Denosumab Demonstrated Superiority Over Zometa(R) in Pivotal Phase 3 Head-to-Head Trial in Prostate Cancer Patients With Bone Me
February 08 2010 - 6:20PM
PR Newswire (US)
Denosumab Trial Met Primary and All Secondary Endpoints by
Significantly Delaying Time to First Skeletal Related Event and
Significantly Reducing First-and-Subsequent Skeletal Related Events
Compared to Zometa Second Phase 3 Advanced Cancer Trial to
Demonstrate Denosumab Superiority Versus Zometa THOUSAND OAKS,
Calif., Feb. 8 /PRNewswire-FirstCall/ -- Amgen (NASDAQ: AMGN) today
announced that a pivotal, Phase 3, head-to-head trial evaluating
denosumab versus Zometa® (zoledronic acid) in the treatment of bone
metastases in 1,901 men with advanced prostate cancer met its
primary and secondary endpoints. Denosumab demonstrated superiority
over Zometa for both delaying the time to the first on-study
skeletal related event (SRE) (fracture, radiation to bone, surgery
to bone or spinal cord compression) (hazard ratio 0.82, 95 percent
CI: 0.71, 0.95), and reducing the rate of multiple SREs (hazard
ratio 0.82, 95 percent CI: 0.71, 0.94). Both results were
statistically significant. Overall rates of adverse events and
serious adverse events, including infections, were generally
similar between the two arms. Osteonecrosis of the jaw was
infrequent (22 patients receiving denosumab as compared with 12
patients receiving Zometa) and there was no statistically
significant difference between treatment arms. As with previous
studies in advanced cancer patients, hypocalcemia was more frequent
in the denosumab arm. Both overall survival and the time to cancer
progression were balanced between treatment arms. "These Phase 3
results demonstrate the ability of denosumab to delay bony
complications in patients suffering from metastatic prostate
cancer," said Roger M. Perlmutter, M.D., Ph.D., executive vice
president of Research and Development at Amgen. "Denosumab has
shown remarkable consistency in reducing the serious complications
of bone metastases. Today's results greatly enhance our
understanding of the efficacy of denosumab in multiple different
tumor types." This study is the final of three pivotal trials in a
total of over 5,700 advanced cancer patients investigating the
potential of denosumab to treat bone metastases. Results from the
previous two trials were presented in September 2009. These three
studies will form the basis of the clinical evidence package for
denosumab in advanced cancer, which will be submitted to regulatory
authorities later this year. Full efficacy and safety data for the
prostate cancer study will be submitted to the American Society for
Clinical Oncology, for possible presentation at their meeting in
early June. Additionally, results are expected in the second half
of the year from a study investigating whether denosumab may
prolong bone metastasis-free survival in prostate cancer patients.
Study Design This study was an international, Phase 3, randomized,
double-blind study comparing denosumab with Zometa in the treatment
of bone metastases in patients with advanced prostate cancer.
Patients enrolled in the study were randomized in a one-to-one
ratio to receive either 120 mg of denosumab subcutaneously every
four weeks (Q4W) or Zometa administered intravenously as at least a
15 minute infusion at a dose of 4 mg every four weeks as per the
labeled instructions. The study consisted of 1,901 patients, mean
age of 71, who have bone metastases from hormone-refractory
prostate cancer. In clinical trials testing new medications for
bone metastases, treatment success has been measured by whether the
bone complications, or SREs, caused by the bone metastases are
reduced or delayed. The primary and secondary endpoints of the
denosumab bone metastases studies use a composite endpoint of four
SREs - fracture, radiation to bone, surgery to bone, and spinal
cord compression - to measure the effectiveness of denosumab versus
Zometa. The primary endpoint was to evaluate if denosumab is
non-inferior to Zometa with respect to the first on-study SRE in
patients with advanced prostate cancer and bone metastases.
