-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, LocQ03NL5LV1K1/tklgRqD7f7HomvfVUb04M+CL/8pBJGtxYHjAx2FDfBQsO9Snb AyEmXngKl2enZmqELOdZOg== 0001104659-05-023329.txt : 20050513 0001104659-05-023329.hdr.sgml : 20050513 20050513151957 ACCESSION NUMBER: 0001104659-05-023329 CONFORMED SUBMISSION TYPE: 8-K PUBLIC DOCUMENT COUNT: 6 CONFORMED PERIOD OF REPORT: 20050513 ITEM INFORMATION: Regulation FD Disclosure ITEM INFORMATION: Financial Statements and Exhibits FILED AS OF DATE: 20050513 DATE AS OF CHANGE: 20050513 FILER: COMPANY DATA: COMPANY CONFORMED NAME: FAVRILLE INC CENTRAL INDEX KEY: 0001285701 STANDARD INDUSTRIAL CLASSIFICATION: BIOLOGICAL PRODUCTS (NO DIAGNOSTIC SUBSTANCES) [2836] IRS NUMBER: 330892797 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 8-K SEC ACT: 1934 Act SEC FILE NUMBER: 000-51134 FILM NUMBER: 05828786 MAIL ADDRESS: STREET 1: 10421 PACIFIC CENTER COURT STREET 2: STE 150 CITY: SAN DIEGO STATE: CA ZIP: 92121 8-K 1 a05-9389_18k.htm 8-K

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION

 

WASHINGTON, DC 20549

 

FORM 8-K

 

CURRENT REPORT

Pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934

 

Date of Report (Date of earliest event reported): May 13, 2005

 

FAVRILLE, INC.

(Exact Name of Registrant as Specified in its Charter)

 

Delaware

 

000-51134

 

33-0892797

(State or Other Jurisdiction  of
Incorporation)

 

(Commission
File Number)

 

(IRS Employer
Identification No.)

 

 

 

 

 

10421 Pacific Center Court, Suite 150
San Diego, California

 

92121

(Address of Principal Executive Offices)

 

(Zip Code)

 

Registrant’s telephone number, including area code: (858) 526-8000

 

N/A

(Former Name or Former Address, if Changed Since Last Report.)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions ( see General Instruction A.2. below):

 

o Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)

 

o Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)

 

o Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))

 

o Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

 



 

Item 7.01. Regulation FD Disclosure.

 

As previously announced in Favrille, Inc.’s May 9, 2005 press release, Favrille will be presenting the results of a physician-sponsored Phase 2 clinical trial using FavId® following autologous stem cell transplantation in patients with follicular cell and mantle cell non-Hodgkin’s lymphoma (NHL) during a poster session on May 15, 2005 at the American Society of Clinical Oncology (ASCO) Annual Meeting in Orlando, Florida. The presentation is attached hereto as Exhibit 99.1 and incorporated by reference herein.

 

The information in this Current Report on Form 8-K shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or otherwise subject to the liability of that section, nor shall it be deemed incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as expressly set forth by specific reference in such a filing.

 

Item 9.01. Financial Statements and Exhibits.

 

(c)

Exhibits.

 

 

 

Exhibit No.

 

Description

 

99.1

 

Poster Presentation by Favrille, Inc.

 

2



 

SIGNATURES

 

Pursuant to the requirements of the Exchange Act, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

Date: May 13, 2005

Favrille, Inc.

 

 

 

By:

/s/ Tamara A. Seymour

 

 

Name:

Tamara A. Seymour

 

Title:

Chief Financial Officer

 

3



 

EXHIBIT INDEX

 

Exhibit No.

 

Description

99.1

 

Poster Presentation by Favrille, Inc.

