On November 8, 2015 Curis, Inc. (NASDAQ:CRIS), a biotechnology company focused on the development and commercialization of innovative drug candidates for the treatment of cancers, reported that its collaborator Aurigene presented preclinical data from two programs at the AACR (Free AACR Whitepaper)-NCI-EORTC AACR-NCI-EORTC (Free AACR-NCI-EORTC Whitepaper) International Conference on Molecular Targets and Cancer Therapeutics (EORTC-NCI-AACR) (Free ASGCT Whitepaper) (Free EORTC-NCI-AACR Whitepaper) including: (1) CA-170 (previously AUPM-170), a first-in-class oral, small molecule immune checkpoint antagonist targeting programmed death ligand-1 (PD-L1) and V-domain Ig suppressor of T cell activation (VISTA), and (2) the interleukin-1 receptor associated kinase 4 (IRAK4) inhibitor program. Curis recently exercised options to license both these programs under a collaboration agreement with Aurigene established earlier this year (Press release, Curis, NOV 8, 2015, View Source [SID:1234508105]).

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CA-170 (PD-L1/VISTA antagonist) presentation:

Aurigene presented a poster entitled "First-in-class orally available immune checkpoint antagonists for cancer therapy" on Friday, Nov. 6. The presentation included data from in vitro functional studies, which showed that CA-170 can rescue effector functions of T cells (such as cytokine secretion) that are inhibited specifically by interactions of PD-L1/L2 and VISTA checkpoint proteins but does not impact T cells functions that are modulated as a result of interactions of other checkpoint regulators such as TIM-3, CTLA4, LAG-3 and BTLA with their respective counterparts. Additionally, studies conducted with isolated human T cells demonstrate that short exposures to CA-170 (in the order of a few hours) are adequate to rescue and sustain activation of T cells functions. Daily oral administration of CA-170 resulted in anti-tumor activity in multiple syngeneic tumor models including melanoma and colon cancer but no activity was observed in immune deficient SCID-Beige mice, suggesting that the anti-cancer effects of CA-170 are mediated via activation of immune responses to these cancers.

"The collective in vitro and animal model data are very compelling and strongly support testing of CA-170 in human clinical trials in multiple cancers," said Ali Fattaey, Ph.D., Curis’ President and CEO. "We are working with Aurigene to complete the IND enabling studies for CA-170 and initiate clinical studies in the first half of 2016."

IRAK4 inhibitor presentation:

Aurigene poster entitled "Efficacy of novel IRAK4 inhibitors in ABC-DLBCL and AML models" was presented on Sunday, Nov. 8. This presentation included data from chemically distinct series of small molecule compounds with potent IRAK4 inhibitory activity in biochemical assays. Anti-tumor activity of lead compounds was confirmed in a MYD88 mutant DLBCL xenograft tumor model. Lead compounds also inhibited inflammatory responses in an in vivo model, suggesting that IRAK4 inhibitors have the potential for use in the treatment of inflammatory diseases. Preliminary in vivo safety studies demonstrate a favorable therapeutic index for further development of lead compounds for potential human testing.

On November 08, 2015 Calithera Biosciences, Inc. (Nasdaq:CALA), a clinical stage biotechnology company focused on the development of novel cancer therapeutics, reported that it will announce new clinical data from the solid tumor expansion cohorts of its lead anti-cancer therapeutic candidate, CB-839, at the 2015 AACR (Free AACR Whitepaper)-NCI-EORTC International Conference on Molecular Targets in Boston, Massachusetts (Press release, Calithera Biosciences, NOV 8, 2015, View Source;p=RssLanding&cat=news&id=2110182 [SID:1234508340]). CB-839 is a potent, selective, orally bioavailable glutaminase inhibitor in phase I clinical trials. The data support earlier findings of the clinical activity, tolerability and unique mechanism of action of CB-839 in patients with solid tumors, as well as show one partial response according to RECIST criteria.

