PDL1

TOKYO, Japan & BASKING RIDGE, NJ, USA I October 30, 2024 I The first patients have been dosed in three global, randomized phase 3 trials evaluating the efficacy and safety of datopotamab deruxtecan (Dato-DXd)-based combinations in patients with locally advanced or metastatic nonsquamous non-small cell lung cancer (NSCLC). Datopotamab deruxtecan is a specifically engineered TROP2 directed DXd antibody drug conjugate (ADC) discovered by Daiichi Sankyo (TSE: 4568) and being jointly developed by Daiichi Sankyo and AstraZeneca (LSE/STO/Nasdaq: AZN). TROPION-Lung10 is evaluating datopotamab deruxtecan plus rilvegostomig, AstraZeneca’s PD-1/TIGIT bispecific antibody, or rilvegostomig alone versus pembrolizumab in patients with previously untreated locally advanced or metastatic nonsquamous NSCLC with high PD-L1 expression (tumor cells [TC] ≥ 50%) and without actionable genomic alterations. TROPION-Lung14 is evaluating datopotamab deruxtecan plus osimertinib, AstraZeneca’s EGFR tyrosine kinase inhibitor (TKI), versus osimertinib alone in patients with previously untreated locally advanced or metastatic EGFR mutated nonsquamous NSCLC. TROPION-Lung15 is evaluating datopotamab deruxtecan with or without osimertinib versus platinum-based doublet chemotherapy in patients with locally advanced or metastatic nonsquamous EGFR mutated NSCLC whose disease progressed on prior treatment with osimertinib. “These three trials in either high PD-L1 expressing or EGFR mutated nonsquamous non-small cell lung cancer are critical to helping us understand the potential role of datopotamab deruxtecan in treating patients across different lines and types of lung cancer,” said Mark Rutstein, MD, Global Head, Oncology Clinical Development, Daiichi Sankyo. “Our growing TROPION clinical program, which now consists of seven phase 3 trials demonstrates our commitment to understanding the full potential of datopotamab deruxtecan in lung cancer.” “Clinical research suggests that combining an antibody drug conjugate with a targeted treatment or a bispecific immunotherapy may drive stronger and more durable tumor responses in patients with a variety of cancers including lung cancer,” said Cristian Massacesi, MD, Chief Medical Officer and Oncology Chief Development Officer, AstraZeneca. “The initiation of these additional three phase 3 trials of datopotamab deruxtecan in combination with our agents, osimertinib and rilvegostomig illustrates our commitment to exploring potential synergies within our oncology pipeline as well as the full potential and combinability of this TROP2 directed antibody drug conjugate across multiple segments and settings of non-small cell lung cancer.” About TROPION-Lung10 TROPION-Lung10 is a global, multicenter, open-label, three-arm phase 3 trial where patients will be randomized in a 2:1:2 ratio to evaluate the efficacy and safety of datopotamab deruxtecan (6.0 mg/kg) in combination with rilvegostomig (750 mg) or rilvegostomig (750 mg) monotherapy versus pembrolizumab (200 mg) monotherapy