CytomX Therapeutics to Present at the Barclays 27th Annual Global Healthcare Conference

On March 5, 2025 CytomX Therapeutics, Inc. (Nasdaq: CTMX), a leader in the field of masked, conditionally activated biologics, reported that Sean McCarthy, D.Phil., chief executive officer and chairman, will present at the Barclays 27th Annual Global Healthcare Conference on Wednesday, March 12, 2025, at 3:00 p.m. ET (Press release, CytomX Therapeutics, MAR 5, 2025, View Source [SID1234650900]).

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A live webcast of the presentation will be available on the Events and Presentations page of CytomX’s website at www.cytomx.com. In addition, management will be available for one-on-one meetings with investors who are registered to attend the conferences.

Circio presents results that further validate the circVec circular RNA platform at two international industry conferences

On March 5, 2025 Circio Holding ASA (OSE: CRNA), a biotechnology company developing powerful circular RNA technology for next generation nucleic acid medicine, reported that CEO Dr. Erik Digman Wiklund and CSO Dr. Victor Levitsky are presenting updated data demonstrating the significant advantages of Circio’s circular RNA circVec platform compared to current mRNA-based vector technology (Press release, Circio, MAR 5, 2025, View Source [SID1234650899]). The data further strengthens the in vitro and in vivo validation of Circio’s platform. The presentations are being delivered at two major biopharma industry conferences in Basel, Switzerland, and Stockholm, Sweden.

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The presentations detail the advantages and potential of the circVec 3.0 generation to improve on current mRNA-based technology for a range of therapeutic applications. In vivo expression data has shown an estimated circRNA half-life of over 600 hours vs. under 10 hours for linear mRNA, which translates to over 70 times prolonged RNA durability and 15 times enhanced protein expression.

Novel systemic LNP-delivery data demonstrates robust and durable circVec expression in spleen, far outperforming equivalent mRNA-vectors. This important finding has the potential to open up attractive therapeutic opportunities for the circVec technology in several areas, such as cell therapy. Further experimental work is currently ongoing to validate and characterize these observations.

"The recent results showing efficient and specific circVec delivery to spleen are very promising and hints at novel opportunities for our circular RNA platform in cell and immune therapies," said Dr. Victor Levitsky, CSO of Circio. "A broad set of experiments to further investigate this observation, as well as in vivo testing of the novel circVec 3.0 generation, will read out over the next 6-12 weeks. The performance of circVec 3.0-AAV constructs is of particular interest, which we believe has the potential to transform current gold-standard AAV gene therapy and generate substantial partnering interest."

See below for titles and presentation materials:

RNA Leaders Europe Congress
Title: Deploying circular RNA expression to boost gene therapy – AAV and beyond
Time & place: 5 March 2025, Basel, SwitzerlandPresenter: Dr. Erik Digman Wiklund, CEO

Biologics World Nordics 2025
Title: CircVec – A Novel Payload Expression Platform Based on Circular RNA Biogenesis: Features and Opportunities
Time & place: 5 March 2025, Stockholm, Sweden
Presenter: Dr. Victor Levitsky, CSO

ALX Oncology Highlights Focused Evorpacept Development Plan, Clinical Progress and Corporate Updates at R&D Day Webcast Event

On March 5, 2025 ALX Oncology Holdings Inc., ("ALX Oncology" or the "Company") (Nasdaq: ALXO), a clinical-stage biotechnology company advancing therapies that boost the immune system to treat cancer and extend patients’ lives, reported that it will highlight progress across its clinical pipeline, including continued advancement of investigational CD47-blocker evorpacept and planned entry into the clinic of its novel EGFR-directed ADC clinical candidate ALX2004, and provide key business and financial updates in an R&D Day webcast event today (Press release, ALX Oncology, MAR 5, 2025, View Source [SID1234650898]).

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ALX Oncology leadership will be joined by external key opinion leaders in the oncology field, Paula R. Pohlmann, M.D., M.S., Ph.D., Chief, Clinical Research, Department of Breast Oncology, and Associate Professor, Department of Breast Medical Oncology and Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, and Eric Van Cutsem, M.D., Ph.D., Professor of Gastroenterology and Digestive Oncology, University Hospitals Gasthuisberg and KU Leuven in Leuven, Belgium.

