2024年11月22日,复宏汉霖(2696.HK)宣布,公司创新型抗HER2单抗HLX22的国际多中心III期研究(HLX22-GC-301)在中国完成首例患者给药,拟用于联合曲妥珠单抗及化疗一线治疗人类表皮生长因子受体2(HER2)阳性晚期胃癌。HLX22-GC-301由北京大学肿瘤医院沈琳担任牵头主要研究者,此前已在美国和日本获得临床试验开展许可。目前,全球尚无同类用于治疗HER2阳性胃癌的HER2双靶向疗法获批准上市。
据GLOBOCAN数据显示,2022年全球约有100万胃癌/胃食管连接部(G/GEJ)癌新发病例[1],构成了一大健康问题。在中国,G/GEJ的新发和死亡病例在全部恶性肿瘤中分别位居第5位和第3位,其中2022年新发病例逾35.9万,死亡病例逾26万[1]。多数G/GEJ癌患者确诊时已处于疾病晚期,总体预后不良,5年生存率仅为6%[2,3],这其中HER2 阳性患者占比约为12%-23%,且其预后较HER2阴性患者更差[2-4]。目前,对于HER2阳性的局部晚期/转移性G/GEJ患者,其标准一线疗法为曲妥珠单抗联用化疗,针对PD-L1 阳性(PD-L1 CPS≥1)的患者,一些指南亦推荐进一步叠加联用免疫治疗,但持续疗效和预后仍有待进一步改善[5]。
HLX22为复宏汉霖自AbClon, Inc.许可引进、并后续自主研发的靶向HER2的创新型单克隆抗体。HLX22可结合在HER2的胞外亚结构域IV,但结合表位与曲妥珠单抗有所不同,使得HLX22和曲妥珠单抗能够同时与HER2结合,促进HER2二聚体(HER2同源二聚体及HER2/EGFR异源二聚体)的内吞和降解,从而产生更强的HER2受体阻断效果。临床前研究表明,HLX22与曲妥珠单抗联合治疗能够协同抑制肿瘤细胞增殖和诱导细胞凋亡,在体内和体外均表现出增强的抗肿瘤活性,且HLX22的I期临床试验证实产品安全且可耐受[6]。HLX22联合汉曲优®(曲妥珠单抗,美国商品名:HERCESSI™️,欧洲商品名:Zercepac®)治疗HER2阳性胃癌II期临床研究(HLX22-GC-201)结果显示,在HLX02(曲妥珠单抗)联用化疗的基础上加入HLX22可提高HER2阳性G/GEJ癌患者一线治疗的生存期和抗肿瘤反应,且安全性可控[7-9]。该研究结果相继于2024年美国临床肿瘤学会胃肠道肿瘤研讨会(ASCO GI)、欧洲肿瘤学会胃肠道肿瘤研讨会(ESMO GI)和Cell Press细胞出版社旗下的综合性医学旗舰期刊Med[10]发布。
HLX22-GC-301临床研究是一项双盲、国际多中心随机对照III期研究,旨在比较HLX22联合曲妥珠单抗和化疗对比曲妥珠单抗和化疗联合或不联合帕博利珠单抗,一线治疗HER2阳性局部晚期或转移性胃癌/胃食管结合部癌患者的疗效和安全性。符合条件的受试者将以1:1的比例随机分配至试验组(接受HLX22(15 mg/kg)联合曲妥珠单抗和化疗)或对照组(接受安慰剂联合曲妥珠单抗和化疗,联合或不联合帕博利珠单抗)。该研究的主要终点为独立影像评估委员会(IRRC)基于RECIST v1.1评估的无进展生存期(PFS)和总生存期(OS)。次要终点包括研究者评估的PFS、IRRC或研究者评估的客观缓解率(ORR)、下一线治疗的PFS2、缓解持续时间(DOR)、生活质量、安全性、免疫原性和药代动力学特征。
HLX22-GC-301临床研究已陆续在中国、美国和日本获得许可。公司将继续以患者需求为核心,在更多国家加速推进HLX22-GC-301研究,为更多患者带去福音。
【参考文献】
[1] Bray F, Laversanne M, Sung H, et al. CA Cancer J Clin. 2024: 1-35.
[2] Ajani JA. et al. J Natl Compr Canc Netw 2022;20(2):167-92.
[3] Alsina M. et al. Nat Rev Gastroenterol Hepatol 2023;20(3):155-70.
[4] Gravalos C. et al. Ann Oncol 2008;19(9):1523-9.
