On March 23, 2023 ONO PHARMA USA, INC., reported that its candidate, tirabrutinib (ONO-4059), a Bruton’s tyrosine kinase inhibitor, was granted Orphan Drug Designation on March 21, 2023 by the U.S. Food and Drug Administration (FDA) for the treatment of patients with primary central nervous system lymphoma (PCNSL) (Press release, Ono Pharmaceutical Co, MAR 23, 2023, View Source [SID1234629268]).

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The FDA’s Orphan Drug Designation program supports the development and evaluation of investigational drugs and biologics that show promise for the diagnosis, treatment, or prevention of rare diseases or disorders, affecting fewer than 200,000 people in the United States (U.S.).

PCNSL is a rare and aggressive extra nodal non-Hodgkin lymphoma affecting the brain, its protective membranes, the spinal cord, and/or eye, without systemic involvement at the time of diagnosis. In the U.S., the incidence of PCNSL is approximately five out of 1,000,000 people per year, with higher rates in people over 65 years old.1 Symptoms can vary depending on the location of the tumor and may include headache, nausea, vomiting, visual symptoms, and seizures, among others. ONO is currently recruiting newly diagnosed and relapsed or refractory adult PCNSL patients in the U.S. for the PROSPECT clinical study (www.theprospectstudy.com; NCT04947319).

"We are extremely pleased that tirabrutinib has been granted orphan drug status for the treatment of PCNSL," said Kunihiko Ito, President and CEO of ONO PHARMA USA. "The designation represents a milestone for ONO. Currently, ONO is carrying out a Phase 2 trial of tirabrutinib in people with newly diagnosed or relapsed/refractory PCNSL, and we look forward to advancing clinical trials so that patients may have therapeutic options as soon as possible."

About PCNSL
PCNSL is a rare and aggressive extra nodal non-Hodgkin lymphoma (NHL) that is confined to the brain parenchyma, spinal cord, eye, or leptomeninges, without systemic involvement. The annual incidence rate of PCNSL is approximately five cases per 1,000,000 people in the U.S. The rate can further increase among immunocompetent people aged 65 years and older. The signs and symptoms presented in patients with PCNSL vary depending on the neuroanatomical site of the lesion, and include cranial neuropathy, neuropsychiatric symptoms, symptoms associated with increased intracranial pressure, seizures, ocular symptoms, headache, dysmotility, cranial neuropathy, and radiculopathy. There are no therapeutic products specifically approved for the treatment of PCNSL in the U.S., and data guiding therapeutic approaches are very limited. Despite recent progress resulting in the improvement of clinical outcomes in newly diagnosed patients with PCNSL after an induction treatment, approximately 20 to 30 percent of patients are refractory to the initial treatment, and up to 60 percent of patients will eventually relapse.

About Tirabrutinib
Tirabrutinib, discovered and developed by Ono Pharmaceutical Co., Ltd., is a highly potent selective BTK inhibitor. Signaling through the B-cell receptor (BCR) regulates cellular proliferation and activation, and promotes survival, differentiation, and clonal expansion of B-cells. The BCR signaling pathway plays an important role in a number of B-cell malignancies. Gene expression profiling data revealed BCR signaling as the most prominent pathway activated in chronic lymphocytic leukemia (CLL) cells isolated from lymphatic tissues. In Japan, tirabrutinib was approved in March 2020 for the treatment of relapsed or refractory PCNSL and launched under the tradename of Velexbru in May 2020. In addition, tirabrutinib was approved for the treatment of relapsed or refractory PCNSL in South Korea in November 2021 and in Taiwan in February 2022. Moreover, Velexbru was approved for the treatment of Waldenstrom macroglobulinemia and lymphoplasmacytic lymphoma in Japan in August 2020.

