Part B CORE Study Rationale Sample Clauses

Part B CORE Study Rationale. Development of CFTR-targeted drugs represents a new era in CF treatment, one that is expected to revolutionize the care of CF patients in a profound way. CFTR modulators specifically target disease-causing CFTR mutations, with the aim of restoring protein function towards normal levels. To date, CFTR ‘potentiators’, which open the mutant CFTR channel and augment the activity of the protein at the plasma membrane, have had the most success in clinical trials. A landmark phase II trial of the CFTR potentiator ivacaftor (Kalydeco™, Vertex Pharmaceuticals, Cambridge, MA) studied in 40 CF patients with at least one copy of the G551D mutation, a class 3 gating mutant, demonstrated impressive improvements in CFTR activity, detected by nasal potential difference (NPD) and sweat chloride testing, resulting in significant changes in lung function.10 This trial was rapidly followed by two pivotal phase III trials in which ivacaftor treatment led to rapid, dramatic, and sustained improvements in lung function, weight, quality of life, and measures of CFTR function, and reductions in pulmonary exacerbations.11, 12 As a result, in 2012, the U.S. Food and Drug Administration (FDA) approved ivacaftor for CF patients ages 6 and older with the G551D mutation. Recently, ivacaftor received FDA approval for CF patients with other non-G551D class III gating mutations. It is anticipated that ivacaftor therapy alone may benefit approximately 15% of the U.S. CF population. In a Cystic Fibrosis Foundation Therapeutics (CFFT) led post-approval study termed the “G551D Observational Trial (GOAL Study)” efficacy of ivacaftor was confirmed in CF patients with the G551D mutation, and additional information was gleaned from the evaluation of biomarkers related to CFTR activity; in addition, a robust biospecimen repository was formed, and is now being accessed by a variety of CF investigators. The next class of CFTR modulators in development and clinical trial testing are ‘correctors’ of F508del CFTR trafficking defects which work by increasing F508del CFTR protein at the plasma membrane. Vertex Pharmaceuticals has developed two F508del correctors that have advanced to clinical trials (VX-809 or lumacaftor, and VX-661). Preclinical testing has shown that combining the CFTR corrector lumacaftor with the potentiator ivacaftor leads to enhanced F508del CFTR activity relative to lumacaftor alone.13 Preliminary results from phase III trials evaluating the combination therapy of lumacaftor and i...
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