Immutep Limited is pleased to announce that it has entered into a clinical trial collaboration and supply agreement with Merck KGaA, Darmstadt, Germany and Pfizer Inc., to evaluate the combination of Immutep’s lead immunotherapy product candidate eftilagimod alpha with avelumab , a human anti-PD-L1 antibody, in patients with advanced solid malignancies.
“We are delighted to have the opportunity to collaborate with Merck KGaA, Darmstadt, Germany, and Pfizer on this Phase I clinical trial that will evaluate the clinical benefits of combining our immune stimulator, eftilagimod alpha, with avelumab, a PD-L1 blocking mechanism of action. We feel that this new collaboration, with these industry leaders, further supports our hypothesis that there is a potentially meaningful therapeutic benefit in combining eftilagimod alpha with a checkpoint inhibitor in the treatment of cancer. We look forward to the initiation of this clinical trial, planned for later this year, and the prospects of further clinical investigations,” said Marc Voigt, CEO of Immutep.
“This novel combination regimen adds to our clinical development program to further evaluate the potential in different challenging cancers,” said AliseReicin, Head of Global Clinical Development at the biopharma business of Merck KGaA, Darmstadt, Germany, which in the US and Canada operates as EMD Serono. “We are eager to assess the opportunity of combining eftilagimod alpha with avelumab to improve patient outcomes.”
“We continue to focus on opportunities to advance combination trials with avelumab, as we believe the pathway to progress in immuno-oncology lies in combination approaches,” said Chris Boshoff, M.D., Ph.D., Senior Vice President and Head of Immuno-Oncology, Early Development, and Translational Oncology, Pfizer Global Product Development. “We look forward to collaborating with Immutep on this clinical trial collaboration, which will help us accelerate and advance treatment options that will potentially benefit more patients.”
The planned clinical evaluation will be an amendment to the existing INSIGHT Phase I clinical trial and will evaluate the safety, tolerability and recommended Phase II dose of efti when combined with avelumab in patients with advanced solid malignancies. The Institute of Clinical Cancer Research, KrankenhausNordwest GmbH in Frankfurt, Germany (“IKF”) will be the sponsor of the clinical trial and it will be conducted under the existing protocol of the ongoing INSIGHT clinical study. Prof.Dr. Salah-Eddin Al-Batran, the lead investigator of INSIGHT and member of Immutep’s clinical advisory board, will be the lead investigator of the trial.
Prof.Dr. Al-Batran commented: “We are excited to have the opportunity to sponsor this clinical trial of two complementary mechanisms of action and build upon the existing relationship between IFK and Immutep. This clinical trial will be conducted through an amendment to our existing protocol which will hopefully allow us to commence the clinical trial before the end of the year.”
The clinical trial will evaluate the clinical benefits of releasing the brakes and pushing the accelerator of the body’s immune system at two different positions in the cancer immunity cycle. Immutep’sefti is a first-in-class antigen presenting cell (“APC”) activator which stimulates cancer-fighting T cells, whileavelumab is an anti-PD-L1 therapy that works by increasing the ability of the body’s immune system to help detect and fight tumor cells.
Avelumab has received accelerated approval** by the US Food and Drug Administration (FDA) for the treatment of patients with metastatic Merkel cell carcinoma (MCC) and previously treated patients with locally advanced or metastatic urothelial carcinoma (mUC), and is under further clinical evaluation across a range of tumor types under a global strategic alliance between Merck KGaA, Darmstadt, Germany, and Pfizer.
*Avelumab is under clinical investigation for treatment of solid malignancies and has not been demonstrated to be safe and effective for these uses. There is no guarantee that avelumab will be approved for solid malignancies by any health authority worldwide.
About Eftilagimod Alpha
Eftilagimod alpha (“efti” or “IMP321”), a LAG-3Ig fusion protein, is a MHC class II agonist that activates antigen-presenting cells (“APCs”) such as dendritic cells and monocytes (primary target cells) and then CD8 T-cells (secondary target cells). The activation of the dendritic cell network and the subsequent T cell recruitment at the tumour site with efti may lead to stronger anti-tumor CD8 T cell responses than observed with checkpoint inhibitor monotherapy, as in the case of the TACTI-mel (Two ACTive Immunotherapies in melanoma) Phase I clinical trial (clinicaltrials.gov identifier NCT02676869). In combination with chemotherapy, the activation of the APC network with efti the day after injection of a single agent chemotherapy may lead to stronger cytotoxic cellular responses associated with an improved long-term Th1 (IFN-γ) immune status, both parameters being essential for a potent immune response against the tumour, as in the case of the AIPAC (Active Immunotherapy PAClitaxel) Phase IIb clinical trial (clinicaltrials.gov identifier NCT02614833).
Avelumab is a human anti-programmed death ligand-1 (PD-L1) antibody. Avelumab has been shown in preclinical models to engage both the adaptive and innate immune functions. By blocking the interaction of PD-L1 with PD-1 receptors, avelumab has been shown to release the suppression of the T cell-mediated antitumor immune response in preclinical models.1-3 Avelumab has also been shown to induce NK cell-mediated direct tumor cell lysis via antibody-dependent cell-mediated cytotoxicity (ADCC) in vitro.3-5 In November 2014, Merck KGaA, Darmstadt, Germany, and Pfizer announced a strategic alliance to co-develop and co-commercialize avelumab.
Avelumab is currently being evaluated in the JAVELIN clinical development program, which involves at least 30 clinical programs, including seven Phase III trials, and more than 8,600 patients across more than 15 different tumor types. For a comprehensive list of all avelumab trials, please visit clinicaltrials.gov.
The US Food and Drug Administration (FDA) granted accelerated approval for avelumab (BAVENCIO®) for the treatment of (i) adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma (mMCC) and (ii) patients with locally advanced or metastatic urothelial carcinoma (mUC) whohave disease progression during or following platinum-containing chemotherapy, or have disease progression within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy. These indications are approved under accelerated approval based on tumor response rate and duration of response. Continued approval for these indications may be contingent upon verification and description of clinical benefit in confirmatory trials.
Important Safety Information from the US FDA Approved Label
The warnings and precautions for avelumab (BAVENCIO®) include immune-mediated adverse reactions (such as pneumonitis, hepatitis, colitis, endocrinopathies, nephritis and renal dysfunction and other adverse reactions), infusion-related reactions and embryo-fetal toxicity.
Common adverse reactions (reported in at least 20% of patients) in patients treated with BAVENCIO for mMCC and patients with locally advanced or metastatic UC include fatigue, musculoskeletal pain, diarrhea, nausea, infusion-related reaction, peripheral edema, decreased appetite/hypophagia, urinary tract infection and rash.