About the PROSPECT Study
The PROSPECT Study is the Phase 2 trial (NCT04947319) evaluating the safety and effectiveness of an investigational oral medicine called tirabrutinib for potential treatment of newly diagnosed or relapsed/refractory primary central nervous system lymphoma, which is a type of cancer that either does not improve from treatment (refractory) or improves only for a limited time (relapsed). Current treatment options for relapsed or refractory PCNSL are limited, and there are no medications approved in the U.S. for the treatment of PCNSL. Learn more about the PROSPECT Study here: www.theprospectstudy.com.

On March 23, 2023 Nuvalent, Inc. (Nasdaq: NUVL), a clinical-stage biopharmaceutical company focused on creating precisely targeted therapies for clinically proven kinase targets in cancer, reported an upcoming poster presentation for the ongoing Phase 1/2 ALKOVE-1 study of its ALK-selective inhibitor, NVL-655 (Press release, Nuvalent, MAR 23, 2023, View Source [SID1234629267]). The poster will be presented at the European Lung Cancer Congress (ELCC 2023), taking place in Copenhagen, Denmark, and virtually, March 29 – April 1, 2023.

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The "Trial in Progress" poster includes background and study design considerations for the ALKOVE-1 Phase 1/2 study (NCT05384626) evaluating the safety and preliminary activity of NVL-655 in patients with solid tumors harboring oncogenic ALK alterations, including those with acquired ALK resistance mutations and CNS metastases. The first-in-human, multicenter, open-label, dose-escalation and expansion study is currently evaluating NVL-655 as an oral monotherapy in the Phase 1 portion.

The poster will be archived on the Nuvalent website at www.nuvalent.com following the presentation.

Details for the poster presentation are as follows:

Title: NVL-655, a Selective Anaplastic Lymphoma Kinase (ALK) Inhibitor, in Patients with Advanced ALK-Positive Solid Tumors: The Phase 1/2 ALKOVE-1 Study
Authors: Melissa Johnson1, Sai-Hong Ignatius Ou2, Enriqueta Felip3, Christina Baik4, Benjamin Besse5, Julien Mazieres6, D. Ross Camidge7, Shirish Gadgeel8, Alexander Drilon9, Yasir Elamin10, Geoffrey Liu11, Joshua E. Reuss12, Tina Kehrig13, Henry E. Pelish13, Viola Zhu13, Jessica J. Lin14
Presentation Number: 81TiP
Abstract Category: Advanced NSCLC
Session Date and Time: Friday, March 31, 2023 from 12:00 – 12:45pm CEST
Location: Bella Center Copenhagen, Exhibition and Poster Area

1Sarah Cannon Research Institute, Nashville, TN, United States of America, 2University of California Irvine Medical Center, Orange, CA, United States of America, 3Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, Spain, 4Fred Hutchinson Cancer Center, Seattle, WA, United States of America, 5Institut Gustave Roussy, Villejuif, France, 6Institut Universitaire du Cancer, Toulouse, France, 7University of Colorado Cancer Center – Anschutz Medical Campus, Aurora, CO, United States of America, 8Henry Ford Cancer Institute, Detroit, MI, United States of America, 9Memorial Sloan Kettering Cancer Center and Weill Cornell Medical Center, New York, NY, United States of America, 10MD Anderson Cancer Center, Houston, TX, United States of America, 11Princess Margaret Cancer Center, Toronto, Ontario, Canada, 12Georgetown University, Washington, DC, United States of America, 13Nuvalent, Inc., Cambridge, MA, United States of America, 14Massachusetts General Hospital, Boston, MA, United States of America

About NVL-655

NVL-655 is a novel brain-penetrant ALK-selective inhibitor created to overcome limitations observed with currently available ALK inhibitors. NVL-655 is designed to remain active in tumors that have developed resistance to first-, second-, and third-generation ALK inhibitors, including tumors with the solvent front G1202R mutation or compound mutations G1202R / L1196M ("GRLM"), G1202R / G1269A ("GRGA"), or G1202R/L1198F ("GRLF"). NVL-655 has been optimized for CNS penetrance to improve treatment options for patients with brain metastases. NVL-655 has been observed in preclinical studies to selectively inhibit wild-type ALK and its resistance variants over the structurally related tropomyosin receptor kinase (TRK) family to potentially avoid TRK-related CNS adverse events seen with dual TRK/ALK inhibitors and drive more durable responses for patients. NVL-655 is currently being investigated in the ALKOVE-1 study (NCT05384626), a first-in-human Phase 1/2 clinical trial for patients with advanced ALK-positive non-small cell lung cancer (NSCLC) and other solid tumors.

