Kite’s Tecartus® Demonstrates Sustained Overall Survival in Adult Patients With Relapsed/Refractory B-cell Acute Lymphoblastic Leukemia

Rhea-AI Summary

Kite, a Gilead company, announced long-term survival data from the ZUMA-3 study of Tecartus® (brexucabtagene autoleucel) in adults with relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL). The study's four-year follow-up revealed a median overall survival (OS) of 25.6 months and a 40% OS rate at 48 months. The data, presented at the 2024 ASCO Annual Meeting, showed consistent safety with previous analyses. Tecartus demonstrated survival benefits regardless of age, prior treatments, or subsequent allogeneic stem cell transplant status. Notably, patients with fewer prior therapies had better outcomes. No new adverse events were reported since the three-year analysis.

Positive

• Four-year follow-up shows a median OS of 25.6 months.
• 40% OS rate at 48 months for treated patients.
• Consistent safety profile with no new adverse events reported.
• Survival benefit observed regardless of age, prior treatment, or transplant status.
• Patients with fewer prior therapies had a median OS of 60.4 months.

Negative

• High rates of serious adverse reactions including cytokine release syndrome and neurologic toxicities.
• Grade 3 or higher infections occurred in 30% of patients.
• Median OS in patients with two or more prior therapies was 25.4 months, showing efficacy in heavily pre-treated patients.
• High rates of prolonged cytopenias, particularly neutropenia and thrombocytopenia.

Insights

Oncology Doctor

The updated data from the ZUMA-3 study offers promising insights into the long-term efficacy of Tecartus for individuals with relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL). With a median overall survival (OS) of 25.6 months and a 40% survival rate at four years, Tecartus demonstrates a substantial improvement over the historically poor prognosis of less than eight months for these patients. The durability of the response, irrespective of age, prior treatment, or subsequent stem cell transplant status, underscores the potential of Tecartus as a game-changer in CAR T-cell therapies.

However, the treatment does have significant safety considerations, particularly concerning cytokine release syndrome (CRS) and neurological toxicities, which require careful monitoring and management. Despite these risks, the long-term survival benefits are noteworthy, suggesting Tecartus could significantly enhance the quality of life for patients with this aggressive leukemia type.

Financial Analyst

From a financial perspective, the four-year survival data for Tecartus is a positive development for Kite and its parent company, Gilead Sciences. Improved long-term data on Tecartus may lead to increased adoption among oncologists, potentially boosting revenue. The median OS of 25.6 months and the 40% four-year survival rate is particularly compelling, given the poor outcomes typically associated with R/R B-ALL.

This data could reinforce confidence among investors in Gilead’s oncology portfolio. However, it is important to consider the cost of CAR T-cell therapies, which are typically high and weigh the potential market penetration against these costs. Additionally, the ongoing need for careful patient monitoring and management of possible severe side effects, such as CRS and neurological toxicities, may impact the overall healthcare costs associated with Tecartus treatment.

Medical Research Analyst

The ZUMA-3 study data highlights Tecartus as an important advancement in the field of hemato-oncology. The overall survival metrics reflect a significant stride in CAR T-cell therapy's potential. The survival benefit irrespective of prior treatments or subsequent stem cell transplant status is particularly intriguing and suggests that Tecartus could be a viable option for a broader patient population.

Furthermore, the absence of new adverse events since the three-year analysis supports the treatment's safety profile over a prolonged period, which is a significant consideration for both clinicians and patients. However, the small sample size and patient characteristic imbalances in the sub-analyses (like those with or without prior blinatumomab) do limit the generalizability of these findings. To build on these promising results, further studies with larger, more diverse cohorts will be essential.

