Bicara Therapeutics’ First-in-class Bifunctional EGFR/TGF-? Inhibitor, BCA101, Demonstrates 65% ORR in Combination with Pembrolizumab in 1L HPV-negative Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma (HNSCC)

On June 5, 2023 Bicara Therapeutics, a clinical-stage biotechnology company developing dual-action biologics to elicit a potent and durable immune response, reported that it will present positive interim data from its ongoing, open-label Phase 1/1b dose expansion study of BCA101, a first-in-class bifunctional EGFR/TGF-β antibody, at the 2023 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting (Press release, Bicara Therapeutics, JUN 5, 2023, View Source;utm_medium=rss&utm_campaign=bicara-therapeutics-first-in-class-bifunctional-egfr-tgf-%25ce%25b2-inhibitor-bca101-demonstrates-65-orr-in-combination-with-pembrolizumab-in-1l-hpv-negative-recurrent-metastatic-head-and-neck [SID1234632463]). In the Phase 1/1b study, BCA101 in combination with pembrolizumab demonstrated a 65% overall response rate (ORR) in frontline, human papillomavirus (HPV)-negative, recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), with a tolerable safety profile.

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"Head and neck squamous cell carcinoma has limited treatment options and generally carries a poor prognosis, particularly for those with HPV-negative disease, which represent the majority of patients in the R/M setting," said Glenn J. Hanna, M.D., Center for Head and Neck Oncology, Dana-Farber Cancer Institute, and principal investigator for the Phase 1/1b clinical trial of BCA101. "These data demonstrate exciting and clinically meaningful activity among first-line R/M HPV-negative HNSCC patients and underscore the potential for BCA101 in combination with pembrolizumab in this underserved patient population."

"A 65% ORR in front-line HPV-negative R/M HNSCC is a significant improvement over pembrolizumab monotherapy and we are thrilled to be showcasing these data in an oral presentation at ASCO (Free ASCO Whitepaper)," said Claire Mazumdar, Ph.D., MBA, chief executive officer of Bicara Therapeutics. "HNSCC is one of the most common cancers worldwide, with increasing prevalence, and represents a significant unmet need. With this promising proof-of-concept data, we look forward to advancing BCA101 in combination with pembrolizumab in frontline R/M HNSCC, while also continuing to explore the utility of BCA101 in other cancer types."

Presentation Highlights:

Interim data (May 22, 2023 cut-off date) from the Phase 1/1b dose expansion cohort include 31 evaluable R/M HNSCC patients. None of the patients received prior systemic therapy and had a PD-L1 combined positive score (CPS) of ≥1. 20 patients were human papillomavirus (HPV)-negative and 11 patients were HPV-positive.
65% ORR in HPV-negative population (13/20 patients), including 12 confirmed partial responses (PR) and one confirmed complete response (CR), with responses observed across different degrees of PD-L1 expression (CPS 1-19 (5/10, 50%) and CPS ≥20 (8/10, 80%)) and varying disease subgroups (distant metastatic (9/14, 64%) and loco-regional disease (4/6, 67%)).
Preliminary median progression free survival (mPFS) in HPV-negative patients (in stage 1) of at least 6.6 months with 6/12 patients ongoing.
48% ORR in total evaluable population (15/31 patients).
Tolerable safety profile with the most common treatment-related adverse events (TRAEs). including acneiform rash (73%, with majority being Grade 1), fatigue (36%), hypophosphatemia (36%) and anemia (30%).
Presentation Details:

Title: Dose expansion results of the bifunctional EGFR/TGF-β inhibitor BCA101 with pembrolizumab in patients with recurrent, metastatic head and neck squamous cell carcinoma.
Presenter: Glenn J. Hanna, M.D.
Abstract Number: 6005
Session Type/Title: Oral Abstract Session – Head and Neck Cancer
Date/Time: June 5, 2023 from 8:00-11:00 a.m. CT
Location: McCormick Place Convention Center, Chicacgo, IL

In addition, Bicara will be hosting a webinar with two leading head and neck oncologists, Glenn J. Hanna, M.D., Center for Head and Neck Oncology, Dana-Farber Cancer Institute,and Ezra Cohen, M.D., FRCPSC, FASCO, University of California San Diego. The webinar will be made available on Bicara’s website shortly after today’s ASCO (Free ASCO Whitepaper) oral presentation at www.bicara.com/news/.

About Head and Neck Squamous Cell Carcinoma
Head and neck squamous cell carcinomas (HNSCCs) develop from the mucosal epithelium in the oral cavity, pharynx and larynx and are the most common malignancies that arise in the head and neck.

