On November 1, 2021 Exact Sciences Corp. (NASDAQ: EXAS) reported that data from the Rx for Positive Node, Endocrine Responsive Breast Cancer, or RxPONDER, trial were published in The New England Journal of Medicine (Press release, Exact Sciences, DEC 1, 2021, View Source [SID1234596335]).i The study, led by the independent SWOG Cancer Research Network and sponsored by the National Cancer Institute (NCI), successfully defined the benefit of chemotherapy in early-stage, node-positive breast cancer patients with Oncotype DX Breast Recurrence Score results of 0 to 25. Initial results from RxPONDER were reported at the 2020 San Antonio Breast Cancer Symposium (SABCS). The findings have now been confirmed in this peer-reviewed publication.

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RxPONDER results show that guiding treatment w/ Oncotype DX test can spare chemo use in majority of postmenopausal women
In the study, postmenopausal women with 1 to 3 positive nodes and Recurrence Score results of 0 to 25 showed no benefit from chemotherapy after a median of five years of follow-up, meaning they can potentially avoid negative side effects of the treatment. Importantly, no chemotherapy benefit was observed regardless of the number of affected nodes, tumor grade or size. In premenopausal women with 1 to 3 positive nodes, a statistically significant chemotherapy benefit was observed.

Approximately one-third of patients diagnosed with hormone receptor (HR)-positive, HER2-negative early breast cancer have a tumor that has spread to their lymph nodes. The vast majority of these patients currently receive chemotherapyii even though approximately 85% of them have Recurrence Score results of 0 to 25.iii In addition, approximately two out of three early-stage breast cancer patients are postmenopausal.iv

"Our goal with RxPONDER was to better understand when to use adjuvant chemotherapy to enable personalized treatment instead of a one-size-fits-all approach," said study lead author Kevin Kalinsky, M.D., a long-time SWOG investigator and director of the Glenn Family Breast Center at the Winship Cancer Institute of Emory University. "These practice-changing results definitively show that postmenopausal women with this common form of breast cancer can be spared unnecessary chemotherapy and receive only hormone therapy, potentially saving tens of thousands of women the time, expense and harmful side effects that can be associated with chemotherapy. For the women diagnosed with breast cancer prior to menopause who may benefit from chemotherapy, the data help individualize the discussion of risk and benefit of chemotherapy."

Based on the RxPONDER results, the National Comprehensive Cancer Network (NCCN)v updated its guidelines for breast cancer and recognized the Oncotype DX Breast Recurrence Score test as the only test that can be used for prediction of chemotherapy benefit in early-stage breast cancer patients with 1 to 3 positive axillary lymph nodes, including micrometastases.vi The Oncotype DX test is now the only test classified as "preferred" with the highest level of evidence for node-negative and postmenopausal node-positive (1 to 3 positive nodes) patients. In addition, NCCN recommends considering the test to assess prognosis in premenopausal node-positive patients who are candidates for chemotherapy.

"The RxPONDER results, together with the foundational TAILORx resultsvii in node-negative, early-stage breast cancer, further elevate the test to a standard of care, supporting its inclusion in guidelines as well as its reimbursement and adoption on a global scale," said Rick Baehner, M.D., chief medical officer of Precision Oncology at Exact Sciences. "Now with the RxPONDER results, many more women worldwide may be able to receive hormone therapy alone, avoiding the negative side effects of chemotherapy without increasing the risk of cancer returning."

One of the largest clinical trials in node-positive, HR-positive, HER2-negative early breast cancer, RxPONDER enrolled more than 5,000 women with up to three positive nodes. The prospective, randomized Phase III study was conducted at 632 sites in nine countries – the United States, Canada, Mexico, Colombia, Ireland, France, Spain, South Korea and Saudi Arabia. Women with a Recurrence Score result of 0 to 25 were randomized to treatment with hormone therapy alone or chemotherapy followed by hormone therapy. Randomized patients were stratified based on their Recurrence Score result, menopausal status and type of lymph node surgery. Further analyses and additional patient follow up are planned by the SWOG investigators.

About the Oncotype DX and Oncotype MAP Portfolio of Tests
The Oncotype DX portfolio of breast, colon and prostate cancer tests applies advanced genomic science to reveal the unique biology of a tumor in order to optimize cancer treatment decisions. In breast cancer, the Oncotype DX Breast Recurrence Score test is the only test that has been shown to predict the likelihood of chemotherapy benefit as well as recurrence in invasive breast cancer. Additionally, the Oncotype DX Breast DCIS Score test predicts the likelihood of recurrence in a pre-invasive form of breast cancer called DCIS. For patients with advanced and metastatic cancer, the company offers the Oncotype MAP Pan-Cancer Tissue test, a rapid, comprehensive tumor profiling panel, which provides results in three to five business daysviii and allows physicians to understand a patient’s tumor profile and recommend actionable targeted therapies or clinical trials. With more than 1 million patients tested in more than 90 countries, the Oncotype DX tests have redefined personalized medicine by making genomics a critical part of cancer diagnosis and treatment. To learn more about the Oncotype DX and Oncotype MAP tests, visit www.OncotypeIQ.com/

On December 1, 2021 INmune Bio, Inc. (NASDAQ: INMB) (the "Company"), a clinical-stage immunology company focused on developing treatments that harness the patient’s innate immune system to fight disease, reported two poster presentations at the 2021 British Society of Immunology Congress, which was held November 28-December 1, in Edinburgh, UK (Press release, INmune Bio, DEC 1, 2021, View Source [SID1234596334]).

