On December 8, 2021 Alpha-1 Biologics, a biotherapeutics company developing innovative treatments for cancers and immune deficiencies, reported that positive data was published in frontiers in Oncology demonstrating Alphataxin, a small molecule that elevates circulating and tumor-infiltrating CD4+ T cells, suppressed kidney cancer and suppressed metastasis in mice (Press release, Alpha Biologics, DEC 8, 2021, View Source [SID1234596614]). Orally available Alphataxin, is the first and only drug in development to increase formation of CD4+ helper T cells. Immune checkpoint inhibitor therapy, the vanguard of cancer therapy, promotes the ability of CD8+ T cells to kill tumor cells. However, CD8+ T cells are unable to kill tumor cells in the absence of chemical mediators secreted by CD4+ helper T cells. The data showed that Alphataxin treatment is efficacious as a monotherapy in kidney cancer in mice and enhances anti-PD-1 immune checkpoint inhibitor therapy, with the potential to expand the number of human cancer patients who respond to checkpoint inhibitor therapy.

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"We are pleased with these pre-clinical results, which have further increased our confidence in the promising potential of Alphataxin to treat cancers and immune deficiencies. Based on this positive data, the company plans to raise additional capital to rapidly advance the Alphataxin development program."

Cynthia L. Bristow, PhD, CEO of Alpha-1 Biologics said, "We are excited to announce this positive pre-clinical data, which showed that Alphataxin, orally delivered in combination with an injected immune checkpoint inhibitor, may provide a powerful approach that can produce long-term remission in kidney cancer and other T cell-responsive tumors. Alphataxin as a monotherapy and in combination with anti-PD-1 immune checkpoint inhibitor therapy significantly suppressed tumor growth in a mouse model of kidney cancer and significantly elevated the number of circulating and tumor-infiltrating CD4+ T cells."

In the study, following implantation of mouse kidney tumor cells within the kidney of mice, combination treatment of Alphataxin and anti-PD-1 therapy resulted in 100% elimination of tumor growth. Moreover, in mice implanted with ten times more tumor cells into the kidney, doubling the Alphataxin dose in combination treatment with anti-PD-1 led to 100% elimination of tumors in one-third of mice and 81% suppression of tumor growth in the remaining two-thirds of mice. Both anti-PD-1 and Alphataxin monotherapy showed decreased tumor growth as compared with untreated mice. Lung metastasis was present in monotherapy but eliminated in combination-treated mice.

The study also investigated the effects of Alphataxin on the immune system in healthy mice. The data showed that Alphataxin increased the normally circulating numbers of CD4+ T cells, Pre-T cells, and CD4/CD8 ratio indicating that Alphataxin acts to increase the formation of CD4+ helper T cells.

"This combination treatment of Alphataxin with an anti-PD-1 therapy addresses a high unmet medical need in patients with kidney cancer who have very low survival rates. The 5-year survival rate for patients with renal adenocarcinoma undergoing anti-PD-1 treatment is estimated to be 27.7%. However, despite the efficacy of checkpoint inhibitors in promoting the cytotoxic activities of tumor infiltrating CD8+ T cells, approximately 87% of cancer patients do not respond to immune checkpoint therapy," said Dr. Bristow. "Kidney cancer is often not diagnosed until after metastasis, a disease stage for which there are few effective treatment options; however, recent promising advances demonstrate that easily accessible blood-based tests provide early detection, and this means that Alphataxin has the potential to be transformative in providing long lasting remission in kidney cancer."

Ron Winston, President, Institute for Human Genetics and Biochemistry said, "We are pleased with these pre-clinical results, which have further increased our confidence in the promising potential of Alphataxin to treat cancers and immune deficiencies. Based on this positive data, the company plans to raise additional capital to rapidly advance the Alphataxin development program."

The full article in frontiers in Oncology can be accessed here: Alphataxin, a Small-Molecule Drug That Elevates Tumor-Infiltrating CD4+ T Cells, in Combination With Anti-PD-1 Therapy, Suppresses Murine Renal Cancer and Metastasis.

