On December 10, 2024 Ensem Therapeutics, Inc. (ENSEM), a pioneering drug discovery and development company that leverages its unique Kinetic Ensemble platform to advance innovative small molecule precision medicines for oncology, reported for the first time preclinical data on ETX-197/BG-68501, a potential best-in-class oral, selective CDK2 inhibitor at the 47th Annual San Antonio Breast Cancer Symposium ("SABCS") in San Antonio, Texas (Press release, ENSEM Therapeutics, DEC 10, 2024, View Source [SID1234649017]). ETX-197/BG-68501 has a differentiated preclinical profile and the potential to deliver clinical benefit to patients with tumors associated with CDK2 dependency.

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CDK2 is a well-established vulnerability of multiple cancers, including tumors with increased expression of Cyclin E (CCNE) or the mutation/loss of the Retinoblastoma 1 gene (RB1). There are currently no approved CDK2 specific drugs. ETX-197/BG-68501 was designed through ENSEM’s Kinetic Ensemble platform to induce previously unexplored interactions within the CDK2 ATP binding pocket, leading to increased potency and selectivity compared to other CDK2 inhibitors.

ETX-197/BG-68501 shows tight binding (slow off-rate) for CDK2 which results in potent and concordant pharmacodynamic modulation and anti-proliferative activity both in vitro and in vivo. ETX-197/BG-68501 is 100-fold more selective for CDK2 over other kinases in the CDK family and this superior selectivity extends more broadly against 385 other kinases, indicating the potential for promising tolerability in the clinic.

In mouse xenograft studies using a CCNE-amplified ovarian cancer cell line or patient-derived tumors, ETX-197/BG-68501 showed sustained target engagement, dose-dependent tumor growth inhibition with excellent tolerability. ETX-197/BG-68501 demonstrated single agent efficacy in a breast cancer xenograft model that had acquired resistance to a CDK4/CDK6 inhibitor. In addition, ETX-197/BG-68501 showed anti-tumor activity in other in vitro and in vivo tumor models including small cell lung and ovarian cancers, indicating its broad clinical potential beyond breast cancer.

"Inhibiting CDK2 potently and selectively over other CDK family members represents a significant challenge," said Shengfang Jin, CEO and Co-Founder of ENSEM. "The promising preclinical results with ETX-197/BG-68501 underscore the potential of our Kinetic Ensemble platform to discover small molecules against high value and difficult to drug targets." She noted that BeiGene is currently conducting a first-in-human Phase 1a/1b clinical study (NCT06257264) to assess the safety tolerability, pharmacokinetics, pharmacodynamics and preliminary anti-tumor activity of ETX-197/BG-68501, and is presenting a "Trial-in-Progress" poster for this ETX-197/BG-68501 clinical study at the Symposium.

Poster Details

Title: ETX-197/BG-68501, a potential best-in-class potent, selective oral small molecule CDK2 inhibitor, has anti-tumor activity in cancer models with Cyclin E amplification or deficiency in the Retinoblastoma 1 gene
Poster ID: P4-12-29
Sessions: Poster Session
Date/Time: Thursday, December 12, 2024, from 5:30 to 7 p.m. CT
Location: Halls 2-3

On December 10, 2024 Curis, Inc. ("Curis") (NASDAQ: CRIS), a biotechnology company focused on the development of emavusertib (CA-4948), an orally available, small molecule IRAK4 inhibitor, reported data from the TakeAim Leukemia study (CA-4948-102) in relapsed/refractory (R/R) Acute Myeloid Leukemia (AML) at the 66th ASH (Free ASH Whitepaper) annual meeting (Press release, Curis, DEC 10, 2024, View Source [SID1234648969]).

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The additional data presented include data for 21 patients with a FLT3 mutation (FLT3m) who had received fewer than 3 lines of prior therapy and were treated with emavusertib as monotherapy at the Recommended Phase 2 Dose (RP2D) of 300 mg BID. This brings the total number of patients dosed at the RP2D from 12 to 21 patients.

Data show 10 objective responses in 19 response-evaluable patients: 6 complete remission (CR), 2 CR with either a complete remission with incomplete hematological recovery (CRi) or a partial hematological recovery (CRh) and 2 morphologic leukemia-free state (MLFS). Prior therapies of responders included Venetoclax (5/10), HMA (6/10), and FLT3i (6/10). Two of the 21 patients were treated, but discontinued treatment prior to first disease assessment (death occurred at Day 8 and Day 13, respectively), and were not included as response-evaluable patients.

Two patients who achieved a CR and CRi, respectively, proceeded to allogenic stem cell transplantation. Responses were achieved rapidly in this population, with 7 of 10 responses reported at the first assessment (Cycle 2 Day 1).

