FDA Grants Fast Track Designation for
Ivonescimab in 2L+ EGFRm NSCLC
HARMONi Completed Enrollment for Summit’s First
Sponsored Study Evaluating Ivonescimab
Topline data from the HARMONi Trial Is Expected
in Mid-2025
Summit Therapeutics Inc. (NASDAQ: SMMT) (“Summit,” “we,” or the
“Company”) today announced that we have completed enrollment in our
HARMONi clinical trial, a multi-regional Phase III study sponsored
by Summit evaluating ivonescimab plus platinum-doublet chemotherapy
vs. placebo plus platinum-doublet chemotherapy with epidermal
growth factor receptor (EGFR)-mutated, locally advanced or
metastatic non-squamous non-small cell lung cancer (NSCLC) who have
progressed after treatment with a 3rd generation EGFR tyrosine
kinase inhibitor (TKI). HARMONi completed enrolling patients from
sites in North America, Europe, and China. This is a clinical
setting with a patient population where PD-1 monoclonal antibodies
have previously been unsuccessful in Phase III global clinical
trials.
“I would like to sincerely thank the investigators, site
coordinators, Team Summit, and, most importantly, the patients
around the world who are participating in the HARMONi study,” said
Dr. Maky Zanganeh, Chief Executive Officer and President of Summit.
“Completing enrollment in the first global study for ivonescimab is
a credit to the growing belief in the potential for ivonescimab to
make a significant difference in the lives of patients around the
world.”
In addition, the U.S. Food and Drug Administration (FDA) has
granted Fast Track designation for the proposed use of ivonescimab
in combination with platinum-based chemotherapy for the treatment
of adult patients with locally advanced or metastatic NSCLC with
EGFR mutation, who have experienced disease progression following
EGFR-TKI therapy.
The FDA’s Fast Track designation is designed to facilitate the
development and expedite the review of drugs to treat serious
conditions and fill an unmet medical need. According to the FDA,
the purpose is to get important new drugs to patients earlier. A
drug that receives Fast Track designation is eligible for some of
the following: more frequent meetings with the FDA to discuss the
drug’s development plan, more frequent written communication from
the FDA, and a rolling review process, allowing the sponsor to
submit completed sections of its Biologic License Application (BLA)
for review rather than every section at once, though the review by
FDA typically begins when the entire application has been
submitted. Per the FDA, once a drug receives Fast Track
designation, early and frequent communication with the FDA is
encouraged throughout the entire drug development and review
process; the frequency of communication assures that questions and
issues are resolved quickly, often leading to earlier drug approval
and access by patients.
“Completing enrollment in the HARMONi study represents another
step towards our goal of bringing to patients a drug that is
intended to improve the quality and potential duration of life for
those facing serious unmet medical needs,” stated Robert W. Duggan,
Chairman & Chief Executive Officer of Summit. “As our belief in
the potential for ivonescimab to make a meaningful, positive
difference continues to grow, we are pleased that the FDA has
granted Fast Track designation for ivonescimab.”
As a reminder, the HARMONi analysis will include all patients
from the HARMONi-A trial who previously received a 3rd generation
TKI. HARMONi-A was a single-region, multi-center Phase III clinical
trial evaluating ivonescimab plus platinum-doublet chemotherapy vs.
placebo plus platinum-doublet chemotherapy with EGFR-mutated,
locally advanced or metastatic non-squamous NSCLC who have
progressed after treatment with an EGFR TKI. HARMONi-A was
sponsored by our collaboration partner, Akeso, Inc. (Akeso, HKEX
Code: 9926.HK), with data generated and analyzed by Akeso. On May
24, 2024, our partner, Akeso, received marketing authorization in
China from the National Medical Products Administration (NMPA)
based on the positive dataset associated with HARMONi-A. HARMONi-A
was designed with a primary endpoint of progression-free survival.
HARMONi is designed with dual primary endpoints of progression-free
survival and overall survival.