About Alphataxin

Alpha-1 Biologics discovered that the protein alpha-1 proteinase inhibitor (α1PI, alpha-1 antitrypsin) regulates the number of circulating CD4+ T cells by stimulating the locomotion of Pre-T cells. The orally available small-molecule drug Alphataxin acts as a surrogate for α1PI in this pathway. The Company is focused on the development of Alphataxin, which suppressed tumor growth in a mouse model of kidney cancer. Alphataxin, in combination with anti-PD-1 antibody, significantly elevated circulating and tumor-infiltrating CD4+ T cells. Because orally available Alphataxin is the first and only drug developed to increase CD4+ T cells, Alphataxin is eligible for FDA Breakthrough Designation. In combination with anti-PD-1, Alphataxin is a powerful therapeutic method that provides long-term remission in kidney cancer in mice and is being tested in other T cell-responsive cancer models.

On December 8, 2021 SynDevRx, Inc., a clinical-stage biotechnology company leading the development in treatments for cancers sensitive to dysregulated metabolic hormones, reported they will be presenting pre-clinical mechanistic/molecular data with evexomostat (SDX-7320) using the Her2+ xenograft model (BT474) in combination with capivasertib/AZD-5363 during the 2021 San Antonio Breast Cancer Symposium (Press release, SynDevRx, DEC 8, 2021, View Source [SID1234596613]).

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Akt inhibitors frequently cause severe elevations in blood glucose. Hyperglycemia is a highly problematic, on-target toxicity associated with Akt inhibition that can lead to treatment resistance (which is likely mediated via subsequent hyperinsulinemia) or dose reductions. Furthermore, this on-target effect can require intense medical support, often from outside endocrinologists. Balancing capivasertib-induced hyperglycemia via dose titration while also titrating anti-diabetic medications to remediate the high blood sugar can be challenging and may lead to sub-optimal cancer treatment.

SynDevRx will be presenting data based on a series of experiments that investigated the impact of evexomostat (SDX-732) on Akt treatment-induced hyperglycemia, as well as the anti-tumor effects of evexomostat when combined with capivasertib. Mechanistically, data showing changes in the expression of a number of key hypoxia and innate immune system gene sets will be presented.

The poster, P5-05-04 "Inhibition of HER2+ tumor growth with SDX-7320, a novel MetAP2 inhibitor, alone and in combination with capivasertib/AZD-5363: Reduced expression of hypoxia-inducible genes" is being presented on Friday, December 10 from 7:00-8:30 AM.

About SDX-7320

SynDevRx believes that evexomostat (SDX-7320) is the first drug being developed specifically for cancer patients with metabolic complications, such as obesity, diabetes, high blood glucose or high HbA1c, pre-diabetes or insulin/leptin resistance. For certain tumor types, metabolic hormones stimulate oncogenic pathways, making the cancer more aggressive and deadlier. Evexomostat acts by binding irreversibly to its target enzyme MetAP2, triggering downstream improvements in the metabolic hormones insulin, leptin and adiponectin, improvements in key lipids, and inhibition of the important angiogenic proteins bFGF and VEGF-C, as was demonstrated in a Phase 1 clinical study in late-stage cancer patients. In preclinical studies using models of breast cancer, evexomostat (in combination with a CDK4/6 inhibitor) decreased levels of multiple cell cycle proteins in ER+ tumors, provided synergistic anti-tumor effects in combination with a PI3K inhibitor, reduced angiogenesis, controlled aberrant metabolic hormone signaling, and reversed obesity-induced immune suppression within the tumor micro-environment of tumor-bearing obese mice. Evexomostat (SDX-7320) is being developed for use in combination with standard-of-care cancer therapies for breast and prostate cancers.