Oral cavity and larynx cancers are generally associated with tobacco consumption, alcohol abuse or both, whereas pharynx cancers are increasingly attributed to infection with human papillomavirus (HPV), primarily HPV-16. Thus, HNSCC can be biologically separated into HPV-negative and HPV-positive HNSCC, the latter carrying a more favorable prognosis. Treatment approaches for locally advanced HNSCC generally consist of surgery followed by chemoradiotherapy (CRT) for oral cavity cancers and primary or definitive CRT for pharynx and larynx cancers. The immune checkpoint inhibitors pembrolizumab and nivolumab are approved by the U.S. FDA for treatment of platinum-refractory recurrent or metastatic HNSCC, and pembrolizumab is approved as first-line monotherapy in patients with unresectable or metastatic disease with a CPS ≥1 or combined with platinum and 5-fluorouracil for patients with any CPS score.

HNSCC is the sixth most common cancer worldwide, with approximately 890,000 new cases and 450,000 deaths in 2018. The incidence of HNSCC continues to rise and is anticipated to increase by 30% by 2030.1

About BCA101
BCA101 is a first-in-class, dual-action, bifunctional antibody designed to inhibit the epidermal growth factor receptor (EGFR) and disable transforming growth factor beta (TGF-β) directly at the tumor site. This approach allows BCA101 to inhibit tumor proliferation, while restoring the cytolytic activity of the local immune cells.

BCA101 is currently being evaluated in a dose expansion phase of an open-label Phase 1/1b study as a monotherapy for cutaneous squamous cell carcinoma and in combination with pembrolizumab in patients with unresectable R/M HNSCC and advanced squamous non-small cell lung cancer (SqNSCLC).

Bayer strengthens gene therapy portfolio with lipid nanoparticle technology from Acuitas Therapeutics

On June 5, 2023 Bayer AG reported to have joined forces with Acuitas Therapeutics, Inc., a biotechnology company specializing in the development of lipid nanoparticle (LNP) delivery systems for molecular therapeutics (Press release, Bayer, JUN 5, 2023, View Source [SID1234632462]). Acuitas’ LNP technology will support Bayer’s in vivo gene editing and protein replacement programs by specifically delivering RNA payloads to the desired target organ, the liver.

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LNPs are spheric drug delivery bodies which can be equipped with therapeutic payloads for intracellular delivery. Acuitas’ proprietary LNP technology is used in multiple vaccines and therapeutics in clinical development and was also used in some of the COVID-19 vaccines that were approved and administered to people in 180 countries. This delivery technology protects the messenger RNA (mRNA) payload after administration allowing it to be safely and effectively delivered into cells. In addition to mRNA, Acuitas LNP can be used to deliver a range of different nucleic acid therapeutics including small interfering RNA (siRNA), antisense oligonucleotides and DNA.

"Complementing in-house expertise with external collaboration continues to be a priority in areas of high unmet medical need where insufficient, or no treatment options are currently available," said Friedemann Janus, acting Head of Business Development and Licensing/Open Innovation, Pharmaceuticals Division, Bayer. "Accessing state-of-the-art LNP technology through this collaboration will add momentum to our gene editing efforts for the benefit of patients."

"Developing therapies at scale is fundamental to provide breakthrough innovations to patients who have no time to wait," said Jost Reinhardt, Head of Cell and Gene Therapy, Pharmaceuticals Division, Bayer. "Adding Acuitas’ clinically-validated and scalable LNP technology to our genomic medicine toolbox is another important step to advance our leadership in the field of cell and gene therapies."

"We are delighted to partner with Bayer in the area of gene therapy. Innovation is the foundation of who we are at Acuitas, and we continue to invest heavily in internal research and development to provide our partners – such as Bayer – with the safest and most effective LNP delivery technology available," said Dr. Thomas Madden, President & CEO of Acuitas Therapeutics. "We support our partners to advance new therapeutics to address unmet clinical needs, and we are excited to work with the Bayer team in the development of medicines that are intended to address serious health issues faced by people worldwide."

Through the development and option for license agreement, Bayer and its gene therapy focused affiliate Asklepios BioPharmaceutical (AskBio) will gain access to Acuitas’ high potency ionizable lipid technology and LNP carriers which will allow for efficient, targeted, and transient delivery of gene editing RNA components to the liver. Market-maturity combined with demonstrated manufacturing scalability will drive the development and has the potential to accelerate the path to the clinic of Bayer and AskBio’s first in vivo gene editing programs. Financial details were not disclosed.