"Our conviction in evorpacept’s potential to deepen responses to important available anti-cancer antibody therapies, particularly in patients with HER2-positive cancers, has been strengthened by recent data. These results support our confidence moving into further clinical trials evaluating evorpacept in breast and colorectal cancers and pave additional regulatory paths forward," said Jason Lettmann, Chief Executive Officer at ALX Oncology. "We look forward to our near-term milestones with ASPEN-03 and ASPEN-04 topline results in head and neck cancer and discussion with the FDA regarding the registrational path in gastric cancer based on the ASPEN-06 data. To ensure that the company is strongly positioned to focus on our highest priority programs, we are streamlining our organization and prioritizing resources to execute on our current studies, progress our de-risked anti-cancer antibody combinations for evorpacept, as well as advance our novel ADC into the clinic. In order to achieve these additional value generating milestones for breast cancer, colorectal cancer and ALX2004 with our existing cash, we are optimizing resources and making the difficult decision to reduce our workforce, primarily in preclinical research. We look forward to sharing more information at today’s R&D Day event, which provides an opportunity for our leadership team and leading clinicians to detail our most recent data, scientific progress and corporate strategy."

Evorpacept Clinical Program Updates

During the R&D Day event, ALX Oncology leadership will discuss the mechanistic rationale and clinical data that support further development of evorpacept with anti-cancer antibodies. In addition to updates on ongoing trials leveraging this combination approach, new plans will be introduced around the initiation of studies evaluating evorpacept in combination with trastuzumab in HER2-positive breast cancer and in combination with cetuximab in colorectal cancer (CRC). Both are anticipated to initiate in the first half of 2025.

Drs. Pohlmann and Van Cutsem will also discuss current treatment paradigms and unmet needs within these cancers, and how evorpacept may provide a new treatment option for patients in the future.

Introduction of New EGFR-Targeted ADC with IND Submission Planned for Q1 2025

During the R&D Day event, Jaume Pons, Ph.D., will introduce a new ALX Oncology ADC clinical candidate, ALX2004. This is a potential best- and first-in-class compound that is designed to optimize ADC-based mechanisms of anti-tumor activity and has demonstrated potent anti-tumor activity in multiple clinically relevant xenograft models. ALX Oncology intends to submit an Investigational New Drug (IND) application for ALX2004 to the U.S. Food & Drug Administration (FDA) in Q1 2025.

Corporate and Financial Updates

In order to support the newly planned clinical trial programs in breast cancer and CRC, ALX Oncology has conducted a strategic prioritization and resource optimization exercise resulting in substantial decreases in preclinical research investments, including an approximately 30% workforce reduction primarily in the preclinical research function. As a result, ALX Oncology now expects its cash runway to extend into Q4 of 2026.

R&D Day Webcast Information

The ALX Oncology virtual R&D Day will be webcast live and a replay will be available after the event by visiting the "Investors" section of ALX Oncology’s website and selecting "Events and Presentations."

Date & Time: Wednesday, March 5, 2025, 6:00 a.m. PT/9:00 a.m. ET
Webcast Access: View Source

Sandoz reports strong FY 2024 results and Q4 2024 sales

On March 5, 2025 Sandoz (SIX: SDZ / OTCQX: SDZNY), the global leader in generic and biosimilar medicines, reported results for the full year and net sales for the fourth quarter of 2024 (Press release, Sandoz, MAR 5, 2025, View Source [SID1234650889]).

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KEY FULL-YEAR FIGURES

Change %
USD millions unless indicated otherwise 2024 2023 USD cc
Generics 7,504 7,432 1 2
Biosimilars 2,853 2,215 29 30
Net sales to third parties 10,357 9,647 7 9
Operating income 307 375 (18) 5
Net income 1 80 (99) nm
Diluted earnings per share (USD) 0.00 0.18 nm nm

Core results
Core EBITDA 2,080 1,743 19 24
Core EBITDA margin (%) 20.1 18.1
Core net income 1,176 953 23 28
Core diluted earnings per share (USD) 2.71 2.20 23 28
Management free cash flow 1,112 99
Net debt to core EBITDA ratio 1.6x 1.8x
Core ROIC (%) 12.3 9.8

nm = not meaningful

Richard Saynor, CEO of Sandoz, said: "We delivered strong results in our first full year as an independent company. At the same time, we made excellent progress in transforming the business, providing sustainable platforms for future growth, while all three regions grew net sales. We produced strong double-digit biosimilars sales growth in both the full year and fourth quarter, with generics growth accelerating in the second half. We also expanded our core EBITDA margin for the full year, driven by the strength of our biosimilars and increasing operating leverage. This was further helped by the transformation program launched in early 2024.

"As we look to 2025, we expect the positive momentum in the business to continue. We anticipate contribution from several exciting biosimilar launches, including Pyzchiva and Tyruko in the US and Wyost/Jubbonti in Europe and the US. These will add to an already-growing in-market portfolio and contribute to margin expansion. In addition, we will continue to build on our industry-leading pipeline across generics and biosimilars. Our 2025 guidance and mid-term outlook reflect the confidence we have in the strategic roadmap, our ability to expand patient access further, as well as the many attractive opportunities ahead."

