Veracyte Receives Final Medicare Coverage Policies for Decipher Bladder

On June 4, 2021 Veracyte, Inc. (Nasdaq: VCYT) reported that Medicare Administrative Contractors Palmetto GBA, WPS and CGS Administrators, LLC have finalized their coverage policies for Decipher Bladder, a genomic subtyping tool that helps physicians manage treatment decisions for patients with bladder cancer (Press release, Veracyte, JUN 4, 2021, View Source [SID1234583612]). These local coverage determinations (LCDs) make Decipher Bladder the first genomic test to be covered by Medicare for such patients. Developed through the Medicare MolDX program, the policies will become effective July 18, 2021, and provide a framework for other participating MACs to follow.

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Noridian Healthcare Solutions, another Medicare Administrative Contractor, is expected to similarly finalize its draft LCD, which will make Decipher Bladder a covered benefit for more than 62 million Medicare beneficiaries. In the United States, more than 80,000 individuals are diagnosed with bladder cancer annually, approximately 44,000 of which will have the non-metastatic, Stage I-IIIa disease indicated in these policies.

"Physicians treating patients with bladder cancer are faced with complex and potentially life-changing treatment decisions, including whether or not to prescribe neoadjuvant chemotherapy or proceed directly to radical cystectomy," said Tina Nova, Ph.D., Veracyte’s general manager, urologic cancers. "Studies have demonstrated that knowledge of an individual’s bladder-tumor molecular subtypes can help guide these decisions, over and above clinical features alone. The coverage decisions announced today will make it possible for physicians to access this critical genomic information."

The Decipher Bladder test is supported by multiple peer-reviewed clinical studies demonstrating its ability to identify which patients have a higher risk of upstaging to non-organ confined disease at surgery and which patients may benefit the most from neoadjuvant therapy. The test also can be used to identify neuroendocrine-like and immune-infiltrated subtypes, which may have implications for future therapeutic strategies.

About Decipher Bladder

Decipher Bladder is a genomic test that measures the molecular profile of bladder cancer using gene expression analysis from transurethral resected bladder tumor specimens. It was developed for bladder cancer patients with muscle-invasive disease who face the question of immediate cystectomy or systemic treatment in the neoadjuvant setting prior to cystectomy (NAC). The assay results are reported as one of five molecular subtypes (Luminal, Luminal-Infiltrated, Basal, Basal Claudin Low or Neuroendocrine-like), each of which has distinct biological composition, clinical behavior and predicted benefit from NAC.

Strata Oncology Presents Data at ASCO 2021 Showing Comprehensive Genomic and Transcriptomic Profiling Predicts Pan-Tumor Benefit of Pembrolizumab

On June 4, 2021 Strata Oncology, Inc., a precision oncology company advancing molecular indications for cancer therapies, reported the results of a study focused on evaluating a novel biomarker approach for immunotherapy, utilizing its comprehensive genomic and transcriptomic profiling (CGTP) assay paired with real-world clinical data to predict pembrolizumab benefit in patients with advanced solid tumors (Press release, Strata Oncology, JUN 4, 2021, View Source [SID1234583607]). The data were shared during a poster presentation at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting, taking place virtually from June 4-8, 2021.

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The study found that PD-L1, PD-L2 and tumor mutation burden (TMB) from the CGTP test independently predicted pembrolizumab benefit in pan-solid tumors – and when combined in a multivariate signature score – predicted benefit better than PD-L1 or TMB alone. Across a dataset of over 20,000 advanced solid tumors, the Strata immune response score identified 12% of all patients across a range of solid tumor types that are outside of currently approved indications but predicted to benefit from immunotherapy. The multivariate signature, developed from the Strata clinical-molecular database and real-world data, also predicted pembrolizumab benefit relative to chemotherapy across solid tumors.

The study included 610 patients with advanced solid tumors with TMB and immune gene expression data from the Strata Oncology CGTP tissue test and documented pembrolizumab treatment outcomes. Pembrolizumab treatment benefit was assessed by time to next treatment (TTNT), which was validated against overall survival. Real-world TTNT was defined as time in months from therapy start to new treatment or death.

