Libtayo® (cemiplimab-rwlc) Data at ESMO 2018 Congress Provide New Insights in Six Tumor Types Under Investigation

On October 8, 2018 Sanofi and Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN) reported that it will present a diverse set of data from their joint clinical program investigating Libtayo (cemiplimab-rwlc) at the ESMO (Free ESMO Whitepaper) 2018 Congress (European Society for Medical Oncology) from October 19 to 23 in Munich, Germany (Press release, Sanofi Genzyme, OCT 8, 2018, View Source [SID1234530053]). These data span six different tumor types, including non-small cell lung cancer (NSCLC), cervical cancer, cutaneous squamous cell carcinoma (CSCC), hepatocellular carcinoma (HCC), head and neck squamous cell carcinoma (HNSCC) and basal cell carcinoma (BCC). Libtayo is a fully-human monoclonal antibody targeting the immune checkpoint receptor PD-1 (programmed cell death protein-1).

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"Following the U.S. FDA approval of Libtayo in advanced CSCC, we remain focused on pursuing science that has the potential to change treatment paradigms in oncology," said Israel Lowy, M.D., Ph.D., Vice President of Global Clinical Development and Head of Translational Science and Clinical Oncology, Regeneron. "At ESMO (Free ESMO Whitepaper), we look forward to sharing new data that support our rationale for pursuing registrational trials of Libtayo in lung, cervical and skin cancers."

All six of the abstracts accepted at ESMO (Free ESMO Whitepaper) focus on ongoing Libtayo clinical trials.

"Three years ago, Sanofi began its immuno-oncology collaboration with Regeneron with the shared vision to address significant unmet needs across various cancer types," said Joanne Lager, M.D., Head of Oncology Development, Sanofi. "This year’s data being presented at ESMO (Free ESMO Whitepaper) are a testament to our commitment to patients and the potential to make our vision a reality."

Among the joint Sanofi and Regeneron presentations are new clinical data from a Phase 1 expansion cohort investigating Libtayo in combination with radiotherapy in advanced NSCLC as well as longer-term follow-up data from the advanced CSCC expansion cohorts in the Phase 1 trial. Additional abstracts will feature initial data from Phase 1 expansion cohorts investigating Libtayo in cervical cancer, HCC and HNSCC, alongside a trial-in-progress update on the potentially pivotal Phase 2 trial in BCC.

Sanofi and Regeneron joint presentations at ESMO (Free ESMO Whitepaper) include:

Cemiplimab, a human PD-1 monoclonal antibody, in patients with recurrent or metastatic cervical cancer: Interim data from phase 1 cohorts
Danny Rischin Oct 20/12:30-13:30/958P

Cemiplimab, a human monoclonal anti-PD-1, plus radiotherapy in advanced non-small cell lung cancer (NSCLC): Results from a Phase 1 expansion cohort (EC 2)
Victor Moreno, Oct 20/12:30-13:30/1162P

Phase 1 study of cemiplimab, a human monoclonal anti-PD-1, in patients with unresectable locally advanced or metastatic cutaneous squamous cell carcinoma (CSCC): Longer follow-up efficacy and safety data
Taofeek K. Owonikoko, Oct 21/12:45-13:45/1292P

Cemiplimab, a human monoclonal anti-PD-1, in patients with advanced or metastatic hepatocellular carcinoma (HCC): Data from an expansion cohort in a Phase 1 study
Michael J. Pishvaian, Oct 20/12:30-13:30/1151P

Phase 1 expansion cohort results of cemiplimab, a human PD-1 monoclonal antibody, in combination with radiotherapy, cyclophosphamide and GM-CSF, in patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC)
Hani Babiker, Oct 20/12:30-13:30/1171P

Phase 2 study of cemiplimab, a human monoclonal anti-PD-1, in patients with advanced basal cell carcinoma (BCC) who experienced progression of disease on, or were intolerant of prior hedgehog pathway inhibitor therapy
Karl D. Lewis, Oct 20/12:30-13:30/1240TiP

Libtayo is being developed jointly by Sanofi and Regeneron under a global collaboration agreement. The potential uses of Libtayo as a treatment for NSCLC, cervical cancer, BCC, HCC and HNSCC are investigational, and its safety and efficacy have not been evaluated by any regulatory authority for these cancers.

