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New EXTEND Analyses Evaluate Efficacy of Single Agent PIXUVRI® in 3rd and 4th Line Salvage Setting With and Without Prior Rituximab Treatment

- Results Presented at 18th Congress of the European Hematology Association -

SEATTLE, June 17, 2013 /PRNewswire/ -- Cell Therapeutics, Inc. (CTI) (NASDAQ and MTA: CTIC) today announced results from sub-set analyses of data from the Phase 3 EXTEND, or PIX301, clinical trial of PIXUVRI® (pixantrone). The analyses evaluated the efficacy of PIXUVRI in the subset of patients with relapsed or refractory aggressive B-cell non-Hodgkin lymphoma (NHL), as confirmed by central independent pathological review, who had failed 2 or 3 prior treatment regimens (3rd and 4th line in the licensed patient population). Compared to physicians' choice of other agents given as monotherapy, single agent PIXUVRI resulted in 30 percent of patients who had previously received rituximab achieving a complete or unconfirmed durable complete response lasting on average 9.5 months with 67 percent of patients surviving at 2 years. In contrast, only 5.6 percent of patients in the comparator arm achieved an unconfirmed complete response. The benefit of PIXUVRI has not be established in patients when used as 5th-line or greater chemotherapy. The analyses were presented by Professor Ruth Pettengell, M.D., St. George's Hospital, at the 18th Congress of the European Hematology Association (EHA) held June 13-16, 2013 in Stockholm, Sweden. 

Abstract #P310:  Pixantrone monotherapy in histologically confirmed, relapsed or refractory aggressive B-cell non-Hodgkin lymphoma: post-hoc analyses from a phase III trial. Poster session, Friday, June 14, 5:45 to 7:00 p.m. CEST.

"PIXUVRI is the first medicinal product approved in the E.U. for treatment of patients with aggressive B-cell NHL," said Ruth Pettengell, M.D., of St. George's Hospital, University of London, the lead investigator for the EXTEND trial. "These subset analyses support PIXUVRI's use and benefit as a 3rd and 4th line treatment, whether or not the patient was previously exposed to rituximab. Prior to PIXUVRI, treatment options were limited to palliative therapy or clinical trials. PIXUVRI may provide the ability to re-introduce effective salvage therapy even after patients fail standard aggressive second line treatment."

Additional highlights from these post-hoc analyses include:

  • PIXUVRI demonstrated superior complete response rates and progression-free survival (PFS) in all the subgroups analyzed.

  • In patients who had aggressive B-cell histology as determined by site pathologists only, who had failed two or three prior lines of therapy, PIXUVRI was more efficacious than physicians' choice of monotherapy, both in patients who had received prior rituximab and those who did not. Among the patients whose histology was confirmed by the panel and who had received rituximab prior to randomization, response rates and PFS were as follows for PIXUVRI compared to physicians' choice of therapy, respectively: CR/CRu=30.0 percent vs. 5.6 percent; ORR=45.0 percent vs. 11.1 percent; PFS=5.4 vs. 2.8 months.

  • In patients with aggressive B-cell NHL, there was a 48 percent improvement in PFS that were confirmed by central review compared to 15 percent improvement in PFS based on site determination. This suggests that the superior efficacy of PIXUVRI in the patients who had previously received rituximab was not due to inclusion of a disproportionate share of patients who could not be confirmed as having aggressive B-cell NHL on central pathological review.

In May 2012, the European Commission granted conditional marketing authorization for PIXUVRI as a monotherapy for the treatment of adult patients with multiply relapsed or refractory aggressive NHL based on the results of the EXTEND, or PIX301, pivotal randomized Phase 3 clinical trial. The benefit of PIXUVRI treatment has not been established in patients when used as fifth line or greater chemotherapy in patients who are refractory to last therapy. The Summary of Product Characteristics (SmPC) has the full prescribing information, including the safety and efficacy profile of PIXUVRI in the approved indication. The SmPC is available at www.pixuvri.eu. CTI is currently accruing patients into a Phase 3 trial comparing PIXUVRI and rituximab with gemcitabine and rituximab in the setting of aggressive B-cell NHL. PIXUVRI does not have marketing approval in the United States.

About PIXUVRI (pixantrone)

PIXUVRI is a novel aza-anthracenedione with unique structural and physiochemical properties. Unlike related compounds, PIXUVRI forms stable DNA adducts and in preclinical models has superior anti-lymphoma activity compared to related compounds. PIXUVRI was structurally designed so that it cannot bind iron and perpetuate oxygen radical production or form a long-lived hydroxyl metabolite -- both of which are the putative mechanisms for anthracycline induced acute and chronic cardiotoxicity. These novel pharmacologic properties allow PIXUVRI to be administered to patients with near maximal lifetime exposure to anthracyclines without unacceptable rates of cardiotoxicity.