"Immune checkpoint inhibitors are approved in many solid tumor types, but current biomarkers for predicting response are imperfect," said Scott Tomlins, MD, PhD, Chief Medical Officer at Strata Oncology. "Currently a minority (20-30%) of patients are estimated to respond to PD-1/PD-L1 therapy so the development of biomarkers for predicting the efficacy of immune checkpoint inhibitors is urgent. Strata’s multivariate biomarker, derived from our genomic and transcriptomic profiling assay, may expand the pan-tumor treatable population beyond current biomarkers."

The full poster can be viewed at www.asco.org.

Poster details

Title: Comprehensive genomic and transcriptomic profiling (CGTP) to predict pembrolizumab benefit in patients with advanced solid tumors
Session: Developmental therapeutics – immunotherapy
Subtrack: Tissue-based biomarkers
Abstract #: 2609

AIkido Pharma Announces Positive Phase 1 Data Presented at ASCO on 225Ac-J591

On June 4, 2021 AIkido Pharma Inc. (Nasdaq: AIKI) ("AIkido" or the "Company") reported that positive Phase 1 testing data was presented at the 2021 ASCO (Free ASCO Whitepaper) Annual Meeting June 4, 2021 (Press release, AIkido Pharma, JUN 4, 2021, View Source [SID1234583606]). The poster presentation of the data was by Dr. Scott Tagawa, a Professor of Medicine & Urology at Weill Cornell Medicine and an AIkido Pharma Scientific Advisory Board member. The full presentation is available at: View Source

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Highlights from the presentation include:

Declining PSA levels in treated patients
Declining circulating tumor cell (CTC) count in treated patients
Actinium-225 radiolabeled J591 well-tolerated with preliminary evidence of efficacy in a heavily pre-treated patient population
Actinium-225 radiolabeled J591 safe at tested dosage
Phase 2 trial underway
Neal Shore, MD, FACS a well-known key opinion leader in prostate cancer research, Medical Director for the Carolina Urologic Research Center and recent addition to the Company’s Advisory Board, stated, "The Phase I trial results of the 225Ac-J591 antibody for these advanced prostate cancer patients, who had extensive tumor burden as well as having experienced numerous life prolonging therapies, are impressive, both from a response and safety standpoint. PSA declines and CTC responses were clearly evident. Additionally, this novel antibody conjugate demonstrated very good tolerability during this DLT phase 1 trial. The unique properties of 225Ac-J591 suggest it as a very promising candidate for combination treatment with beta emitters, whereby the synergy of therapeutic isotope combination and broader tumor effect would have the potential to further shape theragnostic platforms."

Full ASCO (Free ASCO Whitepaper) Presentation Details:

Title: "Phase I study of 225Ac-J591 for men with metastatic castration-resistant prostate cancer (mCRPC)"

Tract: Genitourinary Cancer—Prostate, Testicular, and Penile

Presenter: Dr. Scott Tagawa MD, MS, FACP

Abstract Number: 5015

Date and Time: Available Starting June 4, 2021, 9:00 am (EST)

The Abstract from this study has been released on the ASCO (Free ASCO Whitepaper) Annual Meeting website (View Source). Clinical trial information: NCT03276572 (View Source )

The full ASCO (Free ASCO Whitepaper) meeting program is available at: www.asco.org

PathAI and Genentech Present on AI-Powered Pathologic Response Assessment in NSCLC at the American Society of Clinical Oncology Virtual Scientific Program 2021

On June 4, 2021 PathAI, a global provider of AI-powered technology applied to pathology, reported that new data highlighting the application of its ML-based PathR algorithm to clinical trials as an aid to pathologists will be presented in the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Virtual Scientific Program 2021, held from June 4-8, 2021 (Press release, Genentech, JUN 4, 2021, View Source [SID1234583605]). These results will be shared in full in the oral presentation, Artificial intelligence (AI)–powered pathologic response (PathR) assessment of resection specimens after neoadjuvant atezolizumab in patients with non-small cell lung cancer: Results from the LCMC3 study (Abstract #106) in the Clinical Science Symposium session, Artificial Intelligence: Optimizing Cancer Care Using Imaging and Pathology.