"We continue to be pleased with the monotherapy data in R/R AML patients with a FLT3 mutation," said James Dentzer, President and CEO of Curis, "and believe these data further support the exciting potential of emavusertib’s novel mechanism to address a significant unmet need in patients with AML."

On December 10, 2024 IN8bio, Inc. (Nasdaq: INAB), a clinical-stage biopharmaceutical company developing innovative gamma-delta T cell therapies, reported updated data from the ongoing Phase 1 trial of INB-100, an allogeneic, haploidentical gamma-delta T cell therapy in older patients with hematologic malignancies undergoing haploidentical stem cell transplant (HSCT) with reduced intensity conditioning (RIC) at the 2024 American Society of Hematology (ASH) (Free ASH Whitepaper) Annual Meeting, being hosted in San Diego, CA (Press release, In8bio, DEC 10, 2024, View Source [SID1234648986]).

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"This data demonstrates the potential of allogeneic INB-100 gamma-delta T cells to provide durable relapse-free remissions in high-risk or relapsed AML patients undergoing HSCT," said Dr. Joseph P. McGuirk, Schutte-Speas Professor of Hematology-Oncology, Division Director, Hematologic Malignancies and Cellular Therapeutics Medical Director, Blood and Marrow Transplant, The University of Kansas Cancer Center. "Older, frailer patients who receive non-myeloablative, reduced intensity conditioning regimens typically have a significant risk of relapse. Historically, approximately 25% of AML patients undergoing HSCT would be expected to have a leukemic relapse within the first 100 days post-transplant, with up to nearly 50% of such patients experiencing relapse by one-year, which remains the primary cause of death. The longer AML patients remain in remission post-HSCT, the greater their probability of survival. These observed long-term durable remissions using allogeneic gamma-delta T cells are very encouraging and we look forward to announcing additional data next year."

In a poster presentation, IN8bio reported that there have been no newly reported deaths or relapses as of September 30, 2024. As of that cutoff date, median CR was at 16.4 months following a median of 19.2 months of follow-up. As previously reported, all patients (n=10) remained alive, progression-free, and in durable CR through one-year. 100% of AML patients remain in CR after a median 19.7 months of follow-up with three patients with high-risk cytogenetic AML and receiving no maintenance therapy remaining in mCR for greater than three years.

INB-100 continues to demonstrate in vivo expansion and persistence of an haplo-matched allogeneic, or donor-derived cellular, therapy at 365 days with blood levels of gamma-delta T cells surpassing levels previously observed to be associated with greater survival. The persistence of these cells is suggestive of continued gamma-delta T cell surveillance against leukemic relapse.

In addition to the reported complete responses, INB-100 continued to demonstrate a well-tolerated safety profile with no cytokine release syndrome (CRS) or neurotoxicity (ICANS) observed and limited mild infections. Based upon these encouraging results, the INB-100 trial has been expanded to enroll additional patients at Dose Level (DL) 2, the recommended Phase 2 dose (RP2D). Enrollment of additional patients into the expansion cohort is on-going and updated data, are expected to be reported in the first half of 2025.

Summary of Data Presented at ASH (Free ASH Whitepaper)

The Phase 1 investigator-sponsored trial enrolled and treated ten patients at one of two dose levels (D1 or D2). The median age was 68 years with the majority of patients diagnosed with AML in CR1. Two patients (009 and 011) had TP53 mutations, a tumor suppressor that results in poor prognosis, rapid progression and reduced lifespan due to an inability to respond to mutated or damaged DNA.

The latest INB-100 trial data on immune reconstitution continues to show significant allogeneic gamma-delta T cell expansion and persistence in patients through the first 365 days post-treatment. As of September 30, 2024, 100% of patients (n=10) surpassed one-year survival following their haplo-matched transplant and treatment with INB-100. Historically, approximately 25% of patients relapse by 100 days and 40-50% of patients relapse by one year.

Updated safety data includes:

No dose limiting toxicities (DLTs) and no treatment related deaths were observed.
Low grade (1-2) acute graft versus host disease (GvHD) observed in 60% of patients treated. Cases were all steroid responsive.
Treatment-related serious adverse events included Grade 2 rash (60%) and Grade 3 nausea (20%).
One patient death previously reported due to idiopathic pulmonary syndrome likely related to the underlying HSCT at 15.5 months, without disease progression.
No ICAN, CRS, or major infections were observed.
Seven patients across DL 1 and DL 2 remained on study and in CR, with three having surpassed three years, including one now remaining progression free for over four years.

On December 10, 2024 Scorpion Therapeutics, Inc. ("Scorpion"), a clinical-stage, precision oncology company developing transformational targeted therapies for patients with cancer, reported updated analyses from its Phase 1/2 study of STX-478 in advanced solid tumor patients in a poster spotlight presentation at the San Antonio Breast Cancer Symposium ("SABCS") 2024 and provided program updates, including a new collaboration with Pfizer to evaluate the triplet combination of STX-478 + atirmociclib + fulvestrant in frontline patients with PI3Kα-mutated HR+/HER2- metastatic breast cancer (Press release, Scorpion Therapeutics, DEC 10, 2024, View Source [SID1234649018]).

