OncoMed Provides Update on Tarextumab Phase 2 Pancreatic Cancer ALPINE Trial

On January 25, 2016 OncoMed Pharmaceuticals Inc. (NASDAQ:OMED), a clinical-stage company developing novel anti-cancer stem cell and immuno-oncology therapeutics,reported an update on the Phase 2 ALPINE clinical trial following a pre-planned January 23 interim efficacy assessment of the clinical trial by an independent data safety monitoring board (DSMB) (Press release, OncoMed, JAN 25, 2016, View Source [SID:1234508857]). The DSMB assessed data from 172 patients treated as of a January 6, 2016 data cutoff date.

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From a safety standpoint, the DSMB recommended that the study proceed to completion without modification. No unexpected safety findings emerged from its review.

However, the DSMB informed OncoMed of several findings regarding futility of the trial, notably:

A statistically significant worsening of response rate and progression-free survival (PFS) in the treatment arm in the overall intent-to-treat population, as well as a negative trend in each Notch biomarker subgroup
A strong trend to lack of benefit in the treatment arm for overall survival (OS), regardless of Notch biomarker levels, suggesting a low probability of achieving a statistically significant OS benefit based on analyses reviewed by the DSMB

Based on this information, OncoMed is in the process of unblinding the trial to carefully assess the current results and determine appropriate next steps for this fully enrolled trial. Eighteen patients remain on study drug treatment (tarextumab or placebo) between 172 and 527 days.

"The findings communicated by the DSMB suggest a low likelihood of a statistically significant benefit in overall survival in the tarextumab ALPINE pancreatic cancer trial," said Paul J. Hastings, Chairman and CEO. "Our aim is to quickly unblind the trial and work with our clinical sites and investigators to verify, analyze, interpret, and fully understand the data, including Notch biomarker subgroup trends, and determine next steps."

The Phase 2 ALPINE trial is a randomized, double-blinded, multicenter clinical trial designed to evaluate the efficacy of tarextumab in combination with Abraxane (paclitaxel protein-bound particles for injectable suspension) (albumin bound) plus gemcitabine in patients with previously untreated Stage IV pancreatic cancer. The ALPINE study completed enrollment of 177 patients in August 2015. The trial was designed to compare the overall survival of patients receiving tarextumab 15 mg/kg every two weeks versus placebo in combination with Abraxane plus gemcitabine. Secondary and exploratory endpoints, including progression-free survival and overall response rate, pharmacokinetics, safety and other biomarkers, are to be evaluated. Overall survival, progression-free survival and overall response rates will be assessed using a predictive biomarker for high tumor Notch3 expression. Increased Notch3 expression is estimated to occur in approximately 70 percent of pancreatic tumors and is associated with poor patient outcomes.

Conference Call Today

OncoMed management will host a conference call today beginning at 8:30 a.m. ET/5:30 a.m. PT to answer investor and analysts questions regarding the ALPINE Phase 2 program.

Analysts and investors can participate in the conference call by dialing 1-855-420-0692 (domestic) and 1-484-756-4194 (international) using the conference ID# 37742080. The web broadcast of the conference call will be available for replay through February 15, 2016 via a link in the Investor Relations section of the OncoMed website.

About Tarextumab (anti-Notch2/3, OMP-59R5)
Tarextumab (anti-Notch2/3, OMP-59R5) is a fully human monoclonal antibody that targets the Notch2 and Notch3 receptors. Preclinical studies have suggested that tarextumab exhibits two mechanisms of action: (1) by downregulating Notch pathway signaling, tarextumab appears to have anti-cancer stem cell effects, and (2) tarextumab affects pericytes, impacting stromal and tumor microenvironment. Tarextumab is currently being studied in two randomized Phase 2 clinical trials. The "ALPINE" study (Antibody therapy in first-Line Pancreatic cancer Investigating anti-Notch Efficacy and safety) is assessing tarextumab with Abraxane (paclitaxel protein-bound particles for injectable suspension) (albumin bound) plus gemcitabine in first-line advanced pancreatic cancer patients. The "PINNACLE" study (A Phase 1b/2 Study of OMP-59R5 in Combination with Etoposide and Platinum Therapy in Subjects with Untreated Extensive Stage Small Cell Lung Cancer) is testing tarextumab in combination with etoposide and cisplatin and etoposide and carboplatin in first-line extensive-stage small cell lung cancer patients. Tarextumab is part of OncoMed’s collaboration with GlaxoSmithKline (GSK). GSK has an option to obtain an exclusive license to tarextumab during certain time periods through completion of the proof-of-concept Phase 2 trials.

