On October 23, 2023 OSE Immunotherapeutics SA (ISIN: FR0012127173; Mnemo: OSE) reported that first Phase 1 results for BI 770371, a novel anti-SIRPα monoclonal antibody evaluated in advanced solid tumors, have been presented, at the European Society for Medical Oncology conference, held in Madrid, Spain (October 20 – 24, 2023) (Press release, OSE Immunotherapeutics, OCT 23, 2023, View Source [SID1234636289]).

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BI 770371 is an IgG1 mAb that recognizes both the V1 and V2 variants of SIRPα. In many cancer types, CD47 forms a potent ‘don’t eat me’ signaling complex with SIRPα that triggers a cascade of events that enables cancer cells to avoid detection by the innate immune system and inhibits the ability of macrophage cells to fight cancer. By blocking the interaction between SIRPα and cluster of differentiation 47 (CD47), SIRPα antagonism enhances innate immunity and restores the immune function of myeloid cells in the tumor microenvironment.

Nicolas Poirier, Chief Executive Officer of OSE Immunotherapeutics, commented:

"We congratulate our partner Boehringer Ingelheim for this important new achievement, performed in the frame of our global collaboration and license agreement, which demonstrates their commitment to selective SIRPα inhibitors targeting myeloid cells. We are very pleased to potentially make our selective SIRPα inhibitor technology available to more patients through this strategic collaboration. With the V1 and V2 alleles being similarly expressed across humans in western countries, and V2 being more prevalent in the Asian region, the additional BI 770371 program highlights a new step forward in our partnership with Boehringer Ingelheim aiming to provide this selective SIRPα innovation for the benefits of more patients."

The BI 770371 development program will extend the therapeutic potential of selective SIRPα antagonists in various diseases or disorders, covering the most prevalent allelic variants* of SIRPα, V1 SIRPα and V2 SIRPα expressed on myeloid cells.

Boehringer Ingelheim is currently evaluating BI 770371 as monotherapy and in combination with ezabenlimab, a PD1 inhibitor (BI 754091), in an open-label, dose escalation/dose expansion Phase I clinical trial (NCT05327946) conducted in Canada, USA and Japan in patients with advanced solid tumours. The first clinical results of BI 770371 presented at ESMO (Free ESMO Whitepaper) 2023 conference (Madrid, Abstract #697P) showed that adverse events were manageable during the on-treatment period, Maximal Tolerated Dose (MTD) has not been reached. This clinical trial is ongoing. Boehringer Ingelheim is also evaluating BI 765063 (formerly OSE-172) in different combinations with patients with recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) or hepatocellular carcinoma (HCC) in a Phase 1b trial conducted in the United States, Europe and Asia (NCT05249426).

ESMO, Abstract #697P title:
Open-label, Phase I dose escalation/expansion trial of the anti-SIRPa monoclonal antibody BI 770371 in patients with advanced solid tumours, alone or in combination with the anti-PD-1 monoclonal antibody ezabenlimab -NCT05327946

Martin E. Gutierrez1*, Rahima Jamal2, Noboru Yamamoto3, Toshihiko Doi4, Gunther Kretschmar5, Javier Ferrada5, Stephan Wojciekowski6, Manish R. Patel7
1 Hackensack University Medical Center at Hackensack Meridian Health, Hackensack, NJ, USA; 2 Centre Hospitalier de l’Université de Montréal (CHUM), Centre de recherche du CHUM, Montreal, QC, Canada; 3 National Cancer Center Hospital, Tokyo, Japan; 4 National Cancer Center Hospital East, Kashiwa, Japan; 5 Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT, USA; 6 Boehringer Ingelheim Pharma GmbH & Co KG, Biberach an der Riss, Germany; 7 Florida Cancer Specialists/Sarah Cannon Research Institute, Sarasota, FL, USA

On October 23, 2023 Iksuda Therapeutics (Iksuda), the developer of class leading antibody drug conjugates (ADCs) with enhanced tumour specificity, reported that the first patient has completed a first cycle of therapy with IKS014, a human epidermal growth factor receptor 2 (HER2) ADC targeting patients with advanced HER2+ solid tumours. This follows positive data from Phase 1 clinical trials through Fosun Pharma, which is now progressing FS-1502 (IKS014) through Phase 2 and Phase 3 trials in China (Press release, Iksuda Therapeutics, OCT 23, 2023, View Source [SID1234636288]).

