Synthon’s [vic-]trastuzumab duocarmazine (SYD985) granted FDA Fast Track designation for pre-treated HER2-positive metastatic breast cancer

On January 25, 2018 Synthon Biopharmaceuticals (‘Synthon’) reported that the U.S. Food & Drug Administration (FDA) has granted Fast Track designation for its investigational anti-HER2 antibody-drug conjugate (ADC) [vic-]trastuzumab duocarmazine (SYD985) (Press release, Synthon, JAN 25, 2018, View Source [SID1234523560]). This designation is for treating patients diagnosed with HER2-positive metastatic breast cancer (MBC) that has progressed during or after at least two HER2-targeting treatment regimens for locally advanced or metastatic disease, or progressed during or after [ado-]trastuzumab emtansine treatment.

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U.S. FDA Fast Track designation is one of four programs that are intended to facilitate and expedite development and review of new drugs to address unmet medical need in the treatment of a serious or life threatening condition.

Fast Track designation for [vic-]trastuzumab duocarmazine was granted based on promising data from heavily pre-treated last-line HER2-positive MBC patients participating in a two-part Phase I clinical trial (SYD985.001). The positive clinical results indicate that this HER2-targeting ADC is efficacious and safe and could therefore provide substantial benefit to patients with no other treatment options.

In November 2017, Synthon initiated the pivotal Phase III TULIP trial, a multi-center, open-label, randomized clinical trial comparing the efficacy and safety of the ADC
[vic-]trastuzumab duocarmazine to physician’s choice treatment in patients with HER2-positive unresectable locally advanced or metastatic breast cancer. Patients are currently being enrolled in this trial, which will be conducted in up to 100 sites in the United States, Canada, Europe and Singapore.

Dr. Jacques Lemmens, chief executive officer of Synthon, commented: "We are very pleased with this Fast Track designation for [vic-]trastuzumab duocarmazine based on the promising Phase I data. There is a high unmet medical need in patients that have HER2-positive MBC and have progressed on trastuzumab and [ado-]trastuzumab emtansine. I believe that the benefit/risk balance of [vic-]trastuzumab duocarmazine is favorable and that it can provide extended benefit to these patients. Fast Track designation will support efficient development and review of [vic-]trastuzumab duocarmazine and enable early access of this promising new single-agent therapy option."

Advaxis’ Immunotherapy in Combination with Chemoradiation Highlighted as Potential Treatment for Anal Cancer in International Journal of Radiation Oncology

On January 25, 2018 Advaxis, Inc. (NASDAQ:ADXS), a late-stage biotechnology company focused on the discovery, development and commercialization of immunotherapy products, reported that data from the investigator-initiated study evaluating the Company’s proprietary Lm-based antigen delivery product, axalimogene filolisbac (ADXS11-001), in combination with chemoradiation as a treatment for high-risk, locally advanced anal cancer were published in the International Journal of Radiation Oncology in an article titled, "Tolerability of ADXS11-001 Lm-LLO Listeria Based Immunotherapy With Mitomycin, Fluorouracil and Radiation for Anal Cancer (Press release, Advaxis, JAN 25, 2018, View Source [SID1234523562])."1 The abstract is available on-line here.

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The Phase 1 study, led by Dr. Howard Safran at Brown University, evaluated the safety and preliminary efficacy of the combination of ADXS11-001 with mitomycin, FU and intensity modulated radiation therapy in 10 patients with locally advanced, non-metastatic squamous cell anal cancer. Results showed that 9 patients achieved a complete response, and 8 patients (89%) remained disease free at a median follow-up of 42 months. One patient progressed, approximately 6 months post completion of study treatment and subsequently died from progressive disease, and one patient expired early in the study unrelated to study treatment.

Treatment-related adverse events were consistent with the observed safety profile of ADXS11-001, and consisted of mostly grade 1-2 cytokine-release related events such as chills, headache and fever. Two patients experienced grade 3 treatment-related toxicities. There were no grade 4 events and ADXS11-001 did not cause any additive chemoradiation related toxicities. All adverse events occurred within 24 hours of treatment and resolved with standard care.