On March 23, 2023 Shanghai Henlius Biotech, Inc. (2696.HK) reported that the European Medicines Agency (EMA) has validated the application for its self-developed anti-PD-1 monoclonal antibody (mAb) HANSIZHUANG (serplulimab), in combination with chemotherapy (carboplatin and etoposide), for the first-line treatment of adults with extensive-stage small cell lung cancer (ES-SCLC) (Press release, Shanghai Henlius Biotech, MAR 23, 2023, View Source [SID1234629266]). The European Commission (EC) previously granted Orphan Drug Designation (ODD) to HANSIZHUANG for the treatment of small cell lung cancer (SCLC).

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"HANSIZHUANG is Henlius’ first innovative mAb, as well as the first and only anti-PD-1 therapy approved for treatment of SCLC, which has benefited 13,000 SCLC patients in China. Since launched in March 2022, it has been approved for the treatment of MSI-H solid tumours, squamous non-small cell lung cancer and ES-SCLC in China," said Jason Zhu, President of Henlius. "HANSIZHUANG is steadily making its way from China to Europe and the U.S. Previously, we had Zercepac approved in more than 30 countries including the European Union. We hope HANSIZHUANG will further open that market and spur global expansion as we seek to benefit more patients."

Enhance the global presence

The regulatory application is based on data from ASTRUM-005, a randomized, double-blind, placebo-controlled international multi-centre phase 3 clinical study, which evaluated the efficacy and adverse event profile of the PD-1 inhibitor serplulimab plus chemotherapy compared with placebo plus chemotherapy as first-line treatment in patients with ES-SCLC. The study has set up a total of 128 sites in various countries including China, Poland, Turkey, and Georgia, and enrolled 585 subjects, among whom 31.5% were White. The results of ASTRUM-005 were presented in oral for the first time at the 2022 ASCO (Free ASCO Whitepaper) annual meeting and was then published in the Journal of the American Medical Association (JAMA, impact factor of 157.3), one of the top four medical journals in the world, which made ASTRUM-005 the first study published on JAMA in SCLC immunotherapy, demonstrating the high level of academic acclaim on a global scale.

In 2022, HANSIZHUANG was also granted ODD by the Food and Drug Administration (FDA) for the treatment of SCLC. The ODD granted by the FDA is beneficial for the continuous development of HANSIZHUANG and the enjoyment of certain policy support in terms of registration and commercialization in the United States (U.S.). Based on the positive feedback of FDA Biologics license Application (BLA) submission for HANSIZHUANG for the treatment of ES-SCLC and the discussion results of the FDA’s Class C consultation meeting, Henlius has initiated a bridging head-to-head trial in U.S. patients with ES-SCLC to evaluate the efficacy of HANSIZHUANG, which propels the product towards U.S. market approval further.

