On August 3, 2020 Simcere Pharmaceutical Group Co., Ltd. (hereinafter referred to as "Simcere") and tumor clinical stage company G1 Therapeutics Company ( Nasdaq: GTHX ), reported the signing of an exclusive license to introduce Trilaciclib ‘s development and commercialization rights for all indications in Greater China (Mainland China, Hong Kong, Macau and Taiwan) (Press release, Jiangsu Simcere Pharmaceutical Company, AUG 3, 2020, View Source [SID1234562741]). Trilaciclib is the world’s first innovative drug discovered and developed by G1 to improve the prognosis of cancer patients after chemotherapy.

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" Trilaciclib may become the first prophylactically administered bone marrow protective therapy, which can effectively improve the prognosis of patients undergoing chemotherapy. We are very pleased to cooperate with Simcere , a Chinese company with leading innovative drug development and commercialization capabilities. , To promote this innovative therapy in China," said G1 CEO and MD Dr. Mark Velleca . "Sincere Pharmaceuticals has extensive experience in drug clinical trials and drug registration in China, and has a nationwide professional team that supports product academic promotion and market access. These advantages make them an important strategic partner of G1 to realize our The vision of bringing Trilaciclib to patients around the world."

According to the terms of the agreement, G1 will receive a down payment of US$ 14 million, and will receive development and commercialization milestone payments of up to US$ 156 million. Simultaneously, Simcere Pharmaceuticals will pay G1 low double-digit sales commission based on Trilaciclib ‘s annual net sales in Greater China . Simcere Pharmaceuticals will have the exclusive rights to develop and commercialize Trilaciclib for all indications in Greater China, and will participate in Trilaciclib ‘s global clinical trials. G1 reserves the right to develop and commercialize Trilaciclib in all regions outside the Greater China region. Both parties will be responsible for all development and commercialization costs in their respective regions.

Dr. Wang Pin, Chief Scientific Officer of Simcere Pharmaceuticals, said: "Currently, chemotherapy is the cornerstone therapy for cancer patients. A large number of patients in China are suffering from bone marrow suppression caused by chemotherapy. We are very pleased to have a deep cooperation with G1 Therapeutics in China. Developed and commercialized Trilaciclib , the world’s first product of its kind to protect bone marrow . We look forward to further expanding its clinical value based on Trilaciclib’s unique mechanism. We hope that through the joint efforts of both parties, Trilaciclib can benefit more cancer patients around the world as soon as possible."

Lung cancer is the most common cancer in the world, and small cell lung cancer accounts for about 15% of all lung cancer cases . According to statistics from the International Agency for Research on Cancer ( IARC ), a specialized cancer agency of the World Health Organization ( WHO ) , nearly 750,000 new lung cancer cases were reported in China in 2018 .

About Trilaciclib

Trilaciclib is the world’s first innovative product of its kind designed to improve the prognosis of cancer patients with chemotherapy. Trilaciclib is given before chemotherapy in patients with small cell lung cancer ( SCLC ). Based on the bone marrow protection data of three randomized, double-blind, placebo-controlled clinical trials in the United States, it has obtained FDA breakthrough therapy designation. In a randomized trial of patients with metastatic triple-negative breast cancer, compared with chemotherapy alone, trilaciclib when used in combination with chemotherapy significantly improved the overall survival of the patient. In 2020 Nian 6 Yue, G1 in the United States submitted a new drug application ( NDA ), is used to protect the bone marrow of patients with small cell lung cancer, and as I-Spy2 part of a pilot study began neoadjuvant chemotherapy. G1 expects to initiate a Phase III registered clinical trial for colorectal cancer in the United States in the fourth quarter of 2020 .

On August 3, 2020 Karius, the world leader in liquid biopsy for infectious diseases, reported active enrollment in a multicenter, prospective study that will evaluate the diagnostic value of the Karius Test for pneumonia in immunocompromised adult patients including those with hematological cancers (Press release, Karius, AUG 3, 2020, View Source [SID1234562734]). The Karius Test is a non-invasive blood test based on next-generation sequencing of microbial cell-free DNA that can rapidly detect over 1,000 bacteria, DNA viruses, fungi, and parasites. The test is currently being used by over 100 hospitals nationwide.

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The "Pneumonia in the ImmunoCompromised – Use of the Karius Test for the Detection of Undiagnosed Pathogens" (PICKUP) study will compare the diagnostic yield of the Karius Test to standard testing methods used to diagnose infectious causes of pneumonia in immunocompromised patients including those with hematological cancers. Patients with suppressed immune systems are especially vulnerable to life-threatening pneumonias due to their decreased ability to fight infections. Standard methods to diagnose pneumonia can be invasive, time-consuming (requiring weeks to months for a result), and inconclusive, often failing to identify the pathogen causing the infection. The PICKUP study will investigate the additive diagnostic value of the Karius Test in the diagnosis of pneumonia in these patients and its impact on clinical decision-making in this specific population. In addition, the Karius Test will be used to serially monitor pathogen levels during treatment to examine the association between microbial load and pneumonia progression.

