Results Illustrate Depth and Diversity of
Amgen's Targeted Therapies Across Tumor Types
THOUSAND
OAKS, Calif., Sept. 13,
2024 /PRNewswire/ -- Amgen (NASDAQ: AMGN)
today announced the presentation of new data across its broad
oncology pipeline and portfolio at the European Society for Medical
Oncology (ESMO) Congress 2024, taking place Sept. 13-17 in Barcelona. The abstracts showcase data from
Amgen-sponsored and investigator-sponsored studies for colorectal,
lung, prostate and gastric cancers using molecularly targeted
modalities.
"The breadth of these data reflects our strategy to advance
diverse modalities for difficult-to-treat cancers," said
Jay Bradner, M.D., executive vice
president, Research and Development, and chief scientific officer
at Amgen. "These ESMO results underscore our leadership in
oncology, contributing significant advancements with both
investigational and established therapies. Guided by a deep
understanding of cancer biology and leveraging incisive
therapeutics, we can target dominant drivers of disease with
unprecedented precision."
Key presentations include:
- First findings from the Phase 1b
study of LUMAKRAS® plus Vectibix® in
combination with FOLFIRI in first-line patients with KRAS
G12C-mutated metastatic colorectal cancer (mCRC).
- Phase 1 dose escalation and initial dose expansion data from
AMG 193 selected for a presidential symposium session.
- First-in-human study of xaluritamig in men with metastatic
castration-resistant prostate cancer (mCRPC).
For more information on the Amgen abstracts, see below.
Abstracts and Presentation Times:
Amgen Sponsored Abstracts
LUMAKRAS® (sotorasib) plus
Vectibix® (panitumumab)
- Sotorasib (soto) + panitumumab (pani) and FOLFIRI in the
first line (1L) setting for KRAS-G12C mutated metastatic colorectal
cancer (mCRC): Safety and efficacy from the phase 1b CodeBreaK 101 study
Abstract #505O, Proffered Paper Oral Session: 2, Madrid Auditorium
– Hall 2, Sunday, September 15 from 3:05 - 3:15 p.m. CEST
AMG 193
- Phase 1 dose escalation and initial dose expansion results
of AMG 193, an MTA-cooperative PRMT5 inhibitor, in patients (pts)
with MTAP-deleted solid tumors
Abstract #3482, Proffered Paper Oral Session: Presidential
Symposium III: Eyes to the Future, Barcelona Auditorium – Hall 2,
Monday, September 16 from 16:30 – 18:15 p.m. CEST
Xaluritamig
- Circulating tumor cell (CTC) enumeration and overall
survival (OS) in men with metastatic castration-resistant prostate
cancer (mCRPC) treated with xaluritamig
Abstract #1610P, Poster, September
15
- Xaluritamig, a STEAP1 x CD3 XmAb 2+1 immune therapy, in
patients with metastatic castration-resistant prostate cancer
(mCRPC): Initial results from dose expansion cohorts in a Phase 1
study
Abstract #1598P, Poster, September
15
LUMAKRAS® (sotorasib) for NSCLC
- Sotorasib long-term clinical outcomes in pre-treated
KRAS G12C-mutated advanced NSCLC: pooled analysis from the
CodeBreaK clinical trials
Abstract #1305P, Poster, September
14
- Clinical characteristics and therapeutic sequences of
KRAS G12C advanced Non-Small Cell Lung Cancer (aNSCLC)
patients (pts) treated by sotorasib in the French post-marketing
authorization early access (post-MA EA)
Abstract #1307P, Poster, September
14
Bemarituzumab
- Fibroblast growth factor receptor 2 isoform IIIb (FGFR2b)
protein overexpression and biomarker overlap in patients with
advanced gastric or gastroesophageal junction cancer
(GC/GEJC)
Abstract #1420P, Poster, September
16
Investigator Sponsored Studies
Vectibix® (panitumumab)
- **mRNA profiling as a biomarker of prognosis and response to
first-line treatment in metastatic colorectal cancer: discovery and
validation of a gene expression signature in three randomized
trials
Abstract #581P, Poster, September 16
- Circulating tumor DNA driving anti-EGFR rechallenge therapy
in metastatic colorectal cancer: the RASINTRO prospective
multicenter study
Abstract #517P, Poster, September
16
- Prospective validation of the metastatic colon cancer score
(mCCS) in patients with RAS wild-type metastatic colorectal cancer
treated with first-line panitumumab plus FOLFIRI/FOLFOX: Final
results of the non-interventional study VALIDATE
Abstract #585P, Poster, September
16
About
LUMAKRAS®/LUMYKRAS® (sotorasib)
LUMAKRAS
received accelerated approval from the U.S. Food and Drug
Administration (FDA) on May 28, 2021.
