25.04.2006 12:00:00
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NeoPharm's Cintredekin Besudotox Well-Tolerated in Newly Diagnosed Malignant Glioma Patients
-- Phase I Study Confirms Combination Therapy that Includes Cintredekin Besudotox May Be An Option For This Patient Population
NeoPharm, Inc. (Nasdaq:NEOL) today announced that, based upon arecent Phase I study, evidence was provided that cintredekin besudotox(IL13-PE38QQR) appears to be safe and well tolerated in newlydiagnosed malignant glioma patients. Results from the Phase I studywill be presented at the 74th Annual Meeting of the AmericanAssociation of Neurological Surgeons (AANS) held in San Francisco onTuesday, April 25, 2006
"We always try to optimize the safety and efficacy of currentlyavailable therapies when used in combination with investigationaltherapies," commented Michael Vogelbaum, M.D., Ph.D., Vice-Chairmanand Associate Director of Neurosurgical Oncology, Brain TumorInstitute, Cleveland Clinic Foundation. "We are encouraged thatcintredekin besudotox can apparently be safely used in combinationwith two currently available therapies, radiation therapy andtemozolomide, and that the combination may provide benefits for thispatient population."
Patients in the Phase I study underwent a gross total resection oftumor followed by the placement of 2-4 stereotactically placedintraparenchymal catheters, and administration of cintredekinbesudotox (0.25 ug/mL or 0.5 ug/mL) infused over 96 hours. This wasfollowed, 10-14 days later, by standard fractionated radiation therapy(5940-6100 cGy (centi-Gray units), 5 days/week for 6-7 weeks) with orwithout temozolomide (75 mg/m(2)/day, 7 days/week during radiation).Safety was assessed over an 11-week observation period followingcatheter placement.
Nineteen patients were enrolled and received cintredekinbesudotox. Seventeen of 19 patients (12 male and 7 female, median age55, all had GBM) have completed treatment including cintredekinbesudotox, radiation therapy +/- temozolomide. No patients experienceddose limiting toxicities in the first two cohorts (0.25 ug/mLcintredekin besudotox + radiation (n=3) and 0.25 ug/mL cintredekinbesudotox + radiation + temozolomide (n=3)). After one dose-limitingtoxicity (DLT) (seizure), the third cohort (0.5 ug/mL cintredekinbesudotox + radiation) was expanded to 6 patients without any DLT.Three patients treated at 0.5 ug/mL + radiation + temozolomide havecompleted the safety observation without any DLT. Two additionalpatients are currently being treated and another one was recentlyenrolled to confirm the safety of 0.5 ug/mL + radiation +temozolomide.
Adverse events considered related to cintredekin besudotox orcatheter placement were consistent with adverse events observed inPhase I studies of cintredekin besudotox administered as monotherapyin patients with recurrent malignant glioma.
Patients continue to be followed for survival.
About Glioblastoma Multiforme
Glioblastoma multiforme (GBM) is the most common type of malignantprimary brain tumor in adults. According to the Central Brain TumorRegistry of the United States (www.cbtrus.org), GBM tumors account forapproximately 22 percent of all adult primary brain tumors and usuallyaffect men more commonly than women, particularly men between the agesof 60 and 85 years. GBM is rare in children, comprising approximatelythree percent of all childhood tumors. According to the CBTRUS,approximately 18,500 people are diagnosed annually with primarymalignant brain tumors and approximately 13,000 people die from thisdisease annually. Survival time for patients ranges from six monthsfor recurrent disease to 12 months with newly diagnosed diseasedespite aggressive treatments including surgery, radiation therapy andchemotherapy.
GBM tumors mainly arise in the cerebral hemispheres (the mainportions of the brain), but they can also occur in the brain stem,cerebellum, or spinal cord. Symptoms of a GBM can include headachesthat are caused by increased intracranial pressure, memory loss,seizures, personality changes, and coordination difficulties.
About Cintredekin Besudotox (IL13-PE38QQR)
Cintredekin besudotox is a recombinant protein consisting of asingle molecule composed of two parts: a tumor-targeting molecule(Interleukin-13, or IL13) and a cytotoxic agent (Pseudomonas Exotoxin,or PE). The drug is delivered via Convection Enhanced Delivery (CED),a novel drug delivery system using catheters placed following tumorresection (removal), in areas with microscopic tumor spread or at riskof tumor spread around the tumor resection cavity. IL13 receptors arepresent in appreciable numbers on malignant glioma cells, but only toa minimal amount if at all on healthy brain cells. The IL13 portion isdesigned to bind to receptors on tumor cells like a key fits into alock. The cancer cell appears to latch onto and absorb the IL13 andthe attached PE, causing destruction of the cancer cell. Healthy braincells appear to be unharmed because they do not internalize the PE.
Cintredekin besudotox has received Orphan Drug designation andFast Track designation from the U.S. Food and Drug Administration(FDA). Cintredekin besudotox was also accepted into FDA's Pilot 2Program for continuous marketing applications. Cintredekin besudotoxhas also received Orphan Drug designation in Europe.