On December 8, 2021 PharmaCyte Biotech, Inc. (NASDAQ: PMCB), a biotechnology company focused on developing cellular therapies for cancer and diabetes using its signature live-cell encapsulation technology, Cell-in-a-Box, reported the results of an additional, more detailed, analysis of the integration site of the cytochrome P450 2B1 gene from the augmented HEK293 cell clone that PharmaCyte uses in its CypCap product (Press release, PharmaCyte Biotech, DEC 8, 2021, View Source [SID1234596612]). This assay is one of the assays required by the U.S. Food and Drug Administration (FDA) in order to have the FDA’s clinical hold lifted on PharmaCyte’s Investigational New Drug Application (IND) for the treatment of locally advanced, inoperable pancreatic cancer (LAPC).

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PharmaCyte’s Chief Executive Officer, Kenneth L. Waggoner, said, "We are elated to have completed this sequencing assay given its importance to the FDA, and how incredibly difficult it was to arrive at this successful conclusion. We can report that the DNA sequence analysis of the cytochrome P450 2B1 augmented cells is now complete, and it is a great challenge that is now behind us. This kind of analysis is technically demanding, and we spent a great deal of time getting this right. In addition to extending our characterization of the augmented cells, the data also verifies our previous studies on the cells that are the active component of our novel LAPC therapy."

In previous studies, PharmaCyte showed that the cytochrome P450 2B1 gene in the augmented HEK293 cell clone was located on human chromosome 9 and the flanking sequence had already been determined. The FDA requested that the exact sequence of the cytochrome P450 2B1 gene inserted at that location should also be determined. This is technologically challenging because the introduced DNA is large and concatenated, causing the Company to turn to nanopore sequencing technology for this analysis. Nanopore sequencing is a cutting edge, unique and scalable technology that enables direct, real-time analysis of long DNA fragments. The technology was successfully used to determine the sequence of the introduced DNA, and the analysis of the sequence data shows that it is both intact and complete.

To learn more about PharmaCyte’s pancreatic cancer treatment and how it works inside the body to treat locally advanced, inoperable pancreatic cancer, we encourage you to watch the company’s documentary video complete with medical animations at: View Source

On December 8, 2021 Novartis reported new Kisqali (ribociclib) data demonstrating a consistent overall survival (OS) benefit with Kisqali plus endocrine therapy (ET) across genomic subtypes of hormone receptor positive, human epidermal growth factor receptor-2 negative (HR+/HER2-) advanced or metastatic breast cancer (mBC), similarly in the indolent as well as in the aggressive, endocrine therapy (ET)-resistant subtypes6 (Press release, Novartis, DEC 8, 2021, View Source [SID1234596611]). The findings will be presented as a late-breaking oral presentation at the 2021 San Antonio Breast Cancer Symposium (SABCS).

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"The overall survival benefit seen even in HER2-enriched adds to the body of evidence supporting the need to test the hypothesis that ribociclib may alter tumor biology, resulting in a better response to ET across common HR+/HER2- subtypes," said Aleix Prat, President of SOLTI, Head of the Medical Oncology Department at Hospital Clínic of Barcelona, Head of the Translational Genomics Group and Targeted Therapies in Solid Tumors at IDIBAPS and Professor of Medicine at the University of Barcelona. "One of the most interesting aspects of these ribociclib data is the overall survival benefit seen across the spectrum of indolent, less proliferative disease compared to the aggressive and ET-resistant disease, assuring the overall survival benefit of ribociclib in patients regardless of their baseline prognosis."

A broad ad hoc exploratory analysis of nearly 1,000 tumor samples showed that Kisqali in combination with ET consistently provided significant OS benefit compared to ET alone across main intrinsic subtypes (Luminal A: n=542; HR=0.75; 95% CI: 0.58-0.96; p=.021; Luminal B: n=278; HR=0.69; 95% CI: 0.50-0.95; p=.023; and HER2-enriched: n=147; HR=0.60; 95% CI: 0.40-0.92; p=.018)6. Patients with the HER2-enriched subtype associated with endocrine resistance and poor prognosis in HR+/HER2- breast cancer, achieved a significant improvement in median OS of 40.3 months compared to 29.4 months for ET alone6. The longest survival benefit from Kisqali plus ET was seen in patients with the luminal A subtype, who achieved a median OS of 68.0 months compared to 54.6 months on ET alone6. Patients with basal-like subtype, which is known to behave more like triple-negative breast cancer, had poorer OS outcomes in both the Kisqali combination and ET alone groups with a median OS of 19.4 months and 21.2 months, respectively (n=30; HR=1.89; 95% CI: 0.80-4.47; p=.148)6. These data follow the biomarker analysis of the MONALEESA trials presented at SABCS 2020 and published in Journal of Clinical Oncology, in which Kisqali demonstrated-progression free survival (PFS) benefit across the most common intrinsic subtypes in metastatic breast cancer9-10.