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The open-label, interventional study (View Source) is designed to evaluate the safety and tolerability of increasing dose levels of IKS014 to establish a recommended Phase 2 dose. The second, dose-expansion, phase of the study (Phase 1b) is to further evaluate the safety, pharmacokinetics / pharmacodynamics, and efficacy of IKS014 at the recommended Phase 2 dose. The study is currently enrolling patients at five planned locations in Australia. The Phase 1b trial is expected to read out in 2H 2025.

Dr Dave Simpson, Chief Executive Officer, Iksuda Therapeutics, said:

"The dosing of the first patient in our Phase 1 trial of IKS014 marks a significant milestone for Iksuda: our transition to being a clinical-stage company. We hope that this trial of IKS014 could lead to improved treatment options for patients with HER2+ solid tumours."

About IKS014

IKS014 is a potential best-in-class antibody drug conjugate, benefiting from tumour selective activation and release of the cytotoxic agent monomethyl auristatin F (MMAF). In preclinical trials, it displayed impressive activity in high- and low-HER2 expressing tumours with significantly higher non-severely toxic dose (HNSTD) vs other HER2-directed drugs. Iksuda gained exclusive world-wide rights (excluding Greater China and South Korea) to IKS014 from LegoChem Biosciences. (View Source) Fosun Pharma holds the licence to the ADC in Greater China where it is designated FS-1502. Fosun is currently conducting a Phase 2 clinical trial in China in patients with a range of solid tumours and has also initiated a Phase 3 trial in patients with advanced breast cancer.

On October 23, 2023 HighField Biopharmaceuticals, a clinical stage immuno-oncology company using lipid-based therapeutics to treat cancer, reported results of its Phase 1a study of HF1K16 showing three of five patients with recurrent and refractory glioma had maintained disease control for more than 8 months with one patient experiencing complete response (Press release, HighField Biopharmaceuticals, OCT 23, 2023, View Source [SID1234636287]). HF1K16 is a drug encapsulated immune modulating liposome containing all-trans retinoic acid.

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"These encouraging results show HF1K16 is well tolerated and patients have experienced significant disease control," said Yuhong Xu, CEO of HighField. "We are currently enrolling additional glioma patients in our Phase 1b/2 extension trial to confirm these outcomes and expect to have the results in the first quarter of 2024."

Dr. Xu and HighField Chief Business Officer Donald Wyatt will attend BIO-Europe November 6 – 8, 2023, in Munich, Germany, to discuss the company’s unique lipid-based drug, including details of the Phase 1a trial. Dr. Xu and Mr. Wyatt can be contacted through the conference’s online Partnering platform.

Of the three patients who had experienced disease control, one patient achieved complete remission after 12 months of treatment and has been cancer free afterwards for 7 months. One of the other two patients, with grade IV glioblastoma, maintained stable disease for more than 4 months. The third patient had stable disease for nearly 3 months and survival to date for more than 9 months. HF1K16 was well tolerated with no high grade adverse effects at all dose levels.

HF1K16 is a unique liposome construct of ATRA, a small molecule metabolite of vitamin A. It is administered by infusion, travels through the blood stream and infiltrates the tumor microenvironment. ATRA is released and initiates the maturation of myeloid-derived suppressor cells (MDSCs).

MDSCs are immature myeloid cells which have not differentiated. ATRA promotes the maturation and differentiation of MDSCs into functional cells, such as dendritic cells, which then summon T cells to attack the cancer.

The Phase 1b/2 trial, underway in China, and will assess safety and efficacy as well as evaluate changes in MDSC numbers and phenotypes. See NCT05388487 at clinicaltrials.gov.

On October 23, 2023 ImmuneOncia (CEO Heung Tae Kim) reported the results of its Phase 1a solid tumour clinical trial (IMC-002-K102 Study) of IMC-002, a CD47 monoclonal antibody, at the European Society for Medical Oncology (ESMO 2023) held in Madrid, Spain on October 23rd, 2023 (Press release, ImmuneOncia Therapeutics, OCT 23, 2023, View Source [SID1234636286]).

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The dose-escalation study aimed to assess the safety and tolerability, and to establish the recommended Phase 2 dose (RP2D) of IMC-002. From May 2022 to October 2023, a total of 12 patients were enrolled in four dose cohorts, each receiving IMC-002 at doses of 5, 10, 20, or 30 mg/kg every 2 weeks (Q2W).

