On November 29, 2016 Hutchison China MediTech Limited ("Chi-Med") (AIM/Nasdaq: HCM) reported that results from two non-small cell lung cancer ("NSCLC") clinical studies will be presented at WCLC in Vienna, Austria, from December 4 to 7, 2016 (Press release, Hutchison China MediTech, NOV 29, 2016, View Source [SID1234516838]). Results from the positive Phase II third-line NSCLC clinical trial of fruquintinib, a highly selective and potent oral inhibitor of vascular endothelial growth factor receptors ("VEGFR"), will be detailed in an oral presentation. Results from the ongoing Phase Ib first-line NSCLC clinical trial of epitinib, a highly selective inhibitor of the epidermal growth factor receptor ("EGFR") designed to optimize brain penetration, will also be presented.

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In September 2015, Chi-Med announced that the fruquintinib Phase II NSCLC clinical trial had successfully achieved its primary endpoint. The oral and poster presentations will include more mature data than those included in the following fruquintinib and epitinib study abstracts.

The results of the two studies will be presented in detail at WCLC as follows:

Type: Oral Presentation
Title: A Randomized, Multi-Center, Double-Blind Phase II Study of Fruquintinib in Patients with Advanced Non-Small Cell Lung Cancer
Presenter: Shun Lu
Abstract: #4571
Session: OA11 – Angiogenesis in Advanced Lung Cancer, Oral Session
Date & Time: Tuesday, December 6, 2016 (11:00 AM – 12:30 PM)
Type: Poster Presentations
Title: A Phase I Dose Expansion Study of Epitinib to Evaluate Efficacy and Safety in EGFR Mutation Positive (EGFRm+) NSCLC Patients with Brain Metastasis
Authors: Qing Zhou, et al.
Abstract: #4253
1st Session: JCES01 Joint IASLC–Chinese Society for Clinical Oncology /
Chinese Alliance Against Lung Cancer Session (ID 413)
Date & Time: Sunday, December 4, 2016 (10:30 AM – 11:30 AM)
2nd Session: 07. Advanced NSCLC
P2.03b – Poster Session with Presenters Present (ID 465)
Date & Time: Tuesday, December 6, 2016 (2:30 PM – 3:45 PM)
The WCLC presentations will be made available for download at www.chi-med.com/news on the following day.

Organized by the International Association for the Study of Lung Cancer (IASLC) and held annually, WCLC is a global, multidisciplinary scientific forum for sharing current knowledge and research progress in lung cancer. For more information, please visit: wclc2016.iaslc.com.

On November 29, 2016 VBL Therapeutics (NASDAQ:VBLT), reported top-line results from its exploratory Phase 2 study of VB-111 (ofranergene obadenovec) in patients with advanced, differentiated thyroid cancer (Press release, VBL Therapeutics, NOV 29, 2016, View Source [SID1234516836]). As previously announced, this trial met its primary endpoint, which was defined as 25% progression-free survival at 6 months (PFS-6), in heavily-pretreated patients with late-stage disease. A dose-dependent response was seen, with 35% of patients reaching PFS-6 in the therapeutic dose cohort, versus 25% in a low-dose cohort. Given this positive clinical response, the Company continued to follow patients for overall survival (OS) data, which was not a primary endpoint. Although the trial included a small number of patients and was not powered to show OS differences, the new data show a dose-response and evidence of an overall survival benefit in the cohort of patients treated with multiple therapeutic doses of VB-111, compared to patients who received a single low dose of VB-111 (mOS 761 days versus 469 days; p=0.096). Only one patient remained alive in the low-dose cohort, compared to a tail of about 50% in the high dose group.

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"The appearance of dose-dependent superior overall survival provides encouragement, especially given that this trial enrolled patients with late-stage disease whose tumors were resistant to multiple lines of previous therapies," said Keith C. Bible, MD, PhD, Professor of Oncology, Division of Medical Oncology, Department of Oncology, and Endocrine Malignancies Disease Oriented Group, Mayo Clinic Cancer Center, and Primary Investigator for this trial.

