4SC AG (Frankfurt, Prime Standard: VSC) the German drug
discovery and development company, today announced the dosing of
the first patient in its Phase II trial with 4SC-201 (resminostat),
a pan-histone deacetylase (HDAC) inhibitor, as a new potential
treatment option for patients with advanced hepatocellular
carcinoma (HCC), the most frequent form of liver cancer. This
proof-of-concept (POC) study will evaluate 4SC-201 as a second line
therapy in this indication, for which only a single first line
therapy drug is currently approved.
The 'Shelter' study, entitled 'A proof-of-concept Phase II study
to evaluate efficacy, safety and pharmacokinetics of 4SC-201 and of
the treatment combination of sorafenib plus 4SC-201 in patients
with hepatocellular carcinoma exhibiting progressive disease under
sorafenib treatment', will examine whether treatment with 4SC-201
alone or in combination with sorafenib (Nexavar(R), the current
standard of care in advanced HCC), can induce progression free
survival and tumour responses in HCC patients who display
progressive disease under treatment with sorafenib. This two-arm,
proof-of-concept study will be performed at oncology-experienced
university hospitals in Germany.
In the first study arm 15 patients will be treated with the
maximum tolerated dose of the combination therapy which will be
determined through an initial dose-escalation part, testing
sorafenib in combination with 200mg to 600mg of 4SC-201. In the
second study arm 15 patients will discontinue sorafenib treatment
prior to inclusion into the study and will receive 600mg of 4SC-201
as a monotherapy. In both arms 4SC-201 will be applied orally once
daily over five consecutive days, followed by a nine day
4SC-201-treatment free period. In the combination arm sorafenib is
addionally administered continuously every day. In both study arms,
the resulting 14 day cycle for the treatment with 4SC-201 (a '5 +
9' dosing schedule) will be repeated until there is evidence of
progressive disease. The first two radiological tumour stagings
will be performed after six and 12 weeks. Patients who experience a
clinical benefit, e.g., a stabilisation of their progressive
disease or tumour regression, will be offered the opportunity to
extend the study treatment until disease progression occurs or
until the patient voluntarily withdraws. Based on the data of the
first 15 patients treated in each study arm, an optional extension
phase comprising ten additional patients may be included into each
study arm. The primary endpoint of the study is to determine the
progression free survival rate (PFSR) after twelve weeks of study
treatment. The secondary endpoints include the analysis of
time-to-progression (TTD), PFSR estimated at six weeks and PFSR
estimated beyond twelve weeks of treatment, overall survival,
analysis of drug safety, tolerability, pharmacokinetics and the
investigation of biomarkers.
In preclinical studies 4SC-201 was shown to be very potent in
inhibiting the growth of different liver cancer cells, and also
displayed synergistic activity on liver cancer cell growth when
combined with sorafenib.
Prof. Dr. Michael Bitzer, the coordinating investigator from the
University Hospital Tübingen, Germany, commented, 'Advanced HCC is
an aggressive form of cancer in which classical chemotherapy
approaches fail, despite huge scientific efforts over decades. Only
the recent approval of a targeted therapy sorafenib, the only
approved therapy for the systemic treatment for advanced HCC, has
offered an innovative approach to treat these patients. However,
there is an unmet medical need for new therapeutic approaches for
patients that do not tolerate, or have disease progression whilst
under sorafenib treatment. Notably, this need is in the second line
setting where there is currently no other approved treatment
option. Based on preclinical and Phase I data generated by 4SC-201
(resminostat), we are hopeful that this HDAC inhibitor may offer
considerable clinical benefit to HCC patients that are progressive
under treatment with the only currently approved therapy.'
Dr Bernd Hentsch, Chief Development Officer at 4SC commented,
'We are very excited about commencing this proof-of-concept study
for 4SC-201 (resminostat) in HCC, the first tumour disease to test
the clinical efficacy of our lead oncology candidate. We have
selected this indication as we believe that 4SC-201, based on our
Phase I data, has the potential to stop tumour progression. We will
investigate tumour responses in patients receiving monotherapy
treatment with 4SC-201, and also after combination treatment, in
which we will be able to additionally determine whether 4SC-201-can
induce a re-sensitisation to treatment with sorafenib. Our new
therapy option 4SC-201 could potentially offer tumour regression or
a stabilised disease state, with the aim of moving these patients
towards disease control.'