About gene editing
Gene editing is the targeted manipulation of genetic material. It enables a range of edits to the DNA allowing a diverse range of therapeutic applications. Gene editing can be applied inside and outside the patient to treat a variety of diseases and provide diverse clinical benefits. Gene editing as therapeutic treatment of genetic diseases can be used ex vivo to treat genetic dysfunctions, e.g., sickle cell anemia where a patient’s cells are ex vivo modified and afterwards re-administered, or in vivo, where modifications are made directly within the human body. To deliver the different components needed for in vivo gene editing to the right place in the patient’s body, transport vehicles, such as LNPs can be used.

Updated RINGSIDE Phase 2 Results Featured in Poster Discussion Session at 2023 American Society of Clinical Oncology (ASCO) Annual Meeting

On June 5, 2023 Ayala Pharmaceuticals, Inc. (OTCQX: ADXS), a clinical-stage oncology company, reported further results from the Phase 2 (Part A) segment of the RINGSIDE study evaluating AL102 in desmoid tumors (Press release, Ayala Pharmaceuticals, JUN 5, 2023, View Source [SID1234632461]). The results were presented in a Poster Discussion Session at the 2023 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting on Saturday, June 3. AL102 is a once-daily, potent, selective, oral gamma-secretase inhibitor (GSI).

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"Gamma secretase inhibitors are emerging as a promising new drug class for the management of desmoid tumors with the potential for tumor regression, good tolerability, and symptomatic improvement," said Dr. Mrinal M. Gounder, Medical Oncologist at Memorial Sloan Kettering Cancer Center in New York. "These latest data from the Phase 2 segment of RINGSIDE demonstrate that AL102 is active in desmoid tumors. Responses to treatment were seen in all dose groups, with a higher and more rapid response in the 1.2 mg once-daily dosing group. Most responses were maintained and deepened with time across all the parameters measured, including centrally determined volume, T2 and RECIST-criteria, with a manageable safety profile that is typical for the class. AL102 has potential to be a valuable addition to our treatment armamentarium for desmoid tumor patients," he concluded.

RINGSIDE Poster Highlights

The ongoing Phase 2/3 RINGSIDE clinical trial is a randomized, global multi-center study evaluating AL102 in patients with progressing desmoid tumors. The study consists of two parts: Phase 2 (Part A) is an open-label, dose regimen-finding study; Phase 3 (Part B) is a double blind, placebo-controlled study utilizing the 1.2 mg once daily dose regimen selected based on data from Phase 2. The study also includes an open label extension enrolling patients who were on active drug at the end of Phase 2, as well as crossover patients from Phase 3.

In the Phase 2 segment of RINGSIDE, Patients were randomized to one of three dose regimens of AL102 (n=14 each): either 1.2 mg once-daily (QD), 4 mg twice a week (BIW) or 2 mg BIW. Enrollment of all 42 patients into Phase 2 was completed as of March 2022. As of January 3, 2023, median time on study was 10.3 months (range 0.8 – 14.7) and 30 patients were still on study,10 of whom rolled over to the open label extension.

Efficacy Results

Best overall responses for the three dose arms, as determined by per blinded independent central review (BICR), are summarized in the table below:

Evaluable population

1.2 mg QD 4 mg BIW 2 mg BIW
(n= 12) (n=13) (n=11)
ORR (CR + PR), n (%) 6 (50) 3 (23.1) 5 (45.5)
Complete Response (CR) 0 0 0
Partial Response (PR) 6 (50) 3 (23.1) 5 (45.5)
Stable Disease (SD) 6 (50) 10 (76.9) 4 (36.4)
Progressive Disease (PD) 0 0 2 (18.1)
Disease Control Rate 100% 100% 81.90%
Time to objective response (months), median (range)

6.7 9.8 9.2
(3.8-9.4) (9.0-12.3) (6.4-9.2)
In the intention-to-treat (ITT) population, partial responses were observed in 43% of patients (i.e., 6/14) in the 1.2 mg QD group, 21.4% of patients (3/14) in the 4 mg BIW group, and 36% (5/14) in the 2 mg BIW group.

As shown in the next table, there was a consistent pattern of deeper, more rapid and persistent tumor responses as measured by volume reduction, T2W signal intensity and RECIST with AL102 1.2 mg daily than with intermittent doses. The decrease in T2W, as measured by MRI, reflects a decrease in tumor cellularity and is considered a strong indicator of anti-tumor activity in desmoid tumors. Tumor volume shrinkage consistently deepens over time and some patients who may not have had PRs by RECIST early in treatment may evolve to PRs with longer follow-up.

