- Regenerative Medicine Advanced Therapy (RMAT) designation
follows clinical data of Absolute Lymphocyte Count (ALC) and
significant Overall Survival (OS) correlations in QUILT trials
across multiple tumor types, including third line or greater
metastatic pancreatic cancer, checkpoint relapsed NSCLC, and
supportive data from healthy volunteers
- The reversal of lymphopenia by ImmunityBio’s IL-15 superagonist
is consistent with the mechanism of action of ANKTIVA demonstrating
proliferation and activation of NK cells, CD4+ T cells, CD8+ T
cells and memory T cells without upregulation of suppressive T
regulatory cells and approved in the ANKTIVA label
- Company intends to submit Biologic License Application (BLA)
for the indication of reversal of lymphopenia in patients receiving
standard-of-care chemotherapy and/or radiation and for the
treatment of locally advanced or metastatic pancreatic cancer,
which includes the first-in-class CAR-NK (PD-L1 t-haNK)
- ImmunityBio to provide data from fully enrolled clinical trials
in metastatic pancreatic cancer (QUILT-88) and in checkpoint
relapsed NSCLC (QUILT-3.055, NSCLC Cohort) patients, as well as
lymphopenia reversal across multiple tumor types (QUILT-3.055, All
Cohorts), with supportive data of lymphocyte proliferation in
healthy volunteers (QUILT-1.004)
- In addition, ImmunityBio intends to file an Expanded Access
Policy (EAP) for ANKTIVA and PD-L1 t-haNK in combination with
standard of care chemotherapy/radiotherapy within 15 days and
submit the protocol to the Agency
ImmunityBio, Inc. (NASDAQ: IBRX), a leading immunotherapy
company, today announced the U.S. Food and Drug Administration
(FDA) has granted Regenerative Medicine Advanced Therapy (RMAT)
designation for ANKTIVA® and CAR-NK (PD-L1 t-haNK) for the reversal
of Lymphopenia in Patients Receiving Standard-of-Care
Chemotherapy/Radiotherapy and in Multiply Relapsed Locally Advanced
or Metastatic Pancreatic Cancer.
The complete blood count (CBC) is a standard assay widely used
by oncologist to assess the status of the immune system following
chemotherapy and radiation. To date, information of the cellular
elements in the CBC assay provide information to the physician for
the treatment of anemia, neutropenia and reduced platelet counts
associated with the adverse events of chemotherapy and
radiotherapy. Anemia, neutropenia and reduced platelet counts can
be treated with currently approved therapies, including EPOGEN,
NEUPOGEN and platelet transfusion, respectively.
However, chemotherapy and radiation has also caused a reduction
in the very cells necessary to kill cancer cells. This reduction in
the lymphocytes by our standard of care also inhibits the induction
of T cell memory in the absence of CD4+, CD8+ T cells. A treatment
for the reversal of these adverse events of lymphopenia, induced by
current standard-of-care, has eluded the industry for the past 50
years. ImmunityBio and its Founder Dr. Patrick Soon-Shiong
developed a vision over the past decades that activation and
proliferation of these key lymphocytes was necessary if we were to
win the war against cancer and indeed even prevent cancer in
subjects at high-risk such as with lynch syndrome with a cancer
vaccine. The founder’s vision reflecting the pursuit of addressing
lymphopenia over the past decades will be updated in March.
“RMAT designation for ANKTIVA combined with NK cells was applied
for by the Founder in the initial 2017 IND. With the clinical
results of the QUILT trials across multiple tumor types from 2017
to 2024, validating the hypothesis that high-dose chemotherapy and
radiation induces lymphopenia and can be reversed by ANKTIVA
together with off-the-shelf CAR-NK cells (PD-L1 t-haNK) resulting
in prolongation of overall survival (OS), and enabling ImmunityBio
to reapply for RMAT in 2025,”1 said Dr. Patrick Soon-Shiong,
Founder, Executive Chairman and Global Chief Scientific &
Medical Officer of ImmunityBio. “I am so grateful for the FDA to
have recognized the evolution of science and the need for adoption
of 21st century medicine and cell therapy, particularly the role of
NK cell therapy in our war against cancer as a universal therapy in
cancer, and in the potential treatment of infectious diseases such
as HIV, HPV and COVID. Today’s designation of ANKTIVA and the first
CAR-NK (PD-L1 T-haNK), both first-in-class molecules to activate
lymphocytes within the body (via subcutaneous injection of ANKTIVA)
and via ex-vivo infusion of off-the-shelf PD-L1 NK cells, is an
inflection point and a paradigm change of how we could treat
patients with cancer and viral infections. The absolute lymphocyte
count (ALC) which has been largely ignored by physicians, since no
therapy existed to address lymphopenia, could now be both a
prognostic biomarker but more importantly, the potential as a
therapeutic biomarker.”