2024 STRATEGIC PROGRESS

2024 saw a number of biosimilar launches, beginning in January, when Tyruko (natalizumab) was launched in Germany. The product was available in 11 markets by the end of the year and is ramping up steadily. In April, Sandoz leveraged a private-label agreement in the US to accelerate patient switching to its biosimilar; Hyrimoz (adalimumab) is now the leading adalimumab biosimilar in the US market. In July, the Company launched Pyzchiva (ustekinumab) in Europe and, by the end of the year, the product had been rolled out in 20 markets and took a leading share of the ustekinumab biosimilar market.

Sandoz became the leading biosimilars provider on a worldwide basis. Moving up to #3 in the US during the period, the Company reaffirms its ambition to occupy the leading position in that market. The Company added five assets to its industry-leading biosimilars pipeline, which now comprises 28 molecules. Pembrolizumab and nivolumab, two oncology assets addressing more than USD 40 billion of loss-of-exclusivity value, entered late-stage clinical trials. Around 450 generic pipeline products, in addition to its 28 biosimilars, support the goal of sustainable long-term growth.

Sandoz also made good progress on simplifying the business and adapting its processes. It achieved its planned reduction to 15 internal manufacturing sites, while increasing capacity at its remaining sites through extensions and efficiencies. The Company also made further headway in its consolidation of external suppliers, with the exit of around 100 finished-dosage-form suppliers ongoing and a similar number identified. Finally, Sandoz initiated a transformation program to make its organization more agile, simpler and more efficient.

GUIDANCE: 2025

The Company anticipates further major biosimilar launches in 2025, including Pyzchiva and Tyruko in the US, as well as Wyost/Jubbonti (denosumab) in Europe and the US. Price erosion is expected to return to normalized levels of a low to mid-single-digit percentage. Sandoz anticipates core EBITDA-margin expansion by focusing on product mix, simplification of its external network and its ongoing transformation program. As a result, Sandoz expects, in FY 2025:

net sales to grow by a mid-single digit percentage in constant currencies
a core EBITDA margin of around 21%
The guidance excludes any impacts of unforeseen events or unconfirmed developments. This includes potential trade tariffs emanating from the US government.

MID-TERM OUTLOOK

Reaffirming its mid-term outlook to 2028, the Company expects:

net sales to grow annually by mid-single digit in constant currencies
the core EBITDA margin to increase to 24-26%
the annual dividend to represent 30-40% of full-year core net income
FOURTH-QUARTER AND FULL-YEAR SALES

Net sales for the fourth quarter were USD 2.7 billion, up by 9% in constant currencies. Volume contributed eight percentage points of growth, with the balance reflecting favorable pricing. Strong double-digit growth in biosimilars was driven by recent launches and strong momentum in the base business, while generics delivered solid growth that reflected recent launches.

Net sales for the full year were USD 10.4 billion, up by 9% in constant currencies. Volume contributed 10 percentage points of growth, partly offset by price erosion of one percentage point. The growth in sales primarily reflected the strong double-digit performance in biosimilars, continued demand in the base business, new launches in the US and Europe, as well as the acquisition of Cimerli in the US.

Net sales by business

Change % Change %
USD millions unless indicated otherwise Q4 2024 Q4 2023 USD cc* FY 2024 FY 2023 USD cc*
Generics 1,946 1,920 1 4 7,504 7,432 1 2
Biosimilars 769 623 23 25 2,853 2,215 29 30
Net sales to third parties 2,715 2,543 7 9 10,357 9,647 7 9

* In constant currencies

Generics overview
Net sales for the fourth quarter were USD 1.9 billion, up by 4% in constant currencies. Net sales for the full year were USD 7.5 billion, up by 2% in constant currencies.

Growth in Europe accelerated in the second half of the year, mainly driven by recent launches. Strong momentum also continued in the International region, reflecting favorable pricing dynamics and demand for antifungal agent Mycamine, partly offset by the divestment in the year of the Sandoz Chinese business. The decline in North America generics sales was due to price erosion on the mature products portfolio in the US, partly offset by new launches in the fourth quarter in the US.

Biosimilars overview
Net sales for the fourth quarter were USD 769 million, up 25% in constant currencies. Net sales for the full year were USD 2.9 billion, up 30% in constant currencies. The biosimilars share of total net sales increased from 23% in FY 2023 to 28% in FY 2024.

