HOUSTON & NEW YORK--(BUSINESS WIRE)--
Bristol-Myers
Squibb Company (NYSE:BMY) and The
University of Texas MD Anderson Cancer Center today announced a
novel clinical research collaboration to evaluate multiple
immunotherapies, including Opdivo (nivolumab), Yervoy
(ipilimumab) and three early-stage clinical immuno-oncology assets from
Bristol-Myers Squibb, as potential treatment options for acute and
chronic leukemia as well as other hematologic malignancies.
The agreement represents an innovative approach to research by focusing
numerous clinical trials using multiple agents, in mono and combination
regimens, on a specific disease target, in this case select hematologic
malignancies. Through this approach, Bristol-Myers Squibb and MD
Anderson aim to benefit patients by expediting the delivery of new
therapies. The collaboration will launch up to 10 phase 1 and 2 clinical
trials, conducted by MD Anderson, focused on evaluating investigational
immune-based approaches for acute myeloid leukemia (AML), chronic
lymphocytic leukemia (CLL), chronic myeloid leukemia (CML),
myelodysplastic syndrome (MDS) and myelofibrosis (MF). Additional
studies will be determined by the collaboration at a later date.
Opdivo (nivolumab) is an investigational PD-1 immune checkpoint
inhibitor currently approved in Japan for the treatment of patients with
unresectable melanoma, and Yervoy (ipilimumab) is a
CTLA-4 immune checkpoint inhibitor approved in the U.S. and more than 40
countries for patients with unresectable or metastatic melanoma.
Bristol-Myers Squibb has proposed the name Opdivo (pronounced
op-dee-voh), which, if approved by health authorities, will serve
as the trademark for nivolumab.
"Collaborations between industry and academia can offer a faster and
broader spectrum of clinical trials to benefit patients," said Hagop
Kantarjian, M.D., chair of leukemia
at MD Anderson. "We hope innovative collaborations such as this can help
lead to a higher likelihood for success across the board and will speed
up the clinical development of new compounds for delivery to the
patients who need them."
"Immunotherapy is an extremely promising area of research and a key area
of focus for MD Anderson's Moonshots Program," said MD Anderson
President Ron DePinho, M.D. "Partnerships between academia and industry
have the potential to significantly advance the application of new
discoveries to cancer treatment."
"Bristol-Myers Squibb is committed to advancing the field of
immuno-oncology and complementing our broad research and discovery
programs through innovative collaborations with partners who share our
commitment to patients," said Francis
Cuss, MB BChir, FRCP, executive vice president and chief scientific
officer, Bristol-Myers Squibb. "Cooperation between industry and
academia offers a tremendous opportunity to strengthen our scientific
and clinical understanding of the role of the immune system in treating
cancer."
Immuno-oncology is an innovative approach to cancer research and
treatment that is designed to harness the body's own immune system to
fight cancer. Hematologic malignancies represent significant areas of
high unmet need marked by poor outcomes among the elderly, high-risk
patients and for those with multiple relapses. Existing clinical
research, including studies by MD Anderson, support further research
into the potential of immunotherapies as treatment options for leukemia
and other hematologic malignancies.
About Opdivo (nivolumab)
Cancer cells may exploit "regulatory" pathways, such as checkpoint
pathways, to hide from the immune system and shield the tumor from
immune attack. Opdivo is an investigational, fully-human PD-1
immune checkpoint inhibitor that binds to the checkpoint receptor PD-1
(programmed death-1) expressed on activated T-cells.
Bristol-Myers Squibb has a broad, global development program to study Opdivo
in multiple tumor types consisting of more than 35 trials - as
monotherapy or in combination with other therapies - in which more than
7,000 patients have been enrolled worldwide. Among these are several
potentially registrational trials in non-small cell lung cancer (NSCLC),
melanoma, renal cell carcinoma (RCC), head and neck cancer, glioblastoma
and non-Hodgkin lymphoma.
In 2013, the FDA granted Fast Track designation for Opdivo in
NSCLC, melanoma and RCC. In April 2014, the company initiated a rolling
submission with the FDA for Opdivo in third-line pre-treated
squamous cell NSCLC and expects to complete the submission by year-end.