"This is the third indication in which we have seen profound clinical responses and evidence of an overall survival benefit with VB-111," said Dror Harats, MD, Chief Executive Officer of VBL Therapeutics. "Following our Phase 2 OS data in recurrent GBM and platinum-resistant ovarian cancer, this trial, which evaluated VB-111 as monotherapy, reinforces the potential of VB-111 and its unique mechanism of action, for multiple solid tumor indications. We are continuing to focus on completion of our clinical program, and potentially commercialization, of VB-111 for rGBM, and to advance our ovarian cancer clinical program. Based on the current data, we may expand our program to additional indications, such as thyroid cancer, either independently in the future, or earlier in collaboration with a strategic partner," added Prof. Harats.

The open-label dose-escalating study enrolled patients with advanced, recently-progressive, differentiated thyroid cancer that is unresponsive to radioactive iodine, in two cohorts. The majority of patients had tumors which had failed on several therapeutic lines, including tyrosine kinase inhibitors, prior to enrollment. In the first cohort twelve patients received a single intravenous infusion of VB-111 at a low dose of 3X1012 viral particles (VPs). The second cohort included seventeen patients, who received VB-111 at a therapeutic dose of 1013 VPs every two months until disease progression. The company previously reported that 35% of patients in the therapeutic dose cohort (n=17) met the primary endpoint of 6-month progression-free survival using Response Evaluation Criteria in Solid Tumors (RECIST), compared to 25% of patients in the low dose cohort. PFS at 12 months was 25% in the VB-111 high dose cohort, versus 0% in the low dose cohort. Continued follow-up now indicates further survival benefit for the multiple-dose therapeutic cohort, with median OS of 761 versus 469 in the low-dose cohort (p=0.096). VB-111 was well-tolerated in this study, with no signs of clinically significant safety issues.

About Thyroid Cancer
Thyroid cancer occurs in the thyroid gland, a hormone-producing organ at the base of the neck that regulates heart rate, blood pressure, body temperature and weight. According to the National Cancer Institute, there are an estimated 535,000 people currently living with thyroid cancer in the United States, with an estimated 60,000 new cases each year and an estimated 1,850 annual deaths as a result of the disease. The type of treatment depends on the cancer cell type, tumor size and severity of the disease. First-line treatment is surgical removal of the thyroid gland, and is recommended for most patients. Treatment with radioactive iodine after surgery to destroy any remaining thyroid tissue may be recommended for more advanced disease. If radioactive iodine is ineffective, other treatments are prescribed, such tyrosine kinase inhibitors and systemic chemotherapy. However, if such treatments are unsuccessful, the therapeutic options for patients are currently very limited.

On November 29, 2016 EMD Serono Inc., the biopharmaceutical business of Merck KGaA, Darmstadt, Germany, in the US and Canada, and Pfizer Inc. (NYSE: PFE (link is external)) reported that the US Food and Drug Administration (FDA) has accepted for Priority Review EMD Serono’s Biologics License Application (BLA) for avelumab (Press release, Pfizer, NOV 29, 2016, View Source [SID1234516831]). This review relates to avelumab’s proposed use in patients with metastatic Merkel cell carcinoma (MCC), based on tumor response results from the JAVELIN Merkel 200 trial. Avelumab is an investigational fully human anti-PD-L1 IgG1 monoclonal antibody and could be the first treatment indicated for metastatic MCC in the US, if approved.[*] MCC is a rare and aggressive skin cancer, which impacts approximately 2,500 Americans a year.[1],[2]

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"We are pleased the FDA has granted a Priority Review designation for avelumab," said Luciano Rossetti, M.D., Executive Vice President, Global Head of Research & Development at the biopharma business of Merck KGaA, Darmstadt, Germany, which in the US and Canada operates as EMD Serono. "There are currently no approved treatment options for metastatic MCC, and we are committed to working with the FDA to potentially bring the first approved cancer immunotherapy to patients with this aggressive disease."

The avelumab metastatic MCC BLA submission is supported by data from JAVELIN Merkel 200, a multicenter, single-arm, open-label, Phase II study of 88 patients with metastatic MCC, whose disease had progressed after at least one chemotherapy treatment.[1] The JAVELIN Merkel 200 study represents the largest data set of any anti-PD-L1/PD-1 antibody reported in this patient population. These data were presented in June 2016 at the Annual Meeting of the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) and published in the Lancet Oncology in October 2016.[1]

"Metastatic Merkel cell carcinoma is an aggressive disease, and patients face a very poor prognosis, with less than 20 percent surviving beyond five years," said Chris Boshoff, M.D., Ph.D., Senior Vice President and Head of Immuno-oncology, Early Development and Translational Oncology, Pfizer Global Product Development. "We are encouraged by the results of our Phase II trial and believe avelumab may have potential to be an important treatment option for patients living with this hard-to-treat skin cancer."