Additional information about the clinical trial can be found at
www.clinicaltrials.gov.
Notes to Editor
About 4SC-201
4SC-201 is an oral, pan-isotope histone deacetylase (HDAC)
inhibitor, for which recently the INN 'Resminostat' has been
proposed by the WHO. HDAC inhibitors modify the DNA structure of
tumour cells to cause their differentiation and programmed cell
death (apoptosis) and are therefore considered to offer a mechanism
of action that has the potential to halt tumour progression and
induce tumor regression in order to move towards the therapeutic
control of the cancer diseases. In a Phase I trial in multiple
cancers, stable disease was achieved in over 50% of the patients,
whilst the compound was well tolerated and showed a positive,
differentiating pharmacological profile to other drugs in this
class. This data were presented in a poster presentation (Abstract
#3530 (Temp. Abst. ID: 33511) at ASCO in May 2009. A further Phase
II trial with this compound is planned in Hodgkin's lymphoma this
year.
About Hepatocelluar Carcinoma (HCC)
Hepatocellular carcinoma is the most prevalent form of liver
cancer. HCC is the sixth most common cancer in the world and the
third leading cause of cancer-related deaths globally (1).
HCC is most prevalent in Southeast Asia and is also very common
in sub-Saharan Africa (an estimated 20 cases per 100,000 population
by the World Health Organisation (WHO)). This is because in these
geographies there is a high rate of hepatitis B virus (HBV)
infection, which causes liver cancer as its genetic material
disrupts the normal genetic material in the liver cells, thereby
causing the liver cells to become cancerous.
Historically, North America and Western Europe, has had less
incidence (less than five per 100,000 population according to WHO),
but is on the rise. A new study has shown that the incidence of
liver cancer in the United States tripled between 1975 and 2005 and
researchers believe that these trends may be partially due to an
increase in chronic hepatitis C infections, which along with
hepatitis B is a major risk factor for liver cancer. Other factors
that may contribute to the increase in liver cancer include: heavy
alcohol consumption, fatty liver disease, obesity, diabetes
mellitus and iron storage diseases.(2)
About 4SC
4SC AG (ISIN DE0005753818) is a drug discovery and development
company focused on autoimmune and cancer indications. The company
currently has three clinical programs, with three further clinical
trials planned to commence in 2009. The lead autoimmune compound,
4SC-101, is in a Phase IIa trial in Crohn's disease and is due to
commence a Phase IIb trial in rheumatoid arthritis in 2009. The
lead oncology compound, 4SC-201, is in a Phase II trial in
hepatocellular carcinoma (HCC) and is due to commence a further
Phase II trial in Hodgkin's lymphoma in 2009. Drug candidates are
developed until proof-of-concept and subsequently partnered with
the pharmaceutical industry in return for advance and milestone
payments as well as royalties.
4SC was founded in 1997, has 92 employees, and is listed on the
Prime Standard of the Frankfurt Stock Exchange since December
2005.
References
(1) Ferlay J, et al., GLOBOCAN 2002. Cancer Incidence,
Mortality and Prevalence Worldwide. IARC CancerBase No.5, Version
2.0. IARCPress, Lyon, 2004. (2) Siegel A. B, et al. Risk of
hepatocellular carcinoma (HCC) in patients with previous
malignancy. Journal of Clinical Oncology 2009.
Legal Note
This document may contain projections or estimates relating to
plans and objectives relating to our future operations, products,
or services; future financial results; or assumptions underlying or
relating to any such statements; each of which constitutes a
forward-looking statement subject to risks and uncertainties, many
of which are beyond our control. Actual results could differ
materially, depending on a number of factors.
Language: English Issuer: 4SC AG Am Klopferspitz 19a 82152
Martinsried Deutschland Phone: +49 (0)89 7007 63-0 Fax: +49 (0)89
7007 63-29 E-mail:
public@4sc.com
Internet:
www.4sc.de
ISIN: DE0005753818 WKN: 575381 Listed: Regulierter Markt in
Frankfurt (Prime Standard); Freiverkehr in Berlin, Düsseldorf,
München, Stuttgart
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