On October 19, 2018 X4 Pharmaceuticals, a clinical stage biotechnology company developing novel CXCR4 antagonists to improve immune cell trafficking to treat cancer and rare disease, reported results from a pilot study of X4P-001-IO in combination with Opdivo (nivolumab) in patients with clear cell renal cell carcinoma (ccRCC) who are non-responsive to the anti-PD-1 checkpoint inhibitor Opdivo alone (Press release, X4 Pharmaceuticals, OCT 19, 2018, View Source [SID1234529985]). The data will be presented at a Poster Discussion session at CThe data from this study demonstrate that the combination with X4P-001-IO and nivolumab has the potential to augment responses in patients who previously received the anti-PD-1 checkpoint inhibitor nivolumab alone," said Toni K. Choueiri, M.D. Director, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, and lead investigator of the study. "This pilot study data requires validation in larger studies as we continue to seek treatments to address the larger population of cancer patients who do not adequately respond to checkpoint inhibitors."

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Results were presented from the nine patients with advanced ccRCC enrolled in the pilot study (as of August 1, 2018) who were non-responsive to single agent Opdivo with either stable or progressive disease. Enrolled patients received X4P-001-IO (400 mg, oral, once daily) and continued to receive standard bi-weekly Opdivo therapy. Median duration of treatment with the combination was 3.7 months (range 1-15 months).

Highlights of the data presented at ESMO (Free ESMO Whitepaper) include:

X4P-001-IO in combination with Opdivo was tolerable in ccRCC patients. The most frequent drug related adverse events were diarrhea, nasal congestion, ALT/AST increase, dry eye, fatigue. No grade 4 or 5 adverse events occurred. All Grade 3/serious adverse events were manageable with appropriate intervention.
Combination therapy with X4P-001-IO and Opdivo exhibited anti-tumor activity in some patients with advanced ccRCC who were previously unresponsive to Opdivo monotherapy.
Four patients who had progressed on prior Opdivo monotherapy had a best response of stable disease with the additional X4P-001-IO to Opdivo treatment.
Of the five patients who were stable on prior Opdivo monotherapy, one had a partial response with combination therapy of X4P-001-IO and Opdivo.
Serum biomarker analyses identified significant early changes in cytokines and chemokines, including CXCL9, a chemoattractant ligand for cytotoxic T cell migration.
"These findings add to our clinical experience with X4P-001-IO and our growing understanding of combining CXCR4 antagonists with other agents, such as checkpoint inhibitors," said Ken Gorelick, M.D., Chief Medical Officer of X4 Pharmaceuticals. "X4 continues to explore the important role that CXCR4 antagonism may play in augmenting anti-tumor response in combination with other cancer therapeutic modalities, and therefore, potentially improve outcomes for cancer patients."

About X4P-001-IO in Cancer
X4P-001-IO is an investigational selective, oral, small molecule antagonist of C-X-C receptor type 4 (CXCR4). CXCR4 is a chemokine receptor present in abundance on certain immune cells and cancer cells and it plays a critical role in immune cell trafficking, infiltration and activation in the tumor microenvironment. CXCR4 signaling is disrupted in a broad range of cancers, facilitating tumor growth by allowing cancer cells to evade immune detection and creating a pro-tumor microenvironment. X4P-001-IO has the ability to help restore immunity within the tumor microenvironment and has the potential to enhance the anti-tumor activity of approved and emerging oncology agents, such as checkpoint inhibitors and targeted therapies. X4P-001-IO is being investigated in several clinical studies in solid tumors.

On October 19, 2018 Sensei Biotherapeutics, Inc., a clinical-stage biopharmaceutical company developing precision immuno-oncology therapies, announced today the results of the Phase 1 clinical trial evaluating the safety and immunogenicity of SNS-301 in patients with biochemically recurrent prostate cancer (BRPC) (Press release, Sensei Biotherapeutics, OCT 19, 2018, View Source [SID1234529986]). Patients in the clinical trial were antigen-positive for human aspartate β-hydroxylase (ASPH), a novel tumor-specific embryonic antigen, and selected using Sensei’s proprietary companion diagnostic. SNS-301, a first-in-class immunotherapy candidate targeting ASPH, is the lead clinical candidate in Sensei’s pipeline of innovative cancer immunotherapies created using Sensei’s SPIRIT platform. Results from the Phase 1 study of SNS-301 will be presented at a Poster Discussion session at the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) 2018 Congress, taking place October 19-23, 2018, in Munich, Germany.