The U.S. FDA completed its review of Amgen's supplemental New Drug
Application (sNDA) seeking full approval of
LUMAKRAS® on December 26,
2023, which resulted in a complete response letter. In
addition, the FDA concluded that the dose comparison postmarketing
requirement (PMR) issued at the time of LUMAKRAS accelerated
approval, to compare the safety and efficacy of LUMAKRAS 960 mg
daily dose versus a lower daily dose, has been fulfilled. 960 mg
once-daily is the indicated dose for patients with KRAS
G12C-mutated NSCLC under accelerated approval. The U.S. FDA also
issued a new PMR for an additional confirmatory study to support
full approval that will be completed no later than February 2028.
About Metastatic Colorectal Cancer and
the KRAS G12C Mutation
Colorectal cancer
(CRC) is the second leading cause of cancer deaths worldwide,
comprising 10% of all cancer diagnoses.1 It is also
the third most commonly diagnosed cancer globally.2
KRAS mutations are among the most common genetic
alterations in colorectal cancers, with the KRAS G12C
mutation present in approximately 3-5% of colorectal
cancers.3-5
About Advanced Non-Small Cell Lung Cancer and the
KRAS G12C Mutation
Lung cancer is the leading cause
of cancer-related deaths worldwide, and it accounts for more deaths
worldwide than colon cancer, breast cancer and prostate cancer
combined.6
KRAS G12C is the most
common KRAS mutation in
NSCLC.7 About 13% of patients with non-squamous
NSCLC harbor the KRAS G12C
mutation.8
About CodeBreaK
The CodeBreaK clinical development
program for Amgen's drug sotorasib is designed to study
patients with an advanced solid tumor with the
KRAS G12C mutation and address the longstanding
unmet medical need for these cancers.
Amgen also has several Phase 1b studies investigating sotorasib monotherapy
and sotorasib combination therapy across various advanced solid
tumors (CodeBreaK 101) open for enrollment.9 A Phase 2
randomized study evaluating sotorasib in patients with stage
IV KRAS G12C-mutated NSCLC in need of first-line
treatment is ongoing (CodeBreaK 201).10 A Phase 3
study of LUMAKRAS plus carboplatin and pemetrexed as front-line
therapy in KRAS G12C-mutant, programmed
death-ligand 1 (PD-L1) negative advanced NSCLC is enrolling
patients (CodeBreaK 202). A Phase 3 study of LUMAKRAS in
combination with Vectibix and FOLFIRI in first-line KRAS
G12C–mutated CRC is also enrolling patients (CodeBreak-301).
LUMAKRAS® (sotorasib) U.S. Indication
LUMAKRAS is indicated for the treatment of adult patients
with KRAS G12C-mutated locally advanced or metastatic
non-small cell lung cancer (NSCLC), as determined by an
FDA-approved test, who have received at least one prior
systemic therapy.
This indication is approved under accelerated approval based on
overall response rate (ORR) and duration of response (DOR).
Continued approval for this indication may be contingent upon
verification and description of clinical benefit in a confirmatory
trial(s).
LUMAKRAS® (sotorasib) Important U.S. Safety
Information
Hepatotoxicity
- LUMAKRAS can cause hepatotoxicity, which may lead to
drug-induced liver injury and hepatitis.
