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Agios急性髓细胞白血病新药AG-120一期临床效果显著

2014-12-08 佚名 生物谷

Agios制药近日宣布,该公司的创新药物AG-120(异柠檬酸脱氢酶突变蛋白抑制剂)在急性髓细胞白血病(AML)患者的早期试验中取得了极为显著的疗效。在最近的西班牙巴塞罗那举行的欧洲癌症研究与治疗组织(EORTC)年会上,科罗拉多大学的研究团队组长Daniel Pollyea表示,每一个剂量组的患者都得到完全缓解,这个数据让团队非常激动。 Pollyea认为尽管目前试验处于非常早期的阶段(P

Agios制药近日宣布,该公司的创新药物AG-120(异柠檬酸脱氢酶突变蛋白抑制剂)在急性髓细胞白血病(AML)患者的早期试验中取得了极为显著的疗效。在最近的西班牙巴塞罗那举行的欧洲癌症研究与治疗组织(EORTC)年会上,科罗拉多大学的研究团队组长Daniel Pollyea表示,每一个剂量组的患者都得到完全缓解,这个数据让团队非常激动。

Pollyea认为尽管目前试验处于非常早期的阶段(Phase I,剂量组试验),而且受试者人数也很少(17人),但是结果却是非常轰动的。异柠檬酸脱氢酶(IDH)将会成为治疗AML极为有效的靶点。靶点IDH可以分为两类,一类是在细胞质中发现的IDH1,一类是在线粒体中发现的IDH2。AG-120是一种口服剂,它能够强烈地选择性抑制IDH1癌基因突变位点,该突变在大多数AML患者(6-10%)和骨髓增生异常综合征(MDS)患者(3—6%)中都能发现。

I期临床试验的受试者为具有IDH1变异的AML或 MDS患者,仅仅观察疗效而不深入到肿瘤反应,Pollyea认为AG-120是有效的。和基线相比,可以观察到98%的病人的2-羟戊二酸(2HG)水平有所下降。

反应在治疗的早期就会出现,并且持续期长,最早在两周内就会有效果。Pollyea认为,对于那些容易复发、治疗难度大的AML患者而言,仅服用一个疗程、并且在3—5个月内就会产生明显疗效是非常难得的。

英国弗里曼医院的Ruth Plummer也极为看好这一早期成果,他强调,IDH酶是癌症代谢基因突变最频繁的一种,AG-120不仅会在机制上减少癌细胞的生成,而且是针对该突变非常有用的生物标志物。


相关英文推荐:

Agios early-stage AML drug shines

Agios Pharmaceuticals’ AG-120, a first-in-class inhibitor of the IDH1 mutant protein has shown remarkable efficacy in an early-stage trial in patients with acute myeloid leukaemia.

“We’re very excited to report these clinical responses,” said lead investigator Daniel Pollyea of University of Colorado. “We’ve had a complete remission in every single dose cohort.” Dr Pollyea reported his results at the recent EORTC meeting in Barcelona, Spain.

Granted the work is very early (a Phase I, dose-ranging study) and the enrollment is small (N=17), but the responses observed were striking. “Isocitrate dehydrogenase (IDH) is one of the most promising targets in AML,” Dr Pollyea said.

The target, IDH, comes in two flavours - IDH1, found in the cell’s cytoplasm, and IDH2, found in the mitochondria. AG-120, an oral agent, is a potent, selective inhibitor of the IDH1 oncogenic mutation found in a significant minority of AML (6-10%) and myelodysplastic syndromes (3-6%) patients,” explained Dr Pollyea.

The Phase I study enrolled AML or MDS patients with the IDH1 mutation and in terms of efficacy, without even looking at tumour response, Dr Pollyea knew that the drug was at least working mechanistically. Patients were observed to have upwards of a 98% reduction in 2-hydroxyglutarate (2HG) plasma levels as compared to baseline.

Responses were also early and durable, with the earliest noted at two weeks. Dr Pollyea added that “for a relapse and refractory AML population, taking a single agent and having responses of 3-5 months is quite impressive.”

Ruth Plummer, from Freeman Hospital in Newcastle-upon-Tyne, UK, was also bullish about the early results, noting that IDH enzymes “are among the most frequently mutated metabolic genes in cancer. Not only is this drug mechanistically useful in reducing the production of tumour cells, it’s also an extremely useful biomarker for the mutation”.

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