-- After More Than Four Years of Follow-up in the Pivotal ZUMA-3 Study, Median Overall Survival (OS) was 26 Months and the OS Rate was 40% at 48 Months --

-- Survival Benefit was Seen Regardless of Age, Prior Treatment or Subsequent Allogeneic Stem Cell Transplant Status --

-- Data Being Presented at the 2024 American Society of Clinical Oncology Annual Meeting --

SANTA MONICA, Calif.--(BUSINESS WIRE)-- Kite, a Gilead Company (Nasdaq: GILD), today announced updated, four-year overall survival (OS) data from the pivotal ZUMA-3 study evaluating the CAR T-cell therapy Tecartus^® (brexucabtagene autoleucel) in adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL). The findings showed a median OS of 25.6 months and a four-year OS rate of 40% (95% CI, 28-52) in all treated patients with a safety profile consistent with that observed in the three-year analysis. The results were presented today in a poster presentation (Abstract #6531) at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting.

“B-cell acute lymphoblastic leukemia is a rare and aggressive form of blood cancer associated with poor prognosis – with a median survival of less than eight months in those with relapsed or refractory disease – so to see 40% of these patients treated with one infusion of Brexu-cel still alive after four years is meaningful indeed,” said Olalekan O. Oluwole, MBBS, MD, MPH, Associate Professor of Medicine, Hematology/Oncology at Vanderbilt University and primary investigator for the study. “Additionally, the duration of response and survival benefits were demonstrated regardless of the patients’ subsequent allogeneic stem cell transplant status.”

In the poster being presented, patients treated with the pivotal dose of Tecartus in the pooled analysis Phase 1 and 2 (n=78), the median follow-up time was 53.6 months (range 44.7-82.3) with 4-year minimum follow-up. Among all treated patients, the median OS was 25.6 months, and 47 months in patients with complete remission or complete remission with incomplete hematologic recovery (n=57), the primary endpoint. In patients <26 years (n=15), median OS (95% CI) was 23.2 months (9.0-NE) and was 26.0 months (15.9-NE) in patients ≥26 years (n=63), OS was a key secondary endpoint. Median OS (95% CI) in patients with one prior therapy (n=15) was 60.4 months (7.6-NE) and was 25.4 months (15.9-47.0) in patients with ≥2 prior therapies (n=63).

Medians for OS (95% CI) in patients with (n=38) and without (n=40) prior blinatumomab were 15.9 (8.3-26.0) and 60.4 months (18.6-NE), respectively (unbalanced patient characteristics and small numbers limit interpretation of these results). Median OS (95% CI) was 36.3 months (10.2-NE) in responders who went on to subsequent allogeneic stem cell transplant (n=14) and 60.4 months (23.2-NE) in those who did not (n=43). No new adverse events or deaths occurred since the three-year analysis. Rates of infection were Grade ≥3 and higher in patients over 26 years and in patients with prior blinatumomab.

“We are pleased that Tecartus continues to demonstrate improved survival outcomes after four years of follow-up in adult patients who would otherwise have very few treatment options,” said Ibrahim Elhoussieny, MD, Vice President, Medical Affairs, Kite. “Notably, Tecartus numerically improved overall survival particularly for patients when given in earlier lines of therapy, and is an important treatment option for the large portion of adult B-ALL patients who relapse or are refractory to other treatments. We look forward to continuing to improve survival in more people with this challenging blood cancer.”

About ZUMA-3

ZUMA-3 is an ongoing international multicenter (US, Canada, Europe), single arm, open label, registrational Phase 1/2 study of Tecartus in adult patients (≥18 years old) with ALL whose disease is refractory to or has relapsed following standard systemic therapy or hematopoietic stem cell transplantation. The primary endpoint is the rate of overall complete remission or complete remission with incomplete hematological recovery by central assessment. Duration of remission and relapse-free survival, overall survival, minimal residual disease (MRD) negativity rate, and alloSCT rate were assessed as secondary endpoints.

About Acute Lymphoblastic Leukemia

ALL is an aggressive and rare type of blood cancer that can also involve the lymph nodes, spleen, liver, central nervous system and other organs. While 80% of ALL occurs in children, it represents a devastating disease in adults. In adults, B-cell precursor ALL is the most common form, accounting for 75% of cases. Survival rates in adults with R/R B-ALL are poor, with median OS at less than eight months.

