squamous cell carcinoma of the anus

Having an in-house PD-1 allows Incyte to test novel combinations with fewer costs and faster R&D timelines than it otherwise could, CEO Hervé Hoppenot said. Incyte’s late PD-1 entrant Zynyz has chalked up a unique clinical win. Yet company CEO Hervé Hoppenot views the antibody molecule not necessarily as a major revenue driver but as an aide to the company’s oncology pipeline.In a first-in-class win, Zynyz and chemotherapy slashed the risk of progression or death by 37% compared with chemo alone in patients with previously untreated, inoperable advanced squamous cell anal carcinoma (SCAC), according to results from the phase 3 POD1UM-303 trial presented at the annual European Society for Medical Oncology Congress (ESMO).Patients in the Zynyz arm went a median 9.3 months without tumor progression versus 7.4 months for the control group.Incyte plans to file Zynyz with the FDA by the end of the year in the indication, potentially making it the first PD-1 inhibitor approved for first-line anal cancer, Hoppenot said in an interview with Fierce Pharma.Anal cancer is not a large oncology market from a financial perspective, Hoppenot acknowledged. Zynyz’s target patient population in the potential use has about 10,000 new diagnoses per year across the U.S. and Europe.Even before an official FDA approval, some doctors have been using PD-1 inhibitors such as Merck & Co.’s Keytruda off label to treat anal cancer patients, Hoppenot explained. These uses aren’t always covered by insurance because of the absence of a regulatory approval. Now, Incyte hopes Zynyz can fill that niche market. The company’s original bid to get Zynyz approved as a post-chemo second-line anal cancer treatment was rejected by the FDA in 2021 because of a low tumor response rate and some patient deaths unrelated to disease progression.Besides the progression-free survival result in the POD1UM-303 trial, Zynyz has shown a preliminary trend toward improving patient survival. While the data are immature, Zynyz was linked to a 30% reduction in the risk of death, as patients who took the PD-1 agent survived a median 29.2 months versus 23 months for the control arm. Zynyz showed the advantage despite the trial allowing patients in the control arm to cross over to receive the PD-1 inhibitor after progression.Given the effect size and statistical considerations, Hoppenot said he’s confident that Zynyz will show a statistically significant overall survival benefit at the final analysis, which he said is coming “very soon” next year. The value of an in-house PD-1 drugZynyz entered the market last year with an FDA approval in Merkel cell carcinoma, another rare cancer type. In addition, Incyte announced a positive phase 3 trial, POD1UM-304, for Zynyz’s combination with chemo in first-line non-small cell lung cancer (NSCLC). But that indication faces some regulatory uncertainty given the trial’s comparator arm is chemotherapy alone, when Keytruda in combination with chemo is the current standard of care.Incyte will speak with the FDA to discuss the drug’s best path forward in first-line NSCLC, and the company is prioritizing the anal cancer filing first, Hoppenot said.Even if Zynyz eventually secures its first-line NSCLC nod, the drug’s market potential there seems limited given Keytruda’s dominance, and because the PD-1 king is nearing its patent cliff in 2028.Still, Zynyz could provide Incyte some returns in the niche indications. But, more importantly, “we believe that the optionality value of being able to develop our other pipeline products in combination with [an] approved PD-1 is very valuable,” Hoppenot said.Having an in-house PD-1 allows Incyte to test its novel agents in combinations without having to buy Keytruda, the CEO said. That translates into millions of dollars in savings and faster R&D timelines.“It’s basically giving me strategic flexibility in a way that would be very difficult if I had to do it with another product,” Hoppenot said. “So, after approval, is it going to be used with biosimilar of Keytruda? I don’t really care.” Oncology's place at IncyteGeneral oncology isn’t Incyte’s biggest business area. The company is best known for its Novartis-partnered myelofibrosis and graft-versus-host disease drug Jakafi, and that department just got bigger with the FDA approval for its Syndax-partnered CSF-1R antibody Niktimvo last month.Investors are also focused on the launch of Incyte’s Opzelura cream in autoimmune skin conditions and potential phase 3 readouts for the JAK1 inhibitor