- Among 357 patients who received LUMAKRAS in CodeBreaK
100, hepatotoxicity occurred in 1.7% (all grades) and 1.4% (Grade
3). A total of 18% of patients who received LUMAKRAS had
increased alanine aminotransferase (ALT)/increased aspartate
aminotransferase (AST); 6% were Grade 3 and 0.6% were Grade 4. In
addition to dose interruption or reduction, 5% of patients received
corticosteroids for the treatment of hepatotoxicity.
- Monitor liver function tests (ALT, AST and total bilirubin)
prior to the start of LUMAKRAS every 3 weeks for the first 3 months
of treatment, then once a month or as clinically indicated, with
more frequent testing in patients who develop
transaminase and/or bilirubin elevations.
- Withhold, reduce or permanently discontinue LUMAKRAS based on
severity of adverse reaction.
Interstitial Lung Disease (ILD)/Pneumonitis
- LUMAKRAS can cause ILD/pneumonitis that can be fatal. Among 357
patients who received LUMAKRAS in CodeBreaK 100,
ILD/pneumonitis occurred in 0.8% of patients, all cases were Grade
3 or 4 at onset, and 1 case was fatal. LUMAKRAS was discontinued
due to ILD/pneumonitis in 0.6% of patients.
- Monitor patients for new or worsening pulmonary symptoms
indicative of ILD/pneumonitis (e.g., dyspnea, cough, fever).
Immediately withhold LUMAKRAS in patients with suspected
ILD/pneumonitis and permanently discontinue LUMAKRAS if no other
potential causes of ILD/pneumonitis are identified.
Most Common Adverse Reactions
- The most common adverse reactions occurring in ≥ 20% were
diarrhea, musculoskeletal pain, nausea, fatigue, hepatotoxicity and
cough.
Drug Interactions
- Advise patients to inform their healthcare provider of all
concomitant medications, including prescription medicines,
over-the-counter drugs, vitamins, dietary and herbal products.
- Inform patients to avoid proton pump inhibitors and
H2 receptor antagonists while taking LUMAKRAS.
- If coadministration with an acid-reducing agent cannot be
avoided, inform patients to take LUMAKRAS 4 hours before or 10
hours after a locally acting antacid.
Please see LUMAKRAS full Prescribing
Information.
About Vectibix® (panitumumab)
Vectibix is
the first and only fully human monoclonal anti-EGFR antibody
approved by the FDA for the treatment of mCRC. Vectibix
was approved in the U.S. in September 2006 as a
monotherapy for the treatment of patients with EGFR-expressing mCRC
after disease progression after prior treatment with
fluoropyrimidine-, oxaliplatin-, and irinotecan-containing
chemotherapy.
In May 2014, the FDA approved Vectibix for use in
combination with FOLFOX as first-line treatment in patients with
wild-type KRAS (exon 2) mCRC. With this approval,
Vectibix became the first-and-only biologic therapy indicated for
use with FOLFOX, one of the most commonly used chemotherapy
regimens, in the first-line treatment of mCRC for patients with
wild-type KRAS mCRC.
In June 2017, the FDA approved a refined indication for Vectibix
for use in patients with wild-type RAS (defined as wild-type
in both KRAS and NRAS as determined by
an FDA-approved test for this use) mCRC.
INDICATION AND LIMITATION OF USE
Vectibix® is indicated for the treatment of patients
with wild-type RAS (defined as wild-type in
both KRAS and NRAS as determined
by an FDA-approved test for this use) metastatic colorectal cancer
(mCRC): as first-line therapy in combination with FOLFOX, and as
monotherapy following disease progression after prior treatment
with fluoropyrimidine-, oxaliplatin-, and irinotecan-containing
chemotherapy.
Limitation of Use: Vectibix® is not indicated for the
treatment of patients with RAS mutant mCRC or for
whom RAS mutation status is unknown.