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"The principal outcomes from this study further energize our strategy of pursuing next-generation targets, such as ASPH, combined with visionary bioengineering and precision medicine," said John Celebi, President and Chief Executive Officer of Sensei Biotherapeutics. "Based on these positive results, we plan to initiate a Phase 2 trial for SNS-301 in various hematological malignancies and solid tumors in early 2019. We also plan to accelerate the development of our cell therapy programs targeting ASPH and other novel tumor-specific antigens."

"SNS-301’s strong anti-tumor immune activity was shown through increases in both ASPH-specific CD8+ T-cells and ASPH-specific B-cell responses," said Ildiko Csiki, M.D., Ph.D., Chief Medical Officer of Sensei Biotherapeutics. "Based on these compelling early data showing anti-tumor immune response, coupled with a favorable safety profile, we believe SNS-301 has the potential to benefit patients with ASPH-expressing tumors. In a Phase 2 setting, we plan to focus on head and neck cancer, myelodysplastic syndrome, and additional solid tumor indications."

In the multi-center Phase 1 clinical trial, SNS-301 was administered every 21 days via intradermal injection to BRPC patients using a fixed dose-escalation schema to establish the recommended Phase 2 dose. The clinical trial enrolled 12 patients who were confirmed to express ASPH using Sensei’s proprietary serum-based companion diagnostic test. Patients received between 8 to 23 doses of SNS-301 (with an average of 10 doses per patient) at the three different doses in the study, with the cohort of low-dose patients progressing through to the high dose, and the cohort of mid-dose patients escalating successfully to the high dose.

Data from the Phase 1 trial demonstrated a favorable safety profile, improvements in disease-related parameters, and ASPH-specific immune responses. Highlights of the safety and immunogenicity data presented at ESMO (Free ESMO Whitepaper) include:

At all three dose levels in the Phase 1 trial (2 x 1010, 1 x 1011, 3 x 1011 particles), SNS-301 was well tolerated with a favorable safety profile. No dose-limiting toxicities or grade 4-5 adverse events were observed in the trial.
Eight out of the 12 patients (75%) achieved improvements in PSA doubling time and/or absolute PSA level, leading to decreased PSA velocity and suggesting a disease stabilizing effect of SNS-301.
An average 8-to-10-fold increase in the percentage of ASPH-specific CD8+ T-cells was observed post-treatment, compared to baseline measurements. Peak antigen-specific T-cell levels were observed between 43 and 85 days from initial treatment. All seven patients that were evaluable for immune responses showed increases in ASPH-specific T-cells.
An average 5-to-7-fold increase in the percentage of ASPH-specific B-cell responses was observed post-treatment, compared to baseline measurements. Peak antigen-specific B-cell levels were observed between 64 and 106 days from initial treatment. All 12 patients enrolled had increases in ASPH-specific B-cells.
A strong corresponding increase in anti-ASPH antibody titers across patients correlated with B-cell response and a subsequent reduction in serum-based ASPH was observed.
The recommended Phase 2 dose was identified as the mid-dose (1 x 1011 particles) in the Phase 1 trial based on immunogenicity and PSA results of the three evaluated doses.
Sensei’s planned Phase 2 program will evaluate SNS-301 as monotherapy in hematological malignancies and as combination therapy with checkpoint inhibitors in multiple solid tumors, with clinical trials to be initiated in 2019.

About SNS-301
SNS-301 is a first-in-class cancer immunotherapy targeting human aspartate β-hydroxylase (ASPH), a cell surface enzyme that is normally expressed during embryonic development. Following embryonic development, the protein is no longer expressed in healthy adults. Expression of ASPH is uniquely upregulated in more than 20 different types of cancer and is related to cancer cell growth, cell motility and invasiveness. ASPH signaling occurs through the Notch pathway and expression levels in various tumors are inversely correlated with disease prognosis. SNS-301 is a bio-engineered, inactivated bacteriophage virus expressing a fusion protein of native bacteriophage GPD (Glyceraldehyde-3-phosphate dehydrogenase) protein and a selected domain of ASPH. SNS-301 is designed to overcome immune tolerance and induce robust and durable ASPH-specific humoral and cellular responses. SNS-301 is paired with a companion diagnostic to ensure appropriate patient selection and is delivered easily through an intradermal injection to aid in generating robust immune response.