About Tecartus

Please see full FDA Prescribing Information, including BOXED WARNING and Medication Guide. Tecartus is a CD19-directed genetically modified autologous T cell immunotherapy indicated for the treatment of:

• Adult patients with relapsed or refractory mantle cell lymphoma (MCL).
  This indication is approved under accelerated approval based on overall response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in a confirmatory trial.
• Adult patients with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).

U.S. IMPORTANT SAFETY INFORMATION

BOXED WARNING: CYTOKINE RELEASE SYNDROME, NEUROLOGIC TOXICITIES, and SECONDARY HEMATOLOGICAL MALIGNANCIES

• Cytokine Release Syndrome (CRS), including life-threatening reactions, occurred in patients receiving Tecartus. Do not administer Tecartus to patients with active infection or inflammatory disorders. Treat severe or life-threatening CRS with tocilizumab or tocilizumab and corticosteroids.
• Neurologic toxicities, including life-threatening reactions, occurred in patients receiving Tecartus, including concurrently with CRS or after CRS resolution. Monitor for neurologic toxicities after treatment with Tecartus. Provide supportive care and/or corticosteroids as needed.
• T-cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T-cell immunotherapies.
• Tecartus is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Yescarta and Tecartus REMS Program.

Ensure that a minimum of two doses of tocilizumab are available for each patient prior to infusion of Tecartus. Following infusion, monitor patients for signs and symptoms of CRS daily for at least seven days at the certified healthcare facility, and for four weeks thereafter. Counsel patients to seek immediate medical attention should signs or symptoms of CRS occur at any time. At the first sign of CRS, institute treatment with supportive care, tocilizumab, or tocilizumab and corticosteroids as indicated.

Neurologic Events, including those that were fatal or life-threatening, occurred following treatment with Tecartus. Neurologic events occurred in 87% (68/78) of patients with ALL, including ≥ Grade 3 in 35% of patients. The median time to onset for neurologic events was seven days (range: 1 to 51 days) with a median duration of 15 days (range: 1 to 397 days) in patients with ALL. For patients with MCL, 54 (66%) patients experienced CRS before the onset of neurological events. Five (6%) patients did not experience CRS with neurologic events and eight patients (10%) developed neurological events after the resolution of CRS. Neurologic events resolved for 119 out of 134 (89%) patients treated with Tecartus. Nine patients (three patients with MCL and six patients with ALL) had ongoing neurologic events at the time of death. For patients with ALL, neurologic events occurred before, during, and after CRS in 4 (5%), 57 (73%), and 8 (10%) of patients; respectively. Three patients (4%) had neurologic events without CRS. The onset of neurologic events can be concurrent with CRS, following resolution of CRS or in the absence of CRS.

The most common neurologic events (>10%) were similar in MCL and ALL and included encephalopathy (57%), headache (37%), tremor (34%), confusional state (26%), aphasia (23%), delirium (17%), dizziness (15%), anxiety (14%), and agitation (12%). Serious events including encephalopathy, aphasia, confusional state, and seizures occurred after treatment with Tecartus.

Monitor patients daily for at least seven days for patients with MCL and at least 14 days for patients with ALL at the certified healthcare facility and for four weeks following infusion for signs and symptoms of neurologic toxicities and treat promptly.

REMS Program: Because of the risk of CRS and neurologic toxicities, Tecartus is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Yescarta and Tecartus REMS Program which requires that:

• Healthcare facilities that dispense and administer Tecartus must be enrolled and comply with the REMS requirements. Certified healthcare facilities must have on-site, immediate access to tocilizumab, and ensure that a minimum of two doses of tocilizumab are available for each patient for infusion within two hours after Tecartus infusion, if needed for treatment of CRS.
• Certified healthcare facilities must ensure that healthcare providers who prescribe, dispense, or administer Tecartus are trained in the management of CRS and neurologic toxicities. Further information is available at www.YescartaTecartusREMS.com or 1-844-454-KITE (5483).