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The new data to be presented by Funda Meric-Bernstam, MD, from MD Anderson Cancer Center (Abstract #C49), demonstrate stable disease across a variety of tumor types, as well as a single agent partial response (PR, on study >5 months) in a renal cell carcinoma (RCC) patient. This patient showed a 32% reduction in target lesions by RECIST with generalized shrinkage of lymph node metastases. Among the fifteen evaluable patients with RCC, nine (60%) had stable disease lasting at least three cycles (63 days) or a partial response, with four patients remaining on study. Among efficacy-evaluable patients across a range of tumor types treated on the current dosing schedule of twice-daily with food, 22 of 50 patients (44%) experienced stable disease or better. Five stable disease patients currently on study have been treated with CB-839 for over 8 months without progression (2 triple negative breast cancer, 1 RCC, 1 mesothelioma and 1 IDH1 mutant chondrosarcoma).

"We are very encouraged by these findings in that they reinforce the published safety and efficacy profile of CB-839. We believe that this first partial response in solid tumors points to the potential of our novel agent’s efficacy in renal cell carcinoma, and we look forward to sharing data as our single agent and combination studies mature," said Susan Molineaux, PhD, President and Chief Executive Officer of Calithera. "We are currently expanding enrollment of CB-839 as a monotherapy in renal cell carcinoma patients, as well as dosing CB-839 in combination with everolimus."

The Phase 1 multi-center open label dose escalation study was designed to evaluate the safety and tolerability of CB-839 in locally advanced, metastatic and/or refractory solid tumors. Oral CB-839 was administered in doses of 100 mg to 1000 mg, in 21 day cycles using one of two regimens: TID or BID with food. As of October 1, 2015, 98 patients were enrolled in the solid tumor study (32 TID, 66 BID with food) and evaluable for safety; 77 were evaluable for efficacy. All future patients enrolled to the study will be dosed on the BID with food regimen.

Safety Data

Among 98 patients evaluable for safety, a maximum tolerated dose has not been established. CB-839 was generally well tolerated with the majority of treatment-emergent adverse events being mild to moderate, Grade 1/2 and reversible. Among patients in the BID with food regimen, 4.5% (3/66) experienced a Grade 3/4 adverse event suspected to be related to CB-839 and 3% discontinued due to drug-related adverse events (2/66). The rate of Grade 3 alanine aminotransferase (ALT) elevations of 1.5% (1/66) in the BID with food cohort was substantially reduced relative to that observed in the TID cohort 16% (5/32).

In addition, a preclinical poster was presented by Calithera’s collaborators. Details for the presentation are as follows:

Targeting glutamine metabolism in colorectal cancers with PIK3CA mutations

Abstract #C115
Zhenghe John Wang, Ph.D., Case Western Reserve University
Poster Session C

On November 8, 2015 Ignyta, Inc. (Nasdaq: RXDX), a precision oncology biotechnology company, reported that interim results from the company’s ongoing Phase 1 clinical trial of RXDX-105, the company’s orally-available, small molecule multikinase inhibitor with potent activity against such key targets as RET and BRAF, were presented at the 27th EORTC-NCI-AACR (Free EORTC-NCI-AACR Whitepaper) Symposium on Molecular Targets and Cancer Therapeutics in Boston, Massachusetts (Press release, Ignyta, NOV 8, 2015, View Source [SID:1234508112]).

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"We are excited by the data from our Phase 1 clinical trial of RXDX-105, including the overall safety profile and the recent partial response in a non-small lung cancer patient," said Pratik Multani, M.D., Chief Medical Officer of Ignyta. "We believe we are close to determining the recommended phase 2 dose (RP2D) and we look forward to further study of this product candidate in cancer histologies and molecular alterations of interest."

The dose escalation clinical trial was designed to determine the maximum tolerated dose (MTD) and/or recommended Phase 2 dose (RP2D), as well as preliminary anti-cancer activity, of single agent RXDX-105 in patients with advanced or metastatic solid tumors that were not selected based on any molecular alteration.

