New results for Johnson & Johnson's bleximenib demonstrate promising antileukemic activity in combination with venetoclax and azacitidine for acute myeloid leukemia
Bleximenib, an investigational selective menin inhibitor, shows potential as combination therapy for the treatment of relapsed or refractory AML and newly diagnosed, intensive chemo-ineligible AML
Phase 1b data show low rate of differentiation syndrome and no cardiac safety signal of QTc prolongation
Even though AML is the most common type of acute leukemia in adults, it has the lowest survival rate and is associated with poor patient outcomes, despite treatment advances to date – especially for patients with KMT2Ar and NPM1m.2,3,4
"AML encompasses a spectrum of genetically diverse cancers affecting the bone marrow and blood, which progress rapidly, making it an extremely challenging cancer to treat," said
The Phase 1b dose-finding study (NCT05453903) evaluated 125 patients with relapsed or refractory AML and newly diagnosed, intensive chemo-ineligible AML who harbored KMT2Ar (n=52) or NPM1m (n=73). Bleximenib in combination with VEN + AZA was evaluated across multiple dose levels without step-up dosing. Of the 85 relapsed or refractory patients, 36 percent received one, 42 percent received two and 12 percent received three lines of prior treatment; 47 percent had previously been treated with venetoclax.1
The bleximenib data at 100 mg twice a day in combination with VEN + AZA showed higher efficacy and a similar safety profile in comparison to other dose levels. At the recommended Phase 2 dose (RP2D), patients with relapsed or refractory AML achieved an overall response rate (ORR) of 82 percent and a composite complete response (cCR) rate of 59 percent.1 The newly diagnosed, intensive chemo-ineligible patient population showed an ORR of 90 percent and a cCR rate of 75 percent.1
Safety analysis of the study population showed a profile comparable among dose groups, genetic subtypes and disease settings. At the RP2D in combination with VEN+AZA, differentiation syndrome events were reported in two of 49 patients (4 percent). Bleximenib safety data continued to support a lack of QTc prolongation signal, with no events of Grade 3 or higher and only three Grade 1 events (6 percent) at the RP2D.1 The most common all-grade treatment-emergent adverse events (TEAEs) were nausea (65 percent), thrombocytopenia (61 percent), neutropenia (59 percent) and anemia (49 percent).1 The most common Grade 3 or higher TEAEs were thrombocytopenia (59 percent), neutropenia (59 percent), and anemia (49 percent).1
"Building on our heritage of leadership and innovation in hematologic malignancies, we are committed to delivering transformative treatment options that address the significant unmet needs of patients with acute myeloid leukemia," said
About Phase 1b Bleximenib Combination Dosing Study
This bleximenib combination trial (NCT05453903) is an ongoing Phase 1b open-label, non-randomized sequential assignment multicenter study to determine the recommended Phase 2 dose (RP2D) and further evaluate the safety and tolerability of bleximenib in combination with VEN + AZA in approximately 200 patients with either newly diagnosed or relapsed/refractory acute myeloid leukemia harboring KMT2A or NPM1 alterations.
Patients received VEN + AZA in combination with oral bleximenib twice daily at 15–150 mg (relapsed/refractory) or 30–100 mg (newly diagnosed) over a 28-day cycle and during count recovery. Bleximenib was started on day 4 without the need for step-up dosing. Primary outcome measures included adverse events and dose-limiting toxicity. Secondary efficacy measures included depletion of leukemic blasts, percentage of patients achieving complete response (CR), and percentage of patients who achieve overall response.
About Bleximenib (JNJ-75276617)
Bleximenib is an investigational oral menin inhibitor being evaluated for the treatment of patients with newly diagnosed and relapsed or refractory AML. It targets a key oncogenic interaction between menin and KMT2A fusion proteins, disrupting a pathway that drives leukemic cell growth in patients with KMT2Ar or NPM1m mutations.
It is currently being investigated in Phase 1, 2, and 3 trials, both as a monotherapy and in combination with AML-directed therapies to further explore its potential in both relapsed or refractory and newly diagnosed AML populations.
About Acute Myeloid Leukemia (AML)
Acute myeloid leukemia is an aggressive, fast-growing blood cancer that originates in the bone marrow and is marked by the uncontrolled proliferation of immature white blood cells known as myeloblasts.2, 5 These malignant cells crowd out healthy blood-forming cells, leading to complications such as anemia, infections and bleeding.6 Acute myeloid leukemia progresses rapidly, often requiring immediate treatment after diagnosis.5 It is the most common type of acute leukemia in adults, with a median age of diagnosis around 70 years.2
Despite treatment advances, acute myeloid leukemia remains associated with poor patient outcomes, particularly in older adults or those with high-risk genetic profiles.7 The five-year survival rate remains the lowest among leukemias, with outcomes especially poor in patients with KMT2Ar or NPM1m where relapse/refractory disease survival can be as short as 2 to 3 months after a second relapse – highlighting a significant unmet medical need.7
About Johnson & Johnson
At
Cautions Concerning Forward-Looking Statements
This press release contains "forward-looking statements" as defined in the Private Securities Litigation Reform Act of 1995 regarding product development and the potential benefits and treatment impact of
bleximenib (JNJ-75276617)
. The reader is cautioned not to rely on these forward-looking statements. These statements are based on current expectations of future events. If underlying assumptions prove inaccurate or known or unknown risks or uncertainties materialize, actual results could vary materially from the expectations and projections of
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1 Wei, A.H., et al. RP2D Determination of Bleximenib in Combination with VEN+AZA: Phase 1b study in ND & R/R AML with KMT2A/NPM1 Alterations. 2025 EHA Annual Congress – |
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3 Cancer Research |
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4 Khan, A.M., et al. Comprehensive age–stratified impact of NPM1 mutation in acute myeloid leukemia. Blood. 2022;140(Supplement 1):1433–1434. |
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7 Shimony, S., Stahl, M., & Stone, R.M. Acute myeloid leukemia: 2023 update on diagnosis, risk–stratification, and management. |
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