2022年9月27日,由程颖教授牵头的国际多中心研究——ASTRUM-005研究在全球四大顶级医学期刊之一的《美国医学会杂志》(JAMA,影响因子:157.3)在线发表,成为全球首个登上JAMA主刊的小细胞肺癌免疫治疗临床研究。ASTRUM-005研究是复宏汉霖自主研发的抗PD-1单抗H药 汉斯状®(斯鲁利单抗)联合化疗一线治疗广泛期小细胞肺癌(ES-SCLC)的Ⅲ期临床研究,2022年ASCO年会程颖教授首次报告结果后,引起了全球同行的广泛关注,而今再度登上国际顶级学术舞台,体现了国际学术界的高度认可,彰显出中国研究者的智慧化和生物医药领域国际一流的自主创新实力和临床运营能力。
ASTRUM-005是一项在既往未接受过治疗的ES-SCLC患者中比较H药联合化疗及安慰剂联合化疗的临床有效性和安全性的随机、双盲、国际多中心、Ⅲ期临床研究,在中国、土耳其、欧盟波兰、格鲁吉亚等多个国家共开设128个试验中心,其中114个试验中心有受试者参与了筛选,共入组585例受试者,约31.5%为白人。截至2021年10月22日,本研究共入组的斯鲁利单抗组(n=389)和安慰剂组(n=196)中位随访时间为12.3个月。斯鲁利单抗组和安慰剂组的中位OS分别为15.4个月(95% CI 13.3–NE)和10.9个月(95% CI 10.0–14.3),风险比(HR)为0.63(95% CI 0.49–0.82;p<0.001)。两组的24个月总生存率分别为43.1%和7.9%。斯鲁利单抗组及安慰剂组经独立影像评估委员会(IRRC)依据RECIST v1.1评估的中位PFS分别为5.7和4.3个月(HR 0.48,95% CI 0.38–0.59)。安全性方面,斯鲁利单抗组的免疫相关不良事件(irAEs)发生率与已获批的PD-1/PD-L1单抗相似。
未来,复宏汉霖将持续加码创新,以临床需求为先导,继续高效地为全球患者提供更多可负担、疗效更好的治疗方案。
2022年3月,H药正式获批用于治疗微卫星高度不稳定(MSI-H)实体瘤。围绕H药,复宏汉霖积极推进其与公司其他产品的协同以及与创新疗法的联合,相继获得中国、美国、欧盟等国家及地区的临床试验许可,在全球同步开展11项肿瘤免疫联合疗法临床试验,广泛覆盖肺癌、食管癌、头颈鳞癌和胃癌等适应症,全面覆盖肺癌一线治疗。截至目前,H药已于中国、土耳其、波兰、格鲁吉亚等国家和地区累计入组超3100人,其中2项国际多中心临床试验入组白人的比例超过30%,是拥有国际临床数据较多的抗PD-1单抗之一。H药联合化疗一线治疗鳞状非小细胞肺癌(sqNSCLC)、广泛期小细胞肺癌(ES-SCLC)和食管鳞状细胞癌(ESCC)的NDA已获得NMPA受理,H药有望成为全球首个一线治疗SCLC的抗PD-1单抗。此外,该药入选《2022 CSCO小细胞肺癌诊疗指南》作为ES-SCLC治疗推荐,针对ES-SCLC的国际多中心临床研究ASTRUM-005成为全球首个登上JAMA的小细胞肺癌免疫治疗临床研究,其治疗小细胞肺癌(SCLC)也已获得美国FDA孤儿药资格认定。
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20多种创新单克隆抗体,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。继国内首个生物类似药汉利康®(利妥昔单抗)、中国首个自主研发的中欧双批单抗药物汉曲优®(曲妥珠单抗,欧洲商品名:Zercepac®,澳大利亚商品名:Tuzucip®和Trastucip®)、汉达远®(阿达木单抗)和汉贝泰®(贝伐珠单抗)相继获批上市,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,其鳞状非小细胞肺癌、广泛期小细胞肺癌和食管鳞状细胞癌3项适应症的上市注册申请也正在审评中。公司亦同步就13个产品、11个免疫联合治疗方案在全球范围内开展20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。
ASTRUM-005: The first immunotherapy clinical study of SCLC published in JAMA, one of the top medical journals in the world
OS 15.4 months, a new record
SCLC is the most aggressive subtype of lung cancer, accounting for around 15% of all lung cancer cases. Both limited stage SCLC (LS-SCLC) and ES-SCLC exhibit high malignancy, strong invasiveness, early metastasis, fast disease progression, and a poor prognosis. The advent of immune checkpoint inhibitors has brought new hope to patients with ES-SCLC. At present, anti-PD-L1 mAbs combined with chemotherapy have been recommended by clinical practice guidelines at home and abroad as the first-line treatment for ES-SCLC. Compared with chemotherapy, the overall survival (OS) of patients with SCLC has been prolonged to a certain extent, but the improvements were still modest, suggesting the need for more effective treatments in this patient population.
