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513 Initial Results from the BEACON Clinical Study: A Phase 1/2 Study Evaluating the Safety and Efficacy of a Single Dose of Autologous CD34+ Base Edited Hematopoietic Stem Cells (BEAM-101) in Patients with Sickle Cell Disease with Severe Vaso-Occlusive Crises

Program: Oral and Poster Abstracts
Type: Oral
Session: 801. Gene Therapies: Gene Editing and Replacement Therapies for Hemoglobinopathies: From Bench to Bedside
Hematology Disease Topics & Pathways:
Research, Clinical trials, Sickle Cell Disease, Clinical Research, Hemoglobinopathies, Diseases, Technology and Procedures, Gene editing
Sunday, December 8, 2024: 10:00 AM

Ashish O. Gupta, MBBS, MPH1, Akshay Sharma, MBBS2, Haydar Frangoul, MD3, Jignesh Dalal, MD4*, Julie Kanter, MD5, Asif Alavi, MD6*, John DiPersio, MD, PhD7*, Mary Eapen, MBBS, MS8, Jennifer J. Jaroscak, MD9, Ernesto Ayala, MD10, Edward D. Ziga, MD, MPH11*, Stacey Rifkin-Zenenberg, DO12, Alex C. Minella, MD13, Guo Chen, PhD13*, Yinzhong Chen, PhD13*, Priya S. Chockalingam, PhD13*, Ling Lin, PhD13*, Marcelyne Joseney-Antoine13*, Leanne Ianniello, MPH13*, Beth Gardner, BSc, EMBA, PMP13*, Adam J. Hartigan, PhD13*, Giuseppe Ciaramella, PhD, BSc13*, Sunita Goyal, MD13*, Amy Simon, MD13*, Alexis Thompson, MD, MPH14 and Matthew M. Heeney, MD15

1Division of Pediatric Blood and Marrow Transplant and Cellular Therapies, University of Minnesota, Minneapolis, MN
2Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN
3Sarah Cannon Research Institute at the Children's Hospital at TriStar Centennial, Nashville, TN
4Division of Hematology and Bone Marrow Transplant, Rainbow Babies & Children’s Hospital, Cleveland, OH
5Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL
6Henry Ford Health System, Detroit, MI
7Division of Oncology, Washington University, St Louis, MO
8Department of Medicine, The Medical College of Wisconsin, Inc., Milwaukee, WI
9Medical University of South Carolina, Charleston, SC
10Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL
11Miller School of Medicine, Miami, FL
12Pediatric Hematology/Oncology Division, Hackensack University Medical Center, Hackensack, NJ
13Beam Therapeutics Inc., Cambridge, MA
14Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, PA
15Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA

Fetal hemoglobin (HbF) is anti-sickling and elevated HbF ameliorates sickle cell disease (SCD) manifestations. BEAM-101 is an investigational cell therapy comprised of autologous CD34+ hematopoietic stem and progenitor cells (HSPCs) that are base edited ex vivo to introduce naturally occurring A-to-G substitutions into the promoters of the HBG1/2 genes that encode γ-globin to disrupt BCL11A transcriptional repressor binding sites, leading to increased HbF production. We previously demonstrated in pre-clinical studies that base editing potently induced HbF (>60%) and proportionately reduced sickle hemoglobin (HbS) (<40%) without relying on double-stranded DNA breaks. We present initial data from BEACON (NCT05456880), a Phase 1/2, single-arm, open-label study evaluating the safety and efficacy of a single dose of BEAM-101 in patients with SCD with severe vaso-occlusive crises (VOCs).

Patients 18–35 years diagnosed with SCD and ≥4 severe VOCs in the 2-year period prior to screening per trial criteria were eligible. After plerixafor mobilization, autologous CD34+ HSPCs were collected by leukapheresis/isolation and genetically modified with an adenine base editor. After myeloablative conditioning with pharmacokinetically adjusted busulfan, patients received a single infusion of BEAM-101 (≥3.0 × 106 viable CD34+ cells/kg) and are monitored for neutrophil and platelet engraftment, adverse events (AEs), total hemoglobin (Hb), Hb fractions, % F-cells, hemolysis markers, peripheral blood editing, and VOCs for 24 months.

As of July 2, 2024, >20 patients are enrolled and BEAM-101 has been manufactured for 8 patients, of whom 6 patients have been dosed. One patient not included in this analysis discontinued during the mobilization/collection period prior to BEAM-101 treatment for non-medical reasons. Baseline demographics were as follows: 5/6 patients βSS, 1/6 patients βS0, all self-reported Black/African American, 50% female, aged 19–27 years. Of the 6 patients, half (n=3) required only a single mobilization cycle and the other half required 2. Patients received a mean BEAM-101 dose of 11.9 × 106 (5.2–23.4) viable CD34+ cells/kg.

Excepting safety data that include all patients dosed (n=6), the following data are from patients dosed with ≥1 month of follow up (n=4; 6, 5, 2, and 1 month[s] post-treatment, each). All 4 patients with ≥1 month of follow up achieved neutrophil and platelet engraftment at a median of 17 (15–19) and 20 (11–34) days, respectively. One patient died due to respiratory failure, likely related to busulfan conditioning, 4 months after infusion. In all patients dosed (n=6), there have been no ≥Grade 3 AEs or serious AEs related to BEAM-101.

