On April 29, 2025 Cellworks Group Inc., a leader in Personalized Therapy Decision Support and Best-in-Class PTRS, reported compelling results from a new study demonstrating the ability of the Cellworks Platform to identify patients with high microsatellite instability (MSI-H) who may not respond to immune checkpoint inhibitors (ICIs), despite MSI-H status (Press release, Cellworks, APR 29, 2025, View Source [SID1234652343]). Results from the study were showcased in a poster presentation titled, Use of Biosimulation to Predict Immune Checkpoint Inhibitor Resistance in Patients with High Microsatellite Instability as part of the AACR (Free AACR Whitepaper) Annual Meeting 2025 taking place April 25-30, 2025 at the McCormick Place Convention Center in Chicago.

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While immune checkpoint inhibitors (ICIs) such as pembrolizumab are considered a standard-of-care for MSI-H cancers, MSI-H status alone is not a definitive predictor of treatment success. In this study, Cellworks applied its unique mechanistic Computational Biology Model (CBM) to biosimulate patient-specific responses to ICIs. The computational biosimulation process in the study uncovered molecular signatures of resistance in MSI-H patients who were predicted to have poor response to ICIs, providing a deeper understanding of why some MSI-H patients fail to benefit from immunotherapy.

Key Findings

Efficacy Scores Significantly Higher in MSI-H Patients. MSI-H patients demonstrated significantly higher pembrolizumab efficacy scores compared to microsatellite stable (MSS) patients in both STAD (average ES: 20.5 vs. 3.2, p < 0.001) and CRC (average ES: 13.4 vs. 2.4, p < 0.001).
Large Subset of MSI-H Patients Predicted to Have Low ICI Response. Despite being MSI-H, 59% of STAD and 81% of CRC patients were identified as low pembrolizumab responders.
Molecular Drivers of Resistance Identified. In MSI-H patients classified as low pembrolizumab responders, higher rates of NOTCH2, EGFR, and EZH2 amplifications, along with TP53 loss-of-function mutations, were identified. In MSI-H/ES-L CRC patients, MYC amplification was significantly enriched (p < 0.05).
"These findings highlight the power of using patient-specific drug response methods to move beyond MSI-H status and identify critical molecular drivers of immune checkpoint inhibitor resistance," said Dr. James Wingrove, Chief Development Officer at Cellworks and presenting author of the study. "By identifying patients unlikely to respond to ICIs, we can help oncologists personalize treatment strategies and improve outcomes for MSI-H patients who may otherwise receive ineffective therapies."

"This study demonstrates the importance of looking beyond MSI status to understand immune checkpoint inhibitor resistance at a molecular level," said Dr. Michael Castro, Chief Medical Officer at Cellworks. "Our biosimulation revealed that MSI-H patients with low predicted response to pembrolizumab frequently harbored alterations such as NOTCH2, EGFR, and EZH2 amplifications, as well as TP53 loss-of-function mutations in STAD, and MYC amplifications in CRC. Identifying these resistance-associated biomarkers can help guide clinicians in selecting more effective, personalized treatment strategies for MSI-H patients who may not benefit from ICIs alone."

Study Design

Cellworks developed a mechanistic Computational Biology Model (CBM) that can be personalized based on a patient’s tumor-based genomic profile, revealing signaling pathway dysregulation and patient-specific drug response. Output from the model was used to identify MSI-H patients who may have a poorer response to ICIs. Computational biosimulation was performed using real-world retrospective cohorts of 423 STAD patients and 534 CRC patients (TCGA). MSI measurements were provided by TCGA. Efficacy scores based on biosimulated composite cell growth in response to disease and therapy were generated on all patients for pembrolizumab. Molecular rationales for ICI resistance were identified for MSI-H patients with low pembrolizumab efficacy scores.

The Cellworks Platform

The Cellworks Platform performs computational biosimulation of protein-protein interactions, enabling in silico modeling of tumor behavior using comprehensive genomic data. This allows for the evaluation of how personalized treatment strategies interact with the patient’s unique tumor network. Multi-omic data from an individual patient or cohort is used as input to the in silico Cellworks Computational Biology Model (CBM) to generate a personalized or cohort-specific disease model.