The FDA granted its first Breakthrough Therapy Designation for Opdivo
in May 2014 for the treatment of patients with Hodgkin lymphoma after
failure of autologous stem cell transplant and brentuximab. On July
4, Ono Pharmaceutical Co. announced that Opdivo received
manufacturing and marketing approval in Japan for the treatment of
patients with unresectable melanoma, making Opdivo the first PD-1
immune checkpoint inhibitor to receive regulatory approval anywhere in
the world. On September 26, Bristol-Myers Squibb announced that the FDA
accepted for priority review the Biologics License Application (BLA) for
previously treated advanced melanoma, and the Prescription Drug User Fee
Act (PDUFA) goal date for a decision is March 30, 2015. The FDA also
granted Opdivo Breakthrough Therapy status for this indication.
In the European Union, the European Medicines Agency (EMA) has validated
for review the Marketing Authorization Application (MAA) for Opdivo
in advanced melanoma. The application has also been granted accelerated
assessment by the EMA's Committee for Medicinal Products for Human Use
(CHMP). The EMA also validated for review the MAA for nivolumab in NSCLC.
About Yervoy (ipilimumab)
Yervoy, which is a recombinant, human monoclonal antibody, blocks
the cytotoxic T- lymphocyte-associated antigen-4 (CTLA-4). CTLA-4 is a
negative regulator of T-cell activation. Yervoy binds to CTLA-4
and blocks the interaction of CTLA-4 with its ligands, CD80/CD86.
Blockade of CTLA-4 has been shown to augment T-cell activation and
proliferation. The mechanism of action of Yervoy's effect in
patients with melanoma is indirect, possibly through T-cell mediated
anti-tumor immune responses. On March 25, 2011, the FDA approved Yervoy 3
mg/kg monotherapy for patients with unresectable or metastatic melanoma. Yervoy is
now approved in more than 40 countries, including Taiwan. There is a
broad, ongoing development program in place for Yervoy spanning
multiple tumor types. This includes Phase 3 trials in prostate and lung
cancers.
Immuno-Oncology at Bristol-Myers Squibb
Surgery, radiation, cytotoxic or targeted therapies have represented the
mainstay of cancer treatment over the last several decades, but
long-term survival and a positive quality of life have remained elusive
for many patients with advanced disease.
To address this unmet medical need, Bristol-Myers Squibb is leading
advances in the innovative field of immuno-oncology, which involves
agents whose primary mechanism is to work directly with the body's
immune system to fight cancer. The company is exploring a variety of
compounds and immunotherapeutic approaches for patients with different
types of cancer, including researching the potential of combining
immuno-oncology agents that target different and complementary pathways
in the treatment of cancer.
Bristol-Myers Squibb is committed to advancing the science of
immuno-oncology, with the goal of changing survival expectations and the
way patients live with cancer.
Yervoy (ipilimumab) INDICATION & IMPORTANT SAFETY
INFORMATION
Yervoy (ipilimumab) is indicated for the treatment of
unresectable or metastatic melanoma.
Important Safety Information
WARNING: IMMUNE-MEDIATED ADVERSE REACTIONS
Yervoy can result in severe and fatal immune-mediated
adverse reactions due to T-cell activation and proliferation. These
immune-mediated reactions may involve any organ system; however, the
most common severe immune-mediated adverse reactions are enterocolitis,
hepatitis, dermatitis (including toxic epidermal necrolysis),
neuropathy, and endocrinopathy. The majority of these immune-mediated
reactions initially manifested during treatment; however, a minority
occurred weeks to months after discontinuation of Yervoy.
Assess patients for signs and symptoms of enterocolitis, dermatitis,
neuropathy, and endocrinopathy and evaluate clinical chemistries
including liver function tests (LFTs) and thyroid function tests at
baseline and before each dose.
Permanently discontinue Yervoy and initiate systemic high-dose
corticosteroids for sever immune-mediated reactions.
Recommended Dose Modifications
Withhold dose for any moderate immune-mediated adverse reactions or for
symptomatic endocrinopathy until return to baseline, improvement to mild
severity, or complete resolution, and patient is receiving <7.5 mg
prednisone or equivalent per day.