About Ivonescimab
Ivonescimab, known as SMT112 in Summit’s license territories,
the United States, Canada, Europe, Japan, Latin America, including
Mexico and all countries in Central America, South America, and the
Caribbean, the Middle East, and Africa, and as AK112 in China and
Australia, is a novel, potential first-in-class investigational
bispecific antibody combining the effects of immunotherapy via a
blockade of PD-1 with the anti-angiogenesis effects associated with
blocking VEGF into a single molecule. Ivonescimab displays unique
cooperative binding to each of its intended targets with multifold
higher affinity when in the presence of both PD-1 and VEGF.
This could differentiate ivonescimab as there is potentially
higher expression (presence) of both PD-1 and VEGF in tumor tissue
and the tumor microenvironment (TME) as compared to normal tissue
in the body. Ivonescimab’s tetravalent structure (four binding
sites) enables higher avidity (accumulated strength of multiple
binding interactions) in the TME with over 18-fold increased
binding affinity to PD-1 in the presence of VEGF in vitro, and over
4-times increased binding affinity to VEGF in the presence of PD-1
in vitro (Zhong, et al, SITC, 2023). This tetravalent structure,
the intentional novel design of the molecule, and bringing these
two targets into a single bispecific antibody with cooperative
binding qualities have the potential to direct ivonescimab to the
tumor tissue versus healthy tissue. The intent of this design,
together with a half-life of 6 to 7 days (Zhong, et al, SITC,
2023), is to improve upon previously established efficacy
thresholds, in addition to side effects and safety profiles
associated with these targets.
Ivonescimab was engineered by Akeso Inc. (HKEX Code: 9926.HK)
and is currently engaged in multiple Phase III clinical trials.
Over 1,800 patients have been treated with ivonescimab in clinical
studies globally.
Summit has begun its clinical development of ivonescimab in
non-small cell lung cancer (NSCLC), commencing enrollment in 2023
in two multi-regional Phase III clinical trials, HARMONi and
HARMONi-3, with a plan to initiate HARMONi-7 in early 2025.
HARMONi is a Phase III clinical trial which intends to evaluate
ivonescimab combined with chemotherapy compared to placebo plus
chemotherapy in patients with EGFR-mutated, locally advanced or
metastatic non-squamous NSCLC who have progressed after treatment
with a 3rd generation EGFR TKI (e.g., osimertinib).
HARMONi-3 is a Phase III clinical trial which is designed to
evaluate ivonescimab combined with chemotherapy compared to
pembrolizumab combined with chemotherapy in patients with
first-line metastatic squamous NSCLC.
HARMONi-7 is a planned Phase III clinical trial which is
intended to evaluate ivonescimab monotherapy compared to
pembrolizumab monotherapy in patients with first-line metastatic
NSCLC whose tumors have high PD-L1 expression (PD-L1 TPS
> 50%).
In addition, Akeso has recently had positive read-outs in two
single-region (China), randomized Phase III clinical trials for
ivonescimab in NSCLC, HARMONi-A and HARMONi-2.
HARMONi-A was a Phase III clinical trial which evaluated
ivonescimab combined with chemotherapy compared to placebo plus
chemotherapy in patients with EGFR-mutated, locally advanced or
metastatic non-squamous NSCLC who have progressed after treatment
with an EGFR TKI.
HARMONi-2 is a Phase III clinical trial evaluating monotherapy
ivonescimab against monotherapy pembrolizumab in patients with
locally advanced or metastatic NSCLC whose tumors have positive
PD-L1 expression (PD-L1 TPS >1%).
Ivonescimab is an investigational therapy that is not approved
by any regulatory authority in Summit’s license territories,
including the United States and Europe. Ivonescimab was approved
for marketing authorization in China in May 2024. Ivonescimab was
granted Fast Track designation by the US Food & Drug
Administration (FDA) for the HARMONi clinical trial setting.