The CBM is a highly curated mechanistic network of 6,000+ human genes, 30,000 molecular species and 600,000 molecular interactions. This model along with associated drug models are used to biosimulate the impact of specific compounds or combinations of drugs on the patient or cohort and produce therapy response predictions, which are statistically modeled to produce a qualitative therapy response score for a specific therapy. The Cellworks CBM has been tested and applied against various clinical datasets with results provided in over 125 presentations and publications with global collaborators.

On April 29, 2025 Ensoma, a genomic medicines company advancing the future of medicine through one-time, in vivo therapies designed to precisely and durably engineer the hematopoietic system to treat chronic diseases, reported it will present preclinical data and manufacturing advancements at the American Society of Gene & Cell Therapy (ASGCT) (Free ASGCT Whitepaper) 28th Annual Meeting, hosted May 13-17 in New Orleans (Press release, Ensoma, APR 29, 2025, View Source [SID1234652342]).

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The company’s poster presentations will highlight key programs that leverage its in vivo HSC engineering platform. Ensoma combines a unique delivery system with an advanced gene engineering toolkit, offering the potential for durable, transformative therapies to address chronic diseases, improve patient access and significantly reduce treatment burden. The platform uses virus-like particles (VLPs) that preferentially bind to HSCs, efficiently deliver DNA to the nucleus and de-target the liver. With a 35-kilobase cargo capacity, these VLPs carry a diverse range of genomic engineering constructs, including control elements that enable specific cargo expression in targeted cells, from single base edits to large multi-gene insertions.

"We look forward to presenting preclinical data at ASGCT (Free ASGCT Whitepaper) that underscore the potential of our in vivo HSC engineering platform to address complex genetic disorders and cancer," said Robert Peters, Ph.D., chief scientific officer of Ensoma. "Exciting new findings from our non-human primate studies reinforce the precision and effectiveness of our VLPs, showcasing their ability to safely deliver genetic therapies with targeted biodistribution and expression. With this strong progress, Ensoma remains on track to initiate our first clinical trial in the second half of 2025—marking a major step toward bringing this groundbreaking therapy to patients."

"Building on this momentum, our novel adenovirus production process is a significant milestone for Ensoma, ensuring the scalable and high-quality production of VLPs needed for clinical trials," said Dan Leblanc, chief technology officer of Ensoma. "This robust suspension manufacturing process is delivering consistent product yield and quality to support the clinical use of EN-374 for the treatment of X-CGD. It’s incredibly rewarding to see our platform move closer to delivering potentially transformative therapies to patients."

Poster Presentations at ASGCT (Free ASGCT Whitepaper) 28th Annual Meeting:

Title: In Vivo Engineering of Hematopoietic Stem Cells with Virus-like Particles to Generate Multi-Lineage CAR Immune Cell Therapy for Cancer (1783)
Poster Presentation Time/Date: 5:30-7:30 p.m. CT, Thursday, May 15
Location: Poster Hall I2
Presenter: Chirayu Chokshi, Ph.D., Ensoma

Data Summary: Ensoma will present updated data from its preclinical HER2 CAR program. An HSC-targeted VLP encoding lineage-specific regulatory elements to direct CAR expression resulted in robust generation of HSC-derived CAR-M, NK and T cells in vivo. This lineage-restricted, multi-cellular CAR therapy mediated tumor control and microenvironment remodeling, supporting Ensoma’s technology as a highly differentiated approach to addressing solid tumors.

Title: Novel In Vivo Gene Therapy Approach to Hematopoietic Stem Cell (HSC) Engineering Creates Durable HSC-Derived Neutrophils to Treat X-Linked Chronic Granulomatous Disease (1780)
Poster Presentation Time/Date: 5:30-7:30 p.m. CT, Thursday, May 15

Location: Poster Hall I2

Presenter: Sravya Kattula, Ph.D., Ensoma

Data Summary: Ensoma will present updated preclinical data from its X-CGD program with EN-374, which highlights the use of its VLP platform to efficiently modify HSCs in vivo and restore neutrophil function. In this preclinical study in a CGD mouse model, EN-374 provided durable gene correction in neutrophils to restore CYBB protein expression and activity. This study sets the foundation for Ensoma’s in vivo HSC gene therapy to reach the clinic and be applied to a range of genetic disorders that thus far have only been addressed with ex vivo gene therapies.

