- Long-term efficacy data
from the registrational Phase 2 trial of
REZLIDHIA® (olutasidenib) in heavily
pretreated patients with R/R mIDH1 AML, including those receiving
prior venetoclax
-
Data from a subgroup analyses of elderly R/R mIDH1
AML patients treated with olutasidenib shows consistent CR/CRh
results
- Overview of
the Phase 1b trial of
R289 in patients with lower-risk MDS
SOUTH
SAN FRANCISCO, Calif., June 3, 2024
/PRNewswire/ -- Rigel Pharmaceuticals, Inc. (Nasdaq: RIGL) today
announced the presentation of three posters at the 2024 American
Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, IL today and online. Presentations
include five-year results from the pivotal cohort of the
registrational Phase 2 trial of
REZLIDHIA® (olutasidenib) for the treatment of
relapsed or refractory (R/R) mutated isocitrate dehydrogenase-1
(mIDH1) acute myeloid leukemia (AML), the safety and efficacy of
olutasidenib treatment in a subgroup analyses of elderly patients
with R/R mIDH1 AML, and an overview of the ongoing Phase
1b trial of R2891, a
potent and selective inhibitor of IRAK1 and IRAK4, in patients with
lower-risk myelodysplastic syndrome (LR-MDS).
"Our presentations at ASCO build on the strength of REZLIDHIA's
data, reinforcing its important role in the R/R mIDH1 AML treatment
landscape. REZLIDHIA continues to demonstrate durable responses and
was well tolerated, even in difficult to treat and elderly patients
with mIDH1 AML who have more safety concerns," said Raul Rodriguez, Rigel's president and CEO. "In
addition, we are sharing an overview of the ongoing Phase
1b trial of R289 in lower-risk MDS,
an area of high unmet need. We believe R289 could potentially
provide a new treatment option to patients who have failed other
agents."
Monday, June 3, 2024,
9:00am to 12:00pm
CT
Abstract #: 6528
Title: Olutasidenib for Mutated IDH1 Acute Myeloid
Leukemia: Final Five-Year Results from the Phase 2 Pivotal
Cohort
Presenter: Jorge E. Cortes,
M.D.
Location: McCormick Place South, Exhibit Hall A
- An additional two years of data, beyond the results that led to
FDA approval of olutasidenib, further demonstrates the durable
responses observed with olutasidenib in heavily pretreated patients
with mIDH1 AML, including those R/R to prior venetoclax. The safety
profile was consistent with what was previously reported.
- Of 147 efficacy evaluable patients, complete remission (CR) or
CR with partial hematologic recovery (CRh) was achieved in
35%. The median time to CR/CRh was 1.9 months and median
duration of CR/CRh was 25.3 months, with maximum duration ongoing
at 54.6 months. Overall response rate was 48%, with median duration
15.5 months and maximum duration ongoing at 54.6 months. Median
overall survival was 11.6 months.
- Transfusion independence (for ≥56 days) from red blood cells
was achieved in 34 patients (39%) who were dependent at baseline
and from platelets was achieved in 28 patients (41%) who were
dependent at baseline.
- In the 12 patients that were R/R to prior venetoclax, 33%
achieved a CR/CRh; median duration of CR/CRh was not reached
(ongoing at 50.6 months), and median overall survival was 16.2
months.
Monday, June 3, 2024,
9:00am to 12:00pm
CT
Abstract #: 6527
Title: Safety and Efficacy of Olutasidenib Treatment in
Elderly Patients with Relapsed/Refractory mIDH1 Acute Myeloid
Leukemia
Presenter: Stéphane de Botton, M.D., Ph.D.
Location: McCormick Place South, Exhibit Hall A
- Olutasidenib was generally well tolerated in elderly patients
with R/R mIDH1 AML and induced durable remissions, consistent with
the population in the pivotal cohort of the Phase 2 registrational
trial. Despite the challenges of treating elderly patients who had
already failed prior AML treatment, the results suggest that
elderly patients can benefit from therapy with
olutasidenib.
