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Cytheris
Announces Initiation of CONVERT,
a Phase I/IIa Study of CYT107 with
Antiviral Therapy and Vaccination for HBV
Initiation
of CYT107 Study in HBV Expands Company's Hepatitis
Investigations, Which Include Three Ongoing
Studies in Hepatitis C (HCV)
Paris
-- December 8, 2009 -- Cytheris SA, a clinical
stage biopharmaceutical company focused on research
and development of new therapies for immune
modulation, today announced that it has begun
enrolling patients in its Phase I/IIa clinical
program evaluating the company's investigative
immune-modulator, recombinant human Interleukin-7
(CYT107), in combination with standard antiviral
treatment and vaccination in HBeAg-negative
chronic hepatitis B-infected (HBV) patients.
"Cytheris
is currently conducting three clinical trials
of CYT107 in chronic hepatitis C-infected patients
in Europe and Asia," said Michel Morre,
DVM, President and CEO of Cytheris, "and
we are now pleased to initiate CONVERT in chronic
hepatitis B infection here in Europe, underscoring
our dedication to exploring new treatment options
for the millions of patients throughout the
world afflicted with these devastating viral
infections."
"Though
the most effective HBV antiviral drugs have
shown a remarkable ability to rapidly drop HBV
viral load, even with these powerful drugs the
percentage of patients reaching HBsAg seroconversion
-- the ultimate goal of therapy -- remains low,"
said Christophe Hézode, MD, of the Department
of Hepatology-Gastroenterology at Hospital Henri
Mondor, Creteil, France, Principal Investigator
and International Study Chairman for the trial.
"This failure to cure the disease explains
why investigators have tried to boost long-term
immunological response through patient vaccination
or immunomodulation, though these attempts have
so far been insufficient to fully control the
disease. It is our hope that combining IL-7
with an antiviral and a vaccine will ultimately
result in the production of a protective and
long lasting immune response against the HBV
virus in a significant proportion of treated
patients."
About
the Study (CLI-107-10)
CONVERT is a randomized open label, controlled
multicentre Phase I inter-patient dose escalation
study, followed by a Phase IIa extension of
1 or 2 dose levels of CYT107 which have demonstrated
safety and sufficient immunological or antiviral
activity.
The primary objective of the study is to determine
the short and long-term safety and biological
activity of CYT107 in patients with a HBeAg-negative
chronic hepatitis B virus who have, at screening,
undetectable HBV DNA and who have been stable
for at least 3 months with antiviral treatment.
The trial will initiate at 7 study centers in
France and 3 sites in Italy.
At each dose level, two cohorts of 4 patients,
3 treated with CYT107 and 1 control patient,
will be run in parallel. The treatment of the
two cohorts is characterized by the following:
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Tri-therapy
group: patients will receive CYT107 + HBV
vaccine (GenHevac B Pasteur) + antiviral
treatment [Baraclude (entecavir) or Viread
(tenofovir)] and one control patient will
receive only antiviral treatment. |
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Bi-therapy
group: patients will receive CYT107 + antiviral
treatment (entecavir or tenofovir) and one
control patient will receive antiviral treatment
only. |
Patients
with chronic HBeAg-negative hepatitis will be
assessed for study participation if they have
undetectable HBV DNA for at least 3 months when
treated with entecavir or tenofovir. For all
included patients the antiviral therapy will
be continued during the full duration of the
study. Patients will be followed up to Week
48, with a mid-term evaluation of the biological
activity at Week 16.
According to Thérèse Croughs,
MD, Chief Medical Officer of Cytheris, "The
combination of three factors is expected to
result in producing a protective immune response
against the HBV virus in a significant proportion
of patients:
1.
The severe drop in viral load produced by
HBV antivirals such as entecavir or tenofovir
will decrease the frequency of PD-1 expressing
T-cells and rescue them from exhaustion, leaving
room for protective T-cells expressing the
IL-7 receptor (CD127+);
2. The repeated administration of GenHevac
B Pasteur vaccine should support the production
of anti-HBV specific T-cells, including central
memory T-cells, and it is these cells that
will be further augmented and supported by
CYT107 treatment; and,
3. The cycle of CYT107 treatment will both
facilitate the production of naive CD4 and
CD8 T-cells available for specific antigen
response and support the production of long
lived central memory specific T-cells."
The
restoration of a specific immune response should
translate into HBsAg seroconversion together
with direct elimination of residual viral DNA.
Moreover, the anti-fibrotic effects CYT107 may
prevent or slow the evolution to cirrhosis.