Title: Acute Safety and Biodistribution Profile of Hematopoietic Stem Cell (HSC) Targeting Virus-like Particles Based on Helper-dependent Adenovirus Serotype 5/35++ in Non-human Primates (1779)
Poster Presentation Time/Date: 5:30-7:30 p.m. CT, Thursday, May 15
Location: Poster Hall I2
Presenter: Patrick Au, Ph.D., Ensoma

Data Summary: Ensoma will present data from a non-human primate study evaluating the safety, biodistribution and transgene expression profiles of its HSC-targeting VLPs. Results showed favorable tolerability without any clinical signs of toxicity and a well-characterized biodistribution, supporting the continued development of Ensoma’s VLP-based platform as a safe and effective solution for in vivo HSC engineering.

Title: Development and Scale-up of a Novel Adenovirus Production Process (2016)
Poster Presentation Time/Date: 6:00-7:30 p.m. CT, Tuesday, May 13
Location: Poster Hall I2
Presenter: Chapman Wright, Ph.D., Ensoma

Data Summary: Ensoma will present the establishment of a novel, serum-free suspension manufacturing process for large-scale, high-efficiency VLP manufacturing. The presentation will address adaptation of an adherent cell line to a serum-free suspension cell culture, followed by a design-of-experiment strategy for efficient development of a clinical-scale production process.

On April 29, 2025 Shorla Oncology (‘Shorla’), a U.S.-Ireland specialty pharmaceutical company, reported that the U.S. Food and Drug Administration has granted approval for 100 mg/10mL multi-dose vial of TEPYLUTE, a ready-to-dilute formulation of thiotepa to treat breast and ovarian cancer, that eliminates the need for reconstitution and may reduce preparation time and errors offering more scheduling flexibility for their patients (Press release, Shorla Oncology, APR 29, 2025, View Source [SID1234652341]).

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"We are pleased to offer another viable treatment option for patients with breast and ovarian cancer," said Sharon Cunningham, Chief Executive Officer and Co-Founder of Shorla Oncology. "Once opened, our 100mg vial of TEPYLUTE is stable for 14 days when properly stored, giving providers the flexibility they need when preparing and administering this very important treatment.

TEPYLUTE is a ready to dilute formulation of a well-established, standard of care oncology drug thiotepa that has been manufactured as freeze-dried powder since the 1950s.

"This is a huge win for providers because TEPYLUTE avoids the need for complicated and time-consuming reconstitution," said Orlaith Ryan, Chief Technical Officer and Co-Founder of Shorla Oncology.

We are excited to bring TEPYLUTE to the US Market. It provides consistent dosing accuracy and allows for "just in time" preparation, which benefits everyone, especially patients." said Rayna Herman, Chief Commercial Officer, Shorla Oncology.

The American Cancer Society estimates that more than 300,000 women will be diagnosed with breast cancer in the U.S in 2025.2 About 20,890 women will be diagnosed with ovarian cancer in the U.S. in 2025.

On April 29, 2025 Pilatus Biosciences, a biotechnology company developing immunometabolic therapies for cancer, reported a preclinical publication in Cancer Discovery detailing the mechanism and therapeutic potential of its lead candidate, PLT012 (Press release, Pilatus Biosciences, APR 29, 2025, View Source [SID1234652340]).

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The paper, titled: "PLT012, a Humanized CD36-Blocking Antibody, Is Effective for Unleashing Anti-Tumor Immunity Against Liver Cancer and Liver Metastasis," establishes PLT012 as the first humanized antibody to target CD36, a lipid scavenger receptor implicated in immune dysfunction in metabolically hostile tumor microenvironments and highlights its efficacy in restoring anti-tumor immunity in hepatocellular carcinoma (HCC) and colorectal liver metastases.

CD36 is upregulated in immune cells exposed to lipid-rich, inflammatory environments and has emerged as a key driver of immune suppression in solid tumors. By blocking CD36-mediated lipid uptake, PLT012 reduces intratumoral Tregs and pro-tumor macrophages, while enhancing CD8+ T cell infiltration, survival, and cytotoxicity.

"Liver cancer presents a unique opportunity to improve patient outcomes by addressing the underlying immunometabolic suppression that can limit the effectiveness of current checkpoint inhibitors," said Yi-Ru Yu, Ph.D., Lead Scientist of Pilatus Biosciences and co-first author of the study. "Our data show that PLT012, our lead CD36-targeting immunometabolic therapy, restores immune function at its metabolic core to reprogram the tumor environment to enable effective and durable anti-tumor responses."