Secondary endpoints were to evaluate if denosumab was superior to
Zometa with respect to the first on-study SRE, as well as
first-and-subsequent on-study SREs, and to assess the safety and
tolerability of denosumab compared with Zometa. About Denosumab and
Amgen's Research in Bone Biology Denosumab is the first fully human
monoclonal antibody in late stage clinical development that
specifically targets RANK Ligand, the essential regulator of
osteoclasts (the cells that break down bone). With more than 19,000
patients in trials across indications worldwide, the denosumab
development program is the largest ever initiated by Amgen. This
broad and deep development program demonstrates Amgen's commitment
to researching and delivering pioneering medicines to patients with
unmet medical needs. Amgen is studying denosumab in numerous tumor
types across the spectrum of cancer induced bone disease. Over
11,000 patients have been enrolled in the denosumab oncology
clinical trials testing the drug for bone loss and destruction
associated with cancer treatment-induced bone loss in breast and
prostate cancers, for the prevention of skeletal related events due
to the spread of cancer to the bone in multiple myeloma and
multiple solid tumors, and for its potential to delay bone
metastases in prostate cancer. Bone Metastases: Impact and
Prevalence Bone metastases, cancer cells that separate from tumors
and migrate to bone tissue where they settle and grow, occur in
more than 1.5 million people worldwide.(1) With improvements in
cancer care, including earlier diagnosis and new treatment options,
leading to increases in survival rates(2), the number of patients
developing metastatic disease secondary to a primary cancer is
increasing. Bone metastases are a significant problem for patients
with certain types of advanced cancer, with incidence rates of
nearly 100 percent in myeloma patients and as high as 75 percent in
breast and prostate cancer patients. With bone metastases the
growing cancer cells weaken and destroy the bone around the tumor.
The damage the tumor has caused to the bone can result in a number
of serious complications, collectively called SREs. All are serious
complications for advanced cancer patients. The economic burden of
U.S. patients with bone metastases is significant and is estimated
to be $12.6 billion annually.(3) Patients with bone metastases who
experience an SRE incur significantly higher medical costs compared
with those who do not experience an SRE.(4) Bone Metastases in
Prostate Cancer Nearly 50 percent of castrate-resistant patients
with prostate cancer who are not treated for bone metastases
experience an SRE, suffering intractable pain and functional
impairment.(5,6) SREs pose significant incremental healthcare costs
for patients and for the system. Patients with cancer pain are
among the most difficult to treat and require much time and effort
from physicians and their healthcare team.(7) About Amgen Amgen
discovers, develops and delivers innovative human therapeutics. A
biotechnology pioneer since 1980, Amgen was one of the first
companies to realize the new science's promise by bringing safe and
effective medicines from lab, to manufacturing plant, to patient.
Amgen therapeutics have changed the practice of medicine, helping
millions of people around the world in the fight against cancer,
kidney disease, rheumatoid arthritis, and other serious illnesses.
With a deep and broad pipeline of potential new medicines, Amgen
remains committed to advancing science to dramatically improve
people's lives. To learn more about our pioneering science and our
vital medicines, visit http://www.amgen.com/. Forward-Looking
Statements This news release contains forward-looking statements
that are based on management's current expectations and beliefs and
are subject to a number of risks, uncertainties and assumptions
that could cause actual results to differ materially from those
described. All statements, other than statements of historical
fact, are statements that could be deemed forward-looking
statements, including estimates of revenues, operating margins,
capital expenditures, cash, other financial metrics, expected
legal, arbitration, political, regulatory or clinical results or
practices, customer and prescriber patterns or practices,
reimbursement activities and outcomes and other such estimates and
results. Forward-looking statements involve significant risks and
uncertainties, including those discussed below and more fully
described in the Securities and Exchange Commission (SEC) reports
filed by Amgen, including Amgen's most recent annual report on Form
10-K and most recent periodic reports on Form 10-Q and Form 8-K.