The strong double-digit biosimilars growth reflects the uptake of Hyrimoz in the US through the private- label agreement with Cordavis as well as the Sandoz Hyrimoz and unbranded adalimumab-adaz. In addition, the acquisition of Cimerli, the continued strong demand for the first-ever biosimilar, Omnitrope (somatropin), and the launches of Tyruko and Pyzchiva in Europe all contributed to the strong performance.

Net sales by region[5]

Change % Change %
USD millions unless indicated otherwise Q4 2024 Q4 2023 USD cc FY 2024 FY 2023 USD cc
Europe 1,367 1,272 7 8 5,363 5,023 7 6
North America 695 615 13 14 2,437 2,129 14 15
International 653 656 0 6 2,557 2,495 2 8
Net sales to third parties 2,715 2,543 7 9 10,357 9,647 7 9

Europe overview
Net sales for the fourth quarter were USD 1.4 billion, up 8% in constant currencies. Net sales for the full year were USD 5.4 billion, up 6% in constant currencies.

Strong growth in biosimilars continued, led by demand for Omnitrope and the contribution from the recent launch of Tyruko and Pyzchiva. Generics momentum accelerated in the second half of the year, driven by recent launches.

North America overview
Net sales for the fourth quarter were USD 695 million, up 14% in constant currencies. Net sales for the full year were USD 2.4 billion, up 15% in constant currencies.

Growth was driven by biosimilars with the ongoing uptake of Hyrimoz in the US, the acquisition of Cimerli, market share gains for Omnitrope in the US, and the launch of Wyost/Jubbonti in Canada. In generics, price erosion on the mature portfolio in the US was partly offset by new launches in the fourth quarter, including paclitaxel.

International overview
Net sales for the fourth quarter were USD 653 million, up 6% in constant currencies. Net sales for the full year were USD 2.6 billion, up 8% in constant currencies.

This was primarily a result of strong volume growth across both generics and biosimilars, the contribution from the acquisition of Mycamine in the prior year, favorable price dynamics and recent launches, partly offset by the divestment of the Chinese business in the second quarter.

OPERATING RESULTS

Change %
USD millions unless indicated otherwise 2024 2023 USD cc

Net sales to third parties 10,357 9,647 7 9
Gross profit 4,926 4,564 8 10
EBITDA 820 914 (10) (1)
Operating income 307 375 (18) 5

Core results
Core gross profit 5,253 4,913 7 9
% of net sales to third parties 50.7 50.9
Core EBITDA 2,080 1,743 19 24
% of net sales to third parties 20.1 18.1
Core operating income 1,821 1,488 22 28
% of net sales to third parties 17.6 15.4

Core gross profit amounted to USD 5.3 billion compared to USD 4.9 billion in the prior year, resulting in a core gross profit margin of 50.7% compared to 50.9% in 2023. Adjusted for sales to the former parent, the core gross profit margin was 49.4% in 2023. The favorable product mix from strong double-digit biosimilars growth and operational improvements was partly offset by price erosion and inflation on cost of goods sold, which impacted the results in the first half of 2024.

Core EBITDA was USD 2.1 billion versus USD 1.7 billion in the prior year, resulting in a core EBITDA margin of 20.1% compared to 18.1% in 2023. Adjusted for sales to the former parent and the ramp-up of standalone costs, the core EBITDA margin was 16.9% in 2023. The strong increase was driven by improvement in core gross profit margin, leveraging expenses from a growing topline and initial savings from our transformation program.

EBITDA was USD 820 million versus USD 914 million in the prior year. Core adjustments for EBITDA in 2024 were USD 1.3 billion compared to USD 829 million in 2023. These were mainly driven by separation costs of USD 348 million, transformation costs of USD 233 million and costs of rationalization of internal manufacturing sites of USD 78 million. In addition, adjustments for legal costs of USD 598 million were mainly driven by the legacy US generic antitrust class action litigation.

NON-OPERATING RESULTS

Change %
USD millions unless indicated otherwise 2024 2023 USD cc

Net financial result (318) (245) (30) (41)
Income taxes 12 (50) nm nm
Net income 1 80 nm nm
Diluted earnings per share (USD) 0.00 0.18 nm nm

Core results
Core net financial results (325) (251) (29) (41)
Core income taxes (320) (284) (13) (17)
Core effective tax rate (%) 21.4 23.0
Core net income 1,176 953 23 28
Core diluted earnings per share (USD) 2.71 2.20 23 28

nm = not meaningful

The core net financial result was an expense of USD 325 million compared to an expense of USD 251 million in 2023. The increase was primarily a result of our new standalone financing structure following the spin-off from our former parent and net currency result.

