On March 30, 2025 Innovent Biologics, Inc. ("Innovent") (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of oncology, cardiovascular and metabolic, autoimmune, ophthalmology and other major diseases, reported that the Center for Drug Evaluation (CDE) of China’s National Medical Products Administration (NMPA) has granted Breakthrough Therapy Designation (BTD) for IBI363, a first-in-class PD-1/IL-2α-bias bispecific antibody fusion protein, as monotherapy for the treatment of unresectable locally advanced or metastatic mucosal or acral melanoma who have not received prior systemic therapy (Press release, Innovent Biologics, MAR 30, 2025, View Source [SID1234651609]).

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Recently, Innovent initiated and dosed the first patient for IBI363 in its first pivotal study to evaluate the efficacy and safety of IBI363 monotherapy versus pembrolizumab (Keytruda) monotherapy in patients with unresectable, locally advanced or metastatic mucosal or acral melanoma who have not received prior systemic therapy. Furthermore, IBI363 has received two fast track designations (FTD) from the U.S. Food and Drug Administration (FDA), for the treatment of squamous non-small cell lung cancer and melanoma, respectively.

IBI363 has demonstrated outstanding efficacy signals in immunotherapy (IO)-naïve melanoma patients across two earlier clinical trials (Phase 1a/1b study NCT05460767 and Phase 2 study NCT06081920), which enrolled a total of 26 patients with advanced acral or mucosal melanoma:

The overall objective response rate (ORR) was 61.5%, and the disease control rate (DCR) was 84.6%—significantly higher than current domestic immunotherapy standards.
Prolonged follow-up revealed sustained tumor responses and long-term benefits, suggesting the potential superiority of IBI363 over existing standard therapies.
Dr. Hui Zhou, Senior Vice President of Innovent, said, "As Innovent’s first-in-class next-generation IO therapy, IBI363 simultaneously and selectively inhibits the PD-1/PD-L1 pathway and activates the IL-2 pathway. IBI363 has recently received multiple FTD and BTD designations, signifying regulatory recognition of its clinical value in addressing unmet medical needs. Non-cutaneous melanoma subtypes like mucosal melanoma—which are more prevalent in China—are particularly resistant to immunotherapy with limited clinical benefits[i]. We aim to validate IBI363’s potential in its first pivotal trial, through a head-to-head comparison with pembrolizumab, as a superior treatment option for melanoma patients over the current standard-of-care. We are also accelerating the global development of IBI363 across multiple tumor types, with the goal of extending the benefits of China’s innovation to patients worldwide."

NMPA Breakthrough Therapy Designation is intended to facilitate and expedite the development and review of investigational drugs for serious diseases or conditions when preliminary clinical evidence indicates substantial improvement over current therapies. BTD qualifies a drug candidate for accelerated review by the CDE and provides the sponsor with timely advice and communication to expedite the approval process, helping to address the unmet clinical needs of patients more swiftly.

About IBI363 (First-in-class PD-1/IL-2α-bias bispecific antibody fusion protein)

IBI363 is a first-in-class drug candidate independently developed by Innovent Biologics. It is a PD-1/IL-2 bispecific antibody fusion protein designed to enhance efficiency while minimizing toxicity. The IL-2 arm of IBI363 has been engineered to optimize therapeutic effects with reduced side effects, while the PD-1 binding arm enables PD-1 blockade and selective IL-2 delivery. By simultaneously inhibiting the PD-1/PD-L1 pathway and activating the IL-2 pathway, IBI363 facilitates more precise and efficient targeting and activation of tumor specific T cells. Preclinical studies have shown that IBI363 exhibits strong anti-tumor activity across multiple tumor-bearing pharmacological models, including those resistant to PD-1 inhibitors and metastatic models. Additionally, it has demonstrated a favorable safety profile in preclinical models.

Clinical trials of IBI363 are currently underway in China, the United States, and Australia to evaluate its safety, tolerability and preliminary efficacy in subjects with advanced malignancies. The first pivotal study of IBI363 has been initiated, for the treatment of IO-naive mucosal or acral melanoma.

Furthermore, IBI363 has received two fast track designations (FTD) from the U.S. FDA, for the treatment of melanoma and squamous NSCLC, respectively. IBI363 has also received breakthrough therapy designation from the NMPA of China for the treatment of melanoma.

