Helsinn and MEI Pharma announced the European Medicines Agency (EMA) has granted Orphan Drug Designation to pracinostat, an investigational drug candidate currently in a Phase 3 study in combination with azacitidine for the treatment of acute myeloid leukemia (AML) in adult patients unfit to induction chemotherapy.
The EMA orphan drug designation is a status assigned to a medicine intended for use against a rare condition in the European Union (prevalence of the condition in the European Union must not be more than 5 in 10,000). The designation allows pharmaceutical companies to benefit from incentives offered by the EU to develop a medicine for the treatment, prevention or diagnosis of a disease that is life threatening or a chronically debilitating rare disease. These include 10 years of market exclusivity once approved, alongside a range of other regulatory advantages.
"Helsinn is pleased with the decision of the EMA to grant orphan drug designation to pracinostat. This decision encourages us to continuously dedicate significant resources to accelerate our clinical trial program, with a goal of helping patients who are fighting rare and difficult-to-treat diseases, such as AML and, at present, have very few treatment options. Following the positive Phase 2 clinical trials of pracinostat for patients with AML, Helsinn has recently initiated the Phase 3 program," Riccardo Braglia, Helsinn Group Vice Chairman and CEO, said.
In August of 2017, the first patient has been dosed in the pivotal Phase 3 study of the investigational agent pracinostat in combination with Azacitidine in adults with newly diagnosed acute myeloid leukemia (AML) who are unfit to receive intensive induction chemotherapy. The primary endpoint of the study is overall survival. Secondary endpoints include, among others, morphologic complete remission (CR) rate, cytogenetic complete remission and complete remission without minimal residual disease.
Results from a Phase 2 open-label, single-arm, multicenter study of pracinostat and azacitidine in 50 patients aged ≥ 65 years with newly diagnosed AML not eligible for induction chemotherapy showed a median overall survival of 19.1 (95%CI: 10.0-26.5) months, one-year survival of 62% and a CR rate of 42%. These results were presented at the American Society of Hematology (ASH) Annual Meeting in December 2016.
AML is the most common acute leukemia affecting adults, and its incidence is expected to continue to increase as the population ages. The American Cancer Society estimates about 21,380 new cases and 10,590 deaths from AML in the U.S. for 2017; the average age of a patient with AML is about 67 years. According to the Surveillance of Rare Cancers in Europe project, the incidence of AML in Europe is 3.7 per 100,000. There are currently no drugs approved in the U.S. to treat AML in patients who are unfit for intensive induction chemotherapy, though hypomethylating agents are recommended by the National Comprehensive Cancer Network (NCCN) guidelines. In the EU, Azacitidine is approved for the treatment of adult patients who are not eligible for hematopoietic stem cell transplant (HSCT) with AML with >30% marrow blasts according to the World Health Organization (WHO) classification, and decitabine is approved the treatment of adult patients with newly diagnosed de novo or secondary AML, according to the World Health Organization (WHO) classification, who are not candidates for standard induction chemotherapy.
Pracinostat is an oral histone deacetylase (HDAC) inhibitor that is in late-stage clinical development. The U.S. Food and Drug Administration has granted Breakthrough Therapy Designation for pracinostat in combination with Azacitidine for the treatment of patients with newly diagnosed AML who are ≥75 years of age or unfit for intensive chemotherapy. In August 2016, Helsinn and MEI Pharma entered into an exclusive license, development and commercialization agreement for pracinostat in AML and other potential indications. Under the terms of the agreement, Helsinn is granted a worldwide exclusive license to develop, manufacture and commercialize pracinostat, and is primarily responsible for funding its global development and commercialization. Pracinostat is under clinical investigation and has not been approved by any health authority worldwide.