Please refer to Amgen's most recent Forms 10-K, 10-Q and 8-K for
additional information on the uncertainties and risk factors
related to our business. Unless otherwise noted, Amgen is providing
this information as of Feb. 8, 2010 and expressly disclaims any
duty to update information contained in this news release. No
forward-looking statement can be guaranteed and actual results may
differ materially from those we project. Discovery or
identification of new product candidates or development of new
indications for existing products cannot be guaranteed and movement
from concept to product is uncertain; consequently, there can be no
guarantee that any particular product candidate or development of a
new indication for an existing product will be successful and
become a commercial product. Further, preclinical results do not
guarantee safe and effective performance of product candidates in
humans. The complexity of the human body cannot be perfectly, or
sometimes, even adequately modeled by computer or cell culture
systems or animal models. The length of time that it takes for us
to complete clinical trials and obtain regulatory approval for
product marketing has in the past varied and we expect similar
variability in the future. We develop product candidates internally
and through licensing collaborations, partnerships and joint
ventures. Product candidates that are derived from relationships
may be subject to disputes between the parties or may prove to be
not as effective or as safe as we may have believed at the time of
entering into such relationship. Also, we or others could identify
safety, side effects or manufacturing problems with our products
after they are on the market. Our business may be impacted by
government investigations, litigation and products liability
claims. We depend on third parties for a significant portion of our
manufacturing capacity for the supply of certain of our current and
future products and limits on supply may constrain sales of certain
of our current products and product candidate development. In
addition, sales of our products are affected by the reimbursement
policies imposed by third-party payors, including governments,
private insurance plans and managed care providers and may be
affected by regulatory, clinical and guideline developments and
domestic and international trends toward managed care and
healthcare cost containment as well as U.S. legislation affecting
pharmaceutical pricing and reimbursement. Government and others'
regulations and reimbursement policies may affect the development,
usage and pricing of our products. In addition, we compete with
other companies with respect to some of our marketed products as
well as for the discovery and development of new products. We
believe that some of our newer products, product candidates or new
indications for existing products, may face competition when and as
they are approved and marketed. Our products may compete against
products that have lower prices, established reimbursement,
superior performance, are easier to administer, or that are
otherwise competitive with our products. In addition, while we
routinely obtain patents for our products and technology, the
protection offered by our patents and patent applications may be
challenged, invalidated or circumvented by our competitors and
there can be no guarantee of our ability to obtain or maintain
patent protection for our products or product candidates. We cannot
guarantee that we will be able to produce commercially successful
products or maintain the commercial success of our existing
products. Our stock price may be affected by actual or perceived
market opportunity, competitive position, and success or failure of
our products or product candidates. Further, the discovery of
significant problems with a product similar to one of our products
that implicate an entire class of products could have a material
adverse effect on sales of the affected products and on our
business and results of operations. The scientific information
discussed in this news release related to our product candidates is
preliminary and investigative. Such product candidates are not
approved by the U.S. Food and Drug Administration (FDA), and no
conclusions can or should be drawn regarding the safety or
effectiveness of the product candidates. Only the FDA can determine
whether the product candidates are safe and effective for the
use(s) being investigated. Further, the scientific information
discussed in this news release relating to new indications for our
products is preliminary and investigative and is not part of the
labeling approved by the U.S. Food and Drug Administration (FDA)
for the products. The products are not approved for the
investigational use(s) discussed in this news release, and no
conclusions can or should be drawn regarding the safety or
effectiveness of the products for these uses. Only the FDA can
determine whether the products are safe and effective for these
uses. Healthcare professionals should refer to and rely upon the
FDA-approved labeling for the products, and not the information
discussed in this news release. ZOMETA is a registered trademark of
Novartis Oncology. *Editors Note: The FDA has provisionally
approved the trade name Prolia(TM) for the proposed indications of
treatment and prevention of osteoporosis in postmenopausal women,
and treatment and prevention of bone loss in patients undergoing
hormone ablation for prostate or breast cancer. The Prolia(TM)
trade name is only for these indications and may not apply for
other indications of denosumab. Amgen Thousand Oaks Lisa Rooney
805-447-6437 (media) Arvind Sood 805-447-1060 (investors) (Logo:
http://www.newscom.com/cgi-bin/prnh/20081015/AMGENLOGO) (1) Capanna
R, Coia LR, Coleman R. et al. eds. Textbook of Bone Metastases.
Hoboken, NJ: Edition: John Wiley and Sons; 2005:105. (2) Mundy GR.
Metastasis to bone: causes, consequences and therapeutic
opportunities. Nat Rev Cancer. 2002 Aug;2(8):584-93. (3) Schulman K
and Kohles J. Cancer. 2007;109:2334-2342. (4) GVD/Barber ISPOR 2008
Poster; Schulman 2007; Delea et al. 2006. (5) Saad F, et al.
Long-term efficacy of zoledronic acid for prevention of skeletal
complications in patients with metastatic hormone-refractory
prostate cancer. J Nat Cancer Inst. 2004; 96(11):879-882. (6)
Coleman RE. Metastatic bone disease: Clinical features,
pathophysiology and treatment strategies. Cancer Treat Rev. 2001:
27:165-176. (7) Podnos YD, Borneman TR, Koczywas M, Uman G, Ferrell
BR. Symptom concerns and resource utilization in patients with lung
cancer. J Pall Med 2007;10(4):899-903.
http://www.newscom.com/cgi-bin/prnh/20081015/AMGENLOGO
http://photoarchive.ap.org/ DATASOURCE: Amgen CONTACT: media, Lisa
Rooney, +1-805-447-6437, or investors, Arvind Sood,
+1-805-447-1060, both of Amgen, Thousand Oaks Web Site:
http://www.amgen.com/
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