Bavarian Nordic A/S Announces Completion of Directed Issue of 7,046,839 New Ordinary
Shares

On February 20, 2023 Bavarian Nordic A/S ("Bavarian Nordic" or the "Company") reported its intention to raise new capital through an accelerated bookbuilding process (Press release, Bavarian Nordic, FEB 20, 2023, View Source [SID1234627415]). The offering (the "Offering") of new shares (the "New Shares") in Bavarian Nordic has now been successfully completed. Reference is made to company announcement no. 05 of 20 February 2023.

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Bavarian Nordic has successfully completed a directed issue and private placement of 7,046,839 new shares at an offer price of DKK 233 per share, raising gross proceeds to Bavarian Nordic of DKK 1,642 million.

The Offering has not been registered under the U.S. Securities Act and was made pursuant to applicable exemptions from the obligation to publish a prospectus in Denmark as well as exemptions from the U.S. Securities Act and the securities laws of other applicable jurisdictions in a directed issue and private placement and subscribed for by eligible qualified institutional and professional investors in Denmark and in certain other jurisdictions at market price and without pre-emption rights for Bavarian Nordic’s existing shareholders.

The net proceeds from the Offering will be used in accordance with company announcement no. 05 of 20 February 2023.

As the Offering was oversubscribed, an individual allocation of the New Shares was made.

Bavarian Nordic has in connection with the Offering, agreed to undertake a lock-up commitment for 180 calendar days following settlement of the Offering (subject to certain exceptions). In addition, members elected at the general meeting of Bavarian Nordic’s board of directors as well as members of the executive management have in connection with the Offering, agreed to undertake a lock-up commitment for 90 calendar days following settlement of the Offering (subject to certain exceptions).

CAPITAL INCREASE

Subject to settlement, a share capital increase will be registered with the Danish Business Authority and the share capital of Bavarian Nordic will hereafter consist of 77,782,215 shares of DKK 10 each, equivalent to a registered share capital of DKK 777,822,150.

The New Shares represent approximately 9.96% of Bavarian Nordic’s registered share capital before the capital increase and will account for approximately 9.06% of Bavarian Nordic’s registered share capital upon completion of the capital increase.

ADMISSION TO TRADING AND OFFICIAL LISTING

The New Shares will be issued under the temporary ISIN code DK0062266201. No application for admission to trading and official listing has been, or will be, filed for the New Shares issued under the temporary ISIN code, and the temporary ISIN code will only be registered with VP Securities A/S ("Euronext Securities") for subscription of the New Shares. The temporary ISIN code in Euronext Securities will be merged with the permanent ISIN code for the existing shares, DK0015998017, as soon as possible following registration of the share capital increase with the Danish Business Authority. The New Shares are expected to be admitted to trading and official listing on Nasdaq Copenhagen A/S, in the permanent ISIN code for the existing shares, DK0015998017, on or around 24 February 2023.

The admission to trading and official listing of the New Shares is subject to the Offering not being withdrawn prior to the settlement of the Offering and the Company making an announcement to that effect.

EXPECTED TIMETABLE FOR THE OFFERING

Date

Event Expected Thursday 23 February 2023 Settlement and payment for the New Shares
Expected Thursday 23 February 2023 Registration of the capital increase with the Danish Business Authority
Expected Friday 24 February 2023 Admission to trading and official listing of the New Shares on Nasdaq Copenhagen A/S Expected Monday 27 February 2023 Merger of the temporary ISIN code with the permanent ISIN code in the system of Euronext Securities

NEW SHARES

The decision to launch an offering of new shares in a directed issue was made pursuant to Article 5a(2) in Bavarian Nordic’s articles of association pursuant to which its board of directors is authorised to make share capital increases without preemption rights for the existing shareholders at market price.

The New Shares will rank pari passu in all respects with existing shares in Bavarian Nordic. The New Shares will be negotiable instruments, and no restrictions will apply to their transferability. No shares, including the New Shares, carry or will carry any special rights. Rights conferred by the New Shares, including voting rights and dividend rights, will apply from the time when the capital increase is registered with the Danish Business Authority. The New Shares must be registered in the name of the holder in the Company’s register of shareholders.

