Geron Corporation is advancing its lead drug candidate, imetelstat, through key clinical trials and regulatory milestones, positioning the company for potential commercialization and expansion in hematologic malignancies.
Imetelstat in Lower-Risk MDS
Following positive top-line results from the IMerge Phase 3 study, imetelstat has shown statistically significant and clinically meaningful improvements in transfusion independence in patients with lower-risk myelodysplastic syndromes (MDS). The trial met its primary endpoint of 8-week transfusion independence, as well as a key secondary endpoint of 24-week transfusion independence. These results underscore imetelstat's potential to modify the course of the underlying hematologic malignancy.
"We saw substantial increases in both hemoglobin levels and reductions in transfusions. We also saw efficacy across MDS subtypes," said Dr. Faye Feller, Executive Vice President and Chief Medical Officer at Geron, highlighting the broad applicability of the drug.
Geron is on track to submit a New Drug Application (NDA) to the FDA in mid-2023, with a request for priority review. If granted, the FDA approval and U.S. commercial launch of imetelstat in lower-risk MDS could occur as early as the first quarter of 2024. A Marketing Authorization Application (MAA) submission in Europe is planned by the end of 2023, potentially leading to EU approval by the end of 2024.
IMpactMF Trial in Myelofibrosis
Imetelstat is also being evaluated in the IMpactMF Phase 3 trial for relapsed/refractory myelofibrosis, with overall survival (OS) as the primary endpoint. An interim analysis for OS is expected in 2024, dependent on the number of death events occurring in the study. Enrollment strategies are being implemented to accelerate site activation and patient recruitment.
Dr. Feller emphasized the significance of OS as a measure of benefit, stating, "If the improvement in OS that was observed in imetelstat-treated patients in our IMbark Phase 2 trial can be confirmed in the Phase 3 IMpactMF trial, we believe imetelstat will be strongly differentiated from other treatments in MF."
Expanding Imetelstat's Potential
Geron is exploring further applications of imetelstat in combination with other therapies and in additional hematologic malignancies. The IMproveMF Phase 1 study is evaluating imetelstat in combination with ruxolitinib in frontline myelofibrosis. Preliminary data from this study is expected by the end of 2023. Additionally, an investigator-led study (IMpress) is evaluating imetelstat as a single-agent treatment in relapsed/refractory acute myeloid leukemia (AML) and higher-risk MDS.
Financial Position and Commercial Preparedness
Geron's financial position is strong, with over $445 million in cash holdings. This is expected to fund operations through the end of the third quarter of 2025, supporting regulatory submissions, clinical trials, and the potential U.S. commercial launch of imetelstat. The company is actively building its commercial organization, hiring experienced professionals to prepare for the anticipated launch.
"We are taking important steps to ensure commercial readiness at launch," said Anil Kapur, Executive Vice President of Corporate Strategy and Chief Commercial Officer. "Our commercial go-to-market strategy revolves around building a comprehensive clinical and economic value proposition."