povorcitinib, which is being developed in a broad range of inflammatory diseases.In oncology beyond the bone marrow cancer myelofibrosis, Incyte in February gained full rights to CD19 antibody Monjuvi from former partner MorphoSys and in August announced a positive phase 3 readout in previously treated follicular lymphoma. At ESMO 2024, the company is also sharing for the first time early-phase data for its CDK2 inhibitor, INCB123667, in certain gynecological cancers. Still, Hoppenot argued that the three business areas are essentially equal in their importance to the company. The key is optionality, the CEO said, so that success from one of the drugs could more than compensate for the expected decline of Jakafi, which faces its own patent cliff in 2028.Incyte is interested in striking deals to access external innovations, having recently bought immunology biotech Escient Pharmaceuticals for $750 million. In oncology dealmaking, the company doesn’t have specific guardrails around tumor types but is more focused on whether the mechanism in question is unique, Hoppenot said.Being realistic about the price of a first- or best-in-class drug in late-stage development, Hoppenot said Incyte is focusing on earlier-stage assets, especially around targets where the company has done some internal research.

WILMINGTON, Del.--( BUSINESS WIRE )--Incyte (Nasdaq:INCY) today announced results from the Phase 3 POD1UM-303/InterAACT2 trial of retifanlimab (Zynyz ® ), a humanized monoclonal antibody targeting programmed death receptor-1 (PD-1), in combination with platinum-based chemotherapy (carboplatin–paclitaxel) for the treatment of adults with inoperable locally recurrent or metastatic squamous cell anal carcinoma (SCAC). These data were featured today in a Presidential Symposium (LBA 2) at the European Society for Medical Oncology (ESMO) Congress 2024, held in Barcelona and virtually. The POD1UM-303/InterAACT2 trial results build on previously announced topline results, showing that the study met its primary endpoint by demonstrating a statistically significant and clinically meaningful improvement in progression-free survival (PFS) in patients with SCAC not previously treated with systemic therapy, as assessed by blinded independent central review (BICR) using RECIST v1.1. Adding retifanlimab to standard of care chemotherapy resulted in a clinically meaningful 37% reduction in the risk of progression or death (Hazard Ratio [HR]: 0.63; 95% Confidence Interval [CI] (0.47, 0.84); P =0.0006). Patients in the retifanlimab and chemotherapy combination group achieved a median PFS of 9.3 months compared to 7.4 months for patients in the placebo combination group. “The POD1UM-303/InterAACT2 trial is the first and largest Phase 3 trial evaluating a checkpoint inhibitor for the treatment of patients with squamous cell anal carcinoma, a disease with significant medical need. The positive efficacy and safety data presented today at ESMO illustrate the potential of retifanlimab in combination with carboplatin and paclitaxel to become a new standard-of-care treatment for patients with advanced SCAC,” said Pablo J. Cagnoni, M.D., President and Head of Research and Development, Incyte. “We look forward to working with regulatory authorities to progress the supplemental Biologics License Application (sBLA) for retifanlimab and potentially bring the first-ever PD-1 or PD-L1 antibody to patients with SCAC.” The trial also showed improvement in key secondary endpoints, including: In an interim analysis for overall survival (OS), patients that received retifanlimab in combination with chemotherapy achieved an approximately 6-month improvement in median OS versus the placebo combination group, with a strong trend toward statistical significance (median OS 29.2 months vs. 23 months [HR: 0.70; 95% CI (0.49, 1.01); P =0.0273]; OS follow-up is ongoing). Overall response rate (ORR) and duration of response (DOR) by BICR each showed improvement in the retifanlimab and chemotherapy combination group versus the placebo combination group (ORR of 56% vs. 44% [95% CI (48, 64) and (36, 52), respectively; nominal P =0.0129]; DOR of 14 months vs. 7 months [95% CI (8.6, 22.2) and (5.6, 9.3), respectively]). Retifanlimab was generally well-tolerated, and safety was consistent with other chemotherapy plus checkpoint inhibitor regimens. The most common treatment-emergent adverse events (TEAEs) in the retifanlimab and chemotherapy combination group were anemia (66.2%), nausea (56.5%) and alopecia (51.3%). “Advanced SCAC is an