Libtayo is currently approved in the U.S. for the treatment of patients with metastatic CSCC or locally advanced CSCC who are not candidates for curative surgery or curative radiation. The generic name for Libtayo in the U.S. is cemiplimab-rwlc, with rwlc as the suffix designated in accordance with Nonproprietary Naming of Biological Products Guidance for Industry issued by the US Food and Drug Administration. Sanofi Genzyme, the specialty care global business unit of Sanofi, and Regeneron market Libtayo jointly in the U.S. The safety and efficacy of Libtayo have not been evaluated by any regulatory authority outside of the U.S. for the treatment of advanced CSCC.

IMPORTANT SAFETY INFORMATION AND INDICATION FOR U.S. PATIENTS

What is the most important information I should know about Libtayo?

Libtayo is a medicine that may treat a type of skin cancer by working with your immune system. Libtayo can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. These problems may happen anytime during treatment or even after your treatment has ended.

Call or see your healthcare provider right away if you develop any symptoms of the following problems or these symptoms get worse:

Lung problems (pneumonitis). Signs and symptoms of pneumonitis may include new or worsening cough, shortness of breath, and chest pain.
Intestinal problems (colitis) that can lead to tears or holes in your intestine. Signs and symptoms of colitis may include diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky or that have blood or mucus; and severe stomach-area (abdomen) pain or tenderness.
Liver problems (hepatitis). Signs and symptoms of hepatitis may include yellowing of your skin or the whites of your eyes, severe nausea or vomiting, pain on the right side of your stomach area (abdomen), drowsiness, dark urine (tea colored), bleeding or bruising more easily than normal, and feeling less hungry than usual.
Hormone gland problems (especially the adrenal glands, pituitary, thyroid and pancreas). Signs and symptoms that your hormone glands are not working properly may include headaches that will not go away or unusual headaches, rapid heartbeat, increased sweating, extreme tiredness, weight gain or weight loss, dizziness or fainting, feeling more hungry or thirsty than usual, hair loss, feeling cold, constipation, deeper voice, very low blood pressure, urinating more often than usual, nausea or vomiting, stomach-area (abdomen) pain, and changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness.
Kidney problems, including nephritis and kidney failure. Signs of these problems may include decrease in your amount of urine, blood in your urine, swelling in your ankles, and loss of appetite.
Skin problems. Signs of these problems may include rash, itching, skin blistering, and painful sores or ulcers in the mouth, nose, throat, or genital area.
Problems in other organs. Signs of these problems may include headache, tiredness or weakness, sleepiness, changes in heartbeat (such as beating fast, seeming to skip a beat, or a pounding sensation), confusion, fever, muscle weakness, balance problems, nausea, vomiting, stiff neck, memory problems, seizures (encephalitis), swollen lymph nodes, rash or tender lumps on skin, cough, shortness of breath, vision changes, or eye pain (sarcoidosis), seeing or hearing things that are not there (hallucinations), severe muscle weakness, low red blood cells (anemia), bruises on the skin or bleeding, and changes in eyesight.
Rejection of a transplanted organ. Your doctor should tell you what signs and symptoms you should report and monitor you, depending on the type of organ transplant that you have had.
Infusion (IV) reactions that can sometimes be severe and life-threatening. Signs of these problems may include chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, fever, feeling of passing out, back or neck pain, and facial swelling.

Getting medical treatment right away may help keep these problems from becoming more serious.

Your healthcare provider will check you for these problems during your treatment with Libtayo. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may delay or completely stop treatment if you have severe side effects.

Before you receive Libtayo, tell your healthcare provider about all your medical conditions, including if you:

have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus;
have had an organ transplant;
have lung or breathing problems;
have liver or kidney problems;
have diabetes;
are pregnant or plan to become pregnant; Libtayo can harm your unborn baby

Females who are able to become pregnant:

Your healthcare provider will give you a pregnancy test before you start treatment.
You should use an effective method of birth control during your treatment and for at least 4 months after your last dose of Libtayo. Talk with your healthcare provider about birth control methods that you can use during this time.
Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with Libtayo.
are breastfeeding or plan to breastfeed. It is not known if Libtayo passes into your breast milk. Do not breastfeed during treatment and for at least 4 months after the last dose of Libtayo.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

The most common side effects of Libtayo include tiredness, rash, and diarrhea. These are not all the possible side effects of Libtayo. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Regeneron Pharmaceuticals and Sanofi at 1-877-542-8296.