in adult patients with previously untreated locally advanced or metastatic nonsquamous NSCLC with high PD-L1 expression (TC ≥ 50%) and without actionable genomic alterations. The dual primary endpoints of TROPION-Lung10 are progression-free survival (PFS) as assessed by blinded independent central review (BICR) and overall survival (OS) in patients with TROP2 positive tumors receiving datopotamab deruxtecan in combination with rilvegostomig versus the pembrolizumab arm. A pre-specified retrospective analysis from tumor biopsies collected pretreatment will be conducted following validation of a potential TROP2 biomarker determined by quantitative continuous scoring, a computational pathology approach. Key secondary endpoints for all arms of the trial include PFS as assessed by BICR and investigator and OS in the intention-to-treat (ITT) population, objective response rate (ORR) as assessed by BICR and duration of response (DoR) as assessed by BICR and investigator in both TROP2 biomarker positive and the ITT populations. The safety and tolerability of datopotamab deruxtecan in combination with rilvegostomig and rilvegostomig monotherapy as compared with pembrolizumab also will be assessed. TROPION-Lung10 will enroll approximately 675 patients in Asia, Europe, North America, Oceania and South America. For more information visit ClinicalTrials.gov . The TIGIT component of rilvegostomig is derived from the clinical-stage anti-TIGIT antibody, COM902, developed by Compugen Ltd. (Nasdaq/TASE: CGEN). About TROPION-Lung14 TROPION-Lung14 is a global, randomized, multicenter, open-label phase 3 trial evaluating the efficacy and safety of datopotamab deruxtecan (6.0 mg/kg) in combination with osimertinib (80 mg) versus osimertinib (80 mg) monotherapy in adult patients with previously untreated locally advanced or metastatic nonsquamous NSCLC with an EGFR mutation (Exon 19 deletion and/or L858R). The randomized period of the trial is preceded by a single-arm safety run-in period which will enroll approximately 20 patients to evaluate the combination therapy. The primary endpoint of TROPION-Lung14 is PFS as assessed by BICR. Key secondary endpoints include central nervous system (CNS) PFS as assessed by CNS BICR, PFS as assessed by investigator, ORR as assessed by BICR and investigator, OS and safety. TROPION-Lung14 will enroll approximately 580 patients in Asia, Europe, North America, Oceania and South America. For more information visit ClinicalTrials.gov . About TROPION-Lung15 TROPION-Lung15 is a global, multicenter, open-label, three-arm phase 3 trial where patients will be randomized in a 1:1:1 ratio to evaluate the efficacy and safety of datopotamab deruxtecan (6.0 mg/kg) as monotherapy or in combination with osimertinib (80 mg) versus platinum-based doublet chemotherapy (pemetrexed in combination with carboplatin or cisplatin followed by pemetrexed maintenance) in adult patients with locally advanced or metastatic nonsquamous NSCLC with at least one EGFR mutation (G719X, Ex19del, S768I, L858R, and/or