About Summit Therapeutics
Summit Therapeutics Inc. is a biopharmaceutical oncology company
focused on the discovery, development, and commercialization of
patient-, physician-, caregiver- and societal-friendly medicinal
therapies intended to improve quality of life, increase potential
duration of life, and resolve serious unmet medical needs.
Summit was founded in 2003 and our shares are listed on the
Nasdaq Global Market (symbol "SMMT"). We are headquartered in
Miami, Florida, and we have additional offices in Menlo Park,
California, and Oxford, UK.
For more information, please visit https://www.smmttx.com and
follow us on X @SMMT_TX.
Summit Forward-looking Statements
Any statements in this press release about the Company’s future
expectations, plans and prospects, including but not limited to,
statements about the clinical and preclinical development of the
Company’s product candidates, entry into and actions related to the
Company’s partnership with Akeso Inc., the intended use of the net
proceeds from the private placements, the Company's anticipated
spending and cash runway, the therapeutic potential of the
Company’s product candidates, the potential commercialization of
the Company’s product candidates, the timing of initiation,
completion and availability of data from clinical trials, the
potential submission of applications for marketing approvals,
potential acquisitions, statements about the previously disclosed
At-The-Market equity offering program (“ATM Program”), the expected
proceeds and uses thereof, and other statements containing the
words "anticipate," "believe," "continue," "could," "estimate,"
"expect," "intend," "may," "plan," "potential," "predict,"
"project," "should," "target," "would," and similar expressions,
constitute forward-looking statements within the meaning of The
Private Securities Litigation Reform Act of 1995. Actual results
may differ materially from those indicated by such forward-looking
statements as a result of various important factors, including the
Company’s ability to sell shares of our common stock under the ATM
Program, the conditions affecting the capital markets, general
economic, industry, or political conditions, including the results
of our evaluation of the underlying data in connection with the
development and commercialization activities for ivonescimab, the
outcome of discussions with regulatory authorities, including the
Food and Drug Administration, the uncertainties inherent in the
initiation of future clinical trials, availability and timing of
data from ongoing and future clinical trials, the results of such
trials, and their success, and global public health crises, that
may affect timing and status of our clinical trials and operations,
whether preliminary results from a clinical trial will be
predictive of the final results of that trial or whether results of
early clinical trials or preclinical studies will be indicative of
the results of later clinical trials, whether business development
opportunities to expand the Company’s pipeline of drug candidates,
including without limitation, through potential acquisitions of,
and/or collaborations with, other entities occur, expectations for
regulatory approvals, laws and regulations affecting government
contracts and funding awards, availability of funding sufficient
for the Company’s foreseeable and unforeseeable operating expenses
and capital expenditure requirements and other factors discussed in
the "Risk Factors" section of filings that the Company makes with
the Securities and Exchange Commission. Any change to our ongoing
trials could cause delays, affect our future expenses, and add
uncertainty to our commercialization efforts, as well as to affect
the likelihood of the successful completion of clinical development
of ivonescimab. Accordingly, readers should not place undue
reliance on forward-looking statements or information. In addition,
any forward-looking statements included in this press release
represent the Company’s views only as of the date of this release
and should not be relied upon as representing the Company’s views
as of any subsequent date. The Company specifically disclaims any
obligation to update any forward-looking statements included in
this press release.
Appendix: Glossary of Critical Terms Contained Herein
Affinity – Affinity is the strength of binding of a
molecule, such as a protein or antibody, to another molecule, such
as a ligand.
Avidity – Avidity is the accumulated strength of multiple
binding interactions.
Angiogenesis – Angiogenesis is the development,
formation, and maintenance of blood vessel structures. Without
sufficient blood flow, tissue may experience hypoxia (insufficient
oxygen) or lack of nutrition, which may cause cell death.1
Cooperative binding – Cooperative binding occurs when the
number of binding sites on the molecule that can be occupied by a
specific ligand (e.g., protein) is impacted by the ligand’s
concentration. For example, this can be due to an affinity for the
ligand that depends on the amount of ligand bound or the binding
strength of the molecule to one ligand based on the concentration
of another ligand, increasing the chance of another ligand binding
to the compound.2
Immunotherapy – Immunotherapy is a type of treatment,
including cancer treatments, that help a person’s immune system
fight cancer. Examples include anti-PD-1 therapies.3
Intracranial - Within the cranium or skull.
