BeyondSpring Presents Efficacy/Safety Results from a Phase 2 Study of Pembrolizumab plus Plinabulin/Docetaxel in Metastatic NSCLC after Progressing on First-Line Immune Checkpoint Inhibitors at ESMO Congress 2024

Rhea-AI Summary

BeyondSpring (NASDAQ: BYSI) presented interim phase 2 data on the 303 Study at ESMO Congress 2024, evaluating a triple combination regimen of pembrolizumab plus plinabulin/docetaxel in 2L/3L NSCLC patients after progression on 1L PD-1/L1 inhibitors. The study showed promising results:

- Median PFS of 8.63 months (compared to historical 3-4 months)
- Disease Control Rate of 89.5%
- Confirmed ORR of 21.1%
- 6-month PFS rate: 67.1%; 12-month PFS rate: 49.2%
- Median Duration of Response: 11.40 months

The combination was well-tolerated, with 52.6% of patients experiencing grade 3 or higher treatment-related adverse effects. No treatment-related deaths were reported. The study is ongoing at Peking Union Medical College Hospital, aiming to enroll 47 patients total.

Positive

• Median PFS of 8.63 months, doubling historical controls of 3-4 months
• High Disease Control Rate of 89.5%
• Confirmed ORR of 21.1%, higher than historical docetaxel ORR of 12.8%
• Median Duration of Response of 11.40 months
• Well-tolerated combination with no treatment-related deaths

Negative

• 52.6% of patients experienced grade 3 or higher treatment-related adverse effects

Insights

Oncology Researcher

This phase 2 study presents promising results for a novel triple combination therapy in previously treated metastatic NSCLC patients. The regimen of pembrolizumab, plinabulin and docetaxel showed a median PFS of 8.63 months and an impressive disease control rate of 89.5%. These outcomes are notably superior to historical controls, which typically show 3-4 months PFS with standard treatments.

The 21.1% confirmed ORR and 11.40 months median duration of response further underscore the potential of this combination. Particularly intriguing is plinabulin's role in potentially overcoming acquired resistance to immune checkpoint inhibitors through its effect on dendritic cell maturation. This mechanism could address a significant challenge in NSCLC treatment.

While these results are encouraging, it's important to note the small sample size (n=19) and the need for further validation in larger trials. The 52.6% grade 3 or higher treatment-related adverse effects also warrant careful consideration of the risk-benefit profile in future studies.

Market Analyst

BeyondSpring's presentation of these positive interim results could significantly impact investor sentiment. The company's focus on addressing the unmet need in NSCLC patients who have progressed after first-line immunotherapy positions it well in a competitive oncology market.

Key points for investors:

• Collaboration with Merck (MSD) adds credibility and potential for future partnerships.
• The 89.5% disease control rate is a standout figure that could drive interest.
• If confirmed in larger trials, this combination could become a new standard of care, representing a substantial market opportunity.

However, investors should remain cautious due to the early stage of research and potential challenges in larger trials. The stock may see increased volatility as the market digests this information and awaits further data. Long-term potential looks promising, but short-term risks remain due to the nature of clinical development in oncology.

Median PFS at 8.63 months and Disease Control Rate of 89.5% in Previously Treated NSCLC Patients after Progression on PD-1/L1 Monotherapy or in Combination with Platinum Doublet Chemotherapy

FLORHAM PARK, N.J., Sept. 16, 2024 (GLOBE NEWSWIRE) -- BeyondSpring Inc. (NASDAQ: BYSI) (“BeyondSpring” or the “Company”), a clinical-stage global biopharmaceutical company developing innovative cancer therapies, today presented interim phase 2 data on the 303 Study, a study in 2L/3L non-small cell lung cancer (NSCLC) after disease progression on 1L PD-1/L1 inhibitors with and without chemotherapy, with financial support from Merck & Co., Inc’s (NYSE: MRK, known as MSD outside of the United States and Canada) Investigator Studies Program and provision of study drug, at the European Society for Medical Oncology (ESMO) Congress 2024, on September 14, 2024 in Barcelona, Spain.

Docetaxel remains the standard of care for patients with 2L/3L NSCLC without targetable alterations who progress on 1L immune checkpoint inhibitors (ICI) with and without standard chemotherapy, with an overall response rate (ORR) of 12.8% and median PFS (mPFS) of 3.7 months in TROPION Lung-01 phase 3 studies. In metastatic NSCLC resistant to previous PD-1/L1 therapy¹, PD-L1 and CTLA-4 inhibition alone or in combination with hypofractionated radiotherapy produced limited clinical benefits with ~11.5% ORR.

This investigator-initiated, single-arm, open-label, phase 2 study (KeyPelms-004 or 303 Study) evaluates the efficacy and safety of a triple combination regimen of pembrolizumab plus plinabulin/docetaxel (NCT05599789). The study intends to enroll a total of 47 patients and is ongoing at Peking Union Medical College Hospital, Beijing, China with the principal investigator Dr. Mengzhao Wang, Chief of the Department of Respiratory and Critical Care Medicine. Here, we report on a planned formal interim analysis of 19 patients.

At the database lock on 29 April 2024, 29 patients were enrolled and 19 were evaluable for stage 1 data analysis. All patients experienced disease progression after initial clinical benefit with ICI. Of the 19 evaluable patients (median age at 66.4 years; ranged 50-76 years), 68.4% were male and 31.6% were female; 57.9% were current or former smokers. Histology included 57.9% patients with non-squamous cell carcinoma and 42.1% with squamous cell carcinoma. The median follow-up was 8.67 months. Below is an efficacy summary table.