Please see accompanying full Prescribing Information, including Medication Guide.

What is Libtayo?

Libtayo is a prescription medicine used to treat people with a type of skin cancer called cutaneous squamous cell carcinoma (CSCC) that has spread or cannot be cured by surgery or radiation.

OncoSec Chief Scientific Officer to Present at Advances in Immuno-Oncology USA Congress

On October 8, 2018 OncoSec Medical Incorporated (OncoSec) (NASDAQ:ONCS), a company developing intratumoral cancer immunotherapies, reported that its Chief Scientific Officer Christopher G. Twitty, PhD, will give a presentation during the Advances In Immuno-Oncology Congress being held in San Diego, October 11-12 (Press release, OncoSec Medical, OCT 8, 2018, View Source [SID1234529803]).

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Dr. Twitty’s presentation, titled Intratumoral IL-12 in Combination with Pembrolizumab to Treat Metastatic Melanoma in Patients Unlikely to Respond to Anti PD-1 Therapies: Insights Gained from a Biomarker Program, will discuss ongoing research of TAVO (tavokinogene telseplasmid) in combination with KEYTRUDA(pembrolizumab) as a potential treatment for metastatic melanoma.

The Immuno-Oncology USA Congress will feature over 20 presentations from companies at the forefront of immune-oncology, each presenting insights on new technologies, clinical discoveries and future targets in immuno-oncology research, from cancer vaccines to checkpoint inhibitors, alongside in-depth discussion of patient stratification and clinical development.

"Melanoma is but one of the many types of cancers where the largest part of the immune checkpoint market has yet to be unlocked due to poor/failed/no responses to checkpoint monotherapy, the so-called ‘cold tumor’ problem, which is well known to this audience," said Dr. Twitty, Chief Scientific Officer of OncoSec. "We are excited to share our finding with them indicating TAVO’s ability to recruit more tumor infiltrating lymphocytes (TILs) into the tumors, paving the way for checkpoints to be effective in the largest, but still unresponsive, segment of the checkpoint market."

Details of the presentation are as follows:

Session Title: Translational Immuno-Oncology and Clinical Development

Presentation Title: Intratumoral IL-12 in combination with pembrolizumab to treat metastatic melanoma in patients unlikely to respond to anti PD-1 therapies: Insights gained from a biomarker program

Date and Time: Thursday, October 11, 2018 12:00 PM – 12:30 PM PST

Location: The San Diego Convention Center, Conference Room 5

CytomX Therapeutics Announces Presentations at 2018 ESMO Annual Meeting

On October 8, 2018 CytomX Therapeutics, Inc. (Nasdaq:CTMX) a clinical-stage oncology-focused biopharmaceutical company pioneering a novel class of investigational antibody therapeutics based on its Probody therapeutic technology platform, reported that additional clinical results from PROCLAIM-072, an ongoing Phase 1/2 trial evaluating CX-072, a Probody therapeutic targeting PD-L1, will be presented at the 2018 Annual Meeting of the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) (Press release, CytomX Therapeutics, OCT 8, 2018, View Source [SID1234529821]). The conference will take place from October 19-23 in Munich, Germany.

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Two posters will provide additional results from the ongoing monotherapy dose escalation arm and the combination arm with Yervoy (ipilimumab) of the PROCLAIM-CX-072 trial, each in patients with advanced unresectable solid tumors.

CytomX’s ESMO (Free ESMO Whitepaper) poster presentations will include longer follow-up periods from additional patients treated in both the monotherapy and combination arms, new patient data from the combination arm and will reflect a data cutoff approximately three months after the abstract data cutoff.