The core effective tax rate was 21.4% compared to 23.0% in the prior year, mainly driven by the geographical allocation of pre-tax income and losses.

Core net income was USD 1.2 billion, compared to USD 953 million in the prior year, mainly driven by a higher core operating income, partly offset by a higher core net financial result and core income taxes.

Core diluted earnings per share were USD 2.71, compared to USD 2.20 in the prior year. The weighted average number of shares diluted was 434.0 million in 2024.

CASH FLOW

Change
USD millions 2024 2023 in USD

Net cash flow from operating activities 656 362 294
Cash flows used for net CAPEX (554) (586) 32
Free cash flow 98 (234) 332
Management free cash flow 1,112 99 1,013

The Company generated net cash flows from operating activities of USD 656 million, compared with USD 362 million in the prior year. This was driven by working capital enhancements through improvements in receivables and a lower rate of increase in inventories following the spin-off from our former parent, partly offset by two deposited settlement amounts relating to the legacy US legal matters.

Cash flows used for capital expenditures (CAPEX) were USD 554 million compared to USD 586 million in the prior year. This includes investments in our new biosimilars facility in Slovenia and new development capabilities in Slovenia and Germany, as well as separation-related investments in facilities and technology. These investments are mainly focused on meeting growing demand for our current and future biosimilars and include a new biosimilar production plant in Lendava, Slovenia, and investments in the Sandoz antibiotics network in Kundl, Austria.

Free cash flow was USD 98 million compared to negative USD 234 million in the prior year. The improvement was mainly due to net cash flows from operating activities.

Management free cash flow, defined as free cash flow adjusted for one-off items, was USD 1.1 billion, a USD 1.0 billion improvement compared to USD 99 million in the prior year. The increase was mainly driven by higher core EBITDA and improvement in net working capital.

CAPITAL RESOURCES

December 31 Change
USD millions unless indicated otherwise 2024 2023 in USD

Inventories 2,800 2,700 100
Trade receivables 2,205 2,615 (410)
Trade payables 1,519 1,593 (74)
Net working capital 3,486 3,722 (236)
Total financial debts (incl. derivative financial instruments) 4,535 4,259 276
Cash and cash equivalents 1,191 1,109 82
Net debt 3,329 3,115 214
Net debt to core EBITDA ratio 1.6x 1.8x
Total equity 8,164 8,654 (490)
Core ROIC (%) 12.3 9.8

Net working capital decreased by USD 236 million compared to the prior year. Inventories increased by USD 100 million, mainly driven by the build-up for product launches and higher sales. Trade receivables decreased by USD 410 million while trade payables remained broadly in line with the prior year.

Total financial debts increased by USD 276 million, resulting mainly from the issuance of a EUR senior fixed rate note in September 2024 of EUR 600 million (USD 660 million), partly offset by favorable currency translation effects and repayments of local debt facilities.

Cash and cash equivalents increased by USD 82 million, mainly driven by net proceeds from the issuance of the senior fixed rate note and net cash flows from operating activities, partly offset by the first dividend payment of USD 215 million and the Cimerli acquisition of USD 188 million.

As a result, net debt increased to USD 3.3 billion on December 31, 2024 compared to USD 3.1 billion on December 31, 2023. Net debt to core EBITDA ratio decreased to 1.6 times on December 31, 2024, compared to 1.8 times in the prior year, reflecting the strong growth in core EBITDA in 2024.

Total equity decreased by USD 490 million. Net income of USD 1 million for the year was primarily offset by the dividend payment of USD 212 million and unfavorable currency-translation differences of USD 323 million.

Core ROIC was 12.3% versus 9.8% in the prior year, driven mainly by strong growth in core operating income.

DIVIDEND

The Board of Directors recommends a dividend of CHF 0.60 per share, representing 24% of core net income in line with Company guidance. This represents a CHF 0.15 per share increase compared to prior year. Shareholders will vote on this proposal at the Annual General Meeting on April 15, 2025.

INTEGRATED ANNUAL REPORT

The Company published its 2024 Integrated Annual Report today, which can be found online here.

KEY LINKS

Webcast – Live at 9am CET, March 5, 2025.
Analyst call presentation
Analyst consensus

CALENDAR

Sandoz will hold its Annual General Meeting on April 15, 2025. The Company intends to publish its first-quarter sales update on April 30, 2025.