The FDA’s Priority Review status reduces the review time from 10 months to a goal of six months from the day of filing and is given to drugs that may offer major advances in treatment or may provide a treatment where no adequate therapy exists. The FDA previously granted avelumab Orphan Drug Designation for MCC, as well as Fast Track and Breakthrough Therapy Designations for the treatment of patients with metastatic MCC whose disease has progressed after at least one previous chemotherapy regimen. Breakthrough Therapy Designation is intended to expedite the development and review of treatments for serious or life-threatening disease where preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over existing therapies for one or more endpoints.[3] Additionally, the European Medicines Agency has validated for review Merck KGaA, Darmstadt, Germany’s Marketing Authorization Application (MAA) for avelumab, for the proposed indication of metastatic MCC.

The clinical development program for avelumab, known as JAVELIN, involves at least 30 clinical programs and more than 3,000 patients evaluated across more than 15 different tumor types. In addition to metastatic MCC, these cancers include breast, gastric/gastroesophageal junction, head and neck, Hodgkin’s lymphoma, melanoma, mesothelioma, non-small cell lung, ovarian, renal cell carcinoma and urothelial (primarily bladder).

*Avelumab is not approved for any indication in any market. This marks the first acceptance of an application by the US FDA to review the investigational product, avelumab.

On November 29, 2016 CytRx Corporation (NASDAQ: CYTR) reported positive updated results from its pivotal Phase 3 clinical trial evaluating aldoxorubicin compared to investigator’s choice in patients with relapsed or refractory soft tissue sarcomas (STS) (Press release, CytRx, NOV 29, 2016, View Source [SID1234516830]).

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The study, which enrolled 433 patients, demonstrated a statistically significant improvement in progression-free survival (PFS) between aldoxorubicin and investigator’s choice therapy in 246 patients with leiomyosarcoma and liposarcoma, (p=0.007). The hazard ratio (HR) was 0.62 (95% CI 0.44-0.88), representing a 38% reduction in the risk of tumor progression for patients receiving aldoxorubicin versus investigator’s choice. Leiomyosarcoma and liposarcoma are the two most common types of STS and accounted for 57% of the patients enrolled in the trial.

Aldoxorubicin demonstrated a statistically significant improvement in PFS over investigator’s choice in 312 patients treated in North America (p=0.028; HR=0.71, 95% CI 0.53-0.97). Notably, aldoxorubicin performed better than investigator’s choice for the entire study population and narrowly missed statistical significance (p=0.12; HR=0.81, 95% CI 0.64-1.06). All responses were determined by an independent, blinded central lab assessment of scans.

"This data represents a major step forward for STS, a rare, highly complex and very difficult-to-treat group of cancers," commented Sant Chawla, M.D., F.R.A.C.P., Director of the Sarcoma Oncology Center in Santa Monica, California, and Principal Investigator for the Phase 3 trial. "These results are important because they demonstrate that treatment with aldoxorubicin can extend the time to progression in a clinically meaningful way. The trial design used was more stringent than any prior clinical trial in STS as it compared aldoxorubicin to real world alternatives. The control arm allowed trial investigators to select any one of the five most widely used treatments best suited for their patients’ specific type of STS. Unlike other clinical trials for relapsed or refractory STS which used either dacarbazine or placebo as the control, this study was biased in favor of choosing the best therapy for the patients, a truly unique study design."

CytRx plans to submit the results of this clinical trial for presentation at an upcoming major scientific meeting.

In the entire study population, aldoxorubicin achieved a statistically significant improvement in the disease control rate (DCR; defined as objective response rate (ORR) plus stable disease for at least 4 months) of 29.4% versus 20.5% for the patients treated with investigator’s choice (p=0.030). In North American patients, the benefit was even more pronounced with aldoxorubicin-treated patients exhibiting a DCR of 32.9%, compared to 19.2% for patients treated with investigator’s choice (p=0.007), an overall improvement of 71%. ORR in North American patients also favored aldoxorubicin over investigator’s choice, 8.7% versus 3.3% (p=0.058). Of note, no objective responses were observed in patients treated with Votrient (pazopanib). Patients continue to be followed for overall survival (OS), a secondary endpoint, and CytRx expects the OS data to be available in 2017.