- In this subgroup analyses of the registrational Phase 2 trial
of olutasidenib in 45 participants aged 75 and older with R/R mIDH1
AML, 31% of patients achieved CR/CRh; median time to CR/CRh was 1.5
months, and median duration of CR/CRh was 25.9 months.
- Of the five elderly patients who were R/R to
prior venetoclax, four patients (80%) achieved an overall
response, including two patients (40%) with CR/CRh.
Monday, June 3, 2024,
9:00am to 12:00pm
CT
Abstract #: TPS6591
Title: Phase 1b Trial of
IRAK 1/4 Inhibition for Lower-Risk Myelodysplastic Syndrome
Refractory/Resistant to Prior Therapies: A Trial in Progress
Presenter: Guillermo Garcia-Manero, M.D.
Location: McCormick Place South, Exhibit Hall A
- An overview of the study design of the ongoing Phase
1b trial evaluating R289 in
patients with LR-MDS will be presented. The primary endpoint for
this trial is safety with key secondary endpoints including
preliminary efficacy and evaluation of pharmacokinetic
properties.
- Enrollment in dose levels 1 (250 mg QD), 2 (500 mg QD),
and 3 (750 mg QD) has been completed. Two additional dose levels
with twice daily dosing have been added (250 mg BID and 500/250 mg)
and the trial is actively recruiting.
To learn more about Rigel and the company's clinical and
commercial hematology and oncology portfolio, visit Booth #11059
during ASCO.
About AML
Acute myeloid leukemia (AML) is a rapidly
progressing cancer of the blood and bone marrow that affects
myeloid cells, which normally develop into various types of mature
blood cells. AML occurs primarily in adults and accounts for about
1 percent of all adult cancers. The American Cancer Society
estimates that there will be about 20,800 new cases in the United States, most in adults, in
2024.2
Relapsed AML affects about half of all patients who, following
treatment and remission, experience a return of leukemia cells in
the bone marrow.3 Refractory AML, which affects between
10 and 40 percent of newly diagnosed patients, occurs when a
patient fails to achieve remission even after intensive
treatment.4 Quality of life declines for patients with
each successive line of treatment for AML, and well-tolerated
treatments in relapsed or refractory disease remain an unmet
need.
About R289
R289 is a prodrug of R835, an IRAK1/4 dual inhibitor, which
has been shown in preclinical studies to block inflammatory
cytokine production in response to toll-like receptor (TLR) and
interleukin-1 receptor (IL-1R) family signaling. TLRs and IL-1Rs
play a critical role in the innate immune response and
dysregulation of these pathways can lead to various inflammatory
conditions. Chronic stimulation of both these receptor systems is
thought to cause the pro-inflammatory environment in the bone
marrow responsible for persistent cytopenias in lower-risk MDS
patients.5
About
REZLIDHIA®
INDICATION
REZLIDHIA is
indicated for the treatment of adult patients with relapsed or
refractory acute myeloid leukemia (AML) with a susceptible
isocitrate dehydrogenase-1 (IDH1) mutation as detected by an
FDA-approved test.
IMPORTANT SAFETY INFORMATION
WARNING:
DIFFERENTIATION SYNDROME
Differentiation
syndrome, which can be fatal, can occur with REZLIDHIA treatment.
Symptoms may include dyspnea, pulmonary
infiltrates/pleuropericardial effusion, kidney injury, hypotension,
fever, and weight gain. If differentiation syndrome is suspected,
withhold REZLIDHIA and initiate treatment with corticosteroids and
hemodynamic monitoring until symptom resolution.
|
WARNINGS AND PRECAUTIONS
Differentiation Syndrome
REZLIDHIA can cause
differentiation syndrome. In the clinical trial of REZLIDHIA in
patients with relapsed or refractory AML, differentiation syndrome
occurred in 16% of patients, with grade 3 or 4 differentiation
syndrome occurring in 8% of patients treated, and fatalities in 1%
of patients. Differentiation syndrome is associated with rapid
proliferation and differentiation of myeloid cells and may be
life-threatening or fatal. Symptoms of differentiation syndrome in
patients treated with REZLIDHIA included leukocytosis, dyspnea,
pulmonary infiltrates/pleuropericardial effusion, kidney injury,
fever, edema, pyrexia, and weight gain. Of the 25 patients who
experienced differentiation syndrome, 19 (76%) recovered after
treatment or after dose interruption of REZLIDHIA. Differentiation
syndrome occurred as early as 1 day and up to 18 months after
REZLIDHIA initiation and has been observed with or without
concomitant leukocytosis.
