On November 09, 2015 TG Therapeutics, Inc. (NASDAQ:TGTX) reported its financial results for the third quarter ended September 30, 2015 and recent company developments (Press release, TG Therapeutics, NOV 9, 2015, View Source [SID:1234508143]).

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Michael S. Weiss, the Company’s Executive Chairman and Interim Chief Executive Officer, stated, "During the third quarter, we achieved another major milestone for the Company in obtaining a Special Protocol Assessment for our UNITY-CLL trial, a study evaluating the safety and efficacy of our proprietary ‘1303′ combination regimen in patients with front-line as well as previously treated CLL. This is a very important and exciting clinical trial for the Company, as it represents our first pivotal trial for our proprietary combination and, if successful, should provide a broad approval in CLL offering patients in both first-line and relapsed/refractory setting, a novel, non-chemotherapy treatment option. Further, it would provide us a broad label for building additional three and, possibly, four drug proprietary combinations to further improve outcomes for patients with CLL. With Phase 3 programs in oncology now underway for both TG-1101 and TGR-1202, we’re excited to begin exploring the potential of our pipeline products for the treatment of autoimmune disease, an area where B-cell targeted therapies have proven highly effective, and anticipate commencing our first trial in Multiple Sclerosis in the near-term." Mr. Weiss continued, "We also remain focused on aggressively enrolling into our ongoing GENUINE Phase 3 clinical trial, and expect top-line data from this study in the second half of 2016. Finally, from a financial perspective, with more than $115 million in cash and investments we have enough cash to execute on our business plan."

Recent Developments and Highlights

In September 2015, we announced a Special Protocol Assessment (SPA) agreement with the FDA for the first Phase 3 clinical trial of our proprietary combination regimen of TG-1101 (ublituximab) with TGR-1202 ("1303") for patients with chronic lymphocytic leukemia, the UNITY-CLL study.
In September 2015, we announced the initiation of a Phase 1/2 clinical trial investigating the use of TG-1101 and TGR-1202 in combination with pembrolizumab, the anti-PD-1 immune checkpoint inhibitor, in patients with relapsed or refractory CLL, the first clinical trial evaluating the safety, tolerability and effectiveness of the triple combination of a PI3K delta inhibitor with an anti-CD20 mAb and an anti-PD-1 checkpoint inhibitor.

Goals/Objectives for the Remainder of 2015

Continue to aggressively recruit into the GENUINE Phase 3 Clinical Trial of TG-1101 in combination with ibrutinib
Enroll the first patient by year end in our UNITY-CLL Phase 3 clinical trial of TG-1101 plus TGR-1202 in front-line and relapsed/refractory CLL
Announce our next registration trial evaluating 1303 in patients with NHL
Continue to recruit into the triple combination cohort of 1303 plus ibrutinib as well as the triple combination study of 1303 plus pembrolizumab, as well as seek to evaluate additional novel triple combinations of interest
Expand into autoimmune diseases with the first Phase 2 trial in Multiple Sclerosis to commence in the near-term
Continue to advance our pre-clinical compounds, including IRAK4, anti PD-L1 and anti-GITR forward towards clinical development
Continue to seek additional compounds to further complement our current portfolio

Financial Results for the Third Quarter 2015

At September 30, 2015 the Company had cash, cash equivalents, investment securities, and interest receivable of $115.4 million, which includes approximately $67.0 million of net proceeds from the utilization of the Company’s at-the-market ("ATM") sales facility during the year (all of which was previously disclosed in connection with our last quarterly update), as compared to December 31, 2014 when we had $78.9 million.

Our consolidated net loss for the third quarter ended September 30, 2015, excluding non-cash items, was approximately $12.4 million, which included approximately $6.9 million of manufacturing and CMC expenses in preparation for Phase 3 clinical trials and potential commercialization. The consolidated net loss for the third quarter ended September 30, 2015, inclusive of non-cash items, was $13.7 million, or $0.28 per diluted share, compared to a consolidated net loss of $17.5 during the comparable quarter in 2014, representing a decrease in consolidated net loss of $3.8 million. The decrease in consolidated net loss during the third quarter ended September 30, 2015 was primarily the result of $8.1 million of expense ($4.1 million of which was non-cash stock expense) recorded during the quarter ended September 30, 2014 in conjunction with the Company’s licensing agreement for TGR-1202, and a $2.9 million decrease in non-cash compensation expense related to equity incentive grants over the comparable period in 2014. Partially offsetting the aforementioned decreases, other research and development expenses for TG-1101 and TGR-1202 increased $4.8 million and $2.1 million, respectively, over the comparable period in 2014.