About Melanoma

Melanoma is a malignant tumor that develops from melanocytes. Although melanoma accounts for only 3% of all types of skin cancer, it has the highest mortality rate of all types and is the most likely to metastasize. In China, the incidence and mortality rate of melanoma continue to rise. Melanoma is classified into three main subtypes: cutaneous, acral and mucosal. The characteristics of melanoma in Chinese patients differs greatly from those seen in European and American Caucasian populations in terms of pathogenesis, biological behavior, histological morphology, treatment response and prognosis[i]. For advanced cutaneous and acral melanomas, patients with the BRAF V600 mutation typically receive BRAF inhibitor combined with MEK inhibitors as the preferred molecular targeted therapy. For those without the BRAF V600 mutation, chemotherapy combined with anti-angiogenic drugs can be is a first-line treatment option. Notably, pembrolizumab has been approved as the first-line treatment indication for advanced melanoma in September 2024 in China, although clinical benefits are limited. For second-line treatment, therapies not previously used in first-line settings are recommended. Patients who have not received PD-1 monoclonal antibody in the first-line setting may be treated with PD-1 inhibitors as a second-line option. For advanced mucosal melanoma -which are more prevalent in China-are particularly resistant to immunotherapy with limited clinical benefits, in urgent need of new treatment options.

On March 30, 2025 Akeso Inc. (9926.HK) ("Akeso", "the Company") reported its 2024 annual results, emphasizing the company’s key achievements in drug research, clinical development, and commercialization (Press release, Akeso Biopharma, MAR 30, 2025, View Source [SID1234651611]).

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In 2024, Akeso achieved key success in antibody therapy research and development. The approval of new indications for cadonilimab and the launch of first-in-class drugs like ivonescimab expanded the company’s footprint in major solid tumors, including lung and gastric cancers. Akeso continues to challenge current standard of care with head-to-head trials against pembrolizumab and other therapies, while advancing novel treatments such as anti-CD47 monoclonal antibody, antibody drug conjugates ("ADCs") and bispecific ADCs. The company also achieved major milestones in commercialization and patient access, with products included in national insurance directories. Currently, over 25 registrational and Phase III clinical trials are actively progressing.

On the commercial front, Akeso’s adjustments in drug pricing and optimization of its commercial systems led to new drug sales revenue surpassing RMB 2 billion in 2024, a 25% year-on-year increase. The company continues to reduce operating losses, with an EBITDA loss of 225 million RMB in 2024.

Dr. Xia Yu, Founder, Chairwoman, President, and CEO of Akeso Biopharma:

"We are thrilled to have reached historic milestones in our innovative drug development in 2024. The approval of several globally competitive products and breakthroughs in advanced therapies have strengthened our global competitiveness in biopharmaceutical innovation.

Notably, our first-in-class bispecific antibodies, cadonilimab and ivonescimab, have been approved for commercial sales and included in China’s NRDL. This significantly improves drug accessibility, reduces patient burdens, and fulfills a key strategic goal in our domestic commercialization efforts. In clinical development, cadonilimab and ivonescimab are currently in over 20 registrational/Phase III clinical trials globally, establishing a strong presence in first-line treatments for a wide range of high-incidence cancers. Additionally, more than 40 Phase II trials are ongoing, further strengthening our leadership in global cancer immunotherapy.

We’ve also made key advances in novel therapies, with ligufalimab (anti-CD47 mAb) moving to Phase III for solid tumors, and progress in next-gen ADCs, bispecific ADCs, and autoimmune bispecific antibodies.

These achievements have expanded our oncology pipeline and strengthened our global expansion strategy with a comprehensive ‘IO 2.0+’ combination therapy platform."

Akeso’s Bispecific Antibody Clinical Portfolio Continues to Expand, Demonstrating Global Leadership in Next-Generation Tumor Immunotherapy

In 2024, Akeso continued to focus and make progress on research and clinical development. The accomplishments from these efforts include :

3 novel drugs approved for market
5 NDAs under review for 5 indications
24 drug candidates in global clinical development
Over 25 registrational/Phase III trials actively progressing
Notably, Akeso has focused on redefining global treatment paradigms through the development of breakthrough therapies that provide additional survival and safety benefit to current standard of care. Centered around its internally developed first-in-class bispecific antibodies—cadonilimab (PD-1/CTLA-4) and ivonescimab (PD-1/VEGF)—the company has conducted over 40 clinical trials across a number of indications.

Cadonilimab

After its approval for recurrent/metastatic cervical cancer, cadonilimab reached a major milestone in 2024 with the approval for a new indication in first-line gastric cancer, addressing unmet needs in PD-L1 low/negative populations. The sNDA for first-line cervical cancer is currently under review. Cadonilimab is also currently in 8 Phase III trials and nearly 20 Phase II studies, exploring treatments for major cancers in both first- and later-line settings.