PD-1 – Programmed cell Death protein 1 is a protein on
the surface of T cells and other cells. PD-1 plays a key role in
reducing the regulation of ineffective or harmful immune responses
and maintaining immune tolerance. However, with respect to cancer
tumor cells, PD-1 can act as a stopping mechanism (a brake or
checkpoint) by binding to PD-L1 ligands that exist on tumor cells
and preventing the T cells from targeting cancerous tumor
cells.4
PD-L1 – Programmed cell Death Ligand 1 is expressed by
cancerous tumor cells as an adaptive immune mechanism to escape
anti-tumor responses, thus believed to suppress the immune system’s
response to the presence of cancer cells.5
PD-L1 TPS – PD-L1 Tumor Proportion Score represents the
percentage of tumor cells that express PD-L1 proteins.
PFS – Progression-Free Survival.
RANO – Response Assessment in Neuro-Oncology, the
standard for assessing the response of a brain or spinal cord tumor
to therapy.
SQ-NSCLC – Non-small cell lung cancer tumors of squamous
histology.
T Cells – T cells are a type of white blood cell that is
a component of the immune system that, in general, fights against
infection and harmful cells like tumor cells.6
Tetravalent – A tetravalent molecule has four binding
sites or regions.
Tumor Microenvironment – The tumor microenvironment is
the ecosystem that surrounds a tumor inside the body. It includes
immune cells, the extracellular matrix, blood vessels and other
cells, like fibroblasts. A tumor and its microenvironment
constantly interact and influence each other, either positively or
negatively.7
VEGF – Vascular Endothelial Growth Factor is a signaling
protein that promotes angiogenesis.8
Summit Therapeutics and the
Summit Therapeutics logo are trademarks of Summit Therapeutics Inc.
Copyright 2024, Summit Therapeutics Inc. All Rights Reserved.
__________________ 1 Shibuya M. Vascular
Endothelial Growth Factor (VEGF) and Its Receptor (VEGFR) Signaling
in Angiogenesis: A Crucial Target for Anti- and Pro-Angiogenic
Therapies. Genes Cancer. 2011 Dec;2(12):1097-105 2 Stefan MI, Le
Novère N. Cooperative binding. PLoS Comput Biol. 2013;9(6) 3 US
National Cancer Institute, a part of the National Institute of
Health (NIH).
https://www.cancer.gov/about-cancer/treatment/types/immunotherapy.
Accessed April 2024. 4 Han Y, et al. PD-1/PD-L1 Pathway: Current
Researches in Cancer. Am J Cancer Res. 2020 Mar 1;10(3):727-742. 5
Han Y, et al. PD-1/PD-L1 Pathway: Current Researches in Cancer. Am
J Cancer Res. 2020 Mar 1;10(3):727-742. 6 Cleveland Clinic.
https://my.clevelandclinic.org/health/body/24630-t-cells. Accessed
April 2024. 7 MD Anderson Cancer Center.
https://www.mdanderson.org/cancerwise/what-is-the-tumor-microenvironment-3-things-to-know.h00-159460056.html.
Accessed April 2024. 8 Shibuya M. Vascular Endothelial Growth
Factor (VEGF) and Its Receptor (VEGFR) Signaling in Angiogenesis: A
Crucial Target for Anti- and Pro-Angiogenic Therapies. Genes
Cancer. 2011 Dec;2(12):1097-105.
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Contact Summit Investor Relations: Dave Gancarz Chief
Business & Strategy Officer
Nathan LiaBraaten Senior Director, Investor Relations
investors@smmttx.com
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