Promising data for this potential therapeutic advance in thetreatment of GBM has been observed in Phase I/II trials. In addition,the importance of adequate catheter positioning in order to achieveoptimal distribution of cintredekin besudotox in brain tissue wasassessed, leading to the specific guidelines for catheter positioningand deferred catheter placement used in the Company's ongoing PhaseIII PRECISE Trial. Improved catheter placement translated into abetter patient outcome for the 45 (complete Phase I/II patient set)recurrent GBM patients treated post-tumor resection in the Phase I/IItrials, with an overall median survival of 44.0 weeks (95% ConfidenceInterval (CI): 36.1-55.6) including 42 percent of patients with lessthan 2 adequately positioned catheters, while patients with greaterthan or equal to 2 catheters adequately positioned surviving with amedian of 53.6 weeks (95% CI: 36.1-70.3). Separately, one-year andtwo-year survival rates for recurrent GBM patients were 40 percent and13 percent respectively.
Pivotal Phase III Trial - PRECISE
PRECISE, an acronym for Phase III Randomized Evaluation ofConvection Enhanced Delivery of IL13-PE38QQR with Survival Endpoint,www.precisetrial.com, is a randomized, controlled Phase III clinicaltrial. It was designed to enroll up to 300 patients in order to obtain270 patients with confirmed GBM at first recurrence at study entrysurgical resection for the intent-to-treat patient population, andcompare overall survival, drug safety and quality of life of patientsreceiving cintredekin besudotox with patients receiving Gliadel(R)Wafer in the treatment of first recurrent GBM following surgical tumorresection.
PRECISE achieved the 270 patient intent-to-treat milestone (276intent-to-treat) in early December after enrolling 294 patients.Patients were randomized so that 2 patients received cintredekinbesudotox via CED for every 1 patient that received Gliadel(R) Waferplaced in the resection cavity at the time of resection. The primaryefficacy analysis of the trial will be based on the comparison of theoverall patient survival curves of the two treatment groups.
In December 2005, an independent Data Monitoring Committee (DMC)recommended that the PRECISE Trial continue as planned under theapproved protocol. The DMC observed no treatment related adverse orserious adverse events that differed from those seen in the Phase I/IItrials, and observed that, at that time, optimal catheter placement(greater than or equal to 2 catheters adequately positioned) had beenachieved in more than 80% of patients. A planned interim efficacyanalysis (triggered at 160 deaths) is expected to occur in late-secondor early third quarter of 2006, and a final efficacy analysis(triggered at 215 deaths) is currently expected to occur late in thefourth quarter of 2006 or first quarter of 2007.
NeoPharm's Commitment to Oncology
NeoPharm employees share a common goal: bringing hope to cancerpatients and their families through the research and development ofnew cancer drugs and therapies. The Company's oncology portfolio isbuilt on two novel, proprietary platforms: a tumor-targeting platform,and the NeoLipid(R) Liposomal Drug Delivery platform. Through itsresearch and clinical studies, as well as its work with physicians,scientists, and advocacy groups, NeoPharm is helping to enhance thelives of cancer patients.
About NeoPharm, Inc.
NeoPharm, Inc., based in Waukegan, Illinois, is a publicly tradedbiopharmaceutical company dedicated to the research, development andcommercialization of new and innovative cancer drugs for therapeuticapplications. Additional information, including ongoing clinicaltrials, can be obtained by visiting NeoPharm's Web site atwww.neopharm.com.
Forward Looking Statements - This press release contains"forward-looking statements" within the meaning of Section 27A of theSecurities Act of 1933 and Section 21E of the Securities Exchange Actof 1934. The Company has tried to identify such forward-lookingstatements by use of such words as "expects," "intends," "hopes,""anticipates," "believes," "could," "may," "evidences" and"estimates," and other similar expressions, but these words are notthe exclusive means of identifying such statements. Such statementsinclude, but are not limited to, any statements relating to theCompany's drug development program, including, but not limited toclinical trials involving cintredekin besudotox, future patientsurvival in the Company's ongoing Phase I/II studies and PRECISE trialfor cintredekin besudotox, and any other statements that are nothistorical facts. Such statements involve risks and uncertainties,including, but not limited to, those risks and uncertainties relatingto difficulties or delays in financing, development, testing,obtaining regulatory approval, production and marketing of theCompany's drug and non-drug compounds, including, but not limited to,cintredekin besudotox, uncertainty regarding the availability of thirdparty production capacity, unexpected adverse side effects orinadequate therapeutic efficacy of the Company's drug and non-drugcompounds, including, but not limited to, cintredekin besudotox, thatcould slow or prevent products coming to market, uncertainty regardingthe Company's ability to market its drug and non-drug products,including, but not limited to, cintredekin besudotox, directly orthrough independent distributors, the uncertainty of patent protectionfor the Company's intellectual property or trade secrets, including,but not limited to, cintredekin besudotox, and other risks detailedfrom time to time in filings the Company makes with the Securities andExchange Commission including its annual reports on Form 10-K andquarterly reports on Forms 10-Q. Such statements are based onmanagement's current expectations, but actual results may differmaterially due to various factors, including those risks anduncertainties mentioned or referred to in this press release.Accordingly, you should not rely on these forward-looking statementsas a prediction of actual future results.
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