 

4


EX-99.1 2 a05-9389_1ex99d1.htm EX-99.1

Exhibit 99.1

 

Idiotype (Id) immunotherapy (IT) following high dose therapy and autologous stem cell transplant (HDT/ASCT) in mantle cell (MC) and indolent lymphoma (IL): cellular, humoral and clinical responses

 

P. R. Holman, M. deMagalhaes-Silverman, B. Medina, S. Corringham, A. Bashey, J. Castro, E. Carrier, T. Lane, D. P. Gold, E. D. Ball; Univ of California-San Diego, La Jolla, CA; University of Iowa, Iowa City, IA; Favrille Inc, San Diego, CA

 



 

INTRODUCTION

 

MCL accounts for 6% of all non-Hodgkin’s lymphoma (NHL). It is generally considered an incurable disease. Although high response rates can be achieved with initial chemotherapy (+/- immunotherapy), median survival is only 3-4 years. Intensified consolidation with HDT (+/- radiotherapy) and ASCT has been reported to improve progression free survival (PFS)(1, 2) but patients eventually relapse.

 

Indolent lymphoma accounts for 35% of all NHL and is associated with a median survival of 9 years. Like MCL, it is also generally considered to be incurable. PFS also appears to be improved following HDT/ASCT (3).

 

Both MCL and IL can respond to immunotherapy. The most studied immunotherapy in NHL is currently the anti-CD20 antibody, rituximab (4, 5). Allogeneic transplantation via a graft-versus-lymphoma effect appears to be a potentially curative therapy, at least in some cases (6, 7).

 

An additional immunotherapeutic approach is Id vaccination. The Id is the hypervariable region of the immunoglobulin receptor, which is generally identical on all affected cells. Coupling of the Id protein to KLH (keyhole limpet hemocyanin) and simultaneous local administration of GM-CSF results in augmented immune responses. Clinical studies have demonstrated the induction of both cellular and humoral anti-Id responses following chemotherapy, accompanied by clinical benefit (8, 9). Patients with molecularly detectable disease following chemotherapy have achieved molecular remissions following Id vaccination (10).

 

Against this background, we initiated a phase 2 trial evaluating Id vaccination following high dose therapy and autologous stem cell transplantation for patients with mantle cell lymphoma, indolent NHL and transformed NHL to evaluate the feasibility and effectiveness of this post autologous transplant immunotherapeutic strategy.

 



 

STUDY OBJECTIVES

 

                                          To evaluate the ability of Id-KLH to induce immune responses when administered following HDT/ASCT for MCL, indolent NHL and transformed NHL

 

                                          To evaluate PFS for patients receiving Id-KLH post ASCT

 

KEY ELIGIBILITY CRITERIA

 

                                          Follicular Grade 1 or 2 NHL, small lymphocytic lymphoma or MCL

                                          Tissue availability (via biopsy) for Id vaccine preparation

                                          Age 18-70

                                          Previously treated or newly diagnosed

                                          No prior splenectomy

                                          No ongoing steroid requirement

                                          Meets institutional criteria for HDT/ASCT

 

PATIENTS AND METHODS

 

13 patients, (8 MCL, 4 IL, 1 TL) underwent biopsy to obtain lymph node tumor material for Id vaccine preparation.

Cytoreductive chemotherapy +/- antibody therapy was chosen and administered at the discretion of the treating physician.

Stem cell collection was undertaken

Patients proceeded to HDT/ASCT following an adequate stem cell collection Starting a minimum of 3 months post ASCT, patients received 5 Id immunizations over a 6-month period.

 



 

PATIENT CHARACTERISTICS

 

Patient

 

Histology

 

Age

 

Sex

 

Most Recent Regimen

 

1

 

MCL

 

63

 

M

 

CHOP HyperCVAD

 

2

 

MCL

 

61

 

M

 

HyperCVAD

 

3

 

MCL

 

56

 

M

 

HyperCVAD

 

4

 

MCL

 

62

 

M

 

HyperCVAD/Rituximab

 

5

 

MCL

 

60

 

M

 

CHOP-R/R-ICE

 

6

 

MCL

 

52

 

M

 

HyperCVAD

 

7

 