If differentiation syndrome is suspected, temporarily withhold
REZLIDHIA and initiate systemic corticosteroids (e.g.,
dexamethasone 10 mg IV every 12 hours) for a minimum of 3 days and
until resolution of signs and symptoms. If concomitant
leukocytosis is observed, initiate treatment with hydroxyurea, as
clinically indicated. Taper corticosteroids and hydroxyurea after
resolution of symptoms. Differentiation syndrome may recur with
premature discontinuation of corticosteroids and/or hydroxyurea
treatment. Institute supportive measures and hemodynamic monitoring
until improvement; withhold dose of REZLIDHIA and consider dose
reduction based on recurrence.
Hepatotoxicity
REZLIDHIA can cause hepatotoxicity,
presenting as increased alanine aminotransferase (ALT), increased
aspartate aminotransferase (AST), increased blood alkaline
phosphatase, and/or elevated bilirubin. Of 153 patients with
relapsed or refractory AML who received REZLIDHIA, hepatotoxicity
occurred in 23% of patients; 13% experienced grade 3 or 4
hepatotoxicity. One patient treated with REZLIDHIA in combination
with azacitidine in the clinical trial, a combination for which
REZLIDHIA is not indicated, died from complications of drug-induced
liver injury. The median time to onset of hepatotoxicity in
patients with relapsed or refractory AML treated with REZLIDHIA was
1.2 months (range: 1 day to 17.5 months) after REZLIDHIA
initiation, and the median time to resolution was 12 days (range: 1
day to 17 months). The most common hepatotoxicities were elevations
of ALT, AST, blood alkaline phosphatase, and blood bilirubin.
Monitor patients frequently for clinical symptoms of hepatic
dysfunction such as fatigue, anorexia, right upper abdominal
discomfort, dark urine, or jaundice. Obtain baseline liver function
tests prior to initiation of REZLIDHIA, at least once weekly for
the first two months, once every other week for the third month,
once in the fourth month, and once every other month for the
duration of therapy. If hepatic dysfunction occurs, withhold,
reduce, or permanently discontinue REZLIDHIA based on
recurrence/severity.
ADVERSE REACTIONS
The most common (≥20%) adverse
reactions, including laboratory abnormalities, were aspartate
aminotransferase increased, alanine aminotransferase increased,
potassium decreased, sodium decreased, alkaline phosphatase
increased, nausea, creatinine increased, fatigue/malaise,
arthralgia, constipation, lymphocytes increased, bilirubin
increased, leukocytosis, uric acid increased, dyspnea, pyrexia,
rash, lipase increased, mucositis, diarrhea and transaminitis.
DRUG INTERACTIONS
- Avoid concomitant use of REZLIDHIA with strong or moderate
CYP3A inducers.
- Avoid concomitant use of REZLIDHIA with sensitive CYP3A
substrates unless otherwise instructed in the substrates
prescribing information. If concomitant use is unavoidable, monitor
patients for loss of therapeutic effect of these drugs.
LACTATION
Advise women not to breastfeed during
treatment with REZLIDHIA and for 2 weeks after the last dose.
GERIATRIC USE
No overall differences in effectiveness
were observed between patients 65 years and older and younger
patients. Compared to patients younger than 65 years of age, an
increase in incidence of hepatotoxicity and hypertension was
observed in patients ≥65 years of age.
HEPATIC IMPAIRMENT
In patients with mild or moderate
hepatic impairment, closely monitor for increased probability of
differentiation syndrome.
Click here for Full Prescribing Information, including
Boxed WARNING.
To report side effects of prescription drugs to the FDA,
visit www.fda.gov/medwatch or call 1-800-FDA-1088
(800-332-1088).
REZLIDHIA is a registered trademark of Rigel Pharmaceuticals,
Inc.