Poster 435P – Preliminary Results of PROCLAIM-CX-072: The First-In-Human, Dose-Finding Trial of PD-L1 Probody Therapeutic CX-072 as Monotherapy in Patients with Advanced Solid Tumors
Presenter: Valentina Boni, M.D., Ph.D., START Madrid-CIOCC HM University Hospital Sanchinarro, Madrid, Spain
Date/Time: Monday, October 22, 12:45 p.m. – 1:45 p.m. CEST/ 6:45 a.m. – 7:45 a.m. EDT
Location: Hall A3

Poster 436P – Preliminary Results of the First-In-Human, Dose-Finding PROCLAIM-CX-072 Trial Evaluating the PD-L1 Probody Therapeutic CX-072 in Combination with Ipilimumab in Patients with Advanced Solid Tumors
Presenter: Ruth Plummer, M.D., Northern Centre for Cancer Care, Newcastle, United Kingdom
Date/Time: Monday, October 22, 12:45 p.m. – 1:45 p.m. CEST/ 6:45 a.m. – 7:45 a.m. EDT
Location: Hall A3

Poster abstracts can be located by searching The ESMO (Free ESMO Whitepaper) 2018 Online Program Session and using the Poster numbers above.

CytomX’s posters will be available online under the Events and Presentations section of the CytomX website at the time of presentation at www.CytomX.com.

Conference Call and Webcast

CytomX will host a conference call and webcast to discuss these presentations on Monday, October 22, 2018 at 2:30 p.m. CEST/ 8:30 a.m. EDT. Participants can dial 1-877-809-6037 U.S. Toll Free or 1-615-247-0221 International using the Conference ID: 1275596.

A live webcast can be accessed under the Events and Presentations Section of CytomX’s Investor Relations section at View Source Access the website 15 minutes prior to the start of the call to download and install any necessary audio software and slides. A replay of the webcast will be archived and available on CytomX’s website for 30 days following the event.

About PROCLAIM

PROCLAIM (Probody Clinical Assessment In Man) is an international umbrella program designed to evaluate CytomX Probody therapeutics. The first module is the PROCLAIM-072 clinical program, an open-label, dose-finding Phase 1/2 trial evaluating CX-072 as monotherapy and in combination with Yervoy (ipilimumab) or Zelboraf(vemurafenib) in patients with metastatic or locally advanced unresectable solid tumors or lymphomas. CytomX aims to achieve three goals as part of the PROCLAIM-072 clinical trial:

Tolerability: Demonstrate that CX-072 is well tolerated in patients, and potentially improves safety, particularly in the combination setting.

Anti-cancer activity: Demonstrate initial evidence of CX-072’s anti-cancer activity as monotherapy and in combination.

Translational program and Probody platform proof-of-concept: Explore mechanistic aspects of Probody activity in patients as observed in preclinical models.

Cabozantinib to Be Featured in 13 Presentations at ESMO 2018 Congress

On October 8, 2018 Exelixis, Inc. (NASDAQ:EXEL) reported that data from clinical trials of cabozantinib will be the subject of 13 presentations at the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) 2018 Congress, which is being held October 19-23, 2018 in Munich, Germany (Press release, Exelixis, OCT 8, 2018, View Source;p=irol-newsArticle&ID=2370700 [SID1234529822]).

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Poster presentations will include results from the dose escalation stage of the phase 1b COSMIC-021 study of cabozantinib in combination with atezolizumab in previously untreated advanced renal cell carcinoma (RCC). Additionally, a poster discussion session will feature a late-breaking abstract evaluating the effect of PD-L1 status on clinical outcomes with cabozantinib in advanced RCC in the CABOSUN and METEOR trials.

"The data at ESMO (Free ESMO Whitepaper) showcase the potential of cabozantinib across a range of difficult-to-treat cancers," said Gisela Schwab, M.D., President, Product Development and Medical Affairs and Chief Medical Officer, Exelixis. "We are especially excited to present results from the dose escalation stage of the COSMIC-021 trial evaluating the combination of cabozantinib and atezolizumab in advanced kidney cancer and look forward to sharing these data and more with the oncology community at this year’s ESMO (Free ESMO Whitepaper) Congress."

