On September 13, 2019 The Multiple Myeloma Research Foundation (MMRF) reported the presentation of twenty-four research abstracts at the 17th International Myeloma Workshop in Boston (Press release, Multiple Myeloma Research Foundation, SEP 13, 2019, View Source [SID1234539493]). Eighteen of the research abstracts use data from the MMRF CoMMpass Study℠—the largest genomic data set of any cancer and one of the most highly published studies in multiple myeloma. The other six abstracts include data from MMRC trials, the MMRF Answer Fund, and the MMRF Immunotherapy Initiative. Several of these are highlighted below.

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MMRF CoMMpass Study

New data from the CoMMpass Study include the following:

Important new insights into the instability and heterogeneity of the multiple myeloma genome and implications for outcome and resistance.
Greater understanding of the biology of high-risk disease and early relapse.
Novel findings regarding use of genomic markers for prediction of risk and response to specific therapies, including Clonal Heterogeneity of Indeterminate Potential (CHIP).
Promising new targets for drug development, such as MAGEA3.
MMRF Answer Fund

Constantine Mitsiades, MD, PhD, and his colleagues at the Dana-Farber Cancer Institute will present an abstract made possible by the MMRF Answer Fund, an initiative focused on addressing critical questions about high-risk multiple myeloma. MMRF funding enabled Dr. Mitsiades to apply functional genomics to explore CoMMpass data. His work identified a subset of genes essential for myeloma cell survival, identifying potential new targets for future therapies.

MMRF CureCloud

MMRF Chief Scientific Officer Daniel Auclair, PhD is presenting the first poster on the CureCloud patient registry. This direct-to-patient registry allows patients to contribute their data to a centralized data hub that generates, aggregates and visualizes their data to accelerate the delivery of precision medicine and cures. The poster describes the results from the pilot program, which includes data captured from 65 multiple myeloma patients.

MMRF Work in Smoldering Multiple Myeloma

Hearn Jay Cho, MD, PhD, the recently appointed MMRF Chief Medical Officer, and his colleagues at Mount Sinai in New York analyzed samples from the MMRC tissue bank to better understand predictors of progression from smoldering to active myeloma. Dr. Cho’s team confirmed that disease progression results from multiple pathways and complex interactions between tumor cells and the immune microenvironment. Understanding these interactions are critical to developing therapies that will delay and ultimately prevent disease progression.

"At the MMRF, our goal is to build collaborative models where clinicians, researchers and patients work together to accelerate the development of more effective, precision-based treatments," said Paul Giusti, President and CEO at the MMRF. "All of the work presented here at the International Myeloma Workshop reflects this focus and we’re proud to see the impact of our work with our world-class partners benefiting the patient community."

About the MMRF CoMMpass Study℠

The MMRF CoMMpass Study is a longitudinal study of patients with newly diagnosed active multiple myeloma. The goal is to map the genomic profile of each patient to clinical outcomes to develop a more complete understanding of patient responses to treatments. A cornerstone of the MMRF’s Personalized Medicine Initiative, the study is collecting and analyzing tissue samples, clinical data and genetic information from 1,000 newly diagnosed multiple myeloma patients for at least eight years. The CoMMpass Study was made possible by a $40M investment by the MMRF.

The MMRF CoMMpass Study opened in July of 2011 and now includes 1,143 patients from 76 centers in the United States, Canada and European Union. Data from the MMRF CoMMpass Study is made available to researchers via the MMRF’s Researcher Gateway, an online, open-access portal designed to make key genomic and clinical data available for additional study. The MMRF CoMMpass Study is being supported through a public-private partnership of patient donors and industry partners, including Takeda Oncology, Amgen, Bristol-Myers Squibb, Janssen Pharmaceuticals, Inc. and Janssen Diagnostics.

Please visit www.themmrf.org/research-partners/the-commpass-study to learn more.

On September 13, 2019 Genmab A/S (Nasdaq: GMAB) reported topline results from the Phase III CANDOR study, sponsored by Amgen, of daratumumab in combination with carfilzomib and dexamethasone (Kd) versus Kd alone in patients with multiple myeloma who have relapsed after one to three prior therapies (Press release, Genmab, SEP 13, 2019, View Source [SID1234539492]). The study met the primary endpoint of improving progression free survival (PFS). The regimen resulted in a 37% reduction in the risk of progression or death in patients with relapsed or refractory multiple myeloma treated with daratumumab in combination with Kd (HR=0.630; 95% CI: 0.464, 0.854; p=0.0014). The median PFS for patients treated with daratumumab in combination with Kd had not been reached by the cut-off date compared to a median PFS of 15.8 months for patients who received Kd alone.