The clinical data showed no dose-limiting toxicities (DLT). 92% of treatment-related adverse events (TRAE) were of Grade 1-2, with 94% occurring during the first treatment cycle. Common side effects associated with anti-CD47 therapy, such as infusion-related reactions, thrombocytopenia, and neutropenia, were not reported.

The recommended Phase 2 dose of 20 mg/kg every 3 weeks (Q3W) was established. 6 out of 11 evaluable patients with measurable lesions also demonstrated stable disease (SD). 5 of the patients had liver cancer, and 1 had breast cancer.

Professor Ho Young Lim of Samsung Medical Center, the Principal Investigator (PI) of IMC-002, commented, "CD47 is a promising immune checkpoint inhibitor for activating the anticancer function of macrophages, but it is also expressed on normal cells, raising concerns about hemolytic anemia and thrombocytopenia. However, most of the side effects of IMC-002 were mild, and 4 out of 6 SD patients received long-term treatment for over 6 months. This clinical trial has confirmed the safety of IMC-002."

Heung Tae Kim, CEO of ImmuneOncia, said, "The recommended dose of every 3 weeks (Q3W) enhances patient convenience and opens up combination treatment opportunities with immune checkpoint inhibitors such as PD-(L)1 or other cytotoxic agents. Observing disease control for over 6 months in 4 SD patients, we expect to further confirm efficacy in Phase 1b, which is set to commence in November this year. We hope to further advance towards our goal of providing patients with a best-in-class anti-CD47 therapy."

IMC-002 is an anti-CD47 antibody that functions as an immune checkpoint inhibitor against macrophages, allowing them to attack cancer cells by blocking the ‘don’t eat me’ signal between CD47 on cancer cells and SIRPα on macrophages. IMC-002 is expected to have a good safety profile by minimising binding to normal cells, including red blood cells.

ImmuneOncia is a biotechnology company specialising in immuno-oncology drug development. In addition to the CD47 antibody IMC-002, ImmuneOncia also has a wide range of pipeline that includes the Phase 2 clinical-stage PD-L1 antibody IMC-001, and the preclinical-stage bispecific antibody IMC-201.

On October 23, 2023 CEL-SCI Corporation (NYSE American: CVM) reported that it has finalized the selection criteria for the head and neck cancer target population to be treated with the Company’s immunotherapy drug Multikine (Leukocyte Interleukin, Injection) (Press release, Cel-Sci, OCT 23, 2023, View Source [SID1234636285]). Five-year survival in the target population was 73% alive for Multikine-treated patients vs only 45% alive in the control who did not receive Multikine, with the five-year risk of death cut in half for Multikine-treated subjects in the target population versus the control. These data, which are statistically significant and accompanied by strong hazard ratios, are a crucial achievement on the path for the approval of Multikine. CEL-SCI presented the data for the first time at the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) Congress in Spain on October 22, 2023. The selection criteria for this target population were developed based on the completed Phase 3 randomized controlled trial, advice from regulators, and advice from physician consultants associated with the University of California San Diego Cancer Center and Yale Medical School, recognized as among the nation’s most esteemed immuno-oncologists in head and neck cancer.

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Patients within this Multikine target population can be readily identified upon diagnosis with tests that physicians routinely use in cancer screening—another crucial achievement towards making Multikine available for use, as it is given immediately after diagnosis and before any other treatment. Working with regulators, CEL-SCI can now write an appropriate approval label defining Multikine’s target population, which is supported by strong positive data from the Phase 3 trial. The target population is estimated to cover ~145,000 advanced primary head and neck cancer patients globally per year.

The final Multikine selection criteria are:

No involvement of disease in the lymph nodes ("N0") and no extracapsular spread of the tumor, as confirmed using PET-CT/MRI imaging, and
Low PD-L1 tumor expression (defined as tumor proportion score < 10).
CEL-SCI’s ESMO (Free ESMO Whitepaper) poster reports three major new advancements supporting Multikine’s approvability:

