全球首个获批一线治疗小细胞肺癌的抗PD-1单抗

国际多中心III期研究中位OS达15.8个月，刷新全球纪录

全球上市持续推进，获美国、欧盟孤儿药资格认定

2023年1月17日，上海—复宏汉霖（2696.HK）宣布，公司自主研发的创新生物药抗PD-1单抗H药——汉斯状®（通用名：斯鲁利单抗注射液）新适应症上市申请获得国家药品监督管理局（NMPA）批准，联合卡铂和依托泊苷用于广泛期小细胞肺癌（ES-SCLC）的一线治疗，成为全球首个一线治疗小细胞肺癌的抗PD-1单抗，开启小细胞肺癌免疫治疗新时代。此前，H药已获批治疗微卫星高度不稳定 (MSI-H) 实体瘤和鳞状非小细胞肺癌（sqNSCLC）两项适应症。

复宏汉霖董事长、执行董事兼首席执行官张文杰表示：

“

继鳞状非小细胞肺癌之后，H药获批治疗小细胞肺癌，其在肺癌领域的治疗潜力再次得以验证。这不仅是H药开发历程中的又一里程碑，更首次证实了抗PD-1单抗联合化疗能够为小细胞肺癌患者带来生存改善，成为小细胞肺癌治疗领域的重要突破。未来，期待H药作为中国创新药代表，以优异的疗效扬帆出海，将高品质的国产生物药带给更广大的肺癌患者。

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H药广泛期小细胞肺癌 III期临床研究主要研究者、吉林省肿瘤医院程颖教授表示：

“

小细胞肺癌（SCLC）是肺癌中侵袭性最强的亚型，疾病进展迅速，总体预后不良。斯鲁利单抗针对ES-SCLC开展的国际多中心临床研究取得了历史性的突破，其获批不仅为我国SCLC患者带来了更优的免疫治疗选择，还将重塑该领域一线免疫治疗新格局，助力全球肺癌治疗创新发展。

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持续创新厚积薄发，突破小肺治疗瓶颈

肺癌是全球最常见的恶性肿瘤之一。据GLOBOCAN数据显示，2020年全球肺癌新发病例220万例，新发肺癌死亡病例180万例，位居癌症死亡人数榜首[1]。小细胞肺癌（SCLC）约占肺癌总数的15%[2]，是肺癌中侵袭性最强的亚型，分为局限期小细胞肺癌（LS-SCLC）和ES-SCLC。多数患者在确诊时已处于广泛期[3]，临床病情恶化快，总体预后不良。过去20年，依托泊苷联合卡铂或顺铂长期作为ES-SCLC患者的标准一线治疗，但中位OS（总生存期）不到1年，并且绝大多数化疗患者在一年内复发[4]。免疫检查点抑制剂的出现为ES-SCLC的治疗带来了新希望，其中，抗PD-L1单抗联合化疗一线治疗ES-SCLC中位OS可达12-13个月，但相较于化疗，抗PD-L1单抗 2个多月的总生存优势仍不能满足临床需求，同时，多款抗PD-1单抗产品在SCLC领域多番折戟，迫切需要一个更为有效的方案突破桎梏。

H药此次获批主要基于一项随机、双盲、安慰剂对照的国际多中心III期临床研究（ASTRUM-005）。该研究在中国、土耳其、欧盟波兰、格鲁吉亚等多个国家共开设128个试验中心，入组585例受试者，其中约31.5%为白人。此项研究结果在2022 ASCO年会上以口头报告形式首次公布，更新随访数据也于2022年12月ESMO Asia上发布。值得一提的是，2022年9月，ASTRUM-005研究结果于全球四大顶级医学期刊之一的《美国医学会杂志》（JAMA，影响因子：157.3）在线发表，成为全球首个登上JAMA主刊的小细胞肺癌免疫治疗临床研究，再度验证了国际学术界对该研究的高度认可。