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There was a higher frequency of adverse events reported with daratumumab plus Kd, a three-agent regimen, than with Kd, a two-agent regimen. The types of observed adverse events were consistent with the known safety profiles of the individual agents. The most frequently reported treatment-emergent adverse events (greater than or equal to 20%) in the daratumumab plus Kd arm were thrombocytopenia, anemia, diarrhea, hypertension, upper respiratory tract infection, fatigue and dyspnea.

The CANDOR data will be submitted to a future medical meeting and Amgen will discuss the data with health authorities in preparation for regulatory submissions.

"We are very pleased that daratumumab has shown efficacy in yet another combination regimen – in this case with carfilzomib, a newer member of the proteasome inhibitor class. We look forward to the potential for this combination to provide an additional regimen for patients diagnosed with relapsed multiple myeloma," said Jan van de Winkel, Ph.D., Chief Executive Officer of Genmab.

In August 2012, Genmab granted Janssen Biotech, Inc. an exclusive worldwide license to develop, manufacture and commercialize daratumumab.

About the CANDOR study
The Phase III trial (NCT03158688) is a randomized, open-label study that includes approximately 460 patients with multiple myeloma who have relapsed after 1 to 3 prior therapies. Patients were randomized to receive either daratumumab in combination with carfilzomib (a proteasome inhibitor) and dexamethasone (a corticosteroid) or carfilzomib and dexamethasone alone. In the daratumumab treatment arm, patients received 8 milligrams per kilogram (mg/kg) on days 1 and 2 of cycle 1, then 16 mg/kg once weekly for the remaining doses of the first 2 cycles, then every 2 weeks for 4 cycles (cycles 3 to 6), and then every 4 weeks for the remaining cycles or until disease progression. In both treatment arms carfilzomib was dosed twice weekly (20 mg/m2 on cycle 1 days 1 and 2 and 56 mg/m2 beginning on cycle 1 day 8 and thereafter) and dexamethasone was given weekly (40 mg orally or via IV infusion). The primary endpoint of the study is PFS.

About multiple myeloma
Multiple myeloma is an incurable blood cancer that starts in the bone marrow and is characterized by an excess proliferation of plasma cells.1 Multiple myeloma is the third most common blood cancer in the U.S., after leukemia and lymphoma.2 Approximately 26,000 new patients were expected to be diagnosed with multiple myeloma and approximately 13,650 people were expected to die from the disease in the U.S. in 2018.3 Globally, it was estimated that 160,000 people were diagnosed and 106,000 died from the disease in 2018.4 While some patients with multiple myeloma have no symptoms at all, most patients are diagnosed due to symptoms which can include bone problems, low blood counts, calcium elevation, kidney problems or infections.5

About DARZALEX(daratumumab)
DARZALEX (daratumumab) intravenous infusion is indicated for the treatment of adult patients in the United States: in combination with lenalidomide and dexamethasone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant; in combination with bortezomib, melphalan and prednisone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant; in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of patients with multiple myeloma who have received at least one prior therapy; in combination with pomalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least two prior therapies, including lenalidomide and a proteasome inhibitor (PI); and as a monotherapy for the treatment of patients with multiple myeloma who have received at least three prior lines of therapy, including a PI and an immunomodulatory agent, or who are double-refractory to a PI and an immunomodulatory agent.6 DARZALEX is the first monoclonal antibody (mAb) to receive U.S. Food and Drug Administration (U.S. FDA) approval to treat multiple myeloma. DARZALEX is indicated in Europe in combination with bortezomib, melphalan and prednisone for the treatment of adult patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant; for use in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of adult patients with multiple myeloma who have received at least one prior therapy; and as monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma, whose prior therapy included a PI and an immunomodulatory agent and who have demonstrated disease progression on the last therapy. The option to split the first infusion of DARZALEX over two consecutive days has been approved in both Europe and the U.S. In Japan, DARZALEX is approved in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of adults with relapsed or refractory multiple myeloma and in combination with bortezomib, melphalan and prednisone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant. DARZALEX is the first human CD38 monoclonal antibody to reach the market in the United States, Europe and Japan. For more information, visit www.DARZALEX.com.