JOINT GLOBAL COORDINATORS AND JOINT BOOKRUNNERS

Danske Bank A/S, Morgan Stanley & Co. International plc and Nordea Danmark, filial af Nordea Bank Abp, Finland are acting as Joint Global Coordinators and Joint Bookrunners in connection with the Offering (jointly the "Joint Global Coordinators and Joint Bookrunners").

Kromann Reumert and Latham & Watkins LLP act as Danish and U.S. legal advisors respectively to the Company. Plesner acts as Danish legal advisors to the Joint Global Coordinators and Joint Bookrunners.

Medivir has determined the recommended phase 2 dose for fostrox in combination with Lenvima in HCC

On February 20, 2023 Medivir AB (Nasdaq Stockholm: MVIR), a pharmaceutical company focused on developing innovative treatments for cancer in areas of high unmet medical need, reported that the initial dose escalation part (phase 1b) of the company’s 1b/2a study with the candidate drug fostroxacitabine bralpamide (fostrox) in hepatocellular carcinoma (HCC), in combination with Lenvima, was successfully completed (Press release, Medivir, FEB 20, 2023, View Source [SID1234627417]).

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The preliminary results from the dose cohorts are positive with a good safety and tolerability profile and no dose-limiting toxicity has been observed. The recommended dose (RP2D) for the first combination arm of the phase 2a part of the study has been determined to 30 mg for fostrox.

– " It is very satisfactory that we have now completed the first part of the study with good preliminary results and have been able to determine the starting dose for the first combination arm in the phase 2a part of the study. With the great interest we have seen in the study, it is also gratifying for the patients that we can now start the first combination arm in the phase 2a part," says Jens Lindberg, CEO at Medivir AB. "Although Lenvima is now widely used as a second-line treatment for advanced HCC, there is still a need to improve the number of patients who respond to the treatment. By using fostrox in addition to Lenvima, our hope is that more of these patients will obtain a clinical response to their treatment."

In the open-label multi-center study, fostrox is given in combination with two other medicines, either with Lenvima, a tyrosine kinase inhibitor, or with Keytruda, an anti-PD-1 checkpoint inhibitor. The study includes patients with HCC for whom current first-line treatment has shown to be ineffective or intolerable. The purpose of the study is to evaluate safety and tolerability, as well as to get an indication of the efficacy of fostrox in combination with two already existing drugs. The phase 1b dose escalation part with Keytruda is still ongoing. Currently six patients are on active treatment in the study.

In the phase 2a part of the study, a total of up to 30 further patients with HCC will be recruited for an initial evaluation of safety and efficacy. The study is being conducted at 14 clinics in the UK, Spain and South Korea.

For additional information, please contact
Magnus Christensen, CFO, Medivir AB
Telephone: +46 8 5468 3100.
E-mail: [email protected]

Medivir AB is obliged to make this information public pursuant to the EU Market Abuse Regulation.
The information was submitted for publication, through the agency of the contact person set out above, at 10.10 CET on February 20, 2023

About fostrox
Fostrox is a pro-drug designed to selectively treat liver cancers and to minimize side effects. It has the potential to become the first liver-targeted and orally administered drug for patients with HCC and other forms of liver cancer. Fostrox has completed a phase 1b monotherapy study, and a combination study in HCC currently ongoing.

About primary liver cancer
Primary liver cancer is the third leading cause of cancer-related deaths worldwide and hepatocellular carcinoma (HCC) is the most common cancer that arises in the liver. Although existing therapies for advanced HCC can extend the lives of patients, treatment benefits are insufficient and death rates remain high. There are 42,000 patients diagnosed with primary liver cancer per year in the US and current five-year survival is
11 percent. HCC is a heterogeneous disease with diverse etiologies, and lacks defining mutations observed in many other cancers. This has contributed to the lack of success of molecularly targeted agents in HCC. The limited overall benefit, taken together with the poor overall prognosis for patients with intermediate and advanced HCC, results in a large unmet medical need.