"The ability to diagnose invasive life-threatening infections in immunocompromised patients has been one of the most challenging areas in clinical infectious disease practice," said Karius CEO, Mickey Kertesz. "We are enthusiastic to be collaborating with a number of leading cancer centers for this study and anticipate that the Karius Test will demonstrate a higher diagnostic yield than traditional invasive testing methods."

"Often in pneumonia, the causative pathogen is unknown or can be challenging to diagnose despite extensive diagnostic testing," said Dr. Stephen Bergin, Assistant Professor of Pulmonary and Critical Care Medicine at Duke University Health System and lead investigator for the PICKUP study. "Accurate and timely pathogen identification is particularly critical for immunocompromised patients who are susceptible to life-threatening infections from a much broader array of pathogens. We look forward to exploring the potential value of a non-invasive tool capable of rapidly diagnosing respiratory infections in this vulnerable population."

Previous studies have demonstrated the ability of the Karius Test to overcome many of these limitations to diagnose the cause of pneumonia and enable targeted treatment. The study will include approximately 200 patients from up to 10 centers in the United States.

On August 3, 2020 Natera, Inc. (NASDAQ: NTRA), a pioneer and global leader in cell-free DNA testing, reported the publication of a manuscript in Nature Cancer1 that validates the ability of its Signatera personalized circulating tumor DNA (ctDNA) technology to evaluate tumor response to immunotherapy in 25 different types of solid cancer (Press release, Natera, AUG 3, 2020, View Source [SID1234562731]). The full study can be found here.

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"Although immune checkpoint inhibitors are an effective tool for treating many types of cancer, the decision to treat beyond radiological progression can sometimes be challenging due to potential pseudo-progression," explained Lillian Siu, MD, FRCPC, BMO Chair in Precision Cancer Genomics at the Princess Margaret Cancer Centre and lead investigator of the study. "We are delighted to have partnered with Natera on this landmark study, which shows that ctDNA-based surveillance using the Signatera test, in conjunction with imaging, can be used to identify true disease progression and thus help patients receive appropriate immunotherapy treatment."

Pseudo-progression is a phenomenon whereby the tumor appears larger on an initial scan during treatment before shrinking on subsequent scans, and it has been reported in up to 1 in 10 patients treated with immunotherapy.2,3 The ability to distinguish true progression from pseudo-progression, earlier in the course of treatment, has emerged as a significant unmet clinical need.

The prospective phase II INSPIRE study, led by the Princess Margaret Cancer Centre in Toronto, followed patients with advanced solid tumors being treated with the immunotherapy drug, pembrolizumab. Whole exome sequencing was performed using tumor and matched normal DNA, and then bespoke ctDNA assays were designed using Signatera technology. ctDNA assessments were made at baseline in 94 patients, and every three cycles during treatment in 73 patients where serial plasma samples were available.

In the published manuscript, the study’s authors concluded, "The findings from this prospective study suggest broad clinical utility for ctDNA-based surveillance in patients treated with immune checkpoint blockade."

Key findings from the study include:

Signatera technology detected ctDNA before treatment in 98% of cases (92/94), emphasizing its validity as a universal biomarker across tumor types.
ctDNA increase after just 6 weeks of treatment, together with increasing tumor volume on imaging, was identified in 42% of patients (30/73) and predicted treatment non-response with 100% accuracy. These patients received on average 6 extra weeks of treatment that potentially could have been avoided.
ctDNA clearance at any time point during treatment was achieved by 16% of patients (12/73) and was associated with 100% overall survival with a median of 25.4 months of followup beyond first clearance.
All findings were independent of tumor mutational burden (TMB) and PD-L1 status.
"With over 200,000 patients per year being treated with immunotherapy,4 we see a significant opportunity for serial use of Signatera to help physicians determine treatment response earlier," said Solomon Moshkevich, General Manager of Natera’s oncology business. "We think this novel application could be as significant as Signatera’s use case in early-stage colorectal cancer."

We thank Merck for contributing the drug for this clinical trial.