As of the October 26, 2015, data cut-off for the presentation, the findings showed:

A total of 41 patients with a range of solid tumors were dosed in the clinical trial;
RXDX-105 was well tolerated to date:

The most frequent treatment-emergent adverse events were fatigue, vomiting, nausea, decreased appetite, constipation, diarrhea, hypertension and muscle spasms;

Three Grade 3 dose-limiting toxicities were observed: maculopapular rash, fatigue and diarrhea, each of which resolved upon study drug interruption;

There were no treatment-related serious adverse events. Two Grade 4 adverse events had occurred, consisting of intestinal obstruction and anemia, neither of which was considered to be treatment-related. No Grade 5 treatment-related adverse events or cumulative adverse events were observed;

The MTD and RP2D had not yet been determined;

Pharmacokinetic measurements showed increased exposure with increasing dose, with a half-life compatible with once-daily dosing. Dosing in the fed state appears to further increase exposure;

Exposure was reaching levels expected to be efficacious based on tumor growth inhibition in animal models of RET- and BRAF-driven tumors; and

Tumor regression was observed in six patients treated with 275 mg, including one confirmed partial response (40% reduction) in a patient with non-small cell lung cancer with a KRAS G12C mutation. Two additional patients with thyroid cancer and squamous cell lung cancer exhibited reductions of 20% and 27%, respectively. In patients with tumor regression, there appears to be an exposure/response correlation.

On Monday, November 9, 2015, Ignyta will file a Form-8-K with the U.S. Securities and Exchange Commission (SEC) containing the materials presented at the EORTC-NCI-AACR (Free EORTC-NCI-AACR Whitepaper) Symposium. The company’s SEC filings can be found on the company’s website at www.ignyta.com and on the SEC’s website at www.sec.gov.

At the EORTC-NCI-AACR (Free EORTC-NCI-AACR Whitepaper) Symposium, Ignyta also presented a poster relating to the potent RET inhibitory activity of RXDX-105 in multiple preclinical models of RET-rearrangement driven cancer. This poster is available on the company’s website at www.ignyta.com.

On November 8, 2015 ImmunoGen, Inc. (Nasdaq: IMGN), a biotechnology company that develops targeted anticancer therapeutics using its antibody-drug conjugate (ADC) technology, reported findings with mirvetuximab soravtansine, its novel folate receptor alpha (FRα)-targeting ADC product candidate, being presented at the AACR (Free AACR Whitepaper)-NCI-EORTC AACR-NCI-EORTC (Free AACR-NCI-EORTC Whitepaper) International Conference on Molecular Targets and Cancer Therapeutics (EORTC-NCI-AACR) (Free ASGCT Whitepaper) (Free EORTC-NCI-AACR Whitepaper) (abstract #C47) (Press release, ImmunoGen, NOV 8, 2015, View Source [SID:1234508113]). Analysis of the association between the amount of FRα present on patient cancer cells and response to treatment with mirvetuximab soravtansine found nine of ten (90%) patients with high levels of FRα had an objective response on treatment.

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"These early findings are highly encouraging as they underscore the potential of mirvetuximab soravtansine to make an important difference for patients with ovarian cancer," said Dr. Charles Morris, chief development officer. "The data are from patients with heavily pretreated platinum-resistant ovarian cancer, which is a difficult disease to treat. We will be assessing mirvetuximab soravtansine as single-agent therapy for patients with pretreated FRα-positive ovarian cancer in our FORWARD I trial, a study we intend to use for registration purposes."

The findings presented today are from an analysis of 20 efficacy-evaluable patients with platinum-resistant ovarian cancer who received mirvetuximab soravtansine in Phase 1 testing at its selected dose. Patients were categorized as having high, medium or low amounts of FRα on their cancer cells.1 Enrollment criteria for the clinical study required all patients to have at least low expression.

Nine of the ten patients with high FRα expression had an objective response (2 complete responses/CRs, 7 partial responses/PRs by RECIST 1.1 criteria). Six of these responders remained on treatment for at least 24 weeks.

The six patients with medium expression all had tumor regression. One patient had an objective response (unconfirmed PR) and one had tumor shrinkage with new lesion formation (mixed response/MR). An additional patient remained on treatment for more than six months but did not have an objective response.

Four patients had low expression and none had an objective response. One patient was still on treatment at the time of data cut off for presentation.

The ORR was 50% for all 20 efficacy-evaluable patients. Among all 22 patients evaluable for tolerability, the majority of adverse events reported were low grade (grade 1 or 2), with diarrhea, blurred vision, vomiting, fatigue, and nausea the most common treatment-emergent events reported ( > 30% of patients).

