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ASH 2020 | CPI-0610: a novel BET inhibitor for MF

Srdan Verstovsek, MD, PhD, University of Texas MD Anderson Cancer Center, Houston, TX, discusses the updated data from the Phase II MANIFEST study (NCT02158858): a trial of novel epigenetic modifier CPI-0610 in combination with ruxolitinib (rux) in myelofibrosis. CPI-0610 is a first-in-class inhibitor of bromodomain and extraterminal domain (BET) proteins, which regulate gene transcription in numerous pro-fibrotic pathways. The combination was well-tolerated. The results provide evidence of synergy between CPI-0610 and rux in these myelofibrosis patients, and the spleen and symptom benefits are promising. This interview took place during the 62nd American Society of Hematology (ASH) Annual Meeting and Exposition, 2020.

Transcript (edited for clarity)

MANIFEST study is quite an extensive study. And so to give you perspective of what we are talking about here is the new medication. It has no name, it’s called CPI-610. It is a BET inhibitor, maybe hard to understand, let me keep it simple. It is one of the medications, so-called epigenetic modifiers. Modifier is the gene expression, that’s I think is a simple explanation. It’s a pill...

MANIFEST study is quite an extensive study. And so to give you perspective of what we are talking about here is the new medication. It has no name, it’s called CPI-610. It is a BET inhibitor, maybe hard to understand, let me keep it simple. It is one of the medications, so-called epigenetic modifiers. Modifier is the gene expression, that’s I think is a simple explanation. It’s a pill. It’s the study that has multiple different arms. There’s the CPI-610 is addition to ruxolitinib, a standard JAK inhibitor therapy in frontline setting. It is an addition to ruxolitinib in people who have already been on ruxolitinib and are still on it, but have suboptimal response. And there is another arm where you studied it as a single agent after ruxolitinib, once they’ve failed. And in all of these case scenarios, we also look at the benefits on a spleen and the symptoms as well as on anemia, does it improve the anemia?

So I actually was presenting the part where people who are on the ruxolitinib have suboptimal response, get the CPI on top, like add on approach. And we report that it does improve the symptoms and the spleen, and it has some anemia benefit as well. In fact, it has been shown to be active across the board in any of these situations to different extent. And based on these results, these presentation that I’m presenting and others that are included in ASH presentations on different parts of this complex study suggest its activity. And we are looking forward to open soon globally, a phase three randomized study for possible approval of CPI-610, as it’s combined in a frontline setting from the day one with ruxolitinib together to possibly provide more of the spleen and symptoms benefit the ruxolitinib alone. So that’s the next Phase III study for its possible approval.

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Disclosures

Srdan Verstovsek, MD, PhD, has received research support for clinical studies from Incyte, Roche, NS, Pharma, Celgene, Gilead, Promedior, CTI BioPharma, Abbvie, Blueprint Medicines Corp., Novartis, Sierra Oncology, PharmaEssentia, Constellation, Ital Pharma, Protagonist and Kartos.