Bicycle Therapeutics Reports Fourth Quarter and Full Year 2020 Financial Results and Provides Corporate Update

On March 11, 2021 Bicycle Therapeutics plc (NASDAQ: BCYC), a biotechnology company pioneering a new and differentiated class of therapeutics based on its proprietary bicyclic peptide (Bicycle) technology, reported financial results for the fourth quarter and full year ended December 31, 2020 and discussed recent corporate updates (Press release, Bicycle Therapeutics, MAR 11, 2021, View Source [SID1234576500]).

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"Bicycle has overcome the unprecedented challenges caused by the COVID-19 pandemic this past year, executing on our 2020 goals, including advancing multiple Bicycle Toxin Conjugates (BTCs) in the clinic and preparing our first tumor targeted immune cell agonist (TICA) for an expected clinical start later this year, while also thoughtfully strengthening our balance sheet," said Kevin Lee, Ph.D., Chief Executive Officer of Bicycle Therapeutics. "We are encouraged by the progress of our pipeline and are looking forward to continuing the momentum in 2021. With our clinical data presented to date, we believe we are closer to actualizing a world where Bicycles offer a much-needed new treatment paradigm for people living with cancer and other serious diseases."

Fourth Quarter 2020 and Recent Highlights

Announced Publication of Preclinical Data of Tumor-targeted Immune Cell Agonizing Molecules (TICAs) in the Journal for ImmunoTherapy of Cancer. The article, titled "Anticancer immunity induced by a synthetic tumor-targeted CD137 agonist," outlines the work Bicycle is undertaking to unlock a new method of cancer immunotherapy via small molecule agonism of TNF superfamily receptors.
Provided Oncology Pipeline Progress Update. In January 2021, Bicycle announced progress updates for its wholly owned oncology pipeline:
BT1718: The Phase IIa portion of the Phase I/IIa trial of BT1718, a potential first-in-class BTC targeting a key tumor antigen MT1-MMP, is actively enrolling patients in the Phase I/IIa trial sponsored by Cancer Research UK’s Center for Drug Development. Enrollment in the Phase IIa portion of the trial is ongoing at four clinical sites, with additional sites expected to begin enrolling patients during the first half of 2021. Patients are currently being enrolled into two solid tumor cohorts, one in squamous non-small cell lung cancer (NSCLC) and the other in an all-comers "basket" cohort. Following receipt of results from these first two cohorts, Cancer Research UK may initiate up to two additional cohorts.
BT5528: Enrollment in the company-sponsored Phase I/II trial of BT5528, a second-generation BTC targeting EphA2, a target for which prior antibody-based approaches have been unsuccessful, remains on track with additional sites expected to begin enrolling patients in 2021. BT5528 has been dosed up to 8.5mg/m2 weekly, which Bicycle believes, based on pre-clinical studies, is toward the top of the therapeutic range, with transient neutropenia observed at that dose. The dose-escalation of the Phase I/II trial remains ongoing. Bicycle observed preliminary signs of anti-tumor activity. Since implementation of an EphA2 immunohistochemistry (IHC) assay in 2020, as of January 14, 2021, two EphA2 selected patients have enrolled in the trial, one of whom was response evaluable: in a urothelial patient currently receiving 6.5mg/m2 of BT5528 every other week, whose prior lines of therapies included both a PD-1 inhibitor and enfortumab vedotin, a 43% reduction in target lesions was observed at the first radiologic response assessment, constituting a partial response under RECIST version 1.1 criteria. Reductions in non-target lesions were also observed, and the patient remains enrolled in the trial.
BT8009: Early clinical data for BT8009, a second-generation Nectin-4-targeting BTC with a potentially differentiated profile as compared to a Nectin-4 targeting antibody-drug conjugate (ADC), supports a pharmacokinetic profile that is consistent with both preclinical predications and data as of January 14, 2021 from Bicycle’s ongoing Phase I trial of BT5528, a BTC that utilizes the same linker and toxin payload. Patient enrollment in the Phase I portion of the Phase I/II clinical trial of BT8009 remains ongoing. The first clinical trial site outside of the United States opened in the first quarter of 2021.
BT7480: Bicycle continues to advance its novel TICAs and expects BT7480 to enter the clinic in the second half of this year. Bicycle has identified additional TICA candidates targeting natural killer (NK) cells through early immuno-oncology (I-O) discovery efforts and is moving these TICA candidates into lead optimization.
Presented Posters at the Society for Immunotherapy of Cancer (SITC) (Free SITC Whitepaper)’s (SITC) (Free SITC Whitepaper) 35th Anniversary Annual Meeting. In November 2020, Bicycle presented new data that demonstrated the potential generalizability of its TICA platform, with a Nectin-4/CD137 TICA and an EphA2/CD137 TICA exhibiting similar anti-tumor activity and immune modulation.
Continued to Strengthen the Balance Sheet in 2021. In March 2021, the Company drew an additional $15.0 million available under its debt facility with Hercules Capital, Inc. and amended the loan and security agreement to extend the interest-only payment period until the second half of 2023, with the potential to further extend it into 2024, contingent on the satisfaction of performance milestones. In addition, gross proceeds from Bicycle’s at-the-market (ATM) offering program during the first quarter of 2021 totaled $50.2 million as of March 10, 2021. Cash at December 31, 2020 does not include additional borrowings under the debt facility or gross proceeds from the ATM offering program received in the first quarter of 2021.
Financial Results

