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Pacylex Publishes Phase 1 Safety and Efficacy of Zelenirstat in Cancer Patients in the Journal Investigational New Drugs

Data prompts Pacylex to open Phase 2a studies in colorectal cancer and B-cell Non-Hodgkin Lymphoma
Key Takeaways
  • Zelenirstat was well tolerated, and adverse events were primarily gastrointestinal side effects, most of which resolved spontaneously without dose reduction.
  • Patients with heavily pre-treated colorectal, appendiceal, and ovarian cancers had 6 to 16 months of stable disease when treated with the recommended Phase 2 dose.
  • Zelenirstat inhibits myristoylation of proteins involved in several key cancer-driving processes explaining its broad spectrum of activity.

Edmonton, Alberta, Canada June 10, 2024. Pacylex Pharmaceuticals Inc. (Pacylex) is a clinical-stage pharmaceutical company developing N-myristoyltransferase (NMT) inhibitors to treat hematologic cancers and solid tumors. Today Pacylex announced the publication of Phase 1 clinical trial results in the journal Investigational New Drugs. The report, titled: "A First-in-Human Phase I Trial of Daily Oral Zelenirstat, a N-myristoyltransferase Inhibitor, in Patients with Advanced Solid Tumors and Relapsed/Refractory B-cell Lymphomas," describes effects of zelenirstat at various doses on cancer patients who exhausted all other therapeutic options.

Myristoylation is a fatty acid modification critical to targeting certain proteins to cell membranes where they participate in activities essential to cancer cell survival and proliferation. Zelenirstat works by the unique mechanism of inhibiting the myristoylation required for the assembly, translocation, and function of EGFR, VEGFR, and the B-cell receptor. Last month Pacylex published in the Journal of Translational Medicine that zelenirstat also blocks Complex I formation in mitochondria of cancer cells to shut down oxidative phosphorylation, an energy generation process needed for metastases and cancer stem cell survival. 

The Phase 1 dose escalation safety and tolerability study was conducted in 29 patients with refractory/relapsed (r/r) lymphoma and refractory solid tumors who averaged 4 lines of prior therapy. Zelenirstat, administered as a once daily oral medication, was well-tolerated in Phase 1 patients up to the recommended Phase 2 dose (RP2D) with no dose limiting toxicities observed in 6 dose levels. The most common treatment related adverse events were mild to moderate gastrointestinal side effects which were self-limiting and occurred in a minority of patients. 

The study was designed and sponsored by Pacylex Pharmaceuticals and was conducted at the Cross Cancer Institute, Edmonton, AB, under the direction of Principal Investigator Dr. Randeep Sangha; the British Columbia Cancer Centre for Lymphoid Cancer, Vancouver, BC, by Dr. Laurie Helen Sehn; Princess Margaret Cancer Centre, Toronto, ON by Dr. John Kuruvilla; and Université de Montréal's hospital affiliated research centre, the CRCHUM, QC by Dr. Rahima Jamal.

The 7 patients receiving the recommended Phase 2 dose had significantly better progression free and overall survival than the 17 treated at lower doses; 57% had stable disease or better for six months or longer, including patients with ovarian, appendiceal, and colorectal cancer. The sole person with colorectal cancer receiving the RP2D had experienced only short-term benefit from any of the 6 prior lines of therapy, but continues to receive the zelenirstat 450 days after starting therapy and had reductions of approximately 50% in CEA (carcinoembryonic antigen) and tumor volumes. 

“These Phase 1 results are as encouraging as any cancer study I have run with an oral cancer therapy”, said Dr. Randeep Sangha. “The safety profile was consistent with long-term therapy and considering how many prior lines of therapy these patients had received, the signals of potential efficacy in several different types of solid tumor cancers was surprising.”

“Given the outstanding safety of zelenirstat in Phase 1 and the prolonged stable disease or better seen in patients with refractory ovarian, appendiceal and colorectal cancer who received the RP2D, we are advancing zelenirstat into two Phase 2a studies that have begun dosing patients with refractory and relapsed B-cell non-Hodgkin’s lymphoma, and advanced refractory colorectal cancer”, said Dr. John Mackey, CMO of Pacylex Pharmaceuticals.