Invitation to Immunovia’s Q4 presentation

On February 20, 2023 Immunovia reported its full year 2022 results on February 23, 2023 at 8:30 am CET. Analysts, investors and media are invited to a webcast teleconference on the same day at 11:00 CET (Press release, Immunovia, FEB 20, 2023, View Source [SID1234627416]). The report together with the presentation slides will be available at www.immunovia.com

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Philipp Mathieu, CEO and President, Jeff Borcherding, CEO Immunovia, Inc. and Karin Almqvist Liwendahl, CFO, will present on Immunovia’s development. The presentation will be held in English and be followed by a Q&A session. You are welcome to join via webcast or phone, see details below.

Telephone numbers and webcast

Call any of the numbers below to participate via telephone. Please dial in a few minutes before the presentation starts.

Sweden: +46 (0)8 5051 0031
United Kingdom: +44 (0) 207 107 06 13
United States: +1 (1) 631 570 56 13

Link to the webcast: https://link.edgepilot.com/s/94d445d8/kGg7TnRc0kW8IMCMe-92zw?u=http://creo-live.creomediamanager.com/d1d6a3da-b961-48c9-beb8-3d4026f05d6f

To ask questions, it is necessary to dial in. A recording of the presentation will be available on Immunovia’s website.

For more information, please contact:

Karin Almqvist Liwendahl
CFO
[email protected]
46 70 911 56 08

The information was submitted for publication on February 20, 2023, at 15:20 am CET.

Almirall’s Full-Year 2022 Results: Almirall closes 2022 with a Core Net Sales growth of 6.6%, driven by its European Dermatology Business

On February 20, 2023 Almirall reported that it has consolidates its position in Europe (Press release, Almirall, FEB 20, 2023, View Source [SID1234627413]). The Dermatology business in this continent grew 18.4% year-on-year, boosted by new launches

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Almirall achieved its guidance for 2022, delivering its mid-single-digit Core Net Sales target and hitting the mid-range of the EBITDA level: Core Net Sales* reached €863.2 MM (+6.6% year-on-year) and Total EBITDA €198.3 MM (-15.8% year-on-year) due mainly to a higher investment in R&D and SG&A. Growth drivers contributed to robust operational performance: Ilumetri -52.1% year-on-year sales increase-; Klisyri -Net Sales of c.€15 MM-; and Wynzora -Net Sales of c. €7 MM-

In October 2022, lebrikizumab (atopic dermatitis) was submitted for EU regulatory approval, which is expected in late 2023. Almirall’s focused strategy on Medical Dermatology and the biologics market space positions the company well for continued growth acceleration over the mid-term

Pipeline continues to progress: Phase I for anti-IL-1RAP monoclonal antibody is initiated. Almirall entered in 2022 into a licensing agreement for IL-2muFc fusion protein with Simcere; more recently, the company signed a research collaboration with Isolex to explore novel approaches for IgE-mediated diseases

Guidance for 2023: Core Net Sales growth of low to mid-single-digit and Total EBITDA of €165-€180 MM

In light of the very positive evolution, performance and momentum of the Company towards its key priorities over the last few months, the Board of Directors of Almirall has asked Carlos Gallardo to remain as CEO and has suspended the search for a new CEO for the time being. He will also continue in the role of Chairman of the Board of directors

The company will submit a dividend to its shareholders of €0.19 per share at the next Annual General Meeting on May 5th , in line with previous years’ dividend

Financial highlights (€ rounded million)

2022

2021

Variation

Total Revenues

878.5

836.5

5.0%

Net Sales

863.2

827.2

4.4%

Other Income

15.3

9.3

64.5%

Gross Profit

572.9

571.3

0.3%

% of sales

66.4%

69.1%

EBITDA

198.3

235.6

(15.8%)

Normalized Net Income

33.5

81.4

(58.8%)

* Core results excludes AstraZeneca/Covis contribution: Deferred Income and Other Income. From 2022 onwards, there is no difference between Core Net Sales and Net Sales as no additional Deferred Income from AstraZeneca is registered, the difference related to Core EBITDA and EBITDA is explained by the other income related to AstraZeneca and Covis

"We are pleased to see that Almirall achieved strong financial results in 2022, delivering our guidance thanks to the excellent evolution of our core dermatology business, which continues to perform well and is driven by our recently launched products and strength in the European business. In the meantime, we have also made good progress with our pipeline. We started 2023 on a high note. We are confident that Almirall’s growth drivers will continue their positive trajectory during 2023 while we keep preparing for Lebrikizumab’s launch. We are very well-positioned for mid and long-term growth. Our strong balance sheet and flexible capital structure will allow us to continue to explore inorganic growth options that align with our corporate strategy."

