Earlier today, EMD Serono, Inc., a subsidiary of Germann based Merck KGaA, Germany announced the initiation of the international Phase III Stimulating Targeted Antigenic Responses To NSCLC or START2 study, which is designed to assess the efficacy and safety of its investigational MUC1 antigen specific cancer immunotherapy tecemotide (also known as L-BLP25) in patients with unresectable, locally advanced Stage III non-small cell lung cancer (NSCLC).
The START2 study is a Phase III, multicenter, 1:1 randomized, double-blind, placebo-controlled clinical trial designed to assess the efficacy, safety and tolerability of tecemotide in patients suffering from unresectable, locally advanced (Stage IIIA or IIIB) NSCLC who have had aresponse or stable disease after at least two cycles of platinum-based concurrent chemoradiotherapy (CRT). Concurrent CRT ? a combination of chemotherapy and radiotherapy given at the same time ? is the current standard of care for most of these patients.
There is clearly a very real need for additional treatment options for people fighting NSCLC. The results of the initial START study provided scientific and clinical evidence to inform the design of this new pivotal Phase III program….
The study is expected to recruit about 1,000 patients. The study?s primary endpoint is overall survival (OS). Secondary endpoints include time to symptom progression, progression-free survival and time to progression. EMD Serono received Scientific Advice from the EuropeanMedicines Agency (EMA) on the program, and reached an agreement with the U.S. Food and Drug Administration (FDA) on a Special Protocol Assessment (SPA) for the trial.
?Sadly, the cure rate for stage III NSCLC has not improved in recent years; novel treatment strategies are urgently needed,? said Professor Suresh Ramalingam, Winship Cancer Institute, Emory University, Atlanta, U.S., coordinating clinical investigator of the START2 trial and member of the corresponding steering committee. ?Modulating the immune system to treat cancer has entered an exciting new phase in the past 2 to 3 years. We hope that the START2 trial will establish tecemotide as a new treatment option for patients with NSCLC.?
The basis for the new Phase III trial is the outcome of the initial START study.[1] START did not meet the primary endpoint of demonstrating an improved OS with tecemotide compared with placebo in the overall patient population (n=1,239). Median OS was 25.6 months for patients in the tecemotide group compared with 22.3 months for those in the placebo group (adjusted hazard ratio [HR]: 0.88; 95% confidence interval [CI]: 0.75?1.03; p=0.123).
However, data from an exploratory analysis of a pre-defined subgroup of patients in the START trial, who received tecemotide after concurrent CRT, showed that these patients achieved a median OS of 30.8 months versus 20.6 months in patients treated with placebo (n=806; HR: 0.78; 95% CI: 0.64?0.95; p=0.016).
John Orloff,MD, Global Head of Clinical Development for Merck Serono, the biopharmaceutical division of Merck KGaA, Darmstadt, Germany, commented: “There is clearly a very real need for additional treatment options for people fighting NSCLC. The results of the initial START study provided scientific and clinical evidence to inform the design of this new pivotal Phase III program. We are pleased that START2 is now underway, and feel confident that this study will address the appropriate gaps in understanding the potential role that tecemotide could play in the management of patients living with unresectable stage III NSCLC.?
Tecemotide is an investigational MUC1 antigen-specific cancer immunotherapy designed to stimulate the body?s immune system to identify and target cancer cells expressing the cell-surface glycoprotein MUC1.[2][3] MUC1 is expressed in many cancers, including NSCLC, and has multiple roles in tumor growth and survival.[2][4]
Globally, lung cancer is the most common cause of cancer-related deaths in men and the third most common in women, responsible for almost twice as many deaths as both breast and prostate cancer combined.[5] NSCLC is the most common type of lung cancer, accounting for 80?85% of all lung cancers, and locally advanced or Stage III disease accounts for approximately 30% of patients with NSCLC.[6][7] Unfortunately, at diagnosis, most patients have advanced disease with a very poor prognosis.[8]
For more information:
[1] Butts C, et al. Lancet Oncol 2014 ;15(1) :59-68.
[2] Agrawal B, et al. Int Immunol 1998;10(12):1907?16.
[3] Palmer M, et al. Clin Lung Cancer 2001;3(1):49?57.
[4] Sangha R and Butts C. Clin Cancer Res 2007;13:(15 pt 2)4652s?4654s.
[5] Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer; 2013. Last accessed on February 5, 2014.
[6] D?Addario G, et al. Ann Oncol 2008;19 (suppl 2):ii39?40.
[7] Crino L, et al. Ann Oncol 2010;21(suppl 5):v103?v115.
[8] Bunn PA and Thatcher N. Oncologist 2008;13(suppl 1):1?4.
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