorable data on the
combined use of two state-of-the-art assays to evaluate the
genotoxicity risk of integrating vectors used in HSC gene therapy
prior to clinical use.
Gaucher Disease Program Update webcast information
A live webcast of the Virtual Gaucher Disease Program Update and
accompanying slides will be available under “Events and
Presentations” in the Investors section of the company’s website at
www.avrobio.com. An archived webcast recording of the event will be
available on the website for approximately 30 days.
About Gaucher disease
Gaucher disease is a rare, inherited lysosomal disorder
characterized by the toxic accumulation of glucosylceramide
(GlcCer) and glucosylsphingosine (GlcSph) in macrophages.
Macrophages enlarged with these fatty substances are called Gaucher
cells which amass primarily in the spleen, liver and bone marrow.
This results in a variety of potential symptoms, including grossly
enlarged liver and spleen, bone issues, fatigue, low hemoglobin
levels and platelet counts and an adjusted lifetime relative risk
of developing Parkinson's disease that may be more than 20 times
greater than the general population. Even on enzyme replacement
therapy (ERT) – the current standard of care – people with Gaucher
disease typically have a shortened life expectancy and may
experience debilitating symptoms that significantly reduce their
quality of life.
About AVROBIO
Our vision is to bring personalized gene therapy to the world.
We target the root cause of genetic disease by introducing a
functional copy of the affected gene into patients’ own
hematopoietic stem cells (HSCs), with the goal of durably
expressing the therapeutic protein throughout the body, including
the central nervous system. Our first-in-class pipeline includes
clinical programs for Gaucher disease and cystinosis, as well as
preclinical programs for Hunter syndrome and Pompe disease. Our
proprietary plato® gene therapy platform is scalable for planned
global commercialization. We are headquartered in Cambridge, Mass.
For additional information, visit avrobio.com, and follow us on
Twitter and LinkedIn.
Forward-Looking Statements
This press release contains forward-looking statements,
including statements made pursuant to the safe harbor provisions of
the Private Securities Litigation Reform Act of 1995. These
statements may be identified by words and phrases such as “aims,”
“anticipates,” “believes,” “continue,” “could,” “designed to,”
“estimates,” “expects,” “forecasts,” “goal,” “intends,” “may,”
“plans,” “possible,” “potential,” “predicts,” “projects,” “seeks,”
“strives,” “should,” “will,” and variations of these words and
phrases or similar expressions that are intended to identify
forward-looking statements. These forward-looking statements
include, without limitation, statements regarding our business
strategy for and the potential therapeutic benefits of our
preclinical and clinical product candidates, including AVR-RD-02
for the treatment of Gaucher disease, including its use in a
compassionate use or named patient setting, the design,
commencement, enrollment and timing of planned clinical trials, our
plans and expectations with respect to the development of our
clinical and preclinical product candidates, including timing,
design, and initiation of our potential clinical and registration
trials and anticipated interactions and expectations with
regulatory agencies, the timing of anticipated clinical and
regulatory updates, the timing of patient recruitment and
enrollment activities, preclinical, compassionate use or clinical
trial results, product approvals and regulatory pathways,
anticipated benefits of our gene therapy platform including
potential impact on our commercialization activities, timing and
likelihood of success, the expected benefits and results of our
implementation of manufacturing technology, including the
implementation of our plato® platform in our clinical trials and
gene therapy programs including its late-stage readiness, and the
expected safety profile of our preclinical and investigational gene
therapies. Any such statements in this press release that are not
statements of historical fact may be deemed to be forward-looking
statements. Results in preclinical or early-stage clinical trials
may not be indicative of results from later stage or larger scale
clinical trials and do not ensure regulatory approval. You should
not place undue reliance on these statements, or the scientific
data presented.
Any forward-looking statements in this press release are based
on AVROBIO’s current expectations, estimates and projections about
our industry as well as management’s current beliefs and
expectations of future events only as of today and are subject to a
number of risks and uncertainties that could cause actual results
to differ materially and adversely from those set forth in or
implied by such forward-looking statements. These risks and
uncertainties include, but are not limited to, the risk that any
one or more of AVROBIO’s product candidates will not be
successfully developed or commercialized, the risk of cessation or
delay of any ongoing or planned clinical trials of AVROBIO or our
collaborators, the risk that AVROBIO may not successfully recruit
or enroll a sufficient number of patients for our clinical trials,
the risk that AVROBIO may not realize the intended benefits of our
gene therapy platform, including the features of our plato®
platform, the risk that our product candidates or procedures in
connection with the administration thereof will not have the safety
or efficacy profile that we anticipate, the risk that prior
results, such as signals of safety, activity or durability of
effect, observed from preclinical or clinical trials, will not be
replicated or will not continue in ongoing or future studies or
trials involving AVROBIO’s product candidates, the risk that we
will be unable to obtain and maintain regulatory approval for our
product candidates, the risk that the size and growth potential of
the market for our product candidates will not materialize as
expected, risks associated with our dependence on third-party
suppliers and manufacturers, risks regarding the accuracy of our
estimates of expenses and future revenue, risks relating to our
capital requirements and needs for additional financing, risks
relating to clinical trial and business interruptions resulting
from the COVID-19 outbreak or similar public health crises,
including that such interruptions may materially delay our
enrollment and development timelines and/or increase our
development costs or that data collection efforts may be impaired
or otherwise impacted by such crises, and risks relating to our
ability to obtain and maintain intellectual property protection for
our product candidates. For a discussion of these and other risks
and uncertainties, and other important factors, any of which could
cause AVROBIO’s actual results to differ materially and adversely
from those contained in the forward-looking statements, see the
section entitled “Risk Factors” in AVROBIO’s most recent Quarterly
Report, as well as discussions of potential risks, uncertainties
and other important factors in AVROBIO’s subsequent filings with
the Securities and Exchange Commission. AVROBIO explicitly
disclaims any obligation to update any forward-looking statements
except to the extent required by law.
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Investor Contact: Christopher F. Brinzey Westwicke, an
ICR Company 339-970-2843 chris.brinzey@westwicke.com
Media Contact: Kit Rodophele Ten Bridge Communications
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