Median % Change from Baseline
Study Visit

1.2 mg QD 4 mg BIW 2 mg BIW
(n= 12) (n=13) (n=11)
Tumor Volume
Week 16 -51.9 -9.5 -15.2
Week 28 -76.4 -35.5 -51.2
Week 40 -75.9 -63.4 -61.2
T2W Signal Intensity (cellularity)
Week 16 -58.4 -37.9 -28.2
Week 28 -77.8 -42.1 -50.2
Week 40 -85.2 -56.6 -54.9
RECIST (sum of diameters)
Week 16 -13.3 1.7 -7.2
Week 28 -29.4 -9.6 -7
Week 40 -22.8 -16.7 -22
Safety

AL102 was generally well tolerated with a manageable safety profile across all dose arms. The safety profile was consistent with the GSI class of drugs. Regardless of dose regimen, adverse events (AEs) were predominantly Grade 1 (~70%) or Grade 2 (~20%). There were no Grade 4 or Grade 5 related AEs. Serious AEs were reported in 6 of 42 patients (14%) and assessed as unrelated to AL102 by investigators. There were no new safety signals.

Discontinuation due to AEs occurred in 6 of 42 (14%) patients. These were due to Grade 2 rash, keratitis, stomatitis, diarrhea, ALT elevation. All occurred within 3 months of treatment initiation.

Ovarian dysfunction was reported in 11 of 23 (48%) women of childbearing potential across all dose arms, but in only 3 of 9 (33%) women who received the 1.2 mg once-daily dose.

The registration-enabling Phase 3 segment is enrolling patients globally. For more information on RINGSIDE, please visit ClinicalTrials.gov and reference Identifier NCT04871282 (RINGSIDE).

A copy of the poster can be found on the Ayala corporate website here.

Conference Call and Webcast

There will be a conference call and webcast with slides at 10:00 a.m. Eastern Time on Wednesday, June 7, during which Ayala management will discuss the latest RINGSIDE data presented at ASCO (Free ASCO Whitepaper) and respond to questions.

Investors Dial: 1-877-407-9039
Int’l Investors Dial: 1-201-689-8470
Investors in Israel Dial: 1-809-406-247
Conference ID: 13739267

Participants can use Guest dial-in numbers above and be answered by an operator OR click the Call me link for instant telephone access to the event. The Call me link will be made active 15 minutes prior to scheduled start time.

Webcast: View Source;tp_key=d058de57b1

The webcast will also be archived for a period of 90 days on the Investor Relations web pages of Ayala (View Source).

MSK Disclosure: Dr. Gounder has financial interests related to Ayala Pharmaceuticals

About Desmoid Tumors

Desmoid tumors, also called aggressive fibromatosis or desmoid-type fibromatosis, are rare connective tissue tumors that typically arise in the upper and lower extremities, abdominal wall, head and neck area, mesenteric root, and chest wall, or other parts of the body. Desmoid tumors do not metastasize, but often aggressively infiltrate neurovascular structures and vital organs. People living with desmoid tumors are often limited in their daily life due to chronic pain, functional deficits, general decrease in their quality of life and organ dysfunction. Desmoid tumors have an annual incidence of approximately 1,700 patients in the United States and typically occur in patients between the ages of 15 and 60 years. They are most commonly diagnosed in young adults between 30-40 years of age and are more prevalent in females. Today, surgery is no longer regarded as the cornerstone treatment of desmoid tumors due to surgical morbidity and a high rate of recurrence post-surgery. There are currently no FDA-approved systemic therapies for the treatment of unresectable, recurrent or progressive desmoid tumors.

About AL102

AL102 is an investigational small molecule gamma secretase inhibitor (GSI) that is designed to potently and selectively inhibit Notch 1, 2, 3 and 4, and is currently being evaluated in the Phase 2/3 RINGSIDE clinical studies in patients with progressing desmoid tumors. AL102 is designed to inhibit the expression of Notch gene targets by blocking the final cleavage step by the gamma secretase required for Notch activation. Ayala obtained an exclusive, worldwide license to develop and commercialize AL102 from Bristol-Myers Squibb Company in November 2017. AL102 was granted U.S. FDA Fast Track Designation for the treatment of DT.

Atara Biotherapeutics Presents Updated Tab-cel® Clinical Effectiveness Data at ASCO 2023

On June 5, 2023 Atara Biotherapeutics, Inc. (Nasdaq: ATRA), a leader in T-cell immunotherapy, leveraging its novel allogeneic Epstein-Barr virus (EBV) T-cell platform to develop transformative therapies for patients with cancer and autoimmune diseases, reported updated effectiveness and safety data for tabelecleucel (tab-cel or EBVALLO) from the multicenter Expanded Access Program (EAP) study in Europe (Press release, Atara Biotherapeutics, JUN 5, 2023, View Source [SID1234632460]). The results will be featured in a poster presentation at the 2023 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting taking place June 2-6 in Chicago.