Permanently discontinue Yervoy for any of the following:
-- Persistent moderate adverse reactions or inability to reduce
corticosteroid dose to 7.5 mg prednisone or equivalent per day
-- Failure to complete full treatment course within 16 weeks from
administration of first dose
-- Severe or life-threatening adverse reactions, including any of the
following:
o Colitis with abdominal pain, fever, ileus, or peritoneal signs;
increase in stool frequency (=7 over baseline), stool incontinence,
need for intravenous hydration for >24 hours, gastrointestinal
hemorrhage, and gastrointestinal perforation
o AST or ALT >5 × the upper limit of normal (ULN) or total bilirubin >3
× the ULN
o Stevens-Johnson syndrome, toxic epidermal necrolysis, or rash
complicated by full-thickness dermal ulceration or necrotic, bullous,
or hemorrhagic manifestations
o Severe motor or sensory neuropathy, Guillain-Barré syndrome, or
myasthenia gravis
o Severe immune-mediated reactions involving any organ system
o Immune-mediated ocular disease which is unresponsive to topical
immunosuppressive therapy
Immune-mediated Enterocolitis:
-- In the pivotal Phase 3 study in Yervoy-treated patients, severe,
life-threatening, or fatal (diarrhea of =7 stools above baseline, fever,
ileus, peritoneal signs; Grade 3-5) immune-mediated enterocolitis
occurred in 34 (7%) and moderate (diarrhea with up to 6 stools above
baseline, abdominal pain, mucus or blood in stool; Grade 2)
enterocolitis occurred in 28 (5%) patients
-- Across all Yervoy-treated patients (n=511), 5 (1%) developed intestinal
perforation, 4 (0.8%) died as a result of complications, and 26 (5%)
were hospitalized for severe enterocolitis
-- Infliximab was administered to 5 of 62 (8%) patients with moderate,
severe, or life-threatening immune-mediated enterocolitis following
inadequate response to corticosteroids
-- Monitor patients for signs and symptoms of enterocolitis (such as
diarrhea, abdominal pain, mucus or blood in stool, with or without
fever) and of bowel perforation (such as peritoneal signs and ileus). In
symptomatic patients, rule out infectious etiologies and consider
endoscopic evaluation for persistent or severe symptoms
-- Permanently discontinue Yervoy in patients with severe enterocolitis and
initiate systemic corticosteroids (1-2 mg/kg/day of prednisone or
equivalent). Upon improvement to =Grade 1, initiate corticosteroid taper
and continue over at least 1 month. In clinical trials, rapid
corticosteroid tapering resulted in recurrence or worsening symptoms of
enterocolitis in some patients
-- Withhold Yervoy for moderate enterocolitis; administer anti-diarrheal
treatment and, if persistent for >1 week, initiate systemic
corticosteroids (0.5 mg/kg/day prednisone or equivalent)
Immune-mediated Hepatitis:
-- In the pivotal Phase 3 study in Yervoy-treated patients, severe,
life-threatening, or fatal hepatotoxicity (AST or ALT elevations >5x the
ULN or total bilirubin elevations >3x the ULN; Grade 3–5) occurred in 8
(2%) patients, with fatal hepatic failure in 0.2% and hospitalization in
0.4%
-- 13 (2.5%) additional Yervoy-treated patients experienced moderate
hepatotoxicity manifested by LFT abnormalities (AST or ALT elevations
>2.5x but =5x the ULN or total bilirubin elevation >1.5x but =3x the
ULN; Grade 2)
-- Monitor LFTs (hepatic transaminase and bilirubin levels) and assess
patients for signs and symptoms of hepatotoxicity before each dose of
Yervoy. In patients with hepatotoxicity, rule out infectious or
malignant causes and increase frequency of LFT monitoring until
resolution
-- Permanently discontinue Yervoy in patients with Grade 3-5 hepatotoxicity
and administer systemic corticosteroids (1-2 mg/kg/day of prednisone or
equivalent). When LFTs show sustained improvement or return to baseline,
initiate corticosteroid tapering and continue over 1 month. Across the
clinical development program for Yervoy, mycophenolate treatment has
been administered in patients with persistent severe hepatitis despite
high-dose corticosteroids
-- Withhold Yervoy in patients with Grade 2 hepatotoxicity
-- In a dose-finding trial, Grade 3 increases in transaminases with or
without concomitant increases in total bilirubin occurred in 6 of 10
patients who received concurrent Yervoy (3 mg/kg) and vemurafenib (960
mg BID or 720 mg BID)
Immune-mediated Dermatitis:
-- In the pivotal Phase 3 study in Yervoy-treated patients, severe,
life-threatening, or fatal immune-mediated dermatitis (e.g.,
Stevens-Johnson syndrome, toxic epidermal necrolysis, or rash
complicated by full thickness dermal ulceration, or necrotic, bullous,
or hemorrhagic manifestations; Grade 3–5) occurred in 13 (2.5%) patients
o 1 (0.2%) patient died as a result of toxic epidermal necrolysis
o 1 additional patient required hospitalization for severe dermatitis
-- There were 63 (12%) Yervoy-treated patients with moderate (Grade 2)
dermatitis
-- Monitor patients for signs and symptoms of dermatitis such as rash and
pruritus. Unless an alternate etiology has been identified, signs or
symptoms of dermatitis should be considered immune-mediated
-- Permanently discontinue Yervoy in patients with severe,
life-threatening, or fatal immune-mediated dermatitis (Grade 3-5).