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The study describes ML-quantification of PathR, a clinically significant histologic endpoint that is currently calculated manually from tumor resection slides by pathologists. PathR, specifically MPR (10% or less viable tumor remaining), can be used as an efficacy endpoint in clinical trials investigating neoadjuvant therapies in patients with resectable NSCLC. MPR is studied as a potential surrogate efficacy outcome measure for disease free survival (DFS) or overall survival (OS).

"Through our partnership with PathAI, we are better understanding response and histopathologic changes in the tumor of lung cancer patients that received Tecentriq prior to surgery, and together developed a tool that could potentially support and simplify pathologists’ day to day work." said Nai-Shun Yao, M.D., vice president and chief medical partner, Oncology at Genentech.

ML-quantification of tumor histology features can provide a reproducible assessment of percent viable tumor that was shown to be at least as accurate as manual assessment. These ML-based tools have the potential to impact how PathR is assessed in clinical trials, potentially providing a rapid and more scalable solution to MPR determination. PathAI models were trained to identify and quantify cells and tissues within NSCLC tumor samples collected following neoadjuvant atezolizumab therapy, as part of the LCMC3 clinical trial sponsored by Genentech, a member of the Roche Group, and from those measurements, determine PathR (digital PathR). ML-model assessed MPR strongly agreed with manual MPR (AUROC = 0.975) and showed comparable DFS and OS for both digital PathR and manual PathR, however it should be noted that DFS and OS data in LCMC3 are still immature. Digitally assessed MPR was significantly associated with better DFS and OS, whereas manually assessed MPR showed a non-significant trend toward better DFS and OS. These results suggest that ML-based quantification of PathR after neoadjuvant immunotherapy may serve as surrogate for survival outcome measures, but further data maturation and validation is needed.

This investigation, together with another also presented at ASCO (Free ASCO Whitepaper) 2021 (poster #3061), demonstrate PathAI’s multi-faceted approach toward integrating scalable AI-powered tools that generate clinically relevant, accurate, and reproducible pathology scores into oncology clinical trial workflows.

Yingli Pharma Announces presentations on the Phase 1 trials of linperlisib, a PI3Kδ selective inhibitor, and YL-13027, an oral TGFβR1 inhibitor, at the American Society for Clinical Oncology 2021 Annual Meeting

On June 4, 2021 Shanghai Yingli Pharmaceuticals Ltd (Yingli Pharma), a clinical stage pharmaceutical company providing new therapies for cancer and metabolic diseases, reported that there will be three presentations on clinical trials sponsored by the company at the annual meeting of the American Society for Clinical Oncology (ASCO) (Free ASCO Whitepaper) June 4-7, 2021 (Press release, Yingli Pharmaceutical, JUN 4, 2021, View Source [SID1234583604]).

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Linperlisib in Peripheral T cell lymphoma

The clinical trial report entitled "A phase Ib study of a PI3Kδ inhibitor Linperlisib in patients with relapsed or refractory peripheral T-cell lymphoma" was presented at the June 4, 2021 proceedings of the conference.

In this phase Ib study that enrolled 38 relapsed and refractory Peripheral T cell lymphoma patients, linperlisib, a novel oral PI3Kδ inhibitor, was evaluated as monotherapy for safety, tolerability and efficacy at recommended phase 2 dose of 80mg once daily. The clinical data from an interim data cutoff was presented at ASCO (Free ASCO Whitepaper) by Dr. Jie Jin, professor of First Hospital Affiliated with Zhe Jiang Medical University. Top line data from this study indicated that for the 38 r/r PTCL patients enrolled, 30 were evaluable. As of the data cutoff, an Overall Response Rate (ORR) of 70% was reported of which 33% were complete responses. A 100% disease control rate was also observed. Linperlisib was well-tolerated with Grade 1 and Grade 2 adverse events most frequently observed, and with limited Grade 3 adverse events of neutrophil decrease in 4 pts, (10.5%), and 1 (2.6%) case each of leukopenia, thrombocytopenia, blood lipase increase, pneumonia and stomatitis.

"Peripheral T cell lymphoma is a devastating and aggressive lymphoma where patients have very few treatment options in the relapsed and refractory setting," said Dr. Jie Jin. "The results of this Phase1b clinical trial suggest that linperlisib is a promising PI3Kδ selective inhibitor with important anti-tumor properties in this indication, and we hope it will be able to bring clinical benefits of linerlisib to patients suffering from this serious disease. Globally, there are no PI3K inhibitors that have been approved for the treatment of T cell lymphomas. In China, no PI3K inhibitors have been approved for any indications. By evaluating linperlisib for its safety, tolerability and efficacy, we are optimistic that this novel oral therapy will advance into registration clinical trials in PTCL for regulatory approval."

Linperlisib evaluated in advanced solid tumors

Another clinical study of linperlisib was also presented at ASCO (Free ASCO Whitepaper) entitled "A phase Ib study of the PI3Kδ inhibitor linperlisib in patients with advanced solid tumors". In this study that enrolled 78 advanced solid tumor patients, linperlisib monotherapy was evaluated for safety, tolerability, and durability at the recommended phase2 dose of 80 mg once daily, the dose previously established for the treatment of lymphomas. The clinical data from an interim analysis of this study was presented by Dr. Jin Li, Professor and Oncologist at Shanghai East Hospital.

Linperlisib is an immunomodulatory PI3Kδ inhibitor in solid tumors that has been demonstrated to alter the tumor immune microenvironment in preclinical research. "These properties of solid tumors are a challenge for therapeutic intervention because the regulatory immune cells will frequently repress an anti-tumor immune response. Our hypothesis is that linperlisib will unleash the anti-tumor suppression in a beneficial manner for patient treatments", said Zusheng Xu, General Manager of Yingli Pharma.

In the open-label Phase 1b study including 15 advanced solid tumor types, linperlisib was demonstrated to be safe and well-tolerated. The most common treatment related adverse events were Grade 1 and Grade 2, with the Grade 3 TRAE of neutropenia (3.8%), diarrhea (2.6%), elevated γ-glutaminase (1.3%) and leukopenia (1.3%) observed. The disease control rate with linperlisib monotherapy was reported to be 41.4%, with one complete response observed in a patient with thymic carcinoma.

Dr. Jin Li stated "Linperlisib is a PI3K inhibitor with a distinct chemical structure highly selective to the δ isoform, compared to other PI3K inhibitors. The preliminary clinical findings are supportive of Linperlisib demonstrating a favorable safety profile with very limited off-target effects that have been associated with other PI3K inhibitors in the clinic. We were pleased to see that Linperlisib can be administered to patients with advanced solid tumors in a manner that is safe and well-tolerated. Linperlisib has great potential for combination therapies and additional indications in the future. We committed to investigating how this new PI3K inhibitor can improve the health condition of patients suffering from advanced solid tumors."

YL-13027, a novel and selective TGFβR1 inhibitor in a Phase 1 dose escalation study

A first-in-human clinical trial of YL-13027, an oral, potent, and selective TGFβR1 inhibitor, is being presented at the ASCO (Free ASCO Whitepaper) meeting, entitled "A phase I study of a TGF-β receptor I kinase inhibitor YL-13027 in patients with advanced solid tumors".