PFS, DCR and ORR data are summarized in the following table:

Phase 3 Aldoxorubicin Efficacy Results

N
Aldoxorubicin
Investigator’s Choice
P Value
All patients with Leiomyosarcoma and Liposarcoma (PFS)

246
HR = 0.62 (95% CI 0.44-0.88)
0.007




North American1 patients (PFS)

312
HR = 0.71 (95% CI 0.53-0.97)
0.028
Disease Control Rate (DCR)2

32.9%
19.2%
0.007
Objective Response Rate (ORR)

8.7%
3.3%
0.058
All patients (PFS)

433
HR = 0.81 (95% CI 0.64-1.06)
0.120
Disease Control Rate (DCR)2

29.4%
20.5%
0.030






1Per trial statistical analysis plan, North America is defined as United States, Canada and Australia and comprises 72% of total trial patients
2DCR=ORR + stable disease for ≥4 months
Pre-specified analyses were based on sarcoma histopathology and geography. The geographic analysis includes patients from North America (defined as the United States, Canada and Australia, per the trial statistical analysis plan). The 312 patients treated in North America comprise 72% of the total trial population, including 296 patients from the United States, 8 patients from Canada and 8 patients from Australia. The 246 patients with leiomyosarcoma or liposarcoma comprise 57% of the total trial population.

Aldoxorubicin did not cause clinically significant cardiac, renal, or hepatic toxicities. For the global trial population, the most commonly reported adverse events were neutropenia and anemia consistent with prior clinical trials with aldoxorubicin. Grade 3 or higher hypertension occurred in patients receiving Votrient (pazopanib). Grade 3 or higher adverse events were manageable with supportive care and occurred at a rate of 61% for patients receiving aldoxorubicin and 46% in patients treated with investigator’s choice. Importantly, treatment-emergent adverse events leading to discontinuation occurred in 4.2% of patients treated with aldoxorubicin, compared to 6.3% for patients receiving investigator’s choice. Serious adverse events, primarily febrile neutropenia that resolved and rarely led to treatment termination occurred more frequently in patients administered aldoxorubicin. Treatment-related deaths occurred in one aldoxorubicin-treated patient and in no patients receiving investigators’ choice drugs.

Based on these results, CytRx expects to submit a New Drug Application (NDA) with the U.S. Food and Drug Administration (FDA) for aldoxorubicin as a treatment for patients with relapsed or refractory STS in 2017.

"These results show that globally leiomyosarcoma and liposarcoma patients treated with aldoxorubicin exhibited significantly longer PFS than patients treated with both FDA-approved and commonly used therapies in the second-line setting," said Daniel Levitt, M.D., Ph.D., EVP and Chief Medical Officer of CytRx. "We are also very encouraged by the statistically significant improvements observed in North American STS patients treated with aldoxorubicin who exhibited both longer PFS and superior response rates."

"We are deeply grateful for the support and commitment of the sarcoma investigators, along with the patients and families who took part in or contributed to this Phase 3 trial," stated Steven A. Kriegsman, CytRx’s Chairman and Chief Executive Officer. "We look forward to sharing the data from these key patient populations with the FDA to support an NDA for aldoxorubicin as a second-line treatment for patients suffering with soft tissue sarcomas."

About the Phase 3 Clinical Trial

The randomized, controlled Phase 3 trial enrolled a total of 433 patients at 79 clinical sites. Patients with metastatic, locally advanced or unresectable soft tissue sarcomas who had either not responded to, or who had progressed following treatment with one or more systemic regimens of non-adjuvant chemotherapy were randomized 1:1 to be treated with aldoxorubicin or the investigator’s choice of an approved chemotherapeutic regimen, including doxorubicin, ifosfamide, dacarbazine, pazopanib (Votrient), or gemcitabine plus docetaxel. The primary endpoint of the study is PFS. Secondary endpoints include overall survival, response rates, disease control rates and safety.

About Soft Tissue Sarcoma

Soft tissue sarcoma is a cancer occurring in muscle, fat, blood vessels, tendons, fibrous tissues and connective tissue. It can arise anywhere in the body at any age. STS remains a high unmet medical need because of the difficulty in treating the more than 50 types of this aggressive cancer. According to the American Cancer Society, in 2016 more than 12,300 new cases were diagnosed in the U.S. and approximately 5,000 Americans died from this disease. In addition, approximately 40,000 new cases and 13,000 deaths in the U.S. and Europe are part of a growing underserved market.

