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ARIAD Pharmaceuticals, Inc.
today announced twelve-month
follow-up data from the pivotal PACE trial of ponatinib, its investigational
BCR-ABL inhibitor, in heavily pretreated patients with advanced forms of
chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute
lymphoblastic leukemia (Ph+ ALL). The study now shows that 57 percent of
accelerated-phase CML patients in the trial, including 50 percent of patients
with the T315I mutation, achieved a major hematologic response (MaHR), the
primary end-point for patients with advanced disease in the trial.
The data are being featured today at 8:00 a.m. (ET) in an oral presentation at
the 54th Annual Meeting of the American Society of Hematology (ASH) being held
in Atlanta, Georgia. ARIAD filed for regulatory approval of ponatinib in the
third quarter of 2012 in the U.S. and in the E.U. based on clinical data from
the pivotal PACE trial.
“Patients with advanced forms of Philadelphia chromosome-positive leukemia and
those who have failed currently available therapy have limited treatment
options available to them,” said Hagop M. Kantarjian, M.D., chairman and
professor, Department of Leukemia, University of Texas M.D. Anderson Cancer
Center. “The overall prognosis is poor for patients with advanced disease.”
“The pivotal PACE trial data show that ponatinib has robust activity in
heavily pretreated patients with accelerated phase CML, more than doubling
their reported best prior responses to available TKI therapy,” he added. “What
is equally striking is that the median time to achieve a response to ponatinib
among accelerated phase patients was only three weeks and that the median
duration of major hematologic response in these patients is one year.”
* Trial Design
* Efficacy data were reported at ASH on 444 treated patients in six
pre-specified cohorts at 45 mg of ponatinib administered orally once
daily, including 177 treated patients with advanced disease (i.e.,
accelerated and blast phase CML and Ph+ ALL).
* Sixty percent of accelerated phase CML patients and 53 percent of
blast-phase CML and Ph+ ALL patients in the trial had received three
or more tyrosine kinase inhibitors (TKI) prior to enrollment.
* Advanced disease patients had a blood test approximately every month
for determination of hematologic response and a bone-marrow
assessment approximately every two months for determination of
cytogenetic response.
* Advanced CML and Ph+ ALL patients evaluable for response (N=177)
* Fifty-seven percent (47 of 83) of accelerated-phase patients achieved
a MaHR, including 50 percent (9 of 18) of accelerated-phase patients
with the T315I mutation. At study entry, the reported best prior
response of MaHR or better to their most recent TKI among
accelerated-phase patients was 21 percent.
* Thirty-four percent (32 of 94) of blast-phase CML or Ph+ ALL patients
achieved a MaHR, including 33 percent (15 of 46) of blast-phase CML
or Ph+ ALL patients with the T315I mutation. At study entry, the
reported best prior response of MaHR or better to their most recent
treatment with a TKI among blast-phase CML or Ph+ ALL patients was 24
percent.
* Thirty-nine percent (32 of 83) of accelerated-phase CML patients and
31 percent (29 of 94) of blast-phase CML or Ph+ ALL patients achieved
a MCyR. Furthermore, 24 percent (20 of 83) of patients with
accelerated-phase CML and 24 percent (23 of 94) of patients with
blast-phase CML or Ph+ ALL achieved a complete cytogenetic response.
* Median duration, progression-free survival and overall survival
* In accelerated-phase CML patients, the median time to achieve a MaHR
was 21 days, and the median duration of this response was 12 months.
In blast-phase CML or Ph+ ALL patients, the median time to achieve a
MaHR was 26 days, and the median duration of this response was 5
months.
* Progression-free survival (PFS) in accelerated-phase CML patients was
estimated to be 55 percent at 12 months (median, 18 months).
Progression-free survival in blast-phase CML or Ph+ ALL patients was
estimated to be 15 percent at 12 months (median, 3 months).
* Overall survival at 12 months in accelerated-phase CML patients was
estimated to be 84 percent (median not yet reached). Overall survival
at 12 months in blast-phase CML or Ph+ ALL patients was estimated to
be 33 percent, with a median overall survival of 7 months.
* Safety profile (N=449)
* The most common non-hematologic treatment-emergent adverse events
across all patients in the PACE trial included rash (in 38% of
patients), abdominal pain (38%), headache (35%), dry skin (35%), and
constipation (34%), with the majority of these being grades 1 or 2 in
severity.
* The most common hematologic treatment-emergent adverse events were
thrombocytopenia (42%), neutropenia (24%), and anemia (20%), which
were primarily grades 3 or 4 in severity.
* Pancreatitis and pneumonia were the most common non-hematologic
treatment-emergent serious adverse events (5% each), followed by
abdominal pain (4%), myocardial infarction (3%), congestive heart
failure (3%), atrial fibrillation (3%), and pyrexia (3%). The most
common hematologic serious adverse events were anemia, febrile
neutropenia, and thrombocytopenia (3% each).
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