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BeyondSpring Presents New Promising Data in Chemotherapy-Induced Neutropenia at 2019 ASCO-SITC Clinical Immuno-Oncology Symposium
Neulasta, a long acting G-CSF and the current standard of care for CIN, activates the bone marrow, resulting in a temporary overproduction of neutrophils, many of which are immature. Immature neutrophils can travel to the tumor tissue and cause the microenvironment to be immune-suppressive. Established markers for immune-suppression are high Neutrophil-to-Lymphocyte Ratio (NLR>5) and low Lymphocyte-to-Monocyte Ratio (LMR<3.2), which are associated with low survival outcomes. Previously,
The combination of Plinabulin with Neulasta resulted in better protection against CIN. Importantly, the data also demonstrates that adding Plinabulin to Neulasta reverses the immune-suppressive profile of Neulasta by lowering the percentage of patients with a Neutrophil-to-Lymphocyte Ratio (NLR) of less than 5 (p<0.007) or with a Lymphocyte-to-Monocyte Ratio (LMR) of greater than 3.2 (p<0.07) versus Neulasta alone.
“As thousands of people suffer from chemotherapy-induced neutropenia around the world, combination therapies offer a superior treatment compared to the status quo today,” said Dr.
“The observation that adding Plinabulin to Neulasta leads to a reversal of the immune-suppressive profile may have an important impact on patient outcomes, as maintaining an optimal immune response against cancer is very important for patient survival. With the new treatment landscape of combinations in chemotherapy and immunotherapy, such as PD-1 antibodies, this Plinabulin and Neulasta combination would be a timely option for the prevention of CIN in this population,” added Dr.
About Chemotherapy-Induced Neutropenia
As many as 90 percent of patients on high-risk chemotherapy and G-CSF monotherapy may still experience grade 3 or 4 neutropenia (Lee et al., Annals of Surgical treatment and research 94(5): 223-228 (2018)). Patients with grade 4 (severe) neutropenia have an abnormally low concentration of neutrophils, making these patients more susceptible to bacterial and fungal infections and sepsis, which can require hospitalization and be fatal. Grade 4 CIN can have an adverse effect on chemotherapy administration and is usually considered a significant predictor of low relative dose intensity (RDI), dose delays and dose reductions (Lalami Y, Critical Reviews in Oncology / Hematology, 120: 163 – 179 (2017)). A reduction in dose of as little as 15 percent can reduce long-term survival by as much as 50 percent (Bonadonna, Med Oncol 29:1495–1501 (2012)).
As many as 70 percent of patients using G-CSF monotherapy experience bone pain while on G-CSF monotherapy (Moore et al., Annals of Pharmacotherapy 51(9): 797-803 (2017)). Additionally, 25 percent of patients report that the pain is severe. NCCN guidelines require that patients with grade 3/4 neutropenia decrease chemotherapy dose intensity, delay chemotherapy cycle timing or discontinue chemotherapy, each of which can have a negative effect on the long-term outcomes of cancer care (Lalami et al., Critical Reviews in Oncology / Hematology 120: 163-179 (2017)).
Cautionary Note Regarding Forward-Looking Statements
Neulasta® is a registered trademark of Amgen, Inc.