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"Scorpion is dedicated to expanding the reach of precision medicine to as many patients as quickly as possible. Our updated analyses presented at SABCS show STX-478’s low dose modification rates and increased response rate at higher doses, reflecting its high level of pathway inhibition. These studies, along with our new collaboration with Pfizer to advance the triplet study of STX-478 + fulvestrant with their novel, selective investigative CDK4 inhibitor in frontline patients, bring us one step closer to this ambitious goal," said Adam Friedman, M.D., Ph.D., Chief Executive Officer of Scorpion. "We are committed to being at the forefront of the emerging treatment landscape as we actively enroll our fulvestrant +/- CDK4/6 inhibitors cohorts of STX-478 and explore new triplet combinations with promising next-generation therapies such as atirmociclib."

Expansion Study Collaboration Updates

Scorpion Therapeutics and Pfizer Inc. (NYSE: PFE) entered into a new clinical trial collaboration and supply agreement to evaluate atirmociclib, Pfizer’s investigative selective-CDK4 inhibitor, in combination with STX-478 and fulvestrant in patients with PI3Kα-mutated, HR+/HER2- metastatic breast cancer in the frontline metastatic setting. Under the terms of the agreement, Scorpion and Pfizer will equally share the development costs of the study. In addition, Pfizer will supply atirmociclib for use in the study and Scorpion will manage the conduct of the study. The STX-478 + atirmociclib + fulvestrant triplet combination is planned to begin in 2H25.

Data from the Phase 1/2 Study of STX-478 in Advanced Solid Tumors at SABCS 2024

Scorpion has shown in Phase 1 monotherapy data that STX-478, an oral, once-daily, mutant-selective, allosteric PI3Kα inhibitor, demonstrated robust PI3Kα pathway inhibition as a monotherapy, with anti-tumor activity observed in multiple cancer types, including a 23% overall response rate (ORR) in HR+/HER2- breast cancer (BC) and a 44% ORR in gynecological tumors, amongst others. STX-478 was well-tolerated, including in pre-diabetic, diabetic and heavily pre-treated patients and showed minimal significant wild-type-mediated toxicities. These results suggest that STX-478 could overcome the limitations of currently available pathway inhibitors and, consequently, meaningfully improve clinical outcomes for patients with PI3Kα kinase or helical domain-mutated solid tumors.

In the poster presented at SABCS 2024, updated analyses for STX-478 demonstrated a favorable safety profile with minimal dose modifications observed, including no patient discontinuations due to an adverse event. Updated efficacy analyses demonstrated a positive dose-response relationship as monotherapy in patients with HR+/HER2- breast cancer, which correlates with a high level of PI3Kα pathway target coverage. Combination cohorts with a STX-478 + fulvestrant doublet and STX-478 + fulvestrant + CDK4/6 inhibitor triplet are actively enrolling in patients with HR+/HER2- breast cancer.

The presentation is available here on Scorpion’s website.

"STX-478 is characterized by a markedly higher therapeutic index, improving clinical outcomes and quality of life for patients during treatment compared to approved non-mutant-selective inhibitors," said Dejan Juric, M.D., Director of the Termeer Center for Targeted Therapies at the Massachusetts General Hospital and STX-478 trial investigator. "Based on the very promising monotherapy results, I look forward to studying STX-478’s activity in doublet and triplet combination trials, particularly those that capture the known synergy between inhibition of PI3Kα and estrogen receptor antagonism in HR+/HER2-breast cancer, as well as CDK inhibition. Development of higher order combinations of increasingly selective targeted therapeutic agents represents the next frontier in precision oncology, and I believe STX-478 is well-positioned to drive major progress in this area."

About STX-478

STX-478 is an allosteric, wild-type-sparing, CNS-penetrant, oral small molecule inhibitor of mutant PI3Kα, a well-known, clinically-validated oncogene associated with a variety of solid tumors and one of the most highly mutated targets in all of cancer, which occurs in more than 166,000 patients per year with breast, gynecological and other solid tumors in the United States alone. Based on preclinical data and initial data from the ongoing Phase 1/2 trial, STX-478 has the potential to address significant unmet needs in patients with PI3Kα-mutant cancers left by existing therapies through less toxicity and sustained and deeper responses. STX-478 is in an ongoing Phase 1/2 trial exploring its activity across a range of solid tumors with both kinase and helical domain mutations. The trial includes patients both previously exposed to and naïve to alpelisib and other PI3K pathway inhibitors and includes expansion cohorts in which STX-478 is being evaluated in combination with fulvestrant in second line HR+/HER2- breast cancer and in combination with fulvestrant plus CDK4/6 inhibitors in frontline HR+/HER2- breast cancer. To learn more about the first-in-human trial of STX-478, please visit this page.