On October 19, 2018 – Novartis reported presentation of a new analysis of Lutathera (lutetium Lu 177 dotatate*) NETTER-1 data at the 2018 European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) congress examining the impact of Lutathera treatment on patients with low, medium or high liver tumor burden (Press release, Novartis, OCT 19, 2018, View Source [SID1234529967]). The data show that Lutathera treatment results in significant improvement in progression free survival (PFS) regardless of the extent of baseline liver tumor burden (LTB), elevated alkaline phosphatase (ALP) liver enzyme or presence of large (>30mm diameter) lesion in patients with progressive midgut neuroendocrine tumors (NETs) compared to octreotide LAR alone[1].

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Lutathera is the first Peptide Receptor Radionuclide Therapy (PRRT) to receive regulatory registration, with approval by the European Commission in September 2017 and by the US Food and Drug Administration (FDA) in January 2018. Lutathera is an Advanced Accelerator Applications product.

"Patients with metastatic midgut NET and a high liver tumor load at diagnosis have a poorer prognosis than patients with few liver metastases[2],[3]," said Jonathan Strosberg, MD, Associate Professor, Section Head, Neuroendocrine Tumor Program at Moffitt Cancer Center, and Principle Investigator of the NETTER-1 study. "These new data provide hope for these patients and reinforce the potential benefit of Lutathera treatment in this population."

Liver tumor burden (LTB) was defined as tumor volume/total liver volume by CT or MRI, and categorized as low (<25%), moderate (25-50%), and high (>50%)[1]. Median PFS (months) in Lutathera arm vs 60 mg octreotide LAR alone was 28.35 vs 11.04 in low (HR=0.218, 95% CI 0.120 to 0.394); Not Reached (NR) vs 8.67 in moderate (HR=0.202, 95% CI 0.077 to 0.525); 19.38 vs 5.52 in high LTB (HR= 0.193, 95% CI 0.079 to 0.474), respectively[1].

Because the numbers of patients and events of deteriorations are small for the moderate and high liver burden groups for quality of life assessments, moderate/high liver burden groups were pooled into one group[1]. Median TTD (months) for global health status (self-assessment of overall health and quality of life) in Lutathera arm vs 60 mg octreotide LAR alone was 28.81 vs 6.11 in low (HR=0.376, 95% CI 0.196 to 0.720); and NR vs 5.98 in moderate/high LTB (HR=0.453, 95% CI 0.178 to 1.152) [1]. Median TTD (months) for physical functioning was 25.20 vs 11.47 in low (HR=0.512, 95% CI 0.264 to 0.994); and NR vs 11.56 in moderate/high LTB (HR=0.526, 95% CI 0.207 to 1.335) [1].

"These results from the NETTER-1 study continue to show that Lutathera delivers strong efficacy in patients with a challenging disease burden," said Samit Hirawat, MD, Head of Novartis Oncology Global Drug Development. "Demonstrating improved PFS and maintenance of QoL in patients with neuroendocrine tumors with poor prognosis due to a high liver tumor burden is a great example of our commitment to reimagining cancer."

Additional sub-analysis evaluated median PFS in patient subgroups with normal or elevated baseline levels of liver enzyme alkaline phosphatase (ALP), and in subgroups with presence or absence of a large (>30 mm diameter) lesion at baseline[1]. Median PFS (months) in Lutathera arm vs 60 mg octreotide LAR alone for the group with normal ALP was 28.35 vs 8.74 (HR=0.204, 95% CI 0.117 to 0.357)[1]. Median PFS (months) in Lutathera arm vs 60 mg octreotide LAR alone for the group with elevated ALP was NR vs 5.78 (HR=0.191, 95% CI 0.090 to 0.405)[1]. Median PFS (months) in Lutathera arm vs 60 mg octreotide LAR alone for the group with a large tumor lesion was 28.35 vs 8.44 (HR=0.266, 95% CI 0.165 to 0.429)[1]. Median PFS (months) in Lutathera arm vs 60 mg octreotide LAR alone for the group without a large tumor lesion was NR vs 8.74 (HR= 0.069, 95% CI 0.021 to 0.233)[1].