MCL

 

66

 

M

 

CHOP-R

 

8

 

MCL

 

50

 

M

 

HyperCVAD/Rituximab

 

9

 

IL

 

54

 

M

 

ESHAP

 

10

 

IL

 

54

 

F

 

CHOP

 

11

 

IL

 

54

 

F

 

Zevalin

 

12

 

IL

 

48

 

M

 

Fludarabine-Mitoxantrone

 

13

 

TL

 

51

 

M

 

ESHAP

 

 

Id PRODUCTION

 

The Id genes are molecularly cloned from the lymph node biopsy. They are then cloned into a baculovirus expression vector and introduced into an insect cell expression system. The resulting IgG1 antibody contains k or l light chain, depending on the light chain expressed by the lymphoma cell. The intact antibody is then purified using standard techniques. Following purification, it is conjugated to keyhole limpet hemocyanin (KLH), ready for administration.

 

EVALUATION OF CELLULAR AND HUMORAL IMMUNE RESPONSES

 

For cellular immune responses peripheral blood mononuclear cells (PBMC) are cultured with KLH, autologous Id or a control patient Id. We then determine the frequency of CD4+ T cells that stain for cytoplasmic IFN-gamma or TNF-alpha. At any time point measured, a positive T-cell response to KLH is indicated by a result above the mean plus 3 standard

 



 

deviations observed in the controls. A positive T-cell response to Id is indicated by a result threefold higher than that observed with the irrelevant control Ig.

 

To evaluate humoral immune responses, serial dilutions of serum samples are added to wells containing Id Fab fragments, KLH coated wells, Id/KLH or a sham control. The presence of bound antibody is detected using a goat anti-human IgG HRP conjugated antibody preparation in a standard ELISA assay. At any time point measured, a positive response to KLH is indicated by a result above the mean plus 3 standard deviations observed in the controls. A positive response to Id is indicated by a result threefold higher than that observed with the irrelevant control Id.

 



 

TREATMENT PLAN

 

 

Lymph Node Biopsy:

For vaccine preparation

Cytoreductive Chemotherapy:

At discretion of treating physician

Stem Cell Mobilization + Leukapheresis

High Dose Chemotherapy/Stem Cell Transplant

BEAM

Vaccination: 5 in 6 Months

Day 1:  Id-KLH + GM-CSF

Day 2-4:  GM-CSF alone

 



 

RESULTS

 

Immune responses to Id vaccination post-ASCT

 

 

 

 

 

Humoral Responsiveness

 

Cellular
Responsiveness

 

Patient

 

Histology

 

Anti-KLH

 

Anti-Id

 

Anti-KLH

 

Anti-Id

 

1

 

MCL

 

After 4th V

 

After 4th V

 

After 1st V

 

After 1st V

 

2

 

MCL

 

NR

 

NR

 

NT

 

NT

 

3

 

MCL

 

After 3rd V

 

NSR

 

After 1st V

 

After 3rd V

 

4

 

MCL

 

After 3rd V

 

After 3rd V

 

After 2nd V

 

After 2nd V

 

5

 

MCL

 

NR

 

NT

 

After 2nd V

 

After 2nd V

 

6

 

MCL

 

NT

 

NT

 

NT

 

NT

 

7

 

MCL

 

NT

 

NT

 

NT

 

NT

 

8

 

MCL

 

NT

 

NT

 

NT

 

NT

 

9

 

IL

 

After 2nd V

 

After 2nd V

 

After 1st V

 

After 1st V

 

10

 

IL

 

After 2nd V

 

NSR

 

After 1st V

 

After 5th V

 

11

 

IL

 

After 3rd V

 

Weak+ after 5thV

 

NT

 

NT

 

12

 

IL

 

NT

 

NT

 

NT

 

NT

 

13

 

IL

 

After 3rd V

 

Weak+ after 3rd V

 

NR

 

NR

 

 

V=vaccination NSR=non-specific response NT=not tested NR=no response

 