Key Findings from the Cancer Discovery Study:

PLT012 monotherapy drives tumor regression in both immune-inflamed and immune-excluded HCC models, including β-catenin–driven tumors resistant to checkpoint blockade.
In combination with anti-PD-L1 and anti-VEGF therapies, PLT012 significantly improves tumor control and increases complete response rates.
In colorectal cancer models with liver metastases, PLT012 restores responsiveness to PD-1 blockade and reprograms macrophage phenotypes.
Ex vivo validation in human HCC samples showed increased CD8+ T cell activity in 45% of patient samples and decreased Tregs in 82% of samples treated with PLT012.
Toxicology studies in non-human primates confirmed a favorable safety profile, with no adverse effects observed at doses up to 200 mg/kg.
"This work validates CD36 as a tractable target in immuno-oncology and positions PLT012 as a first-in-class therapeutic with broad potential across solid tumors characterized by metabolic immune suppression," said Raven Lin, CEO & Founder, Pilatus Biosciences. "These important milestones highlight PLT012’s potential to transform treatment for patients with advanced solid tumors."

"The ability of PLT012 to reprogram the tumor microenvironment by overcoming metabolic immune suppression marks a major advancement for the field of immuno-oncology," said Ping-Chih Ho, Ph.D., Co-Founder and Chair of the Scientific Advisory Board at Pilatus Biosciences, who presented the data as an oral presentation at AACR (Free AACR Whitepaper) 2025. "Our findings validate CD36 as a novel immunometabolic target and demonstrate the broad potential of PLT012 to restore effective anti-tumor immunity across solid tumors. I look forward to seeing Pilatus bring this important new therapeutic approach into clinical development."

PLT012 has received FDA Orphan Drug Designation for the treatment of HCC and intrahepatic bile duct cancer, reinforcing its potential to address rare, aggressive liver malignancies with limited treatment options. Pilatus is advancing PLT012 through IND-enabling studies, with plans to file an IND by end of 2025 to initiate clinical development next year.

About PLT012

PLT012 is a humanized monoclonal antibody designed to selectively block CD36-mediated lipid uptake, a key mechanism driving immunosuppression and immune exclusion within the tumor microenvironment. PLT012 simultaneously reduces Tregs and pro-tumor macrophages while enhancing anti-tumor activities of intratumoral NK cell and cytotoxic CD8+ T cell. The antibody has demonstrated potent monotherapy and combination activity in preclinical models of HCC, liver metastases, and high-fat-diet–induced tumor progression, with a favorable safety profile across species.

On April 29, 2025 Bayer reported new post-hoc analyses from the investigational Phase III ARANOTE trial showed that patients receiving NUBEQA (darolutamide) plus androgen deprivation therapy (ADT) were more likely to experience an ultra-low (<0.02 ng/mL) prostate specific androgen (PSA) response (42.6%) at any time versus patients receiving placebo plus ADT (7.8%), with ultra-low response rates in the NUBEQA group being higher than in the placebo group regardless of baseline PSA (Press release, Bayer, APR 29, 2025, View Source [SID1234652339]). The post-hoc analyses from the pivotal ARANOTE trial also showed that in patients receiving NUBEQA plus ADT, achieving ultra-low PSA response correlated with prolonged radiographic progression-free survival (rPFS) time (HR 0.09; 95% CI: 0.05–0.16), time to metastatic castration-resistant prostate cancer (mCRPC) (HR 0.07; 95% CI: 0.04–0.11) and time to PSA progression (HR 0.02; 95% CI: 0.01–0.05).1

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The safety profile of NUBEQA was independent of PSA response, with lower treatment discontinuation rates due to treatment emergent adverse events (TEAEs) in patients receiving NUBEQA plus ADT versus placebo.1

The results were presented today at the 2025 American Urological Association (AUA) Annual Meeting in Las Vegas, Nevada. NUBEQA is indicated in the U.S. for the treatment of adult patients with mHSPC in combination with docetaxel and for the treatment of adult patients with non-metastatic castration-resistant prostate cancer (nmCRPC).2

Prostate cancer is the second most common cancer in men.3 Only 30% of those diagnosed with mHSPC will survive five years or more after diagnosis.4 Most people with mHSPC eventually progress to mCRPC, a condition with limited long-term survival.5,6

"The subgroup analyses of the ARANOTE trial contribute to the valuable insights of the management of metastatic hormone-sensitive prostate cancer and equip physicians with additional data to help inform treatment options," said Dr. Neal Shore, Medical Director, Carolina Urologic Research Center and Urologist at AUC Urology Specialists, Myrtle Beach, South Carolina.