Carlos Gallardo, Chairman and Interim CEO

Almirall, S.A. (ALM) a global biopharmaceutical company based in Barcelona, has announced its full-year 2022 financial results today.

Summary of results
Net Sales* at €863.2 MM represent a 6.6% year-on-year growth, driven by strong EU Dermatology portfolio performance

Total EBITDA* reached €198.3 MM, a 15.8% year-on-year decrease, and was impacted by due to higher R&D, SG&A investment related to new and coming launches, US sales decrease.

Almirall closed 2022 with a healthy balance sheet and solid liquidity position at 0.8x Net Debt to EBITDA.

Core Gross Margin of 66.4%, as expected, was impacted by higher energy costs and inflation affecting purchase costs of certain materials

Research & Development investment of €103.2 MM, increasing as expected reaching 12% of Core Net Sales, driven by investment in studies for lebrikizumab and Klisyri (tirbanibulin), as well as the acquisition of earlier stage assets, such as the anti IL1-Rap and the IL-2 mu-Fc.

Selling, General & Administrative expenses were €409.7 MM, up 4.3%, due to supporting recent launches of Wynzora, Klisyri in Europe and Ilumetri rollout in new countries.

Divestment of Motilex in Italy, with a positive impact of €18.5 MM in Q4 2022, broadly in line with the positive divestment impact of €16m in 2021.

* Core results excludes AstraZeneca/Covis contribution: Deferred Income and Other Income. From 2022 onwards, there is no difference between Core Net Sales and Net Sales as no additional Deferred Income from AstraZeneca is registered, the difference related to Core EBITDA and EBITDA is explained by the other income related to AstraZeneca and Covid.

Growth Drivers Performance
Psoriasis

Ilumetri, an anti-IL-23 high-affinity humanized monoclonal antibody indicated for the treatment of adult patients with moderate-to-severe plaque psoriasis, had a strong performance in 2022 reaching Net Sales of over €124.6 MM and achieving a 52.1% sales increase year-on-year. Growth was boosted by the positive contribution from new country launches, and sales in Germany, where the new patient market is clearly driven by the anti-IL23 class, with over 40% market share of new patients within biologics.

This growth trend is expected to continue during 2023, with added contribution of new country launches.

Almirall strengthened its psoriasis franchise with the successful rollout of Wynzora* cream, a once-daily aqueous cream with a fixed combination of calcipotriene and betamethasone diproprionate (CAL/BDP) indicated for the topical treatment of mild to moderate psoriasis vulgaris in adults. The launch of this product also reinforces Almirall’s position as the only company with an entire portfolio of psoriasis products covering the treatment paradigm.

Wynzora keeps increasing its market share in key countries, achieving Net Sales of c. €7 MM in 2022, driven by the strong performance in Germany and Spain where the product reached double digit market share. The product also had a successful rollout campaign during 2022 in the UK, Denmark, Netherlands, and Austria and Almirall is confident that Wynzora will have a good uptake in these markets as well as in additional EU countries in the upcoming quarters.

* Wynzora is authorized with this name in France, the UK, Spain, the Czech Republic, Denmark, Norway, Sweden, Finland, Germany, Portugal, Italy, Ireland, and The Netherlands. In Austria, it is authorized under a different tradename: Winxory.

Actinic Keratosis (AK)

Klisyri* (tirbanibulin), a microtubule inhibitor for the topical treatment of actinic keratosis (AK) of the face or scalp, delivered a solid performance and positive uptake in Europe thanks to the positive feedback among users and physicians due to its convenience and safety profile. The product reached Net Sales of c.€9 MM in 2022 in Europe with strong performance in Germany, where Klisyri was awarded "Most Innovative Product 2022" at the Pharma Trend Image & Innovation Awards. It is also gaining strong traction in countries like the Netherlands, Austria, Switzerland, Spain, and Italy.