[5] NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Gastric Cancer V.1.2024
[6] Zhu X, Ding Y, Wang Q, Yang G, Zhou L, Wang Q. HLX22, an anti-HER-2 monoclonal antibody, in patients with advanced solid tumors overexpressing human epidermal growth factor receptor 2: an open-label, dose-escalation, phase 1 trial. Invest New Drugs. 2023;41(3):473-482. doi:10.1007/s10637-023-01338-7
[7] Jin Li et al., HLX22 plus HLX02 and XELOX for first-line treatment of HER2-positive locally advanced or metastatic gastric/gastroesophageal junction cancer: A randomized, double-blind, multicenter phase 2 study.. JCO 42, 354-354(2024).DOI:10.1200/JCO.2024.42.3_suppl.354
[8] J. Li et al., 422P HLX22 plus HLX02 and XELOX as first-line therapy for HER2-positive advanced gastric/gastroesophageal junction cancer: Updated results from a randomized, double-blind phase II study, Annals of Oncology,Annals of Oncology (2024) 35 (suppl_1): S162-S204. 10.1016/annonc/annonc1482
[9] Li N, Qiu M, Zhang Y, et al. A randomized phase 2 study of HLX22 plus trastuzumab biosimilar HLX02 and XELOX as first-line therapy for HER2-positive advanced gastric cancer. Med. 2024;5(10):1255-1265.e2. doi:10.1016/j.medj.2024.06.004
[10] Li N, Qiu M, Zhang Y, et al. A randomized phase 2 study of HLX22 plus trastuzumab biosimilar HLX02 and XELOX as first-line therapy for HER2-positive advanced gastric cancer. Med. 2024;5(10):1255-1265.e2. doi:10.1016/j.medj.2024.06.004
关于复宏汉霖
复宏汉霖(2696.HK)是一家国际化的创新生物制药公司,致力于为全球患者提供可负担的高品质生物药,产品覆盖肿瘤、自身免疫疾病、眼科疾病等领域,已有6款产品在中国获批上市,3款产品在国际获批上市,24项适应症获批,4个上市申请分别获中国药监局、美国FDA和欧盟EMA受理。自2010年成立以来,复宏汉霖已建成一体化生物制药平台,高效及创新的自主核心能力贯穿研发、生产及商业运营全产业链。公司已建立完善高效的全球创新中心,按照国际药品生产质量管理规范(GMP)标准进行生产和质量管控,不断夯实一体化综合生产平台,其中,公司商业化生产基地已相继获得中国、欧盟和美国GMP认证。
复宏汉霖前瞻性布局了一个多元化、高质量的产品管线,涵盖50多个分子,并全面推进基于自有抗PD-1单抗H药汉斯状®的肿瘤免疫联合疗法。截至目前,公司已获批上市产品包括国内首个生物类似药汉利康®(利妥昔单抗)、自主研发的中美欧三地获批单抗生物类似药汉曲优®(曲妥珠单抗,美国商品名:HERCESSI™,欧洲商品名:Zercepac®)、汉达远®(阿达木单抗)、汉贝泰®(贝伐珠单抗)以及汉奈佳®(奈拉替尼),此外,创新产品汉斯状®(斯鲁利单抗)已获批用于治疗微卫星高度不稳定(MSI-H)实体瘤、鳞状非小细胞肺癌、广泛期小细胞肺癌和食管鳞状细胞癌,并成为全球首个获批一线治疗小细胞肺癌的抗PD-1单抗。公司亦同步就16个产品在全球范围内开展30多项临床试验,对外授权全面覆盖欧美主流生物药市场和众多新兴市场。
First Patient Dosed in Phase 3 MRCT of Dual HER2 Blockade Therapy for HER2+ GC
Shanghai, China, November 22, 2024 - Shanghai Henlius Biotech, Inc. (2696.HK) announced that the first patient has been dosed in the phase 3 international multi-centre clinical trial (HLX22-GC-301) of HLX22, an innovative anti-HER2 monoclonal antibody (mAb) in combination with trastuzumab and chemotherapy for the first-line treatment of HER2-positive advanced gastric/gastroesophageal junction (G/GEJ) cancer. The leading principal investigator is Lin Shen from Peking University Cancer Hospital. Previously, the investigational new drug (IND) applications have received regulatory approvals in China, the U.S. and Japan for HLX22-GC-301. As of now, no similar dual HER2 blockade therapy for the treatment of HER2-positive gastric cancer has received approval for commercialization globally.
Until now, gastric/gastroesophageal junction (G/GEJ) cancer still constitutes a major global health problem. Globally, there were around 1 million new cases in 2022 [1]. While in China, the incidence and mortality of G/GEJ rank fifth and third among all malignant tumors, respectively, with over 358,600 new cases and 260,300 deaths in 2022 [1]. G/GEJ cancer generally carries a poor prognosis since it is often diagnosed at an advanced stage, with a 5-year relative survival rate of only 6% [2,3]. The reported rates of HER2 positivity in patients with gastric cancer range from 12% to 23%, and the prognosis for patients with HER2-positive disease used to be even worse than those with HER2-negative disease [2-4]. Currently, for patients with HER2-positive locally advanced/metastatic G/GEJ cancer, the current standard first-line treatment is trastuzumab plus chemotherapy. Immunotherapies are recommended to be added for tumours with PD-L1 expression levels by CPS (Combined Positive Score) of greater than 1. However, the effectiveness and prognosis for these treatments need to be further improved [5].