The four intrinsic subtypes of breast cancer (Luminal A, Luminal B, HER2-enriched and basal-like) have revealed critical differences in terms of incidence, survival and response to treatment11-15. Additionally, the insights provided by genomic intrinsic subtypes complement and expand upon the information provided by standard clinical parameters and pathological markers.

"The consistent overall survival data presented at SABCS again show the unique profile of Kisqali, reinforcing the scientific rationale for initiating HARMONIA, the first Phase III, head-to-head trial evaluating Kisqali versus Ibrance in HR+/HER2- metastatic breast cancer," said Susanne Schaffert, PhD, President of Novartis Oncology. "We know that for people living with metastatic breast cancer, quality of life in addition to extending life is so important to them, so we are excited to share meaningful outcomes from a global quality of life assessment."

Additional research of interest to be presented at SABCS includes the following:

Abstract Title Abstract Number/
Presentation Details
Genomic profiling of PAM50-based intrinsic subtypes in HR+/HER2- advanced breast cancer across the MONALEESA studies17 PD2-05
Wednesday, December 8 7:00am CT
Analysis of first-line patients with de novo disease vs late relapse and all pts with vs without prior chemotherapy in the MONALEESA-3 trial18 P1-18-11
Wednesday, December 8,
7:00am CT

Overall survival subgroup analysis by metastatic site from the Phase III MONALEESA-2 study of first-line ribociclib + letrozole in postmenopausal patients with HR+/HER2− advanced breast cancer8 GS2-01
Wednesday, December 8
8:45am CT
Circulating tumor DNA (ctDNA) dynamics in patients with hormone receptor positive HR+/HER2- advanced breast cancer treated in first line with ribociclib and letrozole in the BioItaLEE trial19 GS3-07
Thursday, December 9
10:15am CT
Assessment of quality of life in patients with advanced breast cancer in clinical practice: a real-world multi-country survey16 P4-12-03
Thursday, December 9
5:00pm – 6:30pm CT
Visit View Source for the latest information from Novartis, including our commitment to the Oncology community, and access to our SABCS Virtual Scientific Program data presentations (for registered participants).

About Kisqali (ribociclib)
Kisqali is the CDK4/6 inhibitor with the largest body of clinical trial evidence demonstrating consistent and superior overall survival benefit compared to endocrine therapy alone. Overall survival results were presented previously: MONALEESA-7 (ASCO 2019) and MONALEESA-3 (ESMO 2019) and MONALEESA-2 (ESMO 2021); MONALEESA-7 and MONALEESA-3 were published in the New England Journal of Medicine, with updated exploratory analyses presented at SABCS 2020 and ASCO (Free ASCO Whitepaper) 2021, demonstrating Kisqali plus endocrine therapy significantly extends life in pre/perimenopausal or postmenopausal women with HR+/HER2- advanced breast cancer1-5.

Kisqali is approved by the US Food and Drug Administration (FDA) and by the European Commission (EC) as initial endocrine-based therapy for postmenopausal women with HR+/HER2- locally advanced or metastatic breast cancer in combination with an aromatase inhibitor. Kisqali in combination with an aromatase inhibitor is approved for the treatment of pre-, peri- or postmenopausal women as initial endocrine-based therapy, and also indicated for use in combination with fulvestrant as both first- or second-line therapy in postmenopausal women by the FDA and by the EC20. Kisqali is approved in over 95 countries21.