Hypersensitivity Reactions: Serious hypersensitivity reactions, including anaphylaxis, may occur due to dimethyl sulfoxide (DMSO) or residual gentamicin in Tecartus.

Severe Infections: Severe or life-threatening infections occurred in patients after Tecartus infusion. Infections (all grades) occurred in 56% (46/82) of patients with MCL and 44% (34/78) of patients with ALL. Grade 3 or higher infections, including bacterial, viral, and fungal infections, occurred in 30% of patients with ALL and MCL. Tecartus should not be administered to patients with clinically significant active systemic infections. Monitor patients for signs and symptoms of infection before and after Tecartus infusion and treat appropriately. Administer prophylactic antimicrobials according to local guidelines.

Febrile neutropenia was observed in 6% of patients with MCL and 35% of patients with ALL after Tecartus infusion and may be concurrent with CRS. The febrile neutropenia in 27 (35%) of patients with ALL includes events of “febrile neutropenia” (11 (14%)) plus the concurrent events of “fever” and “neutropenia” (16 (21%)). In the event of febrile neutropenia, evaluate for infection and manage with broad spectrum antibiotics, fluids, and other supportive care as medically indicated.

In immunosuppressed patients, life-threatening and fatal opportunistic infections have been reported. The possibility of rare infectious etiologies (e.g., fungal and viral infections such as HHV-6 and progressive multifocal leukoencephalopathy) should be considered in patients with neurologic events and appropriate diagnostic evaluations should be performed.

Hepatitis B virus (HBV) reactivation, in some cases resulting in fulminant hepatitis, hepatic failure, and death, can occur in patients treated with drugs directed against B cells. Perform screening for HBV, HCV, and HIV in accordance with clinical guidelines before collection of cells for manufacturing.

Prolonged Cytopenias: Patients may exhibit cytopenias for several weeks following lymphodepleting chemotherapy and Tecartus infusion. In patients with MCL, Grade 3 or higher cytopenias not resolved by Day 30 following Tecartus infusion occurred in 55% (45/82) of patients and included thrombocytopenia (38%), neutropenia (37%), and anemia (17%). In patients with ALL who were responders to Tecartus treatment, Grade 3 or higher cytopenias not resolved by Day 30 following Tecartus infusion occurred in 20% (7/35) of the patients and included neutropenia (12%) and thrombocytopenia (12%); Grade 3 or higher cytopenias not resolved by Day 60 following Tecartus infusion occurred in 11% (4/35) of the patients and included neutropenia (9%) and thrombocytopenia (6%). Monitor blood counts after Tecartus infusion.

Hypogammaglobulinemia: B cell aplasia and hypogammaglobulinemia can occur in patients receiving treatment with Tecartus. Hypogammaglobulinemia was reported in 16% (13/82) of patients with MCL and 9% (7/78) of patients with ALL. Monitor immunoglobulin levels after treatment with Tecartus and manage using infection precautions, antibiotic prophylaxis, and immunoglobulin replacement.

The safety of immunization with live viral vaccines during or following Tecartus treatment has not been studied. Vaccination with live virus vaccines is not recommended for at least six weeks prior to the start of lymphodepleting chemotherapy, during Tecartus treatment, and until immune recovery following treatment with Tecartus.

Secondary Malignancies: Patients treated with TECARTUS may develop secondary malignancies. T-cell malignancies have occurred following treatment of hematologic malignancies with BCMA- and CD19-directed genetically modified autologous T-cell immunotherapies. Mature T-cell malignancies, including CAR-positive tumors, may present as soon as weeks following infusions, and may include fatal outcomes. Monitor life-long for secondary malignancies. In the event that a secondary malignancy occurs, contact Kite at 1-844-454-KITE (5483) to obtain instructions on patient samples to collect for testing.

Effects on Ability to Drive and Use Machines: Due to the potential for neurologic events, including altered mental status or seizures, patients are at risk for altered or decreased consciousness or coordination in the 8 weeks following Tecartus infusion. Advise patients to refrain from driving and engaging in hazardous activities, such as operating heavy or potentially dangerous machinery, during this period.