In the US, where AK is the second most common diagnosis made by dermatologists, Klisyri received a recommendation in the AAD guidelines. The product continues to gain penetration in the AK topical market with around 70,000 prescriptions since its launch in February 2021, a result that highlights the product’s good performance despite being a new product launched in a market with numerous generic alternatives. Since its launch, Klisyri has been prescribed by over 5,000 healthcare professionals, who have reported positive feedback and successful patient engagement. The product now has a greater than 70% commercial coverage.

Acne

Seysara, an oral antibiotic derived from tetracycline and specifically designed to treat acne, has registered continued volume recovery during 2022. With over 250,000 TRx, the product achieved 22% growth year-on-year in prescriptions.

The product continues to make good progress on market access with 75% commercial payer coverage. Furthermore, Seysara achieved a 6% market share in the oral antibiotic market and Almirall continues to focus its efforts on driving demand and improving the commercial profile and productivity (TRx/HCP) which will be key for continued growth

Progressing promising late-stage pipeline, while building early stage
Atopic Dermatitis (AD)
In October 2022, Almirall submitted a Marketing Authorisation Application (MAA) to the EMA for Lebrikizumab, an anti-IL13 monoclonal antibody for the treatment of moderate-to-severe atopic dermatitis (AD). AD is an underserved, large and growing market, estimated to have more than 5 million moderate-to-severe patients in Europe by 2026. 1 . The application of lebrikizumab is currently under review, and the approval is expected in Q4 2023.

Lebrikizumab showed a consistent safety profile across a clinical development program with more than 2000 patients. Consistent across geographies, whether in monotherapy or in combination with topical corticosteroids, in adults as well as in adolescents and across ethnicities.

In terms of clinical updates, the Advantage Phase 3b study is fully recruited. This study is a randomised, doubleblind, placebo-controlled Phase 3 clinical trial to assess the efficacy and safety of Lebrikizumab in combination with Topical Corticosteroids in Adult and Adolescent Patients with Moderate-To-Severe Atopic Dermatitis that are not adequately controlled with cyclosporine or for whom cyclosporine is not medically advisable. The results for the Week 16 readout are expected in H1 2023. In addition, a paediatric study was initiated by Almirall’s partner.

The data presented to date demonstrate the potential benefit that lebrikizumab could bring to HCPs and patients and confirm the potential of lebrikizumab to be a first-line advanced biologic treatment for moderate-to-severe atopic dermatitis.

Onychomycosis

Efinaconazole is a triazole antifungal compound indicated for the treatment of mild-to-moderate fungal infection of the nail in adults and children (aged 6 years and older). Almirall has submitted regulatory filings under the European decentralised procedure. The German regulatory authority is acting as the Reference Member State. The outcome of the filing is expected in 2023.

With the potential launch of this antifungal expected in 2023, Almirall will reinforce its onychomycosis franchise by complementing Ciclopoli, Almirall’s OTC product indicated to treat this condition.

Acne

The Phase III clinical trial conducted in China for the oral antibiotic Seysara (sarecycline) met primary and key secondary endpoints and Almirall plans to file the application to the Chinese National Medical Products Administration later this year.

Autoimmune dermatological diseases

Almirall is working on building its early-stage pipeline with some promising recent in-licensing. In 2022 Almirall entered into a licensing agreement with Simcere Pharmaceutical Group for Simcere’s IL-2 mutant fusion protein (IL-2muFc) autoimmune drug candidate, ALM223* (previously SIM0278). This molecule, developed utilising Simcere’s protein engineering platform, activates regulatory T-cells. Preclinically, ALM223 exhibits an improved PK profile and the potential to restore immune balance. The start of the Phase I clinical trial is expected in the second half of 2023.

Under the agreement signed with Simcere Pharmaceutical Group, Almirall will be granted an exclusive right to develop and commercialise ALM223 for all indications outside the Greater China region (Mainland China, Hong Kong, Macau and Taiwan).

* ALM223 in licensed from Simcere. Formally referred to as SIM-0278, worldwide ex-Greater China.