Using the central laboratory data, patients’ total Hb increased from baseline (mean 9.3 [7.9–10.9] g/dL) to 17.9, 18.2, 11.0, and 11.8 g/dL at last time point (LTP) available for P1, P2, P3, and P4, respectively. No signs/symptoms or interventions were undertaken for high total Hb. All patients achieved >60% HbF of non-transfused Hb (total Hb HbA) at Month (M) 1 and sustained this elevation to the LTP available. By M1, HbS% in non-transfused blood dropped to ≤36% in all 4 patients and was sustained through LTP. In total blood, % F-cells were 99.6% in P1 at M6, 94.4% in P2 at M4, 52.0% in P3 at M2, and 13.3% in P4 at M1 with all patients having >19 pg HbF/F-cell at LTP available. Peripheral blood editing in nucleated cells, measured in P1 (at M6) and P2 (at M3), was 69.9% and 76.1%, respectively. Markers of hemolysis (lactate dehydrogenase, indirect bilirubin, haptoglobin, and reticulocyte counts) have normalized or improved for all patients. No VOCs have been reported by investigators following BEAM-101 treatment.

These initial data show a safety profile for BEAM-101 consistent with busulfan conditioning and autologous HSCT. Treatment with BEAM-101 resulted in rapid engraftment, improvement in hemolysis markers, and marked improvement of anemia in all 4 dosed patients. We observed rapid and robust HbF induction consistent with pre-clinical data by M1 (>60%) and corresponding HbS reduction (≤36%) in non-transfused blood in all post-treatment assessments. No VOCs were reported by investigators post-treatment. These initial data support base editing of the HBG1/2 promoters as an effective therapeutic modality for the treatment of SCD and will continue to be investigated in the ongoing BEACON study. Updated data to be presented.

Disclosures: Gupta: Emerging Therapies Solutions: Speakers Bureau; Jazz Pharmaceuticals: Research Funding; Vertex Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees; Orchard Therapeutics: Research Funding; Beam Therapeutics: Research Funding; bluebird bio, Inc.: Research Funding. Sharma: CRISPR Therapeutics: Other: Clinical Trial site-PI, Research Funding; Novartis: Other: Clinical Trial site-PI; Beam Therapeutics: Other: Clinical Trial site-PI; Vertex Pharmaceuticals: Consultancy, Other: Clinical Trial site-PI; Medexus Inc.: Consultancy; Editas Medicine: Consultancy; Sangamo Therapeutics: Consultancy. Frangoul: Vertex Pharmaceuticals: Consultancy; Editas Medicine: Consultancy; Jazz Pahrmaceuticals: Speakers Bureau; BioLineRx: Consultancy; Rocket Pharma: Consultancy. Kanter: Watkins, Lourie, Roll & Chance: Consultancy; GSK: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Novo Nordisk: Consultancy, Research Funding; EcoR1: Consultancy; Bioline Rx: Consultancy; Vifor: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Optum United Health: Consultancy; Guidepoint Global: Consultancy; GLG Pharma: Consultancy; Sanofi: Consultancy; Chiesi: Honoraria, Membership on an entity's Board of Directors or advisory committees; Beam Tx: Consultancy, Research Funding; Novartis: Consultancy; bluebird bio: Consultancy, Research Funding; Affimmune: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; GlycoMimetics: Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Consultancy; NIH/NHLBI: Other: Federal Funding; CDC: Other: Federal Funding; Health Resources and Services Administration: Other: Federal Funding; Bausch: Consultancy; Emerging Therapy Solutions: Honoraria; Fulcrum: Consultancy; Merck: Membership on an entity's Board of Directors or advisory committees; Takeda: Research Funding. Alavi: Vertex Pharmaceuticals: Other: Advisory Board participation . DiPersio: Magenta Therapeutics: Current equity holder in publicly-traded company; WUGEN: Current equity holder in publicly-traded company, Research Funding; RiverVest Venture Partners: Consultancy; SPARC: Consultancy; Vertex: Consultancy; RiverVest Venture Partners: Membership on an entity's Board of Directors or advisory committees; Magenta: Membership on an entity's Board of Directors or advisory committees; hC Bioscience, Inc.: Membership on an entity's Board of Directors or advisory committees; NeoImmune Tech: Research Funding; Macrogenics: Research Funding; Bioline Rx: Research Funding; CART w/WashU and WUGEN: Patents & Royalties; VLA-4 Inhibitors w/WashU and Magenta: Patents & Royalties. Jaroscak: Pfizer: Other: Advisory Board; Bioline Rx: Other: Advisory Board; Just Worldwide: Other: Market Research. Rifkin-Zenenberg: Vertex: Honoraria, Membership on an entity's Board of Directors or advisory committees. Minella: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Chen: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Chen: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Chockalingam: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Lin: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Joseney-Antoine: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Ianniello: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Gardner: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Hartigan: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Ciaramella: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Goyal: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Simon: Beam Therapeutics: Current Employment, Current equity holder in publicly-traded company. Thompson: bluebird bio: Consultancy, Research Funding; Global Blood Therapeutics: Divested equity in a private or publicly-traded company in the past 24 months; CRISPR/Vertex: Consultancy, Research Funding; Novartis: Research Funding; Editas: Consultancy, Research Funding; Beam Therapeutics: Consultancy, Research Funding. Heeney: Bluebird Bio: Consultancy; Amgen: Current equity holder in publicly-traded company; MiNA Therapeutics: Consultancy; Beam Therapeutics: Consultancy, Current equity holder in publicly-traded company; Dianthus Therapeutics: Current equity holder in publicly-traded company; Blueprint Medicines: Consultancy; Pfizer: Consultancy, Current equity holder in publicly-traded company; CRISPER Therapeutics: Current equity holder in publicly-traded company; Abbvie: Current equity holder in publicly-traded company; Novartis: Consultancy, Current equity holder in publicly-traded company; GE Healthcare: Current equity holder in publicly-traded company; Omeros: Consultancy; Abbott Labs: Current equity holder in publicly-traded company; Praxis: Current equity holder in publicly-traded company.

*signifies non-member of ASH