The FDA granted a fast track designation for ALLO-605 based on its potential to treat patients with relapsed/refractory multiple myeloma who progressed on previous standard multiple myeloma therapies.
ALLO-605 was granted a fast track designation by the FDA for the treatment of patients with relapsed/refractory multiple myeloma due to its potential to address unmet needs for a population of patients whose disease progressed following previous standard therapies.1
Preclinical data assessing ALLO-605 in patients with relapsed/refractory multiple myeloma were presented at the 2020 American Society of Hematology (ASH) Annual Meeting, indicating that the drug demonstrated prolonged persistence and antitumor activity, along with a tolerable safety profile, supporting further clinical investigation.2 The B-cell maturation antigen (BCMA)–targeted CAR T-cell therapy demonstrated an enhanced cytokine secretion, polyfunctionality, and improvements in serial killing activity in an in vitro model. Additionally, in a disseminated mouse model of myeloma, ALLO-605 yielded a 2-fold increase in peak expansion and enhanced survival vs BCMA CAR T cells. This translated to prolonged anti-tumor responses and delays in disease relapse.
However, investigators reported that exposure to target cells was necessary in order to achieve expansion and long-term activity of the BCMA-directed CAR T cells. Investigators did not observe evidence of target- and cytokine-independent proliferation
Additionally, the phase 1 dose escalation portion of the IGNITE trial investigating ALLO-605, Allogene’s first TurboCAR clinical candidate, was initiated in the second quarter of 2021.
“We are very pleased with the continued momentum of our anti-BCMA portfolio for patients with multiple myeloma and look forward to making allogeneic CAR T therapy a potential option for these patients,” Rafael Amado, MD, executive vice president of research and development and chief medical officer, said in a press release.
ALLO-605, the next-generation of allogeneic CAR T-cell therapy BCMA, is the third prong of Allogene’s approach of targeting BCMA for patients with multiple myeloma. The CAR T product is the first TurboCAR clinical candidate—a next generation platform technology based on programmable cytokine signaling that can work to ultimately to improve the function and potency of allogenic CAR T-cells. ALLO-715 was granted a regenerative medicine advanced therapy (RMAT) designation by the FDA in April 2021. Moreover, data from the phase 1 UNIVERSAL study (NCT04093596), in which patients with relapsed/refractory disease will receive treatment with ALLO-715, read out at the 2020 ASH Annual Meeting. The UNIVERSE trial also began separately enrolling begun enrolling patients in the first half of 2021 in order to evaluate ALLO-715 in combination with an investigational gamma secretase inhibitor, nirogacestat.
Additional findings from the preclinical phase 1 study identified 2 possible strategies to modulate the BCMA CAR T-cell product in order to respond to potential treatment-related toxicities. Investigators accessed the possibility of a CD20-based off switch that could be incorporated into the CAR in order to sensitize cells to rituximab (Rituxan). This resulted in a successful depletion of BCMA CAR T cells. Additionally, investigators were able to confirm the rapid inhibition of BCMA TurboCAR T cells through the use of protein tyrosine kinase inhibitor dasatinib (Sprycel).
“With studies now underway for ALLO-715 alone and in combination with a gamma secretase inhibitor, as well as ALLO-605 as our next generation CAR T, we are taking an aggressive three-pronged approach aimed at exploring the unique attributes of AlloCAR T therapies for patients with rapidly progressing disease,” Amado said in a press release.
References
1. Allogene Therapeutics Granted FDA Fast Track Designation for ALLO-605, the First TurboCAR™ T Cell Therapy, for the Treatment of Relapsed/Refractory Multiple Myeloma. News release. Allogene. Published June 30, 2021. Accessed August 10, 2021. https://tinyurl.com/5d92cpju
2. Cesar Sommer, Regina Lin, Janette Sutton, et al. Preclinical Evaluation of ALLO-605, an Allogeneic BCMA Turbocar TTM Cell Therapy for the Treatment of Multiple Myeloma. Blood 2020; 136 (Supplement 1): 8. https://doi.org/10.1182/blood-2020-141477
FDA Approves Cilta-Cel for Relapsed/Refractory Myeloma After 1 Therapy
April 6th 2024The FDA has approved ciltacabtagene autoleucel for the treatment of adult patients with relapsed/refractory multiple myeloma who have received at least 1 prior line of treatment, including a proteasome inhibitor and an immunomodulatory agent, and are refractory to lenalidomide.
Relapsed/Refractory Multiple Myeloma Trial Updates From ASCO 2023
August 7th 2023Experts from Mayo Clinic and The University of Texas MD Anderson Cancer Center discuss results from multiple myeloma trials presented at the 2023 American Society of Clinical Oncology Annual Meeting and how they may apply to clinical practice.