“Multiple publications in the last five years have shown that
patients with low lymphocyte counts, especially those with severe
lymphopenia, have a statistically lower survival rate regardless of
the tumor types.2-5 With this RMAT designation and the attributes
of a RMAT designation including all Breakthrough Therapy
Designation features and statutory ways to support Accelerated
Approval, we will move rapidly to file the BLA for these authorized
indications provided by the RMAT designation,” said Soon-Shiong.
“In addition, per the requirement under section 561A(f)(2) of the
Federal Food, Drug, and Cosmetic Act (FD&C Act), ImmunityBio
will make publicly available the Expanded Access Policy of ANKTIVA
and PD-L1 t-haNK in combination with standard-of-care
chemotherapy/radiotherapy within 15 days.”
In the authorization letter, the FDA has committed to work
closely with ImmunityBio to provide guidance and advice on
generating the evidence needed to “support approval” of the
indication above “in an efficient manner.”
About ANKTIVA®
The cytokine interleukin-15 (IL-15) plays a crucial role in the
immune system by affecting the development, maintenance, and
function of key immune cells—NK and CD8+ killer T cells—that are
involved in killing cancer cells. By activating NK cells, ANKTIVA
overcomes the tumor escape phase of clones resistant to T cells and
restores memory T cell activity with resultant prolonged duration
of complete response.
ANKTIVA is a first-in-class IL-15 agonist IgG1 fusion complex,
consisting of an IL-15 mutant (IL-15N72D) fused with an IL-15
receptor alpha, which binds with high affinity to IL-15 receptors
on NK, CD4+, and CD8+ T cells. This fusion complex of ANKTIVA
mimics the natural biological properties of the membrane-bound
IL-15 receptor alpha, delivering IL-15 by dendritic cells and
drives the activation and proliferation of NK cells with the
generation of memory killer T cells that have retained immune
memory against these tumor clones. The proliferation of the
trifecta of these immune killing cells and the activation of
trained immune memory results in immunogenic cell death, inducing a
state of equilibrium with durable complete responses. ANKTIVA has
improved pharmacokinetic properties, longer persistence in lymphoid
tissues, and enhanced anti-tumor activity compared to native,
non-complexed IL-15 in-vivo.
ANKTIVA was approved by the FDA in 2024 for BCG-unresponsive
non-muscle invasive bladder cancer CIS with or without papillary
tumors. For more information, visit ImmunityBio.com (Founder’s
Vision) and Anktiva.com.
About CAR-NK (PD-L1 t-haNK)
PD-L1 t-haNK is a human, allogeneic, stable clonal NK cell line
generated from the parental aNK cell line (NK-92), manufactured by
the Sponsor under cGMP conditions.
Based on the demonstrated therapeutic efficacy of CAR targeting
and on the important role of FcγR-mediated ADCC in the
effectiveness of therapeutic IgG1 monoclonal antibodies, we
hypothesized that modification of the parental aNK cell line to
stably express both a PD-L1–targeted CAR and the high-affinity
variant of CD16 would result in potent and selective antitumor
activity. Myeloid-derived suppressor cells (MDSCs) express PD-L1 in
concert with MHC-I loss to induce immune escape of tumors resistant
or relapsed from chemo-immunotherapy including checkpoint
inhibitors. Thus, there is a rationale for the combination of
Anktiva (converting a cold tumor to hot tumor and rescuing T cells
by re-expressing MHC-I) and PD-L1 t-haNK to overcome the
immunosuppressive effect of TGFβ secreted by MDSCs.
The ability to target both the tumor and MDSCs with off-the-shelf,
outpatient based safe infusion of allogeneic CAR-NKs targeting
PD-L1, was the basis for the development of this CAR-NK.
Preclinical studies published in the J Immunotherapy Cancer 2020
“PD-L1 targeting high-affinity NK (t-haNK) cells induce direct
antitumor effects and target suppressive MDSC populations” (Fabian
et al. 2020) demonstrate that PD-L1 targeting of high affinity NK
cells (PD-L1 t-haNK) induced direct anti-tumor effects in TNBC
tumor cell lines and target suppressive MDSCs populations.
About ImmunityBio
ImmunityBio is a leading biotechnology company addressing cancer
and infectious diseases by bolstering the natural immune system.
The company is developing therapeutics that coordinate innate and
adaptive immune responses, stimulating robust, multifunctional
immunity and sustained immune memory that results in safe,
long-term protection against disease recurrence.