Daratumumab is a human IgG1k monoclonal antibody (mAb) that binds with high affinity to the CD38 molecule, which is highly expressed on the surface of multiple myeloma cells. Daratumumab triggers a person’s own immune system to attack the cancer cells, resulting in rapid tumor cell death through multiple immune-mediated mechanisms of action and through immunomodulatory effects, in addition to direct tumor cell death, via apoptosis (programmed cell death).6,7,8,9,10

Daratumumab is being developed by Janssen Biotech, Inc. under an exclusive worldwide license to develop, manufacture and commercialize daratumumab from Genmab. A comprehensive clinical development program for daratumumab is ongoing, including multiple Phase III studies in smoldering, relapsed and refractory and frontline multiple myeloma settings. Additional studies are ongoing or planned to assess the potential of daratumumab in other malignant and pre-malignant diseases in which CD38 is expressed, such as amyloidosis, NKT-cell lymphoma and B-cell and T-cell ALL. Daratumumab has received two Breakthrough Therapy Designations from the U.S. FDA for certain indications of multiple myeloma, including as a monotherapy for heavily pretreated multiple myeloma and in combination with certain other therapies for second-line treatment of multiple myeloma.

On September 13, 2019 Roche (SIX: RO, ROG; OTCQX: RHHBY) reported the phase III FeDeriCa study met its primary endpoint (Press release, Hoffmann-La Roche, SEP 13, 2019, View Source [SID1234539487]). The study showed a new investigational fixed-dose combination (FDC) of Perjeta (pertuzumab) and Herceptin (trastuzumab), administered by subcutaneous (SC) injection in combination with intravenous (IV) chemotherapy, demonstrated non-inferior levels of Perjeta in the blood (pharmacokinetics) compared to standard IV infusion of Perjeta plus Herceptin and chemotherapy in people with HER2-positive early breast cancer (eBC). The safety profile of the FDC of Perjeta and Herceptin was consistent with that of Perjeta and Herceptin administered intravenously.1,2

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"With this single injection under the skin, people with HER2-positive breast cancer receiving Perjeta and Herceptin can have a faster treatment option," said Sandra Horning, MD, Roche’s Chief Medical Officer and Head of Global Product Development. "Our medicines have helped millions of people living with HER2-positive breast cancer and this latest development is particularly exciting as, for the first time, we have combined two therapeutic antibodies as a single subcutaneous formulation."

SC administration of the FDC takes approximately 8 minutes for the initial loading dose, and approximately 5 minutes for each subsequent maintenance dose. This is compared to approximately 150 minutes for infusion of a loading dose of Perjeta and Herceptin using the standard IV formulations, and between 60-150 minutes for subsequent maintenance infusions for the combination.1,2,3

Full data from the FeDeriCa study will be submitted for presentation at an upcoming medical meeting and to health authorities around the world.

About the FeDeriCa study
FeDeriCa is an international, multi-centre, two-arm, randomised, open-label, phase III study evaluating the pharmacokinetics, efficacy and safety of SC injection of the FDC of Perjeta and Herceptin in combination with chemotherapy, compared with standard IV infusions of Perjeta and Herceptin in combination with chemotherapy in people with HER2-positive eBC who are being treated in the neoadjuvant (before surgery) and adjuvant (after surgery) settings.4 The primary endpoint of the study is minimum levels of Perjeta in the blood during a given dosing interval (Ctrough). Secondary endpoints include safety; minimum levels of Herceptin in the blood during a given dosing interval (Ctrough); and total pCR, meaning there is no tumour tissue detectable at the time of surgery.4

About the FDC of Perjeta and Herceptin
The FDC of Perjeta and Herceptin is a new SC formulation that combines Perjeta and Herceptin with Halozyme Therapeutics’ Enhanze drug delivery technology.