Primary Endpoint	Plinabulin + Pembrolizumab + Docetaxel (n=19)
Confirmed ORR (RECIST 1.1)	21.1%
Secondary Endpoints
Median PFS (RECIST 1.1)	8.63 M (6 M PFS rate: 67.1%; 12 M PFS rate: 49.2%)
Median OS (Overall Survival)	Not reached
Median DoR (Duration of Response)	11.40 M
Disease Control Rate (PR + SD > 4 months)	89.5%

• The combination was well tolerated. 52.6% of patients experienced grade 3 or higher treatment-related adverse effects. There were no treatment-related deaths.
  

“Plinabulin is a potent inducer of dendritic cell or DC maturation that leads to T cell activation. DC is the most potent antigen presenting cell (APC). This unique mechanism of action reinforces anti-tumor immune response with the potential to overcome acquired ICI resistance, which may derive from APC pathway mutation or T cell exhaustion. Compared to historical controls of 3-4 months of median PFS², this study’s early efficacy data doubled median PFS to 8.6 months, with an impressive disease control rate of almost 90%, which is encouraging and clinically meaningful for this severe unmet need,” said Dr. Mengzhao Wang, principal investigator at Peking Union Medical College Hospital.

ESMO Congress 2024 (1330P): Phase 2 Study of Pembrolizumab plus Plinabulin and Docetaxel for Patients (pts) with Metastatic NSCLC after Failure on First-line Immune Checkpoint Inhibitor Alone or Combination Therapy: Initial Efficacy and Safety Results on Immune Re-sensitization

• Presenter: Dr. Yan Xu, Peking Union Medical College Hospital, Beijing, China
• Poster Session: NSCLC, metastatic

References:

1. Schoenfeld et al. 2022, Lancet Oncology 23:279-291
2. TROPION Lung-01: https://doi.org/10.1200/JCO-24-01544

About Plinabulin
Plinabulin is a novel first-in-class dendritic cell maturation therapeutic with durable anti-cancer benefit observed across multiple clinical studies. As a reversible binder at a distinct tubulin pocket, plinabulin does not change tubulin dynamics or antagonize tubulin stabilizing agents, such as docetaxel, which contributes to its differentiated activity and tolerability compared to other tubulin binders. In addition, plinabulin significantly reduces chemotherapy induced neutropenia and could thereby increase docetaxel tolerability. Over 700 patients have been treated with plinabulin with good tolerability.

About KeyPelms-004 or 303 Study
303 Study is an open-label, single-arm Phase 2 Study of Plinabulin plus docetaxel and pembrolizumab for previously treated patients with metastatic NSCLC and progressive disease after anti-PD-(L)1 inhibitor alone or in combination with platinum-doublet chemotherapy. This study evaluates the efficacy and safety of this triple combination and is being conducted at Peking Union Medical College Hospital, Beijing, China. The regimen includes Pembrolizumab 200 mg IV every 3 weeks (Q3W) on Day 1, Docetaxel 75 mg/m2 IV Q3W on Day 1 and Plinabulin 30mg/m2 IV Q3W on Day 1 in a 21-day cycle. The primary endpoint is investigator-based ORR (RECIST 1.1). The secondary endpoints include PFS, OS, DoR, and safety. The study intends to enroll 47 patients with a formal interim analysis of 19 patients enrolled. The study is funded by Merck’s Investigator Studies Program with provision of study drug and financial support.
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About BeyondSpring
BeyondSpring is a global clinical-stage biopharmaceutical company developing innovative therapies to improve clinical outcomes for patients with high unmet medical needs. The Company is advancing its first-in-class lead asset, Plinabulin, a potent inducer of dendritic cell maturation, in late-stage clinical development as a direct anti-cancer agent in NSCLC and a variety of cancer indications. BeyondSpring’s pipeline also includes three preclinical immuno-oncology assets. Additionally, BeyondSpring is an equity owner of SEED Therapeutics, Inc which is a pioneer in Target Protein Degradation technology and its application in innovative drug development. Learn more by visiting https://beyondspringpharma.com.

Investor Contact:
IR@beyondspringpharma.com

Media Contact:
PR@beyondspringpharma.com

FAQ

What were the key results of BeyondSpring's (BYSI) Phase 2 study presented at ESMO Congress 2024?

The key results included a median PFS of 8.63 months, a Disease Control Rate of 89.5%, and a confirmed ORR of 21.1% in 2L/3L NSCLC patients after progression on 1L PD-1/L1 inhibitors.

How does the efficacy of BYSI's triple combination compare to historical controls in NSCLC treatment?

The study's median PFS of 8.63 months doubled the historical controls of 3-4 months, and the ORR of 21.1% was higher than the historical docetaxel ORR of 12.8% in similar patient populations.

What is the safety profile of BeyondSpring's (BYSI) triple combination therapy in the Phase 2 study?

The combination was well-tolerated, with 52.6% of patients experiencing grade 3 or higher treatment-related adverse effects. Importantly, there were no treatment-related deaths reported.

What is the mechanism of action of plinabulin in BeyondSpring's (BYSI) triple combination therapy?

Plinabulin is a potent inducer of dendritic cell maturation, leading to T cell activation. This mechanism reinforces anti-tumor immune response and potentially overcomes acquired immune checkpoint inhibitor resistance.