Immunocore’s IMCgp100 Granted Orphan Drug Designation by US FDA for the Treatment of Uveal Melanoma

On January 25, 2016 Immunocore, a world-leading biotechnology company developing novel T cell receptor (TCR) based biological drugs to treat cancer, infectious diseases and autoimmune disease, reported that the US Food and Drug Administration (FDA) has granted Orphan Drug Designation to its lead programme, IMCgp100, for the treatment of uveal melanoma (Press release, Immunocore, JAN 25, 2016, View Source [SID1234518904]). The Orphan Drug status qualifies Immunocore for a number of development incentives and will enable Immunocore to receive fast track registration for IMCgp100, its lead ImmTAC (Immune mobilising mTCR Against Cancer) therapeutic.

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Uveal melanoma, a rare disease in which cancer cells form in the tissues of the eye, comprises approximately 3% of all melanomas, and is the primary intraocular malignancy of the adult eye. There are currently no effective treatments on the market for this debilitating disease.

For a drug to qualify for orphan drug designation both the drug and the disease must meet certain criteria specified in the Orphan Drug Act (ODA) and FDA’s implementing regulations at 21 CFR Part 316.

IMCgp100 is Immunocore’s wholly-owned and most advanced ImmTAC, currently in Phase IIa clinical trials for the treatment of late stage cutaneous and uveal melanoma. To date, more than 85 patients have been treated with IMCgp100.

IMCgp100 was also accepted last year to participate in the European Medicines Agency’s (EMA) Adaptive Pathways Pilot Programme, part of the EMA’s strategy of providing timely access for patients to new medicines to treat serious conditions with high unmet medical need.

Eliot Forster, Chief Executive Officer of Immunocore, commented: "Immunocore now has the opportunity to fast-track this important programme, which we believe has the scope to offer a treatment option to people who currently have none. We look forward to accelerating the ongoing clinical programme with IMCgp100."

MorphoSys Announces Clinical Milestone for Start of Bayer’s Phase 2 Trial Designed to Support Registration of Anetumab Ravtansine

On January 26, 2016 MorphoSys AG (FSE: MOR; Prime Standard Segment, TecDAX; OTC: MPSYY) reported that the company earned a milestone payment with Bayer’s initiation of a global phase 2 clinical study designed to support registration of anetumab ravtansine (BAY 94-9343) (Press release, MorphoSys, JAN 25, 2016, View Source [SID:1234508860]). Anetumab ravtansine, an antibody-drug conjugate (ADC) targeting mesothelin, is a potential new treatment for mesothelioma developed by Bayer using MorphoSys’s HuCAL technology. Further financial details were not disclosed.

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"We are delighted to see our partner Bayer moving anetumab ravtansine into a clinical study designed to support its registration in mesothelioma, an indication with high medical need", commented Dr. Marlies Sproll, Chief Scientific Officer of MorphoSys AG. "This is the fourth antibody derived from the MorphoSys technology platform to advance into decisive stages of clinical development. This again reflects the increasing maturity and value of the MorphoSys pipeline comprising both proprietary and partnered programs."

MorphoSys’s collaboration with Bayer has resulted in two clinical programs to date. In total, MorphoSys’s partnered and proprietary clinical pipeline currently comprises 25 unique antibody molecules which are currently being evaluated in more than 50 clinical trials.

8-K – Current report

On January 25, 2016 Lixte Biotechnology Holdings, Inc. (OTCQB: LIXT) reported that a major shareholder has purchased $1,750,000 of Convertible Preferred stock (Filing, 8-K, Lixte Biotechnology, JAN 25, 2016, View Source [SID:1234508859]). If fully converted, this purchase would convert to 2,187,500 common shares at a per share price of $0.80.

