information: Treatment of the first patient
Company: Noxxon Pharma (Germany) Merck&Co (USA - NJ)
Product: pembrolizumab and olaptesed pegol (NOX-A12)
mechanism: monoclonal antibody/immune checkpoint inhibitor/spiegelmer. Keytruda® (pembrolizumab - MK-3475) is a highly selective monoclonal anti-PD-1 antibody designed to restore the natural ability of the immune system to recognize and target cancer cells by selectively achieving dual ligand blockade (PD-L1 and PD-L2) of the PD-1 protein. By blocking PD-1, pembrolizumab enables activation of the immune system’s T-cells that target cancer by essentially releasing a brake on the immune system. Keytruda® is the first approved drug that blocks the PD-1 cellular pathway.
Olaptesed pegol/NOX-A12 specifically antagonizes CXCL12/SDF-1 (CXC Chemokine Ligand 12 / Stromal Cell-Derived Factor-1), a chemokine which attracts and activates immune and non-immune cells including stem cells from the bone marrow. CXCL12 binds with high affinity to two chemokine receptors, CXCR4 and CXCR7. The CXCL12 / CXCR4 / CXCR7 axis has been shown to play a role in stem cell mobilization, vasculogenesis, tumor growth and metastasis. CXCL12 signaling has been shown to play an important role in the pathophysiology of CLL, especially in the interaction of leukemic cells with the tissue microenvironment. The therapeutic concept of NOX-A12 is to inhibit such tumor-supporting interactions and thereby sensitize CLL cells to chemotherapy.
Disease: metastatic colorectal cancer, metastatic pancreatic cancer
area: Cancer - Oncology
- The purpose of this study is to show that the type, number and/or distribution of tumor metastases infiltrating immune cells such as cytotoxic T cells and/or the cytokine signature in the tumor metastases can be modulated by treatment with olaptesed pegol and to explore safety, tolerability and efficacy of olaptesed pegol in combination with pembrolizumab as a basis for subsequent studies in combination with immunotherapies, in particular checkpoint inhibitors.
- Noxxon and Merck&Co collaborated closely in the two-arm clinical trial design that is composed of two parts: patients will receive NOX-A12 monotherapy for two weeks, followed by combination therapy of NOX-A12 plus Keytruda® for up to two years. The open-label trial is designed to include 20 patients, 10 patients for each metastatic pancreas and colorectal cancer. (NCT03168139)
- • On July 4, 2017, Noxxon Pharma announced that the first patients were treated in its Phase 1/2 clinical trial in patients with metastatic colorectal and pancreatic cancer at the National Center for Tumor Diseases in Heidelberg, Germany. The goal of the trial is to evaluate safety and the effects of NOX-A12 (olaptesed pegol) as a monotherapy on immune cell infiltration into tumors in addition to safety and efficacy of NOX-A12 in combination with Keytruda® (pembrolizumab), a programmed death receptor-1 (PD-1) immune checkpoint-inhibiting antibody marketed by Merck&Co.
- Two patients have now completed part 1 of the trial in which they received NOX-A12 monotherapy for two weeks. Data from this stage will be used to analyze safety and, through tumor biopsies taken before and after NOX-A12 treatment, the ability of NOX-A12 to modulate the tumor microenvironment including the number of T-cells present in the tumors.
- Part 1 could, as such, provide clinical data to support the broad potential applicability for combinations of NOX-A12 not only with checkpoint inhibitors but also other T-cell based therapeutics such as CAR-T approaches. Both patients that completed part 1 have now progressed into part 2, receiving NOX-A-12 in combination with Keytruda®. Top-line data for all 20 patients from part 1 is targeted to be available in Q2 2018, and initial response-rate data in Q4 2018.