About Aldoxorubicin

Aldoxorubicin is a rationally-engineered cytotoxic which combines doxorubicin, a widely used chemotherapeutic agent, with a novel linker molecule that binds directly and specifically to circulating albumin, the most abundant protein in the bloodstream. Protein-hungry tumors concentrate albumin, which facilitates the delivery of the linker molecule with the attached doxorubicin to tumor sites. In the acidic environment of the tumor, but not the neutral environment of healthy tissues, doxorubicin is released. Typically, doxorubicin is delivered systemically and is highly toxic, which limits its dose to a level below its maximum therapeutic benefit. Doxorubicin also is associated with many side effects, especially the potential for damage to heart muscle at cumulative doses greater than 450 mg/m2. Using this acid-sensitive linker technology, aldoxorubicin delivers greater doses of doxorubicin (3 ½ to 4 times). To date, there has been no evidence of clinically significant effects of aldoxorubicin on heart muscle, even at cumulative doses of drug well in excess of 2,000 mg/m2. Aldoxorubicin is the first-ever single agent to show superiority over doxorubicin in a randomized clinical trial in first-line STS.

On November 29, 2016 OncoMed Pharmaceuticals Inc. (NASDAQ:OMED) reported initial first-in-human data from its ongoing Phase 1 clinical trials of anti-DLL4/VEGF bispecific (OMP-305B83) and anti-RSPO3 (OMP-131R10) antibodies in two posters at the 28th EORTC-NCI-AACR (Free EORTC-NCI-AACR Whitepaper) Molecular Targets and Cancer Therapeutics Symposium being held in Munich, Germany (Press release, OncoMed, NOV 29, 2016, View Source [SID1234516827]).

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"In these first-in-human Phase 1 trials of our anti-DLL4/VEGF bispecific and anti-RSPO3 antibodies we have accomplished the primary goal of defining the safety profiles and establishing the single-agent doses for these agents. We have also observed initial evidence of anti-tumor activity in patients treated to date," said Jakob Dupont, M.D., Chief Medical Officer of OncoMed. "Dual blockade of DLL4 and VEGF has shown synergies preclinically, and in the clinic we are seeing evidence of single-agent activity with partial responses in ovarian and uterine cancers and stable disease in about one-third of the Phase 1 patients treated. We look forward to completing these trials and, in the near future, initiating Phase 1b studies with the anti-DLL4/VEGF bispecific in combination with standard of care in ovarian and colorectal cancers."

Dr. Dupont continued, "Data from the ongoing anti-RSPO3 Phase 1a/b trial show evidence of target engagement and some encouraging signals of prolonged stable disease. With a single-agent dose identified and a good understanding of the safety profile of anti-RSPO3, we are excited to continue enrolling the biomarker-selected and combination portions of this study. Overexpression of RSPO3 is associated with the growth of a number of solid tumors, including colorectal cancers, and we have developed a CLIA-validated assay and a custom liquid biopsy to identify tumors with RSPO3 high gene expression and gene fusions where responses to treatment may be more likely."

Anti-DLL4/VEGF Bispecific — Interim Phase 1a Data in Advanced Solid Tumors
As of the data cut off of October 17, 2016, a total of 51 patients with advanced solid tumors had received single-agent doses ranging from 0.5 to 12.5 mg/kg every three weeks in the ongoing Phase 1a clinical trial of OncoMed’s anti-DLL4/VEGF bispecific antibody.

Safety and Pharmacokinetics: Anti-DLL4/VEGF bispecific was generally well tolerated with hypertension, headache, fatigue and pulmonary hypertension being the most common drug-related toxicities. One dose-limiting toxicity of diverticulitis occurred at 2.5 mg/kg. Hypertension side effects were successfully managed with anti-hypertensives and most pulmonary hypertension adverse events were reversible and of mild to moderate severity. A dose of 7.5 mg/kg once every three weeks was set for the Phase 1a expansion cohort following the observation of Grade 3 and 4 toxicities at the 10 mg/kg dose. The anti-DLL4/VEGF bispecific had a half-life of 14 days and anti-drug antibody response occurred primarily at low doses (≤3.5 mg/kg).

Efficacy: Two of the 46 patients (4%) evaluable for anti-tumor effects had unconfirmed partial responses, while another sixteen (35%) patients achieved stable disease. The partial responses occurred in patients with ovarian cancer and uterine carcinosarcoma. Five of eight evaluable ovarian patients had reductions in tumor volume and remained on therapy for 129, 170, 185, 309 and 323 days as of the data cut off.

