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Cancer Cell Published the Results of ASTRUM-004: HANSIZHUANG Combined with Chemotherapy for the First-line Treatment of sqNSCLC

2024-01-05

Shanghai, China, January 5th, 2024 – Shanghai Henlius Biotech, Inc. (2696.HK) announced that ASTRUM-004, Henlius’ pivotal phase 3 clinical study of anti-PD-1 mAb HANSIZHUANG (serplulimab) plus chemotherapy as first-line treatment for previously untreated locally advanced or metastatic squamous non-small-cell lung cancer (sqNSCLC), was published in Cancer Cell, a highly regarded oncology journal with an impact factor of 50.3. This publication serves as further evidence of the exceptional performance of HANSIZHUANG in the field of lung cancer. The study was led by Professor Caicun Zhou from Shanghai Pulmonary Hospital.



Results of the overall population ASTRUM-004 were initially presented at the IASLC 2023 World Conference on Lung Cancer (WCLC 2023) in the form of oral presentation. Additionally, the data from its Asian subgroup were showcased in a poster session at the European Society of Medical Oncology Asia (ESMO Asia) Congress 2023. Previously in 2022, the new drug application (NDA) of serplulimab for the treatment of sqNSCLC has been approved by the National Medical Products Administration (NMPA) based on the results of ASTRUM-004. Furthermore, HANSIZHUANG has been recommended as Grade I by the 2023 CSCO Guidelines for Non-Small Cell Lung Cancer for the first-line treatment of advanced sqNSCLC due to its outstanding clinical effectiveness and survival advantages for sqNSCLC patients.


Prof. Caicun Zhou, the corresponding author, as well as the leading principal investigator of the study, said, “The ASTRUM-004 study validated in the final analysis that serplulimab in combination with chemotherapy significantly improved survival with a manageable safety profile in previously untreated locally advanced or metastatic sqNSCLC patients. These findings re-energize research and innovation in the field of sqNSCLC. Serplulimab has become the first-line treatment of sqNSCLC in China and offers a novel, effective, and reliable therapy option for this patient population.”


Mr. Jason Zhu, Executive Director, CEO, and CFO of Henlius said, “Henlius has always prioritized innovation and quality in our company's development, and the publication of multiple pivotal studies of HANSIZHUANG in internationally known journals is testimony of our unwavering commitment revolves around a patient-centric approach. We will remain devoted to promoting scientific frontier translation, focusing on clinical treatment challenges and pain points, and providing more breakthrough therapeutic solutions for patients worldwide.”


Addressing unmet medical needs in lung cancer

Lung cancer is one of the most common cancers in the world, and it is the malignant tumour with the highest morbidity and mortality in China. According to the latest national cancer statistics released by the National Cancer Center, there are 828,000 new cases of lung cancer, with a total death toll of 657,000 [1], in which NSCLC accounts for about 80% - 85% of all lung cancers [2], and about 50% of NSCLC patients are in locally advanced stage that is not suitable for surgical resection or have metastasis at the time of diagnosis. Treatment of advanced sqNSCLC, making up about 30% of the advanced NSCLC, is given first place to a platinum-based doublet chemotherapy, which has limited efficacy, and the median survival time is quite short, many of which are less than 1 year. Therefore, there are huge unmet medical needs. In recent years, immune checkpoint inhibitors have made breakthroughs in NSCLC treatment, especially, the anti-PD-1 mAb combined with carboplatin and albumin-bound paclitaxel which has been recommended by domestic and international authoritative guidelines for the treatment of advanced or metastatic sqNSCLC, pushing forward the treatment of the advanced NSCLC into the era of immunotherapy.


ASTRUM-004 is a randomized, double-blind, international multicentre phase 3 study to compare the clinical efficacy and safety of serplulimab plus chemotherapy versus chemotherapy in patients with locally advanced or metastatic sqNSCLC who have not previously received systemic treatment. As of January 31, 2023, a total of 537 patients were randomized 2:1 to receive intravenous serplulimab 4.5 mg/kg or placebo (up to 35 cycles) in combination with chemotherapy (carboplatin and nab-paclitaxel, 4-6 cycles) in 3-week cycles. Updated analysis of progression-free survival (PFS) showed that with a median follow-up of 16.9 months, the PFS benefit of serplulimab-chemotherapy vs. placebo-chemotherapy was maintained (IRRC-assessed, median, 8.3 vs. 5.7 months; hazard ratio [HR] 0.53, 95% CI 0.42-0.67). The HR for PFS consistently favoured serplulimab-chemotherapy group across the prespecified subgroups. Final analysis of overall survival (OS) demonstrated that with a median follow-up of 31.1 months, OS was significantly prolonged with the addition of serplulimab (median, 22.7 vs. 18.2 months; HR 0.73, 95% CI 0.58-0.93; p=0.010, crossing the significance boundary of 0.046). By the time of the final analysis, 97 (54.2%) patients in the placebo-chemotherapy group had crossed over to serplulimab monotherapy. The median OS in the placebo-chemotherapy group adjusted by the two-stage model was 11.5 months (95% CI 9.6–13.5), resulting in an adjusted HR of 0.49 (95% CI 0.37–0.64). The safety profile of serplulimab plus chemotherapy was manageable. In conclusion, serplulimab plus chemotherapy could be a promising treatment option for this patient population.


