Millennium
Pharmaceuticals, Inc. (Nasdaq: MLNM) today reported presentation of results
from several clinical trials of VELCADE(R) (bortezomib) for Injection
combination therapies for treatment of relapsed multiple myeloma (MM). The
results of these trials showed overall response rates (ORR) as high as 93
percent and complete and near complete response (CR/nCR) rates as high as
43 percent. Based on an interim analysis of a randomized Phase III trial
announced by Johnson & Johnson Pharmaceutical Research & Development,
L.L.C. (J&JPRD), VELCADE in combination with DOXIL(R) (pegylated liposomal
doxorubicin) achieved a statistically significant improvement in time to
disease progression (TTP), the primary endpoint of the study, compared to
VELCADE alone. These data were presented at the 48th Annual Meeting of the
American Society of Hematology (ASH) being held December 9-12, 2006, in
Orlando, Fla.
"VELCADE is the market leader in relapsed multiple myeloma with the
strongest single-agent activity," said Nancy Simonian, M.D., Senior Vice
President and Chief Medical Officer, Millennium. "Our strategy is to build
on the strength of these data by adding novel and conventional therapies to
further increase the clinical benefit to patients."
The Combination of Pegylated Liposomal Doxorubicin and VELCADE
(Bortezomib) Significantly Improves Time to Progression of Patients with
Relapsed/Refractory Multiple Myeloma Compared with VELCADE (Bortezomib)
Alone: Results from a Planned Interim Analysis of a Randomized Phase III
Study.
The randomized, multicenter Phase III trial is evaluating the efficacy
and safety of VELCADE in combination with DOXIL in 646 relapsed MM patients
who had received at least one prior therapy. The primary endpoint of the
study is TTP as defined by the interval between the date of randomization
and the date of disease progression, including relapse after CR or death
due to disease progression. Patients were randomized in a one-to-one ratio.
Three hundred twenty-two patients received VELCADE at 1.3 mg/m2 on days 1,
4, 8, and 11 of the 21-day cycle. Three hundred twenty-four patients
received the same dose and schedule of VELCADE with the addition of DOXIL
at 30 mg/m2 given on day four of each cycle. Patients were treated for up
to eight cycles. Responses were assessed by European Group for Blood and
Marrow Transplantation (EBMT) criteria.
Based on the results of a planned interim analysis, an independent data
monitoring board determined that the pre-specified criterion of TTP was
met. As a result, patients receiving VELCADE in the study were offered the
opportunity to add DOXIL to their regimen. The trial is ongoing. The oral
presentation was given by Robert Orlowski, M.D., Ph.D., of the Lineberger
Comprehensive Cancer Center, University of North Carolina at Chapel Hill.
Interim results showed:
-- A statistically significant improvement in median TTP of 9.3 months was
achieved for patients receiving the combination compared to 6.5 months
for patients randomized to VELCADE alone (p= < 0.0001)
-- The overall survival analysis showed a trend favoring the combination
therapy group (a secondary endpoint of the study), but results had not
reached statistical significance at interim analysis, performed after
230 progression events
-- ORR (CR and PR) was 48 percent for patients who received the combination
compared to 43 percent for patients who received VELCADE alone
-- The most common adverse events were anemia, neutropenia and
thrombocytopenia
For full information please see: orthobiotech/releaseDetail.jsp?releaseID=300001.
A Phase I/II Trial of VELCADE (Bortezomib) Plus Oral Cyclophosphamide
and Prednisone for Relapsed/Refractory Multiple Myeloma.
The Phase I/II clinical trial evaluated the addition of VELCADE to
cyclophosphamide (CY) and prednisone (P) in 27 evaluable relapsed MM
patients who had received a median of two prior regimens and who had
previously undergone autologous stem cell transplantation. VELCADE was
administered at 1.5 mg/m2 on a weekly schedule on days 1, 8 and 15 of a
28-day cycle in combination with full dose oral CY + P for up to eight
cycles. The data were presented by Donna Reece, M.D., Princess Margaret
Hospital, University Health Network, Toronto, Canada. Results showed:
-- Of the 14 evaluable patients enrolled in the Phase I stage of the trial,
ORR was 93 percent, with a CR/nCR rate of 43 percent and median
progression-free survival (PFS) of 11 months
-- Of the seven patients enrolled in the Phase II stage of the trial, ORR
was 75 percent with two patients achieving a CR
-- Toxicities were generally mild and manageable; the most common adverse
events were infection and febrile neutropenia
"The substantial response rates seen with this combination are some of
the highest recorded to date in this underserved patient group," said Dr.
