Positive Results for Ziftomenib Trial

Topline data for KOMET-001 has been submitted for presentation at an upcoming medical conference in the second quarter of 2025, and Kura is on track to submit a New Drug Application (NDA) to the FDA for ziftomenib in the second quarter of 2025. 

The companies, which announced their joint collaboration to commercialize ziftomenib in 2024, also announced they plan to initiate a single protocol containing two independently powered, randomized, double-blind, placebo-controlled, registrational Phase III trials to evaluate ziftomenib in combination with both intensive and non-intensive combination regimens in patients with newly diagnosed NPM1-m and KMT2A-rearranged (KMT2A-r) AML, following successful interactions with the FDA. Each frontline trial design includes dual-primary endpoints to support potential U.S. accelerated approval and full approval. The companies plan to initiate the two frontline Phase 3 trials in the second half of 2025 and anticipate multiple clinical data presentations for the ziftomenib AML program as well as Kura’s pipeline programs in 2025. 

Positive KOMET-001 Ziftomenib Monotherapy Trial in R/R NPM1-m AML; Kura and Kyowa Kirin  announced positive topline results from KOMET-001, a Phase II registration-directed trial of ziftomenib, in patients with R/R NPM1-m AML. The KOMET-001 trial achieved its primary endpoint of CR plus CR with partial hematological recovery (CRh) and the primary endpoint was statistically significant. The benefit-risk profile for ziftomenib is highly encouraging, and safety and tolerability were consistent with previous reports.  The KOMET-001 registration-directed trial is designed to assess evidence of clinical activity, safety and tolerability of ziftomenib, the only investigational therapy to receive Breakthrough Therapy Designation (BTD) from the FDA for treatment of R/R NPM1mutant AML. Full results from the KOMET-001 trial will be presented at a future medical meeting in the second quarter of 2025. After successful FDA interactions in part facilitated by BTD, Kura announced that it is on track to submit an NDA to the FDA for ziftomenib for the treatment of patients with R/R NPM1-mutant AML in the second quarter of 2025.

Positive FDA Feedback for Upcoming Frontline Combination Trial Designs; Kura and Kyowa Kirin recently announced plans for KOMET-017, a global protocol evaluating ziftomenib in combination with standards of care for adults with newly diagnosed NPM1-m or KMT2A-r AML. Following successful End-of-Phase 1 meetings with the FDA, the companies announced they will proceed with plans to initiate the KOMET-017 trial, comprising of two independent, global, randomized, double-blind, placebo-controlled Phase 3 trials to evaluate ziftomenib in combination with both intensive and non-intensive combination regimens in patients with newly diagnosed NPM1-m and/or KMT2A-r AML. The positive feedback from the FDA, along with data from the KOMET-007 trial presented at the 2024 American Society of Hematology Annual Meeting, reinforces Kura’s and Kyowa Kirin’s commitment to evaluating ziftomenib in patients across the continuum of frontline treatment options

The registrational KOMET-017-IC (Intensive Combination) trial will evaluate the combination of ziftomenib with induction chemotherapy (7+3) in newly diagnosed NPM1m and KMT2A-r AML patients. Patients will be randomized to receive ziftomenib or placebo, in combination with standard induction, consolidation chemotherapy and post consolidation maintenance. The KOMET-017-IC trial will assess minimum residual disease (MRD) negative complete response (CR) and event-free survival (EFS) as dual primary endpoints to support potential U.S. accelerated approval and full approval, respectively and is anticipated to be initiated in the second half of 2025. The registrational KOMET-017-NIC (Non-Intensive Combination) trial will evaluate the combination of ziftomenib with venetoclax plus azacitidine in newly diagnosed NPM1-m patients unfit to receive intensive chemotherapy. The KOMET-017-NIC trial will assess CR and overall survival (OS) as dual-primary endpoints to support potential U.S. accelerated approval and full approval, respectively. Patients will be randomized to receive ziftomenib or placebo, in combination with venetoclax and azacitidine. The KOMET-017-NIC trial is anticipated to be initiated in the second half of 2025.