Cabozantinib to be featured in 13 presentations
The full schedule of cabozantinib presentations expected at the meeting is as follows:

Proffered Paper Session

[Abstract LBA67] "Cabozantinib in Patients with Advanced Osteosarcomas and Ewing Sarcomas: a French Sarcoma Group (FSG)/ US National Cancer Institute Phase II Collaborative Study"
Antoine Italiano, M.D., Ph.D., Early Phase Trials Unit, Institut Bergonié, Bordeaux, France
Session: Sarcoma
Proffered Paper Session Friday, October 19, 2:00 – 3:30 PM CEST, Hall B3 – Room 21

Poster Discussion

[Abstract LBA34] "PD-L1 Status and Clinical Outcomes to Cabozantinib, Sunitinib and Everolimus in Patients with Metastatic Clear-Cell RCC Treated on CABOSUN and METEOR Clinical Trials"
Toni K. Choueiri, M.D., Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Session: Genitourinary Tumors, Non Prostate
Poster Discussion Session Saturday, October 20, 2:45 – 4:05 PM, CEST, ICM – Room 1

[Abstract 1310PD] "Prospective Genome and Transcriptome Sequencing in Advanced-Stage Neuroendocrine Neoplasms"
Leonidas Apostolidis, M.D., National Center for Tumor Diseases (NCT), Heidelberg, Germany
Session: NETs
Poster Discussion Session Monday, October 22, 11:00 AM – 12:15 PM CEST, Hall B3 – Room 22

Poster Presentations

[Abstract 702P] "Outcomes by Baseline Alpha-Fetoprotein (AFP) Levels in the Phase 3 CELESTIAL Trial of Cabozantinib (C) versus Placebo (P) in Previously Treated Advanced Hepatocellular Carcinoma (HCC)"
R. K. Kelley, M.D., University of California San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA
Session: Poster Display Session
Poster presented Sunday, October 21, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 703P] "Assessment of Disease Burden in the Phase 3 CELESTIAL Trial of Cabozantinib (C) versus Placebo (P) in Advanced Hepatocellular Carcinoma (HCC)"
Jean Frederic Blanc, M.D., Hôpital Haut-Lévêque, CHU Bordeaux, Bordeaux, France
Session: Poster Display Session
Poster presented Sunday, October 21, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 704P] "Outcomes by Prior Transarterial Chemoembolization (TACE) in the Phase 3 CELESTIAL Trial of Cabozantinib (C) versus Placebo (P) in Patients (pts) with Advanced Hepatocellular Carcinoma (HCC)"
Thomas Yau, M.D., Queen Mary Hospital, Hong Kong, China
Session: Poster Display Session
Poster presented Sunday, October 21, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 1829TiP] "A Noninferiority Trial of Cabozantinib (C) Comparing 60 mg vs 140 mg Orally per Day to Evaluate the Efficacy and Safety in Patients (pts) with Progressive, Metastatic Medullary Thyroid Cancer (MTC)"
Jolanta Krajewska, M.D., Ph.D., M. Sklodowska-Curie Institute – Oncology Center, Gliwice, Poland
Session: Poster Display Session
Poster presented Sunday, October 21, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 1913P] "A Guided and Personnalized Treatment in Metastatic Breast Cancer: Optimisation of Gene and Protein Expression in Tumor Tissue"
Emmanuel Seront, M.D., Cliniques Universitaires Saint-Luc King Albert II Institute, Brussels, Belgium
Session: Poster Display Session
Poster presented Sunday, October 21, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 872P] "Phase 1b Study (COSMIC-021) of Cabozantinib in Combination with Atezolizumab: Results of the Dose Escalation Stage in Patients (pts) with Treatment-Naïve Advanced Renal Cell Carcinoma (RCC)"
Neeraj Agarwal, M.D., Huntsman Cancer Center, Salt Lake City, Utah, USA
Session: Poster Display Session
Poster presented Monday, October 22, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 893P] "Cabozantinib in Metastatic Renal Cell Carcinoma (mRCC): Data from UK Expanded Access Program (EAP)"
Alfonso Gomez de Liano Lista, M.D., Barts Cancer Institute, London, England
Session: Poster Display Session
Poster presented Monday, October 22, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 879P] "Activity of Cabozantinib (cabo) after PD-1/PD-L1 Immune Checkpoint Blockade (ICB) in Metastatic Clear Cell Renal Cell Carcinoma (mccRCC)"
Bradley A. McGregor, M.D., Dana-Farber Cancer Institute, Boston, Massachusetts, USA
Session: Poster Display Session
Poster presented Monday, October 22, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 882P] "Potent Natural Killer (NK) and Myeloid Blood Cell Remodeling by Cabozantinib (Cabo) in Pretreated Metastatic Renal Cell Carcinoma (mRCC) Patients (pts)"
Elena Verzoni, M.D., Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
Session: Poster Display Session
Poster presented Monday, October 22, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