IMPORTANT SAFETY INFORMATION
BOXED WARNING: DERMATOLOGIC TOXICITY
Dermatologic Toxicity: Dermatologic toxicities
occurred in 90% of patients and were severe (NCI-CTC grade 3 and
higher) in 15% of patients receiving Vectibix
monotherapy [see Dosage and Administration (2.3),
Warnings and Precautions (5.1), and Adverse Reactions
(6.1)].
- In Study 20020408, dermatologic toxicities occurred in 90% of
patients and were severe (NCI-CTC grade 3 and higher) in 15% of
patients with mCRC receiving Vectibix®. The clinical
manifestations included, but were not limited to, acneiform
dermatitis, pruritus, erythema, rash, skin exfoliation, paronychia,
dry skin, and skin fissures.
- Monitor patients who develop dermatologic or soft
tissue toxicities while receiving Vectibix® for the
development of inflammatory or infectious sequelae.
Life-threatening and fatal infectious complications including
necrotizing fasciitis, abscesses, and sepsis have been observed in
patients treated with Vectibix®. Life-threatening and
fatal bullous mucocutaneous disease with blisters, erosions, and
skin sloughing has also been observed in patients treated with
Vectibix®. It could not be determined whether these
mucocutaneous adverse reactions were directly related to EGFR
inhibition or to idiosyncratic immune- related effects
(e.g., Stevens Johnson syndrome or toxic epidermal
necrolysis). Withhold or discontinue Vectibix® for
dermatologic or soft tissue toxicity associated with severe or
life-threatening inflammatory or infectious complications. Dose
modifications for Vectibix® concerning dermatologic
toxicity are provided in the product labeling.
- Vectibix® is not indicated for the treatment of
patients with colorectal cancer that harbor
somatic RAS mutations in exon 2 (codons 12 and 13),
exon 3 (codons 59 and 61), and exon 4 (codons 117 and 146) of
either KRAS or NRAS and hereafter is
referred to as "RAS."
- Retrospective subset analyses across several randomized
clinical trials were conducted to investigate the role
of RAS mutations on the clinical effects of
anti-EGFR-directed monoclonal antibodies (panitumumab or
cetuximab). Anti-EGFR antibodies in patients with tumors
containing RAS mutations resulted in exposing
those patients to anti-EGFR related adverse reactions without
clinical benefit from these agents. Additionally, in Study
20050203, 272 patients with RAS-mutant mCRC tumors
received Vectibix® in combination with FOLFOX and
276 patients received FOLFOX alone. In an exploratory subgroup
analysis, OS was shorter (HR = 1.21, 95% CI: 1.01-1.45)
in patients with RAS-mutant mCRC who received
Vectibix® and FOLFOX versus FOLFOX alone.
- Progressively decreasing serum magnesium levels leading to
severe (grade 3-4) hypomagnesemia occurred in up to 7% (in Study
20080763) of patients across clinical trials. Monitor patients for
hypomagnesemia and hypocalcemia prior to initiating
Vectibix® treatment, periodically during
Vectibix® treatment, and for up to 8 weeks after
the completion of treatment. Other electrolyte disturbances,
including hypokalemia, have also been observed. Replete magnesium
and other electrolytes as appropriate.
- In Study 20020408, 4% of patients experienced infusion
reactions and 1% of patients experienced severe infusion reactions
(NCI-CTC grade 3-4). Infusion reactions, manifesting as fever,
chills, dyspnea, bronchospasm, and hypotension, can occur following
Vectibix® administration. Fatal infusion reactions
occurred in postmarketing experience. Terminate the infusion for
severe infusion reactions.
- Severe diarrhea and dehydration, leading to acute renal failure
and other complications, have been observed in patients treated
with Vectibix® in combination with chemotherapy.
- Fatal and nonfatal cases of interstitial lung disease (ILD)
(1%) and pulmonary fibrosis have been observed in patients treated
with Vectibix®. Pulmonary fibrosis occurred in less than
1% (2/1467) of patients enrolled in clinical studies of
Vectibix®. In the event of acute onset or worsening of
pulmonary symptoms interrupt Vectibix® therapy.