These data show that ADXS11-001 can be safely administered with standard chemoradiation for patients with locally advanced, non-metastatic anal cancer.

"We are delighted to have these promising data highlighted in this prestigious, peer-reviewed journal. The complete clinical response demonstrated in patients who completed the combination treatment is very encouraging, particularly as there are limited treatment options or therapies under development for patients suffering with anal cancer," said Anthony Lombardo, interim Chief Executive Officer of Advaxis. "We look forward to advancing this promising therapy for anal cancer through investigator-led studies."

Can-Fite Receives from Gebro Holdings $2,200,000 Payment as Part of Distribution Agreement for Piclidenoson in 3 European Countries

On January 25, 2018 Can-Fite BioPharma Ltd. (NYSE American: CANF) (TASE:CFBI), a biotechnology company advancing a pipeline of proprietary small molecule drugs that address cancer, liver and inflammatory diseases, reported it has received its first payment of approximately $2,200,000 from Gebro Holding GmBH (Press release, Can-Fite BioPharma, JAN 25, 2018, View Source [SID1234523563]). Can-Fite recently announced entering into a distribution agreement with Gebro for the exclusive right to distribute to distribute Can-Fite’s lead drug candidate, Piclidenoson (CF101), for the treatment of rheumatoid arthritis and psoriasis in 3 European countries including Spain, Switzerland and Austria, upon receipt of regulatory approvals. The recently signed Gebro distribution agreement adds to the distribution agreements for Piclidenoson that the company already has in place with Cipher Pharmaceuticals (for the distribution of Piclidenoson in Canada for rheumatoid arthritis and psoriasis) and Kwang Dong Pharmaceutical (for the distribution of Piclidenoson in Korea for rheumatoid arthritis).

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Under the terms of the distribution agreement, Gebro is making a total upfront and milestone payment of approximately $2,200,000 to Can-Fite. In addition, the agreement provides that additional payments of up to approximately $7,000,000 will be received by Can-Fite upon the achievement of certain regulatory, launch and sales milestones plus double digit royalty payments on net sales.

Gebro Pharma is a privately-owned leading pharma group founded in Austria in the late 1940s with over 500 employees. Its headquarters are located in Fieberbrunn (Austria), where Gebro is a top local leading player, with commercial operations in Spain and Switzerland. In Spain, Gebro is ranked among the top growing companies within the Pharma sector. The therapeutic focus of Gebro is pain with a strong franchise in rheumatology and in Spain, Gebro is ranked nº1 in rheumatology and pain. Alongside, rheumatology and pain, Gebro has also built a portfolio around dermatology, urology, respiratory, GI, and CV depending on the territory.

"We are pleased to receive this upfront and milestone payment of $2,200,000 from Gebro and look towards future potential milestone payments as we advance Piclidenoson through completion of our current Phase III trials in rheumatoid arthritis and psoriasis," stated Can-Fite CEO Dr. Pnina Fishman. Can-Fite recently initiated patient enrolment for its Phase III ACRobat trial of Piclidenoson for the treatment of rheumatoid arthritis.

The rheumatoid arthritis and psoriasis therapeutic market is dominated by biological drugs that are primarily administered via intravenous injection (IV) and have potential side effects. Rheumatoid arthritis and psoriasis are huge unmet need markets, where rheumatoid arthritis is estimated to reach $35B in 2020 and psoriasis is forecast to reach $9B in 2018.