Our consolidated net loss for the nine months ended September 30, 2015, excluding non-cash items, was approximately $32.5 million, which included approximately $16.0 million of manufacturing and CMC expenses in preparation for Phase 3 clinical trials and potential commercialization. The consolidated net loss for the nine months ended September 30, 2015, inclusive of non-cash items, was $45.3 million, or $1.01 per diluted share, compared to a consolidated net loss of $37.0 million during the comparable period in 2014, representing an increase in consolidated net loss of $8.3 million. The increase in consolidated net loss during the nine months ended September 30, 2015 was primarily the result of other research and development expenses for TG-1101 and TGR-1202 increasing approximately $14.6 million and $4.5 million, respectively, over the comparable period in 2014. This was offset by $9.3 million of expense ($5.3 million of which was non-cash stock expense) recorded in conjunction with the Company’s licensing agreements for TGR-1202 and the IRAK4 inhibitors program during the nine months ended September 30, 2014, and a decrease of $3.2 million in non-cash compensation expense related to equity incentive grants over the comparable period in 2014.

On November 9, 2015 Sunesis Pharmaceuticals, Inc. (Nasdaq:SNSS) reported that two posters detailing preclinical data from its BTK and PDK1 inhibitor programs were presented on Sunday, November 8th at the AACR (Free AACR Whitepaper)-NCI-EORTC AACR-NCI-EORTC (Free AACR-NCI-EORTC Whitepaper) International Conference on Molecular Targets and Cancer Therapeutics (EORTC-NCI-AACR) (Free ASGCT Whitepaper) (Free EORTC-NCI-AACR Whitepaper) being held in Boston, Massachusetts (Press release, Sunesis, NOV 9, 2015, View Source;p=RssLanding&cat=news&id=2110307 [SID:1234508142]).

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The two poster presentations (Abstracts C198 and C186), titled "SNS-062 is a potent noncovalent BTK inhibitor with comparable activity against wild type BTK and BTK with an acquired resistance mutation" and "PDK1 inhibitors SNS-229 and SNS-510 cause pathway modulation, apoptosis and tumor regression in hematologic cancer models in addition to solid tumors," are available on the Sunesis website at www.sunesis.com.

"These data represent the first peer-reviewed presentations by Sunesis of our two proprietary kinase inhibitor pipeline programs," said Dan Swisher, Chief Executive Officer of Sunesis. "Each shows compelling, anti-cancer activity and a distinct product profile. SNS-062, our novel, second-generation BTK inhibitor, maintains potent preclinical activity in the presence of a cysteine-481 mutation associated with acquired resistance to ibrutinib. In addition, SNS-062 has a kinase selectivity profile distinct from ibrutinib that may confer additional safety and efficacy advantages that we look forward to uncovering in our upcoming clinical studies. SNS-510 and SNS-229, which belong to a novel class of PDK1 kinase inhibitors, show broad activity in a variety of hematologic cancer cell lines, including cell lines resistant to PI3K and AKT inhibitors, that correlates with significant PDK1 pathway modulation and anti-proliferative activity. We believe this program could soon yield a first-in-clinic selective PDK1 inhibitor to test this important pathway in cancer patients. Near term, we look forward to advancing SNS-062 into the clinic in the first quarter of 2016."