ASTRUM-005 is a randomised, double-blind, international, multi-centre, phase 3 clinical study that aims to compare the efficacy and safety of HANSIZHUANG with placebo when combined with chemotherapy in previously untreated patients with ES-SCLC. ASTRUM-005 has set up a total of 128 sites in various countries including China, Turkey, Poland, and Georgia, and enrolled 585 subjects who were screened from 114 sites, among whom 31.5% were White. As of data cutoff for this interim analysis (October 22, 2021), 585 eligible patients were randomised (serplulimab group, n=389; placebo group, n=196), with a median follow-up duration of 12.3 months. Median OS was significantly longer in the serplulimab group (15.4 months, 95% confidence interval [CI] 13.3-not evaluable) than in the placebo group (10.9 months, 95% CI 10.0-14.3) (hazard ratio [HR] 0.63, 95% CI 0.49-0.82; P <0.001). The 24-month OS rate in the two treatment groups were 43.1% and 7.9%, respectively. Median progression-free survival assessed by an independent radiology review committee per RECIST v1.1 was also longer in the serplulimab group compared to the placebo group (5.7 months vs. 4.3 months; HR 0.48, 95% CI 0.38-0.59). Incidence of immune-related adverse events (irAEs) was similar to the approved PD-1/PD-L1 antibodies.
Providing more treatment options for patients worldwide
The success of ASTRUM-005 is a breakthrough in the treatment of ES-SCLC with PD-1 inhibitors. Based on the results of ASTRUM-005, the New Drug Application (NDA) of HANSIZHUANG in combination with chemotherapy for the first-line treatment of ES-SCLC has been accepted by the National Medical Products Administration (NMPA). Furthermore, HANSIZHUANG has been recommended for the first-line treatment of ES-SCLC by the 2022 CSCO Guidelines for Diagnosis and Treatment of SCLC.
In April 2022, the US Food and Drug Administration (FDA) has granted Orphan-Drug Designation (ODD) for HANSIZHUANG for the treatment of SCLC. Based on the positive feedback from FDA Biologics License Application (BLA) submission for HANSIZHUANG for the treatment of ES-SCLC and the discussion on the FDA’s Type C consultation meeting, Henlius is planning to soon carry out a bridging study in the US and expected to submit BLA to FDA before Q1 of 2024. At present, there is no anti-PD-1 mAb approved for the first-line treatment of SCLC worldwide. HANSIZHUANG is expected to become the world’s first anti-PD-1 mAb for the first-line treatment of SCLC and to fill the clinical gap in the next five years.
Looking forward, Henlius will actively improving efficiency through innovations, focusing on unmet medical needs to bring more high-quality and affordable therapies to patients worldwide.
HANSIZHUANG was approved by the NMPA for the treatment of MSI-H solid tumours in March 2022 and its synergy with in-house products of the company and innovative therapies are being actively promoted. It has successively obtained clinical trial licenses in China, the United States, the European Union and other countries and regions to initiate 11 clinical trials on immuno-oncology combination therapies in a wide variety of indications, such as lung cancer, esophageal carcinoma, head and neck squamous cell carcinoma and gastric cancer, etc., and covering the full range of first-line treatments of lung cancers. As of now, the company has enrolled more than 3,100 subjects in China, Turkey, Poland, Georgia and other countries and regions, and the proportion of White is over 30% in two MRCTs, making HANSIZHUANG an anti-PD-1 mAb with one of the largest global clinical data pools. The NDAs of the first-line treatment for squamous non-small cell lung cancer (sqNSCLC), extensive-stage small cell lung cancer (ES-SCLC), and esophageal squamous cell carcinoma (ESCC) have been accepted by the NMPA, which makes HANSIZHUANG potentially the world’s first anti-PD-1 mAb for the first-line treatment of SCLC. Furthermore, HANSIZHUANG was recommended by the 2022 CSCO Guidelines for Diagnosis and Treatment of Small Cell Lung Cancer (SCLC) for the treatment of ES-SCLC, and the related clinical trial has also become the first study published in JAMA on SCLC immunotherapy. Serplulimab was also granted orphan drug designation by the FDA for treatment of SCLC.
Henlius has pro-actively built a diversified and high-quality product pipeline covering over 20 innovative monoclonal antibodies (mAbs) 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 in Europe: Zercepac®; trade names in Australia: Tuzucip® and Trastucip®), the first China-developed mAb biosimilar approved both in China and Europe, HANDAYUAN (adalimumab) and HANBEITAI (bevacizumab), the innovative product HANSIZHUANG has been approved by the NMPA for the treatment of MSI-H solid tumors and its NDA for the treatment of squamous non-small cell lung cancer (sqNSCLC), extensive-stage small cell lung cancer (ES-SCLC), and esophageal squamous cell carcinoma (ESCC) are under review. What’s more, Henlius has conducted over 20 clinical studies for 13 products and 11 combination therapies, expanding its presence in major markets as well as emerging markets.
【参考文献】 Cheng Y, Han L, Wu L, et al. Effect of First-Line Serplulimab vs Placebo Added to Chemotherapy on Survival in Patients With Extensive-Stage Small Cell Lung Cancer: The ASTRUM-005 Randomized Clinical Trial. JAMA.2022;328(12):1223–1232. doi:10.1001/jama.2022.16464
*图片素材来源于JAMA官网
投资者:IR@Henlius.com
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