[Abstract 889P] "Clinical Outcomes of Patients with Metastatic Renal Cell Carcinoma (mRCC) Treated with Vascular Endothelial Growth Factor Receptor (VEGFR) Tyrosine Kinase Inhibitors (TKI) and Mammalian Target of Rapamycin Inhibitors (mTORI) after Immuno-oncology (IO) Checkpoint Inhibitors"
Jeffrey Graham, M.D., Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
Session: Poster Display Session
Poster presented Monday, October 22, 12:45 – 1:45 PM CEST, Hall A3 – Poster Area Networking Hub

About CABOMETYX (cabozantinib)

CABOMETYX tablets are approved in the United States for the treatment of patients with advanced RCC. CABOMETYX tablets are also approved in the European Union, Norway, Iceland, Australia, Switzerland, South Korea and Canada for the treatment of advanced RCC in adults who have received prior VEGF-targeted therapy, and in the European Union for previously untreated intermediate- or poor-risk advanced RCC. In March 2017, the FDA granted orphan drug designation to cabozantinib for the treatment of advanced HCC. In May 2018, the FDA accepted Exelixis’ supplemental New Drug Application for CABOMETYX as a treatment for patients with previously treated HCC and assigned it a Prescription Drug User Fee Act action date of January 14, 2019. On March 28, 2018, Ipsen announced that the European Medicines Agency validated its application for a new indication for cabozantinib as a treatment for previously treated advanced HCC in the European Union; on September 20, 2018 the CHMP provided a positive opinion for CABOMETYX as a monotherapy for the treatment of HCC in adults who have been previously treated with sorafenib. In 2016, Exelixis granted Ipsen exclusive rights for the commercialization and further clinical development of cabozantinib outside of the United States and Japan. In 2017, Exelixis granted exclusive rights to Takeda Pharmaceutical Company Limited for the commercialization and further clinical development of cabozantinib for all future indications in Japan.

U.S. Important Safety Information

Hemorrhage: Severe and fatal hemorrhages have occurred with CABOMETYX. In two RCC studies, the incidence of Grade ≥ 3 hemorrhagic events was 3% in CABOMETYX-treated patients. Do not administer CABOMETYX to patients that have or are at risk for severe hemorrhage.
Gastrointestinal (GI) Perforations and Fistulas: In RCC studies, fistulas were reported in 1% of CABOMETYX-treated patients. Fatal perforations occurred in patients treated with CABOMETYX. In RCC studies, gastrointestinal (GI) perforations were reported in 1% of CABOMETYX-treated patients. Monitor patients for symptoms of fistulas and perforations, including abscess and sepsis. Discontinue CABOMETYX in patients who experience a fistula which cannot be appropriately managed or a GI perforation.
Thrombotic Events: CABOMETYX treatment results in an increased incidence of thrombotic events. In RCC studies, venous thromboembolism occurred in 9% (including 5% pulmonary embolism) and arterial thromboembolism occurred in 1% of CABOMETYX-treated patients. Fatal thrombotic events occurred in the cabozantinib clinical program. Discontinue CABOMETYX in patients who develop an acute myocardial infarction or any other arterial thromboembolic complication.
Hypertension and Hypertensive Crisis: CABOMETYX treatment results in an increased incidence of treatment-emergent hypertension, including hypertensive crisis. In RCC studies, hypertension was reported in 44% (18% Grade ≥ 3) of CABOMETYX-treated patients. Monitor blood pressure prior to initiation and regularly during CABOMETYX treatment. Withhold CABOMETYX for hypertension that is not adequately controlled with medical management; when controlled, resume CABOMETYX at a reduced dose. Discontinue CABOMETYX for severe hypertension that cannot be controlled with anti-hypertensive therapy. Discontinue CABOMETYX if there is evidence of hypertensive crisis or severe hypertension despite optimal medical management.
Diarrhea: In RCC studies, diarrhea occurred in 74% of patients treated with CABOMETYX. Grade 3 diarrhea occurred in 11% of patients treated with CABOMETYX. Withhold CABOMETYX in patients who develop intolerable Grade 2 diarrhea or Grade 3-4 diarrhea that cannot be managed with standard antidiarrheal treatments until improvement to Grade 1; resume CABOMETYX at a reduced dose.
Palmar-Plantar Erythrodysesthesia (PPE): In RCC studies, palmar-plantar erythrodysesthesia (PPE) occurred in 42% of patients treated with CABOMETYX. Grade 3 PPE occurred in 8% of patients treated with CABOMETYX. Withhold CABOMETYX in patients who develop intolerable Grade 2 PPE or Grade 3 PPE until improvement to Grade 1; resume CABOMETYX at a reduced dose.
Reversible Posterior Leukoencephalopathy Syndrome (RPLS), a syndrome of subcortical vasogenic edema diagnosed by characteristic finding on MRI, occurred in the cabozantinib clinical program. Perform an evaluation for RPLS in any patient presenting with seizures, headache, visual disturbances, confusion or altered mental function. Discontinue CABOMETYX in patients who develop RPLS.
Embryo-fetal Toxicity may be associated with CABOMETYX. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during CABOMETYX treatment and for 4 months after the last dose.
Adverse Reactions: The most commonly reported (≥25%) adverse reactions are: diarrhea, fatigue, nausea, decreased appetite, hypertension, PPE, weight decreased, vomiting, dysgeusia, and stomatitis.
Strong CYP3A4 Inhibitors: If concomitant use with strong CYP3A4 inhibitors cannot be avoided, reduce the CABOMETYX dosage.
Strong CYP3A4 Inducers: If concomitant use with strong CYP3A4 inducers cannot be avoided, increase the CABOMETYX dosage.
Lactation: Advise women not to breastfeed while taking CABOMETYX and for 4 months after the final dose.
Hepatic Impairment: In patients with mild to moderate hepatic impairment, reduce the CABOMETYX dosage. CABOMETYX is not recommended for use in patients with severe hepatic impairment.

