Key takeaways
- Orphan drug designation for quemliclustat highlights regulatory momentum and unmet need in pancreatic cancer treatment development.
- PRISM-1 Phase III trial design reflects gold-standard methodologies (randomized, double-blind, placebo-controlled) with a large global patient population.
- ARC-8 survival data and use of a Synthetic Control Arm (SCA) underscore the growing role of adaptive and historical control strategies in oncology trial design.
The FDA has granted orphan drug designation to Arcus Biosciences’ quemliclustat, an investigational small molecule CD73 inhibitor, for the treatment of pancreatic cancer. Additionally, Arcus provided an update on its Phase III clinical trial evaluating quemliclustat plus chemotherapy, PRISM-1 (NCT06608927), and expects enrollment to be completed by the end of this year.1
In a press release, Richard Markus, MD, PhD, chief medical officer at Arcus Biosciences, said: “The orphan drug designation indicates the importance of developing new treatment options for rare diseases like pancreatic cancer, which has the highest mortality rate of all major cancers, and which has seen few treatment advancements over the past 30 years. We expect the Phase III PRISM-1 study to be fully enrolled this year and, if positive, intend to quickly bring this new first-line treatment option to patients, with the goal of prolonging survival for those with metastatic pancreatic cancer.”
PRISM-1 trial targets first-line mPDAC
- PRISM-1 is a Phase III, global, multi-center study involving approximately 610 patients with previously untreated metastatic pancreatic ductal adenocarcinoma (mPDAC).
- The trial uses a randomized, double-blind, placebo-controlled design.
- Participants are assigned in a 2:1 ratio to receive either quemliclustat plus gemcitabine/nab-paclitaxel or gemcitabine/nab-paclitaxel with a placebo.
- The main outcome measure is overall survival (OS).
- Additional endpoints include progression-free survival (PFS), objective response rate (ORR), duration of response, disease control rate, and safety.
Phase Ib ARC-8 trial showed encouraging survival results
Arcus initiated the PRISM-1 trial based on positive data from another study of quemliclustat, ARC-8 (NCT04104672). The study, co-developed with Gilead, evaluated quemliclustat plus chemotherapy with or without zimberelimab, an investigational anti-PD-1 antibody, in patients with previously untreated mPDAC.2