Intensity Therapeutics Presents Positive INT230-6 Data in Patients with Early-Stage Breast Cancer in a Podium Poster Spotlight Discussion at the 2023 SABCS

On December 8, 2023 Intensity Therapeutics, Inc. (Nasdaq: INTS), a clinical-stage biotechnology company focused on the discovery and development of proprietary, novel immune-based intratumoral cancer therapies designed to kill tumors and increase immune system recognition of cancers, reported that safety, tolerability, efficacy and immune activation data from the company’s Phase 2 INVINCIBLE trial of INT230-6 in patients with early-stage breast cancer without chemotherapy was presented at a Podium Poster Spotlight discussion session today during the 2023 San Antonio Breast Cancer Symposium (SABCS) (Press release, Intensity Therapeutics, DEC 8, 2023, View Source [SID1234638352]). Information on the presentation is below.

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Concurrent Poster Spotlight Session Block #6
PS16 Enhancing Immunotherapy for Triple Negative Breast Cancer: Novel Therapies and Biomarkers
Moderator: Hope S. Rugo, MD, FASCO, University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California
Title: Intra-tumoral dosing of INT230-6 in early-stage breast cancer patients induces tumor cell necrosis and immunomodulatory effects: A phase II randomized window-of-opportunity study – the INVINCIBLE trial
Presentation #: PS16-03
Date and Time: Friday, December 8, 7:00 – 8:00 a.m. CT
Location: Stars at Night Ballroom 3 & 4
Presenter: Angel Arnaout, M.D., MSc, Ottawa Hospital Research Institute, Ontario Institute for Cancer Research
Discussant: Sangeetha Reddy, M.D., M.S.C.I., UT Southwestern Medical Center, Dallas, Texas

Copies of the presentation materials are available on Intensity’s website on the publications, papers and posters page.

"A large unmet need in the treatment of breast cancer is that the majority of breast cancers are immune quiescent; resulting in minimal response to immunotherapies. INT230-6 has the potential to fill this unmet need for multiple subtypes, including triple negative breast cancer, through its unique multiple anti-cancer mechanisms of action that cause tumor cell necrosis, ignition of an anti-cancer immune-based activation, increasing the diversity of the T-cell repertoire systemically that can enter into the tumor and its microenvironment," said Angel Arnaout, M.D.,MSc., Breast Surgical Oncologist at the Ottawa Hospital, Scientist at the Ottawa Hospital Research Institute, Professor of Surgery at the University of Ottawa and Co-Lead of the Ontario Institute for Cancer Research’s Window-of-Opportunity Network. "The ability for INT230-6 to induce necrosis and noted immune effects prior to a patient’s surgery, while maintaining a favorable safety profile, would be a major move forward for the treatment paradigm of breast cancer and potentially many other cancers."

"I am encouraged by the immune-related data being reported and the potential of INT230-6 as a presurgical treatment for women suffering from early-stage breast cancer," said Melanie Spears, Ph.D., Co-Director of Diagnostic Development and Co-Lead of the Window-of-Opportunity Network at the Ontario Institute for Cancer Research. "The localized effect of increased CD4 T-cells and NK cells within injected tumors and systemically increased T-cell diversity from baseline in these patients is quite interesting and remarkable for a locally-delivered therapy."

The INVINCIBLE Trial is a Phase 2, randomized study that enrolled women with newly diagnosed, operable early-stage intermediate or high-grade T1-T2 invasive breast cancers 2 to 5 weeks prior to surgery (lumpectomy or mastectomy). Drug dose was set by the diameter of the tumor. Subjects were randomly allocated (2:1) prior to resection to 1-3 IT injections of INT230-6 versus either no treatment (part 1 N=29) or saline sham injection (part 2 N=58). Several markers normally associated with systemic treatment were evaluated.

Efficacy Data:
The INVINCIBLE Phase 2 trial of INT230-6 demonstrated a high order of necrosis in presurgical breast cancer tumors in the period from diagnosis to surgery, with some patients in the Phase 2 study experiencing greater than 95% necrosis of the tumor. A functional pathway enrichment analysis was conducted and confirmed positive changes in T-cell activation, lymphocyte activation and inflammatory response. Further, INT230-6 treated patients experienced differential gene expression with an increase in median clonal diversity compared to baseline as well as significant changes in the immune cell composition, including CD4 T-cell and NK cells.