Altimmune Announces $25 million Registered Direct Offering

On October 8, 2018 Altimmune, Inc. (Nasdaq: ALT), a clinical-stage immunotherapeutics company, reported it has entered into a purchase agreement with several institutional investors for the purchase of common units and pre-funded units for a combined total of 4,629,630 units in a registered direct offering, for expected gross proceeds of approximately $25 million before placement agent fees and other offering expenses payable by Altimmune (Press release, Altimmune, OCT 8, 2018, View Source [SID1234529904]).

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Each common unit is being sold at a public offering price of $5.40 and consists of one share of common stock and a warrant to purchase one share of common stock at an exercise price of $5.40. Each pre-funded unit is being sold at a public offering price of $5.39 and consists of a pre-funded warrant to purchase one share of common stock at an exercise price of $0.01 per share and a warrant to purchase one share of common stock at an exercise price of $5.40. The public offering price of each pre-funded unit is equal to the public offering price of each common unit being sold to the public in this offering, minus $0.01. The pre-funded warrants will be immediately exercisable and may be exercised at any time until all of the pre-funded warrants are exercised in full. The other warrants will be exercisable immediately and will expire five years from the date of issuance. The terms of the warrants and the pre-funded warrants will be substantially the same as the terms of the warrants and the pre-funded warrants issued in connection with the Company’s public offering completed October 2, 2018. For a summary of the material terms of the warrants and pre-funded warrants, please refer to Exhibit A attached to this press release.

The offering is expected to close on or about October 10, 2018, subject to customary closing conditions. Altimmune intends to use the net proceeds from this offering for the continued advancement of development activities for our clinical-stage product pipeline, general corporate purposes and strategic growth opportunities.

Roth Capital Partners is acting as sole placement agent for the offering.

The securities described above are being offered by Altimmune pursuant to a registration statement on Form S-3 (File No. 333-217034) that was declared effective by the Securities and Exchange Commission (SEC) on April 6, 2017. A final prospectus supplement and an accompanying prospectus relating to the offering will be filed with the SEC and will be available on the SEC’s web site at www.sec.gov. Copies of the final prospectus supplement and the accompanying prospectus relating to this offering may be obtained, when available, by contacting Roth Capital Partners, LLC, Attention: Equity Capital Markets, 888 San Clemente Drive, Suite 400, Newport Beach, California 92660, by telephone at (800) 678-9147 or e-mail at [email protected].

This press release shall not constitute an offer to sell or a solicitation of an offer to buy, nor shall there be any sale of these securities in any state or jurisdiction in which such offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction.