Otsuka’s U.S. Subsidiary Astex Pharmaceuticals Enters Clinical Trial Collaboration to Explore the Potential of Combining Guadecitabine (SGI-110) with Atezolizumab in the Treatment of Acute Myeloid Leukemia

On April 19, 2016 Astex Pharmaceuticals, Inc., a pharmaceutical company dedicated to the development of novel small molecule oncology therapeutics, reported that it has entered into a clinical collaboration with Genentech (Press release, Otsuka, APR 19, 2016, View Source;date=2016-04-20 [SID:1234511123]).

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The collaboration will evaluate the potential for combining Astex’s next-generation hypomethylating agent, guadecitabine (SGI-110), with Genentech’s investigational anti-PD-L1 monoclonal antibody, atezolizumab, in the treatment of acute myeloid leukemia (AML). An initial Phase 1b study will investigate the safety and pharmacology of the combination.

Randomized, Double-Blind Phase II Trial With Prospective Classification by ATM Protein Level to Evaluate the Efficacy and Tolerability of Olaparib Plus Paclitaxel in Patients With Recurrent or Metastatic Gastric Cancer.

Gastric cancer cell lines, particularly those with low levels of ataxia telangiectasia mutated (ATM), a key activator of DNA damage response, are sensitive to the poly (ADP-ribose) polymerase inhibitor olaparib. We compared the efficacy of olaparib plus paclitaxel (olaparib/paclitaxel) with paclitaxel alone in patients with recurrent or metastatic gastric cancer and assessed whether low ATM expression is predictive of improved clinical outcome for olaparib/paclitaxel.
In this phase II, double-blind study (Study 39; NCT01063517), patients were randomly assigned to oral olaparib 100 mg twice per day (tablets) plus paclitaxel (80 mg/m(2) per day intravenously on days 1, 8, and 15 of every 28-day cycle) or placebo plus paclitaxel (placebo/paclitaxel), followed by maintenance monotherapy with olaparib (200 mg twice per day) or placebo. The study population was enriched to 50% for patients with low or undetectable ATM levels (ATMlow). Primary end point was progression-free survival (PFS).
One hundred twenty-three of 124 randomly assigned patients received treatment (olaparib/paclitaxel, n = 61; placebo/paclitaxel, n = 62). The screening prevalence of ATMlow patients was 14%. Olaparib/paclitaxel did not lead to a significant improvement in PFS versus placebo/paclitaxel (overall population: hazard ratio [HR], 0.80; median PFS, 3.91 v 3.55 months, respectively; ATMlow population: HR, 0.74; median PFS, 5.29 v 3.68 months, respectively). However, olaparib/paclitaxel significantly improved overall survival (OS) versus placebo/paclitaxel in both the overall population (HR, 0.56; 80% CI, 0.41 to 0.75; P = .005; median OS, 13.1 v 8.3 months, respectively) and the ATMlow population (HR, 0.35; 80% CI, 0.22 to 0.56; P = .002; median OS, not reached v 8.2 months, respectively). Olaparib/paclitaxel was generally well tolerated, with no unexpected safety findings.
Olaparib/paclitaxel is active in the treatment of patients with metastatic gastric cancer, with a greater OS benefit in ATMlow patients. A phase III trial in this setting is under way.
© 2015 by American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper).

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Iomab-B

Iomab-B for Hematopoietic Stem Cells Transplantation:

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Iomab-B (BC8-I-131 construct) has already been successfully used as a myeloconditioning/myeloablative agent in over 250 patients with incurable blood cancers (Company Pipeline, Actinium Pharmaceuticals, APR 19, 2016, View Source [SID:1234511053]). In both Phase I and Phase II trials Iomab-B has led to effective cures in patients with no options left. The only potentially curative treatment option for those patients is bone marrow transplantation (BMT), also known as a hematopoietic stem cell transplant (HSCT), but vast majority of patients over the age of 50 are either ineligible for myeloablative conditioning due to concomitant conditions or have a high burden and/or very resistant disease that makes reduced dose conditioning futile.