ASTRUM-005研究分析显示，H药（斯鲁利单抗）联合化疗组的中位OS达15.8个月，较对照组显著延长4.7个月，OS得到了明显改善，H药（斯鲁利单抗）联合化疗组患者死亡风险降低38%（HR=0.62，95%CI: 0.50~0.76）。亚裔人群中位OS达15.9个月，较对照组延长4.8个月（HR=0.63，95%CI: 0.49~0.81）。其独立影像评估委员会根据RECIST v1.1评估的中位PFS也获得了延长（5.8 vs. 4.3个月；HR 0.47，95% CI: 0.38~0.58）。研究结果表明，H药联合卡铂-依托泊苷一线治疗既往未接受过治疗的广泛期小细胞肺癌（ES-SCLC）患者获益显著，达到预设的主要终点，且具有良好的安全性和耐受性，并有望为亚裔人群带来更显著的潜在获益。

全面推进国际布局，加速惠及全球患者

作为复宏汉霖首个自主研发的创新型单抗，H药于2022年3月正式获批上市，成为国内首批率先开启“泛癌种”治疗MSI-H实体瘤的抗PD-1单抗，目前可用于治疗MSI-H实体瘤、sqNSCLC及ES-SCLC。其治疗局部晚期/复发或转移性食管鳞状细胞癌（ESCC）的上市注册申请（NDA）也已获得国家药监局（NMPA）受理。以H药为基石，复宏汉霖也积极推进其与公司其他产品的协同以及与创新疗法的联合，目前已获得中国、美国、欧盟等国家及地区的临床试验许可，在全球同步开展12项肿瘤免疫联合疗法临床试验，广泛覆盖肺癌、食管癌、头颈鳞癌和胃癌等适应症。

以临床需求为导向，复宏汉霖潜心深耕肺癌治疗领域，围绕H药进行了肺癌一线治疗的全面布局，除已获批上市的sqNSCLC、ES-SCLC外，广泛覆盖非鳞状非小细胞肺癌（nsNSCLC）、LS-SCLC等适应症，可望惠及超过90%的肺癌患者。在SCLC领域，复宏汉霖就广泛期和局限期小细胞肺癌两项适应症均开展了国际多中心临床试验，充分的国际临床试验数据有望支持海外市场的申报。其中，H药用于治疗SCLC于2022年相继获美国食品药品监督管理局（FDA）和欧盟委员会(EC)的孤儿药资格认定。基于FDA对H药治疗ES-SCLC的上市申请的正向反馈和要求及FDA C类咨询会议的讨论结果，公司于2022年在美国启动了一项桥接临床试验，以评估H药在美国ES-SCLC患者中的疗效。根据在SCLC适应症上的研究进展，公司计划后续在欧盟和美国递交H药的上市注册申请。

与此同时，复宏汉霖积极规划H药的商业化布局，从市场推广、渠道管理、定价及市场准入等方面入手，多渠道提升H药的可及性。截至2022年底，H药已惠及逾1万名中国患者，公司已完成H药在中国境内28个省份的招标挂网，并进入宁波、金华等5个城市的定制型商业保险目录。在海外商业化方面，复宏汉霖于2019年与KG Bio达成合作，授予其H药首个单药疗法及两项联合疗法在东南亚地区10个国家的独家开发和商业化权利；2022年底，公司授予复星医药H药ES-SCLC适应症在美国市场的独家商业化权益，借助复星医药的国际化优势和商业化能力，协同拓展H药的海外市场布局。后续公司也将根据H药的临床和获批进展，稳健持续拓展H药的海外布局，覆盖更多国家和地区，让国际品质的创新药走上世界PD-1舞台。

未来，复宏汉霖将以H药为典范，加速推动管线的差异化创新，并不断拓展产品的国际化布局，持续打造民族品牌、国际品质的高质量创新药，为全球更广泛的患者群体带来福音。

关于H药 汉斯状®

H药 汉斯状®为重组人源化抗PD-1单抗注射液（通用名：斯鲁利单抗注射液），是复宏汉霖首个自主研发的创新型单抗，同时为全球首个获批一线治疗小细胞肺癌的抗PD-1单抗。目前H药有3项适应症获批上市，1项适应症上市申请获受理，10余项临床试验同步在全球开展。