Administer systemic corticosteroids (1-2 mg/kg/day of prednisone or
equivalent). When dermatitis is controlled, corticosteroid tapering
should occur over a period of at least 1 month. Withhold Yervoy in
patients with moderate to severe signs and symptoms
-- Treat mild to moderate dermatitis (e.g., localized rash and pruritus)
symptomatically. Administer topical or systemic corticosteroids if there
is no improvement within 1 week
Immune-mediated Neuropathies:
-- In the pivotal Phase 3 study in Yervoy-treated patients, 1 case of fatal
Guillain-Barré syndrome and 1 case of severe (Grade 3) peripheral motor
neuropathy were reported
-- Across the clinical development program of Yervoy, myasthenia gravis and
additional cases of Guillain-Barré syndrome have been reported
-- Monitor for symptoms of motor or sensory neuropathy such as unilateral
or bilateral weakness, sensory alterations, or paresthesia. Permanently
discontinue Yervoy in patients with severe neuropathy (interfering with
daily activities) such as Guillain-Barré–like syndromes
-- Institute medical intervention as appropriate for management of severe
neuropathy. Consider initiation of systemic corticosteroids (1-2
mg/kg/day of prednisone or equivalent) for severe neuropathies. Withhold
Yervoy in patients with moderate neuropathy (not interfering with daily
activities)
Immune-mediated Endocrinopathies:
-- In the pivotal Phase 3 study in Yervoy- treated patients, severe to
life-threatening immune-mediated endocrinopathies (requiring
hospitalization, urgent medical intervention, or interfering with
activities of daily living; Grade 3-4) occurred in 9 (1.8%) patients
o All 9 patients had hypopituitarism, and some had additional
concomitant endocrinopathies such as adrenal insufficiency,
hypogonadism, and hypothyroidism
o 6 of the 9 patients were hospitalized for severe endocrinopathies
-- Moderate endocrinopathy (requiring hormone replacement or medical
intervention; Grade 2) occurred in 12 (2.3%) Yervoy-treated patients and
consisted of hypothyroidism, adrenal insufficiency, hypopituitarism, and
1 case each of hyperthyroidism and Cushing’s syndrome
-- Median time to onset of moderate to severe immune-mediated
endocrinopathy was 11 weeks and ranged up to 19.3 weeks after the
initiation of Yervoy
-- Monitor patients for clinical signs and symptoms of hypophysitis,
adrenal insufficiency (including adrenal crisis), and hyper- or
hypothyroidism
o Patients may present with fatigue, headache, mental status changes,
abdominal pain, unusual bowel habits, and hypotension, or nonspecific
symptoms which may resemble other causes such as brain metastasis or
underlying disease. Unless an alternate etiology has been identified,
signs or symptoms should be considered immune-mediated
o Monitor thyroid function tests and clinical chemistries at the start
of treatment, before each dose, and as clinically indicated based on
symptoms. In a limited number of patients, hypophysitis was diagnosed
by imaging studies through enlargement of the pituitary gland
-- Withhold Yervoy in symptomatic patients. Initiate systemic
corticosteroids (1-2 mg/kg/day of prednisone or equivalent) and initiate
appropriate hormone replacement therapy. Long-term hormone replacement
therapy may be necessary
Other Immune-mediated Adverse Reactions, Including Ocular
Manifestations:
-- In the pivotal Phase 3 study in Yervoy-treated patients, clinically
significant immune-mediated adverse reactions seen in <1% were:
nephritis, pneumonitis, meningitis, pericarditis, uveitis, iritis, and
hemolytic anemia
-- Across the clinical development program for Yervoy, likely
immune-mediated adverse reactions also reported with <1% incidence were:
myocarditis, angiopathy, temporal arteritis, vasculitis, polymyalgia
rheumatica, conjunctivitis, blepharitis, episcleritis, scleritis,
leukocytoclastic vasculitis, erythema multiforme, psoriasis,
pancreatitis, arthritis, autoimmune thyroiditis, sarcoidosis,
neurosensory hypoacusis, autoimmune central neuropathy (encephalitis),
myositis, polymyositis, and ocular myositis
-- Permanently discontinue Yervoy for clinically significant or severe
immune-mediated adverse reactions. Initiate systemic corticosteroids
(1-2 mg/kg/day of prednisone or equivalent) for severe immune-mediated
adverse reactions