Trovagene Announces Initiation of UNITE Phase 2 Clinical Trial of PCM-075 in Patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC)

On January 25, 2018 Trovagene, Inc. (NASDAQ: TROV), a clinical-stage precision medicine biotechnology company, engaged in the development of targeted cancer therapies, reported the initiation of its Phase 2 clinical trial, evaluating the combination of PCM-075 and abiraterone acetate (Zytiga – Johnson & Johnson), in patients with metastatic Castration-Resistant Prostate Cancer (mCRPC) (Press release, Trovagene, JAN 25, 2018, View Source [SID1234523575]). This clinical trial is called UNITE, "A Phase 2 Study to Understand the Novel Combination of PCM-075 and Abiraterone and the Opportunity to Improve Treatment and Extend Response in Patients with Metastatic Castration-Resistant Prostate Cancer." The study will enroll 25 patients with mCRPC who are showing early signs of disease progression while on abiraterone/prednisone therapy and will evaluate the proportion of patients achieving disease control after 12 weeks of study treatment.

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"Initiation of the UNITE trial in mCRPC marks an important milestone in the clinical development of PCM-075 and builds upon the promising data from our completed and published Phase 1 trial in metastatic solid tumor cancers, as well as preclinical data demonstrating significant synergy for the combination of PCM-075 and abiraterone in CRPC tumor cells," said Bill Welch, Chief Executive Officer of Trovagene. "We are excited to be working with leading prostate cancer specialists and the Harvard Medical Institutions to conduct this trial and believe that the highly synergistic combination of PCM-075 and Zytiga has the potential to address the medical need to extend the benefit of response to treatment in patients with mCRPC."

Trovagene filed its Phase 2 metastatic Castration-Resistant Prostate Cancer protocol to the FDA and its active solid tumor IND in December, 2017. The Company successfully passed the 30-day FDA review period and has selected PRA Health Sciences as the Clinical Research Organization (CRO) to facilitate the trial.

About the Phase 2 mCRPC Clinical Study

In the UNITE multi-center, open-label, Phase 2 trial, the combination of PCM-075 with the standard dose of abiraterone and prednisone, all administered orally, will be evaluated to determine the proportion of patients achieving disease control after 12 weeks of study treatment. Disease control is defined by the lack of Prostate Specific Antigen (PSA) progression in patients who are showing signs of early progressive disease (rise in PSA, but minimally symptomatic or asymptomatic) while currently receiving androgen deprivation therapy (ADT) plus abiraterone and prednisone.

The Phase 2 UNITE trial will enroll 25 patients with metastatic Castration-Resistant Prostate Cancer showing signs of disease progression demonstrated by two rising PSA values separated by at least one week, while on abiraterone/prednisone therapy. The follow-up of patients will occur approximately every six weeks until disease progression in patients with stable disease, or better at the end of treatment assessments.

The Phase 2 trial also includes the following secondary observation endpoints:

The effects of PCM-075 in combination with abiraterone and prednisone on time to PSA progression in subjects with mCRPC;
The effects of PCM-075 in combination with abiraterone and prednisone on time to radiographic progression, based on the Prostate Cancer Working Group 3 (PCWG3) guidelines; and
The effects of PCM-075 in combination with abiraterone and prednisone on radiographic response (per Response Evaluation Criteria in Solid Tumors [RECIST] 1.1 criteria) in subjects with mCRPC and measurable disease.
About PCM-075

PCM-075 is a highly-selective adenosine triphosphate (ATP) competitive inhibitor of the serine/threonine polo-like-kinase 1 (PLK 1) enzyme, which is over-expressed in multiple hematologic and solid tumor cancers. Studies have shown that inhibition of polo-like-kinases can lead to tumor cell death, including a Phase 2 study in Acute Myeloid Leukemia (AML) where response rates up to 31% were observed when used in conjunction with a standard therapy for AML (low-dose cytarabine-LDAC) versus treatment with LDAC alone with a 13.3% response rate. A Phase 1 open-label, dose escalation safety study of PCM-075 has been completed in patients with advanced metastatic solid tumor cancers, and published in Investigational New Drugs.