often-neglected rare condition that, despite its increasing incidence and the often poor prognosis, has had the same standard-of-care treatment for decades with very few trials,” said Sheela Rao, M.D., Consultant Medical Oncologist, The Royal Marsden National Health Service Foundation Trust. “I believe the positive results from the POD1UM-303/InterAACT2 trial may provide a long-awaited, new treatment option with retifanlimab in addition to platinum-based chemotherapy for adults with inoperable locally recurrent or metastatic SCAC.” About Squamous Cell Anal Carcinoma (SCAC) Squamous cell anal carcinoma (SCAC) is an orphan disease for which the incidence is increasing approximately 3% per year, largely due to endemic human papillomavirus (HPV). 1,2,3,4 Human immunodeficiency virus (HIV) is an important amplifier of SCAC, as people with HIV are 25 to 35 times more likely to develop SCAC. 5,6 Patients with unresectable metastatic SCAC have poor 5-year survival, and there are currently no FDA-approved treatments for patients with advanced disease. 7 About POD1UM The POD1UM (PD1 Clinical Program in Multiple Malignancies) clinical trial program for retifanlimab includes POD1UM-303 and several other Phase 1, 2 and 3 studies for patients with solid tumors, including registration-directed trials evaluating retifanlimab as a monotherapy for patients with microsatellite instability-high endometrial cancer; and in combination with platinum-based chemotherapy for patients with non-small cell lung cancer. About POD1UM-303/InterAACT 2 POD1UM-303/InterAACT2 (NCT04472429) is a Phase 3, randomized, multicenter, double-blind, placebo-controlled study evaluating retifanlimab or placebo in combination with platinum-based chemotherapy (carboplatin and paclitaxel) in adult patients with inoperable locally recurrent or metastatic SCAC who have not been previously treated with systemic chemotherapy. During the blinded portion of the study, patients, including those with well-controlled HIV infection, were randomized 1:1 to receive retifanlimab 500 mg intravenously or placebo during each 28-day cycle for up to 6 months in combination with standard therapy of carboplatin and paclitaxel followed by monotherapy for up to 1-year total treatment. Crossover to active therapy retifanlimab was allowed for patients assigned to placebo upon verification of progression by blinded independent central review (BICR). The primary endpoint is progression-free survival (PFS) as determined by BICR using RECIST v1.1. The key secondary endpoint includes overall survival (OS). Secondary objectives include objective response rate (ORR), duration of response (DOR), disease control rate (DCR) by BICR, safety and pharmacokinetics. For more information about the study, please visit https://clinicaltrials.gov/study/NCT04472429 . About Zynyz ® (retifanlimab-dlwr) Zynyz (retifanlimab-dlwr), is an intravenous PD-1 inhibitor indicated in the U.S. for the treatment of adult patients with metastatic or recurrent locally advanced Merkel cell carcinoma (MCC). This indication is approved under accelerated approval based on tumor response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. Zynyz is marketed by Incyte in the U.S. In 2017, Incyte entered into an exclusive collaboration and license agreement with MacroGenics, Inc. for global rights to retifanlimab. Zynyz is a registered trademark of Incyte. Important Safety Information What is the most important information I should know about ZYNYZ? ZYNYZ is a medicine that may treat a certain type of skin cancer by working with your immune system. ZYNYZ can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen anytime during treatment or even after your treatment has ended. Call or see your healthcare provider right away if you develop any new or worsening signs or symptoms, including: Lung problems: cough, shortness of breath, chest pain Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; severe stomach-area (abdomen) pain or tenderness Liver problems: yellowing of your skin or the whites of your eyes; severe nausea or vomiting; pain on the right side of your stomach area (abdomen); dark urine (tea colored); bleeding or bruising more easily than normal Hormone gland problems: headaches that will not go away or unusual headaches; eye sensitivity to light; eye problems; rapid heartbeat; increased sweating; extreme tiredness; weight gain or weight loss; feeling more hungry or thirsty than usual; urinating more often than usual; hair loss; feeling cold; constipation; your voice gets deeper; dizziness