Adverse Reactions: The most common non-laboratory adverse reactions (≥ 20%) were fever, cytokine release syndrome, hypotension, encephalopathy, tachycardia, nausea, chills, headache, fatigue, febrile neutropenia, diarrhea, musculoskeletal pain, hypoxia, rash, edema, tremor, infection with pathogen unspecified, constipation, decreased appetite, and vomiting. The most common serious adverse reactions (≥ 2%) were cytokine release syndrome, febrile neutropenia, hypotension, encephalopathy, fever, infection with pathogen unspecified, hypoxia, tachycardia, bacterial infections, respiratory failure, seizure, diarrhea, dyspnea, fungal infections, viral infections, coagulopathy, delirium, fatigue, hemophagocytic lymphohistiocytosis, musculoskeletal pain, edema, and paraparesis.

About Kite

Kite, a Gilead Company, is a global biopharmaceutical company based in Santa Monica, California, focused on cell therapy to treat and potentially cure cancer. As the global cell therapy leader, Kite has treated more patients with CAR T-cell therapy than any other company. Kite has the largest in-house cell therapy manufacturing network in the world, spanning process development, vector manufacturing, clinical trial supply and commercial product manufacturing.

About Gilead Sciences

Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis and cancer. Gilead operates in more than 35 countries worldwide, with headquarters in Foster City, California. Gilead Sciences acquired Kite in 2017.

Forward-Looking Statements

This press release includes forward-looking statements, within the meaning of the Private Securities Litigation Reform Act of 1995 that are subject to risks, uncertainties and other factors, including the ability of Gilead and Kite to initiate, progress or complete clinical trials within currently anticipated timelines or at all, and the possibility of unfavorable results from ongoing or additional clinical studies, including those involving Tecartus (such as the ZUMA-3 study); the risk that physicians may not see the benefits of prescribing Tecartus; and any assumptions underlying any of the foregoing. These and other risks, uncertainties and factors are described in detail in Gilead’s Quarterly Report on Form 10-Q for the quarter ended March 31, 2024, as filed with the U.S. Securities and Exchange Commission. These risks, uncertainties and other factors could cause actual results to differ materially from those referred to in the forward-looking statements. All statements other than statements of historical fact are statements that could be deemed forward-looking statements. The reader is cautioned that any such forward-looking statements are not guarantees of future performance and is cautioned not to place undue reliance on these forward-looking statements. All forward-looking statements are based on information currently available to Gilead and Kite, and Gilead and Kite assume no obligation and disclaim any intent to update any such forward-looking statements.

Kite, the Kite logo, Tecartus, and GILEAD are trademarks of Gilead Sciences, Inc., or its related companies.

For more information about Kite, please visit the company’s website at www.kitepharma.com or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000. Follow Kite on social media on X (@KitePharma) and LinkedIn.

View source version on businesswire.com: https://www.businesswire.com/news/home/20240603095365/en/

Jacquie Ross, Investors

investor_relations@gilead.com

Meaghan Smith, Gilead Media

Public_Affairs@gilead.com

Source: Gilead Sciences, Inc.

FAQ

What is the survival rate of Tecartus treatment in R/R B-ALL patients?

The four-year overall survival rate is 40%.

What was the median overall survival in the ZUMA-3 study for Tecartus?

The median overall survival was 25.6 months.

Were there any new adverse events reported for Tecartus in the long-term study?

No new adverse events were reported since the three-year analysis.

How does Tecartus perform in patients with fewer prior therapies?

Patients with one prior therapy had a median OS of 60.4 months.

What are the common serious adverse reactions to Tecartus?

Common serious adverse reactions include cytokine release syndrome, neurologic toxicities, and infections.

What was the impact of Tecartus on patients' overall survival based on age?

Patients under 26 years had a median OS of 23.2 months, while patients 26 years and older had a median OS of 26.0 months.

How did Tecartus perform in patients with prior blinatumomab treatment?

Patients with prior blinatumomab had a median OS of 15.9 months, compared to 60.4 months in those without prior blinatumomab.