“Zelenirstat is a very unique approach to treating cancer – it inhibits proteins that have been hijacked in cancer cells for survival and proliferation signaling, tumor blood supply, cell surface receptor recycling, and energy production, all with one drug”, said Dr. Michael Weickert, CEO of Pacylex. “This explains how zelenirstat has potential as an important therapeutic option across many different cancers.”


About zelenirstat (PCLX-001)

Zelenirstat (formerly identified as PCLX-001) is a first-in-class, oral, small molecule NMTi being developed to treat patients with leukemia, lymphoma, and solid tumors. Zelenirstat selectively killed cancer cells in vitro and in animal models has been shown to fully regress hematologic malignancies and inhibit the growth of lung and breast cancer tumors. In AML models, zelenirstat preferentially killed leukemic stem enriched cell populations and reduced the bone marrow leukemic burden. 

About zelenirstat Phase 1 and 2 studies 

Pacylex completed the dose escalation phase of a Phase 1 multiple ascending dose safety, tolerability, and pharmacokinetics study on zelenirstat in people with relapsed/refractory lymphoma and refractory solid tumors (NCT04836195). A recommended Phase 2 dose was determined. Zelenirstat demonstrated an acceptable safety and tolerability profile, pharmacokinetics consistent with once daily oral dosing, and early signs of efficacy.

Zelenirstat is currently being studied in a Phase 2a open-label study designed to evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics, and clinical activity of zelenirstat in patients with relapsed/refractory B-cell non-Hodgkin Lymphoma (NHL) and a separate Phase 2a cohort in patients with refractory metastatic colorectal cancer that has progressed despite all available standard therapies. 

About Pacylex Pharmaceuticals

Pacylex is a clinical-stage pharmaceutical company headquartered in Edmonton, Alberta, Canada, targeting hematologic and solid cancers with orally bioavailable NMT inhibitors. Zelenirstat is the lead drug in a new class of NMT inhibitors, enabling Pacylex to exploit NMTs as new clinical targets for cancer treatment. Pacylex is conducting two multi-center Phase 2a studies in Canada in patients with relapsed/refractory NHL and refractory metastatic colorectal cancer. The IND for a Phase 1 multiple ascending dose study in acute myeloid leukemia (AML) has been cleared and the FDA has granted zelenirstat both Orphan Drug Designation and Fast Track Designation for AML. The US Department of Defense is supporting the initial clinical investigation of zelenirstat in patients with AML. The Cure Cancer Foundation supported initial clinical studies through its World’s Longest Games. 



Key Takeaways
  • Zelenirstat was well tolerated, and adverse events were primarily gastrointestinal side effects, most of which resolved spontaneously without dose reduction.
  • Patients with heavily pre-treated colorectal, appendiceal, and ovarian cancers had 6 to 16 months of stable disease when treated with the recommended Phase 2 dose.
  • Zelenirstat inhibits myristoylation of proteins involved in several key cancer-driving processes explaining its broad spectrum of activity.
Media Gallery
Quotes
These Phase 1 results are as encouraging as any cancer study I have run with an oral cancer therapy. The safety profile was consistent with long-te...
Dr. Randeep SanghaPrincipal Investigator at the British Columbia Cancer Centre for Lymphoid Cancer, Vancouver, BC
Given the outstanding safety of zelenirstat in Phase 1 and the prolonged stable disease or better seen in patients with refractory ovarian, appendi...
Dr. John MackeyCMO of Pacylex Pharmaceuticals
Zelenirstat is a very unique approach to treating cancer – it inhibits proteins that have been hijacked in cancer cells for survival and proliferat...
Dr. Michael WeickertCEO of Pacylex
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Contacts
Michael Weickert Ph.D
michael.weickert@pacylex.com
650-218-1840
Chief Executive Officer