Study Results in Detail

"SNS-062 is a potent noncovalent BTK inhibitor with comparable activity against wild type BTK and BTK with an acquired resistance mutation"

For this study, Sunesis researchers explored the potential of SNS-062, a potent, noncovalent BTK inhibitor, to overcome resistance mechanisms of ibrutinib, a BTK inhibitor with validated anti-cancer efficacy in several B-cell malignancies. These resistance mechanisms include mutation of the cysteine in the BTK active site that ibrutinib requires for covalent binding (C481). SNS-062 has a kinase selectivity profile distinct from ibrutinib showing nM binding affinity for BTK, ITK and Tec kinase family members, but does not meaningfully bind EGFR. A lack of EGFR inhibition by SNS-062 may offer safety advantages over ibrutinib, including reduced diarrhea and rash potentially related to inhibition of EGFR.

Prolonged SNS-062 mediated in vivo inhibition of BTK correlates with potent anti-inflammatory activity in a BTK dependent B-cell mediated collagen induced rat arthritis model. To assess the activity of SNS-062 and ibrutinib against BTK with acquired resistance mutations, inhibition of wild type (WT) and mutant C481S BTK was evaluated in direct kinase assays. SNS-062 inhibits WT and C481S BTK with similar inhibitory concentrations while ibrutinib potency is reduced 40 fold. Similarly, ibrutinib shows a 100 fold loss of potency in inhibiting pBTK levels in C481S BTK expressing cells while SNS-062 activity is unaffected.

SNS-062 shows good oral bioavailability in multiple animal species with a terminal half-life of three to six hours. Pharmacokinetic, pharmacodynamic and toxicity studies demonstrate that SNS-062 plasma concentrations providing >90% inhibition of BTK can be sustained with acceptable tolerability.

"PDK1 inhibitors SNS-229 and SNS-510 cause pathway modulation, apoptosis and tumor regression in hematologic cancer models in addition to solid tumors"

Phosphatidylinositol (PI) dependent kinase 1, or PDK1, is a master kinase that activates kinases important in cell growth and survival including members of the AKT, PKC, RSK and SGK families and can interact with its substrates through PI-dependent (PH-mediated) or PI-independent (PIF-mediated) mechanisms. For this study, Sunesis researchers characterized two potent PDK1 kinase inhibitors, SNS-229 and SNS-510, with broad preclinical antitumor activity in hematologic cancers.

SNS-229 and SNS-510 belong to a novel class of PDK1 inhibitors that bind the inactive conformation of PDK1 as determined by X-ray crystallography and induce a conformational change that perturbs the PIF-pocket, thereby inhibiting PIF-mediated substrate binding, in contrast to the ATP-competitive PDK1 inhibitor tool compounds GSK2334470 and BX-320.

SNS-229 and SNS-510 were evaluated in more than twenty cell lines derived from hematologic cancers including acute myeloid leukemia, multiple myeloma, B-cell lymphoma, and mantle cell lymphoma. SNS-510 shows strong anti-proliferative activity and induces apoptosis in PI3K and AKT inhibitor resistant cell lines. SNS-229 and SNS-510 are compared to the PDK1 inhibitor GSK2334470 and were up to 30 fold more potent at inhibiting PDK1, S6K, RSK and AKT phosphorylation and up to 50 fold more potent in cancer cell viability assays.

In vivo, SNS-510 shows dose and time dependent inhibition of PDK1 autophosphorylation and up to 90% inhibition of RSK2 and AKT phosphorylation after eight hours, whereas GSK-2334470 and the pan-PI3K inhibitor GDC0941 only show moderate PDK1 and RSK2 inhibition and no AKT inhibition. In PK studies in CD/1 mice, SNS-229 and SNS-510 have good pharmacokinetic properties, with a terminal half-life of four to five hours and an oral bioavailability of >90%.

In an AML xenograft mouse model, both SNS-229 and SNS-510 show dose-related efficacy with >95% tumor growth inhibition and partial regression (>50% tumor shrinkage) in 70% and 100% of animals at the highest dose after 21-day dosing. These studies show that targeting the inactive conformation of PDK1 leads to potent and sustained pathway inhibition resulting in strong tumor growth inhibition and regression.

On November 09, 2015 Progenics Pharmaceuticals, Inc. (Nasdaq:PGNX) reported results of operations for the quarter and nine months ended September 30, 2015 (Press release, Progenics Pharmaceuticals, NOV 9, 2015, View Source [SID:1234508141]).

