On November 5, 2018 Provectus (OTCQB: PVCT) reported that the Company was granted orphan drug designation (ODD) by the U.S. Food and Drug Administration (FDA) for small molecule oncolytic immunotherapy PV-10 for the treatment of neuroblastoma, a non-central nervous system (CNS) pediatric solid tumor (Press release, Provectus Biopharmaceuticals, NOV 5, 2018, View Source [SID1234530736]). Intratumoral injection of PV-10 can yield immunogenic cell death (ICD) in solid tumor cancers and stimulate tumor-specific reactivity in circulating T cells.1-4
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Neuroblastoma forms from immature nerve cells and usually begins in the adrenal glands. It may also begin in the abdomen, chest, or near the spine. Neuroblastoma most often occurs in children younger than 5 years of age, and presents when the tumor grows and causes symptoms. According to the National Cancer Institute SEER Cancer Statistics Review 1975-2015, the 5-year survival among children 0 to 19 years of age is 75.2%.5
Initial non-clinical testing of PV-10 in treatment-refractory neuroblastoma has closely paralleled previous non-clinical and clinical study of PV-10 for murine and human adult solid tumors, at both the tumor (selective destruction of injected tumors) and cellular (ICD) levels.6 Non-clinical investigation by member institutions of the Pediatric Oncology Experimental Therapeutics Investigators’ Consortium (POETIC) has confirmed that ICD also occurs in neuroblastoma.
The FDA grants ODD status to medicines intended for the treatment, diagnosis or prevention of rare diseases or disorders that affect fewer than 200,000 people in the US. ODD status qualifies companies for benefits that include seven years of market exclusivity following marketing approval, tax credits on U.S. clinical trials, eligibility for orphan drug grants, and waiver of certain administrative fees.
ODD status previously was granted to PV-10 for the treatments of metastatic melanoma in 2007 and hepatocellular carcinoma (HCC) in 2013.
About Neuroblastoma
If detected at an early stage, surgery is the definitive treatment. Once neuroblastoma has recurred or spread from the primary site, therapeutic options are limited principally to chemotherapy or clinical trial.7 A recent review of emerging treatment options for neuroblastoma noted that "less than 50% of patients with high-risk neuroblastoma will survive long-term with current therapies, and survivors are at risk for serious treatment-related late toxicities."8
Therapeutic options include high-dose systemic chemotherapy with alkylating agents, radiation therapy, experimental treatments like regional therapy, or immunotherapy. Unlike many adult solid tumor types, pediatric solid tumors have largely proven unresponsive to immune checkpoint inhibitors such as anti-PD-1 antibodies. A recent Phase 2 study of pembrolizumab in pediatric solid tumors showed that less than 20% of patients tested were candidates for anti-PD-1 therapy based on low expression of the PD-L1 biomarker, and no candidates achieved an objective response.9
About PV-10
Provectus’ lead investigational oncology drug, PV-10, the first small molecule oncolytic immunotherapy, can induce immunogenic cell death. PV-10 is undergoing clinical study for adult solid tumor cancers, like melanoma and cancers of the liver, and preclinical study for pediatric cancers.
About the Pediatric Oncology Experimental Therapeutics Investigators’ Consortium
The Pediatric Oncology Experimental Therapeutics Investigators’ Consortium (POETIC) was founded in February 2003 by Dr. Tanya Trippett at Memorial Sloan Kettering Cancer Center and Dr. Lia Gore at the University of Colorado Cancer Center. POETIC is composed of ten large academic medical centers in North America with a major emphasis on comprehensive cancer care and research that provide the collaborative and research strength needed to complete intensive phase I and II studies. Each of the institutions is uniquely suited to complete early studies in the pediatric and adolescent populations. POETIC’s assets include membership in NCI-designated Comprehensive Cancer Centers, on-site NIH-funded pediatric and/or general clinical translational research centers (CTRCs/CTSAs), and active collaborations with developmental therapeutics programs for adults at a majority of its member institutions. The availability of strong basic science and translational research programs at the institutions allows focus on the development and evaluation of new therapeutic strategies for patients with cancer and related disorders. POETIC’s pediatric oncology studies focus on the biologic basis for anti-cancer therapy, and in particular, attempt to explore and evaluate novel agents and/or combinations of therapies early in clinical development as well as new approaches to targeted delivery. For additional information about POETIC, please visit the Consortium’s website at www.poeticphase1.org.