Discontinue Vectibix® therapy if ILD is confirmed.
- In patients with a history of interstitial pneumonitis or
pulmonary fibrosis, or evidence of interstitial pneumonitis or
pulmonary fibrosis, the benefits of therapy with
Vectibix® versus the risk of pulmonary complications
must be carefully considered.
- Exposure to sunlight can exacerbate dermatologic toxicity.
Advise patients to wear sunscreen and hats and limit sun exposure
while receiving Vectibix®.
- Keratitis and ulcerative keratitis, known risk factors for
corneal perforation, have been reported with
Vectibix® use. Monitor for evidence of keratitis or
ulcerative keratitis. Interrupt or discontinue
Vectibix® for acute or worsening keratitis.
- In an interim analysis of an open-label, multicenter,
randomized clinical trial in the first-line setting in patients
with mCRC, the addition of Vectibix® to the
combination of bevacizumab and chemotherapy resulted in decreased
OS and increased incidence of NCI-CTC grade 3-5 (87% vs 72%)
adverse reactions. NCI-CTC grade 3-4 adverse reactions occurring at
a higher rate in Vectibix®-treated patients included
rash/acneiform dermatitis (26% vs 1%), diarrhea (23% vs 12%),
dehydration (16% vs 5%), primarily occurring in patients with
diarrhea, hypokalemia (10% vs 4%), stomatitis/mucositis (4% vs <
1%), and hypomagnesemia (4% vs 0).
- NCI-CTC grade 3-5 pulmonary embolism occurred at a higher rate
in Vectibix®-treated patients (7% vs 3%) and included
fatal events in three (< 1%) Vectibix®-treated
patients. As a result of the toxicities experienced, patients
randomized to Vectibix®, bevacizumab, and chemotherapy
received a lower mean relative dose intensity of each
chemotherapeutic agent (oxaliplatin, irinotecan, bolus 5-FU, and/or
infusional 5-FU) over the first 24 weeks on study compared with
those randomized to bevacizumab and chemotherapy.
- Vectibix® can cause fetal harm when administered to
a pregnant woman. Advise pregnant women and females of reproductive
potential of the potential risk to a fetus. Advise females of
reproductive potential to use effective contraception during
treatment, and for at least 2 months after the last dose of
Vectibix®.
- In monotherapy, the most commonly reported adverse reactions (≥
20%) in patients with Vectibix® were skin rash with
variable presentations, paronychia, fatigue, nausea, and
diarrhea.
- The most commonly reported adverse reactions (≥ 20%) with
Vectibix® + FOLFOX were diarrhea, stomatitis,
mucosal inflammation, asthenia, paronychia, anorexia,
hypomagnesemia, hypokalemia, rash, acneiform dermatitis, pruritus,
and dry skin. The most common serious adverse reactions (≥ 2%
difference between treatment arms) were diarrhea and
dehydration.
To see the Vectibix® Prescribing Information,
including Boxed Warning visit www.vectibix.com.
About Amgen
Amgen discovers, develops, manufactures and delivers innovative
medicines to help millions of patients in their fight against some
of the world's toughest diseases. More than 40 years ago, Amgen
helped to establish the biotechnology industry and remains on the
cutting-edge of innovation, using technology and human genetic data
to push beyond what's known today. Amgen is advancing a broad and
deep pipeline that builds on its existing portfolio of medicines to
treat cancer, heart disease, osteoporosis, inflammatory diseases
and rare diseases.
In 2024, Amgen was named one of the "World's Most Innovative
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References
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- ClinicalTrials.gov. CodeBreaK 101. Available at:
https://clinicaltrials.gov/ct2/show/NCT04185883. Accessed on
May 7, 2024.
- ClinicalTrials.gov. CodeBreaK 201. Available at:
https://clinicaltrials.gov/ct2/show/NCT04933695. Accessed on
May 7, 2024.
**These data are a combined analysis of three
studies, one of which was not Amgen supported.
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