-- Administer corticosteroid eye drops for uveitis, iritis, or
episcleritis. Permanently discontinue Yervoy for immune-mediated ocular
disease unresponsive to local immunosuppressive therapy
Pregnancy & Nursing:
-- Yervoy is classified as pregnancy category C. There are no adequate and
well-controlled studies of YERVOY in pregnant women. Use Yervoy during
pregnancy only if the potential benefit justifies the potential risk to
the fetus
-- Human IgG1 is known to cross the placental barrier and Yervoy is an
IgG1; therefore, Yervoy has the potential to be transmitted from the
mother to the developing fetus
-- It is not known whether Yervoy is secreted in human milk. Because many
drugs are secreted in human milk and because of the potential for
serious adverse reactions in nursing infants from Yervoy, a decision
should be made whether to discontinue nursing or to discontinue Yervoy
Common Adverse Reactions:
-- The most common adverse reactions (=5%) in patients who received Yervoy
at 3 mg/kg were fatigue (41%), diarrhea (32%), pruritus (31%), rash
(29%), and colitis (8%)
Please see Full Prescribing Information, including Boxed WARNING
regarding immune-mediated adverse reactions, available at www.bms.com
www.bms.com
About Bristol-Myers Squibb
Bristol-Myers Squibb is a global biopharmaceutical company whose mission
is to discover, develop and deliver innovative medicines that help
patients prevail over serious diseases. For more information, please
visit www.bms.com
or follow us on Twitter at http://twitter.com/bmsnews.
About MD Anderson
The University of Texas MD Anderson Cancer Center in Houston ranks as
one of the world's most respected centers focused on cancer patient
care, research, education and prevention. MD Anderson is one of only 41
comprehensive cancer centers designated by the National Cancer Institute
(NCI). For the past 25 years, MD Anderson has ranked as one of the
nation's top two cancer centers in U.S.
News & World Report's annual "Best Hospitals" survey.
MD Anderson receives a cancer center support grant from the NCI of the
National Institutes of Health (P30 CA016672).
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Bristol-Myers Squibb Forward-Looking Statement
This press release contains "forward-looking statements" as that term
is defined in the Private Securities Litigation Reform Act of 1995
regarding the research, development and commercialization of
pharmaceutical products. Such forward-looking statements are based on
current expectations and involve inherent risks and uncertainties,
including factors that could delay, divert or change any of them, and
could cause actual outcomes and results to differ materially from
current expectations. No forward-looking statement can be guaranteed.
Among other risks, there can be no guarantee that the immunotherapies
discussed in this release will be successfully developed or approved for
any of the indications described in this release, such as acute and
chronic leukemia and other hematologic malignancies. Forward-looking
statements in this press release should be evaluated together with the
many uncertainties that affect Bristol-Myers Squibb's business,
particularly those identified in the cautionary factors discussion in
Bristol-Myers Squibb's Annual Report on Form 10-K for the year ended
December 31, 2013 in our Quarterly Reports on Form 10-Q and our Current
Reports on Form 8-K. Bristol-Myers Squibb undertakes no obligation to
publicly update any forward-looking statement, whether as a result of
new information, future events or otherwise.

CONTACT: Bristol-Myers Squibb
Media:
Ken Dominski, 609-252-5251
ken.dominski@bms.com
or
Laura Hortas, 609-252-4587
laura.hortas@bms.com
or
MD Anderson Cancer Center
Media:
Ron Gilmore, 713-745-1898
rlgilmore1@mdanderson.org
or
Bristol-Myers Squibb
Investors:
Ranya Dajani, 609-252-5330
ranya.dajani@bms.com
or
Ryan Asay, 609-252-5020
ryan.asay@bms.com
Source: Bristol-Myers Squibb Company
Bristol-Myers Squibb
Media:
Ken Dominski, 609-252-5251
ken.dominski@bms.com
or
Laura Hortas, 609-252-4587
laura.hortas@bms.com
or
MD Anderson Cancer Center
Media:
Ron Gilmore, 713-745-1898
rlgilmore1@mdanderson.org
or
Bristol-Myers Squibb
Investors:
Ranya Dajani, 609-252-5330
ranya.dajani@bms.com
or
Ryan Asay, 609-252-5020
ryan.asay@bms.com