The NETTER-1 trial is an international phase III study in patients with progressive, somatostatin receptor-positive midgut neuroendocrine tumors[4]. Patients were randomized to treatment with Lutathera (Lu)(n=117) and best supportive care (30 mg octreotide LAR), or 60 mg octreotide LAR alone (Oct) (n=114). In total, 141 patients had low (71 Lu, 70 Oct), 50 patients had moderate (19 Lu, 31 Oct), and 40 patients had high LTB (27 Lu, 13 Oct).

European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaires, a commonly used metric for analysis of HRQoL in cancer patients, were assessed during the trial to determine the impact of treatment on HRQoL[5]. Patients completed the questionnaires at baseline and every 12 weeks until tumor progression. TTD was defined as the time from randomization to the first QoL deterioration >=10 points (on a 100-point scale) compared to baseline score for the same domain.

About Lutathera
Lutathera (lutetium Lu 177 dotatate*) is a lutetium Lu 177-labeled somatostatin analog peptide. Lutathera belongs to a class of treatments called Peptide Receptor Radionuclide Therapy (PRRT). Lutathera is comprised of a targeting molecule which carries a radioactive component. Lutathera has received orphan drug designation from the FDA and the European Medicines Agency (EMA). In the US, Lutathera is indicated for the treatment of somatostatin receptor positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors in adults[6]. In Europe, Lutathera is indicated for the treatment of unresectable or metastatic, progressive, well differentiated (G1 and G2), somatostatin receptor positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in adults[7]. Lutathera can cause serious side effects that may include bone marrow problems, kidney problems, liver problems, hormonal gland problems, fertility problems and problems arising from radiation exposure. Please see Important Safety Information and Full Prescribing Information at: www.lutathera.com.

* USAN: lutetium Lu 177 dotatate / INN: lutetium (177Lu) oxodotreotide

On October 19, 2018 Deciphera Pharmaceuticals, Inc. (NASDAQ:DCPH), a clinical-stage biopharmaceutical company focused on addressing key mechanisms of tumor drug resistance, reported the presentation today of updated preliminary results from its ongoing Phase 1 clinical study of DCC-2618, the company’s broad-spectrum KIT and PDGFRα inhibitor, in patients with gastrointestinal stromal tumors (GIST) as a proffered paper presentation at the European Society of Medical Oncology (ESMO) (Free ESMO Whitepaper) 2018 Congress in Munich, Germany (Press release, Deciphera Pharmaceuticals, OCT 19, 2018, View Source [SID1234529987]).

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"We are extremely pleased with the preliminary results presented today that we believe demonstrate the potential of DCC-2618 to provide improved, durable clinical benefit for GIST patients from second-line through fourth-line-plus," said Michael D. Taylor, Ph.D., President and Chief Executive Officer of Deciphera. "While the data set is still maturing, we believe the median progression free survival value of 42 weeks observed in second-line GIST patients strongly supports our planned randomized Phase 3 study, INTRIGUE, in second-line GIST patients, which we expect to initiate before the end of the year. In addition, the disease control rate and objective response rate observed with DCC-2618 in second-line GIST patients continues to exceed the values reported in previously published, centrally-read, registrational trials for sunitinib."

The presentation reported preliminary results with a cutoff date of August 31, 2018 that include investigator-assessed median progression free survival (mPFS), objective response rates by best response (ORR) and disease control rates at 3 months (DCR) as determined by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 across 178 patients receiving DCC-2618 at doses of ≥100mg daily:

Notes: (1) Includes nine unconfirmed responses: 2nd line (n=1), 3rd line (n=3) and ≥4th line (n=5); (2) Does not reflect one PR reported after cutoff date, which would result in an ORR in 2nd line of 21% and an ORR in 2nd line and 3rd line combined of 22%; (3) Excludes five patients due to missing data at the time of data cutoff (n=2), lack of first tumor assessment (n=1), withdrawal of consent prior to first assessment (n=1) and unrelated death at C1D4 prior to first assessment (n=1); (4) 59 of 67 combined 2nd line and 3rd line patients received 150mg once daily; and (5) Censored patients for mPFS were 2nd line (58%), 3rd line (52%), 4th line and 4th line plus (35%) and 2nd and 3rd line (55%).