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Lixte’s CEO, John S. Kovach, M.D., said, "This new investment allows Lixte to pursue opportunities that have emerged regarding our lead anticancer compound, LB-100.

First, in the Phase I trial, several solid tumor patients with a variety of recurrent progressive cancers had stabilization of their disease in the absence of dose-limiting toxicity as reported at the 2015 AACR (Free AACR Whitepaper)-NCI-EORTC International Conference in Boston. We had not anticipated that LB-100 alone would stop tumor progression in some solid tumor patients. This finding raises opportunities, currently being explored, to go directly to Phase 2 studies of LB-100 as a single agent.

Second, Lixte has licensed LB-100 to the Taiwan Medical University to determine the activity of LB-100 plus doxorubicin in Asian patients with hepatocellular cancer, beginning with a Phase 1b/2 trial planned to start this summer. This will test the ability of LB-100, demonstrated in several animal models, to enhance the effectiveness of a widely used anticancer drug against one of the most common and devastating cancers worldwide.

Third, scientists at the National Institutes of Health (NIH) reported that LB-100 enhances the anti-tumor activity of cisplatin and reduced cisplatin-resistance of human medulloblastoma cells in animal models. Previously, NIH investigators found that LB-100 enhanced the activity of cisplatin in models of cisplatin sensitive and cisplatin-resistant human ovarian cancer."

Dr. Kovach continued, "Because of these new developments, Lixte is considering several options for Phase 1b/2 trials, with recurrent platinum-resistant ovarian cancer at the top of the list. The most definitive trial design would be a randomized study of LB-100 plus a platinum compound versus the therapeutic choice of the treating doctor with an opportunity for those failing treatment with the ‘physician’s choice’ to receive the LB-100 regimen. The cost of a randomized trial would require additional financial resources beyond those of the private placement."

Boston Biomedical’s Investigational Cancer Stem Cell Pathway Inhibitor, Napabucasin (BBI608), Featured at the ASCO 2016 Gastrointestinal Cancers Symposium

On January 25, 2016 Boston Biomedical, an industry leader in the development of novel compounds designed to target cancer stem cell (CSC) pathways, reported that three poster presentations were highlighted at the 2016 Gastrointestinal Cancers Symposium, held by the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper), January 21 to 23, 2016, in San Francisco (Press release, Dainippon Sumitomo Pharma, JAN 25, 2016, View Source [SID:1234508858]).

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"We were pleased to share these data from napabucasin (BBI608) in advanced and difficult-to-treat tumor types at this year’s ASCO (Free ASCO Whitepaper) Gastrointestinal Cancers Symposium," said Chiang J. Li, M.D. FACP, the President, CEO and Chief Medical Officer of Boston Biomedical, and the Head of Global Oncology for Sumitomo Dainippon Pharma Group. "These studies continue to show napabucasin’s safety and early efficacy across doses and in combination with a variety of established agents. We plan to apply these findings as we advance and expand our clinical development program for this first-in-category cancer stemness inhibitor."

Data presented at the symposium support the continued development of the investigational cancer stemness inhibitor napabucasin (also known as BBI608, BB608 or BBI-608) — an orallyadministered agent designed to inhibit cancer stem cell pathways by targeting the STAT3 pathway — for anti-cancer activity when used in combination with other agents across advanced, pretreated and untreated metastatic pancreatic cancers, as well as advanced, pretreated colorectal cancer.

"These clinical studies of napabucasin in advanced gastroenterological cancers, including the presentation of data in refractory colorectal cancer specifically, show encouraging clinical activity by targeting cancer stem cell pathways that contribute to cancer recurrence, metastases and resistance to therapies," commented Axel Grothey, M.D., professor of oncology, Mayo Clinic. "I look forward to the further investigation of this innovative approach to cancer treatment in additional clinical studies."