Ivonescimab

In 2024, ivonescimab was approved for the treatment of EGFR-TKI-resistant, locally advanced or metastatic non-squamous non-small cell lung cancer (nsq-NSCLC). A major milestone was reached in May 2024 when the Phase III HARMONi-2 trial, comparing ivonescimab to pembrolizumab in first-line PD-L1-positive NSCLC, showed positive results. Data presented at the 2024 World Conference on Lung Cancer (WCLC) revealed a median Progression-Free Survival (mPFS) of 11.14 months for ivonescimab, compared to 5.82 months for pembrolizumab. This breakthrough highlights ivonescimab’s potential as a key therapy in next-gen immuno-oncology and boosts its global commercialization prospects.

Currently, ivonescimab is in 12 registrational/Phase III clinical trials, including 6 head-to-head studies against PD-1/L1 therapies, as well as in over 20 Phase II trials.

Key Phase III Trials in NSCLC :

Ivonescimab monotherapy vs. pembrolizumab as first-line (1L) treatment for PD-L1+ NSCLC
Ivonescimab + chemotherapy vs. pembrolizumab + chemotherapy (global multicenter trial) as 1L treatment for NSCLC
Ivonescimab + chemotherapy vs. tislelizumab + chemotherapy as 1L treatment for squamous NSCLC (sq-NSCLC)
Phase III Trials in Other Major IO Indications:

Ivonescimab + chemotherapy vs. durvalumab + chemotherapy as 1L treatment for biliary tract cancer
Ivonescimab + AK117 (CD47 mAb) vs. pembrolizumab as 1L treatment for PD-L1+ head and neck squamous cell carcinoma (HNSCC)
Ivonescimab combination as 1L treatment for triple-negative breast cancer (TNBC)
Ivonescimab in PD-(L)1-resistant NSCLC, and ivonescimab combination as 1L treatment for pancreatic cancer (preparation/initiation underway)
These trials reflect ivonescimab’s development strategy that is based on a fundamental understanding of tumor immunobiology and designing clinical studies that compares it with standard of care, encompassing both first-line and later-line treatments for high-incidence, high-mortality cancers. This positions Akeso as a key innovator in next-generation cancer immunotherapy, improving and contributing to the global IO cancer treatment landscape.

Breakthrough Bispecifics Enter NRDL, Paving the Way for the Next Stage of Commercial Growth

In 2024, Akeso Biopharma achieved commercial sales of RMB 2 billion, representing a 25% year-over-year growth.

As China’s innovative drug market transforms, clinically innovative medicines face historic development opportunities. Both cadonilimab and ivonescimab, recognized for their innovation and clinical value, were successfully included in the National Reimbursement Drug List (NRDL) during the 2024 negotiations, marking a major milestone in Akeso’s commercial franchise.

The inclusion of both cadonilimab and ivonescimab in the NRDL represents the next stage in Akeso’s market strategy, with a clear focus on hospital-based markets as the core growth area. It greatly improves the therapy accessibility, reduces patient treatment burdens, and evolves the innovative value of the company’s first-in-class bispecific antibodies into tangible social and commercial benefits.

Following the NRDL inclusion, Akeso has made key upgrades to its commercial infrastructure, aligning with its strategic priorities for accelerated growth:

Rapid Hospital Access: Prioritizing swift hospital access for cadonilimab and ivonescimab through data-driven tiering of key accounts.
Commercial Team Expansion: Enhancing coverage of core hospitals and regional hubs to ensure maximum reach and impact.
Scientific Leadership: Strengthening engagement with KOLs and generating real-world evidence to highlight the differentiated efficacy and safety profiles of its bispecifics, driving physician adoption.
These initiatives set the stage for Akeso’s growth in 2025 and beyond, while building a strong foundation for long-term, sustainable commercial growth.

Akeso’s non-oncology portfolio is also advancing with the launch of PCSK9 inhibitor ebronucimab and the potential approvals for assets like ebdarokimab and gumokimab. The company is building a dedicated commercial team to tap into the multi-billion RMB metabolic and autoimmune markets. Akeso’s strong pipeline in non-oncology indications will provide additional drivers for sales growth.

Potential Disclosure of Ivonescimab’s Topline HARMONi Clinical Data Mid-Year

International Expansion of Novel Drug Development Accelerates

Akeso’s global partner on ivonescimab, Summit Therapeutics, is advancing three international multicenter Phase III clinical trials:

The HARMONi study, a Phase III clinical trial that evaluates ivonescimab combined with chemotherapy compared to placebo plus chemotherapy in patients with EGFR-mutated, locally advanced or metastatic non-squamous NSCLC who have progressed after treatment with a 3rd generation EGFR TKI (e.g., osimertinib). Summit has announced plans to disclose topline data in mid-2025.
Summit expanded the HARMONi-3 study cohort in 2024 to include both squamous NSCLC (sq-NSCLC) and non-squamous NSCLC (nsq-NSCLC), expanding first-line coverage for all NSCLC populations.
The HARMONi-7 study, a global Phase III trial comparing ivonescimab monotherapy with pembrolizumab monotherapy as a first-line treatment for PD-L1-high NSCLC, is expected to begin in 2025.
In February 2025, Summit has entered into a clinical collaboration with Pfizer to evaluate ivonescimab in combination with Pfizer’s antibody-drug conjugates (ADCs) across solid tumors. Pfizer will be responsible for conducting the operations of the studies. The studies will be overseen by both Summit and Pfizer. Both parties retain their respective rights to their products. Akeso is responsible for the production of ivonescimab used in the clinical trial conducted globally.

Beyond bispecific antibodies

Akeso is advancing a pipeline of promising candidates beyond bispecific antibodies. The company’s first self-developed ADC, AK138D1, with the first patient enrolled in Australia for Phase I. Clinical trials for the Company’s first bispecific ADC have also begun. Additionally, the IND application for AK139, the first IL-4Rα/ST2-targeting bispecific, has been accepted.

Ligufalimab (CD47 mAb), considered a key target in immuno-oncology, advanced to Phase III in 2024. A randomized, double-blind, controlled Phase III trial (vs. pembrolizumab) is ongoing for first-line PD-L1(+) head and neck squamous cell carcinoma (HNSCC), making ligufalimab the first CD47 mAb to reach Phase III for solid tumors. A global Phase II trial combining ligufalimab with azacitidine for first-line myelodysplastic syndromes (MDS) is actively progressing across multiple countries, including the U.S.

In parallel with the accelerated global expansion of its novel drug development, Akeso’s therapies and clinical studies have also received recognition in top-tier academic journals and conferences. In 2024, the company revealed nearly 80 groundbreaking research findings in prestigious journals and academic conferences, including JAMA, Nature Medicine, and The Lancet.

On March 30, 2025 Jecho Laboratories, Inc. reported it will present three proprietary progams in poster format at the 2025 American Association for Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting (Press release, Jecho Laboratories, MAR 30, 2025, View Source [SID1234653896]). The featured innovations include:

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Development of JLF025: an optimized anti-mesothelin T-cell engager for enhanced safety and efficacy
Persistent elimination of tumors via balanced regulation of immune signals
Development of an anti-TF ADC with a potentially improved therapeutic index
As one of the world’s largest and most influential cancer research conferences, the 2025 AACR (Free AACR Whitepaper) Annual Meeting will be held April 25–30, 2025, in Chicago.

"These presentations represent a key milestone in Jecho’s growth," said by the Chief Executive Officer of Jecho Laboratories. "We are proud to demonstrate our evolution from a fast follower to a global innovator in drug development. Our team is focused on delivering differentiated therapies that address unmet needs through scientific rigor, targeted design, and a commitment to patient impact."

Details on presentation are below:

Development of an anti-TF ADC with a potentially improved therapeutic index
• Abstract Presentation Number: 348
• Poster Section: 16
• Session Time: April 27, 2025, 2:00 PM – 5:00 PM (U.S. Central Time)
• AACR (Free AACR Whitepaper) Link: View Source!/20273/presentation/3205
Persistent elimination of tumors via balanced regulation of immune signals
• Abstract Presentation Number: 2230
• Poster Section: 38
• Session Time: April 28, 2025, 9:00 AM – 12:00 PM (U.S. Central Time)
• AACR (Free AACR Whitepaper) Link: View Source!/20273/presentation/8429
Development of JLF025, an anti-mesothelin T cell engager optimized for efficacy and safety
• Abstract Presentation Number: 6021
• Poster Section: 35
• Session Time: April 29, 2025, 2:00 PM – 5:00 PM (U.S. Central Time)
• AACR (Free AACR Whitepaper) Link: View Source!/20273/presentation/1929

On March 28, 2025 Checkpoint Therapeutics, Inc. ("Checkpoint") (Nasdaq: CKPT), a commercial-stage immunotherapy and targeted oncology company, reported financial results for the fiscal year ended December 31, 2024, and recent corporate updates (Press release, Checkpoint Therapeutics, MAR 28, 2025, View Source [SID1234651574]).