About Rigel
Rigel Pharmaceuticals, Inc. (Nasdaq: RIGL)
is a biotechnology company dedicated to discovering, developing and
providing novel therapies that significantly improve the lives of
patients with hematologic disorders and cancer. Founded in 1996,
Rigel is based in South San Francisco,
California. For more information on Rigel, the Company's
marketed products and pipeline of potential products,
visit www.rigel.com.
- R289 is an investigational compound not approved by the
FDA.
- de Botton S, et al. Olutasidenib (FT-2102) induces durable
complete remissions in patients with relapsed or
refractory IDH1-mutated AML. Blood Advances.
February 1, 2023.
doi: https://doi.org/10.1182/bloodadvances.2022009411
The American Cancer Society. Key Statistics for Acute Myeloid
Leukemia (AML). Revised January 17,
2024. Accessed Feb. 19,
2024: https://www.cancer.org/cancer/acute-myeloid-leukemia/about/key-statistics.html
- Leukaemia Care. Relapse in Acute Myeloid Leukaemia (AML).
Version 3. Reviewed October 2021.
Accessed Feb 19,
2024: https://media.leukaemiacare.org.uk/wp-content/uploads/Relapse-in-Acute-Myeloid-Leukaemia-AML-Web-Version.pdf
- Thol F, Schlenk RF, Heuser M, Ganser A. How I treat
refractory and early relapsed acute myeloid leukemia. Blood
(2015) 126 (3): 319-27.
doi: https://doi.org/10.1182/blood-2014-10-551911
- Sallman DA et al. Unraveling the Pathogenesis of MDS:
The NLRP3 Inflammasome and Pyroptosis Drive the MDS Phenotype.
Front Oncol. June 16, 2016.
DOI: https://doi.org/10.3389/fonc.2016.0015
Forward-Looking Statements
This press release
contains forward-looking statements relating to, among other
things, the use of olutasidenib in the treatment
of R/R mIDH1 AML patients including those receiving
prior venetoclax treatment, the use of
olutasidenib in treating
elderly patients, and an overview of
a Phase 1b trial of R289 in
patients with lower-risk myelodysplastic
syndrome. Any statements contained in this press
release that are not statements of historical fact may be deemed to
be forward-looking statements. Forward-looking statements can be
identified by words such as "may", "potential", "look forward",
"believe", "will" and similar expressions in reference to future
periods. Forward-looking statements are neither historical facts
nor assurances of future performance. Instead, they are based on
Rigel's current beliefs, expectations, and assumptions and hence
they inherently involve significant risks, uncertainties and
changes in circumstances that are difficult to predict and many of
which are outside of our control. Therefore, you should not rely on
any of these forward-looking statements. Actual results and the
timing of events could differ materially from those anticipated in
such forward looking statements as a result of these risks and
uncertainties, which include, without limitation, risks and
uncertainties associated with the FDA, European Medicines Agency,
PMDA or other regulatory authorities may make adverse decisions
regarding olutasidenib; risks that clinical trials may not be
predictive of real-world results or of results in subsequent
clinical trials; risks that olutasidenib may have unintended side
effects, adverse reactions or incidents of misuses; the
availability of resources to develop Rigel's product candidates;
market competition; as well as other risks detailed from time to
time in Rigel's reports filed with the Securities and Exchange
Commission, including its Annual Report on Form 10-K for the year
ended December 31, 2023 and
subsequent filings. Any forward-looking statement made by us in
this press release is based only on information currently available
to us and speaks only as of the date on which it is made. Rigel
does not undertake any obligation to update forward-looking
statements, whether written or oral, that may be made from time to
time, whether as a result of new information, future developments
or otherwise, and expressly disclaims any obligation or undertaking
to release publicly any updates or revisions to any forward-looking
statements contained herein, except as required by law.
Contact for Investors & Media:
Investors:
Rigel Pharmaceuticals, Inc.
650.624.1232
ir@rigel.com
Media:
David
Rosen
Argot Partners
212.600.1902
david.rosen@argotpartners.com
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SOURCE Rigel Pharmaceuticals, Inc.