Overview of the Boston Biomedical poster presentations:

• Abstract #284 (NCT02231723), Poster Session B Board #E8: A Phase Ib study of Cancer Stem Cell (CSC) pathway inhibitor Napabucasin (BBI608) in combination with Gemcitabine and nab-Paclitaxel (nab-PTX) in patients (pts) with metastatic pancreatic ductal adenocarcinoma (mPDAC) [Safi Shahda, M.D., IU Health University Hospital]

o Data from this phase Ib study demonstrate that napabucasin (BBI608) at 240 mg twice daily was combined with gemcitabine and nab-paclitaxel, resulting in early anti-tumor activity in patients with metastatic pancreatic ductal adenocarcinoma.

Of the 31 patients enrolled, 25 patients were treatment-naïve and 6 patients had received one prior line of systemic therapy in the adjuvant setting only. Safety data was available for 18 patients and efficacy data was available for 8 patients at clinical cut off for abstract submission for the 8-patient cohort of recommended phase II dose determination. Safety and efficacy data for the rest of the patients are being followed.

Of the 8 patients enrolled to determine the recommended phase II dose, 7 patients were evaluable for response and 100% had partial response (PR) or stable disease (SD). Tumor regression was observed in 6/7 patients (85.7%) with 3 PR (41.3%, 37.1% and 33.3% regression) and 3 SD (25.8%, 21.1%, and 20.5% regression). Six of 7 evaluable patients (85.7%) had prolonged PR or SD of 24 weeks or longer.

The most common adverse events included grade 1 diarrhea, nausea, fatigue, abdominal pain and anorexia.

• Abstract #196 (NCT01325441), Poster Session B Board #A6: Phase Ib/II Study of Napabucasin (BBI608) combined with Weekly Paclitaxel in Advanced Pancreatic Cancer [Tanios Bekaii-Saab, M.D., Ohio State University Wexner Medical Center]

o Results from this phase Ib/II extension study of napabucasin (BBI608) at 480 mg twice daily plus weekly paclitaxel showed early anti-cancer activity in patients with refractory, heavily pretreated pancreatic cancer, particularly in taxane-naïve patients. Durable disease control and prolonged overall survival in this study patient population were also observed.

The 41 patients enrolled had received a median of two prior lines of treatment including FOLFIRINOX (71%), gemcitabine/nab-paclitaxel (44%) or both (37%).

The 31 evaluable patients had a response rate (partial response, PR + complete response, CR) of 6% and disease control rate (stable disease, SD + PR + CR) of 48%. The 19 evaluable taxane-naïve patients had a response rate of 11% and disease control rate of 63%, and 16% were progression-free at 24 weeks. Overall for the 41 patients, median progression-free survival (mPFS) was 2.2 months and median overall survival (mOS) was 6.0 months, while the 23 taxane-naïve patients demonstrated mPFS of 3.9 months and mOS of 7.4 months.

The most common adverse events included grade 1 and 2 diarrhea, fatigue and abdominal pain, and grade 1 nausea, anorexia and vomiting.

• Abstract #569 (NCT02024607), Poster Session C Board #D18: A Phase Ib study of first-in-class cancer stemness inhibitor Napabucasin (BBI608) in combination with FOLFIRI with and without Bevacizumab in Patients with Advanced Colorectal Cancer [Joleen Hubbard, M.D., Mayo Clinic]

o This phase Ib study showed that napabucasin (BBI608) at 240 mg twice daily can be combined with FOLFIRI with and without bevacizumab, and demonstrated early anti-tumor activity in heavily pretreated colorectal cancer patients, even in those with prior progression on FOLFIRI-based therapy.
Of the 18 enrolled heavily pretreated patients (average of >3 prior lines of therapy), 10 patients previously progressed on FOLFIRI. Of the 17 evaluable patients, 8 patients received FOLFIRI and 9 received FOLFIRI with bevacizumab, both in combination with napabucasin.

Disease control (partial response, PR + stable disease, SD) was observed in 94% of evaluable patients (16 of 17). Ten evaluable patients (59%) achieved prolonged disease control (PR and SD) of 24 weeks or more.

The most common adverse events included grade 1 and 2 diarrhea, fatigue, nausea, vomiting, abdominal pain and anorexia; no dose limiting toxicity or new adverse events were seen and the safety profile was similar to that of each regimen as monotherapy.

The full posters of the above studies are available on the R&D publications page of the Boston Biomedical website.