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"We had a highly productive quarter, with positive regulatory developments, key additions to our pipeline and continued clinical progress," stated Mark Baker, CEO of Progenics. "The Breakthrough Therapy Designation for ultra-orphan candidate AzedraTM provides for an expedited development and review process, while the April 2016 PDUFA date for Oral RELISTOR establishes a pivotal near-term catalyst for our RELISTOR franchise. We acquired PyL, an imaging agent which is highly complementary with our 1404 program, establishing the leading portfolio of prostate cancer imaging agent candidates. In addition, our acquisition of EXINI will provide us with software development expertise to help further build our imaging toolkit for prostate cancer. We are well-positioned as we approach critical clinical milestones in the fourth quarter, including the completion of enrollment in our pivotal Phase 2b trial for Azedra and the launch of our Phase 3 program for 1404."

Net loss for the quarter was $10.0 million or $0.14 per diluted share, compared to net income of $37.0 million or $0.51 per diluted share in the third quarter of 2014. Net loss for the current nine months was $32.0 million, or $0.46 per diluted share, compared to net income of $16.6 million or $0.24 per diluted share in 2014. Progenics ended the quarter with cash and cash equivalents of $90.4 million, a decrease of $8.9 million in the quarter and $28.9 million from 2014 year-end.

Third quarter revenue totaled $1.4 million, down from $41.7 million in the third quarter of 2014, reflecting a decrease in collaboration revenue for RELISTOR (methylnaltrexone bromide) of $39.8 million, primarily resulting from the recognition of $40.0 million milestone from Salix and royalty income of $1.2 million compared to $1.6 million in the corresponding period in 2014, based on net sales reported to Progenics by our commercialization partner, Valeant Pharmaceuticals International, Inc. The current quarter decrease in royalty revenue is primarily due to lower net sales of $8.0 million for the three months ended September 30, 2015, compared to $10.8 million for the corresponding period in 2014. Current year first nine months revenues were $3.6 million, down from $44.9 million in the first nine months of 2014, reflecting royalty income of $3.2 million compared to $3.7 million and collaboration revenue of $0.4 million compared to $41.1 million in the corresponding period in 2014.

Third quarter research and development expenses were flat compared to the third quarter of 2014, reflecting higher expenses for the Azedra clinical trial, 1404 and consulting expenses, offset by lower contract manufacturing and compensation expenses. Year-to-date research and development expenses decreased by $2.1 million compared to the corresponding period in 2014 primarily due to lower clinical trial expenses for PSMA ADC and 1404 and compensation expenses, partially offset by higher Azedra-related expenses. Third quarter general and administrative expenses increased by $0.5 million from the corresponding period in 2014 primarily due to higher compensation, consulting and professional fees. Year-to-date general and administrative expenses increased by $2.9 million compared to prior year period primarily due to an action brought by a former employee. The change in the contingent consideration liability for the quarter and year-to-date periods is a non-cash item and resulted from changes in estimates for fair value of contingent consideration liability.

Third Quarter and Recent Events

In October, the Company announced an offer to acquire EXINI Diagnostics AB, a leader in the development of software solutions for medical decision support based on advanced image analysis. The Company reported today that over 90 percent of the outstanding shares of EXINI have been tendered, and Progenics expects the settlement of the Offer to occur on or about November 12, 2015. EXINI is expected to complement Progenics’s strategy to support its imaging and therapeutic agents with sophisticated software and other technologies that help physicians and patients visualize, understand, target and treat cancer. The planned acquisition would provide Progenics with in-house development capabilities in these areas that it can apply to its own pipeline, including its prostate cancer imaging agents 1404 and PyL.

Also in October, Dr. Thomas Strack joined Progenics as Vice President of Clinical Affairs. Prior to joining Progenics, he was the Vice President of Research and Development at Asubio Pharmaceuticals where he led clinical research programs as well as R&D portfolio strategies. Prior to joining Asubio, Dr. Strack held a number of key positions at Eli Lilly, Pfizer, and Takeda Pharmaceuticals, where he led global clinical programs in multiple therapeutic areas, including endocrinology, ophthalmology, and oncology. Dr. Strack is board certified in internal medicine and endocrinology.

In September, Valeant Pharmaceuticals International, Inc. and Progenics announced that the U.S. Food and Drug Administration (FDA) has accepted for review Valeant’s New Drug Application for RELISTOR (methylnaltrexone bromide) Tablets for the treatment of opioid-induced constipation (OIC) in adult patients with chronic non-cancer pain. The FDA has assigned a Prescription Drug User Fee Act (PDUFA) action date of April 19, 2016.

In August, Progenics announced an exclusive worldwide licensing agreement with Johns Hopkins University for [18F]DCFPyL ("PyL"), a clinical-stage prostate specific membrane antigen (PSMA)-targeted imaging agent for prostate cancer. PyL complements Progenics’ existing portfolio of pipeline products for the detection and treatment of prostate cancer, including 1404, the Company’s lead PSMA-targeted imaging agent that is used in conjunction with widely-available SPECT-CT imaging.

In July, Progenics announced that the FDA granted Azedra designation as a Breakthrough Therapy for the treatment of patients with iobenguane-avid metastatic or recurrent pheochromocytoma and paraganglioma. Azedra is currently being evaluated in a pivotal Phase 2b trial, which is being conducted under a Special Protocol Assessment Agreement (SPA), and has received Orphan Drug and Fast Track designations from the FDA.

Also in July, the Company announced the design and key elements of its planned Phase 3 clinical trial for 1404, following the successful completion of the End-of-Phase 2 interactions with the FDA. Progenics expects the Phase 3 trial to commence by the end of this year.

On November 09, 2015 Peregrine Pharmaceuticals, Inc. (NASDAQ:PPHM) (NASDAQ:PPHMP), a biopharmaceutical company focused on developing therapeutics to stimulate the body’s immune system to fight cancer, reported results from multiple new preclinical studies demonstrating enhanced anti-tumor activity and immune activation for combinations of a preclinical bavituximab equivalent and checkpoint inhibitors such as anti-PD-1 and anti-CTLA-4 in preclinical models of breast cancer and melanoma (Press release, Peregrine Pharmaceuticals, NOV 9, 2015, View Source [SID:1234508140]). Additionally, the company announced preliminary results for a new clinical test specifically designed to illustrate how bavituximab, the company’s investigational phosphatidylserine (PS)-signaling pathway inhibitor, modulates immune responses in the tumor microenvironment. Results from these studies were presented at the 2015 annual meeting of the Society for Immunotherapy of Cancer (SITC) (Free SITC Whitepaper), which was held in National Harbor, MD, on November 4 – 8, 2015.

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"The positive data presented at SITC (Free SITC Whitepaper) with regard to combinations of bavituximab and checkpoint inhibitors further support our belief that bavituximab has the potential to be a critical component of innovative combination cancer immunotherapies," said Jeff T. Hutchins, vice president preclinical development of Peregrine. "Particularly exciting is the new data in animal models of breast cancer which showed that a significantly greater number of subjects demonstrated anti-tumor activity when treated with the combination of bavituximab and anti-PD-1 as compared to treatment with anti-PD-1 alone. Additionally, combination treatment led to prolonged protection for animals as evidenced by their lack of new tumor development when later re-challenged with the same tumors."

Bavituximab is an investigational immunotherapy designed to assist the body’s immune system by targeting and modulating the activity of phosphatidylserine (PS), a highly immune-suppressive signaling molecule expressed broadly on the surface of cells in the tumor microenvironment. Peregrine’s PS signaling pathway inhibitor candidates, including bavituximab, reverse the immunosuppressive environment that many tumors establish in order to proliferate, while also fighting cancer by activating immune cells that target and fight cancer. The preclinical equivalent of bavituximab, ch1N11, is used in animal model studies as a guide for clinical development.

Breast Cancer
Researchers from Duke University and Peregrine evaluated the combination of ch1N11 (preclinical bavituximab equivalent) and anti-PD-1 therapy versus anti-PD-1 stand-alone therapy in well-characterized murine breast cancers, including the triple negative breast cancer (TNBC) model E0771. Study data showed that the combination therapy significantly enhanced overall survival (p=0.0016) and was capable of mediating complete tumor regressions in a greater number of subjects compared to single agent treatments (60% vs. 20%). Data also demonstrated that animals receiving combination treatment had significant increases in tumor associated indicators of immune system activation, including CD45+, CD8+ and CD3+ T-cells. Importantly, the combination treatment led to a prolonged anti-tumor immune response which protected the animals against a re-challenge with the same tumor. This sustained anti-tumor response suggests the potential of the combination therapy to trigger immune system memory and support adaptive immune responses against reemerging disease in breast cancers. All study animals experienced no signs of adverse effects following repeated doses of all therapeutic agents.

Melanoma
In follow-on work, researchers from the University of Texas, Southwestern and Peregrine evaluated combinations of ch1N11 and checkpoint inhibitors (anti-PD-1 or anti-CTLA-4) versus each agent as a stand-alone therapy in common models of melanoma (B16F10 and K1735). Data showed that the combinations of ch1N11 with either anti-PD-1 or anti-CTLA-4 led to significantly greater levels of tumor infiltrating CD8+ T cells than any of the three agents alone. Additionally, findings demonstrated that the combination therapies were more effective at shifting the tumor microenvironment from immunosuppressive to immune active than the single agents, as shown by greater increases in the ratio of T effector cells to T regulatory cells, reactivation of tumor infiltrating T cells and restoration of the effector function of the tumor infiltrating T cells. This activity was more pronounced for the ch1N11/anti-PD-1 combination than for the ch1N11/anti-CTLA-4 combination. Based on these data, study investigators concluded that ch1N11 synergizes with checkpoint inhibitors to induce strong tumor specific CD8 T cell immunity.

"There is an extensive and growing collection of data that demonstrates that phosphatidylserine directly triggers broad immunosuppression in the tumor microenvironment and contributes to resistance to checkpoint inhibitor therapy. By targeting and blocking PS, bavituximab appears able to shift the tumor environment from immunosuppressive to immune active and, in turn, enhance the anti-tumor activity of checkpoint inhibitors such as anti-PD-1 and anti-CTLA4," said Bruce Freimark, Ph.D., director of pre-clinical oncology of Peregrine. "This latest data in well validated models of multiple tumor types further support our belief that bavituximab may be able to play an essential role in combination immuno-oncology treatment regimens. With this in mind, we are committed to evaluating the agent’s potential in combination with a range of cancer therapies against various cancer types."

ImmunoProfiling
Researchers presented preliminary results for a new custom assay designed to provide detailed profiles of immune activity in patient tumors. The Opal 6-plex quantitative immunofluorescence (IF) assay is specifically designed to measure the level and type of lymphocytes, myeloid and dendritic cell subsets found within the tumor microenvironment. This information is important as it can be used to correlate immune response parameters with bavituximab treatment outcome and patient survival.

Presented results demonstrated that the Opal assay could reliably detect, measure and phenotype lymphocytes and monocytes present in tumor tissues from rectal adenocarcinoma, hepatocellular carcinoma and advanced melanoma patients treated with bavituximab combination therapies. Importantly, the findings were able to show changes in key indicators of immune activation, including CD8+, CD4+ and regulatory T-cells, as well as myeloid and dendritic cells, in the tumor microenvironment following bavituximab treatment. The ability of this new assay to accurately measure specific immune responses is expected to provide important additional information to assist in Peregrine’s ongoing development efforts for bavituximab. This will be particularly valuable as the company works to better elucidate the connection between the drug candidate’s impact on immunomodulation and patient response to treatment.

"We are very pleased with the performance of the Opal assay, particularly its ability to compare the interaction of up to six phenotypic and functional markers on a single slide of tissue. The power and prognostic value of such immune activity assessments in the area of cancer was initially established by the Immunoscore, and we believe the Opal assay represents an important evolution of that work," said Bernard A. Fox, Ph.D., Harder Family Endowed Chair for Cancer Research, Member and Chief, Molecular and Tumor Immunology, Earle A. Chiles Research Institute, Providence Cancer Center; a world-renowned translational cancer immunotherapist; a founding member of the Immunoscore steering committee. "I am looking forward to continued collaboration with Peregrine to further optimize and validate this assay to improve our understanding of immune infiltrate in tumors thereby facilitating the rational design and use of bavituximab in combination with novel and standard therapies."