DISCLAIMER

This media release contains forward-looking statements, which offer no guarantee with regard to future performance. These statements are made on the basis of management’s views and assumptions regarding future events and business performance at the time the statements are made. They are subject to risks and uncertainties including, but not confined to, future global economic conditions, exchange rates, legal provisions, market conditions, activities by competitors and other factors outside of the control of Sandoz. Should one or more of these risks or uncertainties materialize or should underlying assumptions prove incorrect, actual outcomes may vary materially from those forecasted or expected. Each forward-looking statement speaks only as of the date of the particular statement, and Sandoz undertakes no obligation to publicly update or revise any forward-looking statements, except as required by law.
This media release includes non-IFRS financial measures as defined by Sandoz. An explanation of non-IFRS measures can be found in the Supplementary financial information of the 2024 Integrated Annual Report.

SECuRE trial update: 92% of pre-chemo participants experience greater than 35% drop in PSA levels across all cohorts. Cohort Expansion Phase commences

On March 5, 2025 Clarity Pharmaceuticals (ASX: CU6) ("Clarity" or "Company"), a clinical-stage radiopharmaceutical company with a mission to develop next-generation products that improve treatment outcomes for children and adults with cancer, reported the completion of the Dose Escalation Phase of the SECuRE trial (NCT04868604) (Press release, Clarity Pharmaceuticals, MAR 5, 2025, View Source [SID1234650876]). The SRC recommended the trial progress to the Cohort Expansion Phase (Phase II) at the 8 GBq of 67Cu-SAR-bisPSMA dose level based on the safety and efficacy data demonstrated in every cohort of the study.

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Across cohorts 1-4 of the SECuRE study, 68% of participants have shown reductions in PSA levels, despite the vast majority of the participants (77%) only receiving a single dose of 67Cu-SAR-bisPSMA. Most of these participants had a high level of bone metastases at study entry (77.3%), a high median PSA of 112.86 ng/mL (range 0.1-1503.1) and were heavily pre-treated with ≥3 lines of therapy (63.6%). Disease control based on radiographic assessment (complete response + partial response + stable disease) was achieved in 78% of the participants so far (including 2 partial responses and 1 complete response observed to date based on the RECIST assessment). The complete response was seen in a patient dosed twice at 12 GBq. This is the second complete response recorded following 67Cu-SAR-bisPSMA treatment, first being the patient previously reported to have a complete response following 2 doses at 8 GBq (first dose administered through the SECuRE trial, and a second dose administered under the the United States [US] Food and Drug Administration [FDA] Expanded Access Program [EAP]).

Safety profile of 67Cu-SAR-bisPSMA is favourable across cohorts 1-4 with the majority of AEs being Grade 1-2. Anaemia and thrombocytopenia were the most prevalent AEs among the haematological events. No overall trends in other haematological parameters or renal safety were observed in any of the cohorts. Only 1 DLT has been reported in the trial (transient Grade 4 thrombocytopenia, which improved to Grade 3 after 2 weeks) in a patient in the highest dose cohort (cohort 4). This participant had a baseline PSA of 1503.12 ng/mL, had been treated with multiple lines of therapy, including chemotherapy in the mCRPC setting and multiple doses of 177Lu-PSMA-617, and had bone metastases prior to entering the study. The participant’s baseline characteristics may have contributed to the lowering of the platelet levels. Despite the unfavourable prognosis of this participant, which included a very high PSA and being heavily pre-treated, 1 cycle of 67Cu-SAR-bisPSMA was still able to reduce his PSA by 10.7% (to 1341.80 ng/mL).

Pre-chemotherapy participants
Thirteen participants across cohorts 1-4 in the SECuRE trial were naïve to taxanes in the mCRPC setting (pre-chemotherapy), including 2 in cohort 1 and 3 in cohort 2. The majority of pre-chemotherapy participants had bone metastases (69.2%) with a median PSA of 42.41 ng/mL (range 0.1-182.4) at study entry. Almost half of these participants received ≥3 lines of therapy prior to trial enrolment (46.2%).

Despite the heavy disease burden and the majority of participants only receiving single doses of 67Cu-SAR-bisPSMA, there was an outstanding result observed in the pre-chemotherapy setting. Out of the total of 13 pre-chemotherapy participants across all cohorts, 12 had PSA drops greater than 35%. PSA reductions greater than 50% were reached in 61.5% (8/13) of participants, and reductions of 80% or more were achieved in 46.2% (6/13) of participants. Disease control based on the RECIST assessment was also observed in 11 out of 12 pre-chemotherapy participants (92%) who had measurable disease at baseline. One participant reached a complete response with 2 doses of 12 GBq in cohort 4, 2 participants had partial responses (cohort 2 and cohort 4), and 8 participants achieved stable disease at this time.