Cash was $136.0 million as of December 31, 2020, compared to $92.1 million as of December 31, 2019. The increase in cash at December 31, 2020 was primarily due to net proceeds of $48.1 million received from the ATM offering program during 2020, $31.0 million received from Genentech under the strategic collaboration agreement, as well as $14.4 million in net proceeds received from the debt facility with Hercules Capital, Inc., offset by cash used in operating activities. Cash of $136.0 million at December 31, 2020 is expected to provide financial runway through multiple clinical milestones.
Research and development expenses were $10.1 million for the three months ended December 31, 2020 and $33.1 million for the year ended December 31, 2020, compared to $6.6 million for the three months ended December 31, 2019 and $25.5 million for the year ended December 31, 2019. The increase in expense of $3.5 million for the three months ended December 31, 2020 as compared to the same period in the prior year was primarily due to increased clinical program expenses for BT5528 and BT8009, increased other unallocated discovery and platform related expenses due to the timing of development activities, and increased personnel-related expenses, including $0.3 million of incremental non-cash share-based compensation expense. The increase in expense of $7.6 million for the year ended December 31, 2020 as compared to the same period in the prior year was primarily due to increased clinical program expenses for BT5528 and BT8009, as well as increased TICA program development expenses and increased personnel-related expenses, including $1.3 million of incremental non-cash share-based compensation expense.
General and administrative expenses were $10.9 million for the three months ended December 31, 2020 and $29.2 million for the year ended December 31, 2020, compared to $3.4 million for the three months ended December 31, 2019 and $14.6 million for the year ended December 31, 2019. The increase of $7.5 million for the three months ended December 31, 2020 and $14.6 million for the year ended December 31, 2020 as compared to the same period in the prior year was primarily due to an increase in professional fees and costs including costs due to operations as a public company, the settlement and license agreement with Pepscan entered into in November 2020, an unfavorable effect of foreign exchange rates and an increase in personnel-related costs, including $0.2 million and $2.1 million of incremental non-cash share-based compensation expense for the three months ended December 31, 2020 and for the year ended December 31, 2020, respectively.
Net loss was $17.4 million, or $(0.83) basic and diluted net loss per share, for the three months ended December 31, 2020, and net loss was $51.0 million, or $(2.66) basic and diluted net loss per share for the year ended December 31, 2020, compared to net loss of $4.4 million, or $(0.25) basic and diluted net loss per share for three months ended December 31, 2019, and net loss of $30.6 million, or $(2.77) basic and diluted net loss per share for the year ended December 31, 2019.