BC8-I-131 has demonstrated ability to successfully prepare such patients for bone marrow transplants when no other treatment was indicated. ATNM intends to develop Iomab-B through a regulatory approval via a pivotal registration trial in AML refractory/relapsing patients. That would allow for a relatively quick path to the market and provide a potentially curative treatment to patients who currently have little or no chance of achieving even a temporary remission, let alone a cure.

The targeting part of the Iomab-B construct is a monoclonal antibody that targets CD45, an antigen widely expressed on hematopoietic cells but not other tissues. Due to this broad expression, Iomab-B has demonstrated utility in other groups of patients and other indications as well, including Myelodysplastic Syndrome, Acute Lymphoblastic Leukemia, Hodgkin’s Disease and Non-Hodgkin Lymphoma. These are follow-on indications which could be pursued simultaneously or delayed, for cash conservation, and financed from commercial revenues.

The company is already preparing a program for replacing iodine 131 with Actinium 225 to create a second generation drug that would enable a significant expansion of use, described below as Actimab-B, Iomab-B was invented by researchers at the Fred Hutchinson Cancer Research Center (FHCRC), ATNM’s key collaborator on this program from whom ATNM obtained rights for all the commercial uses. FHCRC played a pivotal role in developing the entire field of bone marrow transplantation and the lead Hutchinson researcher, Dr. E. Donnall Thomas received the 1990 Nobel Prize in physiology/medicine for work in this area.

A phospholipid-PEG2000 conjugate of a vascular endothelial growth factor receptor 2 (VEGFR2)-targeting heterodimer peptide for contrast-enhanced ultrasound imaging of angiogenesis.

The transition of a targeted ultrasound contrast agent from animal imaging to testing in clinical studies requires considerable chemical development. The nature of the construct changes from an agent that is chemically attached to microbubbles to one where the targeting group is coupled to a phospholipid, for direct incorporation to the bubble surface. We provide an efficient method to attach a heterodimeric peptide to a pegylated phospholipid and show that the resulting construct retains nanomolar affinity for its target, vascular endothelial growth factor receptor 2 (VEGFR2), for both the human (kinase insert domain-containing receptor – KDR) and the mouse (fetal liver kinase 1 – Flk-1) receptors. The purified phospholipid-PEG-peptide isolated from TFA-based eluents is not stable with respect to hydrolysis of the fatty ester moieties. This leads to the time-dependent formation of the lysophospholipid and the phosphoglycerylamide derived from the degradation of the product. Purification of the product using neutral eluent systems provides a stable product. Methods to prepare the lysophospholipid (hydrolysis product) are also included. Biacore binding data demonstrated the retention of binding of the lipopeptide to the KDR receptor. The phospholipid-PEG2000-peptide is smoothly incorporated into gas-filled microbubbles and provides imaging of angiogenesis in a rat tumor model.

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DelMar Pharmaceuticals Announces New Data Supporting the Unique Anti-cancer Mechanism of VAL-083

On April 19, 2016 DelMar Pharmaceuticals, Inc. (OTCQX: DMPI) ("DelMar" and reported that its collaborators from the University of British Columbia’s Vancouver Prostate Center presented results of new research related to the anti-cancer mechanism of its lead anti-cancer product candidate, VAL-083 (dianhydrogalactitol) (Press release, DelMar Pharmaceuticals, APR 19, 2016, View Source [SID:1234511054]).

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Abstract #2985: "Molecular mechanisms of dianhydrogalactitol (VAL-083) in cancer treatment," is being presented during this morning’s "New Mechanisms of Anticancer Drug Action" session at the American Association of Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting in New Orleans.

Specifically,

VAL-083 displayed broad anti-tumor activity against lung and prostate cancer cells;
VAL-083 treatment causes rapid and durable DNA interstrand crosslinks leading to irreparable DNA double-strand breaks, S/G2 phase cell-cycle arrest and apoptosis in cancer cells; and
This new understanding of the molecular mechanisms underlying VAL-083’s anti-cancer activity offers support for effective combination therapies.
"These data indicate that the DNA-damaging cross-links resulting from VAL-083 treatment occur rapidly and, once formed, are not easily repaired by the cell," noted Dr. Dennis Brown, DelMar’s Chief Scientific Officer.

