On July 6, 2022 Kazia Therapeutics Limited (NASDAQ: KZIA; ASX: KZA), an oncology-focused drug development company, reported that the United States Food and Drug Administration (FDA) has awarded Rare Pediatric Disease Designation (RPDD) to Kazia’s paxalisib for the treatment of atypical rhabdoid / teratoid tumors (AT/RT), a rare and highly-aggressive childhood brain cancer (Press release, Kazia Therapeutics, JUL 6, 2022, View Source [SID1234616497]).

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Key Points

Rare Pediatric Disease Designation (RPDD) is granted to drugs which are under development for rare childhood diseases.

RPDD means that the sponsor may be entitled to receive a pediatric priority review voucher (pPRV) if the drug is initially approved for that rare childhood disease. A PRV grants the holder an expedited six-month review of a new drug application. PRVs are tradeable and have historically commanded prices in excess of US$ 100 million.

FDA’s award of RPDD follows the presentation of promising preclinical data for paxalisib in AT/RT, which was presented by Professor Jeffrey Rubens and colleagues at the American Association of Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting in New Orleans, LA, in April 2022.

Paxalisib was previously granted orphan drug designation (ODD) for AT/RT by FDA on 16 June 2022.

Kazia CEO, Dr James Garner, commented, "this is the second time that paxalisib has been granted RPDD, and it demonstrates the importance of childhood brain cancer in the overall paxalisib development program. Brain cancer is the most common cause of cancer death in children, and outcomes in many forms of childhood brain cancer have not improved in decades. We very much hope that paxalisib can make a difference to families affected by both DIPG and AT/RT, and we will be working closely with clinicians, researchers, and FDA to determine the optimal way to move the drug forward."

Rare Pediatric Disease Designation

The Food and Drug Administration Safety and Innovation Act (2012) established FDA’s RPDD initiative. RPDD may be granted to drugs in development for diseases which primarily affect children (under the age of 18 years), have an incidence of less than 200,000 new cases per annum in the United States, and which are serious or life-threatening.

A sponsor of a drug with RPDD may request a Rare Pediatric Disease Priority Review Voucher (PRV) at the time of a marketing application to FDA. In effect, the PRV shortens the FDA review period for a future marketing application of any drug from 12 months to 6 months. PRVs can be sold to other companies and have historically been transacted at prices in the tens to hundreds of millions of dollars. For a large company launching a billion-dollar drug, the six-month acceleration in regulatory review can be of substantial economic value. In 2019, five pediatric PRVs were granted by FDA.

Next Steps

A phase II clinical trial of multiple drug therapies, including paxalisib, is ongoing, under the sponsorship of the Pacific Pediatric Neuro-Oncology Consortium (PNOC) (NCT05009992). This study combines several investigational drugs in the treatment of patients with diffuse midline gliomas (DMGs), a category which includes DIPG. Initial data from this study is anticipated in CY2023.

A phase I study of paxalisib in DIPG, led by St Jude Children’s Research Hospital in Memphis, TN (NCT03696355), is nearing completion, and final data is expected to be submitted for publication by the end of CY2022.

On July 6, 2022 Turnstone Biologics Corp., a clinical-stage biotechnology company developing next-generation immunotherapies to treat and cure solid tumors, and Moffitt Cancer Center ("Moffitt"), a world leader in advancing cellular immunotherapies for the treatment of cancer, reported the formation of a broad strategic alliance, deepening their existing multi-year research collaboration (Press release, Turnstone Biologics, JUL 6, 2022, View Source [SID1234616515]). As part of this expanded partnership, Turnstone will have priority access to Moffitt’s scientific research, manufacturing, and clinical capabilities for the development of novel tumor infiltrating lymphocyte ("TIL") therapies. The parties also announced U.S. Food and Drug Administration ("FDA") clearance of an Investigational New Drug ("IND") application for a Moffitt-sponsored Phase 1 clinical study of TIDAL-01, Turnstone’s lead TIL therapy candidate, in cutaneous and non-cutaneous melanoma. The trial is expected to commence later this year.

