Novartis drug PKC412 (midostaurin) receives Breakthrough Therapy designation from the FDA for newly-diagnosed FLT3-mutated acute myeloid leukemia (AML)

On February 19, 2016 Novartis reported that the United States Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to PKC412 (midostaurin)(Press release, Novartis, FEB 19, 2016, View Source [SID:1234509105]). PKC412 (midostaurin) is an investigational treatment for adults with newly-diagnosed AML who are FLT3 mutation-positive, as detected by an FDA-approved test, and who are eligible to receive standard induction and consolidation chemotherapy.

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The Breakthrough Therapy designation for PKC412 (midostaurin) is primarily based upon the positive results from the Phase III RATIFY (CALGB 10603) clinical trial. This study was conducted in partnership with the Alliance for Clinical Trials in Oncology and presented during a plenary session at the 57th American Society of Hematology (ASH) (Free ASH Whitepaper) Annual Meeting[4].

Patients who received PKC412 (midostaurin) and standard induction and consolidation chemotherapy experienced a significant improvement in overall survival (OS) (hazard ratio = 0.77, P = 0.0074) compared to those who received standard induction and consolidation chemotherapy alone[4]. The median OS for patients in the PKC412 (midostaurin) treatment group was 74.7 months (95% confidence interval [CI]: 31.7, not attained), versus 25.6 months (95% CI: 18.6, 42.9) for patients in the placebo group[4]. No statistically significant differences were observed in the overall rate of grade 3 or higher hematologic and non-hematologic adverse events in the PKC412 (midostaurin) treatment group versus the placebo group[4]. A total of 37 deaths were reported, with no difference in treatment-related deaths observed between groups[4].

"For more than 25 years, medical developments have been limited for AML patients and the chemotherapy treatment strategy has essentially remained unchanged," said Alessandro Riva, MD, Global Head, Novartis Oncology Development and Medical Affairs. "We look forward to working closely with the FDA to bring PKC412 (midostaurin), the first potential AML targeted therapy, to patients as quickly as possible."

According to the FDA, Breakthrough Therapy designation is intended to expedite the development and review of new medicines that treat serious or life-threatening conditions, if the therapy has demonstrated substantial improvement over an available therapy on at least one clinically significant endpoint. The designation includes all of the Fast Track program features, as well as more intensive FDA guidance on an efficient drug development program[5].

This designation adds to the growing number granted to Novartis by the FDA, illustrating the company’s continued commitment to developing innovative therapies for diseases with a significant unmet medical need.

In the US, about 20,000 people were diagnosed with AML in 2015, the majority of whom were adults[6]. According to the latest research, approximately one-third of AML patients also harbor a FLT3 gene mutation[7], which is associated with worse outcomes and shorter survival than in those without the mutation[8]. PKC412 (midostaurin) is the first drug targeting FLT3 to demonstrate an overall survival benefit in AML[4].

Since PKC412 (midostaurin) is investigational at this time and is expected to be submitted for FDA approval, Novartis opened a Global Individual Patient Program (compassionate use program) and a US Expanded Treatment Protocol (ETP) to enable PKC412 (midostaurin) access. Patients 18 years of age and older with newly-diagnosed FLT3-mutated AML and able to receive standard induction and consolidation therapy will be considered.

In order to help identify patients who may have a FLT3 mutation and potentially benefit from treatment with PKC412 (midostaurin), Novartis is collaborating with Invivoscribe Technologies, Inc. who is leading regulatory submissions for a companion diagnostic.

About acute myeloid leukemia (AML) and the FLT3 mutation
AML is an aggressive cancer of the blood and bone marrow[9]. It prevents white blood cells from maturing, causing an accumulation of "blasts" which do not allow room for the normal blood cells[9]. AML is the most common acute leukemia in adults, but also has the lowest survival rate[1]. AML accounts for approximately 25% of all adult leukemias worldwide, with the highest incidence rates occurring in the United States, Europe and Australia[1].

Mutations in specific genes are found in many cases of AML, and biomarker testing is considered standard of care for newly-diagnosed patients to help determine the best possible treatment option[7]. FMS-like tyrosine kinase-3 (FLT3) is a receptor tyrosine kinase, a type of cell-surface receptor, which plays a role in the proliferation, or increase, in the number of certain blood cells[10].