Reece. "Building on previously reported studies, these data show that
VELCADE may have synergistic activity with alkalating agents like
cyclophosphamide and encourage the exploration of additional VELCADE based
combinations with these agents that could provide even deeper responses
that are durable."
Combination of VELCADE (Bortezomib), Melphalan, Prednisone and
Thalidomide (VMPT) for Relapsed Multiple Myeloma: Results of a Phase I/II
Clinical Trial.
The open-label, multicenter Phase I/II clinical trial evaluated the
safety and efficacy, as defined by ORR, duration of PFS and survival, of
the four-drug combination -- VELCADE, melphalan, prednisone and thalidomide
(VMPT) -- in 30 patients with relapsed/refractory MM. Response was assessed
using International Myeloma Working Group criteria. VELCADE was
administered on days 1, 4, 15 and 22 at three dose levels: 1.0 mg/m2 in the
first cohort of 10 patients; 1.3 mg/m2 in the second cohort of 10 patients;
and 1.6 mg/m2 in the third cohort of 10 patients. Oral melphalan was
administered at 6 mg/m2 and oral prednisone at 60 mg/m2 on days one through
five. Thalidomide was delivered at 50 mg on days one through 35. The data
were presented by Antonio Palumbo, M.D., Azienda Ospedaliera San Giovanni
Battista, Torino, Italy. Initial results showed:
-- Of all 30 patients, the CR and VGPR rate was 43 percent with a 17
percent CR rate
-- Of the 14 second-line patients, the CR and VGPR rate was 57 percent with
a 36 percent CR rate
- One-year PFS rate was 61 percent; one-year survival from study entry was
84 percent
-- Therapy was well tolerated; the most common adverse events for the
combination included infections, fatigue and vasculitis; incidence of
neurotoxicity was low
VELCADE (Bortezomib) Plus Lenalidomide in Relapsed and/or Refractory
Multiple Myeloma: Final Results of a Multicenter Phase I Trial.
The multicenter Phase I dose-escalation study was designed to determine
the maximum tolerated dose (MTD) and activity of VELCADE plus lenalidomide
with and without dexamethasone in 36 evaluable patients with relapsed
and/or refractory MM. Patients had been heavily pretreated with a median of
five prior therapies, including: VELCADE, thalidomide, lenalidomide and
stem cell transplantation. Response was assessed by modified EBMT criteria.
Patients were treated with VELCADE at 1.0 or 1.3 mg/m2 on days 1, 4, 8 and
11 and lenalidomide at 5, 10, 15, or 20 mg on days one through 14 in 21-day
cycles. Patients with progressive disease were able to receive
dexamethasone 40 mg on day of and day after each VELCADE dose. The data
were presented by Paul Richardson, M.D., of the Dana-Farber Cancer
Institute in Boston, Mass. Final results showed:
-- MTD was defined with VELCADE at 1.0 mg/m2 and lenalidomide at 15 mg for
relapsed MM patients; this dose was taken into a Phase II trial in this
treatment setting
-- ORR was 39 percent, with a median duration of response of eight months
and 11 patients remaining on therapy beyond one year
-- The most common adverse events with the combination were neutropenia and
thrombocytopenia; there was no significant grade 3 or greater peripheral
neuropathy; there was no deep vein thrombosis in the combination arm
-- A Phase I/II study of VELCADE, lenalidomide and dexamethasone in front-
line MM is also ongoing
About Multiple Myeloma
MM is the second most common hematologic malignancy and although the
disease is predominantly a cancer of the elderly (the average age of onset
is 65 to 70 years of age), recent statistics indicate both increasing
incidence and younger age of onset. In the U.S., more than 50,000
individuals have MM and over 15,000 new cases are diagnosed each year.
Worldwide there are approximately 74,000 new cases and over 45,000 deaths
annually.(1)
About VELCADE
VELCADE is being co-developed by Millennium Pharmaceuticals, Inc. and
Johnson & Johnson Pharmaceutical Research & Development, L.L.C. Millennium
is responsible for commercialization of VELCADE in the U.S.; Janssen-Cilag
is responsible for commercialization in Europe and the rest of the world.
Janssen Pharmaceutical K.K. is responsible for commercialization in Japan.
For a limited period of time, Millennium and Ortho Biotech Inc. will
co-promote VELCADE in the U.S. VELCADE also is approved in the European
Union after first relapse.
