Bladder Cancer Drug Meets Primary Endpoint: Pfizer

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Pfizer says the pivotal Phase 3 CREST trial of sasanlimab, an investigational anti-PD-1 monoclonal antibody (mAb), in combination with standard of care (SOC) Bacillus Calmette-Guérin (BCG) met its primary endpoint as an induction therapy with or without maintenance in patients with BCG-naïve, high-risk non-muscle invasive bladder cancer. In the trial, the primary endpoint of evnt-free survival was met, “demonstrating a clinically meaningful and statistically significant improvement with sasanlimab in combination with BCG (induction and maintenance) as compared to BCG alone (induction and maintenance),”  the company says.

The study findings also show a 32% reduction in risk of disease-related events, including high-grade disease recurrence or progression, with the sasanlimab combination regimen as compared with SOC treatment alone. “The probability of being event-free at 36 months was 82.1% (95% CI, 77.4-85.9) with sasanlimab in combination with BCG (induction and maintenance), and 74.8% (95% CI, 69.7-79.2) with BCG alone (induction and maintenance),” Pfizer says. “These Phase 3 results show that combining sasanlimab with BCG induction and maintenance therapy earlier in the course of the disease significantly prolonged event-free survival, highlighting the value and potential of sasanlimab in combination with BCG to redefine the treatment paradigm and reduce the burden for patients.”

Pfizer additionally notes that an early interim analysis for the key secondary overall survival endpoint suggested no difference between treatment arms, with a median follow-up of 40.9 months. The study will continue for survival follow-up until the final analysis, it says.

Sasanlimab is described by Pfizer as a humanized immunoglobulin G4 (IgG4) mAb that binds to human PD-1 to block its interaction with PD-1 and PD-L1/PD-L2. “PD-1 is a protein expressed on T cells, dendritic cells, natural killer cells, macrophages, and B cells, that functions as an immune checkpoint that negatively regulates T-cell activation and effector function when activated by its ligands and may play an important role in tumor evasion from host immunity,” it says.

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