About PKC412 (midostaurin)
PKC412 (midostaurin) is an investigational, oral, multi-targeted kinase inhibitor in development for the treatment of patients with AML with a FLT3 mutation. The safety and efficacy profile has not been fully established. There is no guarantee that PKC412 (midostaurin) will become commercially available.

PKC412 (midostaurin) is also being investigated for the treatment of aggressive systemic mastocytosis/mast cell leukemia.

Heron Therapeutics Announces Fourth Quarter and Full Year 2015 Financial Results and Recent Corporate Progress

On February 19, 2016 Heron Therapeutics, Inc. (NASDAQ:HRTX), a biotechnology company focused on improving the lives of patients by developing best-in-class medicine that address major unmet medical needs, reported fourth quarter and full year 2015 financial results and highlighted recent corporate progress (Press release, Heron Therapeutics, FEB 19, 2016, View Source;p=RssLanding&cat=news&id=2140951 [SID:1234509102]).

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Recent Corporate Progress:
In February 2016, Heron successfully demonstrated bioequivalence of HTX-019 to intravenous (IV) fosaprepitant in a study that included 100 healthy volunteers. In this study, HTX-019 demonstrated a substantially improved safety profile compared to IV fosaprepitant, which contains polysorbate 80. HTX-019, a polysorbate 80-free, IV formulation of the neurokinin-1 (NK1) receptor antagonist aprepitant, is being developed for the prevention of chemotherapy-induced nausea and vomiting (CINV).

In February 2016, Heron initiated a placebo-controlled, dose-finding, Phase 2 clinical trial of HTX-011 for the treatment of post-operative pain in approximately 100 patients undergoing abdominoplasty. HTX-011 is a long-acting formulation of the local anesthetic bupivacaine in a fixed-dose combination with the anti-inflammatory meloxicam formulated with Heron’s Biochronomer drug delivery technology.

In January 2016, the U.S. Food and Drug Administration (FDA) informed Heron that it has not yet completed its review of the New Drug Application (NDA) of SUSTOL (granisetron) Injection, extended release and was unable to take action by the Prescription Drug User Fee Act (PDUFA) goal date of January 17, 2016. The FDA stated that it is targeting taking action in late February 2016.

"While we were disappointed that the FDA was unable to complete the review of the SUSTOL NDA by the original January 2016 PDUFA goal date, we appreciate the work of the FDA and remain confident in the potential of SUSTOL as an important option for the prevention of CINV in patients with cancer," commented Barry D. Quart, Chief Executive Officer of Heron Therapeutics. "Earlier this month, we achieved important milestones for our pipeline programs. We confirmed bioequivalence for HTX-019 compared with IV fosaprepitant and showed substantially improved tolerability of HTX-019, our polysorbate 80-free, IV formulation of aprepitant. In addition, we initiated our third Phase 2 study of HTX-011, which is evaluating HTX-011 in patients undergoing abdominoplasty."

Results of Operations

As of December 31, 2015, Heron had approximately $131.2 million in cash, cash equivalents and short-term investments, compared to $72.7 million as of December 31, 2014. The net increase in cash, cash equivalents and short-term investments was primarily due to Heron’s June 2015 public equity offering that resulted in total net proceeds to us of approximately $128.2 million, partially offset by net cash used in operating activities in 2015. Based on current operating plans and projections, Heron believes that its current working capital is sufficient to fund operations through 2016.

Heron’s net cash used for operating activities for the quarter and year ended December 31, 2015 was $23.2 million and $78.5 million, respectively, compared to net cash used for operating activities of $12.9 million and $60.3 million, respectively, for the same periods in 2014.

Heron’s net loss for the quarter and year ended December 31, 2015 was $31.2 million and $97.6 million, or $0.87 per share and $2.95 per share, respectively, compared to a net loss of $20.6 million and $76.4 million, or $0.71 per share and $2.87 per share, respectively, for the same periods in 2014.

The increases in net cash used for operating activities and net loss in 2015 as compared to 2014 were primarily due to costs incurred in preparation for the commercial launch of SUSTOL, as well as clinical and manufacturing costs related to our Phase 1 and Phase 2 clinical studies for HTX-011 and costs associated with the development of HTX-019.

Abbott Declares 369th Consecutive Quarterly Dividend

On February 19, 2016 The board of directors of Abbott (NYSE: ABT) reported a quarterly common dividend of 26 cents per share(Press release, Abbott, FEB 19, 2016, View Source [SID:1234509101]).

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This marks the 369th consecutive quarterly dividend to be paid by Abbott since 1924. The cash dividend is payable May 16, 2016, to shareholders of record at the close of business on April 15, 2016.

Abbott has increased its dividend payout for 44 consecutive years and is a member of the S&P 500 Dividend Aristocrats Index, which tracks companies that have annually increased their dividend for 25 consecutive years.

Interim Report for Kancera AB (publ) Q4 2015, January 1 – December 31, 2015

On February 19, 2015 Kancera AB reported their Interim Report for Q4 2015, January 1 – December 31, 2015(Press release, Kancera, FEB 19, 2016, View Source;releaseID=1109023 [SID:1234509098]).

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The period January to December 2015 and the fourth quarter 2015 in brief

R&D expenses for the period amounted to SEK 20.4m (SEK 13.7m) of which the fourth quarter constituted SEK 8.3m (SEK 4.1m). Following EU’s approval of Kancera’s mid-term report for the A PARADISE project, the project’s revenues and expenses have been taken up which means that the reported R & D expenses and revenues for the period increased by SEK 4.8m. Thus, excluding the EU-project the R & D expenses for the period amounted to SEK 15.6m (SEK 13.7m), of which the fourth quarter constituted SEK 3.5m (SEK 4.1m).

Operating income for the period amounted to SEK -19.7m (SEK -16.1m) of which the fourth quarter constituted SEK -5.9m (SEK -5.1m).

Income after financial items for the period amounted to SEK -19.6m (SEK -16.0m) of which the fourth quarter constituted SEK -5.9m (SEK -5.0m).

Earnings per share for the period were SEK -0.19 (SEK -0.18) of which the fourth quarter constituted SEK -0.06 (SEK -0.05).

Cash flow from operating activities for the period amounted to SEK -20.7m (SEK -19.1m) of which the fourth quarter constituted SEK -4.5m (SEK -7.5m).

Equity as of December 31, 2015 amounted to SEK 21.9m (SEK 27.3m) or SEK 0.21 (SEK 0.28) per share. The equity/assets ratio as of December 31, 2015 was 80 percent (75 percent).

Cash and cash equivalents as of December 31, 2015 amounted to SEK 15.6m (SEK 23.0m). Cash and cash equivalents exclude the contribution of SEK 2.8m paid by the EU in January 2016.

Significant events during the period

Kancera reported that a second efficacy study of the drug candidate KAN0439834 has been completed in an animal model of an advanced stage of chronic lymphocytic leukemia characterized by a genetic change which makes the disease more difficult to treat. The results show that KAN0439834 reduces the number of ROR expressing leukemia cells in the lymphatic system (spleen) after 14 days of treatment. Further, Kancera reported that a second patent application EP15153394.0 has been filed covering small-molecule ROR inhibitors, including the drug candidate KAN0439834.

Kancera reported that the patent WO 2011/079902 concerning monoclonal antibodies against ROR1 has been approved in China. Kancera has acquired partial rights to this patent from Bioinvent under an agreement that does not involve any financial burden for Kancera (except patent expenses) before revenues are generated. Kancera through the company’s co-founder Professor Håkan Mellstedt has been involved in the development of these antibodies. These antibodies have mainly been used to identify and validate new indications for a future ROR-inhibiting drug. Any further development of the ROR-targeted monoclonal antibodies for therapeutic purposes will only be done in a partnership that provides funding and access to expertise in development of antibody-based drugs.

Kancera reported an operational update of the cancer projects ROR, PFKFB3, and HDAC6.

– The ROR project reported that Kancera’s candidate drug KAN0439834 is effective against both leukemic cells circulating in the blood and leukemic cells that have invaded the lymph nodes in humans.

– Recent studies of clinical samples from leukemia patients underscore that ROR inhibitors mainly target the white blood cells causing cancer while the healthy white blood cells, including T cells, are spared. These results are of significance for the possibility to combine ROR inhibitors with the new generation of immuno-stimulating cancer drugs that have been developed since the effect of those requires functional T-cells.

– A new generation of ROR inhibitors is being developed against solid tumors.

– The PFKFB3 project reported a new discovery showing that Kancera’s PFKFB3 inhibitor KAN0438757 kills cancer cells by preventing them to repair their DNA. The discovery indicates that KAN0438757 could be an efficient complement to radiation for the treatment of advanced cancer.

– The HDAC6 project reported that Kancera’s HDAC6 inhibitors counteract the migration of cancer-associated fibroblast cells and that an international patent application was filed in May.

Kancera’s Annual General Meeting on May 28, 2015 decided to re-elect the current Board of Directors and auditor (Ernst & Young). The General Meeting also decided to authorize the Board, on one or more occasions until the next Annual General Meeting, to issue new shares. A new share issue may be made with or without preferential rights and against cash payment and / or in kind or set-off. The purpose of the authorization and the reason for the deviation from shareholders’ preferential rights is to enable the acquisition of capital for corporate acquisitions and the company’s operation. If the share issue is made against cash payment and without preferential rights for the shareholders, the number of shares issued may not exceed ten percent of the total number of shares outstanding at the time the authorization is exercised.

Kancera announced that a new share issue, with the authorization of the Annual General Meeting in 2014, was closed on May 27, 2015. The issue comprised a maximum of 4,927,386 shares. In total 25,926,793 shares were signed, of which 4,644,304 with preferential rights (with the support of subscription rights) and 21,282,489 without preferential rights. The share issue was thus oversubscribed to about 500 percent. This issue raised Kancera AB approximately SEK 12.3m before issue costs.

Kancera announced that the first subscription period for the exercise of the employee warrants was closed in June 2015. In total 450,246 new shares were signed giving Kancera SEK 1.7m before issue costs. There remain 2,349,754 warrants, of which 560,000 are held by Kancera to cover social security costs that are part of the employee warrants program.

Kancera announced that the company’s HDAC6 project has been awarded a grant totaling SEK 2m from the Swedish innovation agency VINNOVA. The grant is directed to projects that can develop into new strong innovations in a range of common diseases, including cancer. The grant is paid on four occasions during the two-year project. The project will be implemented in collaboration with the Cancer Center Karolinska (CCK), and is also planned to involve Swedish companies such as SARomics Biostructures, MetaSafe and Adlego Biomedical.

Kancera announced that the company has entered into an agreement with Acturum Life Science AB in order to evaluate and further develop the unique Fractalkine receptor antagonist AZD8797. Based on published research that supports that the Fractalkine receptor antagonist may have a central role in different cancer forms, Kancera will evaluate how efficiently the Fractalkine receptor antagonist AZD8797 may stop tumor growth and relieve severe cancer pain. The agreement with Acturum Life Science gives Kancera right to evaluate AZD8797 in preclinical studies and then to acquire the project. This agreement entails no expenses for Kancera apart from investments in the patent portfolio and in the scientific evaluation. If Kancera chooses to acquire the Fractalkine project, following the preclinical evaluation phase, the total payment to Acturum will consist of 6 million Kancera shares divided into three tranches, which are due at pre-defined success-milestones.

Kancera provided an operational update on the ROR and Fractalkine projects:

– In the ROR project, Kancera reported that follow-up studies of the pharmaceutical properties of KAN0439834 show that they probably are better than previously assumed with respect to uptake and penetration of the substance to the cancer. The new studies indicate that dosing 2-3 times a day at 65-300 mg gives a concentration in the body that may be sufficient to exert an effect on solid tumors. Against this background, ROR inhibitors will be tested in animal models of solid tumors. It was further reported that ROR inhibitors have shown effect against leukemic cells from bone marrow which is a capacity wanted since the existing drugs are not sufficiently effective against cancer cells in the bone marrow.

– In the Fractalkine project, Kancera reported that a network of leading cancer and pain scientists that has been established that will evaluate the drug candidate KAN0440567 (AZD8797) in an advanced animal model closely resembling the human form of pancreatic cancer. Kancera has synthesized and quality controlled the salt form of the drug candidate that will be used in this study and has conducted a successful peroral dosing study in mice.

Kancera provided an operational update on the PFKFB3 and HDAC6 projects as well as the EU-funded and epigenetically targeted anti-parasitic project A-PARADDISE:

– From the collaboration with Prof. Thomas Helleday, Kancera reported that Kancera’s PFKFB3 inhibitor significantly reduces the size of a tumor formed by aggressive human breast cancer cells (so-called triple negative breast cancer) transplanted in zebrafish. The results from the study support that Kancera’s PFKFB3 inhibitor is effective against these aggressive cancer cells if the substance reaches the tumor in sufficient concentration, which is easier to achieve in zebrafish than e.g. in mice.