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Recent Corporate Updates:

● In March 2025, Checkpoint announced that it entered into an Agreement and Plan of Merger (the "Merger Agreement") with Sun Pharmaceutical Industries, Inc. ("Sun Pharma"), and a wholly owned subsidiary of Sun Pharma, with Checkpoint continuing as the surviving corporation of the transaction and a wholly owned subsidiary of Sun Pharma (the "Merger"). The total transaction value of the Merger, including the upfront cash payment and the maximum value of the contingent value right ("CVR"), is up to approximately $416 million, and the Merger is expected to be completed in the second quarter of 2025. The transaction is subject to customary closing conditions, including required regulatory approvals and approval by the holders of a majority of the voting power of outstanding shares of Checkpoint common stock, and by the holders of a majority of the shares of Checkpoint common stock that are not held by Fortress Biotech, Inc. or by certain other affiliates of Checkpoint.

● In December 2024, Checkpoint announced that the U.S. Food and Drug Administration ("FDA") approved UNLOXCYTTM (cosibelimab-ipdl) for the treatment of adults with metastatic cutaneous squamous cell carcinoma ("cSCC") or locally advanced cSCC who are not candidates for curative surgery or curative radiation. UNLOXCYT is the first and only programmed death ligand-1 ("PD-L1") blocking antibody to receive FDA marketing approval for this indication.

● In September 2024, Checkpoint presented longer-term data from its pivotal trial of cosibelimab in locally advanced and metastatic cSCC during the European Society for Medical Oncology ("ESMO") Congress 2024. Longer-term results for cosibelimab presented at the ESMO (Free ESMO Whitepaper) Congress demonstrate a deepening of response over time, with higher objective response and complete response rates than initially observed at the primary analyses. A copy of the ESMO (Free ESMO Whitepaper) poster can be found on the Publications page of Checkpoint’s website.

Financial Results:

● Cash Position: As of December 31, 2024, Checkpoint’s cash and cash equivalents totaled $6.6 million, compared to $4.9 million at December 31, 2023, an increase of $1.7 million. Subsequent to the end of the fiscal year, Checkpoint received approximately $38.1 million in cash proceeds through the exercise of existing warrants.

● R&D Expenses: Research and development expenses for the year ended December 31, 2024, were $36.2 million, compared to $43.6 million for the year ended December 31, 2023, a decrease of $7.4 million. Research and development expenses for the year ended December 31, 2024, included $12.9 million of non-cash stock expenses, compared to $4.6 million in non-cash stock expenses for the year ended December 31, 2023.

● G&A Expenses: General and administrative expenses for the year ended December 31, 2024, were $20.1 million, compared to $8.7 million for the year ended December 31, 2023, an increase of $11.4 million. General and administrative expenses for the year ended December 31, 2024, included $11.0 million of non-cash stock expenses, compared to $2.7 million in non-cash stock expenses for the year ended December 31, 2023.

● Net Loss: Net loss attributable to common stockholders for the year ended December 31, 2024, was $56.2 million, or $1.42 per share, compared to a net loss of $51.8 million, or $3.17 per share, for the year ended December 31, 2023.

About UNLOXCYTTM (cosibelimab-ipdl)

UNLOXCYT is a human immunoglobulin G1 monoclonal antibody that binds PD-L1 and blocks the interaction between PD-L1 and its T cell receptors, PD-1 and B7.1. This interaction releases the inhibitory effects of PD-L1 on the anti-tumor immune response. UNLOXCYT has also been shown to induce antibody-dependent cell-mediated cytotoxicity.

INDICATION and IMPORANT SAFETY INFORMATION

INDICATION

UNLOXCYT (cosibelimab-ipdl) is indicated for the treatment of adults with metastatic cSCC or locally advanced cSCC who are not candidates for curative surgery or curative radiation.

IMPORTANT SAFETY INFORMATION

Severe and Fatal Immune-Mediated Adverse Reaction

· Immune-mediated adverse reactions listed herein may not include all possible severe and fatal immune-mediated adverse reactions. Immune-mediated adverse reactions, which can be severe or fatal, can occur in any organ system or tissue, and occur at any time after starting a PD-1/PD-L1–blocking antibody, including UNLOXCYT. While immune-mediated adverse reactions usually manifest during treatment, they can also manifest after discontinuation of PD-1/PD-L1–blocking antibodies. Immune-mediated adverse reactions affecting more than one body system can occur simultaneously.
· Monitor closely for signs and symptoms of immune-mediated adverse reactions. Evaluate liver enzymes, creatinine, and thyroid function tests at baseline and periodically during treatment. In cases of suspected immune-mediated adverse reactions, initiate appropriate workup to exclude alternative etiologies, including infection. Institute medical management promptly, including specialty consultation as appropriate.

· Withhold or permanently discontinue UNLOXCYT depending on the severity of the adverse reaction (see Dosage and Administration in Prescribing Information). In general, if UNLOXCYT requires interruption or discontinuation, administer systemic corticosteroids (1 to 2 mg/kg/day prednisone or equivalent) until improvement to Grade 1 or less. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. Consider administration of other systemic immunosuppressants in patients whose immune-mediated adverse reaction is not controlled with corticosteroids.