L861Q) and with disease progression following prior treatment with osimertinib. The dual primary PFS endpoints of TROPION-Lung15 are PFS as assessed by BICR for datopotamab deruxtecan monotherapy versus chemotherapy and datopotamab deruxtecan in combination with osimertinib versus chemotherapy. Key secondary endpoints include investigator-assessed CNS PFS as assessed by CNS BICR, ORR and DoR as assessed by BICR, OS and safety. TROPION-Lung15 will enroll approximately 630 patients in Asia, Europe, North America, Oceania and South America. For more information visit ClinicalTrials.gov . About Advanced Non-Small Cell Lung Cancer Nearly 2.5 million lung cancer cases were diagnosed globally in 2022. 1 NSCLC is the most common type of lung cancer, accounting for about 85% of cases. 2 Approximately 75% and 25% of NSCLC tumors are of nonsquamous or squamous histology, respectively, with EGFR mutations occurring in 14% to 38% of all NSCLC tumors worldwide. 3,4 A majority of EGFR mutations occur in tumors with nonsquamous histology. 5 For patients with tumors that do not express a known actionable genomic alteration (e.g., EGFR, ALK, ROS1, NTRK, BRAF, RET or MET), the current first-line standard of care in the metastatic setting is an immune checkpoint inhibitor and/or platinum-based chemotherapy based on PD-L1 expression. 6,7,8 For certain patients with tumors that have EGFR mutations, the established first-line treatment in the metastatic setting is an EGFR TKI. 9 While these treatment strategies have improved outcomes in the first-line metastatic setting, most patients eventually experience disease progression. 10,11,12 TROP2 is a protein broadly expressed in the majority of NSCLC tumors. 13 There is currently no TROP2 directed ADC approved for the treatment of lung cancer. 8,9 About Datopotamab Deruxtecan (Dato-DXd) Datopotamab deruxtecan (Dato-DXd) is an investigational TROP2 directed ADC. Designed using Daiichi Sankyo’s proprietary DXd ADC Technology, datopotamab deruxtecan is one of six DXd ADCs in the oncology pipeline of Daiichi Sankyo, and one of the most advanced programs in AstraZeneca’s ADC scientific platform. Datopotamab deruxtecan is comprised of a humanized anti-TROP2 IgG1 monoclonal antibody, developed in collaboration with Sapporo Medical University, attached to a number of topoisomerase I inhibitor payloads (an exatecan derivative, DXd) via tetrapeptide-based cleavable linkers. A comprehensive global clinical development program is underway with more than 20 trials evaluating the efficacy and safety of datopotamab deruxtecan across multiple cancers, including NSCLC, triple negative breast cancer and HR positive, HER2 negative breast cancer. The program includes seven phase 3 trials in lung cancer and five phase 3 trials in breast cancer evaluating datopotamab deruxtecan as a monotherapy and in combination with other anticancer treatments in various settings. About the Daiichi Sankyo and AstraZeneca Collaboration Daiichi Sankyo and AstraZeneca entered into a global