Trastuzumab in the FDC is the same monoclonal antibody as in IV Herceptin and pertuzumab is the same monoclonal antibody as in IV Perjeta. The mechanisms of action of Perjeta and Herceptin are believed to complement each other as both bind to the HER2 receptor, but to different places.5 The combination of Perjeta and Herceptin is thought to provide a more comprehensive, dual blockade of the HER signaling pathways.5

The standard IV formulation of Perjeta in combination with IV Herceptin and chemotherapy (the Perjeta-based regimen) is approved in over 100 countries for the treatment of both early and metastatic HER2-positive breast cancer. In the neoadjuvant eBC setting, the Perjeta-based regimen has been shown to almost double the rate of pCR compared to Herceptin and chemotherapy.6 Additionally, the combination has been shown to significantly reduce the risk of recurrence of invasive disease or death in the adjuvant eBC setting.7 In the metastatic setting, the combination has shown an unprecedented survival benefit in previously untreated (first-line) patients with HER2-positive metastatic breast cancer.8

Halozyme’s Enhanze drug delivery technology may enable and optimise SC drug delivery for appropriate co-administered therapeutics. The technology is based on a proprietary recombinant human hyaluronidase PH20 (rHuPH20), an enzyme that temporarily degrades hyaluronan – a glycosaminoglycan or chain of natural sugars in the body, to aid in the dispersion and absorption of other injected therapeutic drugs.9

About Roche’s medicines for HER2-positive breast cancer
Roche has been leading research into the HER2 pathway for over 30 years and is committed to improving the health, quality of life and survival of people with both early and metastatic HER2-positive disease. HER2-positive breast cancer is a particularly aggressive form of the disease that affects approximately 15-20% of patients.10 Roche has developed three innovative medicines that have helped transform the treatment of HER2-positive breast cancer: Herceptin (trastuzumab), Perjeta (pertuzumab) and Kadcyla (trastuzumab emtansine). Eligibility for treatment with Roche’s HER2-targeted medicines is determined via a diagnostic test which identifies people who will likely benefit from these medicines at the onset of their disease.

On September 13, 2019 Halozyme Therapeutics, Inc. (NASDAQ: HALO), a biotechnology company developing novel oncology and drug-delivery therapies, reported that the global phase III FeDeriCa study conducted by Genentech, a member of the Roche Group, met its primary endpoint (Press release, Halozyme, SEP 13, 2019, View Source [SID1234539472]). The FeDeriCa study investigated a fixed-dose combination of pertuzumab (Perjeta) and trastuzumab (Herceptin) for subcutaneous administration using Halozyme’s ENHANZE drug delivery technology in combination with intravenous chemotherapy. The study results demonstrated non-inferior levels of Perjeta in the blood (pharmacokinetics) compared to standard intravenous (IV) infusion of Perjeta plus Herceptin and chemotherapy in patients with HER2-positive early breast cancer.

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"The results of the phase III FeDeriCa study represent an important development for our ENHANZE drug delivery technology," said Dr. Helen Torley, President and CEO. "This is the first study to combine two therapeutic antibodies as a single fixed-dose subcutaneous formulation utilizing our ENHANZE technology, thereby providing patients with HER2-positive breast cancer the possibility of a faster treatment option."

Subcutaneous administration of the fixed-dose combination of Perjeta and Herceptin is approximately 8 minutes for the initial loading dose and approximately 5 minutes for each subsequent maintenance dose. Intravenous administration is approximately 150 minutes for the loading dose of Perjeta and Herceptin using standard IV formulations and between 60-150 minutes for subsequent maintenance infusions for the combination.

The study also demonstrated that the safety profile of the fixed dose subcutaneous combination of Perjeta and Herceptin was consistent with the safety profile of Perjeta and Herceptin administered intravenously.

Full data from the FeDeriCa study will be submitted for presentation at an upcoming medical meeting and to health authorities worldwide, including the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA).1 2

About ENHANZE Technology
Halozyme’s proprietary ENHANZE drug-delivery technology is based on its patented recombinant human hyaluronidase enzyme (rHuPH20). rHuPH20 has been shown to remove traditional limitations on the volume of biologics that can be delivered subcutaneously (just under the skin). By using rHuPH20, some biologics and compounds that are administered intravenously may instead be delivered subcutaneously. ENHANZE may also benefit subcutaneous biologics by reducing the need for multiple injections. This delivery has been shown in studies to reduce health care practitioner time required for administration and shorten time for drug administration.

