4D pharma plc (AIM: DDDD), a pharmaceutical company leading the development of Live Biotherapeutics, today announces the complete clinical benefit analysis from Part A of its Phase I/II clinical trial of Live Biotherapeutic candidate MRx0518 in combination with immune checkpoint inhibitor (ICI) Keytruda (pembrolizumab), the anti-PD-1 therapy of MSD, a tradename of
In 12 patients with metastatic renal cell carcinoma (mRCC) and metastatic non-small cell lung cancer (mNSCLC), the combination of MRx0518 with KEYTRUDA achieved a disease control rate (DCR) of 42%, with five of 12 patients experiencing a clinically meaningful benefit from the combination. Three patients experienced partial responses (PR), defined as target tumour shrinkage of 30% or greater - an objective response rate (ORR) of 25%. MRx0518 in combination with KEYTRUDA induced durable stable disease (SD) of six months or greater in an additional two patients (17%). Median duration of treatment for the five patients experiencing clinical benefit is now 13.2 months, with four of these patients currently ongoing.
As previously reported, MRx0518 demonstrated a highly favourable safety profile, with no treatment-related serious adverse events (SAEs) or drug discontinuations and, importantly, no increase of immune-related adverse events (irAEs) commonly associated with ICI therapy.
Prof. Jaap Verweij,Emeritus Professor of Medical Oncology, at
Dr
He added, 'We believe that, while this is a small study, these efficacy and safety results in such a difficult-to-treat population are notable.To achieve these results while maintaining a very clean safety profile is to our knowledge unparalleled, and particularly significant in oncology where there is all too often the unfortunate trade-off between treatment and quality of life, and patients often elect to interrupt or stop treatment completely due to adverse side effects.'
Following successful completion of the Part A safety phase, the Part B cohort expansion phase of the trial is enrolling at multiple sites, and will assess the clinical benefit of the combination of MRx0518 and KEYTRUDA in addition to safety, in up to 30 additional patients per tumour type. The study is open-label and 4D pharma expects to make periodic announcements on progress and updated results as appropriate.
The trial is enrolling heavily pre-treated metastatic patients with selected solid tumours refractory to ICIs. Eligible patients must have experienced at least stable disease on previous ICI therapy (as a monotherapy or combination) but eventually progressed, as confirmed by two radiological scans 4 weeks apart in the absence of rapid clinical progression and within 12 weeks of last dose of ICI. Patients are treated with 1 capsule of MRx0518 twice daily and pembrolizumab every 3 weeks for up to 35 cycles (approximately 2 years) or until disease progression. Tumour response is assessed every 9 weeks per the RECIST 1.1 criteria. The primary objective of Part B is to evaluate safety of the combination. Secondary objectives were to evaluate efficacy via overall response rate (ORR), duration of response (DOR), disease control rate (DCR) and progression-free survival (PFS).
About MRx0518
MRx0518 is single strain Live Biotherapeutic product in development for the treatment of cancer. It is delivered as an oral capsule and stimulates the body's immune system, directing it to produce cytokines and immune cells that are known to attack tumours. It is currently being evaluated in three clinical trials in cancer patients. MRx0518-I-001 is a neoadjuvant monotherapy study in a variety of solid tumours and is being conducted at Imperial College (
About MRx0518-I-002 clinical trial
MRx0518-I-002 (NCT03637803) is a Phase I/II open-label, safety and preliminary efficacy study of MRx0518 in combination with KEYTRUDA (pembrolizumab) in patients with solid tumours (non-small cell lung cancer, renal cell carcinoma, bladder cancer or melanoma) who have previously progressed on anti PD-1/PD-L1 therapy. Subjects are treated with intravenous KEYTRUDA every three weeks and one capsule twice daily of MRx0518. Treatment continues as long as clinically relevant, until disease progression, unacceptable AEs or withdrawal of consent up to a maximum of 35 cycles of KEYTRUDA.
Part A was conducted in 12 patients and Part B will be conducted in up to 30 patients of each tumour type.
The Coordinating Investigator of the study is at
About 4D
Founded in
4D's Live Biotherapeutic Products are orally delivered single strains of bacteria that are naturally found in the healthy human gut. The Company has six clinical studies in progress, namely a Phase II clinical study of BLAUTIX in Irritable Bowel Syndrome (IBS), a Phase I/II study of MRx0518 in combination with KEYTRUDA (pembrolizumab) in solid tumours, a Phase I study of MRx0518 in a neoadjuvant setting for patients with solid tumours, a Phase I study of MRx0518 in patients with pancreatic cancer, a Phase I/II study of MRx-4DP0004 in asthma, and a Phase II study of MRx-4DP0004 in patients hospitalised with COVID-19. Preclinical-stage programs include candidates for CNS disease such as Parkinson's disease and other neurodegenerative conditions. The Company has a research collaboration with MSD, a tradename of
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