Safety Data:
Data show that INT230-6 has a favorable safety profile and is well tolerated. Over 95% of treatment-emergent adverse events (TEAEs) were low grade 1 or 2 primarily localized pain, fatigue, and nausea.

"We continue to be impressed with the safety and efficacy of INT230-6. Today’s news about the increase in mean systemic T-cell clonal diversity is truly exciting because it is a signal of the strength of adaptive immune response systemically. We believe that the ability to cause large levels of necrosis on a single dose of our locally-delivered drug with immune effects in a relatively cold cancer type such as breast cancer prior to surgery shortly after diagnosis is truly a new weapon in the war on cancer," said Lewis H. Bender, President and Chief Executive Officer of Intensity. "In addition to our anticipated Phase 3 program in metastatic sarcoma using INT230-6 as a monotherapy, we are underway in our preparations for a Phase 2/3 clinical program to test INT230-6 in combination with standard of care neoadjuvant therapy. We see the potential opportunity for our technology and drug products in both the metastatic and presurgical settings for many types of cancers."

About T-Cell Repertoire
The adaptive immune system is one of the body’s most powerful defenses. By being able to adapt, the body’s immune cells can be trained to attack undesirable cells or viruses anywhere in the body. T-cells are an important systemic component of the adaptive immune system that aid in the destruction of invaders. Immune repertoire refers to all the unique T-cell receptor (TCR) and B-cell receptor (BCR) genetic rearrangements. Only lymphocytes that encounter an antigen with the right receptor to bind to it will be activated and proliferate during an immune response, forming a clone of cells with identical antigen receptors for attack. A greater diversity of T-cell repertoire means there is higher likelihood for a T-cell to bind to the foreign entity (e.g. cancer cells) and increase the specific T-cell clonal population to destroy the invader.

About INT230-6
INT230-6, Intensity’s lead proprietary investigational product candidate, is designed for direct intratumoral injection. INT230-6 was discovered using Intensity’s proprietary DfuseRx℠ technology platform. The drug is composed of two proven, potent anti-cancer agents, cisplatin and vinblastine, and a penetration enhancer molecule (SHAO) that helps disperse potent cytotoxic drugs throughout tumors for diffusion into cancer cells. These agents remain in the tumor resulting in a favorable safety profile. In addition to local disease control, direct killing of the tumor by INT230-6 releases a bolus of neoantigens specific to the patient’s malignancy, leading to engagement of the immune system and systemic anti-tumor effects. Importantly, these effects are mediated without immunosuppression that so often occurs with systemic chemotherapy.

Updated clinical safety and efficacy data for iOnctura’s roginolisib presented at ESMO Immuno-Oncology Congress 2023

On December 8, 2023 iOnctura, a clinical-stage biotech developing selective cancer therapies against targets that play critical roles in multiple tumor survival pathways, reported clinical results for roginolisib, a first-in-class oral allosteric modulator of PI3Kδ, presented at the ESMO (Free ESMO Whitepaper) Immuno-Oncology Congress 2023 in Geneva (Press release, iOnctura, DEC 8, 2023, View Source [SID1234638350]).

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Roginolisib is in development for solid and hematologic malignancies including uveal melanoma, a rare cancer of the eye. The poster presentation titled ‘Safety and clinical efficacy of Roginolisib (IOA-244), the first oral allosteric modulator of phosphoinositide 3-kinase inhibitor delta (PI3Kδ)’ demonstrated that roginolisib continues to be well tolerated over long periods of treatment and continues to show a favourable trend in overall survival exceeding the overall survival previously reported with immune checkpoint inhibitors.

Mass cytometry data showed treatment with roginolisib led to an increase in activated anti-cancer CD8+ T-cells and natural killer (NK) cells, increased interferon signalling and a decrease in cancer-promoting Regulatory T-cells. This shifts the balance of the immune system enabling a more-effective attack on cancer. Boosting of antitumoral immunity was observed in patients with long-term disease control after roginolisib treatment but not patients with progressive disease.