2022年3月，H药正式获批上市，目前可用于治疗微卫星高度不稳定（MSI-H）实体瘤、鳞状非小细胞肺癌（sqNSCLC)及广泛期小细胞肺癌（ES-SCLC）。围绕H药，复宏汉霖积极推进其与公司其他产品的协同以及与创新疗法的联合，相继获得中国、美国、欧盟等国家及地区的临床试验许可，在全球同步开展12项肿瘤免疫联合疗法临床试验，广泛覆盖肺癌、食管癌、头颈鳞癌和胃癌等适应症，全面覆盖肺癌一线治疗。截至目前，H药已于中国、土耳其、波兰、格鲁吉亚等国家和地区累计入组超3100人，其中2项国际多中心临床试验入组白人的比例超过30%，是拥有国际临床数据较多的抗PD-1单抗之一。H药联合化疗一线治疗食管鳞状细胞癌（ESCC）的NDA也已获得NMPA受理。此外，H药分别被《2022 CSCO小细胞肺癌诊疗指南》、《中国食管癌放射治疗指南（2022年版）》纳入ES-SCLC和晚期食管鳞癌（IA类证据）的一线治疗推荐。针对ES-SCLC的国际多中心临床研究ASTRUM-005成为全球首个登上JAMA的小细胞肺癌免疫治疗临床研究。H药治疗SCLC也已获得美国FDA和欧盟EC的孤儿药资格认定，并在美国启动了一项H药对比一线标准治疗阿替利珠单抗的头对头桥接试验。

关于复宏汉霖

复宏汉霖（2696.HK）是一家国际化的创新生物制药公司，致力于为全球患者提供可负担的高品质生物药，产品覆盖肿瘤、自身免疫疾病、眼科疾病等领域，已在中国上市5款产品，在国际上市1款产品，18项适应症获批，1个上市注册申请获得中国药监局受理。自2010年成立以来，复宏汉霖已建成一体化生物制药平台，高效及创新的自主核心能力贯穿研发、生产及商业运营全产业链。公司已建立完善高效的全球创新中心，按照国际药品生产质量管理规范（GMP）标准进行生产和质量管控，不断夯实一体化综合生产平台，其中，上海徐汇基地已获得中国和欧盟GMP认证，松江基地（一）也已获得中国GMP认证。

复宏汉霖前瞻性布局了一个多元化、高质量的产品管线，涵盖20多种创新单克隆抗体，并全面推进基于自有抗PD-1单抗H药汉斯状®的肿瘤免疫联合疗法。继国内首个生物类似药汉利康®（利妥昔单抗）、中国首个自主研发的中欧双批单抗药物汉曲优®（曲妥珠单抗，欧洲商品名：Zercepac®，澳大利亚商品名：Tuzucip®和Trastucip®）、汉达远®（阿达木单抗）和汉贝泰®（贝伐珠单抗）相继获批上市，创新产品汉斯状®（斯鲁利单抗）已获批用于治疗微卫星高度不稳定（MSI-H）实体瘤、鳞状非小细胞肺癌和广泛期小细胞肺癌，成为全球首个获批一线治疗小细胞肺癌的抗PD-1单抗，其食管鳞状细胞癌适应症的上市注册申请也正在审评中。公司亦同步就15个产品、12个免疫联合治疗方案在全球范围内开展20多项临床试验，对外授权全面覆盖欧美主流生物药市场和众多新兴市场。

Henlius’ Novel Anti-PD-1 mAb HANSIZHUANG (Serplulimab) Approved for the Treatment of ES-SCLC

World’s first anti-PD-1 mAb for the first-line treatment of SCLC

Making a new record with the median OS of 15.8 months in an international, multi-center, phase 3 clinical trial

Granted orphan drug designations by the FDA and the EC, paving the way for international commercialization

Shanghai, China, Jan, 17th, 2023 – Shanghai Henlius Biotech, Inc. (2696. HK) announced that its first self-developed innovative anti-PD-1 monoclonal antibody (mAb) HANSIZHUANG (generic name: serplulimab injection), in combination with carboplatin and etoposide for the first-line treatment of extensive stage small cell lung cancer (ES-SCLC), has been approved by the National Medical Products Administration (NMPA), making it the world’s first anti-PD-1 mAb for the first-line treatment of small cell lung cancer (SCLC). HANSIZHUANG had already been approved for the treatment of Microsatellite Instability-High (MSI-H) solid tumors and squamous non-small cell lung cancer (sqNSCLC).