 

Clinical Responses

 

Patient

 

Histology

 

Response Pre
V1

 

Response Pre
V4

 

Response at 9
months

 

Response at
14 months

 

1

 

MCL

 

CR

 

CR

 

CR

 

CR

 

2

 

MCL

 

PR

 

CR

 

CR

 

PD

 

3

 

MCL

 

CR

 

CR

 

CR

 

CR

 

4

 

MCL

 

CRu

 

CRu

 

CRu

 

CR

 

5

 

MCL

 

CR

 

CR

 

CR

 

CR

 

6

 

MCL

 

CR

 

CR

 

PD

 

Off study

 

7

 

MCL

 

CR

 

CR

 

N/A

 

N/A

 

8

 

MCL

 

CR

 

CR

 

N/A

 

N/A

 

9

 

IL

 

PR

 

CRu

 

CR

 

CR

 

10

 

IL

 

SD

 

SD

 

SD

 

CR

 

11

 

IL

 

CR

 

CR

 

CR

 

N/A

 

12

 

IL

 

PD

 

N/A

 

N/A

 

N/A

 

13

 

IL

 

SD

 

SD

 

SD

 

SD

 

 

N/A= Time point not reached

 



 

Current Remission Status

 

Patient

 

Time since ASCT
(months)

 

Status

 

1

 

43

 

CR

 

2

 

12

 

PD

 

3

 

36

 

CR

 

4

 

31

 

CR

 

5

 

20

 

CR

 

6

 

10

 

PD

 

7

 

10

 

CR

 

8

 

12

 

CR

 

9

 

34

 

CR

 

10

 

41

 

CR

 

11

 

14

 

CR

 

12

 

6

 

PD

 

13

 

20

 

CR

 

 



 

 



 

 



 

TOXICITIES

 

Adverse Event

 

Grade 1

 

Grade 2

 

Grade 3

 

Grade 4

 

Chills with rigors

 

5

 

 

 

 

 

 

 

Headache

 

1

 

3

 

 

 

 

 

Fatigue

 

2

 

1

 

 

 

 

 

Upper chest congestion

 

 

 

2

 

 

 

 

 

Injection site reaction

 

4

 

6

 

 

 

 

 

Head cold

 

3

 

2

 

 

 

 

 

Itchy/watery eyes

 

1

 

 

 

 

 

 

 

Blurred vision

 

 

 

1

 

 

 

 

 

Hotflashes

 

 

 

1

 

 

 

 

 

Bloating

 

1

 

 

 

 

 

 

 

Heartburn/Indigestion

 

2

 

1

 

 

 

 

 

Nausea

 

1

 

 

 

 

 

 

 

Aching lymph nodes

 

2

 

 

 

 

 

 

 

Chest pain

 

3

 

 

 

 

 

 

 

Dyspnea

 

 

 

1

 

 

 

 

 

Leukopenia

 

1

 

 

 

1

 

 

 

Vitreous hemorrhage

 

 

 

 

 

1

 

 

 

Joint stiffness

 

1

 

 

 

 

 

 

 

Generalized body aches

 

2

 

1

 

 

 

 

 

Liver abscess

 

 

 

 

 

1*

 

 

 

Infection

 

1

 

 

 

2

 

 

 

Jaundice

 

 

 

1

 

 

 

 

 

Thrombocytopenia

 

1

 

1

 

 

 

 

 

Syncope

 

 

 

 

 

1

 

 

 

Shingles

 

 

 

2

 

 

 

 

 

Gynecomastia

 

 

 

2

 

 

 

 

 

Bone pain

 

1

 

1

 

 

 

 

 

Myalgia

 

1

 

1

 

 

 

 

 

Diarrhea

 

2

 

 

 

 

 

 

 

Tongue discoloration

 

1

 

 

 

 

 

 

 

Anorexia

 

1

 

 

 

 

 

 

 

Dizziness

 

1

 

 

 

 

 

 

 

Abdominal Pain

 

1

 

 

 

 

 

 

 

Cramps in feet

 

1

 

 

 

 

 

 

 

 

N=12

Reporting the greatest grade per patient

 


*Secondary to biliary stent obstruction

 



 

DISCUSSION

 

These preliminary results indicate that Id vaccination is a feasible immunotherapeutic intervention following autologous stem cell transplantation. Early and Id specific cellular immune responses occur in both MCL and IL patients when vaccinated following high dose chemotherapy and ASCT.