– Kancera has developed several chemical families of potent and selective HDAC6 inhibitors based on a common scaffold, and Kancera reported the decision to withdraw the original patent application from 2014 in order to postpone the publication of the structures at least 12 months. This is done in order to prevent Kancera’s existing patent application to become an obstacle to a new patent application covering the recently developed HDAC6 inhibitors.

– Vinnova announced in June 2015 that Kancera has been awarded a grant to support the further development of HDAC6 inhibitors against cancer. The first part of the grant was paid in July. VINNOVA decided to bring forward the second payment (SEK 750, 000) to the HDAC6 project to December 2015.

– In February 2014 Kancera received an initial payment from the EU amounting to € 523,655 (about SEK 4.6m) for the execution of the A-PARADDISE project. The project has now delivered a midterm report which has been approved by the EU. This means that a second installment of the grant was paid to Kancera at year-end according to plan. This payment amounted to € 300,000 (about SEK 2.8m).

Significant events after the end of the reporting period

Kancera has from the 1st of January 2016 extended the lease of the company’s laboratories within the Karolinska Science Park for three years through an agreement with Humlegården Fastigheter.

Kancera has provided an update of the small molecule patent portfolio.
– A patent covering small molecule PFKFB3 inhibitors has been approved in the USA.

– A patent application covering new chemical series in the HDAC6 project has been filed.

– The patent application covering ROR inhibitors filed in February 2015 has been strengthened by adding examples of additional highly potent ROR inhibitors.

Kancera reported that the company has developed a new series of ROR inhibitors that show improved pharmaceutical properties which will allow preclinical studies of their effect on e.g. solid tumors. These results have prompted Kancera to concentrate the investments in the ROR project to small molecule inhibitors and terminate the product development of a ROR-based vaccine. Furthermore, Kancera reported results from the Fractalkine project showing that KAN0440567 after oral administration to mice effectively blocks the function of the Fractalkine receptor.
Statement from the CEO

2016 began as usual with an intense biotech week in San Francisco where Kancera and most of the Pharmaceutical and Biotech industry gathered to discuss cooperation opportunities in individual meetings. During the week in San Francisco, Thomson Reuters also presented its retrospection of 2015 which was a strong year for the industry with more and larger acquisitions than ever and a strong interest in preclinical drug development projects. The generally high interest from major pharmaceutical and biotech companies to acquire pharmaceutical project continues, which is reflected partly in the increasing level of payment upon signature of the acquisition or licensing agreements and partly in increasing total price tags for pharmaceutical projects. Cancer, by virtue of the great medical need, continues to be the therapeutic area in which most agreements are reached (for more information, see the Market Outlook section).

In the third quarterly report in 2015, I described the challenge in the ROR-project to achieve a sufficiently high concentration of the drug candidate in the blood to enable studies of efficacy against more cancer diseases, in addition to chronic lymphocytic leukemia, such as solid tumors. During the fourth quarter we have succeeded to develop a new series of compounds in the ROR project that can be maintained in an active concentration in the blood for 10 hours in mice. This can be compared with the approximately 2.5 hours shown by Kancera’s first drug candidate KAN0439834 in the same type of measurement. This progress now provides us with new opportunities to test the effect of ROR inhibitors in several preclinical models of severe human cancers.

During the fourth quarter we have also been able to show that oral administration of the Fractalkine receptor antagonist KAN0440567 to mice effectively blocks the function of the Fractalkine receptor. This is a first step in the ongoing studies to examine the effect of this substance against cancer of the pancreas in a preclinical model of the disease.

Furthermore, in January we reported several reinforcements of Kancera’s portfolio of patents and patent applications, including a new application from the HDAC6 project, a granted patent from the PFKFB3 project and a completion of the international patent application from the ROR project including new substances showing up to 20 times higher effect against leukemia cells compared to Kancera’s first drug candidate.

Overall, we see progress in Kancera’s entire project portfolio which further strengthens the company’s competitiveness and business development efforts.