"At Bayer, we are committed to redefining prostate cancer care and enhancing patient outcomes at various stages of the disease. The growing evidence supporting NUBEQA reinforces its potential to meet the needs of men with prostate cancer," said Christine Roth, Global Head of Product Strategy and Commercialization at Bayer’s Pharmaceuticals Division. "These data add to the meaningful insights from the ARANOTE trial which can be leveraged by physicians to inform clinical decisions, helping them to identify the right treatment options for their patients living with prostate cancer."

About the ARANOTE Trial7
The ARANOTE trial (NCT04736199) is a Phase III, randomized, double-blind, placebo-controlled trial designed to assess the efficacy and safety of NUBEQA in combination with standard ADT in patients with mHSPC. A total of 669 patients were randomized 2:1 to receive either 600 mg of NUBEQA (n=446) or placebo (n=223) twice daily in addition to ADT.

The primary endpoint of the ARANOTE trial was rPFS, which was statistically significant for the NUBEQA arm vs placebo arm (HR: 0.54; 95% CI: 0.41-0.71; P < 0.0001), measured as time from randomization to date of first documented radiological disease progression or death due to any cause, whichever occurs first. Secondary endpoints include overall survival (OS; time to death from any cause), time to first castration-resistant event, time to initiation of subsequent anti-cancer therapy, time to PSA progression, PSA undetectable rates, time to pain progression, and safety assessments.

Initial results from pivotal Phase III ARANOTE trial (n=669), published in The Journal of Clinical Oncology and presented at the 2024 European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) Congress, demonstrated a statistically significant improvement in rPFS with a 46% reduction in the risk of radiologic progression or death (HR 0.54; 95% CI: 0.41-0.71; P<0.0001) compared to placebo plus ADT.8

About NUBEQA (darolutamide)2
NUBEQA (darolutamide) is an androgen receptor inhibitor (ARi) with a distinct chemical structure that competitively inhibits androgen binding, AR nuclear translocation, and AR-mediated transcription.

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

NUBEQA is an androgen receptor inhibitor indicated for the treatment of adult patients with:

Non-metastatic castration-resistant prostate cancer (nmCRPC)
Metastatic hormone-sensitive prostate cancer (mHSPC) in combination with docetaxel
IMPORTANT SAFETY INFORMATION

Warnings & Precautions
Ischemic Heart Disease – In a study of patients with nmCRPC (ARAMIS), ischemic heart disease occurred in 3.2% of patients receiving NUBEQA versus 2.5% receiving placebo, including Grade 3-4 events in 1.7% vs. 0.4%, respectively. Ischemic events led to death in 0.3% of patients receiving NUBEQA vs. 0.2% receiving placebo. In a study of patients with mHSPC (ARASENS), ischemic heart disease occurred in 3.2% of patients receiving NUBEQA with docetaxel vs. 2% receiving placebo with docetaxel, including Grade 3-4 events in 1.3% vs. 1.1%, respectively. Ischemic events led to death in 0.3% of patients receiving NUBEQA with docetaxel vs. 0% receiving placebo with docetaxel. Monitor for signs and symptoms of ischemic heart disease. Optimize management of cardiovascular risk factors, such as hypertension, diabetes, or dyslipidemia. Discontinue NUBEQA for Grade 3-4 ischemic heart disease.

Seizure – In ARAMIS, Grade 1-2 seizure occurred in 0.2% of patients receiving NUBEQA vs. 0.2% receiving placebo. Seizure occurred 261 and 456 days after initiation of NUBEQA. In ARASENS, seizure occurred in 0.6% of patients receiving NUBEQA with docetaxel, including one Grade 3 event, vs. 0.2% receiving placebo with docetaxel. Seizure occurred 38 to 340 days after initiation of NUBEQA. It is unknown whether antiepileptic medications will prevent seizures with NUBEQA. Advise patients of the risk of developing a seizure while receiving NUBEQA and of engaging in any activity where sudden loss of consciousness could cause harm to themselves or others. Consider discontinuation of NUBEQA in patients who develop a seizure during treatment.

Embryo-Fetal Toxicity – Safety and efficacy of NUBEQA have not been established in females. NUBEQA can cause fetal harm and loss of pregnancy. Advise males with female partners of reproductive potential to use effective contraception during treatment with NUBEQA and for 1 week after the last dose.

