Epizyme Inc., a clinical stage biopharmaceutical company creating innovative personalized therapeutics for patients with genetically defined cancers, reported pre-clinical data and early clinical observations from an ongoing Phase 1 trial, being conducted in collaboration with Eisai, the Institut Gustave Roussy, and the Institut Bergonie, of EZH2 inhibitor EPZ-6438 (E7438) in patients with advanced solid tumors and B-cell lymphomas. These data were presented by Robert Copeland, chief scientific officer, Epizyme, during an oral session on novel therapeutics in lymphoma at the American Society of Hematology (ASH) meeting on Lymphoma Biology.
“EPZ-6438 is the first EZH2 inhibitor to enter the clinic. We are very pleased to see that the maximum tolerated dose has not been reached and that there was a clear PK and PD dose relationship through the first three cohorts that have been evaluated,” said Robert Gould, chief executive officer, Epizyme. “Additionally, we saw two objective responses among NHL patients enrolled in the first three cohorts of the Phase 1 dose escalation study. We plan to present more complete Phase 1 results at a scientific conference later in 2014. Pending review of those results, we expect to initiate two Phase 2 studies in 2014: one in NHL and one in INI1-deficient tumors, such as malignant rhabdoid tumors.”
Pre-clinical data have shown the utility of single-agent EZH2 inhibitors in both EZH2 mutant and EZH2 wild type germinal center (GC) NHL models. Data presented showed that in pre-clinical studies in GC NHL cell lines, combining EPZ-6438 with CHOP, a chemotherapy cocktail regimen that is a standard of care in NHL, resulted in strong synergy of lymphoma cell killing. When EPZ-6438 was combined with each individual component of the CHOP regimen, the synergy was greatest with prednisone, the corticosteroid component of CHOP. Prednisone greatly enhanced the potency of EPZ-6438 for killing EZH2 mutant-bearing lymphoma cell lines, and broadened the activity of EPZ-6438 to all GC NHL cell lines, regardless of EZH2 mutational status. Combining EPZ-6438 with dexamethasone, another corticosteroid, yielded similar synergistic results. Synergy was also observed in both EZH2 mutant and wild type cell lines when EPZ-6438 was combined with B-cell signaling pathway agents and BCL2 antagonists.
Early Clinical Observations
The primary objective of the ongoing Phase 1 dose escalation study is to evaluate the safety and tolerability of EPZ-6438 and determine the maximum tolerated dose (MTD) or recommended Phase 2 dose (RP2D); the secondary objectives are to determine pharmacokinetics (PK) and pharmacodynamics (PD) of EPZ-6438. The study to date consists of five dosing cohorts, with evaluation of doses of 100 mg to 1600 mg BID, orally administered in 28-day cycles without a drug holiday in patients with advanced solid tumors or with relapsed or refractory B-cell lymphoma. Three of five dosing cohorts (100, 200 and 400 mg) have been completed with 12 evaluable patients dosed, four of whom were NHL patients. Dose cohorts evaluating 800 mg and 1600 mg are ongoing.
Early clinical observations from the three completed cohorts include:
- MTD has not been reached; there were no DLTs or AE-related treatment discontinuations
- PK was dose-proportional across these three cohorts
- PD evidence of target inhibition was observed in skin
- Two NHL patients achieved objective responses: a partial response in a patient with relapsed transformed diffuse large B-cell lymphoma (DLBCL), and an ongoing partial response in a patient with primary refractory mediastinal B-cell lymphoma (PMBCL)
- Additionally, a patient with follicular lymphoma with EZH2 mutation had stable disease
Date: August 12, 2014
Filed Under: Drug Discovery