First, Multikine is most effective in patients having tumors with low PD-L1 expression, consisting of about 70% of the study population. (It should be noted that immune checkpoint inhibitors like Keytruda and Opdivo appear to work best in patients with tumors having high PD-L1 expression).
Second, the Multikine target population can now be readily identified upon diagnosis, prior to surgery, using tests that physicians routinely use in cancer screenings.
Third, Multikine patients in the target population saw a significant increase in 5-year overall survival, from 45% for control patients who did not receive Multikine to 73% for Multikine-treated patients, shown in graph 1 above.
A 28% 5-year absolute survival advantage (73% vs 45%, p=0.0015), hazard ratio 0.35 (95% CIs [0.18, 0.66], Wald p=0.0012). The p-value of 0.0015 makes these results strongly significant as a statistical matter. The hazard ratio for Multikine vs control was 0.35, meaning that the Multikine-treated patients had, on average, about 65% lower risk of death at any given time. CEL-SCI is not aware of any head and neck cancer therapy that has shown such a large 5-year survival benefit. In addition, the hazard ratio’s "95% confidence interval" upper bound was 0.66, which supports CEL-SCI’s confidence that a confirmatory trial of Multikine in the target population would likely be a success. These results and statistics support CEL-SCI’s confidence that the data should be sufficient for requesting immediate approval for Multikine to treat these patients who currently have an unmet need for better outcomes.

Another finding presented at ESMO (Free ESMO Whitepaper) is also very important because it predicts improved survival. This finding refers to pre-surgery disease downstaging, which is when the physician assesses a lower stage of disease after Multikine therapy compared to before Multikine therapy. Graph 2 above clearly indicates that Multikine-treated patients with downstaging (improved disease, the green top line) have much better survival. This data is strongly significant as a statistical matter, with a p-value below 0.0002.

Geert Kersten, Chief Executive Officer of CEL-SCI, said: "We are now able to identify upon diagnosis which patients are most likely to have pre-surgery responses to Multikine and improved survival, as seen in the new ESMO (Free ESMO Whitepaper) data. This is a new sign of hope for head and neck cancer patients and a critical milestone for Multikine towards achieving regulatory approval. Because Multikine is a neoadjuvant (pre-surgical) immunotherapy, identifying patients who benefit from Multikine upon diagnosis was very difficult, and we welcomed the assistance of regulators and expert physician consultants to help us. With this success announced at ESMO (Free ESMO Whitepaper), we are eager to present these new data to regulators."

John Cipriano, Senior VP of Regulatory Affairs at CEL-SCI, said: "Patients with this disease have a clear unmet medical need for better outcomes. Multikine’s demonstrated effects in the new intended target population are overwhelmingly large and strong as a statistical matter and support the observed Multikine efficacy. While Multikine has not yet been tested prospectively in the new target population, the Phase 3 data present a compelling case for immediate patient access to Multikine because the Phase 3 study results showed prospectively that Multikine led to pre-surgical responses which in turn led to longer life. Regulators understand that patients should not have to wait before gaining access to these benefits, particularly given Multikine’s safety profile and data that mechanistically and empirically supports the target population definition. There are specific pathways in Europe, the UK, Canada, and the U.S. for such approvals, and we are currently working towards this goal. We filed requests with the UK and European regulatory bodies within the past month, and we intend to press forward with these new results in Canada and the U.S. in the coming months. Therefore, we hope to receive approval in the target population without having to wait for completion of a confirmatory study."

CEL-SCI’s Chief Scientific Officer, Eyal Talor, Ph.D., a co-author of CEL-SCI’s ESMO (Free ESMO Whitepaper) presentation, provided more detail on the data. "This year’s ESMO (Free ESMO Whitepaper) data presentation also relates to pre-surgery disease downstaging, which occurs, for example, when the disease stage goes down from Stage IV to Stage III during Multikine treatment before surgery. In the overall Phase 3 study population, we saw that patients with disease downstaging survived longer than those without. Therefore, we concluded that Multikine benefited patients who had downstaging before surgery. The target population selection criteria are designed to capture as many responder patients as possible, and indeed we saw a 35% rate of pre-surgical downstaging in the Phase 3 study subjects who met these selection criteria when treated with Multikine. This high rate of downstaging and tumor responses from Multikine led to the increase in overall survival seen in the target population and this is why the risk of death was cut in half for Multikine-treated patients as compared to control."

Click here for a link to CEL-SCI’s ESMO (Free ESMO Whitepaper) 2023 poster presentation entitled: "Tumor Node stage shift following Leukocyte Interleukin, Injection (LI) neoadjuvant extends overall survival in treatment-naïve locally advanced primary squamous cell carcinoma of the oral cavity/soft palate."