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Bristol’s son of Revlimid goes pivotal

As part of its Celgene takeover Bristol Myers Squibb inherited a pipeline of “celmod” molecules designed to help weather Revlimid’s patent expiry, and the third of these, golcadomide, is now entering phase 3 development. The Golseek-1 study will enrol 850 front-line B-cell lymphoma patients and compare golcadomide plus R-Chop versus R-Chop alone, a new clinicaltrials.gov listing reveals. This follows the entry into phase 3 of two other Bristol celmods, iberdomide and mezigdomide, in various multiple myeloma settings. Celmods are small molecules that bind to the cereblon protein and lead to the degradation of certain substrates, for instance Ikaros and Aiolos, and it’s only relatively recently that imids like Revlimid and Pomalyst have been found to work this way too. The follow-on compounds have higher potency, however, acting in patients with lower cereblon expression levels, and each is apparently optimised for a different disease setting. Bristol has had a few false starts here: avadomide, an early iteration of golcadomide, was discontinued, as were CC-885 and eragidomide, which degrade the substrate GSPT1. Bristol's work on GSPT1 is now focused on ORM-6151, an anti-CD33 MAb-based asset acquired from Orum Therapeutics.

 

Bristol’s oral small-molecule cereblon E3 ligase modulator (celmod) agents

Project/drugSubstratePossible positioningStatus
Revlimid (lenalidomide)Aiolos & Ikaros*Established 1st-line multiple myeloma therapy, also approved for r/r lymphomaUS patents started expiring 2022
Pomalyst (pomalidomide)Aiolos & IkarosApproved for 3rd-line multiple myelomaUS patents start expiring 2025
Iberdomide (CC-220)Aiolos & IkarosTo replace Revlimid as foundation for 1st-line multiple myelomaPh3 in r/r (Excaliber-RRMM) & 1st-line maintenance (Excaliber-Maintenance) multiple myeloma
Mezigdomide (CC-92480/ BMS-986348)Aiolos & IkarosTo replace Pomalyst in r/r multiple myelomaPh3 in r/r multiple myeloma (Successor-1 & Successor-2)
Golcadomide (CC-99282/ BMS-986369)Aiolos & IkarosNon-Hodgkin's lymphomaPh3 Golseek-1 in 1st-line DLBCL (R-Chop combo)
CC-91633 (BMS-986397)CK1α^AML & MDSPh1 in r/r AML or MDS
Avadomide (CC-122)Aiolos & IkarosNon-Hodgkin's lymphomaDiscontinued in ph1 in favour of golcadomide
Eragidomide (CC-90009)GSPT1^^AMLDiscontinued in ph1
CC-885GSPT1^^AMLDiscontinued in preclinical in favour of eragidomide

Note: *Aiolos (IKZF3) & Ikaros (IKZF1) are zinc finger protein lymphoid transcription factors essential for myeloma cell survival; ^CK1α=casein kinase 1α; ^^GSPT1 is a translation termination factor. Source: OncologyPipeline & company information.