In September 2022, Almirall announced the initiation of the phase I study evaluating the safety, pharmacokinetics, pharmacodynamics and clinical activity of ALM27134*, a first-in-class fully human, high-affinity monoclonal antibody that targets IL-1RAP (Interleukin-1 Receptor Accessory Protein) for the treatment of autoimmune dermatological diseases. Almirall in-licensed in 2021 exclusive global rights from Ichnos Science to develop and commercialise ALM27134. The company is confident that this monoclonal antibody could bring the opportunity to address the unmet needs in several autoimmune dermatology indications.

* Previously referred to as ISB 880.

Agreement with Isolex to develop novel approaches for IgE-mediated diseases

Recently, Almirall has entered a collaboration and option to license agreement with the biotechnology company Isolex with the aim of identifying and developing a novel class of medicines that modulates Immunoglobulin E (IgE). The signed Option and Licensing Agreement will allow the teams to develop a biotherapeutic treatment that utilises a novel mechanism of action to target IgE.

The research project brings together Almirall’s strong knowledge in Medical Dermatology with the expertise of Isolex team, leveraging the technology developed between Combikine Biotechnology Ltd and King’s College London.

Board of Directors of Almirall

The Board of Directors of Almirall views very positively the evolution, performance, and momentum of the Company towards its key priorities over the last few months. Therefore, it has asked Carlos Gallardo to remain as CEO and has suspended the search for a new CEO for the time being. Carlos Gallardo has accepted, and he will also continue in the role of Chairman of the Board of directors. Additionally, the Board will set up a new Governance Committee to check and balance the position of the Chairman-CEO.

Conclusions

Almirall achieved its 2022 guidance, delivering a good operational performance driven by the excellent momentum of its Medical Dermatology business in Europe.

Almirall’s focused strategy on the Medical Dermatology space positions the company well for the mid and long term. Its growth drivers are expected to continue their trajectory during 2023 ewhile keeping the focus on important near-term launches such as the biologic lebrikizumab. Ilumetri should continue to show strong performance thanks to growing contribution from new country launches. The rollouts of Klisyri and Wynzora in Europe are also expected to continue driving positive trends during the year.

The company will also remain focused on unlocking the value of its late-stage pipeline, while strengthening the early-stage with exciting new assets, ensuring sustained growth in the medium and long term.

Almirall is fully committed to creating long-term shareholder value with growth expected to accelerate in the coming years with recent and future launches. The company has a good credit rating, reflecting its healthy balance sheet, and which gives management the flexibility in the current environment to actively pursue bolt-on acquisitions and in-licensing opportunities that align with its corporate strategy.

Board proposals to the Annual General Meeting: Dividend

The AGM will be proposed a dividend of €0.19 per share for approval May 5th 2023.

2023 Full Year Guidance

Core Net Sales: low to mid-single-digit growth vs. previous year (€863 MM)

Total EBITDA: between €165 MM and €180 MM

Investor Calendar 2023

• Q1 2023 Financial Results – 8th May 2023
• H1 2023 Financial Results – 24th July 2023
• 9M 2023 Financial Results – 13th November 2023

MediciNova Announces New Data Regarding MN-166 (ibudilast) in Glioblastoma Tumor Tissue Analysis Presented at the 20th Annual World Congress of Society for Brain Mapping and Therapeutics

On February 20, 2023 MediciNova, Inc., a biopharmaceutical company traded on the NASDAQ Global Market (NASDAQ:MNOV) and the JASDAQ Market of the Tokyo Stock Exchange (Code Number: 4875), reported that MediciNova’s research collaborator, Justin Lathia, PhD, Scientific Director of the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center at Cleveland Clinic and Professor, Department of Molecular Medicine at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Professor and Vice Chair in the Department of Cardiovascular & Metabolic Sciences at the Lerner Research Institute, Cleveland Clinic presented new data regarding tumor tissue analysis and clinical outcome from a glioblastoma clinical trial (protocol no. MN-166-GBM-1201; NCT03782415) at the 20th Annual World Congress of SBMT (Society for Brain Mapping and Therapeutics) held on February 16 – 19, 2023, in Los Angeles, CA (Press release, MediciNova, FEB 20, 2023, View Source [SID1234627412]).