About Non-Hodgkin Lymphoma

In the E.U., there are approximately 37,000 new cases of aggressive B-cell NHL every year.1,2  NHL is caused by the abnormal proliferation of lymphocytes, cells key to the functioning of the immune system. It usually originates in lymph nodes and spreads through the lymphatic system. NHL can be broadly classified into two main forms—aggressive and indolent NHL. Aggressive NHL is a rapidly growing form of the disease that moves into advanced stages much faster than indolent NHL, which progresses more slowly.

There are many subtypes of NHL, but aggressive B-cell NHL is the most common and accounts for about 50 percent of NHL cases.2 After initial therapy for aggressive NHL with anthracycline-based combination therapy, one-third of patients typically develop progressive disease.3 Approximately half of these patients are likely to be eligible for intensive second-line treatment and stem cell transplantation, although 50 percent are expected not to respond.3 For those patients who fail to respond or relapse following second-line treatment, treatment options are limited, and usually palliative only.3

About Conditional Marketing Authorization

Similar to accelerated approval regulations in the United States, conditional marketing authorizations are granted in the E.U. to medicinal products with a positive benefit/risk assessment that address unmet medical needs and whose availability would result in a significant public health benefit. A conditional marketing authorization is renewable annually. Under the provisions of the conditional marketing authorization for PIXUVRI, CTI will be required to complete a post-marketing study aimed at confirming the clinical benefit previously observed.

The European Medicines Agency's (the "EMA") Committee for Medicinal Products for Human Use has accepted PIX306, CTI's ongoing randomized controlled Phase 3 clinical trial, which compares PIXUVRI-rituximab to gemcitabine-rituximab in patients who have relapsed after one to three prior regimens for aggressive B‑cell NHL and who are not eligible for autologous stem cell transplant. As a condition of approval, CTI has agreed to have available the PIX306 clinical trial results by June 2015.

About Cell Therapeutics, Inc.

CTI (NASDAQ and MTA: CTIC) is a biopharmaceutical company committed to the development and commercialization of an integrated portfolio of oncology products aimed at making cancer more treatable. CTI is headquartered in Seattle, WA. For additional information and to sign up for email alerts and get RSS feeds, please visit www.CellTherapeutics.com.

Safe Harbor Statement

This press release includes forward-looking statements that involve a number of risks and uncertainties, the outcome of which could materially and/or adversely affect actual future results and the market price of CTI's securities. Specifically, the risks and uncertainties that could affect the development of PIXUVRI include risks associated with preclinical and clinical developments in the biopharmaceutical industry in general and with PIXUVRI in particular including, without limitation, the potential failure of PIXUVRI to prove safe and effective for the treatment of relapsed or refractory NHL and/or other tumors; that PIXUVRI may not be able to reintroduce effective salvage therapy to patients that have failed standard aggressive second line treatment for patients with aggressive B-cell NHL; that results in future studies of PIXUVRI may differ from the results of past studies;  that CTI may not be able to complete the PIX306 clinical trial of PIXUVRI-rituximab compared to gemcitabine-rituximab in patients who have relapsed after one to three prior regimens for aggressive B-cell NHL and who are not eligible for autologous stem cell transplant by June 2015 or at all as required by the EMA or have the results of such trial available by June 2015 or at all; that CTI may not be able complete a post-marketing study aimed at confirming the clinical benefit observed in the PIX301 trial; that the conditional marketing authorization for PIXUVRI may not be renewed; that CTI may not obtain favorable reimbursement or pricing determinations for PIXUVRI in certain markets in the E.U. as planned; that CTI cannot predict or guarantee the pace or geography of enrollment of its clinical trials or the total number of patients enrolled; that CTI's average net operating burn rate may increase; CTI's may not be able to continue to raise capital as needed to fund its operations in general, and other risks, including, without limitation, competitive factors, technological developments, costs of developing, producing, and selling PIXUVRI, and the risk factors listed or described from time to time in CTI's filings with the Securities and Exchange Commission including, without limitation, CTI's most recent filings on Forms 10-K, 10-Q and 8-K. Except as may be required by law, CTI does not intend to update or alter its forward-looking statements whether as a result of new information, future events, or otherwise.

1. European Cancer Observatory, Cancer Fact Sheets, 2008
2. Harris NL, et al. Ann Oncol. 1999;10(12):1419-32
3. Friedberg ASH Education Book 2011;1:498-505

PIXUVRI is a registered trademark of Cell Therapeutics, Inc.

CTI Media and Investor Contacts:
Monique Greer 
+1 206.272.4343
[email protected]

Ed Bell
+1 206.282.7100
[email protected]

In Europe
CTI Life Sciences Limited, Milan Branch
Laura Villa
E: [email protected]
T: +39 02 89659700


SOURCE Cell Therapeutics, Inc.

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