Three participants in the pre-chemotherapy setting of the SECuRE trial had previously been treated with actinium-225 based radioligand therapies (RLT) and, in 1 case, in combination with lutetium-177 based therapy. All 3 participants showed reductions in PSA levels following treatment with 67Cu-SAR-bisPSMA in the trial. Notably, 1 of these 3 participants showed a PSA reduction of 83.4% following the administration of 2 doses of 12 GBq of 67Cu-SAR-bisPSMA in cohort 4, despite being heavily pre-treated. The lines of therapy administered to the patient prior to the SECuRE trial enrollment included androgen deprivation therapy (ADT), 2 androgen receptor pathway inhibitors (ARPIs), autologous cellular immunotherapy, and investigational agents (immunotherapy and 177Lu-PSMA-I&T plus 225Ac-J591).

Safety assessment in pre-chemotherapy participants was comparable to the overall patient population with most AEs being Grade 1 and Grade 2.

Cohort Expansion Phase
Based on the data from cohorts 1-4, the SRC recommends the SECuRE trial progress to Cohort Expansion (Phase II) at an 8 GBq dose level, with an increase in the total number of cycles from up to 4 to up to 6. This recommendation is based on the favourable safety profile of 67Cu-SAR-bisPSMA observed to date.

Cohort 2 (single dose of 8 GBq of 67Cu-SAR-bisPSMA) with 3 participants had the highest rate of PSA response in the trial, and all participants in the cohort had disease control based on the RECIST assessment (including one partial response). The PSA reductions were 81.4%, 95.2% and 99.4%. Only 1 participant in this cohort developed 67Cu-SAR-bisPSMA-related AEs (Grade 1 dry mouth and altered taste, both improved, and Grade 2 fatigue, resolved). No haematological toxicity was reported in the cohort.

The first patient to receive 2 doses of 67Cu-SAR-bisPSMA at 8 GBq (first dose through the SECuRE trial and second dose under the US EAP) achieved a complete anatomical, molecular and biochemical response (assessed by the RECIST criteria, positron emission tomography [PET] and PSA, respectively). He had been heavily pre-treated (chemotherapy in the neoadjuvant setting, ADT, 2 ARPIs and an investigational agent) prior to entering the SECuRE study. The patient’s recent follow up showed that he remains with undetectable PSA for almost 16 months, having received his first dose of 67Cu-SAR-bisPSMA over 20 months ago (June 2023). A recent PSMA PET showed no signs of recurrent or metastatic disease. Most AEs related to 67Cu-SAR-bisPSMA were mild or moderate, with the majority having either improved or resolved over time.

Based on these safety and efficacy data, where exceptional efficacy signals were observed at lower radiation doses, 8 GBq was chosen as an optimal dose for the Cohort Expansion Phase.

The SECuRE trial protocol has been amended to include evaluation of mCRPC participants who have not received chemotherapy in the metastatic (pre-chemotherapy) setting. This amendment is aligned with Clarity’s strategy of bringing 67Cu-SAR-bisPSMA to participants with earlier stages of the disease and is based on the promising safety and efficacy data, especially in pre-chemotherapy participants of the SECuRE trial.

The protocol amendment also incorporates an increase in the number of participants in the Cohort Expansion Phase of the trial from 14 to 24, in which a subset of participants will receive the combination of 67Cu-SAR-bisPSMA with enzalutamide, an ARPI. These changes are aimed at optimising the development of all of Clarity’s products in prostate cancer, following ongoing discussions with and advice from many important global medical experts in the field of prostate cancer, including the Company’s Clinical Advisory Board members, Prof Louise Emmett and Prof Oliver Sartor, as well as the SRC.

Clarity’s Executive Chairperson, Dr Alan Taylor, commented, "The SECuRE trial continues to generate extraordinary results, and we thank our team, Principal Investigators, members of the SRC, and especially the participants who have contributed to the study. Seeing the safety profile and already observing impressive signs of efficacy (despite the majority of participants only receiving a single cycle of 67Cu-SAR-bisPSMA and the primary focus of the Dose Escalation Phase being safety assessments), we are thrilled to progress to Phase II, the Cohort Expansion Phase, of our theranostic SECuRE trial.

"Dose escalation trial design has not been routinely used in other RLT studies. By pioneering this approach with the SECuRE trial, Clarity was looking to systematically evaluate the safety of 67Cu-SAR-bisPSMA in the context of its therapeutic effect. By gradually increasing the dose from one cohort to the next, we have minimised the risk of AEs and established a favourable safety profile for patients, while also demonstrating that 67Cu-SAR-bisPSMA is effective.