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Atara supported 27 EAP requests in Europe for patients with relapsed or refractory (r/r) Epstein-Barr virus-positive post-transplant lymphoproliferative disease (EBV+ PTLD) following solid organ transplant (SOT) or hematopoietic cell transplant (HCT). 24 EBV+ PTLD patients, 16 SOT recipients and eight HCT recipients, consented to use of data and received at least one dose of tab-cel, including four patients with EBV+ primary central nervous system (PCNS) PTLD.

An objective response rate (ORR) of 66.7% (16/24) was observed for both SOT and HCT groups (95% CI: 44.7, 84.4), 56.3% (9/16) for patients following SOT (95% CI: 29.9, 80.2) and 87.5% (7/8) for HCT patients (95% CI: 47.3, 99.7) with a best overall response of Complete Response (CR; 33.3%; n=4, SOT, n=4, HCT) or Partial Response (PR; 33.3%; n=5, SOT, n=3, HCT).

"These real-world results affirm the favorable risk-benefit profile seen in the pivotal Phase 3 ALLELE study which supported tab-cel as the first-ever allogeneic T-cell immunotherapy approved," said AJ Joshi, MD, Chief Medical Officer at Atara. "Tab-cel was well tolerated and delivered a one-year survival rate of nearly 91% in responders, reinforcing its potential to address an urgent unmet medical need for EBV+ PTLD patients."

The median time to response (TTR) in all patients was 1.0 month (range: 0.8–2.2). Of the subgroup of patients with EBV+ PCNS PTLD, three out of four (75%; 95% CI: 19.4, 99.4) treated patients achieved a response with one CR and two PRs.

One-year survival rates were 73.7% (95% CI: 47.3, 88.3) across both groups, 66.5% for SOT patients (95% CI: 32.7, 86.2) and 87.5% for HCT patients (95% CI: 38.7, 98.1). EBV+ PTLD patients responding to tab-cel had longer one-year survival compared to the non-responders, with a one-year survival rate of 90.9% (95% CI: 50.8, 98.7) versus 34.3% (95% CI: 4.8, 68.5) for non-responders.

"These data provide important insights on the effectiveness of EBVALLO in the real-world treatment setting," said Dr. Sylvain Choquet, Head of the Clinical Hematology Department at Pitié-Salpêtrière, Paris, France. "Findings further reinforce the clinical profile already established for EBVALLO, underscoring its potential as new treatment option for an ultra-rare and highly aggressive form of lymphoma that occurs in some transplant patients."

Safety findings in this real-world program were consistent with previously published data from clinical studies. All treatment-emergent adverse events (TEAEs) were assessed as unrelated to tab-cel by the treating physician and were consistent with patients’ underlying diseases. Detailed results on baseline demographics and disease characteristics, and additional safety data including tab-cel exposure details, will be shared at the conference.

Pierre Fabre leads all commercialization, distribution, medical and regulatory activities for EbvalloTM in Europe, Middle East, Africa and other selected markets.

Poster Presentation Details:

Title: Effectiveness and safety outcomes in patients with EBV+ PTLD treated with allogeneic EBV-specific T-cell immunotherapy (tabelecleucel) under an expanded access program (EAP) in Europe
Presenting Author: Ralf Trappe, M.D., DIAKO Evangelisches Diakonie-Krankenhaus Bremen, Bremen, Germany
Date & Time: June 5, 2023, at 8-11 a.m. CDT / 6-9 a.m. PDT
Abstract Number: 7521
Poster Number: 72
Session: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia
Location: McCormick Place Convention Center Chicago, Hall A

Arvinas to Participate in Upcoming Investor Conferences

On June 5, 2023 Arvinas, Inc. (Nasdaq: ARVN), a clinical-stage biotechnology company creating a new class of drugs based on targeted protein degradation, reported that management will participate in two upcoming investor conferences (Press release, Arvinas, JUN 5, 2023, View Source [SID1234632459]):

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Jefferies Healthcare Conference on Thursday, June 8. A live audio webcast of the fireside chat at 11 a.m. ET will be available here and on the Events + Presentations section of the Company’s website.
Goldman Sachs 44th Annual Global Healthcare Conference on Monday, June 12.

A live audio webcast of the fireside chat at 5:40 p.m. ET / 2:40 p.m. PT will be available here and on the Events + Presentations section of the Company’s website.