The company’s lead asset is ANKTIVA® (nogapendekin alfa
inbakicept-pmln) solution for intravesical use, approved in the
U.S. by the Food and Drug Administration (FDA) indicated with
Bacillus Calmette-Guérin (BCG) for the treatment of adult patients
with BCG-unresponsive bladder carcinoma in situ (CIS) with or
without papillary tumors.
ANKTIVA’s ability to activate natural killer (NK) cells, killer
T cells, and memory T cells makes it a candidate ‘backbone’ therapy
that may enhance the effectiveness of other therapies when used in
combination in various tumor types. In a Phase 2 study, combining
ANKTIVA with checkpoint inhibitor (CPI) therapy has shown potential
to improve overall survival of patients with advanced or metastatic
non-small cell lung cancer who have become resistant to CPI
treatment. Further, Phase 1 findings in healthy participants have
demonstrated ANKTIVA’s potential to reverse lymphopenia, a severe
depletion of key immune white blood cells, that is a frequent
consequence of conventional radiation or chemotherapy in cancer
patients.
Based on the approved mechanism of action of proliferating and
activating NK cells, CD4+, CD8+ T cells and memory T cells without
proliferation of immuno-suppressive Treg cells, ANKTIVA has the
potential to overcome the adverse events of chemotherapy and
radiotherapy of lymphopenia. The company has received Regenerative
Medicine Advanced Therapy (RMAT) designation for the development of
ANKTIVA plus CAR-NK (PD-L1 t-haNK) for the reversal of lymphopenia
for patients receiving standard-of-care chemotherapy/radiotherapy
and in multiply relapsed locally advanced or metastatic pancreatic
cancer.
ANKTIVA is just one product of ImmunityBio’s
vertically-integrated R&D engine comprising state-of-the-art
laboratories and production facilities supporting a range of
next-generation immunotherapies (Immunotherapy 2.0, beyond
checkpoint inhibitors), including cell therapies, and vaccine
platforms, all of which are designed to be effective, safe, easy to
administer, and to reduce or eliminate the need for invasive and
burdensome treatments - such as high-dose chemotherapy - that are
currently standard of care.
For more information, visit ImmunityBio.com (Founder’s Vision)
and connect with us on X (Twitter), Facebook, LinkedIn, and
Instagram.
About Regenerative Medicine Advanced Therapy (RMAT)
The RMAT designation was established under the 21st Century
Cures Act to expedite the development and review of promising
therapeutic candidates, including cell therapies, that are intended
to treat, modify, reverse or cure a serious or life-threatening
disease. RMAT designation includes benefits, such as early
interactions with the FDA, including discussions on surrogate or
intermediate endpoints that could potentially support accelerated
approval and satisfy post-approval requirements, and potential
priority review of a product’s biologics license application
(BLA).
References:
- Fabian KP, Padget MR, Donahue RN, Solocinski K, Robbins Y,
Allen CT, Lee JH, Rabizadeh S, Soon-Shiong P, Schlom J, Hodge JW.
PD-L1 targeting high-affinity NK (t-haNK) cells induce direct
antitumor effects and target suppressive MDSC populations. J
Immunother Cancer. 2020 May;8(1):e000450.
- Rubinstein MP, Williams C, Mart C, Beall J, MacPherson L, Azar
J, Swiderska-Syn M, Manca P, Gibney BC, Robinson MD, Krieg C, Hill
EG, Taha SA, Rock AD, Lee JH, Soon-Shiong P, Wrangle J. Phase I
Trial Characterizing the Pharmacokinetic Profile of N-803, a
Chimeric IL-15 Superagonist, in Healthy Volunteers. J Immunol. 2022
Mar 15;208(6):1362-1370. doi: 10.4049/jimmunol.2100066. Epub 2022
Feb 28. PMID: 35228263.
- Guo Z, Zhang Z, Prajapati M, Li Y. Lymphopenia Caused by Virus
Infections and the Mechanisms Beyond. Viruses. 2021 Sep
20;13(9):1876.
- Ménétrier-Caux C, Ray-Coquard I, Blay JY, Caux C. Lymphopenia
in Cancer Patients and its Effects on Response to Immunotherapy: an
opportunity for combination with Cytokines? J Immunother Cancer.
2019 Mar 28;7(1):85.
- Valero C, Lee M, Hoen D, Weiss K, Kelly DW, Adusumilli PS, Paik
PK, Plitas G, Ladanyi M, Postow MA, Ariyan CE, Shoushtari AN,
Balachandran VP, Hakimi AA, Crago AM, Long Roche KC, Smith JJ,
Ganly I, Wong RJ, Patel SG, Shah JP, Lee NY, Riaz N, Wang J, Zehir
A, Berger MF, Chan TA, Seshan VE, Morris LGT. Pretreatment
neutrophil-to-lymphocyte ratio and mutational burden as biomarkers
of tumor response to immune checkpoint inhibitors. Nat Commun. 2021
Feb 1;12(1):729.
