ASH Clinical News ACN_5.4_Full Issue_web | Page 2

DAURISMO is a Hedgehog pathway inhibitor indicated, in combination with LDAC, for the treatment of newly diagnosed AML in adult patients who are ≥75 years old or who have comorbidities that preclude use of intensive induction chemotherapy. NOW APPROVED Limitation of Use: DAURISMO has not been studied in patients with the comorbidities of severe renal impairment or moderate-to-severe hepatic impairment. EFFICACY WAS ESTABLISHED ON THE BASIS OF OS DAURISMO + LDAC was superior to LDAC alone, with a median follow-up of approximately 20 months 1,2 Kaplan-Meier plot of overall survival for patients with AML 1.0 DAURISMO + LDAC (n=77) LDAC alone (n=38) Censored 0.8 Primary endpoint: OS Median OS: DAURISMO + LDAC: 8.3 months (95% CI, 4.4-12.2) LDAC: 4.3 months (95% CI, 1.9-5.7) 0.6 HR=0.46* (95% CI, 0.30-0.71); P=0.0002† 0.4 AML=acute myeloid leukemia; LDAC=low-dose cytarabine; OS= overall survival. * Hazard ratio based on the Cox proportional hazards model stratifi ed by cytogenetic risk. 0.2 † 1-sided P value from log-rank test stratifi ed by cytogenetic risk. 0.0 0 Number at risk DAURISMO + LDAC 77 LDAC alone 38 5 10 15 20 Months 25 30 35 44 14 30 6 20 2 11 2 5 0 1 0 40 SAFETY PROFILE • Serious adverse reactions (ARs) were reported in 79% of patients treated in the DAURISMO + LDAC arm, compared to 78% in the LDAC-alone arm. The most common (≥5%) serious ARs in patients receiving DAURISMO + LDAC compared to the LDAC-alone arm, respectively, were febrile neutropenia (29% vs 17%), pneumonia (23% vs 17%), hemorrhage (12% vs 7%), anemia (7% vs 0%), and sepsis (7% vs 15%) • Patients treated with DAURISMO can develop QTc prolongation and ventricular arrhythmias, including ventricular fi brillation and ventricular tachycardia. Of the 98 evaluable patients treated with DAURISMO 100 mg + LDAC in the clinical trial, 5% were found to have a QTc interval >500 ms and 4% of patients had an increase from baseline QTc >60 ms Study description: BRIGHT AML 1003 was a randomized (2:1), Phase 2, open-label, multicenter trial of 115 patients with newly diagnosed AML not eligible for intensive chemotherapy who met at least one of the following criteria: a) age ≥75 years, b) severe cardiac disease, c) baseline ECOG performance status of 2, or d) baseline serum creatinine >1.3 mg/dL. Patients received 100 mg of oral DAURISMO once daily, given continuously, in combination with LDAC or LDAC alone (20 mg SC BID Days 1-10 of each 28-day cycle). OS was the primary endpoint. IMPORTANT SAFETY INFORMATION WARNING: EMBRYO-FETAL TOXICITY: DAURISMO can cause embryo-fetal death or severe birth defects when administered to a pregnant woman. DAURISMO is embryotoxic, fetotoxic, and teratogenic in animals. Conduct pregnancy testing in females of reproductive potential prior to initiation of DAURISMO treatment. Advise females of reproductive potential to use eff ective contraception during treatment with DAURISMO and for at least 30 days after the last dose. Advise males of the potential risk of DAURISMO exposure through semen and to use condoms with a pregnant partner or a female partner of reproductive potential during treatment with DAURISMO and for at least 30 days after the last dose to avoid potential drug exposure. Please see additional Important Safety Information on the right side of this spread.