"Typically, a normal cell employs check-point control and DNA repair mechanisms to identify and remove DNA cross-links and double strand breaks such as those resulting from treatment with VAL-083. However, cancer cells, by their very nature tend to have mutations or deficiencies in these mechanisms that may allow VAL-083 mediated cross-links to persist resulting in irreparable and lethal damage to the tumor cell."

Jeffrey Bacha, DelMar’s chairman & CEO continued, "These findings are very exciting and continue to support our belief that VAL-083’s anti-cancer mechanism is unique. Understanding where in the cell cycle VAL-083 elicits its cancer-lethal activity provides guidance in considering combination therapies. This knowledge combined with our own and historical clinical data demonstrating activity against a number of tumors truly establishes a broad stage for the future clinical development of VAL-083."

About the Research:

VAL-083 (dianhydrogalactitol) is a bi-functional alkylating agent causing N7-guanine alkylation and inter-strand DNA crosslinks. VAL-083’s cytotoxic activity is independent of MGMT-expression in various cancer cells and cancer stem cells, suggesting a mechanism that is distinct from that of other alkylating agents. Preclinical and clinical trial data suggest that VAL-083 may have effects in treating various cancers, including lung, brain, cervical, ovarian tumors, and leukemia. However, the detailed molecular mechanisms mediating VAL-083 sensitivity or resistance in cancer have been unclear.

This research was undertaken to investigate the signaling events responsible for VAL-083’s robust activity against cancer.

Crystal violet proliferation assays were performed to assess VAL-083 sensitivity in a variety of cancer cell lines. Propidium iodide (PI) staining and immunofluorescent analyses were used to evaluate cell cycle phases. Western blots were employed to investigate DNA damage response induced by VAL-083 treatment.

Pulse (1 hour) treatment with VAL-083 activated DNA damage signaling pathway as demonstrated by expression of phospho-ATM (S1981), phospho-Chk2 (T68), phospho-RPA32 (S33) and ɣH2A.X which persisted for 24 – 48 hours after removal of VAL-083 from the medium. Specifically, VAL-083 treatment led to long-lasting cell cycle arrest at S/G2 phase of the cell cycle. Additionally, DNA double-strand break signals such as increased levels of ɣH2A.X continued to accumulate at 72 hours following treatment of cancer cells with VAL-083, demonstrating irreparable damage to the tumor cell.

About VAL-083

VAL-083 is a "first-in-class," small-molecule chemotherapeutic. In more than 40 Phase I and II clinical studies sponsored by the U.S. National Cancer Institute, VAL-083 demonstrated clinical activity against a range of cancers including lung, brain, cervical, ovarian tumors and leukemia both as a single-agent and in combination with other treatments. VAL-083 is approved in China for the treatment of chronic myelogenous leukemia (CML) and lung cancer, and has received orphan drug designation in Europe and the U.S. for the treatment of malignant gliomas. DelMar recently announced that the FDA’s Office of Orphan Products had also granted an orphan designation to VAL-083 for the treatment of medulloblastoma.

DelMar has demonstrated that VAL-083’s anti-tumor activity is unaffected by the expression of MGMT, a DNA repair enzyme that is implicated in chemotherapy resistance and poor outcomes in GBM patients following standard front-line treatment with Temodar (temozolomide).

DelMar has been conducting a Phase I/II clinical trial in GBM patients whose tumors have progressed following standard treatment with temozolomide, radiotherapy, bevacizumab (Avastin) and a range of salvage therapies at five clinical centers in the United States: Mayo Clinic (Rochester, MN); UCSF (San Francisco, CA) and three centers associated with the Sarah Cannon Cancer Research Institute (Nashville, TN, Sarasota, FL and Denver, CO).

Interim data from the ongoing Phase I/II clinical trial were presented today at the American Association of Cancer Research Annual Meeting (abstract #CT074). Results to date support the potential of a VAL-083 to offer a clinically meaningful survival benefit and a promising new treatment option for GBM patients who have failed or are unlikely to respond to currently available chemotherapeutic regimens. DelMar plans to discuss a proposed Phase III protocol with the FDA in the coming months.