Recognized by academic communities and industry

HANSIZHUANG (serplulimab) is the first innovative mAb developed by Henlius. Since launched in March 2022, HANSIZHUANG has been approved by the NMPA for the treatment of MSI-H solid tumours, sqNSCLC, extensive-stage small cell lung cancer (ES-SCLC), and esophageal squamous cell carcinoma (ESCC), benefiting more than 51,000 patients. In December 2023, HANSIZHUANG was approved in Indonesia for the treatment of ES-SCLC. The marketing applications of the first-line treatment for non-squamous non-small cell lung cancer (nsNSCLC) and ES-SCLC are under review by the NMPA and the European Medicines Agency (EMA), respectively. Henlius actively promotes HANSIZHUANG in conjunction with in-house products of the company such as tumour-specific target, angiogenesis target, immunotherapeutic target, etc. and chemotherapy drugs to conduct immune combination therapies. Underpinned by the patient-centric strategy, Henlius has carried out a differentiated and multi-dimensional layout in the field of gastrointestinal cancer and lung cancer, covering a wide variety of indications, such as lung cancer, ESCC, head and neck squamous cell carcinoma and gastric cancer, etc. To date, more than 3,600 subjects have been enrolled worldwide for HANSIZHUANG clinical trials.


As for the first-line lung cancer treatment, in addition to ASTRUM-004, a pivotal phase 3 clinical study of HANSIZHUANG for the first-line treatment of ES-SCLC, ASTRUM-005, has been published in the Journal of the American Medical Association (JAMA), one of the top four medical journals, and became the world's first clinical study on SCLC immunotherapy in JAMA. In the field of gastrointestinal cancer, the results of 2 pivotal trials of HANSIZHUANG in MSI-H solid tumours and ESCC were published in the British Journal of Cancer and Nature Medicine, respectively. Furthermore, HANSIZHUANG was respectively recommended by the CSCO Guidelines for Small Cell Lung Cancer, the CSCO Guidelines for Non-Small Cell Lung Cancer, the CSCO Guidelines for Esophageal Cancer, the CSCO Guidelines for Colorectal Cancer, the CSCO Clinical Practice Guidelines on Immune Checkpoint Inhibitor, the China Guidelines for Radiotherapy of Esophageal Cancer, and other definitive guides, providing valuable references for clinical diagnosis and treatment of tumours.



Looking forward, Henlius will actively improve efficiency through innovations, focusing on unmet medical needs to bring more high-quality and affordable therapies to patients worldwide.  



【参考文献】

[1] Rongshou Zheng, Siwei Zhang, Hongmei Zeng, et al. Cancer incidence and mortality in China, 2016. Journal of the National Cancer Center, 2022, ISSN 2667-0054, dio:10.1016/j.jncc.2022.02.002

[2] About Lung Cancer. American Cancer Society. https://www.cancer.org/content/dam/CRC/PDF/Public/8703.00

[3] NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Non-Small Cell Lung Cancer. Version 3.2023



About Cancer Cell

Cancer Cell is a Cell press journal which provides a high-profile forum to promote major advances in cancer discovery, translational research and oncology, with a journal impact factor of 50.3. As a pioneer in publishing innovative cancer research and oncology, the journal aims to bridge the gap between cutting-edge discoveries and clinical applications. It upholds high standards for fundamental research and emphasizes a comprehensive perspective on cancer.


About HANSIZHUANG

HANSIZHUANG (recombinant humanized anti-PD-1 monoclonal antibody injection, generic name: serplulimab injection) is the first anti-PD-1 mAb for the first-line treatment of SCLC and has been approved in China and Indonesia. Up to date, 4 indications are approved for marketing, 2 marketing applications are under review in China and the EU, and more than 10 clinical trials are ongoing across the world.


HANSIZHUANG was approved in China in March 2022 and has been approved by the National Medicinal Products Administration (NMPA) for the treatment of MSI-H solid tumours, squamous non-small cell lung cancer (sqNSCLC), extensive-stage small cell lung cancer (ES-SCLC), and esophageal squamous cell carcinoma (ESCC). The marketing applications of the first-line treatment for non-squamous non-small cell lung cancer (nsNSCLC) and ES-SCLC are under review by the NMPA and the European Medicines Agency (EMA), respectively. Focusing on lung and gastrointestinal cancer, the synergy of HANSIZHUANG with in-house products of the company and innovative therapies are being actively promoted. The company has initiated more than 10 clinical trials on immuno-oncology combination therapies in a wide variety of indications with more than 3,600 subjects enrolled in China, the U.S., Turkey, Poland, Georgia and other countries and regions. The results of 4 pivotal trials of HANSIZHUANG were published in the Journal of the American Medical Association (JAMA)Nature MedicineCancer Cell, and British Journal of Cancer, respectively. Furthermore, HANSIZHUANG was respectively recommended by the CSCO Guidelines for Small Cell Lung Cancer, the CSCO Guidelines for Non-Small Cell Lung Cancer, the CSCO Guidelines for Esophageal Cancer, the CSCO Guidelines for Colorectal Cancer, the CSCO Clinical Practice Guidelines on Immune Checkpoint Inhibitor, the China Guidelines for Radiotherapy of Esophageal Cancer, and other definitive guides, providing valuable references for clinical diagnosis and treatment of tumours. On the other hand, serplulimab was granted orphan drug designations by the U.S. FDA and the EC for the treatment of SCLC, and its bridging head-to-head trial in the United States to compare HANSIZHUANG to standard of care atezolizumab (anti-PD-L1 mAb) for the first-line treatment of ES-SCLC is well under way.