VELCADE is indicated for the treatment of patients with multiple
myeloma who have received at least one prior therapy. VELCADE is indicated
for the treatment of patients with mantle cell lymphoma (MCL) who have
received at least one prior therapy. VELCADE is contraindicated in patients
with hypersensitivity to bortezomib, boron or mannitol. VELCADE should be
administered under the supervision of a physician experienced in the use of
antineoplastic therapy.
Risks associated with VELCADE therapy include new or worsening
peripheral neuropathy, hypotension observed throughout therapy, cardiac and
pulmonary disorders, gastrointestinal adverse events, thrombocytopenia,
neutropenia and tumor lysis syndrome. Women of childbearing potential
should avoid becoming pregnant while being treated with VELCADE. Cases of
severe sensory and motor peripheral neuropathy have been reported. The
long-term outcome of peripheral neuropathy has not been studied in mantle
cell lymphoma. Acute development or exacerbation of congestive heart
failure, and/or new onset of decreased left ventricular ejection fraction
has been reported, including reports in patients with few or no risk
factors for decreased left ventricular ejection fraction. There have been
rare reports of acute diffuse infiltrative pulmonary disease of unknown
etiology such as pneumonitis, interstitial pneumonia, lung infiltration and
Acute Respiratory Distress Syndrome (ARDS) in patients receiving VELCADE.
Some of these events have been fatal. A higher proportion of these events
have been reported in Japan. There have been rare reports of RPLS in
patients receiving VELCADE. RPLS is a rare, reversible, neurological
disorder which can present with seizure, hypertension, headache, lethargy,
confusion, blindness, and other visual and neurological disturbances.
VELCADE is associated with thrombocytopenia and neutropenia. There have
been reports of gastrointestinal and intracerebral hemorrhage in
association with VELCADE. Transfusions may be considered. Complete blood
counts (CBC) should be frequently monitored during treatment with VELCADE.
Rare cases of acute liver failure have been reported in patients receiving
multiple concomitant medications and with serious underlying medical
conditions.
Safety Data: In 1163 patients in MM and MCL studies, the most commonly
reported adverse events were asthenic conditions (64%), nausea (55%),
diarrhea (52%), constipation (41%), peripheral neuropathy (39%),
thrombocytopenia (36%), appetite decreased, including reports of anorexia
(36%), pyrexia (34%), vomiting (33%) and anemia (29%). Twenty percent of
patients reported at least one episode of grade 4 toxicity; the most common
grade 4 toxicities were thrombocytopenia (5%) and neutropenia (3%). Fifty
percent of patients reported serious adverse events (SAEs). The most
commonly reported SAEs were pneumonia (7%), pyrexia (6%), diarrhea (5%),
vomiting (4%), and nausea, dehydration, dyspnea and thrombocytopenia (each
3%).
For more information about VELCADE clinical trials, patients and
physicians can contact the Millennium Medical Product Information
Department at 1-866-VELCADE (1-866-835-2233).
About Millennium
Millennium Pharmaceuticals, Inc., a leading biopharmaceutical company
based in Cambridge, Mass., markets VELCADE, a novel cancer product, and has
a robust clinical development pipeline of product candidates. The Company's
research, development and commercialization activities are focused in two
therapeutic areas: oncology and inflammation. By applying its knowledge of
the human genome, understanding of disease mechanisms and industrialized
drug discovery platform, Millennium is developing an exciting pipeline of
innovative product candidates. The Company's website is millennium/.
This press release contains "forward-looking statements," including
statements about the Company's growth and development of products. Various
important risks may cause the Company's actual results to differ materially
from the results indicated by these forward-looking statements, including:
adverse results in its drug discovery and clinical development programs;
failure to obtain patent protection for its discoveries; commercial
limitations imposed by patents owned or controlled by third parties; the
Company's dependence upon strategic alliance partners to develop and
commercialize products and services based on its work; difficulties or
delays in obtaining regulatory approvals to market products and services
resulting from its development efforts; product withdrawals; competitive
factors; difficulties or delays in manufacturing the Company's products;
government and third party reimbursement rates; the commercial success of
VELCADE and INTEGRILIN(R) (eptifibatide) Injection; achieving revenue
consistent with internal forecasts; and the requirement for substantial
funding to conduct research and development and to expand commercialization
activities. For a further list and description of the risks and
uncertainties the Company faces, see the reports it has filed with the
Securities and Exchange Commission. The Company disclaims any intention or
obligation to update or revise any forward- looking statements, whether as
a result of new information, future events or otherwise.
Millennium Pharmaceuticals, Inc.
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