PCM-075 only targets PLK1 isoform (not PLK2 or PLK3), is oral, has a 24-hour drug half-life with reversible on-target hematologic toxicities. Trovagene believes that targeting only PLK1 with reversible on-target activity and an improved dose/scheduling protocol can significantly improve on the long-term outcome observed in previous studies with a PLK inhibitor in AML.

PCM-075 has demonstrated synergy in preclinical studies with over 10 chemotherapeutic and target agents used in hematologic and solid tumor cancers, including Zytiga (abiraterone), FLT3 and HDAC inhibitors, taxanes, and cytotoxins. Trovagene believes the combination of its targeted PLK-1 inhibitor, PCM-075, with other compounds has the potential for improved clinical efficacy in Castration-Resistant Prostate Cancer (CRPC), Acute Myeloid Leukemia (AML), Non-Hodgkin Lymphoma (NHL), Triple Negative Breast Cancer (TNBC) and Adrenocortical Carcinoma (ACC).

About Castration-Resistant Prostate Cancer (CRPC)

Castration-Resistant Prostate Cancer (CRPC) is defined by disease progression despite androgen-deprivation therapy (ADT) and may present as one or any combination of a continuous rise in serum levels of prostate-specific antigen (PSA), progression of pre-existing disease, or appearance of new metastases. Prognosis is associated with several factors, including performance status, presence of bone pain, extent of disease on bone scan, and serum levels of alkaline phosphatase. Bone metastases occur in 90% of men with CPRC and can produce significant morbidity, including pain, pathologic fractures, spinal cord compression, and bone marrow failure. Paraneoplastic effects are also common, including anemia, weight loss, fatigue, hypercoagulability, and increased susceptibility to infection. Institution of treatment and the choice of systemic or local therapy depend on a number of factors.

Wed, 24 Jan, 2018, 08:15 – English – Quarterly Report I 17/18

On January 24, 2018 Diamyd Medical reported its fourth quarter results (Press release, Diamyd Medical, JAN 24, 2018, View Source;ClipID=2797514 [SID1234523564]).

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Quarterly Report I 17/18
September 2017 – November 2017, Diamyd Medical AB (publ), Fiscal year 2017/2018
September 1, 2017 – November 30, 2017

R&D-expenses amounted to MSEK -7.6 (-2.0). The cost increase compared with the previous year relates to the preparation of the DIAGNODE-2 trial and production of GAD-65
Net result amounted to MSEK -10.8 (-4.3)
Result per share, before and after dilution, amounted to SEK -0.2 (-0.1)
Cash flow from operating activities amounted to MSEK -12.1 (-4.7)
Liquid assets and short-term investments amounted as of November 30 to MSEK 73.7 (26.4)
Significant events during the reporting period

Phase II-trial DIAGNODE-2 open to include patients
Results of the investigator-initiated prevention trial DiAPREV-IT 2 is brought forward to 2020
The GABA portfolio is strengthened with new license
Strategic development of the study drug RemygenTM
Phase II trial DIAGNODE-2 with the diabetes vaccine Diamyd approved to start in all participating countries
Significant events after the reporting period

The diabetes vaccine Diamyd shows continued positive clinical course when four patients have been followed for 30 months and when all twelve patients have been followed for six months
CEO comments

Dear Shareholders and Readers,

The last two months were dominated by new and promising results from DIAGNODE-1, the ongoing investigator-initiated trial where the diabetes vaccine Diamyd is administered to the lymph node in recently diagnosed patients suffering from Type 1 diabetes. The treatment aims to interrupt the immune system’s attack on the insulin-producing cells and in this way preserve the remaining endogenous insulin production at the time of diagnosis. The value of such treatment is considerable for both patients and society, as even a minor ability to produce insulin means patients find it easier to manage their blood sugar levels, which can substantially reduce future complications, such as cardiovascular diseases, renal failure and impaired vision. In addition, the risk of acute hypoglycemia, meaning low blood sugar that may lead to unconsciousness or at worst a fatal outcome, may be decreased if some of the patient’s endogenous insulin producing capacity is being preserved.