Novartis is continuing to reimagine cancer with additional trials of Kisqali. NATALEE is a large confirmatory clinical trial of Kisqali with endocrine therapy in the adjuvant treatment of HR+/HER2- early breast cancer being conducted in collaboration with Translational Research In Oncology (TRIO)22. Novartis is collaborating with the Akershus University Hospital in Norway on the NEOLETRIB-trial, a neoadjuvant phase II trial studying the effects of Kisqali in HR+/HER2- early breast cancer including effects on the gut microbiota and senescence21. Novartis is also collaborating with SOLTI, who is leading the Phase III HARMONIA clinical trial evaluating Kisqali compared to palbociclib in patients with HR+/HER2- advanced breast cancer with aggressive tumor biology, defined as HER2-enriched21.

Kisqali was developed by the Novartis Institutes for BioMedical Research (NIBR) under a research collaboration with Astex Pharmaceuticals.

About Novartis in Advanced Breast Cancer
Novartis tackles breast cancer with superior science, collaboration and a passion for transforming patient care. We’ve taken a bold approach to our research by including patient populations often neglected in clinical trials, identifying new pathways or mutations that may play a role in disease progression and developing therapies that not only maintain, but also improve, quality of life for patients. Our priority over the past 30 years and today is to deliver treatments proven to improve and extend lives for those diagnosed with advanced breast cancer.

Important Safety Information from the Kisqali EU SmPC
Kisqali (ribociclib) is a prescription medicine approved in combination with an aromatase inhibitor as initial endocrine – based therapy in women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer or fulvestrant as initial endocrine – based therapy or following disease progression on endocrine therapy in postmenopausal women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced or metastatic breast cancer. It is not known if Kisqali is safe and effective in children or adolescents. Kisqali can cause a heart problem known as QT prolongation. This condition can cause an abnormal heartbeat and may lead to death. Kisqali is not indicated for concomitant use with tamoxifen due to an increased risk of QT prolongation. Patients should tell their health care provider right away if they have a change in their heartbeat (a fast or irregular heartbeat), or if they feel dizzy or faint. Kisqali can cause serious liver problems. Patients should tell their health care provider right away if they get any of the following signs and symptoms of liver problems: yellowing of the skin or the whites of the eyes (jaundice), dark or brown (tea-colored) urine, feeling very tired, loss of appetite, pain on the upper right side of the stomach area (abdomen), and bleeding or bruising more easily than normal. Low white blood cell counts are very common when taking Kisqali and may result in infections that may be severe. Patients should tell their health care provider right away if they have signs and symptoms of low white blood cell counts or infections such as fever and chills. Before taking Kisqali, patients should tell their health care provider if they are pregnant, or plan to become pregnant as Kisqali can harm an unborn baby. Females who are able to become pregnant and who take Kisqali should use highly effective birth control during treatment and for at least 3 weeks after the last dose of Kisqali. Do not breastfeed during treatment with Kisqali and for at least 3 weeks after the last dose of Kisqali. Patients should tell their health care provider about all of the medicines they take, including prescription and over-the-counter medicines, vitamins, and herbal supplements since they may interact with Kisqali. Patients should avoid grapefruit or grapefruit juice while taking Kisqali. The most common side effects (incidence >=20%) include infections, white blood cell count decreases, headache, cough, nausea, tiredness, diarrhea, vomiting, constipation, hair loss and rash. The most common Grade 3/4 side effects (incidence >5%) were infections, low neutrophils, low leukocytes, low red blood cells, abnormal liver function tests, low lymphocytes, low phosphate levels and vomiting. Abnormalities were observed in hematology and clinical chemistry laboratory tests.

On December 8, 2021 Affimed N.V. (Nasdaq: AFMD) a clinical-stage immuno-oncology company committed to giving patients back their innate ability to fight cancer, reported the initiation of patient recruitment for the open-label, multi-center phase 1/2a study evaluating the safety, tolerability, pharmacokinetics and efficacy of the innate cell engager (ICE) AFM24 in combination with Roche’s atezolizumab, an anti-PD-L1 checkpoint inhibitor (Press release, Affimed, DEC 8, 2021, View Source [SID1234596608]). AFM24 is Affimed’s tetravalent, bispecific epidermal growth factor receptor (EGFR)- and CD16A-targeting ICE, developed for the treatment of patients with solid tumors.