FDA Grants Fast Track Designation to Spectrum Pharmaceuticals’ Poziotinib

On March 11, 2021 Spectrum Pharmaceuticals (NasdaqGS: SPPI), a biopharmaceutical company focused on novel and targeted oncology therapies, reported that the U.S. Food and Drug Administration (FDA) has granted Fast Track designation for poziotinib for the treatment of non-small cell lung cancer (NSCLC) in previously treated patients with HER2 exon 20 mutations (Press release, Spectrum Pharmaceuticals, MAR 11, 2021, View Source [SID1234576516]). Spectrum plans to submit a new drug application (NDA) for poziotinib later this year.

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"There are currently no approved therapies to treat patients with HER2 exon 20 mutations and we are pleased that the FDA has granted Fast Track designation for poziotinib," said Joe Turgeon, President and CEO of Spectrum Pharmaceuticals. "Momentum is building to unlock the potential of poziotinib."

"We are actively preparing the NDA and delighted with this Fast Track designation," stated Francois Lebel, M.D., Chief Medical Officer of Spectrum Pharmaceuticals. "In addition, last week we presented at the European Society for Medical Oncology Targeted Anticancer Therapies (ESMO TAT) Virtual Congress 2021 that twice daily dosing (BID) suggests improved anti-tumor activity and reduced toxicity relative to once daily dosing. We are optimistic about this BID strategy and we will provide a data update at AACR (Free AACR Whitepaper) in April."

About Fast Track Designation

Fast Track is a process designed to facilitate the development and expedite the review of drugs to treat serious and life-threatening conditions and fill unmet medical needs, with the intention of getting important new drugs to patients earlier. Specifically, Fast Track designation facilitates meetings with the FDA to discuss aspects of development to support licensure and provides the opportunity to submit sections of a NDA on a rolling basis as data become available. When Fast Track designation is requested later in development, available clinical data should demonstrate the potential to address an unmet medical need. Additionally, another potential benefit of Fast Track designation is priority review, which reduces the standard 10 months NDA review to six months.

Checkpoint Inhibitor Response Prediction Milestone Achieved in KIYATEC Study Detecting Ex Vivo Cancer Patient-Specific Immune Response

On March 11, 2021 KIYATEC, Inc. reported that research published in the March 2021 Cancer Immunology, Immunotherapy journal solidifies the foundation to characterize predictive accuracy in immuno-oncology (Press release, KIYATEC, MAR 11, 2021, View Source [SID1234576535]). By using a patient’s own tumor cells and infiltrating immune cells to model patient-specific biological complexity, KIYATEC’s platform achieves a fundamental requirement bridging drug discovery through post-approval clinical use. The future ability to accurately predict which patients respond to immunotherapy agents, prior to treatment, will spare non-responders from financial toxicity and drug-induced side effects.

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Immune checkpoint inhibitors that target programmed cell death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1) have only shown modest activity as monotherapies for the treatment of ovarian cancer. Approval for a patient’s use of these immunotherapies is based on the current paradigm of cancer drug selection, spanning genetic sequencing, gene expression and biomarkers. For many checkpoint inhibitor indications, only 10-30% of patients treated with these premium-cost drugs respond. The importance of checkpoint inhibitors meeting key clinical endpoints has recently been brought into focus in more than one cancer indication.

KIYATEC Chief Scientific Officer Tessa DesRochers, PhD, said, "Our research highlights the significant steps that we have defined and those we have met to ultimately validate immuno-oncology response prediction. While clinical prediction is still in progress, pharmaceutical companies can today utilize our technology to make meaningful decisions during their drug development process."