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"Our landmark strategic alliance with Turnstone underscores Moffitt’s commitment to bold research initiatives and groundbreaking clinical studies for the benefit of cancer patients who have limited or no effective treatment options," said Patrick Hwu, M.D., President and CEO, Moffitt Cancer Center. "Cell therapy is a key area of focus at Moffitt, and we are impressed by Turnstone’s novel approach to TIL therapy. Our combined team has made strong progress as part of our ongoing partnership, particularly with the IND clearance of TIDAL-01. We look forward to initiating the clinical study in melanoma and continuing to grow this valuable relationship with Turnstone."

Selected TILs represent the foundational therapeutic modality driving Turnstone’s cancer immunotherapy pipeline and leverage decades of work anchored in academia that have demonstrated the promise of this approach. By identifying, selecting, and expanding the most potent subsets of patient specific tumor-reactive T-cells, Turnstone aims to improve and broaden the clinical efficacy of TILs and overcome the limitations of current treatments to achieve positive outcomes in harder to treat, lower mutational burden, cancers. TIDAL-01 builds on the historical clinical success of Selected TIL treatment protocols and is the initial focus of the Turnstone-Moffitt collaboration as the parties advance the program into a Phase 1 clinical study.

Under the terms of the agreement, Moffitt will grant Turnstone prioritized clinical trial activation, enhanced patient screening and data sharing, full access to Moffitt’s cellular therapies research and development infrastructure and expanded molecular data sets and biospecimens for research. Moffitt will also provide extended governance support and allocated GMP manufacturing capacity for Turnstone product candidates. Turnstone will contribute resources and expertise to the partnership and fund research and development activities at Moffitt. Additional financial terms were not disclosed.

"This industry-leading partnership with Moffitt is a direct result of our unwavering efforts to develop promising new cancer medicines in the most innovative and impactful ways possible," said Sammy Farah, Ph.D., M.B.A., President and CEO, Turnstone Biologics. "We believe Moffitt’s translational insights and clinical execution capabilities coupled with our next-generation Selected TIL technology will accelerate the development of our differentiated TIL therapies and increases our opportunity to create curative outcomes for patients with solid tumors."

On July 6, 2022 Bio-Techne (NASDAQ: TECH), a global life sciences company providing innovative tools and bioactive reagents for the research and clinical diagnostic communities reported the European launch of the CE-IVD marked RNAscope ISH Probe High Risk HPV, intended for use in patients diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) to aid in the identification of high-risk human papillomavirus (HPV) (Press release, Bio-Techne, JUL 6, 2022, View Source [SID1234616500]).

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HPV is a major cause of OPSCC, and HPV has emerged as a valuable diagnostic marker that significantly impacts clinical management.1,2 Immunohistochemistry (IHC) for p16 protein, a surrogate marker, is widely used for HPV detection in OPSCC; however, misdiagnosis rates of 5‑20% have been reported when using p16.3 The presence of E6/E7 mRNA is considered the gold standard for diagnosing HPV-related OPSCC.4 RNAscope offers a superior method for detection of E6/E7 mRNA when assessing HPV status in OPSCC patients, enabling clinicians to provide a more accurate diagnosis and improve patient management.5

"Bio-Techne’s innovative tissue diagnostic solutions empower our customers to serve patients and improve lives," said Kim Kelderman, President, Diagnostics and Genomics Segment of Bio-Techne. "We are excited to launch the new CE-IVD RNAscope ISH Probe High Risk HPV, which provides pathologists a highly accurate tool for the direct detection of HPV mRNA to inform treatment selection in oropharyngeal squamous cell carcinoma patients."

RNAscope in situ hybridization (ISH) is a highly sensitive and specific spatial biology technology. Its double Z probe design enables an exceptional signal-to-noise ratio when staining formalin-fixed paraffin-embedded (FFPE) tissue specimens. RNAscope ISH allows users to visualize and localize biomarker expression patterns by light microscopy. Over the past 10 years, RNAscope ISH has proven its reliability, reproducibility, and robustness with more than 6000 peer reviewed publications, making it a powerful solution for anatomic pathologists.