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"Natural killer cells, which are part of the innate immune system, have the ability to recognise cancer cells. AFM24, a novel immunotherapy, aims to redirect and engage these natural killer cells by linking them to a protein called EGFR, which is expressed on many solid tumours, to increase their tumour killing potency," said Dr Juanita Suzanne Lopez, Consultant Medical Oncologist at The Royal Marsden and Clinical Researcher at The Institute of Cancer Research, London and principal investigator for the study. "By combining AFM24 with an immune checkpoint inhibitor, we aim to activate both the innate and the adaptive immune system to improve patient outcomes. This approach has exciting potential for a broad range of tumour types, including lung, gastroesophageal, liver and pancreatic cancers."

The study will consist of two parts. The first part is a dose escalation phase, aiming to determine the maximum tolerated dose/recommended phase 2 dose of AFM24 in combination with atezolizumab. In the second part, the expansion phase (phase 2a), the goal is to collect preliminary evidence of efficacy as well as to confirm the safety of the therapeutic combination. The trial will include patients with solid tumors, including non-small cell lung cancer (NSCLC, EGFR-wildtype), gastric- and gastroesophageal junction adenocarcinoma and pancreatic/hepatocellular/biliary tract cancer. All patients have failed ≥1 prior line of treatment before receiving the combination of AFM24 and atezolizumab.

"Initiation of this trial is an important step in our three-pronged approach for developing our ICE molecules. We are driven by the biology of the targets and cancer indications to identify the right approach evaluating AFM24 in monotherapy, together with NK cells or immunotherapy," said Dr. Andreas Harstrick, CMO at Affimed. "We believe that the combination with anti-PD-L1 has the potential to provide benefits to a broad population of cancer patients."

Preclinical studies of AFM24 have demonstrated a good safety profile and anti-tumor activity. AFM24 monotherapy is currently being investigated in adult patients with advanced EGFR-positive solid malignancies in an open-label, non-randomized, multi-center, multiple ascending dose escalation/expansion study.

A Phase 1b study of another ICE, AFM13, in combination with the anti-PD-1 checkpoint inhibitor pembrolizumab has been published in Blood last year (Bartlett et al. Blood 2020, 136 (21): 2401–09), demonstrating an objective response rate (ORR) of 88% and a complete response (CR) rate of 46% at the recommended dose level in patients with relapsed/refractory Hodgkin lymphoma. The high ORR and CR rate in this proof-of-concept study were considered highly encouraging for the combination of the ICE with a checkpoint inhibitor and indicated that the activation of innate immunity has the potential to improve current therapies.

About AFM24
AFM24 is a tetravalent, bispecific innate cell engager (ICE) that activates the innate immune system by binding to CD16A on innate immune cells and EGFR, a protein widely expressed on solid tumors, to kill cancer cells. Generated by Affimed’s fit-for-purpose ROCK platform, AFM24 represents a distinctive mechanism of action that uses EGFR as a docking site to engage innate immune cells for tumor cell killing through antibody-dependent cellular cytotoxicity and antibody-dependent cellular phagocytosis.
In addition to the AFM24-102 study presented here (NCT05109442), Affimed is evaluating AFM24 as a monotherapy (AFM24-101) for patients with advanced EGFR-expressing solid malignancies whose disease has progressed after treatment with previous anticancer therapies. The first-in-human Phase 1/2a open-label, non-randomized, multi-center, multiple ascending dose escalation and expansion study and can be found at www.clinicaltrials.gov using the identifier NCT04259450.
Furthermore, Affimed and NKGen Biotech have initiated a Phase 1/2a study (AFM24-103) in November 2021, evaluating AFM24 in combination with SNK01, NKGen Biotech’s NK cell product (NCT05099549).