or fainting; changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness Kidney problems: decrease in your amount of urine, blood in your urine, swelling of your ankles, loss of appetite Skin problems: rash; itching; skin blistering or peeling; painful sores or ulcers in your mouth or nose, throat, or genital area; fever or flu-like symptoms; swollen lymph nodes Problems can also happen in other organs and tissues. These are not all of the signs and symptoms of immune system problems that can happen with ZYNYZ. Call or see your healthcare provider right away for any new or worsening signs or symptoms, which may include: chest pain, irregular heartbeat, shortness of breath, or swelling of ankles confusion, sleepiness, memory problems, changes in mood or behavior, stiff neck, balance problems, tingling or numbness of the arms or legs double vision, blurry vision, sensitivity to light, eye pain, changes in eyesight persistent or severe muscle pain or weakness, muscle cramps low red blood cells, bruising Infusion reactions that can sometimes be severe. Signs and symptoms of infusion reactions may include: chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, feel like passing out, fever, back or neck pain Rejection of a transplanted organ. Your healthcare provider should tell you what signs and symptoms you should report and monitor you, depending on the type of organ transplant that you have had. Complications, including graft-versus-host disease, in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with ZYNYZ. Your healthcare provider will monitor you for these complications. Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with ZYNYZ. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may also need to delay or completely stop treatment with ZYNYZ if you have severe side effects. Before you receive ZYNYZ, tell your healthcare provider about all of your medical conditions, including if you: have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus have received an organ transplant have received or plan to receive a stem cell transplant that uses donor stem cells (allogeneic) have received radiation treatment to your chest area have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome are pregnant or plan to become pregnant. ZYNYZ can harm your unborn baby. Females who are able to become pregnant: — Your healthcare provider should do a pregnancy test before you start treatment with ZYNYZ. — You should use an effective method of birth control during your treatment and for 4 months after your last dose of ZYNYZ. Talk to your healthcare provider about birth control methods that you can use during this time. — Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with ZYNYZ. are breastfeeding or plan to breastfeed. It is not known if ZYNYZ passes into your breast milk. Do not breastfeed during treatment and for 4 months after your last dose of ZYNYZ. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. The most common side effects of ZYNYZ include tiredness, muscle and bone pain, itching, diarrhea, rash, fever, nausea These are not all the possible side effects of ZYNYZ. Call your doctor for medical advice about side effects. General information about the safe and effective use of ZYNYZ. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. If you would like more information about ZYNYZ, talk with your healthcare provider. You can ask your healthcare provider for information about ZYNYZ that is written for health professionals. You may report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch . You may also report side effects to Incyte Corporation at 1-855-463-3463. Please see the full Prescribing Information for ZYNYZ for additional Important Safety Information. About Incyte A global biopharmaceutical company on a mission to Solve On. , Incyte follows the science to find solutions for patients with unmet medical needs. Through the discovery, development and commercialization of proprietary therapeutics, Incyte has established a portfolio of first-in-class medicines for patients and a strong pipeline of products in Oncology and Inflammation & Autoimmunity. Headquartered in Wilmington, Delaware, Incyte has operations in North America, Europe and Asia. For additional information on Incyte, please visit Incyte.com or follow us on social media: LinkedIn , X , Instagram , Facebook , YouTube . Incyte Forward-looking Statements Except for the historical information set forth herein, the matters set forth in this press release, including statements regarding retifanlimab, the