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This tumor analysis study was a collaborative effort between MediciNova, Dr. Patrick Wen (Dana- Farber Cancer Institute), and Dr. Lathia (Cleveland Clinic Foundation). MN-166-GBM-1201 is an ongoing Phase 1/2 study targeting recurrent and newly diagnosed glioblastoma being conducted at Dana-Farber Cancer Institute under Principal Investigator: Dr. Wen, Director at Center for Neuro-Oncology Dana-Farber Cancer Institute, Professor of Neurology, Harvard Medical School.

The highlights of Dr. Lathia ‘s presentation are as follows:

Tumor tissues were analyzed to determine potential predictors of treatment response to MN-166 (ibudilast) and temozolomide (TMZ) combination treatment.
Pre-treatment tumor tissues were obtained from the resected tumors at the initial surgery or biopsy of trial participants (Part 1) diagnosed with recurrent glioblastoma.
Immunohistochemistry was performed on resected tumor tissue to evaluate MIF (macrophage migration inhibitory factor), pERK, Ki67, CD3, CD11b, and CD74. A masked researcher calculated the score for each protein per patient.
Study participants were divided into two groups: non-responders (disease progression within five months after receiving MN-166 and TMZ) and responders (no disease progression for five months after receiving MN-166 and TMZ).
Responders had a lower percentage of CD3+ T cells than non-responders (p<0.05). Additionally, CD74 expression was also lower in the responders and this trended towards significance (p=0.06).
CD3 expression was the best predictor for tumor progression for five months in recurrent glioblastoma patients treated with MN-166 and TMZ.
Dr. Lathia commented "Previously we reported that MN-166, as a brain-penetrant MIF-CD74 interaction inhibitor, reduced myeloid-derived suppressor cells (MDSC) generation and reversed their T cell suppressive capacity in vitro. Additionally, MN-166 reduced monocytic-MDSCs and increased CD8+ T cell number and function in the tumor microenvironment in murine model study. These new findings from clinical tumor tissue analysis may be explained by treatment with MN-166 resulting in increased CD3+ infiltration into tumor tissue in the patients who began with low CD3+ due to high MDSCs. This will need to be confirmed in a larger cohort."

Kazuko Matsuda, M.D. Ph. D, M.P.H., Chief Medical Officer, MediciNova, Inc., commented, "GBM is the most common primary malignant brain tumor and has a poor prognosis. It is a highly immunosuppressive tumor and there are limitations to the extent of a safe immune response in the central nervous system. We are excited by the findings presented by Dr. Lathia. Recently, we have completed study enrollment with MN-166-GBM-1201 study and look forward to the upcoming data analysis with more tissue samples."

About Glioblastoma

According to the American Association of Neurological Surgeons, glioblastoma is an aggressive brain cancer that often results in death during the first 15 months after diagnosis. Glioblastoma develops from glial cells (astrocytes and oligodendrocytes), grows rapidly, and commonly spreads into nearby brain tissue. Glioblastoma is classified as Grade IV, the highest grade, in the World Health Organization (WHO) brain tumor grading system. The American Brain Tumor Association reports that glioblastoma represents about 15% of all primary brain tumors and approximately 10,000 cases of glioblastoma are diagnosed each year in the U.S. Despite decades of advancements in neuroimaging, neurosurgery, chemotherapy and radiation therapy, only modest improvements have been achieved and the prognosis has not improved for individuals diagnosed with glioblastoma. Median survival is about 11-15 months for adults with more aggressive glioblastoma (IDH-wildtype) who receive standard treatment of surgery, temozolomide, and radiation therapy.

About MN-166 (ibudilast)

MN-166 (ibudilast) is a small molecule compound that inhibits phosphodiesterase type-4 (PDE4) and inflammatory cytokines, including macrophage migration inhibitory factor (MIF). It is in late-stage clinical development for the treatment of neurodegenerative diseases such as ALS (amyotrophic lateral sclerosis), progressive MS (multiple sclerosis), and DCM (degenerative cervical myelopathy); and is also in development for glioblastoma, CIPN (chemotherapy-induced peripheral neuropathy), and substance use disorder. In addition, MN-166 (ibudilast) was evaluated in patients that are at risk for developing acute respiratory distress syndrome (ARDS).