Wenjie Zhang, Chairman, Executive Director, and CEO of Henlius, said, “This is the second approval HANSIZHUANG has received in the first-line treatment of lung cancer, after approval of sqNSCLC, demonstrating its great potential in lung cancer treatment. It is another milestone for HANSIZHUANG as well as a remarkable achievement for anti-PD-1 mAbs to improve survival notably in patients with SCLC. Looking forward, as the representative of China’s innovative drugs, HANSIZHUANG is expected to be approved in overseas markets to benefit more lung cancer patients with its consistent efficacy.”

Professor Ying Cheng, the leading principal investigator of the phase 3 clinical study of HANSIZHUANG on ES-SCLC, from Jilin Province Cancer Hospital, said, “SCLC is the most aggressive subtype of lung cancer, patients with SCLC deteriorate rapidly in clinical behavior and the overall prognosis is poor. The success of ASTRUM-005, a multi-center clinical trial of HANSIZHUANG, is a breakthrough in the treatment of ES-SCLC. Apart from providing a better immunotherapy option, this approval will also reshape the first-line treatment of ES-SCLC and promote the treatment of lung cancer around the world.”

Innovate to solve the dilemma of SCLC treatment

Lung cancer (LC) is one of the most common malignancies around the world. According to GLOBOCAN 2020, there were 2.2 million new LC cases and 1.8 million new deaths in 2020 worldwide, and LC is still the leading cause of cancer death[1]. SCLC is the most aggressive subtype of lung cancer, accounting for around 15% of all lung cancer cases[2]. The SCLC breaks down into limited stage small cell lung cancer (LS-SCLC) and ES-SCLC. Most patients are in extensive stage when diagnosed[3]. Their clinical condition deteriorates rapidly and the overall prognosis is poor. In the past 20 years, etoposide combined carboplatin/cisplatin was still the standard of care for ES-SCLC, but almost all patients in extensive stage relapse within one year[4], with a median overall survival (OS) of only 10 to 11 months. The advent of immune checkpoint inhibitors has brought new hope to patients with ES-SCLC. At present, anti-PD-L1 mAbs combined with chemotherapy has prolonged the OS of patients with SCLC to 12-13 months compared to chemotherapy, but the improvements were still modest. Meanwhile, a number of anti-PD-1 mAbs have failed in SCLC, and more effective solutions are urgent needed.

The approval was primarily based on ASTRUM-005, a randomized, double-blind, placebo-controlled international multi-center phase 3 clinical study. The study has set up a total of 128 sites in various countries including China, Turkey, Poland, and Georgia, and enrolled 585 subjects who were screened from 114 sites, among whom 31.5% were White. The results of ASTRUM-005 were presented in oral for the first time at the 2022 ASCO annual meeting，and the results were updated at the 2022 European Society for Medical Oncology Asia (ESMO Asia) Congress in December 2022. In September 2022, the results of ASTRUM-005 had been published in The Journal of the American Medical Association (JAMA, impact factor of 157.3), one of the top four medical journals in the world, which made ASTRUM-005 the first study published on JAMA in SCLC immunotherapy, demonstrating the high level of academic acclaim on a global scale.