Adverse Reactions
In ARAMIS, serious adverse reactions occurred in 25% of patients receiving NUBEQA vs. 20% of patients receiving placebo. Serious adverse reactions in ≥1% of patients who received NUBEQA included urinary retention, pneumonia, and hematuria. Fatal adverse reactions occurred in 3.9% of patients receiving NUBEQA vs. 3.2% of patients receiving placebo. Fatal adverse reactions in patients who received NUBEQA included death (0.4%), cardiac failure (0.3%), cardiac arrest (0.2%), general physical health deterioration (0.2%), and pulmonary embolism (0.2%). The most common adverse reactions (>2% with a ≥2% increase over placebo), including laboratory test abnormalities, were increased AST, decreased neutrophil count, fatigue, increased bilirubin, pain in extremity and rash. Clinically relevant adverse reactions occurring in ≥2% of patients treated with NUBEQA included ischemic heart disease and heart failure.

In ARASENS, serious adverse reactions occurred in 45% of patients receiving NUBEQA with docetaxel vs. 42% of patients receiving placebo with docetaxel. Serious adverse reactions in ≥2% of patients who received NUBEQA with docetaxel included febrile neutropenia (6%), decreased neutrophil count (2.8%), musculoskeletal pain (2.6%), and pneumonia (2.6%). Fatal adverse reactions occurred in 4% of patients receiving NUBEQA with docetaxel vs. 4% of patients receiving placebo with docetaxel. Fatal adverse reactions in patients who received NUBEQA included COVID-19/COVID-19 pneumonia (0.8%), myocardial infarction (0.3%), and sudden death (0.3%). The most common adverse reactions (≥10% with a ≥2% increase over placebo with docetaxel) were constipation, rash, decreased appetite, hemorrhage, increased weight, and hypertension. The most common laboratory test abnormalities (≥30%) were anemia, hyperglycemia, decreased lymphocyte count, decreased neutrophil count, increased AST, increased ALT, and hypocalcemia. Clinically relevant adverse reactions in <10% of patients who received NUBEQA with docetaxel included fractures, ischemic heart disease, seizures, and drug-induced liver injury.

Drug Interactions
Effect of Other Drugs on NUBEQA – Combined P-gp and strong or moderate CYP3A4 inducers decrease NUBEQA exposure, which may decrease NUBEQA activity. Avoid concomitant use.

Combined P-gp and strong CYP3A4 inhibitors increase NUBEQA exposure, which may increase the risk of NUBEQA adverse reactions. Monitor more frequently and modify NUBEQA dose as needed.

Effects of NUBEQA on Other Drugs – NUBEQA inhibits breast cancer resistance protein (BCRP) transporter. Concomitant use increases exposure (AUC) and maximal concentration of BCRP substrates, which may increase the risk of BCRP substrate-related toxicities. Avoid concomitant use where possible. If used together, monitor more frequently for adverse reactions, and consider dose reduction of the BCRP substrate.

NUBEQA inhibits OATP1B1 and OATP1B3 transporters. Concomitant use may increase plasma concentrations of OATP1B1 or OATP1B3 substrates. Monitor more frequently for adverse reactions and consider dose reduction of these substrates.

Review the Prescribing Information of drugs that are BCRP, OATP1B1, and OATP1B3 substrates when used concomitantly with NUBEQA.

For important risk and use information about NUBEQA, please see the accompanying full Prescribing Information.

About Metastatic Hormone-Sensitive Prostate Cancer
Prostate cancer is the second most common cancer in men and the fifth most common cause of cancer death in men worldwide.3.9 In 2020, an estimated 1.4 million men were diagnosed with prostate cancer, including almost 300,000 cases in the U.S., and about 375,000 died from the disease worldwide.10,11

At the time of diagnosis, most men have localized prostate cancer, meaning their cancer is confined to the prostate gland and can be treated with curative surgery or radiotherapy. Upon relapse when the disease will metastasize or spread, androgen deprivation therapy (ADT) is the cornerstone of treatment for this hormone-sensitive disease. Approximately 10% of men will already present with mHSPC when first diagnosed.12,13,14 Men with mHSPC will start their treatment with hormone therapy, such as ADT, androgen receptor inhibitor (ARi) plus ADT or a combination of the chemotherapy docetaxel and ADT. Despite this treatment, most men with mHSPC will eventually progress to mCRPC, a condition with limited survival.