About Bavituximab: A Targeted Investigational Immunotherapy
Bavituximab is an investigational chimeric monoclonal antibody that targets phosphatidylserine (PS). Signals from PS inhibit the ability of immune cells to recognize and fight tumors. Bavituximab, the lead compound in Peregrine’s immuno-oncology development program, blocks PS to remove this immunosuppressive signal and sends an alternate immune activating signal. PS targeting antibodies have been shown to shift the functions of immune cells in tumors, resulting in robust anti-tumor immune responses.

On November 09, 2015 OncoMed Pharmaceuticals Inc. (NASDAQ:OMED) reported clinical and preclinical data related to three of its clinical-stage programs at the AACR (Free AACR Whitepaper)-NCI-EORTC AACR-NCI-EORTC (Free AACR-NCI-EORTC Whitepaper) International Conference on Molecular Targets and Cancer Therapeutics (EORTC-NCI-AACR) (Free ASGCT Whitepaper) (Free EORTC-NCI-AACR Whitepaper) (Press release, OncoMed, NOV 9, 2015, View Source [SID:1234508139]). Data from three posters covered Phase 1a safety, biomarker and anti-tumor activity of brontictuzumab (anti-Notch1, OMP-52M51), novel biomarker discoveries related to vantictumab (anti-Fzd7, OMP-18R5) in non-small cell lung cancer (NSCLC) and preclinical characterization of safety and efficacy for anti-DLL4/VEGF bispecific (OMP-305B83).

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Brontictuzumab Phase 1a: Single-agent Activity in Biomarker-positive Patients; Manageable Safety Profile

Among the data presented were Phase 1a clinical trial results for brontictuzumab in patients with advanced solid tumors. Brontictuzumab demonstrated single-agent activity in a biomarker-selected refractory patient population. Among 15 patients whose tumors overexpressed the activated form of Notch1, as measured by OncoMed’s proprietary immunohistochemistry (IHC) test, eight patients achieved stable disease or partial response for an overall clinical benefit rate of 53 percent. Anti-tumor activity was observed in adenoid cystic carcinoma, colorectal cancer and HER2 negative breast cancer. Partial responses were observed in two patients with adenoid cystic carcinoma after just one dose of brontictuzumab. Among patients whose tumors measured high in Notch1 activation, five have survived 100 days or longer as of the data cut off. There are five additional Notch1 high patients that are currently ongoing on the study and OncoMed plans to present follow-up data on those patients when the data matures. In biomarker negative subjects, only one of 11 had clinical benefit (9%). Brontictuzumab was generally well tolerated, with the most common adverse event being on-target, manageable diarrhea. Notch pathway and cancer stem cell pathway markers were reduced in serial tumor biopsies and in surrogate patient samples (blood) at doses above 1.5 mg/kg every three weeks. The single agent Phase 2 dose of brontictuzumab was established as 1.5mg/kg every three weeks.

"We are very encouraged by this early evidence of single-agent activity of brontictuzumab in a refractory biomarker-selected patient population. Notch1 has been shown to be elevated in a variety of solid tumor types, including breast, colorectal, esophageal, cholangiocarcinoma, pancreatic, small cell lung and adenoid cystic carcinomas," said Jakob Dupont, M.D., OncoMed’s Senior Vice President, Chief Medical Officer. "Based on these results and the manageable safety profile, Phase 1b combination studies of brontictuzumab in combination with chemotherapy are being contemplated with a particular emphasis on the Notch1 biomarker positive subjects."

These data were presented by Pamela Munster, M.D., Professor of Medicine, Program Leader Development Therapeutics, and Director of Early Phase Clinical Trials’ Program Helen Diller Cancer Center of the University of California, San Francisco in a poster titled: Safety and preliminary efficacy results of a first-in-human Phase I study of the novel cancer stem cell (CSC) targeting antibody brontictuzumab (OMP-52M51, anti-Notch1) administered intravenously to patients with certain advanced solid tumors (Abstract #C42).