RNAscope ISH Probe High Risk HPV is used in an RNAscope ISH assay for the qualitative detection of HPV E6/E7 mRNA in FFPE tissue specimens. RNAscope ISH Probe High Risk HPV is for use in clinical laboratories with the CE-IVD marked BOND RNAscope Brown Detection kit on the automated Leica Biosystems BOND-III stainer. The assay detects high-risk HPV types 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, and 82.

On July 6, 2022 Pyramid Biosciences, Inc., a clinical-stage biotechnology company developing a portfolio of precision therapies targeting a range of serious diseases, reported that the U.S. Food and Drug Administration (FDA) has granted orphan drug designation for PBI-200, a next-generation, highly brain penetrant inhibitor of the neurotrophic tyrosine receptor kinase (NTRK) currently in clinical development for the treatment of NTRK fusion-positive solid tumors (Press release, Pyramid Biosciences, JUL 6, 2022, View Source [SID1234616516]).

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"Oncogenic NTRK gene fusions are found in a broad range of cancers," said Pyramid Biosciences CEO Brian Lestini, MD, PhD. "Orphan designation for drugs in development such as PBI-200 are important to ensure continued innovation to address unmet needs for these patients, including primary and metastatic brain tumors."

"We are extremely pleased that the orphan designation was granted, and we look forward to continued enrollment in our global Phase 1/2 clinical trial of PBI-200," said Pyramid Biosciences co-founder and COO Jordan Leef.

The FDA’s Office of Orphan Drug Products grants orphan drug designation to support the development of medicines for underserved patient populations or rare disorders, that affect fewer than 200,000 people in the United States.

About PBI-200

PBI-200 is an oral, highly potent, and selective inhibitor of TRK kinase that is currently in clinical development for the treatment of patients with cancers that harbor abnormalities involving the tropomyosin receptor kinases. In some patients, the NTRK genes, which encode for TRKs, can become abnormally fused to other genes, resulting in growth signals that can lead to cancer in many sites of the body. PBI-200 was discovered and developed by Pyramid Biosciences to overcome a wide range of on-target resistance mutations that have been described with first-generation TRK inhibitors. In addition, preclinical studies have shown that PBI-200 achieves high levels of penetration into brain, which translated into superior efficacy in intracranial xenograft models compared to other TRK inhibitors, as well as a favorable safety profile.

The global Phase 1/2 trial of PBI-200 (PBI-200-101) is a multicenter, open-label study in subjects with NTRK fusion-positive advanced or metastatic tumors including primary and metastatic CNS tumors. The trial consists of a dose-escalation phase, followed by a multicohort expansion at the recommended Phase 2 dose. Additional information can be found at: View Source (NCT04901806).

On July 6, 2022 Shanghai Junshi Biosciences Co., Ltd. ("Junshi Biosciences", HKEX: 1877; SSE: 688180) and Coherus BioSciences, Inc. ("Coherus") reported that the United States Food and Drug Administration ("FDA") has accepted for review the Biologics License Application ("BLA") resubmission for toripalimab in combination with gemcitabine and cisplatin as first-line treatment for patients with advanced recurrent or metastatic nasopharyngeal carcinoma ("NPC") and for toripalimab monotherapy for the second-line or later treatment of recurrent or metastatic NPC after platinum-containing chemotherapy (Press release, Shanghai Junshi Bioscience, JUL 6, 2022, View Source [SID1234616501]).

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The FDA has set a Prescription Drug User Fee Act ("PDUFA") action date for December 23, 2022. The Agency earlier communicated that the review timeline for the BLA resubmission would be six months, as onsite inspections in China would be required. Travel restrictions related to the COVID-19 pandemic previously hindered the FDA’s ability to complete required inspections. Coherus plans to launch toripalimab in the United States in the first quarter of 2023, if approved.