POD1UM-303 clinical trial, the potential for retifanlimab to become an approved treatment option for SCAC, Incyte’s plans to share data with the scientific community and Incyte’s expectations with respect to filing an sBLA or otherwise engaging with regulators, contain predictions, estimates and other forward-looking statements. These forward-looking statements are based on Incyte's current expectations and subject to risks and uncertainties that may cause actual results to differ materially, including unanticipated developments in and risks related to: unanticipated delays; further research and development and the results of clinical trials possibly being unsuccessful or insufficient to meet applicable regulatory standards or warrant continued development; the ability to enroll sufficient numbers of subjects in clinical trials; determinations made by the U.S. FDA and other regulatory authorities outside of the United States; the efficacy or safety of Incyte and its partners' products; the acceptance of Incyte and its partners' products in the marketplace; market competition; sales, marketing, manufacturing and distribution requirements; and other risks detailed from time to time in Incyte's reports filed with the Securities and Exchange Commission, including its annual report on Form-10K and its report on Form 10-Q for the quarter ended June 30, 2024. Incyte disclaims any intent or obligation to update these forward-looking statements. 1 Gondal TA, et al. Curr Oncol. 2023;30:3232-3250. 2 Islami F, et al. Int J Epidemiol. 2017;46:924-938. 3 Giuliano AR, et al. Int J Cancer . 2015;136:2752-2760. 4 Morris V, Eng C. J Gastrointest Oncol . 2016;7:721-726. 5 Wang C-CJ, et al. Surg Oncol Clin N Am. 2017;26:17-31. 6 NCCN Clinical Practice Guidelines in Oncology: Cancer in People with HIV. Version 1.2021. 2021. 7 Eng C, et al. Oncotarget 2014;5:11133-11142.

Incyte announced it is discontinuing five early-stage oncology programmes, including both of its oral PD-L1 inhibitors. The decision, revealed alongside the company's second-quarter earnings results, marks the second major pipeline cut for Incyte in just over a year, highlighting an increased focus on what the company deems "high-impact clinical programmes."Specifically, Incyte is pulling the plug on the PD-L1 candidates INCB99280 and INCB99318. Both were in Phase I testing for solid tumors, with INCB99280 having entered a trial late last year as part of a combination with Bristol Myers Squibb's Krazati (adagrasib) in adult patients harbouring a KRASG12C mutation.Incyte is also scrapping a pair of partnered LAG-3 drug candidates — the monoclonal antibody INCAGN2385 in development with Agenus and the LAG-3xPD-1 bispecific INCA32459 in collaboration with Merus. Rounding out the list is the TIM-3 monoclonal antibody INCAGN2390, another product that stems from the Agenus collaboration."The restructuring was driven primarily by two things," said R&D head Pablo Cagnoni during the company's earnings call. "One, data review of the existing programmes … as well as the continued progression and promising data that we're seeing from the earlier stage pipeline that is now becoming mid-stage and will start delivering important milestones in the next 18 months."Cagnoni denied that recent positive topline Phase III data for Zynyz (retifanlimab) in squamous cell anal carcinoma (SCAC) and non–small-cell lung cancer (NSCLC) was the reason behind the pipeline restructuring. The PODIUM-303 study in SCAC and PODIUM-304 study in NSCLC met their respective primary endpoints of progression-free survival and overall survival. Incyte says it will share more details in the second half.The latest round of cuts follows a similar action last year, when the company discontinued six drugs — one in warm autoimmune haemolytic anaemia and five for different types of cancer. At that time, CEO Hervé Hoppenot had stated the decision would allow Incyte "to optimise our allocation of resources on programmes that can have a high impact for patients and for Incyte."Incyte now says its refocused R&D efforts will prioritise several key areas, chiefly its inflammation and autoimmunity portfolio, including dermatology, with a spotlight on povorcitinib and recently acquired mast cell inhibitors from its $750-million Escient Pharmaceuticals buyout. The company will also maintain its commitment to myeloproliferative neoplasms and graft-versus-host disease, as well as select oncology programmes including a CDK2 inhibitor, a KRAS G12D inhibitor, and a TGFβR2×PD-1 bispecific antibody.