Cornerstone Pharmaceuticals commences Phase I clinical trial of CPI-613 for the treatment of B-cell Non-Hodgkin lymphoma
Cornerstone Pharmaceuticals, Inc., a clinical stage company and leader in the growing field of cancer metabolism-based therapeutics, has announced the initiation of a Phase I clinical trial assessing the safety and efficacy of escalating doses of CPI-613, in combination with bendamustine and rituximab, in patients with relapsed or refractory B-cell Non-Hodgkin lymphoma (NHL). CPI-613 is the company’s lead Altered Energy Metabolism Directed (AEMD) drug candidate, a first-in-class anticancer compound designed to disrupt the altered energy-production pathways in cancer cells by targeting mitochondrial metabolism.
Steve Carchedi, Chief Executive Officer of Cornerstone, said, “Initiating this Phase I trial marks the fourth ongoing trial evaluating our lead compound CPI-613 in advanced hematologic malignancies and overall the eighth study being sponsored by notable, National Cancer Institute-designated comprehensive cancer center, Wake Forest Baptist Medical Center. Furthermore, this study represents the continued interest in CPI-613 by the medical community as a unique approach to fighting cancer by blocking the energy producing pathways that support the growth and development of many cancer cells. We look forward to the active enrollment of B-cell Non-Hodgkin Lymphoma patients in this study as we seek to demonstrate the potential of our lead product candidate as part of a combination therapy.”
NHL is the most common cancer of the lymphatic system, a part of the immune system, with more than 320,000 Americans suffering from the disease and over 65,000 cases diagnosed each year in the United States.[i] B-cell NHL is the most common form of NHL, comprising more than 85% of all NHL cases.i
The single site study, sponsored by Wake Forest Baptist Medical Center and in collaboration with the National Cancer Institute, is a Phase I, open label, dose-escalating study designed to establish the maximum tolerated dose of CPI-613 when used in combination with bendamustine and rituximab. Secondary outcomes including response rate, overall survival rate, disease control rate and progression-free survival will also be assessed.
Bendamustine is a chemotherapy drug that has shown single agent activity in heavily pretreated patients with rituximab-refractory (resistant), indolent NHL, showing an overall response rate of approximately 77% in clinical trials.[ii] An immunotherapy agent, rituximab was the first monoclonal antibody approved for cancer treatment.[iii] It targets a specific antigen called CD-20 found on most B-cell lymphomasii and has been shown to result in a 40-50% response rate in patients who relapse with indolent B-cell lymphomas.[iv]
Zanetta Lamar, MD, of Wake Forest Baptist Medical Center and the Principal Investigator for the trial, commented, “Survival rates for Non-Hodgkin Lymphoma differ extensively and largely depend on lymphoma type, stage and age of the patient. The disease can be devastating for patients, which is reflected in an overall 5-year relative survival rate of approximately 69% and a 10-year relative survival rate of approximately 58%.[v] In this study, our goal is to determine if the combination of chemotherapy, immunotherapy and CPI-613 as a targeted anti-cancer metabolism therapy is effective and safe for patients with relapsed of refractory B-cell Non-Hodgkin Lymphoma.”
CPI-613 is the lead drug candidate from Cornerstone’s proprietary AEMD platform. Cornerstone’s AEMD drug platform disrupts the metabolism (energy producing) pathways that support the growth and development of many types of cancer cells. CPI-613 has been shown in-vitro to be highly selective in inducing the simultaneous inhibition of two key mitochondrial enzymes involved in cancer cell metabolism: pyruvate dehydrogenase (PDH) and alpha ketoglutarate dehydrogenase (KGDH). Disruption of PDH and KGDH function cuts off the tumor’s energy supply, culminating in cell death. CPI-613 is currently being evaluated in several Phase I, I/II and II human clinical trials in solid tumors and hematological malignancies.
[i] Lymphoma Research Foundation. “Non-Hodgkin Lymphoma.” Available at: http://www.lymphoma.org/site/pp.aspc=bkLTKaOQLmK8E&b=6300139&gclid=CKvPttz01sECFeHm7AodBioADg#Overview
[ii] Journal of Clinical Oncology. “Bendamustine in Patients With Rituximab-Refractory Indolent and Transformed Non-Hodgkin’s Lymphoma: Results From a Phase II Multicenter, Single-Agent Study.” 2008. Available online: http://jco.ascopubs.org/content/26/2/204.full
[iii] University of Maryland Medical Center. “Non-Hodgkin Lymphoma.” Available at: http://umm.edu/health/medical/reports/articles/nonhodgkins-lymphoma
[iv] National Cancer Institute. “Treatment for Indolent, Recurrent Adult NHL.” Available at: http://www.cancer.gov/cancertopics/pdq/treatment/adult-non-hodgkins/HealthProfessional/page10
[v] American Cancer Society. “Non-Hodgkin Lymphoma.” Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003126-pdf.pdf