On April 5, 2019 Cotinga Pharmaceuticals Inc. (TSX Venture: COT; OTCQB: COTQF) ("Cotinga" or the "Company"), a clinical-stage pharmaceutical company advancing a pipeline of targeted therapies for the treatment of cancer, reported its financial and operating results today for the three and nine months ended January 31, 2019 (Press release, Cotinga, SEP 12, 2019, View Source [SID1234550033]). Recent highlights include:

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Advanced the clinical development of COTI-2:

Cotinga announced the initiation of dosing patients in the combination therapy trial at MD Anderson Cancer Center evaluating COTI-2 and cisplatin in a wide spectrum of cancers;
The Company announced that it has entered into a research partnership with St. Vincent’s University Hospital in Dublin, Ireland with the intent to evaluate COTI-2 in combination with eribulin in patients with triple negative metastatic breast cancer (TNBC).
"We were thrilled to announce this fiscal quarter the dosing of patients in our Phase 1b/2a trial at MD Anderson of COTI-2 plus cisplatin in patients with solid tumors, as well as announce our collaboration with St. Vincent’s Hospital to begin work in TNBC," said Alison Silva, President & Chief Executive Officer. "We look forward to continuing to provide updates at critical milestones as we advance COTI-2 through clinical development."

Upcoming Milestones

COTI-2:

Continue the dose escalation Phase 1b/2a combination therapy trial evaluating the effect of COTI-2 plus cisplatin in patients with solid tumors;
Contingent on the raising of necessary funds, initiate the TNBC trial with COTI-2 plus eribulin.
Corporate:

Strengthen the balance sheet;
Opportunistically pursue regional or co-development partnerships for COTI-2, pipeline programs and other technologies.
Financial Results

The Company’s operational activities during the quarter were primarily focused on advancing the Phase 1b/2a clinical trial of COTI-2.

For the three months ended January 31, 2019, the Company incurred a net loss of $0.280 million, or $0.01 per share, compared to a net loss of $1.278 million, or $0.08 per share, for the three months ended January 31, 2018. The decrease in net loss during the three-month period is primarily due to decreases in Research and Development (R&D) expense and General and Administrative (G&A) expense.

For the nine months ended January 31, 2019, the Company incurred a net loss of $1.756 million, or $0.08 per share, compared to a net loss of $3.301 million, or $0.21 per share, for the nine months ended January 31, 2018. The decrease in net loss during the period is primarily due to decreases in R&D, Sales and Marketing (S&M) expense and G&A expense, offset by changes in fair value warrant liability.

There was no revenue for the three and nine months ended January 31, 2019 or in the comparative periods in the prior year.

R&D expense in the three-month period ended January 31, 2019 decreased by $0.424 million over the same period in the prior year. The decrease in R&D expense in the three-month period is primarily due to a decrease in salaries and benefits due to lower headcount and preclinical testing as Cotinga continues to work to initiate an expanded protocol for its ongoing Phase 1b/2 clinical trial of COTI-2. For the nine months ended January 31, 2019, R&D expense decreased by $1.568 million over the same period in the year prior.

S&M expense in the three-month period ended January 31, 2019 decreased by $0.063 million over the same period in the year prior. The decrease in S&M expense in the three-month period is primarily due to rebranding undertaken during the three months ended January 31, 2018. For the nine months ended January 31, 2019, S&M expense decreased by $0.085 million over the same period in the prior year due to cost reductions implemented last financial year and rebranding undertaken during the Q3 2018.

G&A expense in the three-month period ended January 31, 2019 decreased by $0.496 million over the same period in the year prior. The decrease in G&A expense in the three-month period is primarily due to a decrease in salaries due to lower head count; streamlining of corporate operations and lower professional fees and share-based compensation. For the nine months ended January 31, 2019, G&A expense decreased by $1.174 million over the same period in the prior year.

Fair value of warrant liability for the nine months ended January 31, 2019, decreased by $1.389 million over the same period in the year prior.

Detailed operating and financial results can be found in the Company’s Unaudited Condensed Interim Financial Statements and Management Discussion and Analysis for the three and nine months ended January 31, 2019, which can be found on SEDAR at www.sedar.com or on the Company’s website at www.cotingapharma.com.