"The preliminary progression free survival data and objective response rates observed with DCC-2618 are very encouraging across all lines of therapy presented: second-, third-, and fourth-line and beyond," said Suzanne George, M.D., Director of Clinical Research, Center for Sarcoma and Bone Oncology and Senior Physician at the Dana Farber Cancer Institute and Associate Professor of Medicine at Harvard Medical School. "There is a clear unmet need for effective and well tolerated options for patients with metastatic GIST beyond the first-line."

Highlights from the proffered paper include:

Preliminary Clinical Activity in Second-, Third-, Fourth- and Fourth-Line-Plus GIST Patients Demonstrates the Potential for Durable Clinical Outcomes with DCC-2618

Progression Free Survival (mPFS): The mPFS values observed with DCC-2618 were 42 weeks in second-line patients and 40 weeks in third-line patients. Previously published results for approved therapies from centrally-read registrational trials reported a mPFS for sunitinib of 24 weeks in second-line patients and a mPFS for regorafenib of 21 weeks in third-line patients. In fourth- and fourth-line-plus patients, where there are currently no approved therapies, the observed mPFS with DCC-2618 was 24 weeks. Published studies have reported a mPFS of 4-6 weeks for similarly heavily pre-treated patients who did not receive an active therapy.
Disease Control Rate (DCR): The observed DCRs at three months of 79% in second-line patients and 83% in third-line patients exceed the previously published results for approved therapies from centrally-read registrational trials of 60% for sunitinib in second-line patients and 53% for regorafenib in third-line patients. The DCR observed for DCC-2618 in fourth-line and fourth-line-plus patients was 66%.
Objective Response Rate (ORR): The observed ORRs of 18% in second-line patients and 24% in third-line patients continue to exceed the previously published results for approved therapies from centrally-read registrational trials of 7% for sunitinib in second-line patients and 5% for regorafenib in third-line patients. These values do not include a partial response in one second-line patient that was observed after the cutoff date, which would result in an ORR in second-line patients of 21%. The ORR observed for DCC-2618 in fourth-line and fourth-line-plus patients was 9%.
Prolonged Treatment Duration in GIST Patients Receiving DCC-2618 – Cutoff Date of August 31, 2018

In the second-line cohort, as of the cutoff date, 17 patients received DCC-2618 at doses of ≥100mg daily for >6 months with 65% (11 of 17) of these patients remaining on study.
In the third-line cohort, as of the cutoff date, 20 patients received DCC-2618 at doses of ≥100mg daily for >6 months with 75% (15 of 20) of these patients remaining on study.
In the fourth-line and fourth-line-plus patients, as of the cutoff date, 46 patients received DCC-2618 at doses of ≥100mg daily for >6 months with 74% (34 of 46) of these patients remaining on study.
Updated Safety Data Continue to Demonstrate a Favorable Tolerability Profile for DCC-2618

For 178 GIST patients treated at doses above ≥100mg daily, DCC-2618 was generally well tolerated.
Among the treatment-emergent adverse events (TEAEs) reported by investigators (>10%), regardless of relationship to DCC-2618, the most common were: alopecia (50%), myalgia (44%), fatigue (43%), constipation (34%), hand-foot skin reaction (32%), nausea (30%), decreased appetite (28%), weight decreased (24%), abdominal pain (23%), diarrhea (23%) and lipase increase (23%).
Among the 178 GIST patients treated at doses above ≥100mg daily:
14% (24) patients experienced dose reductions due to TEAE.
11% (19) experienced treatment discontinuations due to TEAE.
A copy of the proffered paper will be available on the Deciphera Pharmaceuticals website in the Science section under "Presentations and Publications" located at www.deciphera.com. A copy of the updated Corporate Presentation will be available on the Deciphera Pharmaceuticals website in the Investor section under "Events and Presentations" located at www.deciphera.com.