An exploratory analysis from a patient with uveal melanoma outlined the potential of radiomics, an advanced AI driven analysis of imaging data, as a way of tracking changes in cancer lesions over time in addition to standard RECIST measurements.

Overall, these findings are consistent with prior studies in pre-clinical models and support the development of roginolisib in uveal melanoma and other malignancies with immune suppressed conditions.

Catherine Pickering, Chief Executive Officer of iOnctura, said: "These safety and clinical efficacy data demonstrate iOnctura’s progression of roginolisib. Our first-in-class allosteric modulator of PI3Kδ continues to show a favourable trend in overall survival and is well tolerated over very long periods of treatment, now up to 38 months in patients with uveal melanoma. An exploratory readout also shows that patients who respond well to roginolisib, with prolonged stabilisation of their disease, exhibit signs of an activated immune system better able to fight the tumor. We eagerly anticipate a final clinical readout in 2024."

ORIEN to Present Abstracts at 65th Annual ASH Meeting Utilizing Aster Insights’ Avatar Platform

On December 8, 2023 Aster Insights, the leading provider of scientific and clinical intelligence for oncology discovery, reported upcoming research presentations at the American Society of Hematology (ASH) (Free ASH Whitepaper)’s (ASH) (Free ASH Whitepaper) 65th Annual Meeting, December 9-12 in San Diego, CA (Press release, Aster Insights, DEC 8, 2023, View Source [SID1234638349]).

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Three abstracts will be shared at this year’s ASH (Free ASH Whitepaper) meeting by Moffitt Cancer Center, which co-founded the Oncology Research Information Exchange Network (ORIEN) in 2006. The investigations all utilize patient data from Aster Avatar, the best-in-class, deepest multimodal dataset for discovery research in oncology.

The schedule of presentations and highlights include:

Rafael Renatino-Canevarolo, PhD, Ex Vivo Mathematical Myeloma Advisor (EMMA) – a Clinical, Molecular, and Phenotypic Platform to Tailor Personalized Therapeutic Strategies for Multiple Myeloma (abstract 2280)
Presentation time: Saturday, December 9, 2023, 5:30 PM-7:30 PM

Examining the impact of a state-of-the-art platform for clinical-informed decisions, research advancement, and preclinical compound testing called the "Ex Vivo Mathematical Myeloma Advisor" (EMMA) on drug discovery and understanding of drug interaction for multiple myeloma patients.

Praneeth Reddy Sudalagunta, PhD, Selinexor Disrupts Epigenetic Programing and Modulates Immunogenicity in Multiple Myeloma (abstract 3301)
Presentation time: Sunday, December 10, 2023, 6:00 PM-8:00 PM

Investigating the cellular mechanisms of Selinexor (SELI) resistance leading to an immunogenic cell state.

Ciara L. Freeman, PhD, MSc, FRCPC, MRCP, Single Cell RNA Sequencing of Sequential Samples before and after BCMA-Directed CAR-T Reveal Features Associated with Non-Durable Response, Exhausted T-Cells and Decreased Expression of Genes Encoding Key Surface Targets in Particular in Patients with Extramedullary Disease (abstract 3304)
Presentation time: Sunday, December 10, 2023, 6:00 PM-8:00 PM

Longitudinal single cell analysis to identify factors associated with response, or therapeutic failure, to FDA approved anti-B-cell maturation antigen (BCMA) directed CAR-T cell therapy.

"ASH is a unique opportunity to demonstrate the impactful discoveries resulting from ORIEN and Aster Insights’ discovery solutions," said Anand Shah, MD, Aster Insights CEO. "This year, we are proud to showcase our collaborative work with Moffitt Cancer Center’s scientists that continues to push the envelope of multiple myeloma research and patient care."