On December 10, 2024 Pilatus Biosciences Inc. reported that the U.S. Food and Drug Administration (FDA) has granted Orphan Drug Designation (ODD) to its leading molecule, PLT012, for treating liver and intrahepatic bile duct cancer (HCC/ICCA) (Press release, Pilatus Biosciences, DEC 10, 2024, View Source [SID1234649003]). Achieved in November 2024, this designation marks a crucial advancement in developing innovative therapies for patients facing these challenging cancers. Dr. Raven Lin, CEO, emphasized the company’s commitment to addressing urgent medical needs, while Prof. Ping-Chih Ho highlighted PLT012’s unique therapeutic approach targeting the tumor microenvironment. Pilatus is actively working with regulatory authorities to expedite PLT012’s development and availability.

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Pilatus Biosciences, a preclinical-stage biopharmaceutical company spun out from the Ludwig Institute for Cancer Research (Lausanne), is leading the development of first-in-class biologics targeting metabolic checkpoints. Supported by the Cancer Research Institute (New York), the company employs a pioneering approach to immunometabolism, reprogramming the immune microenvironment to combat cancer effectively.

"We are honored to receive Orphan Drug Designation for PLT012, a milestone that reflects our dedication to addressing the urgent need for innovative therapies in liver and intrahepatic bile duct cancer," said Dr. Raven Lin, CEO and Co-founder of Pilatus Biosciences. Prof. Ping-Chih Ho, Chair of the Scientific Advisory Board and Co-founder of Pilatus Biosciences, added, "PLT012 leverages metabolic checkpoint targeting to reprogram the tumor microenvironment (TME), offering a unique therapeutic approach. This designation highlights the promising scientific discoveries and results we have achieved in addressing the underserved area. It further motivates us to accelerate PLT012’s development and collaborate globally to bring this promising treatment to patients with limited options."

Currently, Pilatus Biosciences is advancing the development of PLT012, actively engaging with regulatory authorities and stakeholders to expedite the availability of this promising therapy.

About PLT012

PLT012, is a humanized anti-CD36 antibody with a unique dual mechanism of action (MOA): it simultaneously disarms immunosuppressive cell populations and amplifies effector T cell functions. PLT012 has shown potential against multiple tumors with unmet medical needs. It is set to advance to its first U.S. IND submission and first patient dosing in 2025. As a monotherapy, PLT012 demonstrates remarkable anti-tumor efficacy in both immune ‘hot’ and ‘cold’ tumor models with a significant augmentation in GzmB-expressing CD8+ T cells and reductions in both intratumoral Tregs and pro-tumorigenic macrophage. Additionally, PLT012 treatment alters the exhaustion features of cytotoxic CD8+ T cells by increasing the populations of progenitor- (Texprog) and tumoricidal activities in terminal-exhausted T cells (Texterm), highlighting enhanced anti-tumor immunity when combined with immune checkpoint blockade therapies, such as PD-1 or PD-L1 inhibitors.

About Orphan Drug Designation

The FDA’s Orphan Drug Designation (ODD) program provides orphan status to drugs defined as those intended for the treatment, diagnosis or prevention of rare diseases that affect fewer than 200,000 people in the United States. ODD qualifies the sponsor of the drug for certain development incentives, including tax credits for qualified clinical testing, prescription drug user fee exemptions and 7 years marketing exclusivity upon FDA approval.

About Liver and Intrahepatic Bile Duct Cancer (HCC/ICCA)

Primary liver cancer first occurs in either the liver or the intrahepatic bile ducts. The two most common types of liver and intrahepatic bile duct cancer are hepatocellular carcinoma (HCC, 80-90% of cases), and intrahepatic cholangiocarcinoma (ICCA, 10-15% of cases). In HCC and ICCA, metabolic reprogramming plays a crucial role in promoting tumor progression by modifying the TME to support tumor growth and immune evasion.

For HCC, the most common first-line systemic therapies include either a combination of a PD-L1 inhibitor and a VEGF inhibitor or a combination of a PD-L1 inhibitor and a CTLA-4 inhibitor. Most patients will require multiple lines of treatment, as the recurrence rate of HCC has been reported to be as high as 88%. Second-line treatments for HCC are primarily multiple tyrosine kinase receptor inhibitors, even the incidence of a second HCC recurrence is 50%-70%. Additional lines of treatment may be administered if the patient can tolerate a second-line therapy with a different MOA than those previously administered.

PLT012 emerges as a promising candidate, demonstrating dual MOA that synergizes with existing treatments and provide immune-stimulating effects in the TME, potentially enhancing therapeutic outcomes.