About DCC-2618
DCC-2618 is a KIT and PDGFRα kinase switch control inhibitor in clinical development for the treatment of KIT and/or PDGFRα-driven cancers, including gastrointestinal stromal tumors, or GIST, systemic mastocytosis, or SM, and glioblastoma multiforme. DCC-2618 was specifically designed to improve the treatment of GIST patients by inhibiting a broad spectrum of mutations in KIT and PDGFRα. DCC-2618 is a KIT and PDGFRα inhibitor that blocks initiating and secondary KIT mutations in exons 9, 11, 13, 14, 17, and 18, involved in GIST as well as the primary D816V exon 17 mutation involved in SM. DCC-2618 also inhibits primary PDGFRα mutations in exons 12, 14 and 18, including the exon 18 D842V mutation, involved in a subset of GIST.

On October 19, 2018 NANOBIOTIX (Euronext : NANO – ISIN : FR0011341205), a late clinical-stage nanomedicine company pioneering new approaches in the treatment of cancer, presented NBTXR3 positive Phase II/III Act.in.sarc results in patients with locally advanced Soft Tissue Sarcoma at the European Society for Medical Oncology (ESMO) (Free ESMO Whitepaper) 2018 Congress (Munich, Germany) during the Proffered Paper Oral presentation of the Sarcoma Section (LBA66) (Press release, Nanobiotix, OCT 19, 2018, View Source [SID1234530019]).

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NBTXR3 is a first-in-class product with a new mode of action designed to physically destroy cancer cells when
activated by radiation therapy (RT). NBTXR3 is designed to directly destroy tumors and activate the immune system
for both local control and systemic disease treatment.

Dr. Sylvie Bonvalot, Head of Sarcoma and Complex Tumor Surgery Unit at Institut Curie, Paris, France and Global
Principal Investigator commented: "The medical community was very enthusiastic about the results, presented at
ESMO, one of the largest international multicentric studies carried out in Soft Tissue Sarcoma patients following
guidelines from the EORTC- European Organization for Research and Treatment of Cancer. The results show
unequivocally that NBTXR3 improves current radiation therapy. This should change the standard of care in the
treatment of sarcoma but also potentially of other cancers."

In the Phase II/III Act.in.sarc study, a total of 180 adult patients with locally advanced Soft Tissue Sarcoma of the
extremities or trunk wall were randomly allocated, in a 1:1 ratio, to either (i) Arm A, and received a single
intratumoral injection of NBTXR3 at the recommended dose (10% of baseline tumor volume) followed by radiation
therapy or (ii) Arm B, the control arm, and treated with radiation therapy alone. In both arms, radiotherapy was
followed by surgery. The primary efficacy analysis was performed on the intent-to-treat population following the
Full Analysis Set principle (ITT-FAS) population as per protocol.

Pathological Complete Response Rate (pCRR): the study met its primary endpoint
The study met its primary endpoint with a pathological complete response (<5% viable cancer cells) rate of 16.1% in
the NBTXR3 arm vs 7.9% in the control arm (p=0.0448).

In addition, in the subgroup of patients with a more advanced disease (histologic grade 2 and 3) pathological
complete response was achieved in 4 times more patients in the NBTXR3 arm than in the control arm (17.1% vs
3.9%).

An increase in the proportion of patients with a pathological response regardless of the pre-defined cut-off was
observed in Arm A. The proportion of patients with pathological nearly complete response (<7% of viable cancer
cells) and pathological response with 10% or less of viable cells were 24.7% and 34.6%, respectively, in the NBTXR3
arm vs 14.8% and 19.8% in the control arm. R0 resection margin: the study met its main secondary endpoint
The main secondary endpoint of carcinologic resection was also met with R0 resection margin achieved in 77% of
the patients who received NBTXR3 compared to 64% of patients in the control arm (p=0.0424).

Tumor necrosis/infarction: the study also met this secondary endpoint Histologic analysis showed that the mean percentage of tumor necrosis/infarction was also increased in the NBTXR3 arm compared to the control arm (28.8% vs 19.2%; p=0.014) Safety profile similarity across study arms Similar safety profiles were observed in the NBTXR3 arm and the radiation therapy alone arm. NBTXR3 did not impact the patients’ ability to receive the planned dose of radiotherapy and the radiotherapy safety profile was similar in both arms, including the rate of postsurgical wound complications. NBTXR3 was associated with grade 3-4 acute immune reactions in 7.9% of patients, which were manageable and of short duration.