The company has defined the four critical steps necessary to successfully predict immunotherapy response in the clinic. The latest research from KIYATEC demonstrates achievement of the first three: 1) development of a live cell co-culture test with patient-matched cells, 2) demonstration of sustained functionality of key infiltrating immune cells, and 3) characterization of dose-dependent and patient-specific cellular responses to immunotherapies. These three steps deliver what drug developers need today, strengthening KIYATEC’s basis for high value-added preclinical services. The fourth step will be to correlate the test results with patient immunotherapy endpoints in the clinic, enabling the prediction of patient-specific response to immunotherapies prior to treatment.

KIYATEC’s platform is already predictive for chemotherapy and targeted agents. In December 2020, the company announced that unblinded use of KIYATEC’s test results to inform drug selection for recurrent brain cancer patients approximately doubled the expected clinical outcome. An earlier blinded clinical study, published in 2019, demonstrated that progression-free survival doubled for newly diagnosed ovarian cancer patients if they had received a drug treatment to which KIYATEC’s test results had predicted a response.

"We are optimistic about the growing need for more effective pairing of immunotherapies and patients, particularly given recent developments in this multi-billion-dollar market," said Matthew Gevaert, PhD, CEO and Founder of KIYATEC. "The expansion of our predictive platform beyond chemotherapy and targeted agents has the potential to change how patients are selected for life-saving treatments."

Appleton, K.M., Elrod, A.K., Lassahn, K.A. et al. PD-1/PD-L1 checkpoint inhibitors in combination with olaparib display antitumor activity in ovarian cancer patient-derived three-dimensional spheroid cultures. Cancer Immunol Immunother 70, 843–856 (2021). View Source

Celsius Holdings, Inc. Reports Record Fourth Quarter and Full Year 2020 Financial Results

On March 11, 2021 Celsius Holdings, Inc., (Nasdaq: CELH), maker of the leading global fitness drink, CELSIUS, reported financial results for the fourth quarter and full year ended December 31, 2020 (Press release, Celsius Therapeutics, MAR 11, 2021, View Source [SID1234576557]). Management will host a conference call today at 10:00 a.m. Eastern Time to discuss the results with the investment community.

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A PDF containing our fourth quarter and full year 2020 results and full financial tables is available at: www.celsiusholdingsinc.com/Q4_FY_2020

MHRA authorises Lilly’s RET inhibitor Retsevmo

On March 11, 2021 Eli Lilly reported that The UK Medicines and Healthcare products Regulatory Agency (MHRA) has granted Retsevmo a conditional marketing authorisation for the treatment of RET fusion-positive advanced lung cancer and thyroid cancer (Press release, Eli Lilly, MAR 11, 2021, View Source [SID1234576610]).

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In particular, the authorisation includes Restevmo (selpercatinib) as monotherapy treatment for adults with advanced RET fusion-positive non-small cell lung cancer (NSCLC) who require systemic therapy following prior treatment with immunotherapy and/or platinum-based chemotherapy.

It also includes the treatment of adults with advanced RET fusion-positive thyroid cancer who require systemic therapy after prior treatment with sorafenib/lenvatinib, and also for adults and adolescents aged 12 years and older with advanced RET-mutant medullary thyroid cancer (MTC) who require systemic therapy following prior treatment.

The MHRA authorisation is based on results from the LIBRETTO-00 Phase I/II trial, a single-arm study of over 700 patients with RET-driven cancers.

The primary analysis included 105 previously treated patients with NSCLC – 64% of these participants responded to treatment with an average duration of response of 17.5 months.

In previously treated RET-mutant MTC patients, the primary analysis of 55 patients had a 69.1% response rate.

"This is good news for patients living with RET-driven cancers as they will soon have a treatment option that targets RET alterations directly," said Yvonne Summers, consultant oncologist at The Christie NHS Foundation Trust.

"With trial results showing median benefit of 17.5 months, this treatment represents a significant advancement in this growing field," she added.

RET fusion-positive tumours occur in 1-2% of NSCLC patients, and are more commonly found in people who are below the age of 60 years.