Forward-Looking Statements
This press release contains forward-looking statements within
the meaning of the Private Securities Litigation Reform Act of
1995, such as statements regarding the RMAT designation referenced
herein and potential results therefrom, the related anticipated EAP
submission and timing thereof, the related anticipated BLA
submission and timing thereof, clinical trial data and potential
results to be drawn therefrom, the development of therapeutics for
cancer and infectious diseases, potential benefits to patients,
potential treatment outcomes for patients, the described mechanism
of action and results and contributions therefrom, potential future
uses and applications of ANKTIVA and/or PD-L1 t-haNK and use in
cancer vaccines and across multiple tumor types, and ImmunityBio’s
approved product and investigational agents as compared to existing
treatment options, among others. Statements in this press release
that are not statements of historical fact are considered
forward-looking statements, which are usually identified by the use
of words such as “anticipates,” “believes,” “continues,” “goal,”
“could,” “estimates,” “scheduled,” “expects,” “intends,” “may,”
“plans,” “potential,” “predicts,” “indicate,” “projects,” “is,”
“seeks,” “should,” “will,” “strategy,” and variations of such words
or similar expressions. Statements of past performance, efforts, or
results of our preclinical and clinical trials, about which
inferences or assumptions may be made, can also be forward-looking
statements and are not indicative of future performance or results.
Forward-looking statements are neither forecasts, promises nor
guarantees, and are based on the current beliefs of ImmunityBio’s
management as well as assumptions made by and information currently
available to ImmunityBio. Such information may be limited or
incomplete, and ImmunityBio’s statements should not be read to
indicate that it has conducted a thorough inquiry into, or review
of, all potentially available relevant information. Such statements
reflect the current views of ImmunityBio with respect to future
events and are subject to known and unknown risks, including
business, regulatory, economic and competitive risks,
uncertainties, contingencies and assumptions about ImmunityBio,
including, without limitation, (i) whether the RMAT designation
will lead to an accelerated review or approval, of which there can
be no assurance, (ii) ImmunityBio’s ability to submit the
regulatory submissions referenced herein on the anticipated
timeline or at all, (iii) additional risks and uncertainties
related to the regulatory submission, filing and review process and
the timing thereof, (iv) the ability of ImmunityBio to fund its
ongoing and anticipated clinical trials, (v) whether clinical
trials will result in registrational pathways, (vi) whether
clinical trial data will be accepted by regulatory agencies, (vii)
the ability of ImmunityBio to continue its planned preclinical and
clinical development of its development programs through itself
and/or its investigators, and the timing and success of any such
continued preclinical and clinical development, patient enrollment
and planned regulatory submissions, (viii) potential delays in
product availability and regulatory approvals, (ix) the risks and
uncertainties associated with third party collaborations and
agreements, (x) ImmunityBio’s ability to retain and hire key
personnel, (xi) ImmunityBio’s ability to obtain additional
financing to fund its operations and complete the development and
commercialization of its various product candidates, (xii)
potential product shortages or manufacturing disruptions that may
impact the availability and timing of product, (xiii) ImmunityBio’s
ability to successfully commercialize its approved product and
product candidates, (xiv) ImmunityBio’s ability to scale its
manufacturing and commercial supply operations for its approved
product and future approved products, and (xv) ImmunityBio’s
ability to obtain, maintain, protect, and enforce patent protection
and other proprietary rights for its product candidates and
technologies. More details about these and other risks that may
impact ImmunityBio’s business are described under the heading “Risk
Factors” in the Company’s Form 10-K filed with the U.S. Securities
and Exchange Commission (SEC) on March 19, 2024 and the Company’s
Form 10-Q filed with the SEC on November 12, 2024, and in
subsequent filings made by ImmunityBio with the SEC, which are
available on the SEC’s website at www.sec.gov. ImmunityBio cautions
you not to place undue reliance on any forward looking statements,
which speak only as of the date hereof. ImmunityBio does not
undertake any duty to update any forward-looking statement or other
information in this press release, except to the extent required by
law.
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version on businesswire.com: https://www.businesswire.com/news/home/20250227880542/en/
ImmunityBio Contacts:
Investors Hemanth Ramaprakash, PhD, MBA
ImmunityBio, Inc. +1 858-746-9289
Hemanth.Ramaprakash@ImmunityBio.com
Media Sarah Singleton ImmunityBio, Inc. +1
415-290-8045 Sarah.Singleton@ImmunityBio.com
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