
Peregrine to have 7 Posters at AACR Including 3 with Clinical Data
Bavituximab 1st-Line and 2nd-Line Lung Cancer Data in Coming Months
Download Full 6-Page Note with Important Disclosures: Morning Note 03-01-12 PPHM
Peregrine announced that 7 posters have been accepted for presentation at the 103rd Annual Meeting of the American Association for Cancer Research (AACR), to be held at McCormick Place in Chicago, Illinois, March 31st – April 4th, 2012. Investors should pay particular attention to the 3 poster presentations that cover human clinical trial results as shown below:
Abstract Number: 1744
Presentation Title: A phase Ib study of bavituximab plus carboplatin and pemetrexed in chemotherapy naive stage IV non-squamous non-small cell lung cancer
Presentation Time: Monday, Apr 02, 2012, 8:00 AM -12:00 PM
Location: McCormick Place West (Hall F), Poster Section 27
Poster Section: 27
Poster Board Number: 4
Authors: Juneko Grilley-Olson1, Jared Weiss1, Thomas E. Stinchcombe1, Anastasia Ivanova1, Maureen Tynan1, Joseph Shan2, Mark A. Socinski3. 1Univ. of North Carolina, Chapel Hill, NC; 2Peregrine Pharmaceuticals, Inc., Tustin, CA; 3Univ. of Pittsburgh, Pittsburgh, PA
Background: Bavituximab (B) is a novel chimeric IgG1 phosphatidylserine-targeting monoclonal antibody. B selective binds to phosphatidylserine complexed with β2-glycoprotein I exposed on tumor vasculature resulting in enhanced immune response and inhibition of existing as well as novel tumor vasculature. Pre-clinical data suggest a synergistic action using phosphatidylserine-targeting antibodies in combination with chemotherapy. B has previously been reported to be safe and well tolerated when given in combination with paclitaxel and carboplatin (C) in non-small cell lung cancer (NSCLC) and has produced a promising 43% overall response rate (ORR). Here, we report on the currently enrolling trial of B in combination with pemetrexed (P) and C, in treatment naïve locally advanced or metastatic non-squamous NSCLC.
Methods: This is an ongoing open-label, single arm phase Ib study (standard 3+3 design) of B (0.3mg/kg, 1mg/kg, and 3mg/kg) with fixed dose CP. B is given weekly in combination with C (AUC 6) plus P (500mg/m2), given every 3 weeks, maximum of 6 cycles. Patients may elect to continue on maintenance B until disease progression. At the MTD, up to 16 additional patients will be enrolled to further characterize safety and preliminary evidence of efficacy, using an adaptive design incorporating an early stopping rule based on excessive proportion of DLTs observed. The study objectives are to determine the safety, tolerability and recommended phase 2 dose of B in combination with CP. We will also estimate ORR, progression free and overall survival. DCE-MRI at baseline and end of cycle 1 will be explored as a potential pharmacodynamics biomarker in up to 10 patients. Due to theoretical concern for prothrombotic effects of B, an optional but encouraged prothrombotic evaluation will be performed on all consenting patients, consisting of baseline and end of study Doppler ultrasound, and blood collection for evaluation of D-Dimer and tissue-factor microparticles.
Results: As of November 2011, Cohort 1 is complete with 3 patients (67% female, 100% white), median age of 59 (range 52-65y) at B dose 0.3 mg/kg. Safety data for cohort 1 is as follows: grade 3 thrombocytopenia attributed to CP was reported in one patient resulting in dosing interruption. No DLTs or SAEs have been reported. Currently 2 patients are evaluable for response, with both (100%) reporting partial responses.
Conclusions: To date, the first of 3 planned dose escalations has been well tolerated, with no unexpected safety events. Response rates reported to date are encouraging, although conclusions are limited due to the small number. Dose escalation is ongoing and results will be updated.
Abstract Number: 5591
Presentation Title: A phase I study of bavituximab and sorafenib in patients with advanced hepatocellular carcinoma (HCC)
Presentation Time: Wednesday, Apr 04, 2012, 8:00 AM -12:00 PM
Location: McCormick Place West (Hall F), Poster Section 28
Poster Section: 28
Poster Board Number: 9
Authors: Adam Yopp, Yull Arriega, Amit Singal, John Mansour, Glen Balch, Phillip Thorpe. UT Southwestern Medical Center, Dallas, TX
Background: HCC is the fastest growing cause of cancer-related deaths in the US, with the majority of patients presenting with advanced stage disease. Despite sorafenib being the only systemic therapy with proven efficacy in advanced HCC, the median survival for these patients is still less than one year. Sorafenib, in pre-clinical HCC models, upregulates phosphatidylserine (PS) exposure on tumor vascular endothelium. The phosphatidylserine (PS)-targeting antibody, bavituximab, given in combination with sorafenib has greater efficacy in pre-clinical HCC models than either therapy alone. Bavituximab acts by directing immune cells to destroy the PS-expressing tumor vasculature, and by reactivating tumor immunity.The aim of our study was to evaluate the maximum tolerated dose (MTD) of bavituximab in combination with 400 mg bid of sorafenib in patients with advanced HCC.