Immune-Mediated Pneumonitis

· UNLOXCYT can cause immune-mediated pneumonitis. In patients treated with other PD-1/PD-L1–blocking antibodies, the incidence of pneumonitis is higher in patients who have received prior thoracic radiation. Immune-mediated pneumonitis occurred in 1% (3/223, Grade 2) of patients receiving UNLOXCYT.

Immune-Mediated Colitis

· UNLOXCYT can cause immune-mediated colitis, which may present with diarrhea, abdominal pain, and lower gastrointestinal bleeding. Cytomegalovirus infection/reactivation has occurred in patients with corticosteroid-refractory immune-mediated colitis treated with PD-1/PD-L1–blocking antibodies. In cases of corticosteroid-refractory colitis, consider repeating infectious workup to exclude alternative etiologies. Immune-mediated colitis occurred in 0.4% (1/223, Grade 1) of patients receiving UNLOXCYT.

Immune-Mediated Hepatitis

· UNLOXCYT can cause immune-mediated hepatitis.

Immune-Mediated Endocrinopathies

Adrenal Insufficiency

· UNLOXCYT can cause primary or secondary adrenal insufficiency. For Grade 2 or higher adrenal insufficiency, initiate symptomatic treatment per institutional guidelines, including hormone replacement as clinically indicated. Withhold or permanently discontinue UNLOXCYT depending on severity. Adrenal insufficiency occurred in 0.9% (2/223) of patients receiving UNLOXCYT, including Grade 2 in 0.4% (1/223) of patients.

Hypophysitis

· UNLOXCYT can cause immune-mediated hypophysitis. Hypophysitis can present with acute symptoms associated with mass effect such as headache, photophobia, or visual field cuts. Hypophysitis can cause hypopituitarism. Initiate hormone replacement as clinically indicated. Withhold or permanently discontinue UNLOXCYT depending on severity.

Thyroid Disorders

· UNLOXCYT can cause immune-mediated thyroid disorders. Thyroiditis can present with or without endocrinopathy. Hypothyroidism can follow hyperthyroidism. Initiate hormone replacement or medical management of hyperthyroidism as clinically indicated. Withhold or permanently discontinue UNLOXCYT depending on severity. Hypothyroidism occurred in 10% (22/223) of patients receiving UNLOXCYT, including Grade 2 in 5% (10/223) of patients. Hyperthyroidism occurred in 5% (12/223) of patients receiving UNLOXCYT, including Grade 2 in 0.4% (1/223) of patients.

Type 1 Diabetes Mellitus, Which Can Present with Diabetic Ketoacidosis

· UNLOXCYT can cause type 1 diabetes mellitus, which can present with diabetic ketoacidosis. Monitor patients for hyperglycemia or other signs and symptoms of diabetes. Initiate treatment with insulin as clinically indicated. Withhold or permanently discontinue UNLOXCYT depending on severity.

Immune-Mediated Nephritis with Renal Dysfunction

· UNLOXCYT can cause immune-mediated nephritis.

Immune-Mediated Dermatologic Adverse Reactions

· UNLOXCYT can cause immune-mediated rash or dermatitis. Bullous and exfoliative dermatitis, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug rash with eosinophilia and systemic symptoms (DRESS), have occurred with PD-1/PD-L1–blocking antibodies. Topical emollients and/or topical corticosteroids may be adequate to treat mild to moderate non-bullous/exfoliative rashes. Withhold or permanently discontinue UNLOXCYT depending on severity. Immune-mediated dermatologic adverse reactions occurred in 7% (15/223) of patients receiving UNLOXCYT, including Grade 3 in 0.9% (2/223) of patients and Grade 2 in 4% (9/223) of patients.

Other Immune-Mediated Adverse Reactions

· The following clinically significant immune-mediated adverse reactions occurred in <1% of the 223 patients who received UNLOXCYT or were reported with the use of other PD-1/PD-L1–blocking antibodies. Severe or fatal cases have been reported for some of these adverse reactions.