SkylineDx Presents Pioneering Data at ASH 2023: SKY92 Risk Stratification in Multiple Myeloma Patients

On December 8, 2023 SkylineDx, an innovative diagnostics company focused on research & development of molecular diagnostics reported the release of new data during the American Society of Hematology (ASH) (Free ASH Whitepaper) 2023 Annual Meeting (Press release, SkylineDx, DEC 8, 2023, View Source [SID1234638348]). Dr. Noa Biran, Associate Professor at Hackensack Meridian School of Medicine, will present two posters from the pioneering US study on risk assessment in multiple myeloma. These studies were conducted within the PRospective Observational Multiple Myeloma Impact Study (PROMMIS; NCT02911571) trial, which aim to assess the impact of SKY92 on risk stratification and treatment decisions in clinical practice for newly diagnosed multiple myeloma patients. Multiple Myeloma (MM) is a complex hematologic malignancy marked by genetic instability, variable survival rates, and diverse treatment responses. The SKY92 gene expression profiling (GEP) assay is a valuable tool for stratifying MM patients into high-risk and standard-risk groups for disease progression and survival. Despite advances in MM treatments, a subset of high-risk patients still faces limited benefits from current therapies. This study aims to assess risk classification based on conventional risk markers and the SKY92 risk classifier, providing insights for optimizing risk-adapted treatment.

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A total of 251 MM patients were enrolled in this prospective US multicenter trial. The results based on prospective real-world clinical data show significant differences in progression-free survival (PFS) and overall survival (OS) between SKY92 standard-risk and high-risk patients, confirming SKY92’s reliability as a prognostic marker.

Integrating R-ISS staging with SKY92 classification, as previously reported [Kuiper et al. 2020], resulted in three risk groups. This combined classification method identified a larger number of high-risk patients with a significantly shorter OS and PFS when compared to the R-ISS alone.

The trial results reveal a significant discrepancy between risk stratification derived from conventional clinical practice assessments and that determined by SKY92. Integration of SKY92 into clinical practice enables the identification of a subset of high-risk patients characterized by substantially shorter PFS and OS. These findings support the added value of integrating SKY92 into clinical practice for precise risk assessment of patients. Furthermore, the integration of SKY92 resulted in increased physician confidence in assessing patient risks.

Jvalini Dwarkasing, Chief Scientific Officer of SkylineDx, expressed the company’s enthusiasm for these presentations, saying, "At SkylineDx, our mission is to advance the field of hematological diagnostics and ultimately improve patient care. We are proud that Dr. Biran will be presenting the insights from these groundbreaking studies that have the potential to transform the way we understand and treat hematologic disorders."

Dr. Noa Biran’s presentations at ASH (Free ASH Whitepaper) 2023 promise to challenge risk stratification in multiple myeloma, with implications for personalized treatment approaches and improved patient outcomes.

MEDSIR presents promising results at SABCS 2023: ATRACTIB and DEBBRAH trials hold potential to improve the lives of advanced breast cancer patients

On December 8, 2023 MEDSIR, a global leader in oncology research, reported significant breakthroughs in the fight against aggressive breast cancer at the 46th San Antonio Breast Cancer Symposium (SABCS) that have the potential to transform the lives of breast cancer patients (Press release, MedSIR, DEC 8, 2023, View Source [SID1234638347]). The results from the ATRACTIB trial, focusing on advanced triple-negative breast cancer (TNBC), and DEBBRAH Cohort 5, centered on HER2[+] or HER2-Low advanced breast cancer with leptomeningeal carcinomatosis, offer new hope for patients with limited treatment alternatives.

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ATRACTIB: Transforming the Landscape for TNBC Patients

This phase II clinical trial highlights the success of a combined therapy approach as a first-line treatment for advanced TNBC patients. Specifically, the combination of anti-PD-L1 atezolizumab and antiangiogenic bevacizumab with chemotherapy agent paclitaxel, demonstrated significant antitumor activity. This breakthrough holds particular significance since most of the patients included in this trial had PD-L1 negative tumors.

Dr. María Gion, Medical Oncologist at Ramón y Cajal University Hospital and first author of the study, presented the study’s outcomes, revealing a median progression-free survival of 11 months—a substantial delay in cancer progression compared to previous data on similar patient populations—. Impressively, 63% of patients responded positively to the treatment, achieving 13 complete responses and 50 partial responses, with a median duration of response reaching 10 months. Notably, the clinical benefit was observed in 79% of patients.