More are on the horizon

HANSIZHUANG (recombinant humanized anti-PD-1 monoclonal antibody injection, generic name: serplulimab injection) is the first innovative monoclonal antibody developed by Henlius and has since seen benefits in 19,000 patients in China. Its synergy with in-house products of the company and innovative therapies are being actively promoted and 14 clinical trials on immuno-oncology combination therapies are in progress in a wide variety of indications, such as lung cancer, esophageal carcinoma, head and neck squamous cell carcinoma and gastric cancer, etc., and covering the full range of first-line treatments of lung cancers. In addition to the launched indications of sqNSCLC and ES-SCLC, Henlius also explored to treat patients with non-squamous non-small cell lung cancer (nsNSCLC) and limited-stage small cell lung cancer (LS-SCLC). Recently, the first patient has been dosed in an international multi-centre phase 3 clinical trial of HANSIZHUANG (serplulimab) in patients with LS-SCLC in the U.S. In the field of gastrointestinal cancer, HANSIZHUANG has been approved for the treatment of MSI-H solid tumours, which could benefit patients with MSI-H colorectal cancer and MSI-H gastric cancer. It was also recommended for the first-line treatment of esophageal cancer (category IA) in the 2022 China Guidelines for Radiotherapy of Esophageal Cancer and its NDA for the first-line treatment of esophageal squamous cell carcinoma (ESCC) was accepted by the NMPA based on the data of ASTRUM-007, which was published in Nature Medicine (IF: 87.241). In addition, PD-1 inhibitors are less explored in neoadjuvant/adjuvant therapies for gastric cancer, and Henlius has led the way with a phase 3 clinical study, striving to benefit gastric cancer patients from the early line of immunotherapy.

Through overseas development of HANSIZHUANG, Henlius will accelerate the pace of global internationalisation and deliver more high-quality, affordable treatment options to patients.

About HANSIZHUANG

HANSIZHUANG (recombinant humanized anti-PD-1 monoclonal antibody injection, generic name: serplulimab injection) is the first anti-PD-1 mAb for the first-line treatment of SCLC. Up to date, 3 indications are approved for marketing in China, 2 marketing applications are under review in China and the EU, and more than 10 clinical trials are ongoing across the world.

HANSIZHUANG was launched in March 2022 and has been approved by the NMPA for the treatment of MSI-H solid tumours, squamous non-small cell lung cancer (sqNSCLC) and extensive-stage small cell lung cancer (ES-SCLC). The marketing applications of the first-line treatment for esophageal squamous cell carcinoma (ESCC) and ES-SCLC are under review by the NMPA and the EMA, respectively. Focus on lung and gastrointestinal cancer, the synergy of HANSIZHUANG with in-house products of the company and innovative therapies are being actively promoted. It has successively obtained clinical trial licenses in China, the United States, the European Union and other countries and regions to initiate 14 clinical trials on immuno-oncology combination therapies in a wide variety of indications. As of now, the company has enrolled more than 3,500 subjects in China, the U.S., Turkey, Poland, Georgia and other countries and regions, and the proportion of White is over 30% in two MRCTs, making HANSIZHUANG an anti-PD-1 mAb with one of the largest global clinical data pools. The results of 3 pivotal trials of HANSIZHUANG were published in the Journal of the American Medical Association (JAMA, IF: 157.3), Nature Medicine (IF: 87.241), and the British Journal of Cancer (IF: 9.075), respectively. Furthermore, HANSIZHUANG was respectively recommended for the first-line treatment of ES-SCLC in the 2022 CSCO Guidelines for Diagnosis and Treatment of Small Cell Lung Cancer (SCLC) and the treatment of esophageal cancer (category IA) in the 2022 China Guidelines for Radiotherapy of Esophageal Cancer. Serplulimab was also granted orphan drug designations by the FDA and the EC for the treatment of SCLC, and the first patient has been dosed in a bridging head-to-head trial in the United States to comparing HANSIZHUANG to standard of care Atezolizumab (anti-PD-L1 mAb) for the first-line treatment of ES-SCLC.