 

Id vaccination was well tolerated with only minor and transient toxicity.

 

Of the eight mantle cell lymphoma patients treated, immune responses have been evaluated in five. Of these five patients, an anti-Id T cell response was seen after the first vaccination in one patient, after the second vaccination in two and after the third vaccination in another patient.  In another patient (#2) who failed to recover adequate counts post transplant, the cellular immune response was not tested.  A cellular anti-KLH response was seen after the first vaccination in two patients and after the second vaccination in another two patients.

 

Humoral anti-Id responses were seen after the third or fourth vaccination in two patients.  One patient had no response and in another patient a nonspecific response occurred. The patient who failed to recover adequate counts developed no humoral response to either KLH or Id. Testing is currently pending on patient 6,7 and 8.

 

Four out of five indolent lymphoma patients have undergone testing.  A cellular anti-KLH response occurred in two patients after the first vaccination.  Anti-Id responses occurred are for the first and fifth vaccination respectively.  An anti-KLH humoral response occurred after the second vaccination in two patients, and after the third vaccination in another two patients.  A humoral anti-Id response occurred after the second vaccination in one patient and weakly, after the third and fifth vaccination in another two patients.  An additional patient had no significant response.

 

Patient #2 with MCL failed to develop any significant immune response, either humoral or cellular, to any component of the immunization. Following the ASCT, this patient failed to adequately engraft and was red cell and platelet transfusion dependant. This patient had a suboptimal CD34+ stem cell collection prior to transplant (>2 but <5 x 106/kg). This patient had a rapid decline in T and B cell numbers post-ASCT. In contrast, the responding patients maintained good levels of T and B cells post-ASCT.

 



 

It is currently too early and the number of patients too few to draw any conclusions regarding the clinical responses and their correlation with the immune responses.

 

The ability of post-transplant NHL patients who have received a number of prior chemotherapy regimens (including the HyperCVAD regimen) to mount Id specific immune responses suggests that the post-transplant period, during lymphocyte recovery, may be an opportune time to administer Id immunizations. In the setting of minimal residual disease, at least as evaluated radiologically, T cell reconstitution may be dependant on the maturation of peripheral T cells present in the graft. The maturing T cells may be antigen driven and with the extra “space” for immune reconstitution, may allow a specific post-transplant advantage to the induction of robust Id specific immune responses. This has been demonstrated in murine studies (11). Further studies will determine whether the period of post-transplant T cell recovery may be a window during which tolerance to Id may be overcome.

 

CONCLUSIONS

 

1.              Id vaccination following high-dose chemotherapy and autologous stem cell transplant is safe and feasible.

 

2.              Specific cellular and humoral anti-Id responses occur in both mantle cell lymphoma and indolent lymphoma patients post high-dose chemotherapy and autologous stem cell transplant, even when they have been heavily pretreated.

 

3.              Durable remissions occur in heavily pretreated patients with MCL and IL who receive HDT/ASCT followed by Id immunotherapy.

 



 

BIBLIOGRAPHY

 

1.                                       Khouri, I.F., Romaguera, J., Kantarjian, H., Palmer, J.L., Pugh, W.C., Korbling, M., Hagemeister, F., Samuels, B., Rodriguez, A., Giralt, S., et al. 1998. Hyper-CVAD and high-dose methotrexate/cytarabine followed by stem-cell transplantation: an active regimen for aggressive mantle-cell lymphoma. J Clin Oncol 16:3803-3809.