"We are looking forward to executing our strategy of bringing 67Cu-SAR-bisPSMA to earlier lines of prostate cancer therapy with the recent protocol amendment, given the exciting data in pre-chemotherapy participants. We are also increasing the number of participants in the Cohort Expansion Phase. This decision is partly motivated by the increased demand from oncologists to include their participants into the trial, but it is also led by our decision to explore potential benefits of using a combination of 67Cu-SAR-bisPSMA with enzalutamide, following consultation with world-leading prostate cancer oncologists and nuclear medicine physicians.

"With our focus on treating earlier stage disease (pre-chemotherapy in the mCRPC setting), it is an incredible outcome to have 12 out of 13 pre-chemotherapy participants in the trial experiencing greater than 35% reductions in PSA and almost half of the 13 experiencing drops of 80% or greater. PSA reductions were seen across all cohorts, including the lowest 4 GBq cohort where all pre-chemotherapy participants exhibited greater than 50% drops in PSA from a single dose. Remarkably, one of those participants has had 4 additional doses under EAP and achieved disease control for over 2 years since first treatment. The results from 3 pre-chemotherapy participants who received 8 GBq of 67Cu-SAR-bisPSMA have been outstanding with a favourable safety profile and excellent efficacy, where PSA reductions were greater than 80% for all participants and above 95% for 2 out of the 3 participants, with all of them achieving radiographic disease control and 1 showing a complete response to date.

"The very compelling safety and efficacy data for SAR-bisPSMA that we continue generating stems from Clarity’s strong adherence to the highest level of scientific and clinical research. At the heart of this rigorous approach is the dimer "bis" molecule developed at the benchtop of Australian science and translated into the clinic. When optimising the PSMA molecule, the goal was to create an ideal candidate for both therapy and diagnosis of prostate cancer. We wanted to overcome the shortfalls of the current generation of PSMA-targeting products, increasing not only the amount of product in the lesions, but also how long the product is retained in the lesions over time. We are now seeing these results in the clinic with 67Cu-SAR-bisPSMA in the SECuRE trial and with 64Cu-SAR-bisPSMA in our diagnostic trials.

"The recent receipt of 3 Fast Track Designations from the US FDA for our optimised SAR-bisPSMA molecule, one of which was based off the data presented here, is testament to the high quality of this data, but also reflects a critical need for novel solutions in prostate cancer management. With an estimated combined market value of approximately US$10-15 billion by 2030 for PSMA-targeted products, we are hoping to address the evident high unmet need in this segment, from first diagnosis to the treatment of metastatic disease, and improve treatment outcomes for men with prostate cancer around the world.

"We look forward to swiftly recruiting into the next phase of the SECuRE trial, moving towards a Phase III pivotal trial. We are very excited about what the future holds for this promising product and are working tirelessly to bring it to people who need it most in a timely manner, whilst adhering to the highest standards of clinical research."

About the SECuRE trial
The SECuRE trial (NCT04868604)1 is a Phase I/IIa theranostic trial for identification and treatment of participants with PSMA-expressing mCRPC using 64Cu/67Cu-SAR-bisPSMA. 64Cu-SAR-bisPSMA is used to visualise PSMA-expressing lesions and select candidates for subsequent 67Cu-SAR-bisPSMA therapy. The trial is a multi-centre, single arm, dose escalation study with a cohort expansion involving approximately 54 participants in the US and Australia. The overall aim of the trial is to determine the safety and efficacy of 67Cu-SAR-bisPSMA for the treatment of prostate cancer.

About SAR-bisPSMA
SAR-bisPSMA derives its name from the word "bis", which reflects a novel approach of connecting two PSMA-targeting agents to Clarity’s proprietary sarcophagine (SAR) technology that securely holds copper isotopes inside a cage-like structure, called a chelator. Unlike other commercially available chelators, the SAR technology prevents copper leakage into the body. SAR-bisPSMA is a Targeted Copper Theranostic (TCT) that can be used with isotopes of copper-64 (Cu-64 or 64Cu) for imaging and copper-67 (Cu-67 or 67Cu) for therapy.

67Cu-SAR-bisPSMA and 64Cu-SAR-bisPSMA are unregistered products. The safety and efficacy of 67Cu-SAR-bisPSMA and 64Cu-SAR-bisPSMA have not been assessed by health authorities such as the US FDA or the Therapeutic Goods Administration (TGA). There is no guarantee that these products will become commercially available.

About Prostate Cancer
Prostate cancer is the second most common cancer diagnosed in men globally and the fifth leading cause of cancer death in men worldwide2. Prostate cancer is the second-leading causes of cancer death in American men. The American Cancer Institute estimates in 2025 there will be about 313,780 new cases of prostate cancer in the US and around 35,770 deaths from the disease.