Methods: In this single institution, phase I study (NCT01264705), sorafenib-naive adult patients with measurable, advanced HCC, ECOG PS ≤ 2, and Child-Pugh (CP) class A cirrhosis received escalating doses of bavituximab weekly (0.3, 1.0, and 3.0 mg/kg) and sorafenib 400 mg bid for 28 days.
Results: Median age of patients was 61(range 43-76) years and seven patients were male. Five patients had CP A5 and 4 patients had CP A6 cirrhosis. The majority of patients had underlying HCV (7/9), one patient had HBV and one patient had NASH. Five patients (4 TACE, 1 resection) received prior treatment. Four patients had metastatic disease at initiation of treatment. No dose limiting toxicities were seen at any dose level. No grade 3/4 treatment-related events in the first 28 days were noted. Common toxicities at all grades were related to sorafenib and included hand-foot syndrome (33% grade I, 22% grade II), fatigue (33% grade I) and anorexia (22% grade I).
Conclusions: Bavituximab and sorafenib can be given safely in patients with advanced HCC at 3.0 mg/kg weekly and 400 mg bid, respectively. Hand-foot syndrome, fatigue and anorexia were the most common adverse events and are consistent with known adverse events with sorafenib therapy. These doses are currently being evaluated in an ongoing phase II study in this population.
Abstract Number: 4404
Presentation Title: Microparticle generation and activation after treatment with paclitaxel and bavituximab combination therapy in metastatic breast cancer
Presentation Time: Tuesday, Apr 03, 2012, 1:00 PM – 5:00 PM
Location: McCormick Place West (Hall F), Poster Section 19
Poster Section: 19
Poster Board Number: 21
Authors: Marilyn T. Marron, Pavani Chalasani, Daniel Camacho, Maria Iannone, Kathy Schmidt, Alison Stopeck. University of Arizona, Tucson, AZ
Background: Breast cancer is the leading cause of life-threatening malignancy affecting women and the second leading cause of female cancer death in the United States. Weekly paclitaxel, alone or in combination with other chemotherapies, has proven to be an effective and well-tolerated therapy for patients with metastatic disease. Due to the tumor’s dependence on vascularization for progression, survival and dissemination, targeting a tumor’s vascular network is an important additional cancer management strategy. Bavituximab, a monoclonal antibody developed by Peregrine Pharmaceuticals against phosphatidylserine (PS), is a vascular disrupting agent designed to selectively attack tumor blood vessels already in existence. Under normal conditions, PS is localized to the internal surface of the plasma membrane. However, PS is preferentially localized on the outer surface of vascular endothelial cells in tumors, possibly due to stress conditions in the tumor microenvironment. Bavituximab is able to localize and bind specifically to PS in tumor vessels in a β2-glycoprotein 1 dependent manner, mediating the binding of host effector cells to the tumor vascular endothelium. This leads to vessel damage, vascularity reduction, necrosis, and growth retardation within the tumor. Microparticles are vesicles that are released from cells after activation, stress, death, or malignant transformation. Elevated levels of microparticles derived from platelets, endothelial cells, and/or leukocytes have been associated with several disease states, including cancer, however, the effect of anti-angiogenic or vascular disrupting agents on microparticle production is unclear. We investigated microparticle formation in our patients at baseline, in response to Paclitaxel chemotherapy, and after addition of Bavituximab.
Patients and Methods: We initiated a phase I clinical trial in patients with Her-2 negative metastatic breast cancer treated with paclitaxel (80 mg/m2) on a weekly schedule for 3 out of 4 weeks, and weekly bavituximab (3 mg/kg) for 4 out of 4 weeks. Each cycle was defined as 4 weeks of therapy. Microparticles were isolated from peripheral blood and examined by flow cytometric phenotyping. Leukocyte, endothelial cell, and activated platelet microparticles were quantified and longitudinal trends analyzed. Five patients have been enrolled to date with additional patients accruing. At presentation, the longitudinal trends in microparticle formation from platelets, endothelial cells, and leukocytes will be presented in response to weekly Paclitaxel versus combined Paclitaxel and Bavituximab therapy.
Download Full 6-Page Note with Important Disclosures: Morning Note 03-01-12 PPHM