NBTXR3 showed a good local tolerance and no impact on the severity or incidence of radiotherapy-related adverse
events. Long-term follow-up of the patients is ongoing to evaluate the Time-to-Local/Distant Recurrence and
Local/Distant Recurrence Rate (LRR/DRR) at 12 and 24 months.

About Act.in.sarc study
The Phase II/III study was a prospective, randomized (1:1), multinational, open label and active controlled two arm study of the efficacy and safety of NBTXR3 activated by radiotherapy compared to radiotherapy alone in patients with locally advanced Soft Tissue Sarcoma (STS) of the extremity or trunk wall. Patients have been treated with the standard dose of radiation, a total dose of 50 Gy given in 25 fractions of 2 Gy over 5 weeks, followed by surgical resection of the tumor. The primary objective was to evaluate the pathological complete response rate (pCRR)* in both arms. The secondary endpoints included a safety profile and assessment of carcinologic resection rate** in terms of margin status. Efficacy endpoints have been measured on surgically resected tumors by a pathological central review board. The primary efficacy analysis was planned to be performed on the intentto-treat
(ITT) population***. The ITT-FAS population (176 patients) was used for the analysis, and 4 patients were excluded from the ITT-FAS: 3 did not have STS (2 in Arm A, 1 in Arm B) and 1 (in Arm A) was not eligible for preoperative RT.

*A pathological Complete Response is defined as the presence of less than 5% of residual malignant viable cells in the surgically removed tissue. The primary endpoint compared the proportion of patients presenting pathological Complete Response (pCR) between the two arms. This was determined by an independent pathological central review according to EORTC score (Wardelmann et al., 2016).

** The resection margin status is an evaluation of the quality of surgery. Surgery remains the mainstay of care for locally advanced soft tissue sarcoma. The primary surgical objective is the complete removal of the tumor with negative resection margins (R0).

Several retrospective studies suggest that surgical margin status predicts the risk of local and distant recurrence. In particular, negative surgical margins are significantly correlated to increased patient survival.
*** Intent-to-treat (ITT) population includes all patients with an informed consent given and a successful and confirmed randomization number allocation through the treatment allocation system (IWRS) with a non-missing date of randomization. All analysis using this population is based on the treatment assigned by randomization. ITT population following the Full Analysis Set principle (ITT-FAS) is considered with specific attention paid to the following cases: Patients randomized and having received no treatment / Patients without any data post-randomization / Patients randomized in spite of the non-satisfaction of a major entry criterion (eligibility violation).

About NBTXR3
NBTXR3 is a first-in-class product designed to destroy, when activated by radiotherapy:
• tumors through physical cell death
• metastasis due to immunogenic cell death leading to activation of the immune system
NBTXR3 has a high degree of biocompatibility, requires one single administration before the whole radiotherapy treatment and Nanobiotix believes it has the ability to fit into current worldwide standards of radiation care.

Nanobiotix’s broad clinical program includes 10 patient populations evaluated in 7 clinical trials.

In June 2018, Nanobiotix established human proof of concept for this first-in-class product in its Soft Tissue Sarcoma (STS) Phase III clinical trial. NBTXR3 is actively being evaluated in head and neck cancer with locally advanced squamous cell carcinoma of the oral cavity of oropharynx in elderly and frail patients that are unable to receive chemotherapy or cetuximab and have very limited therapeutic options. Promising results have been observed from the ongoing Phase I/II trial regarding the local control of tumors.

Nanobiotix is running an Immuno-Oncology development program. In the United States, Nanobiotix has received approval from the U.S. Food and Drug Administration (FDA) to launch a clinical study of NBTXR3 activated by radiotherapy in combination with anti-PD1 antibodies in lung, and head and neck cancer patients (head and neck squamous cell carcinoma and non-small cell lung cancer).

The other ongoing NBTXR3 trials are treating patients with liver cancers (hepatocellular carcinoma and liver metastasis), locally advanced or unresectable rectal cancer in combination with chemotherapy, head and neck cancer in combination with concurrent chemotherapy, and prostate adenocarcinoma.

The first market authorization process (CE Marking) is ongoing in Europe in the STS indication.