TGFβ signaling is known to be a driver contributing to the immunosuppressive properties of many solid tumors. In principle, agents that interfere with TGFβ signaling may be beneficial towards interrupting tumor progression and supplying additional targets for anti-cancer therapies. YL-13027 was developed as a potent small molecule inhibitor of TGFβR1, a tyrosine kinase, and has demonstrated anti-tumor efficacy in preclinical models. In this open-label phase1 dose escalation study, the initial safety evaluation of YL-13027 was presented. The most frequent treatment related adverse events in twelve patients who had completed Cycle 1 safety evaluation period as of the data cut, were the following (all Grades/≥Grade 3): γ-glutamyl transferase elevation (38.5%/7.7%), hemoglobin decrease (38.5%/0%), blood alkaline phosphatase elevation (23.1%/7.7%), AST (23.1%/0%), and blood phosphorus decrease (23.1%/0%). Of the 6 evaluable patients with advanced solid tumors treated as of the data cutoff date, 1 triple negative breast cancer patient had a confirmed Partial Response.

"In recent years, immunotherapy has gradually replaced chemotherapy and radiotherapy, and has shown good clinical results for different types of advanced solid tumors, but we still encounter bottlenecks in terms of safety, tolerability and tumor indication selection” said Dr. Jin Li, professor of Shanghai East Hospital, and a lead investigator on the study. "YL-13027 has demonstrated to be a safe and tolerable oral agent that is highly selective for TGFβR1 over TGFβR2. These results are giving us confidence for the dose escalation of YL-13027, and its performance on other tumor types and combination therapies. We are very optimistic about the further development of YL-13027 as an anti-cancer agent."

Schedule for Linperlisib and YL-13027 presentations at ASCO (Free ASCO Whitepaper)

Abstract # 7531; ‘A phase Ib study of a PI3Kδ inhibitor Linperlisib in patients with relapsed or refractory peripheral T-cell lymphoma’ is being presented in the Hematologic Malignancies – Lymphoma and Chronic Lymphocytic Leukemia Session. Citation: J Clin Oncol 39, 2021 (suppl 15; abstr 7531)

Abstract # 3099; ‘A phase Ib study of the PI3Kδ inhibitor linperlisib in patients with advanced solid tumors’ is being presented in the Developmental Therapeutics – Molecularly Targeted Agents and Tumor Biology Session. Citation: J Clin Oncol 39, 2021 (suppl 15; abstr 3099)

Abstract # 3098; ‘A phase I study of a TGF-β receptor I kinase inhibitor YL-13027 in patients with advanced solid tumors’ is being presented in the Developmental Therapeutics – Molecularly Targeted Agents and Tumor Biology Session. Citation: J Clin Oncol 39, 2021 (suppl 15; abstr 3098)

About Linperlisib

Linperlisib (YY-20394) is a highly selective and potent PI3Kδ inhibitor that has shown favorable safety profile, exciting anti-tumor activities, and good PK and pharmaceutical properties as an oral once-a-day agent in late-stage clinical development. A phase 1 clinical trial was completed in 2020 demonstrating linperlisib to be a safe and tolerable agent, and a recommended phase 2 dose of 80 mg QD was established. Linperlisib received FDA Orphan Drug Designations for FL, CLL/SLL, and T cell lymphoma. Linperlisib was awarded NMPA Breakthrough Therapy status in China. A clinical trial in r/r FL for 93 patients having 2 or more prior systemic therapies has been completed and submitted for marketing approval in China. Additional linperlisib clinical trials are ongoing in other lymphomas, solid tumors, and in combination with gemcitabine/oxaliplatin in r/r DLBCL.

About YL-13027

YL-13027 is a potent small molecule antagonist of TGFβR1 kinase activity in early-stage clinical development. The compound was optimized with selectivity against TGFβR2 and other tyrosine kinases, differentiating YL-13027 from other inhibitors blocking TGFβ signaling. In preclinical studies, YL-13027 demonstrated anti-tumor efficacy and combination benefit with immunotherapy. In IND-enabling studies, YL-13027 showed reliable dose-proportionality and pharmacokinetic properties, and the agent proved to be safe and tolerable in toxicity studies. A phase 1 dose escalation of YL-13027 is continuing to establish a recommended phase2 dose of YL-13027.