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Clinical Trials

Date: 2015-11-03

Type of information: Presentation of results at a congress

phase: 1

Announcement: presentation of results at the 27th EORTC-NCI-AACR symposium in Boston

Company: Debiopharm (Switzerland)

Product: Debio 1143

Action mechanism:

protein inhibitor/SMAC mimetic. Debio 1143/AT-406 is an orally available small molecule inhibitor of apoptosis proteins (IAPs) that mimicks the activity of the natural second mitochondrial-derived activator of caspases (SMAC). By targeting IAPs, Debio 1143 can induce cancer cell death and potentiate the efficacy of chemo- and/or radiotherapy. AT-406 was discovered in the laboratory of Dr. Shaomeng Wang at the University of Michigan.

Disease: squamous non-small cell lung cancer (NSCLC), platinum-refractory ovarian cancer, basal-like/claudin low triple negative breast cancer

Therapeutic area: Cancer - Oncology

Country: France, Switzerland

Trial details:

Debio 1143-201 is a two part trial of Debio 1143 combined with concurrent cisplatin and radiotherapy (CRT) in participants with previously untreated stage III, IVa or IVb head and neck cancer. The trial begins with an initial period of dose escalation (Phase I) to investigate the maximum tolerated dose (MTD) of Debio 1143 that can safely be given in combination with CRT. Using the MTD determined in the Phase I portion, the randomized phase II trial in 94 participants compares Debio 1143 to placebo, both with concomitant CRT. The aims are to evaluate the efficacy and safety of Debio 1143, while exploring biomarkers, Debio 1143 pharmacokinetics, and pharmacokinetic/ pharmacodynamic relationships. (NCT02022098)

Latest news:

* On November 3, 2015, Debiopharm International SA presented preliminary results from Phase 1 trials in the development of the IAP inhibitor Debio 1143 at the 27th EORTC-NCI-AACR symposium in Boston. Recommended Dose was achieved in two Phase I studies. Debio 1143 has shown a favorable safety profile in a dose-finding and efficacy Phase I/II trial in combination with chemoradiotherapy in squamous cell carcinoma of the head and neck (Debio 1143-201). The randomized Phase II part of this study will start patient recruitment in November. At the same time, Debiopharm has conducted an indication screening study in combination with carboplatin and paclitaxel in patients with advanced solid malignancies (Debio 1143-103). The recommended dose of Debio 1143 with this combination has been determined with a good tolerability profile. Furthermore, encouraging early signs of efficacy in ovarian cancer patients have been observed (Poster #C2). In addition, new preclinical data illustrating the immunomodulatory function of Debio 1143 will be presented during the conference (Poster #A93). These findings are highly supportive of clinical development in combination with immune checkpoints inhibitors which are currently under development in a wide range of therapeutic indications.

* On November 18, 2014, Debiopharm announced that new data on  Debio 1143 will be presented at the 26th European Organization for Research and Treatment of Cancer (EORTC), National Cancer Institute (NCI) and American Association for Cancer Research (AACR) (EORTC-NCI-AACR) Annual Meeting, November 18 to 21, 2014, to be held in Barcelona. Data featured at the EORTC-NCI-AACR symposium will include the results of the ongoing phase I study of Debio 1143 in combination with carboplatin and paclitaxel in patients with non-small cell lung cancer (NSCLC), triple-negative breast cancer (TNBC) and platinum-refractory epithelial ovarian cancer (EOC). Debio 1143 is an oral, small molecule inhibitor of apoptosis proteins (IAPs) that mimics the activity of the natural second mitochondrial-derived activator of caspases (SMAC). The first signs of activity that have been observed in patients with triple-negative breast cancer and platinum-refractory ovarian cancer will be reported (Abstract number 444).

* On May 28, 2014, Debiopharm announced that new data on Debio 1143 will be presented at the 50th American Society of Clinical Oncology (ASCO) Annual Meeting, May 30 to June 3, 2014, in Chicago. Debio 1143 has been assessed in two phase I clinical studies and two phase I/II trials are ongoing in Europe. The abstracts presented at ASCO are:

- Debio 1143 First-in-human, pharmacokinetic (PK) and pharmacodynamics (PD) phase I study of Debio 1143 (AT406) in patients with advanced cancer. Final results. #2532B
- Phase I study of Debio 1143 (AT406) in combination with daunorubicin (D) and cytarabine (C) in patients with poor-risk acute myeloid leukemia (AML). #7029
- A phase I/II randomized study of Debio 1143 combined with concurrent chemo-radiation therapy (CCRT) in patients with locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). #TPS6097
- Clinical PK/PD model for Debio 1143, a novel antagonist of IAPs in cancer treatment. #2585

* On June 4, 2013, Debiopharm has announced it treated its first patients in a phase I study of Debio 1143 combined with Carboplatin and Paclitaxel in patients with squamous non-small cell lung cancer (NSCLC), platinum-refractory ovarian cancer, and basal-like/claudin low triple negative breast cancer. The aim of this study is to evaluate the safety and tolerability of Debio 1143, a small molecule neutralizing inhibitors of Apoptosis Protein (IAP), in combination with Carboplatin and Paclitaxel, to determine the maximum tolerated dose (MTD) and to establish dosing for further expansion phase.

In September 2011, Debiopharm entered into anexclusive worldwide license agreement with Ascenta Therapeutics Inc. concerning the development and commercialization of Debio 1143. It is currently being tested in monotherapy in a phase I clinical study in the US, on patients suffering from advanced solid tumors.

Is general: Yes