- Cardiac/Vascular: Myocarditis, pericarditis, vasculitis.
- Nervous System: Meningitis, encephalitis, myelitis and demyelination, myasthenic syndrome/myasthenia gravis (including exacerbation), Guillain-Barre syndrome, nerve paresis, autoimmune neuropathy.
- Ocular: Uveitis, iritis, other ocular inflammatory toxicities. Some cases can be associated with retinal detachment. Various grades of visual impairment to include blindness can occur. If uveitis occurs in combination with other immune-mediated adverse reactions, consider a Vogt-Koyanagi-Harada–like syndrome, as this may require treatment with systemic steroids to reduce the risk of permanent vision loss.
- Gastrointestinal: Pancreatitis, including increases in serum amylase and lipase levels, gastritis, duodenitis.
- Musculoskeletal and Connective Tissue: Myositis/polymyositis, rhabdomyolysis and associated sequelae including renal failure, arthritis, polymyalgia rheumatica.
- Endocrine: Hypoparathyroidism.
- Other (Hematologic/Immune): Autoimmune hemolytic anemia, aplastic anemia, hemophagocytic lymphohistiocytosis, systemic inflammatory response syndrome, histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis), sarcoidosis, immune thrombocytopenia, solid organ transplant rejection, other transplant (including corneal graft) rejection.

Infusion-Related Reactions

· UNLOXCYT can cause severe or life-threatening infusion-related reactions. Infusion-related infusion reactions were reported in 11% (24/223) of patients, including Grade 2 in 5.8% (13/223) of patients receiving UNLOXCYT.
· Monitor patients for signs and symptoms of infusion-related reactions. Interrupt or slow the rate of infusion or permanently discontinue UNLOXCYT based on severity of reaction. Consider premedication with an antipyretic and/or an antihistamine for patients who have had previous systemic reactions to infusions of therapeutic proteins.

Complications of Allogeneic HSCT

· Fatal and other serious complications can occur in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT) before or after being treated with a PD-1/PD-L1–blocking antibody. Transplant-related complications include hyperacute graft-versus-host disease (GVHD), acute GVHD, chronic GVHD, hepatic veno-occlusive disease after reduced intensity conditioning, and steroid-requiring febrile syndrome (without an identified infectious cause). These complications may occur despite intervening therapy between PD-1/PD-L1 blockade and allogeneic HSCT. Follow patients closely for evidence of transplant-related complications and intervene promptly. Consider the benefit versus risks of treatment with a PD-1/PD-L1–blocking antibody prior to or after an allogeneic HSCT.

Embryo-Fetal Toxicity

· Based on its mechanism of action, UNLOXCYT can cause fetal harm when administered to a pregnant woman. Animal studies have demonstrated that inhibition of the PD-1/PD-L1 pathway can lead to increased risk of immune-mediated rejection of the developing fetus, resulting in fetal death. Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential to use effective contraception during treatment with UNLOXCYT and for 4 months after the last dose.

Common Adverse Reactions

The most common adverse reactions (≥10%) were fatigue, musculoskeletal pain, rash, diarrhea, hypothyroidism, constipation, nausea, headache, pruritus, edema, localized infection, and urinary tract infection.

On March 28, 2025 FibroGen, Inc. (NASDAQ: FGEN) reported the peer-reviewed publication titled "A Phase 1, First-in-Human Study of FOR46 (FG-3246), an Immune-Modulating Antibody-Drug Conjugate Targeting CD46, in Patients with Metastatic Castration Resistant Prostate Cancer" in the Journal of Clinical Oncology (Press release, FibroGen, MAR 28, 2025, View Source [SID1234651578]). The manuscript includes the complete results from the Fortis Therapeutics-sponsored Phase 1 study of FOR46 (now known as FG-3246), a potential first-in-class anti-CD46 antibody drug conjugate (ADC) with an MMAE-containing payload, in patients with metastatic castration-resistant prostate cancer (mCRPC).

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"I am excited to see the results from the Phase 1 monotherapy study of FOR46 (FG-3246) published in the Journal of Clinical Oncology. This is the first clinical trial targeting CD46 in patients with prostate cancer, and the totality of the data highlights the promising potential of FG-3246 anti-cancer activity, especially when considering the unselected, heavily pre-treated patient population in the trial. The trial results provide key insights into the potential clinical impact of targeting CD46 in the treatment of mCRPC and support its further development in this disease space with high unmet need," said Dr. Rahul Aggarwal, Professor of Medicine at the University of California San Francisco, and Principal Investigator of the study.

"We are looking forward to advancing FG-3246 in the clinic and remain on track for initiating the Phase 2 monotherapy study by mid-2025 as well as disclosing topline results from the combination trial of FG-3246 and enzalutamide in the second half of 2025," added Thane Wettig, Chief Executive Officer of FibroGen. "FG-3246 represents a potential first-in-class, non-PSMA approach to treating mCRPC and we, along with the medical community, are excited about the potential for CD46 to become a next generation target in the prostate cancer treatment paradigm."