Data from the ongoing Phase 1a trial of the anti-DLL4/VEGF bispecific were presented in a poster titled, "A first-in-man Phase 1a study of the bispecific anti-DLL4/anti-VEGF antibody OMP-305B83 in patients with previously treated solid tumors "(Poster #P057; Abstract #87) by Dr. Kathleen Moore of the Stephenson Oklahoma Cancer Center at the University of Oklahoma.

Anti-RSPO3 — Interim Phase 1a/b Data in Advanced Solid Tumors and Colorectal Cancer
As of the data cut-off date of October 11, 2016, 23 patients in the anti-RSPO3 Phase 1a/b clinical trial were evaluable for safety and 15 patients were evaluable for anti-tumor activity. Interim safety, response, pharmacokinetics and biomarker data were included in the analyses in this ongoing clinical trial.

Safety and Pharmacokinetics: Anti-RSPO3 was generally well tolerated as a single agent with the most common adverse events being fatigue and nausea in sixteen subjects treated at doses ranging from 2.5 to 15 mg/kg every two weeks. No dose-limiting toxicities were observed. Based on evidence of target engagement observed by changes in serum biomarkers, a single-agent dose of 15.0 mg/kg every two weeks was selected. Anti-RSPO3 has an estimated half-life of 13 days.

Among seven safety-evaluable Phase 1b colorectal cancer patients who received anti-RSPO3 in combination with FOLFIRI (folinic acid, fluorouracil and irinotecan) chemotherapy the combination did not appear to exacerbate the toxicities of either drug. Dose-escalation continues in the combination portion of the trial.

Efficacy and Biomarkers: In the single-agent Phase 1a portion of the trial, five of eleven patients achieved stable disease and three of those five patients were RSPO3 high, with RSPO3 levels in a fourth patient slightly below the current cut point of OncoMed’s CLIA-validated biomarker assay. Three of the stable disease patients in the Phase 1a portion of the trial demonstrated prolonged stable disease of greater than 112 days as of the data cut off.

In the Phase 1b portion of the trial, three of four evaluable subjects who received the combination of anti-RSPO3 and FOLFIRI achieved stable disease.

Data from the anti-RSPO3 Phase 1a/b were presented in a poster titled: "Initial results from a Phase 1a/b study of OMP-131R10, a first-in-class anti-RSPO3 antibody, in advanced solid tumors and previously treated metastatic colorectal cancer (CRC)" (Poster #P039; Abstract #68) by Dr. Pamela Munster of the University of California, San Francisco.

Both posters from the 28th EORTC-NCI-AACR (Free EORTC-NCI-AACR Whitepaper) Molecular Targets and Cancer Therapeutics Symposium are available on OncoMed’s website at www.oncomed.com.

About Anti-DLL4/VEGF
The anti-DLL4/VEGF bispecific antibody (OMP-305B83) is designed to combine the anti-cancer stem cell, dysangiogenesis and immunotherapy mechanisms of anti-DLL4 with the anti-angiogenic activity of an anti-VEGF agent. It was developed utilizing OncoMed’s BiMAb bispecific platform technology, which enables the design of bispecific antibodies comparable to traditional monoclonal antibodies but possessing dual target-binding specificity. OncoMed initiated the single-agent study of its anti-DLL4/VEGF bispecific in January 2015 in patients with advanced refractory solid tumors. Dose escalation is complete in the Phase 1a trial and enrollment in an expansion cohort is ongoing. The bispecific antibody is part of OncoMed’s collaboration with Celgene.

About Anti-RSPO3
Anti-RSPO3 (OMP-131R10) is believed to be the first drug candidate in its class to target the R-spondin-LGR pathway, an important cancer stem cell pathway identified by OncoMed researchers. OncoMed is currently enrolling patients in an ongoing Phase 1a/b clinical trial of anti-RSPO3 that was started in July 2015. The Phase 1a/b trial initially enrolled patients with advanced refractory solid tumors and includes an expansion arm for biomarker-selected patients to receive single-agent therapy. The Phase 1b portion, which began enrollment in January 2016, is testing anti-RSPO3 with FOLFIRI in patients with second-line metastatic colorectal cancer. Anti-RSPO3 is part of OncoMed’s collaboration with Celgene.