Replies to post #12375 on Entremed (ENMD)

[tborges]

The abstracts are now available to the public at the ASCO website... here is the one you are inquiring about... TPS5260

The 58% refers to partial response or stable disease... I think this is is actually old data from an earlier trial... the current trial is to assess that and other data...

Background: Ovarian clear cell carcinoma (OCCC) represents nearly 15% of all epithelial ovarian carcinomas (EOC). This histology is associated with resistance to chemotherapy and a worse prognosis. VEGF has been found to be strongly expressed in OCCC. Somatic mutations in the ARID1A (the AT-rich interactive domain 1A gene that encodes BAF250a, a key component of the SWI/SNF chromatin remodeling complex) has also been demonstrated in 46-57% of OCCCs. Alteration of this chromatin remodeling complex may result in upregulation and overexpression of Aurora A.

ENMD-2076 is a multi-target kinase inhibitor, which has selective activity against Aurora A and multiple antiangiogenesis and lymphangiogenesis targets.

In a Phase II study in platinum-resistant EOC, 58% of the patients treated with single agent ENMD-2076 showed partial response or stable disease, the PFS at 6 month was 22% with a median time to progression of 3.6 months. Two out of 3 patients with OCCC who were enrolled had a longer PFS than the median.

Methods: This is a multi-center, Phase II study, in patients with recurrent OCCC to assess response rate and progression free survival rate, as primary endpoints, and duration of overall response, as a secondary endpoint, of single agent ENMD-2076 275 mg/day. Exploratory endpoints include association of somatic mutations in PI3KCA, ARID1A and PTEN, and ARID1A and PTEN expression with outcome and response. Patients ECOG =2, with histologically documented diagnosis of recurrence OCCC, any number of prior treatment regimens (chemotherapy, biologics or other target therapies except for Aurora A targeted therapies), and measurable disease (RECIST criteria 1.1) are eligible.

Based on data from previous studies, a sample size of 36 patients will provide 95% power to detect an improvement in response rate from 10 to 30% and 90% power to detect an increase in 6 month PFS from 20 to 40%.

Since September 2013, 6 patien Clinical trial information: NCT01914510.

[tborges]

Here is the other abstract for sarcoma... Not sure why it was presented/accepted. It seems unremarkable. Only 10 patients participated.

Abstract:

Background: The use of angiogenic and Aurora kinase inhibitors has been shown to abrogate tumor growth in STS. ENMD-2076 is an oral Aurora A and angiogenic kinase inhibitor that has demonstrated single-agent activity in STS cell lines and inhibition of sarcoma growth for a patient in a phase 1 clinical trial setting.

Methods: This is a single-center, open-labeled phase II study of ENMD-2076 in advanced STS pts treated with =1 line of prior therapy in the advanced/metastatic setting. Pts were commenced on 275mg daily dose (on a 28-day cycle. Treatment-emergent adverse events were assessed by CTCAE (4.0). Radiographic or clinical tumor measurements occurred every 2 cycles (RECIST 1.1).

Results: 10 pts were enrolled from 2/2013 – 11/2013 and evaluable for efficacy. Median age is 58 yrs (41 – 72). Male: Female 1:9. Histology: Leiomyosarcoma / pleomorphic sarcoma / angiosarcoma: 7/2/1. Pts received the following prior systemic therapies: doxorubicin/gemcitabine/others: 2/3/5.

At time of abstract submission, median follow-up is at 7 months (2-12). 3 pts continue on study. Median number of cycles administered per pt = 2 (1-8). 2 pts had confirmed partial response (PR) and 1 pt with confirmed stable disease (SD) of > 6 months. Clinical benefit rate (PR+SD >6 months) was 30%. Median OS has not been reached. Median PFS at 1.8 months (95% CI: 1.2 – not reached).

ENMD-2076 has generally been well tolerated with primarily grade 1 and 2 adverse events (AEs). Specifically, drug-induced hypertension occurred in 6 pts (grade 1-2: 4 pts, grade 3: 2 pts). Proteinuria, all grade 1-2, occurred in 6 pts. Other drug related grade 3 or 4 AEs include (pts): elevated transaminases (1), leukopenia (1), and diarrhea (1). 1 pt developed Posterior Reversible Encephalopathy Syndrome (PRES) presenting as grade 4 loss of consciousness at Cycle 1 Day 15 required ICU admission. Full neurological recovery was attained after cessation of treatment.

Conclusions: ENMD-2076 has shown activity in patients with advanced STS, with meaningful clinical benefits and a side effects profile typical of this class of agent. PRES is a rare but fully reversible side effect of ENMD-2076. Clinical trial information: NCT01719744.