In the trial, 100 adult patients with untreated advanced TNBC received intravenous atezolizumab, bevacizumab, and paclitaxel until disease progression, intolerable toxicity, death, or patient withdrawal. The safety considerations revealed that peripheral neuropathy (68%) and fatigue (62%) were the most common side effects. Grade 3/4 adverse events, occurred in 47% of patients, primarily peripheral neuropathy (13%) and neutropenia (12%). Importantly, there were no drug-related deaths.

The combination of immunotherapy, antiangiogenic therapy, and chemotherapy demonstrated a manageable safety profile and merits further research for PD-L1-negative advanced TNBC patients.

DEBBRAH Cohort 5: Shaping the future for HER2[+] and HER2-Low Advanced Breast Cancer with Leptomeningeal Carcinomatosis

The DEBBRAH trial, focusing on HER2[+] or HER2-Low advanced breast cancer patients with brain metastases and/or leptomeningeal carcinomatosis, showcased promising results from Cohort 5, which specifically included patients with pathologically confirmed leptomeningeal carcinomatosis. This rare but serious complication occurs in approximately 10% of advanced breast cancer patients and is associated with poor outcomes and limited therapeutic options. Currently, there are no specific drugs approved for metastatic breast cancer patients with brain metastases and/or leptomeningeal carcinomatosis, and there is no consensus on how to manage these cases.

This trial was designed to address this gap in knowledge, aiming to investigate whether an antibody-drug conjugate called trastuzumab deruxtecan, which has shown promise in treating breast cancer that has spread to the brain and elsewhere in the body, can help improve the treatment for this specific group of patients. The antibody-drug conjugate, under evaluation demonstrated notable activity with no new safety concerns. The results of the Cohort 5, which included 7 patients, were presented by Dr. Marta Vaz, Medical Oncologist at Hospital Professor Doutor Fernando Fonseca, showing a remarkable median overall survival of 13.3 months, meeting the primary endpoint. Five patients (71.4%) experienced prolonged disease stabilization for at least 24 weeks, and the median progression-free survival was 8.9 months. The safety profile was consistent with previous studies.

The results of the DEBBRAH trial are extremely interesting and suggest that leptomeningeal carcinomatosis may become a more treatable condition with the introduction of new antibody-drug conjugates targeting HER2. These encouraging data warrant further investigation to address the unmet need in this difficult-to-treat disease.

ABOUT ATRACTIB

The ATRACTIB phase II study explored a combined treatment approach for advanced triple-negative breast cancer (a type of breast cancer characterized by the fact that the cancer cells don’t have estrogen or progesterone receptors, and do not have any or much of a protein called Human Epidermal Growth Factor Receptor-2). The trial evaluated the first-line therapy atezolizumab (an immunotherapy drug), bevacizumab (an antiangiogenic drug), and paclitaxel (a chemotherapy agent) in a cohort of 100 patients, regardless of their PD-L1 tumor expression. Primarily, the study looked at progression-free survival, or how long the disease remained stable. Secondly, it also assessed overall survival, response to treatment, and safety. The results were encouraging, showing that this combination treatment had a positive impact on advanced TNBC patients, even when tumors didn’t express PD-L1. Additionally, the safety profile of the treatment was consistent with what was known from previous studies.

ABOUT DEBBRAH

The DEBBRAH phase II trial was designed to evaluate the efficacy and safety of trastuzumab deruxtecan in patients with HER2[+] and HER2-low advanced breast cancer (meaning that tumors were characterized by the presence of either high or low levels of HER2 protein) with a history of brain metastases and/or leptomeningeal carcinomatosis. Patients were enrolled into one of five cohorts based on the HER2 protein level and type of central nervous system involvement. At SABCS 2023, results of Cohort 5 were presented, which specifically included 7 patients with leptomeningeal carcinomatosis. The main objective for this cohort was to measure the overall survival, or amount of time from the start of the treatment until death from any cause. With a median follow-up of 12 months (range, 2.5-18.6), results showed that treatment with trastuzumab deruxtecan led to a remarkable median overall survival of 13.3 months, meeting the primary endpoint. Five (71.4%) patients experienced a prolonged stabilization of their disease for at least 24 weeks, and the median time before their disease worsened again (known as progression free survival), was 8.9 months.