collaboration to jointly develop and commercialize ENHERTU in March 2019 and datopotamab deruxtecan (Dato-DXd) in July 2020 , except in Japan where Daiichi Sankyo maintains exclusive rights for each ADC. Daiichi Sankyo is responsible for the manufacturing and supply of ENHERTU and datopotamab deruxtecan. About the ADC Portfolio of Daiichi Sankyo The Daiichi Sankyo ADC portfolio consists of seven ADCs in clinical development crafted from two distinct ADC technology platforms discovered in-house by Daiichi Sankyo. The ADC platform furthest in clinical development is Daiichi Sankyo’s DXd ADC Technology where each ADC consists of a monoclonal antibody attached to a number of topoisomerase I inhibitor payloads (an exatecan derivative, DXd) via tetrapeptide-based cleavable linkers. The DXd ADC portfolio currently consists of ENHERTU, a HER2 directed ADC, and datopotamab deruxtecan (Dato-DXd), a TROP2 directed ADC, which are being jointly developed and commercialized globally with AstraZeneca. Patritumab deruxtecan (HER3-DXd), a HER3 directed ADC, ifinatamab deruxtecan (I-DXd), a B7-H3 directed ADC, and raludotatug deruxtecan (R-DXd), a CDH6 directed ADC, are being jointly developed and commercialized globally with Merck. DS-3939, a TA-MUC1 directed ADC, is being developed by Daiichi Sankyo. The second Daiichi Sankyo ADC platform consists of a monoclonal antibody attached to a modified pyrrolobenzodiazepine (PBD) payload. DS-9606, a CLDN6 directed PBD ADC, is the first of several planned ADCs in clinical development utilizing this platform. Datopotamab deruxtecan, ifinatamab deruxtecan, patritumab deruxtecan, raludotatug deruxtecan, DS-3939 and DS-9606 are investigational medicines that have not been approved for any indication in any country. Safety and efficacy have not been established. About Daiichi Sankyo Daiichi Sankyo is an innovative global healthcare company contributing to the sustainable development of society that discovers, develops and delivers new standards of care to enrich the quality of life around the world. With more than 120 years of experience, Daiichi Sankyo leverages its world-class science and technology to create new modalities and innovative medicines for people with cancer, cardiovascular and other diseases with high unmet medical need. For more information, please visit www.daiichisankyo.com . References 1 World Health Organization. Global Cancer Observatory: Lung . Accessed October 2024. 2 Economopoulou P, et al. Ann Transl Med . 2018; 6(8):138 3 National Cancer Institute. SEER Cancer Statistics Factsheets: Lung and Bronchus Cancer, CSR 1975-2017 . Accessed October 2024. 4 Pretelli G, et al. Int J Mol Sci . 2023; 24, 8878. 5 Prabhakar C. Translational Lung Cancer Research . 2015; 4(2), 110-118. 6 Mok TSK, et al. Lancet . 2019 May 4;393(10183):1819-1830. 7 Brahmer J.R. et al. KEYNOTE-024 5-year OS update . ESMO 2021 Virtual Congress. 2021 Sept 16 – 20; Abstract LBA51. 8 Rodríguez-Abreau D, et al. Ann Onc . 2021 Jul;32(7):881-895. 9 American Cancer Society. Targeted Drug Therapy for Non-Small Cell Lung Cancer . Accessed October 2024. 10 Chen R, et al. J Hematol Oncol . 2020:13(1):58. 11 Majeed U, et al. J Hematol Oncol . 2021;14(1):108. 12 Pircher A, et al. Anticancer Research . 2020;70(5):287-294. 13 Mito R, et al. Pathol Int . 2020;70(5):287-294. SOURCE: Daiichi Sankyo