This Phase 1 study was a multi-center, first-in-human, open label dose escalation and expansion study evaluating the safety, tolerability, and anti-tumor activity as measured by the decline of prostate-specific antigen (PSA) from baseline, objective tumor response rate in patients with measurable disease, and radiographic progression free survival (rPFS). The completed Phase 1 trial includes a total of 56 patients from the dose-escalation and dose-expansion cohorts. Notably, patients were biomarker unselected and heavily pre-treated, having received a median of 5 lines of therapy prior to receiving FG-3246.

Key highlights from the publication include:

The maximally tolerated dose of FG-3246 was 2.7 mg/kg by adjusted body weight (AjBW) every 3 weeks
The most frequent adverse events were consistent with other MMAE-based ADCs and included infusion related reactions (48.2%), neutropenia (41.1%), and peripheral neuropathy (32.1%).
Ocular adverse events were infrequent, which may be a distinguishing feature compared with other MMAE-based ADCs
Efficacy observed in the RECIST-evaluable set of 25 patients:
Confirmed objective response rate was 20% with median duration of response of 7.5 months
All objective responses observed at a starting dose of 2.7 mg/kg or higher
Disease control rate was 80% with duration of treatment exceeding 24 weeks in 12 patients (48%)
PSA50 response rate of 36% in 39 evaluable patients
Of eight evaluable patients who received docetaxel in the castration-sensitive setting, four (50%) achieved a confirmed PSA50 response
Median radiographic progression-free survival of 8.7 months in all 40 subjects in the efficacy analysis set
Of 15 evaluable baseline tumors, 12 (80%) were positive for CD46 expression by immunohistochemistry
FG-3246 responders were found to have a significantly higher frequency of effector T cells and lower frequency of immunosuppressive myeloid cells
The Company anticipates initiating the Phase 2 monotherapy dose optimization study of FG-3246 in patients with mCRPC by mid-2025.

FG-3246 is also being evaluated in combination with enzalutamide in an investigator-sponsored study with topline results from the Phase 2 portion of the study anticipated in 2H 2025.

About the Phase 1 Study
FOR46-001 (NCT03575819) is a Phase 1, dose-escalation study sponsored by Fortis Therapeutics to evaluate multiple doses of IV-administered FG-3246 (also known as FOR46) in patients with mCRPC who have progressive disease on at least one ARSI, followed by a dose-expansion cohort, to evaluate the safety, tolerability, PK, biological activity, and preliminary evidence of anti-tumor activity of FG-3246 in this patient population.

Thirty-three (33) patients were enrolled in the dose-escalation phase of the study at doses between 0.1 mg/kg and 3.0 mg/kg every three weeks (Q3W), with adjusted body weight dosing (AjBW) used at most dose levels above 2.1 mg/kg. Safety and tolerability of FG-3246 were evaluated in the dose-escalation period of the study.

Twenty-three (23) patients were enrolled in the dose-expansion period of the study; 18 patients with adenocarcinoma mCRPC (Cohort 1) and five patients with neuroendocrine prostate cancer (Cohort 2). All patients in the expansion cohorts were treated at 2.7 mg/kg AjBW to a maximum of 270 mg every three weeks.

The safety profile of FG-3246 was characterized, and anti-tumor activity of FG-3246 in adenocarcinoma patients dosed at ≥ 1.2 mg/kg was evaluated.

About Metastatic Castration-Resistant Prostate Cancer
Prostate cancer is the second most common malignancy in men, contributing significantly to male mortality rates. Approximately 13% of men will be diagnosed with prostate cancer at some point during their lifetime. There are about 65,000 drug treatable mCRPC cases in the U.S. annually and 5-year survival in mCRPC is approximately 30%1.

About FG-3246
FG-3246 (also known as FOR46) is a potential first-in-class, fully human antibody-drug conjugate (ADC), exclusively in-licensed from Fortis Therapeutics, and is being developed by FibroGen for metastatic castration-resistant prostate cancer and other tumor types. FG-3246 binds to an epitope of CD46, a cell receptor target, that induces internalization upon antibody binding, is present at high levels in prostate cancer and other tumor types and demonstrates very limited expression in most normal tissues. FG-3246 is comprised of an anti-CD46 antibody, YS5, linked to the anti-mitotic agent, MMAE, which is a clinically and commercially validated ADC payload. FG-3246 has demonstrated anti-tumor activity in both preclinical and clinical studies. FG-3246 is currently in an ongoing Phase 1/2 study being conducted at UCSF to evaluate it in combination with enzalutamide with topline data from the Phase 2 portion of the study expected in the second half of 2025, and a biomarker trial using a PET biomarker for CD46 using the same antibody backbone. We anticipate the initiation of the Phase 2 monotherapy dose optimization trial in metastatic castration-resistant prostate cancer by mid-2025. FG-3246 is an investigational drug and not approved for marketing by any regulatory authority.