All twelve patients participating in the DIAGNODE-1 trial have now been followed for 6 months, half of the patients for 15 months and four for 30 months since start of the trial, and we can now see a disease progression suggesting the vaccine is slowing down the immune system’s destruction of the insulin-producing cells. At 6 months, the average decrease of the patients’ own insulin production measured as the stimulated C-peptide was 1.7 % (compared with 15 % in untreated patients of the same age according to published research), at 15 months 10.8% (compared with 35%), and at 30 months 32% (compared with 50% or more). This is in line with observations in our own previous trials with patients receiving placebo, inactive treatment. In the ongoing investigator initiated DIAGNODE-1, patients are on average injecting less insulin compared to at the start of the trial, and maintaining better blood sugar levels, which provides further confirmation of results suggesting that the intralymphatic treatment with the vaccine has a positive and long-term effect on the disease progression. Previously published immunological data also shows that intralymphatic treatment produces a strong and desired immunological response.

Our highest priority now is DIAGNODE-2, the follow-up placebo-controlled Phase II trial comprising a total of 80 patients, where our goal is to complete enrollment within 12 months. The first DIAGNODE-2 clinic opened for enrollment in mid-November and 15 out of 17 clinics in Sweden, Spain and the Czech Republic are now open. Information about the trial is given not only by the different clinics but also through campaigns in social media and in local newspapers.

Our commitment toward our shareholders is to increase the value of your investment. I would like to thank you for your trust and look forward to reporting on the progress of our ongoing projects.

Stockholm, January 24, 2018
Ulf Hannelius,
President and CEO

Significant events during the reporting period

Phase II-trial DIAGNODE-2 open to include patients
The diabetes vaccine Diamydfor intralymphatic administration will be delivered to the clinics participating in the pivotal trial DIAGNODE-2 that can begin screening patients. The trial comprises about 80 patients from Spain, the Czech Republic and Sweden 12–24 diagnosed with type 1 diabetes during the last 6 months.

The results of the investigator-initiated prevention trial DiAPREV-IT 2 is brought forward to 2020
The Swedish Medical Products Agency approves a change to the trial led by Associate Professor Helena Elding Larsson, Lund University, where the diabetes vaccine Diamydis administered subcutaneously and vitamin D orally to a group of individuals at high risk of being diagnosed with type 1 diabetes. The change entails that the recruitment will stop at 26 children instead of 80 children and that the childrens’ metabolic and immunological parameters will be followed in total for 2 years after the first injection instead of 5 years.

The GABA portfolio is strengthened with new license
Diamyd Medical concludes a new exclusive licensing agreement with University of California, Los Angeles (UCLA) Technology Development Group on behalf of UC Regents. The license relates to new patent applications for the therapeutic use of GABA (gamma-aminobutyric acid) with positive allosteric modulators of the GABAA receptor to enhance beta cell regeneration, survival and immunomodulation.

Strategic development of the study drug RemygenTM
A preliminary patent application is filed on the formulation and release characteristics of the GABA-based study drug RemygenTM. Based on feedback from a scientific meeting with the Swedish Medical Products Agency, and in collaboration with Diamyd Medical’s scientific network, the Company will commence designing the first clinical trial based on RemygenTM.

Phase II trial DIAGNODE-2 with the diabetes vaccine Diamyd approved to start in all participating countries
Spanish and Czech Competent Authorities and the relevant Ethics Committees approves Diamyd Medical’s application to conduct DIAGNODE-2, a pivotal follow-up placebo-controlled Phase II trial with the diabetes vaccine Diamydto be tested in children and young adults recently diagnosed type 1 diabetes. Previously, the trial has been approved by the Swedish Medical Products Agency and the Ethics Committee.

Significant events after the reporting period

The diabetes vaccine Diamyd shows continued positive clinical course after 30 months and when all patients have been followed for 15 months
Positive effects such as lower insulin requirements and improved blood glucose levels are observed for the first four diabetes patients that have been followed for 30 months in the DIAGNODE-1 trial. Safety looks good and no serious side effects have been reported.