10 月 31 日，基石药业宣布，英国药品和医疗保健用品管理局（MHRA）已批准舒格利单抗联合含铂化疗用于无 EGFR 敏感突变, 或无 ALK, ROS1, RET 基因组肿或无 ALK, ROS1, RET 基因组肿瘤变异的转移性非小细胞肺癌（NSCLC）成人患者的一线治疗。这也是国产 PD-L1 单抗首次在英国获批上市。 舒格利单抗是首个成功出海的国产 PD-L1 单抗，此前已于今年 7 月获得欧盟委员会批准上市，本次在英国的获批是其在海外市场获得的第二项上市许可申请批准。 此次获批主要是基于 III 期临床研究——GEMSTONE-302 的结果。GEMSTONE-302 研究是一项多中心、随机、双盲的Ⅲ期临床试验，旨在评估舒格利单抗联合含铂化疗对比安慰剂联合含铂化疗，一线治疗 IV 期 NSCLC 患者的有效性和安全性。该试验主要研究终点为研究者评估的疾病无进展生存期（PFS）。 2024 年欧洲肿瘤内科学会（ESMO）年会上公布的数据显示： 截至数据截止日期（2023 年 5 月 15 日），479 名患者中，分别被随机分配至舒格利单抗联合含铂化疗组（320 人）和安慰剂联合含铂化疗组（159 人）。两组的中位随访时间分别为 43.5 个月和 43.0 个月。 在意向治疗人群（ITT）中，舒格利单抗联合化疗组的中位 OS 为 25.2 个月，安慰剂联合化疗组为 16.9 个月，风险比（HR）0.68（95% CI, 0.54-0.85），两组的四年生存率分别为 32.1% 和 17.3%。 在 ITT 中，舒格利单抗联合化疗组的中位 PFS 为 9.0 个月，安慰剂联合化疗组为 4.9 个月（HR=0.49）。 在不同肿瘤组织学类型和 PD-L1 表达水平的患者亚组中，舒格利单抗联合化疗均展现出持续的 PFS 和 OS 获益。 截至数据截止日期，58 例接受舒格利单抗超过 2 年的患者，中位 DoR 尚未达到，4 年生存率为 92.6%。 基线有脑转移的患者，与安慰剂联合化疗相比，舒格利单抗联合化疗同样延长了 PFS（HR=0.31）和 OS（中位 OS：26 个月 vs 9 个月，HR=0.44），4 年生存率为 36.4%。 安全性结果与先前报道的结果一致。 在海外商业化和注册方面，基石药业还正积极与来自西欧、拉美、中东、东南亚、加拿大等地区的合作伙伴洽谈，预计近期将达成其中多项商业合作。同时，该公司还在积极与欧洲药品管理局（EMA）等国际监管机构沟通舒格利单抗其他适应症，如 III 期 NSCLC、一线胃癌、一线食管鳞癌的上市申请。 封面来源：企业 Logo 免责声明：本文仅作信息分享，不代表 Insight 立场和观点，也不作治疗方案推荐和介绍。如有需求，请咨询和联系正规医疗机构。 编辑：馨药 PR 稿对接：微信 insightxb 投稿：微信 insightxb；邮箱 insight@dxy.cn 多样化功能、可溯源数据…… Insight 数据库网页版等你体验 点击阅读原文，立刻解锁！

▎药明康德内容团队编辑 基石药业刚刚宣布，英国药品和医疗保健用品管理局（MHRA）已批准舒格利单抗联合含铂化疗用于无EGFR敏感突变, 或无ALK, ROS1, RET基因组肿瘤变异的转移性非小细胞肺癌（NSCLC）成人患者的一线治疗。这是继欧盟委员会批准之后，舒格利单抗在国际市场获得的第二项上市许可申请的批准。 此次获批主要是基于一项多中心、随机、双盲的3期临床研究——GEMSTONE-302的结果。舒格利单抗联合化疗对比安慰剂联合化疗，可显著延长初治转移性NSCLC患者的无进展生存期和总生存期。该研究数据已在《柳叶刀·肿瘤学》和《自然·癌症》上发表，并曾多次在国际学术会议上以口头汇报和壁报形式公布。 基石药业首席执行官、研发总裁、执行董事杨建新博士在新闻稿中表示：舒格利单抗在英国获批，标志着公司全球化布局的又一重要里程碑。在今年ESMO上公布的长期生存数据，更是进一步巩固了舒格利单抗在转移性NSCLC一线治疗格局中的重要地位。 他还表示，在国际商业化和注册方面，公司正积极与来自西欧、拉美、中东、东南亚、加拿大等地区的合作伙伴洽谈，预计近期将达成其中多项商业合作。同时，公司在积极与欧洲药品管理局（EMA）等国际监管机构沟通舒格利单抗其他适应症，如III期NSCLC、一线胃癌、一线食管鳞癌的上市申请，期待为全球更多患者带来创新的治疗方案。 舒格利单抗是由基石药业研发的抗PD-L1单克隆抗体，其独特分子设计使其具备双重作用机制，不仅阻断PD-1/PD-L1相互作用，还能通过介导PD-L1表达阳性的肿瘤细胞与肿瘤相关巨噬细胞（TAMs），在诱导抗体依赖性细胞吞噬（ADCP）的同时不损害效应性T细胞。 目前，中国国家药品监督管理局（NMPA）已批准舒格利单抗五项适应症： 联合化疗一线治疗转移性鳞状和非鳞状NSCLC患者； 治疗同步或序贯放化疗后未出现疾病进展的、不可切除、III期NSCLC患者； 治疗复发或难治性结外NK/T细胞淋巴瘤患者； 联合氟尿嘧啶类和铂类化疗药物一线治疗不可切除的局部晚期，复发或转移性食管鳞癌患者； 联合含氟尿嘧啶类和铂类药物化疗用于表达PD-L1（综合阳性评分[CPS]≥5）的不可手术切除的局部晚期或转移性胃及胃食管结合部腺癌的一线治疗。 在国际领域，欧盟委员会（EC）已批准舒格利单抗联合含铂化疗用于无EGFR敏感突变, 或无ALK, ROS1, RET基因组肿瘤变异的转移性NSCLC患者的一线治疗；英国药品和医疗保健用品管理局（MHRA）已批准舒格利单抗联合含铂化疗用于无EGFR敏感突变, 或无ALK, ROS1, RET基因组肿瘤变异的转移性NSCLC患者的一线治疗。 参考资料： [1]国产PD-L1首度在英国获批！基石药业宣布舒格利单抗获英国药品和医疗保健用品管理局批准用于一线治疗非小细胞肺癌 Retrieved Oct 31，2024, from https://mp.weixin.qq.com/s/9F1906G2lFkf2ohU-Xm7qg 本文由药明康德内容团队根据公开资料整理编辑，欢迎个人转发至朋友圈。转载授权及其他合作需求，请联系wuxi_media@wuxiapptec.com。 免责声明：药明康德内容团队专注介绍全球生物医药健康研究进展。本文仅作信息交流之目的，文中观点不代表药明康德立场，亦不代表药明康德支持或反对文中观点。本文也不是治疗方案推荐。如需获得治疗方案指导，请前往正规医院就诊。