In this early clinical study, the aim will be
to better understand how to optimize this combined
therapeutic approach to favor a shortened treatment
regimen through induction of a protective and
long lasting immune response.
About Hepatitis B
Hepatitis B virus (HBV) is a hepatotropic non-cytopathic
DNA virus, which is transmitted percutaneously,
sexually and perinatally. Two billion people
in the world are estimated to be infected with
the hepatitis B virus. Chronic infection with
HBV is a major cause of liver disease, ranking
as a substantial cause of cirrhosis and hepatocellular
carcinoma (HCC). An estimated 350 to 400 million
people are living with chronic HBV infection
which annually accounts for 1 million deaths
from cirrhosis, liver failure, and hepatocellular
carcinoma, representing 30% of all cirrhosis
cases and approximately 50% of all HCC cases
worldwide.
The incidence of acute HBV infection has decreased
dramatically in Western countries since the
mid-1980s following the introduction of an effective
vaccine: in the U.S., the incidence in the general
population decreased by 75% between 1990 and
2004, a reduction which can be attributed to
the availability of an effective vaccine and
widespread immunization of infants and high-risk
populations.
The same is true for Europe, where in Germany
the incidence of reported acute HBV cases dropped
from 7.5 cases/100,000 inhabitants in 1995 to
1.4 in 2005, and in Italy, where a similar trend
was observed following introduction of the anti-HBV
vaccination for newborns and young children
in 1991.
In low endemic countries HBV is usually acquired
via injection drug use, sexual contacts, or
body piercing activities, while in endemic regions
(seroprevalence 8%), such as Asia, most infections
are acquired perinatally.
Currently available options for the treatment
of chronic HBV infection include standard
and pegylated interferon [alpha] and five
oral antiviral agents (lamivudine
[Epivir-HBV], adefovir
[Hepsera], entecavir,
tenofovir, and
telbivudine [Tyzeka]).
According to a recent comprehensive literature
search, entecavir efficacy is superior to that
of lamivudine, which in turn would be superior
to that of adefovir in nucleoside-naïve
patients with chronic HBV infection. Low doses
of tenofovir are also more potent than adefovir
in chronic HBeAg negative hepatitis B.
Available antiviral treatments, especially entecavir
and tenofovir, have been shown to induce a remarkable
and rapid drop of HBV viral load as measured
by viral DNA. However, even with these powerful
drugs the percentage of patients reaching HBsAg
seroconversion remains extremely low and the
viral load increases at the end of treatment.
About Interleukin-7
(CYT107)
Recombinant human interleukin-7 (CYT107) is
a critical immune-modulator for immune T-cell
recovery and enhancement. As a growth factor
and cytokine physiologically produced by marrow
or thymic stromal cells and other epithelia,
IL-7 has a critical and, at some steps, a non-redundant
stimulating effect on T lymphocyte development,
notably on thymopoiesis and, downstream from
the thymus, on homeostatic expansion of peripheral
T-cells.
A first-generation form of rhIL-7 was shown
in pre-clinical and Phase I studies in oncology
and HIV-infected patients to be well tolerated
in repeated dose trials, with long-lasting increases
in both CD4 and CD8 T cells. CYT107 is a second-generation
rhIL-7 product made by Cytheris via a recombinant
mammalian cell culture system.
Clinical trials conducted on more than 120 patients
in Europe, North America and Taiwan have demonstrated
the potential of IL-7 to expand and protect
CD4+ and CD8+ T-cells.
Currently, Cytheris is conducting multiple international
investigations of IL-7 in HIV, HCV, idiopathic
CD4 lymphocytopenia (sponsored by NIAID/NIH)
and cancer, the latter including an NCI/NIH-sponsored
study of IL-7 in combination with dendritic
cell vaccines in a pilot study of tumor vaccination
in children and a study designed to restore
CD4+ and CD8+ counts following T-cell depletion
due to bone marrow or peripheral blood stem
cell transplant (being conducted at the Memorial
Sloan-Kettering Cancer Center in New York City).
About Cytheris
Cytheris SA is a privately held clinical-stage
biopharmaceutical company focused on research
and development of new therapies for immune
modulation. These drugs aim at reconstituting
and enhancing the immune system of patients
suffering from cancer, chronic viral or bacterial
infections such as HCV, HBV and HIV, or lympho-depleting
treatments such as chemotherapy, radiotherapy,
bone marrow transplantation (BMT) and hematopoietic
cell transplantation (HCT). The company operates
from its headquarters and laboratories in Issy-les-Moulineaux,
a suburb of Paris, and its U.S. subsidiary in
Rockville, Maryland.
For more information, visit www.cytheris.com.
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