On March 23, 2023 Bayer reported that it has further expanded the global clinical development program for the oral androgen receptor inhibitor (ARi) darolutamide in prostate cancer (Press release, Bayer, MAR 23, 2023, View Source [SID1234629265]). The new Phase III clinical study, ARASTEP, will investigate the efficacy of darolutamide plus androgen deprivation therapy (ADT) versus ADT alone in hormone-sensitive prostate cancer, in patients with high-risk biochemical recurrence (BCR) who have no evidence of metastatic disease by conventional imaging and a positive PSMA PET/CT at baseline. BCR is defined as rising prostate-specific antigen (PSA) levels with a doubling time of <12 months after primary treatment (surgery or radiotherapy).1,2 Darolutamide is already approved under the brand name NubeqaTM for the treatment of patients with non-metastatic castration-resistant prostate cancer (nmCRPC), who are at high risk of developing metastatic disease as well as metastatic hormone-sensitive prostate cancer (mHSPC). Bayer estimates that the peak sales potential for Nubeqa will exceed €3 billion.

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"Many patients with rising PSA levels following surgery or radiation are at an increased risk of developing metastasis. With ARASTEP, we are optimistic about the potential to help patients at this earlier stage of the disease," said Tara Frenkl, M.D., Senior Vice President and Head of Oncology Development at Bayer. "Darolutamide has already demonstrated efficacy and safety in nmCRPC with the Phase III ARAMIS trial, and in mHSPC with the Phase III ARASENS trial. Our goal is to ensure that as many patients as possible benefit from this therapy, therefore we continue to assess the potential of darolutamide in earlier disease stages."

The study is part of a robust global clinical development program for darolutamide. The compound is also being investigated in further studies across various stages of prostate cancer, including in the ARANOTE Phase III trial evaluating darolutamide plus androgen deprivation therapy (ADT) versus ADT alone for metastatic hormone-sensitive prostate cancer (mHSPC), as well as the Australian and New Zealand Urogenital and Prostate Cancer Trials Group (ANZUP) led international Phase III co-operative group DASL-HiCaP (ANZUP1801) trial evaluating darolutamide as an adjuvant treatment for localized prostate cancer with very high risk of recurrence.

Darolutamide is developed jointly by Bayer and Orion Corporation, a globally operating Finnish pharmaceutical company.

About the ARASTEP Trial
The ARASTEP trial is a randomized, double-blind, placebo-controlled Phase III study of darolutamide plus androgen deprivation therapy (ADT) versus placebo plus ADT in hormone-sensitive prostate cancer, in patients with high-risk biochemical recurrence (BCR) who have no evidence of metastatic disease by conventional imaging and a positive PSMA PET/CT at baseline. The primary endpoint of this study is radiological progression-free survival (rPFS), measured by PSMA PET/CT assessed by independent central review. The trial is expected to enroll approximately 750 participants. Patients will be randomized to receive the standard regimen of 600 mg of darolutamide twice a day or matching placebo plus ADT.

About hormone-sensitive prostate cancer and biochemical recurrence (BCR)
Prostate cancer is the second most commonly diagnosed malignancy in men worldwide. In 2020, an estimated 1.4 million men were diagnosed with prostate cancer, and about 375,000 died from the disease worldwide.3

Hormone-sensitive prostate cancer is a type of prostate cancer that needs androgens (male hormones) to grow and therefore stops growing when androgens are not present. Almost all early-stage prostate cancers are androgen-dependent.4

Up to 50% of patients with prostate cancer develop elevated prostate-specific antigen (PSA) levels in their blood after primary therapy (surgery and/or radiation therapy).5 This disease state is called biochemical recurrence (BCR). Current treatment options for patients with biochemical recurrent prostate cancer include prostatectomy, intending to be curative. If these treatments are unsuccessful, androgen deprivation therapy (ADT) is an option to control disease.2

About darolutamide (NubeqaTM)
Darolutamide is an oral androgen receptor inhibitor (ARi) with a distinct chemical structure that binds to the receptor with high affinity and exhibits strong antagonistic activity, thereby inhibiting the receptor function and the growth of prostate cancer cells. The low potential for blood-brain barrier penetration for darolutamide is supported by preclinical models and neuroimaging data in healthy humans. This is supported by the overall low incidence of central nervous system (CNS)-related adverse events (AEs) compared to placebo as seen in the ARAMIS Phase III trial6 and the improved verbal learning and memory observed in the darolutamide arm of the Phase II ODENZA trial.7

The product is approved under the brand name Nubeqa in more than 80 countries around the world for the treatment of patients with non-metastatic castration-resistant prostate cancer (nmCRPC). It is also approved for the treatment of patients with metastatic hormone-sensitive prostate cancer (mHSPC) in a number of markets including the U.S., Japan, China and the EU. Filings in other regions are underway or planned.