Kancera provides operational update of the ROR and Fractalkine projects

On February 19, 2016 Kancera reported that the company has developed a new series of ROR inhibitors that show improved pharmaceutical properties which will allow preclinical studies of their effect on e.g. solid tumors(Press release, Kancera, FEB 19, 2016, View Source;releaseID=1109020 [SID:1234509097]). These results have prompted Kancera to concentrate the investments in the ROR project to small molecule inhibitors and terminate the product development of a ROR-based vaccine. Furthermore, Kancera reported results from the Fractalkine project showing that KAN0440567 after oral administration to mice effectively blocks the function of the Fractalkine receptor in mice.

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During the fourth quarter 2015, the ROR project succeeded to develop a new series of compounds in the ROR project that can be maintained in an active concentration in the blood for 10 hours in mice. This can be compared with the approximately 2.5 hours shown by Kancera’s first drug candidate KAN0439834 in the same type of measurement. This progress now provides us with new opportunities to test the effect of ROR inhibitors in several preclinical models of severe human cancers.

Kancera’s evaluation of peptide sequences for vaccine development has shown that the selected ROR-peptides do not generate an immune response that corresponds to the effect achieved with Kancera’s small molecule inhibitors. Against this background, Kancera has now chosen to terminate the vaccine product development and bring back the vaccine project to academic research. Thus, Kancera will concentrate the ROR-project investments to the development of small molecule inhibitors.

During the fourth quarter 2015, in collaboration with Prof. Mia Phillipson, Uppsala University, Kancera has demonstrated that oral administration of the Fractalkine receptor antagonist KAN0440567 (also referred to as AZD8797) to mice, effectively blocks the function of the Fractalkine receptor. This is a first step in the ongoing studies to examine the effect of this substance against cancer of the pancreas in a preclinical model of the disease.

Further information on these results can be found in Kancera’s Interim Report for Q4, 2015, which is published today.

About the ROR project
ROR is a family of receptors, ROR1 and ROR2. The ROR receptors mediate signals for growth and survival. Originally ROR was linked to fetal development, but it is now known that they also contribute to cancer cell development and proliferation. Professor Håkan Mellstedt, Kancera´s co-founder and professor at the Karolinska Institute, and his colleagues have shown that Kancera´s ROR inhibitors have the ability to kill cells from tumors in pancreas and leukemia cells. Professor Mellstedt and his colleagues as well as independent researchers have shown that ROR is also active as a target in prostate, breast, skin and lung cancer.

Because ROR primarily generates a survival and growth signal to tumor cells but is inactive in healthy cells in adults, there are good prospects that a drug directed against ROR hit the tumor much harder than the surrounding healthy cells. Kancera and Professor Mellstedt have shown that inhibition of ROR leads to that cancer cells eliminate themselves by cellular suicide. Against this background, there are reasons to anticipate that a ROR-targeted drug is both safer and more effective than several chemotherapies currently used to treat cancer.

About the Fractalkine project
Fractalkine is an immune regulatory factor that sends signals via the CX3CR1 receptor, also called G-protein coupled receptor 13 (GPCR13). In the healthy individual, Fractalkine and its receptor regulate migration of immune cells from the blood capillary wall into areas where the immune system is needed. Animal studies show that Fractalkine and its receptor are not essential for survival and that important immune functions remain intact indicating that inhibition of the Fractalkine signaling by a drug probably will be tolerated without significant adverse effects. Fractalkine and its receptor have been linked to the growth and proliferation of pancreatic, breast and prostate cancer. Also, cancer cells that have the Fractalkine receptor on their surface migrate towards nerve ends that have Fractalkine on their surface. Thus, cancer cells are led to surround and apply pressure on nerves and thereby cancer pain may arise. Another proposed mechanism for how Fractalkine and its receptor affect the development of tumors is that they contribute to the transformation of the body’s macrophages from being a threat against the cancer (the M1 form) to supporting the cancer (the M2 form). This mechanism is also suggested as a predictive factor for responsiveness to the new immuno-oncology drugs that act through PD-1 and PD-L1 such as nivolumab, pembrolizumab and pidilizumab. During 2014 and 2015 studies have been published demonstrating that the absence of Fractalkine in tumor cells is a significant marker for how successful the immuno-oncology treatment is expected to be (see e.g. the publication in Nature on November 27, 2014, Vol. 515, pp 563). In the light of these observations, there are good reasons to further study if inhibition of the Fractalkine signaling with KAN0440567 (AZD8797) has the potential to increase the proportion of patients responding to the new immuno-oncology drugs that act through PD-1 and PD-L1.