Positive results are also reported from the trial when all patients have been followed for 6 months. A clinically relevant and positive progression can be demonstrated in terms of the body’s own capacity to produce insulin, as well as long-term blood sugar and insulin dose. No serious adverse events have been reported.

On-going clinical trials with Diamyd

Type 1 diabetes is a devastating disease which requires daily treatment with insulin to sustain life. The importance of finding a drug that improves the prospects for diabetic patients is of utmost importance. The diabetes vaccine Diamyd has been used in clinical trials with more than 1 000 patients and has shown a good safety profile. Diamyd is easy to administer in any clinical setting. The potential annual market is estimated to several billion dollars per year. Five clinical trials are ongoing combining Diamyd with various other immunomodulatory compounds; etanercept, vitamin D and GABA.

DIAGNODE -1 – DIAMYD IN LYMPH GLANDS IN COMBINATION WITH VITAMIN D
An open label trial, where Diamyd is administered directly into lymph nodes in combination with treatment with vitamin D. The trial comprises twelve patients between the ages of 12 and 30 newly diagnosed with type 1 diabetes and will continue for a total of 30 months. The trial was fully recruited in June 2017. The aim of the trial is to evaluate the safety of the combination treatment and the effect on the immune system and the patients’ insulin producing capacity. The trial is led by Professor Johnny Ludvigsson at Linköping University, Sweden.

DIAGNODE -2 – DIAMYD IN LYMPH GLANDS IN COMBINATION WITH VITAMIN D
DIAGNODE-2 is a follow-up double-blind randomized trial where Diamyd is administered directly into lymph nodes in combination with treatment with vitamin D. The trial encompasses approximately 80 patients from Sweden, the Czech Republic and Spain, aged 12–24 years that have recently been diagnosed with type 1 diabetes. The patients are followed for 15 months. The trial is a follow up of DIAGNODE-1. The aim of the trial is to evaluate the patients’ remaining insulin producing capacity. Coordinating Investigator is Professor Johnny Ludvigsson at Linköping University. Diamyd Medical is the Sponsor of the trial.

GABA/ DIAMYD – COMBINING DIAMYD WITH GABA
A placebo-controlled trial, where Diamydis given subcutaneously and being tested in combination with GABA. In accordance with agreement with Jansen Research & Development and JDRF the trial has expanded to comprise 95 patients between the ages of 4 and 18 recently diagnosed with type 1 diabetes. The trial will continue for a total of 12 months. The aim of the combination treatment is to preserve the body’s residual capacity to produce insulin. The trial is led by Professor Kenneth McCormick at the University of Alabama at Birmingham, USA.

EDCR IIa – COMBINING DIAMYD WITH ETANERCEPT AND VITAMIN D
An open label trial, where Diamydis given subcutaneously and being tested in combination with etanercept and vitamin D. The trial comprises 20 patients between the ages of 8 and 18 who have been newly diagnosed with type 1 diabetes and will continue for a total of 30 months. The aim of the trial is to evaluate the safety of the combination treatment and the effect on the immune system and the patients’ insulin producing capacity. The trial is led by Professor Johnny Ludvigsson at Linköping University, Sweden. 15-month results are expected during the first quarter of 2018.

DiAPREV-IT 2 – COMBINING DIAMYD WITH VITAMIN D
A placebo-controlled trial, where Diamyd is given subcutaneously and being tested in combination with vitamin D in children at high risk of developing type 1 diabetes, meaning that they have been found to have an ongoing autoimmune process but do not yet have any clinical symptoms of diabetes. The trial includes 26 children. The aim of the trial is to evaluate whether Diamyd can delay or prevent the participants from presenting with type 1 diabetes. The trial is led by Dr. Helena Elding Larsson at Lund University, Sweden.