HLX22 is an innovative anti-HER2 mAb introduced from AbClon, Inc. and further investigated and developed by Henlius. HLX22 can bind to HER2 extracellular subdomain IV at a binding site different from that of trastuzumab, which allows simultaneous binding of HLX22 and trastuzumab to HER2 dimers (HER2 homodimer and HER2/EGFR heterodimer) on tumour cell surface, thereby promoting the internalisation and HER2 dimer degradation. Pre-clinical studies showed that the co-treatment with HLX22 and trastuzumab synergistically inhibited tumour cell proliferation and apoptosis, which led to enhanced anti-tumour activity in vitro and in vivo. A phase 1 clinical trial of HLX22 demonstrates that HLX22 was well tolerated and had a favorable safety profile. [6] Results from HLX22-GC-201, a phase 2 study of HLX22 in combination with trastuzumab injection (HLX02) and XELOX, as first-line therapy for HER2-positive locally advanced or metastatic gastric cancer patients were subsequently presented at the 2024 American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO GI), 2024 ESMO Gastrointestinal Cancers Congress (ESMO GI) and on Med [10], a flagship medical journal by Cell Press, respectively. Updated results and study data showed that the addition of HLX22 to HLX02 (trastuzumab) plus chemotherapy as first-line therapy improved efficacy in HER2-positive G/GEJ cancer patients with manageable safety. [7-9]
HLX22-GC-301 is a double-blind, randomized, controlled multicenter phase 3 study aims to compare the efficacy and safety of HLX22 in combination with trastuzumab and chemotherapy versus trastuzumab and chemotherapy with or without pembrolizumab as first-line treatment in patients with human epidermal growth factor receptor 2 (HER2)-positive, locally advanced or metastatic gastric/gastroesophageal junction cancer. Eligible participants will be randomized at 1:1 to the experimental arm (treated with HLX22 (15 mg/kg, intravenous injection) plus trastuzumab and chemotherapy) or the control group (placebo plus trastuzumab and chemotherapy with or without pembrolizumab). The primary endpoints of this study are progression-free survival (PFS) accessed by independent radiology review committee (IRRC) per RECIST 1.1 and overall survival (OS), the secondary endpoints include investigator-assessed PFS, IRRC or investigator-accessed objective response rate (ORR), PFS2, duration of response (DOR), quality of life, safety, immunogenicity, and pharmacokinetic characteristics.
The HLX22-GC-301 clinical study has obtained IND approvals in China, the United States, and Japan. The company will continue to focus on patient needs and accelerate the advancement of the HLX22-GC-301 study in more countries, thus bringing hope to more patients.
About Henlius
Henlius (2696.HK) is a global biopharmaceutical company with the vision to offer high-quality, affordable, and innovative biologic medicines for patients worldwide with a focus on oncology, autoimmune diseases, and ophthalmic diseases. Up to date, 6 products have been launched in China, 3 have been approved for marketing in overseas markets, 24 indications are approved worldwide, and 4 marketing applications have been accepted for review in China, the U.S. and the EU, respectively. Since its inception in 2010, Henlius has built an integrated biopharmaceutical platform with core capabilities of high-efficiency and innovation embedded throughout the whole product life cycle including R&D, manufacturing and commercialization. It has established global innovation centre and Shanghai-based commercial manufacturing facilities certificated by China, the EU and U.S. GMP.
Henlius has pro-actively built a diversified and high-quality product pipeline covering over 50 molecules and has continued to explore immuno-oncology combination therapies with proprietary HANSIZHUANG (anti-PD-1 mAb) as backbone. Apart from the launched products HANLIKANG (rituximab), the first China-developed biosimilar, HANQUYOU (trastuzumab, trade name: HERCESSI™ in the U.S., Zercepac® in Europe), a China-developed mAb biosimilar approved in China, Europe and U.S., HANDAYUAN (adalimumab), HANBEITAI (bevacizumab) and HANNAIJIA (neratinib), the innovative product HANSIZHUANG has been approved by the NMPA for the treatment of MSI-H solid tumours, squamous non-small cell lung cancer (sqNSCLC) and extensive-stage small cell lung cancer (ES-SCLC), and esophageal squamous cell carcinoma (ESCC), making it the world’s first anti-PD-1 mAb for the first-line treatment of SCLC. What’s more, Henlius has conducted over 30 clinical studies for 16 products, expanding its presence in major markets as well as emerging markets.
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投资者:IR@Henlius.com
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