According to the study analysis, the median OS was significantly longer in the serplulimab group (15.8 months) than in the placebo group (11.1 months), and a 38% reduction in risk of death was observed in the serplulimab group compared with the placebo group(HR=0.62, 95%CI:0.50-0.76).The Asians subgroup also showed a 4.8 months longer median OS in the serplulimab group (HR=0.63，95%CI: 0.49-0.81). Median PFS assessed by the independent radiology review committee per RECIST v1.1 was prolonged with the addition of serplulimab (5.8 vs. 4.3 months; HR=0.47, 95%CI:0.38-0.58).The results indicated that HANSIZHUANG (serplulimab injection) in combination with chemotherapy (Carboplatin-Etoposide) could bring significant benefits against chemotherapy (Carboplatin-Etoposide) in the treatment of previously untreated patients with ES-SCLC, met the pre-defined primary endpoint criteria, and had good safety and tolerability. HANSIZHUANG could potentially bring more significant benefits to Asian patients.

Global footprint for more patients

HANSIZHUANG is the first innovative mAb developed by Henlius. Since launched in March 2022, HANSIZHUANG has become one of the pioneering anti-PD-1 mAb for the “pan-cancer” treatment of MSI-H solid tumors in China. Up to date, HANSIZHUANG has been approved by the NMPA for the treatment of MSI-H solid tumors, sqNSCLC and ES-SCLC, its new drug application(NDA) in combination with chemotherapy for the first-line treatment of locally advanced/metastatic esophageal squamous cell carcinoma(ESCC) has also been accepted by the NMPA. As a backbone, HANSIZHUANG’s synergy with in-house products of the company and innovative therapies are forging ahead. It has successively obtained clinical trial licenses in China, the United States, the European Union and other countries and regions to initiate 12 clinical trials on immuno-oncology combination therapies in a wide variety of indications, such as lung cancer, esophageal carcinoma, head and neck squamous cell carcinoma and gastric cancer, etc.

Guided by unmet clinical needs, Henlius has devoted itself to lung cancer and built a comprehensive layout of the first-line treatment for lung cancer in sqNSCLC, ES-SCLC, nsNSCLC and LS-SCLC, which covers more than 90% of lung cancer patients. In the field of SCLC, multi-regional clinical trials regarding ES-SCLC and LS-SCLC have been conducted and the results will support NDAs in overseas markets. In 2022, HANSIZHUANG was also granted orphan drug designations by the Food and Drug Administration(FDA) and European Commission(EC) for the treatment of SCLC. Based on the positive feedback of FDA Biologics license Application (BLA) submission for HANSIZHUANG for the treatment of ES-SCLC and the discussion results of the FDA's Class C consultation meeting, Henlius has initiated a bridging head-to-head trial in US patients with ES-SCLC to evaluate the efficacy of HANSIZHUANG, which propels the product towards US market approval further. According to the research progress in SCLC, the company plans to submit new drug applications of the product in the EU and US in the coming years.

In addition, Henlius actively promotes the commercialization of HANSIZHUANG to enhance its accessibility by marketing, channel management, pricing and market access. By the end of 2022, HANSIZHUANG has completed the tendering process on the procurement platform in 28 provinces in Chinese mainland and was included into the commercial medical insurance directory in 5 cities such as Ningbo, Jinhua, etc., benefiting more than 10,000 Chinese patients. As early as 2019, Henlius forged a partnership with PT Kalbe Genexine Biologics（KG Bio）to grant it an exclusive license to develop and commercialize HANSIZHUANG in relation to a monotherapy and two combination therapies in 10 Southeast Asian countries. To accelerate the launch of HANSIZHUANG in the United States, Henlius entered into an exclusive license agreement with Fosun Pharma for the commercialization of HANSIZHUANG in December 2022. By virtual of Fosun Pharma’s advantages and commercial capabilities, HANSIZHUANG will expand its overseas distribution fast to benefit more patients. Going forward, Henlius will continue to expand global commercialization layout of HANSIZHUANG to reach out to more countries and regions, which urges this product to step on to the world PD-1 stage and benefits a broader patient population worldwide with its world-class quality.

With HANSIZHUANG as a model, Henlius will further promote its innovative and differentiated product portfolio and expand the global footprint to establish a prestigious national brand and bring hope to more patients across the world.