"This successful Phase 1 study of brontictuzumab has provided much insight into this drug candidate. We have learned about the safety profile that can be managed; we have evidence of on-target effects against the Notch pathway; and we have observed single-agent activity in biomarker-selected patients," said Dr. Munster. "Taken together, data from this study suggests that brontictuzumab has the potential to benefit patients and should be developed in future studies with standard of care, particularly in biomarker selected patients."

Vantictumab in Non-Small Cell Lung Cancer — Novel Biomarker Identified

In a preclinical patient-derived xenograft non-small cell lung cancer (NSCLC) model, OncoMed researchers confirmed the anti-tumor activity of vantictumab both as a single-agent and in combination with taxane treatment. Sequential dosing (the administration of vantictumab two days prior to treatment with paclitaxel) was more efficacious than same-day dosing. Pharmacodynamic biomarkers showed that vantictumab inhibits genes in cancer stem cell pathways that support its mechanism of action. Importantly, LEF1, a key transcription factor in the Wnt pathway was identified as a potential predictive biomarker for treatment response in patient-derived xenograft models. LEF1 is being retrospectively evaluated as a predictive biomarker in OncoMed’s ongoing Phase 1b clinical trial of vantictumab in combination with docetaxel in patients with previously treated NSCLC. Results of these studies were presented on Friday, November 6 in a poster titled: Predictive and pharmacodynamic biomarkers of vantictumab (OMP-18R5; anti-Frizzled7) in non-small cell lung cancer (Abstract #A30) by Ann Kapoun, Ph.D. of OncoMed.

Anti-DLL4/VEGF Bispecific — Superior Inhibition of Tumor Growth

Preclinical studies of OncoMed’s dual-targeting anti-DLL4/VEGF bispecific antibody in xenograft tumor models demonstrated superior anti-tumor activity compared to either anti-DLL4 and anti-VEGF antibodies alone. The combination of anti-DLL4 and anti-VEGF resulted in broad-spectrum activity in many different tumor types including breast, colon, ovarian and pancreatic tumors. In serial transplantation studies, the anti-DLL4/VEGF bispecific antibody showed a greater effect than anti-DLL4 alone in delaying tumor recurrence following the termination of treatment and reducing the frequency of cancer stem cells in the tumors. Researchers also observed that simultaneous inhibition of DLL4 and VEGF induced a down-regulation of vasculature-related genes and decreased vasculature density. The anti-DLL4/VEGF bispecific antibody showed an improved cardiac profile in cynomolgus monkeys compared to anti-DLL4 which may translate to an improved safety profile in the clinic. OncoMed is currently testing the anti-DLL4/VEGF bispecific in a Phase 1a clinical trial for patients with advanced refractory solid tumors. These data were presented by Wang-Ching Yen, Ph.D., of OncoMed in a poster titled: Dual targeting of the DLL4 and VEGF pathways with a bispecific monoclonal antibody inhibits tumor growth and reduces cancer stem cell frequency (Abstract #C134) on November 8, 2015.

"The results of studies presented at the AACR (Free AACR Whitepaper)-NCI-EORTC meeting provide valuable information on optimal dosing of vantictumab plus taxane therapy and have identified a promising biomarker in the non-small cell lung cancer indication," said John Lewicki, Ph.D., Executive Vice President, Chief Scientific Officer. "And, in preclinical models, our bispecific is demonstrating robust anti-tumor activity against a number of tumor types and the combination of anti-DLL4 and anti-VEGF appears to have the potential to improve upon the cardiotoxicity profiles of either agent alone. We look forward to evaluating how these data translate into the clinic in our ongoing trials."

Brontictuzumab, vantictumab and the anti-DLL4/VEGF bispecific are novel investigational therapeutics currently being evaluated in ongoing clinical trials. Patients interested in learning more about participating in one of OncoMed’s many clinical trials may learn more by calling 1-866-914-7347 or emailing [email protected].