"Although the COVID-19 pandemic has created tremendous challenges for everyone, our dedication to bring better treatment options to patients around the world remains steadfast," said Dr. Patricia Keegan, Chief Medical Officer of Junshi Biosciences. "Through our concerted efforts with our partner, Coherus, we have made continual progress towards obtaining toripalimab’s first marketing authorization outside of China. Over the next several months, we will work closely with the FDA to facilitate the review of this novel drug."

"Toripalimab would address a critical unmet medical need for patients with nasopharyngeal carcinoma, an aggressive cancer for which there are currently no FDA-approved immunotherapy treatments. We collaborated closely with our partner, Junshi Biosciences, to complete the quality process changes requested by the FDA and facilitate the rapid resubmission of the toripalimab BLA," said Dr. Theresa LaVallee, Chief Development Officer of Coherus.

"For Coherus, the toripalimab resubmission is one of several key development and commercialization milestones we are sharply focusing on over the next twelve months, and we are pleased with the Company’s execution and progress on all of them," said Denny Lanfear, CEO of Coherus. "We now look forward to the August 2, 2022 target action date for our BLA for CIMERLI, our Lucentis biosimilar, followed by product launch which we are confident will be very successful. The toripalimab December 2022 PDUFA date follows directly, and the projected toripalimab launch in Q1 2023 will formally mark our entry into immuno-oncology, where Coherus will be one of just a handful of companies with a proprietary PD-1 as a foundation stone to build its oncology franchise upon. Lastly, twelve months from now, in July 2023, we expect to begin marketing our Humira biosimilar, YUSIMRY, which was approved by the FDA in December 2021. Preparations for that commercial launch are going very well. Biosimilar market execution is a demonstrated Coherus competency, and we believe that our commercialization strategy provides a robust framework against which we can successfully execute to meet our market expectations and share projections."

Following approval of toripalimab for NPC, Coherus’ strategy in the US includes evaluating toripalimab’s ability to deliver substantial clinical benefit in significant indications, in combination with other cancer drugs and immunotherapies, through co-development agreements.

About Toripalimab in NPC
NPC is a type of aggressive cancer that starts in the nasopharynx, the upper part of the throat behind the nose and near the base of skull. Due to the location of the primary tumor, surgery is rarely an option, and patients with localized disease are treated primarily with radiation and chemotherapy. In the United States, there are presently no immunotherapies approved for the treatment of NPC.

The toripalimab BLA is supported by the results from JUPITER-02, a randomized, double blind, placebo-controlled, international multi-center Phase 3 clinical trial, as well as POLARIS-02, a multi-center, open-label, pivotal Phase 2 clinical study. The JUPITER-02 results were first presented in June 2021 in a plenary session of the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) ("ASCO") annual meeting (#LBA2) and subsequently published in detail as the cover article of the September 2021 issue of Nature Medicine. The POLARIS-02 results were published online in January 2021 in the Journal of Clinical Oncology.

The FDA has granted Breakthrough Therapy designation ("BTD") for toripalimab in combination with chemotherapy (gemcitabine and cisplatin) for the 1st line treatment of recurrent, locally advanced or primary metastatic non-keratinizing NPC and for toripalimab monotherapy for patients with recurrent or metastatic non-keratinizing NPC with disease progression on or after platinum-containing chemotherapy. Additionally, the FDA has granted Orphan Drug designation for toripalimab for NPC.

In China, the National Medical Products Administration ("NMPA") in 2021 approved toripalimab for two NPC indications.

About Toripalimab
Toripalimab is an anti-PD-1 monoclonal antibody developed for its ability to block PD-1 interactions with its ligands, PD-L1 and PD-L2, and for enhanced receptor internalization (endocytosis function). Blocking PD-1 interactions with PD-L1 and PD-L2 promotes the immune system’s ability to attack and kill tumor cells. In China, toripalimab was the first domestic anti-PD-1 monoclonal antibody approved for marketing (approved in China as TUOYI). Currently, there are five approved indications for toripalimab in China.