“Even with approved therapies, up to 70% of patients who achieve a first CR will see their AML return within 3 years. The 5-year survival rate for AML is 31.9% and as low as 11.2% for patients aged older than 65 years,” said Mollie Leoni, M.D., Chief Medical Officer of Kura Oncology. “Given this urgent need, we are pleased with the outcome of these FDA interactions and look forward to initiating our Phase III trials to establish the benefit-risk profile of ziftomenib in both the intensive and non-intensive chemotherapy settings. We were particularly pleased by the FDA’s willingness to allow the trials to use MRD negative CR and CR as primary endpoints for accelerated approval in the two populations. In so doing, the KOMET-017 protocol is breaking new ground, which may help deliver ziftomenib more quickly to patients living with this devastating disease.” 

“Starting patients on combination therapy early is essential to improving outcomes in AML,” said Takeyoshi Yamashita, Ph.D., Senior Managing Executive Officer and Chief Medical Officer of Kyowa Kirin. “The data from the completed KOMET-001 trial and FDA feedback on the planned KOMET-017 protocol strengthens our confidence these trials may offer valuable treatment options for patients throughout the continuum of treatment. We remain committed to working with our colleagues at Kura to bring ziftomenib as rapidly as possible to AML patients worldwide.”

MRD is a term describing small numbers of leukemic cells, which are still detectable during or after treatment, even when a patient has achieved CR by standard criteria. Remaining leukemia cells in the body can become active and start to multiply, resulting in a relapse of the disease, which may be fatal for patients. Achieving MRD negativity, which may be associated with longer remissions and improved survival, means that a treatment has reduced the number of leukemic cells to below the limit of detection by the most sensitive analytical methods. 

“We carefully designed KOMET-017 to allow patients to go on the same protocol but on one of the two sub-studies based on whether they are fit or unfit for intensive chemotherapy, and this approach is intended to be very patient centric, facilitate rapid enrollment and offer operational advantages to the study sites,” said Amer Zeidan, MBBS, MHS, chief of the Division of Hematologic Malignancies, director of Hematology Early Therapeutics Research at Yale Cancer Center, and the lead investigator of the KOMET017 trial. “Further, we designed KOMET-017 to allow for a potential accelerated approval based on endpoints that have been widely accepted as surrogates for meaningful clinical benefit in these patient populations,” Dr Zeidan added. “The association between MRD negativity and improved survival in patients with NPM1-mutated AML is well established in the literature. AML experts around the world recommend monitoring MRD in patients to guide treatment decisions. The best opportunity to achieve long-lasting remission and extend survival is to achieve MRD negativity with the first attempt at treatment. Therefore, using MRD negative CR as an approvable endpoint in AML is very innovative and could allow faster availability of therapies to our patients,” Dr Zeidan concluded.

2025 Anticipated Clinical Data Highlights; Kura and Kyowa Kirin expect to present multiple clinical data updates from their ziftomenib AML program, and Kura expects to present updates from its KO-2806 and tipifarnib programs, in 2025 as follows: • Topline data from the KOMET-001 trial of ziftomenib monotherapy in R/R NPM1m AML (2Q 2025) • KOMET-007 Phase 1b data of ziftomenib in combination with 7+3 in newly diagnosed NPM1-m AML and KMT2A-r AML (2Q 2025) • FIT-001 Phase 1 data of KO-2806 monotherapy in HRAS-mutant and KRASmutated solid tumors (2H 2025) • FIT-001 Phase 1 data of KO-2806 in combination with cabozantinib in renal cell carcinoma (RCC) (2H 2025) • KURRENT-HN Phase 1 data of tipifarnib in combination with alpelisib in PIK3CAdependent head and neck squamous cell carcinoma (HNSCC) (2H 2025) • KOMET-007 Phase 1b data of ziftomenib in combination with venetoclax / azacitidine in NPM1-m AML (2H 2025).