About Signatera
Signatera is a custom-built circulating tumor DNA (ctDNA) test for treatment monitoring and molecular residual disease (MRD) assessment in patients previously diagnosed with cancer. The test is available for clinical and research use, and, in 2019, it was granted Breakthrough Device Designation by the U.S. Food and Drug Administration (FDA). The Signatera test is personalized and tumor-informed, providing each individual with a customized blood test tailored to fit the unique signature of clonal mutations found in that individual’s tumor. This maximizes accuracy for detecting the presence or absence of residual disease in a blood sample, even at levels down to a single tumor molecule in a tube of blood.
Unlike a standard liquid biopsy, Signatera is not intended to match patients with any particular therapy. Rather, it is intended to detect and quantify how much cancer is left in the body, to detect recurrence earlier, and to help optimize treatment decisions. Signatera test performance has been clinically validated in multiple cancer types including colorectal, non-small cell lung, breast, and bladder cancers. Medicare has proposed insurance coverage for the use of Signatera in patients with Stage II or III colorectal cancer, and it is expected to finalize that coverage decision in 2020. Signatera has been developed and its performance characteristics determined by the CLIA-certified laboratory performing the test. The test has not been cleared or approved by the US Food and Drug Administration (FDA). Although FDA is exercising enforcement discretion of premarket review and other FDA legal requirements for laboratory-developed tests in the US, certification of the laboratory is required under CLIA to ensure the quality and validity of the tests.

On August 3, 2020 Applied BioMath (www.appliedbiomath.com), the industry-leader in applying systems pharmacology and mechanistic modeling, simulation, and analysis to de-risk drug research and development, reported their collaboration with Verseau Therapeutics for the development and delivery of a systems pharmacology model that will be used for efficacious dose prediction for the treatment of cancer (Press release, Applied BioMath, AUG 3, 2020, View Source [SID1234562730]).

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"We previously collaborated with Applied BioMath to evaluate the therapeutic feasibility of a series of assets," said Dr. Tatiana Novobrantseva, Co-founder and Chief Scientific Officer of Verseau Therapeutics. "We look forward to extending this collaboration to predict an efficacious dose for one of our lead macrophage checkpoint inhibitor programs. The intersections between mathematical models and experimental drug development will yield more translatable experiments and better-informed clinical trials."

Applied BioMath employs a rigorous fit-for-purpose model development process which aims to quantitatively integrate knowledge about therapeutics with an understanding of its mechanism of action in the context of human disease mechanisms. Their approach employs proprietary algorithms and software that were designed specifically for systems pharmacology model development, simulation, and analysis. "The mechanistic nature of our systems modeling is ideal for using available data to evaluate Pharmacokinetic (PK)/Pharmacodynamic (PD) relationships when predicting efficacious dose," said Dr. John Burke, PhD, Co-Founder, President, and CEO of Applied BioMath. "This allows project teams to make more informed decisions as they head into IND."

On August 3, 2020 The Melanoma Research Alliance (MRA), the largest non-profit funder of melanoma research worldwide, reported that welcomes the decision by the U.S. Food and Drug Administration (FDA) approving Genentech’s Tecentriq (atezolizumab) plus Cotellic (cobimetinib) and Zelboraf (vemurafenib) for the treatment of BRAF V600 mutation-positive advanced melanoma patients (Press release, Melanoma Research Alliance, AUG 3, 2020, View Source [SID1234562729]).

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The newly approved triplet treatment is the first FDA-approved combination for metastatic melanoma that brings together immunotherapy with targeted therapies. Tecentriq, an immunotherapy, works by releasing the brakes on the immune system allowing it to attack cancerous cells. Cotellic and Zelboraf are targeted therapies that shut down specific pathways used by cancer to grow. Mutated copies of the BRAF V600 protein are found in about half of all melanomas.

"The approval of Tecentriq + Cotellic and Zelboraf marks the 13th new treatment approach approved for melanoma since 2011 and the first that combines checkpoint immunotherapy with BRAF/MEK inhibition," said Michael Kaplan, MRA President and CEO. "This is a huge step forward for patients with BRAF-mutant melanoma and provides even more options to treat their disease."

The FDA approval for Tecentriq + Cotellic and Zelboraf is based on results from the Phase 3 IMSpire 150 study. In the study, the triplet combination of Tecentriq + Cotellic and Zelboraf was compared to placebo + Cotellic and Zelboraf among patients with advanced BRAF-mutant melanoma. In data published June 13, 2020 by The Lancet, the triplet combination helped people live longer without their disease worsening (median PFS 15.1 months versus 10.6 months respectively). Rates of treatment related adverse events were similar between the two groups.

"This approval demonstrates the innovative spirit within the melanoma research community," says Dr. Marc Hurlbert, MRA Chief Science Officer. "It is the first of numerous combinations being studied that bring together checkpoint immunotherapy with targeted kinase therapies in the melanoma field’s pursuit to improve patient outcomes."

Melanoma is the deadliest form of skin cancer and rates have increased over the last three decades. More than 100,000 people in the United States will be diagnosed with melanoma this year alone. Despite incredible advances in melanoma research over the last decade that have supported the approval of 13 new treatment approaches, further advances are needed to fully eliminate suffering and death related to the disease.