About HANSIZHUANG

HANSIZHUANG (recombinant humanized anti-PD-1 monoclonal antibody injection, generic name: serplulimab injection) is the first innovative monoclonal antibody developed by Henlius and and the world’s first anti-PD-1 mAb for the first-line treatment of SCLC. Up to date, 3 indications are approved for marketing in China, 1 NDA has been accepted by the NMPA, and more than 10 clinical trials are ongoing across the world.

HANSIZHUANG was launched in March 2022 and has been approved by the NMPA for the treatment of MSI-H solid tumours, squamous non-small cell lung cancer (sqNSCLC)  and extensive-stage small cell lung cancer (ES-SCLC) . Its synergy with in-house products of the company and innovative therapies are being actively promoted. It has successively obtained clinical trial licenses in China, the United States, the European Union and other countries and regions to initiate 12 clinical trials on immuno-oncology combination therapies in a wide variety of indications, such as lung cancer, esophageal carcinoma, head and neck squamous cell carcinoma and gastric cancer, etc., and covering the full range of first-line treatments of lung cancers. As of now, the company has enrolled more than 3,100 subjects in China, Turkey, Poland, Georgia and other countries and regions, and the proportion of White is over 30% in two MRCTs, making HANSIZHUANG an anti-PD-1 mAb with one of the largest global clinical data pools. The NDA of the first-line treatment for esophageal squamous cell carcinoma (ESCC) has been accepted by the NMPA. Furthermore, HANSIZHUANG was respectively recommended for the first-line treatment of ES-SCLC in the 2022 CSCO Guidelines for Diagnosis and Treatment of Small Cell Lung Cancer (SCLC) and the trentment of esophageal cancer (categary IA) in the 2022 China Guidelines for Radiotherapy of Esophageal Cancer. The associated clinical trial became the first study published in JAMA on SCLC immunotherapy. Serplulimab was also granted orphan drug designations by the FDA and EC for the treatment of SCLC, and the first patient has been dosed in a bridging head-to-head trial in the United States to comparing HANSIZHUANG to standard of care Atezolizumab (anti-PD-L1 mAb) for the first-line treatment of ES-SCLC.

About Henlius

Henlius (2696.HK) is a global biopharmaceutical company with the vision to offer high-quality, affordable and innovative biologic medicines for patients worldwide with a focus on oncology, autoimmune diseases and ophthalmic diseases. Up to date, 5 products have been launched in China, 1 approved for marketing in overseas markets, 18 indications approved worldwide, and 1 New Drug Application (NDA) accepted for review in China. Since its inception in 2010, Henlius has built an integrated biopharmaceutical platform with core capabilities of high-efficiency and innovation embedded throughout the whole product life cycle including R&D, manufacturing and commercialization. It has established global innovation centers and Shanghai-based manufacturing facilities in line with global Good Manufacturing Practice (GMP), including Xuhui Plant certificated by China and the EU GMP and Songjiang First Plant certificated by China GMP.

Henlius has pro-actively built a diversified and high-quality product pipeline covering over 20 innovative monoclonal antibodies (mAbs) and has continued to explore immuno-oncology combination therapies with proprietary HANSIZHUANG (anti-PD-1 mAb) as backbone. Apart from the launched products HANLIKANG (rituximab), the first China-developed biosimilar, HANQUYOU (trastuzumab, trade name in Europe: Zercepac®; trade names in Australia: Tuzucip® and Trastucip®, the first China-developed mAb biosimilar approved both in China and Europe, HANDAYUAN (adalimumab) and HANBEITAI (bevacizumab), the innovative product HANSIZHUANG has been approved by the NMPA for the treatment of MSI-H solid tumors, squamous non-small cell lung cancer (sqNSCLC) and extensive-stage small cell lung cancer (ES-SCLC) , making it the world’s first anti-PD-1 mAb for the first-line treatment of SCLC. Its NDA for the treatment of esophageal squamous cell carcinoma (ESCC) is under review. What's more, Henlius has conducted over 20 clinical studies for 15 products and 12 immuno-oncology combination therapies, expanding its presence in major markets as well as emerging markets.

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