About Prostate Cancer at Bayer
Bayer is committed to delivering science for a better life by advancing a portfolio of innovative treatments. The company has the passion and determination to develop new medicines that help improve and extend the lives of people living with cancer. Prostate cancer is the second most commonly diagnosed cancer in men3 and a key area of focus for Bayer. The company’s franchise includes two products on the market (Nubeqa and Xofigo) and several compounds in development, including a unique approach of advancing targeted alpha therapies. Bayer is focused on addressing the unique needs of prostate cancer patients, providing treatments that extend their lives throughout the different stages of the disease and allowing them to continue their everyday activities, so that they can live longer, better lives.

On March 23, 2023 Onconova Therapeutics, Inc. (NASDAQ: ONTX), ("Onconova"), a clinical-stage biopharmaceutical company focused on discovering and developing novel products for patients with cancer, and Pangea Biomed, a company combining machine learning and deep RNA analysis to expand access to precision oncology, reported a research collaboration between the companies (Press release, Onconova Therapeutics, MAR 23, 2023, View Source [SID1234629264]). The collaboration will leverage Pangea Biomed’s proprietary algorithmic platform, ENLIGHT, with the goal of identifying biomarkers of response to Onconova’s proprietary investigational product candidate rigosertib.

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Rigosertib has a multi-faceted mechanism of action targeting proteins containing the RAS binding domain, allowing it to modulate the PI3K and PLK1 pathways, as well as the tumor immune microenvironment. Clinical data have suggested the anti-cancer activity of rigosertib plus checkpoint inhibition in KRAS-mutated non-small cell lung cancer, and of rigosertib monotherapy in advanced squamous cell carcinoma complicating recessive dystrophic epidermolysis bullosa, an ultra-rare condition driven by PLK1 overexpression.

"Rigosertib’s ability to potently inhibit PLK1 and modulate the tumor immune microenvironment confers broad potential to treat a range of solid cancers," said Steven M. Fruchtman, M.D., President and Chief Executive Officer of Onconova. "By leveraging Pangea’s AI platform to identify predictive biomarkers of response to rigosertib, we aim to inform a precision medicine approach to selecting additional PLK1-dependent tumors and other indications for its potential evaluation. We believe this approach will increase the probability of success for rigosertib’s future development programs."

"Precision medicine is the future of oncology, but gaps in the industry’s current biomarker approaches overly narrow patient populations for promising drugs," said Pangea Biomed Chief Executive Officer Tuvik Beker, Ph.D. "ENLIGHT goes beyond standard biomarkers to expand patient populations for targeted therapies, in addition to surfacing new biomarkers for existing drugs. We’re hopeful our platform can help Onconova accelerate rigosertib’s successful development in a variety of difficult-to-treat cancers."

Pangea Biomed’s ENLIGHT platform is a pan-cancer response predictor that evaluates in vitro, preclinical, and clinical datasets to build genetic interaction maps that infer functional relationships between gene pairs to reveal tumor vulnerabilities to specified therapies. Onconova and Pangea Biomed will chart genetic interactions related to PLK1 to identify a biomarker of response to rigosertib based on its inhibitory activity against this protein. The ENLIGHT platform will then be applied to generate additional genetic interaction maps around other pathways targeted by rigosertib. Per a collaboration agreement between the companies, Onconova retains all rights to rigosertib and will own intellectual property that may result from the research collaboration.