ImmunoGen anticipates reporting mature data from the full 46-patient cohort in this study at a medical meeting in 2016.

The FORWARD I Trial

ImmunoGen’s FORWARD I trial will assess mirvetuximab soravtansine as single-agent therapy for the treatment of ovarian cancer previously treated with three to four prior regimens. Patients will have medium or high expression of FRα to qualify for enrollment in this Phase 2 study. Patient enrollment is expected to start in late 2015.

About Mirvetuximab Soravtansine

Mirvetuximab soravtansine (IMGN853) is a FRα-targeting ADC developed and wholly owned by ImmunoGen. It comprises a FRα-binding antibody conjugated to DM4, a potent cancer-killing agent created by ImmunoGen for use in ADCs. The antibody serves to target the DM4 specifically to FRα-positive cancer cells which the DM4 can then kill. FRα is highly expressed on many cases of epithelial ovarian cancer.2 It also is highly expressed on other types of solid tumors including endometrial cancer and some non-small cell lung cancers.

About Ovarian Cancer

Each year, there are approximately 21,300 new cases of ovarian cancer diagnosed in the US and more than 14,200 women die from the disease.3 Once the cancer has been treated with several lines of combination regimens, patients may be treated with single-agent therapy, which typically have response rates around 15-20%.4

On November 07, 2015 OncoMed Pharmaceuticals Inc. (NASDAQ:OMED), a clinical-stage company developing novel anti-cancer stem cell and immuno-oncology therapeutics, reported new preclinical data for anti-DLL4 combined with anti-VEGF and anti-PD1 during the Society for Immunotherapy of Cancer (SITC) (Free SITC Whitepaper) Conference (Press release, OncoMed, NOV 7, 2015, View Source [SID:1234508091]).

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A series of preclinical experiments compared the impact of anti-DLL4/VEGF bispecific and a triple blockade of DLL4-VEGF-PD1 on anti-tumor immune responses. The combination of anti-DLL4/VEGF and anti-PD1 was found to have more potent anti-tumor and enhanced immuno-oncology activity than either agent alone across a number of measures. The triple blockade of DLL4-VEGF-PD1 significantly inhibited tumor growth with more pronounced tumor regression. The addition of anti-DLL4/VEGF also improved anti-tumor activity of anti-PD1 alone in both PD1 responsive and non-responsive cancers in murine models.

"These data highlight the ability of the anti-DLL4/VEGF bispecific to combine with anti-PD1 and to modulate anti-tumor immune responses," said Austin Gurney, PhD, Senior Vice President of Molecular and Cellular Biology. "In addition to increased anti-tumor efficacy, we note enhanced generation of memory T cell responses and reduced tumor-associated macrophages. These results show that co-targeting of DLL4 and VEGF with PD1 might be an effective and durable anti-cancer therapy in part by promoting anti-tumor immune responses and inhibiting pro-tumor immune responses"

DLL4 is a ligand within the Notch pathway and plays important roles in regulating cancer stem cells, tumor angiogenesis and pro-tumor immune responses. OncoMed has two clinical agents targeting DLL4: demcizumab (anti-DLL4, OMP-21M18), currently in Phase 2 trials for the treatment of pancreatic cancer and non-small cell lung cancer (NSCLC), and anti-DLL4/VEGF bispecific, (OMP-305B83) currently in a Phase 1a trial in advanced solid tumors. The combination of anti-DLL4/VEGF bispecific with anti-PD1 demonstrated a distinct mechanistic profile versus prior observations of the synergistic combination of anti-DLL4 and anti-PD1 presented at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) 2015 Annual Meeting, suggesting potential for increased T-cell activation, maintenance and memory T-cell function.

Angie Park, Ph.D., Director of Immunotherapy and Stem Cell Biology of OncoMed presented these data in a poster titled "Co-Targeting of Delta-like ligand 4 (DLL4) and vascular endothelial growth factor A (VEGF) with Programmed Death 1 (PD1) blockade inhibits tumor growth and facilitates anti-tumor immune responses." during the Optimizing Combination Immunotherapy session.