 

2.                                       Dreyling, M., Lenz, G., Hoster, E., Van Hoof, A., Gisselbrecht, C., Schmits, R., Metzner, B., Truemper, L., Reiser, M., Steinhauer, H., et al. 2005. Early consolidation by myeloablative radiochemotherapy followed by autologous stem cell transplantation in first remission significantly prolongs progression-free survival in mantle-cell lymphoma: results of a prospective randomized trial of the European MCL Network. Blood 105:2677-2684.

 

3.                                       Schouten, H.C., Qian, W., Kvaloy, S., Porcellini, A., Hagberg, H., Johnson, H.E., Doorduijn, J.K., Sydes, M.R., and Kvalheim, G. 2003. High-dose therapy improves progression-free survival and survival in relapsed follicular non-Hodgkin’s lymphoma: results from the randomized European CUP trial. J Clin Oncol 21:3918-3927.

 

4.                                       Foran, J.M., Rohatiner, A.Z., Cunningham, D., Popescu, R.A., Solal-Celigny, P., Ghielmini, M., Coiffier, B., Johnson, P.W., Gisselbrecht, C., Reyes, F., et al. 2000. European phase II study of rituximab (chimeric anti-CD20 monoclonal antibody) for patients with newly diagnosed mantle-cell lymphoma and previously treated mantle-cell lymphoma, immunocytoma, and small B-cell lymphocytic lymphoma. J Clin Oncol 18:317-324.

 

5.                                       Foran, J.M., Gupta, R.K., Cunningham, D., Popescu, R.A., Goldstone, A.H., Sweetenham, J.W., Pettengell, R., Johnson, P.W., Bessell, E., Hancock, B., et al. 2000. A UK multicentre phase II study of rituximab (chimaeric anti-CD20 monoclonal antibody) in patients with follicular lymphoma, with PCR monitoring of molecular response. Br J Haematol 109:81-88.

 

6.                                       Khouri, I.F., and Champlin, R.E. 2004. Nonmyeloablative stem cell transplantation for lymphoma. Semin Oncol 31:22-26.

 

7.                                       Maris, M.B., Sandmaier, B.M., Storer, B.E., Chauncey, T., Stuart, M.J., Maziarz, R.T., Agura, E., Langston, A.A., Pulsipher, M., Storb, R., et al. 2004. Allogeneic hematopoietic cell transplantation after fludarabine and 2 Gy total body irradiation for relapsed and refractory mantle cell lymphoma. Blood 104:3535-3542.

 

8.                                       Kwak, L.W., Campbell, M.J., Czerwinski, D.K., Hart, S., Miller,

 



 

R.A., and Levy, R. 1992. Induction of immune responses in patients with B-cell lymphoma against the surface-immunoglobulin idiotype expressed by their tumors [see comments]. N Engl J Med 327:1209-1215.

 

9.                                       Hsu, F.J., Benike, C., Fagnoni, F., Liles, T.M., Czerwinski, D., Taidi, B., Engleman, E.G., and Levy, R. 1996. Vaccination of patients with B-cell lymphoma using autologous antigen- pulsed dendritic cells. Nat Med 2:52-58.

 

10.                                 Bendandi, M., Gocke, C.D., Kobrin, C.B., Benko, F.A., Sternas, L.A., Pennington, R., Watson, T.M., Reynolds, C.W., Gause, B.L., Duffey, P.L., et al. 1999. Complete molecular remissions induced by patient-specific vaccination plus granulocyte-monocyte colony-stimulating factor against lymphoma [see comments]. Nat Med 5:1171-1177.

 

11.                                 Mackall, C.L., Bare, C.V., Granger, L.A., Sharrow, S.O., Titus, J.A., and Gress, R.E. 1996. Thymic-independent T cell regeneration occurs via antigen-driven expansion of peripheral T cells resulting in a repertoire that is limited in diversity and prone to skewing. J Immunol 156:4609-4616.

 


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