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Mark Lowdell, PhD, Chief Scientific Officer of INmune Bio, stated, "I’m delighted to have two of our team presenting our latest data on the mechanism of action of INKmune. These are the first comprehensive data showing that INKmune-mediated priming generates NK cells with memory-like phenotype (mlNK). Before this, mlNK cells could only be produced using multiple combinations of cytokines. These are the data which led us to the concept that INKmune is a ‘pseudokine’ that provides multiple signals to NK cells, akin to the multi-cytokine cocktails used by others. We also show that INKmune priming promotes significant proliferation of mlNK cells in vitro. These in vitro data have been replicated in the first patient treated with three, weekly doses of INKmune for high risk MDS. At 119 days post first treatment, 60% of the patient’s NK cells showed the activated, tumor killing phenotype compared to fewer than 15% before INKmune therapy. The patient remains well and with a significantly improved ECOG status."

Details of the presentations are as follows:

Title: Tumor-priming generates memory-like natural killer cells with universal anti-tumor functions

Poster: P-107

Session: Poster session 1

Natural killer (NK) cells are innate lymphocytes that target virus-infected and tumor cells. NK cells are exciting candidates for cancer immunotherapy due to their fast-acting ‘innate’ ability to mount anti-tumor responses and recently highlighted ‘adaptive’ properties including priming and memory-like functions. Tumor-priming of NK cells through in-vitro exposure to tumor target cells pre-activates NK cells to demonstrate enhanced tumor cell lysis upon restimulation, generating long-term memory-like features. The generation of memory-like NK cells was previously reported following exposure to cytomegalovirus (CMV), interleukin (IL)-12/15/18 combinations or the tumor cell line NALM-16.

Here, we report a novel type of tumor-induced memory-like (TIML) NK cell induced by the acute lymphoblastic leukemia (ALL) cell line, INB16. These TIML NK cells are generated in vitro over a period of seven days to show better expansion, survival, and proliferation relative to other memory-like NK cells, maintaining similar levels of enhanced NK cell anti-tumor functional abilities including tumor lysis, and pro-inflammatory cytokine secretion against a wide range of tumor targets. Their unique phenotypic and gene expression signatures suggest a novel and distinct form of memory-like NK cell governed by tumor-specific signaling pathways. The universal and wide-acting function of these highly expanded NK cells may have important implications in the clinical setting to better mitigate challenges in low NK cell number and lytic ability.

A link to the abstract can be found here.

Title: Tumor-priming defines an intermediate stage in natural killer cell activity between resting and lytic stages for enhanced NK cell function upon re-stimulation

Poster: P-597

Session: Poster session 1

Natural killer (NK) cells are critical effector cells of the innate immune system belonging to the family of group one innate lymphocytes (ILCs). They display direct cytotoxicity against sensitive tumor targets and secrete a wide array of cytokines that help mount an effective immune response against cancer development and progression, making them attractive candidates for cancer immunotherapy.

We previously reported a tumor-priming approach to NK cell activation, whereby exposure to the acute lymphoblastic leukemia cell line CTV-1 specifically activates NK cells to display more enhanced anti-tumoral functions. This has yielded encouraging results in clinical trials against acute myeloid leukemia and myelodysplastic syndrome. Other groups reported a similar tumor-priming strategy for specific activation of NK cell anti-tumor responses using NALM-16. Still, the mechanisms involved in tumor-priming of NK cells remain to be elucidated, and it is unclear how the ‘primed’ state can be achieved for optimal clinical benefit.

Here, we show that tumor-priming stimulates NK cells to a point along the lytic activation pathway for enhanced NK cell function upon re-stimulation. The primed state is achieved through exposure to less sensitive tumor targets that form fewer conjugates, and induce lower levels of avidity, degranulation, activation marker expression, pro-inflammatory cytokine secretion and lysis by NK cells. This tumor-primed state leads to enhanced NK cell function upon re-stimulation and potent NK cell killing of previously insensitive tumor targets. Interestingly, tumor-priming of NK cells is achieved in the presence of inhibitory signals and can be achieved using whole cell or cell lysate preparations, which generate differential activation signatures relative to cytokine stimulation.

This may have important implications in the clinic, where continuous cytokine exposure is associated with a dose-limiting toxicity in patients. These findings help define the tumor-primed NK cell activation state for the development of more optimal NK cell-based immunotherapeutic strategies in cancer.

A link to the abstract can be found here.

About INKmune

INKmune is a pharmaceutical-grade, replication-incompetent human tumor cell line (derived from CTV-1) which conjugates to resting NK cells and delivers multiple, essential priming signals akin to treatment with at least three cytokines in combination. INKmune is stable at -80oC and is delivered by a simple IV infusion. The INKmune:NK interaction ligates multiple activating and co-stimulatory molecules on the NK cell and enhances its avidity of binding to tumor cells; notably those resistant to normal NK-mediated lysis. Tumor-primed NK (TpNK) cells can lyse a wide variety of NK-resistant tumors including leukemias, lymphomas, myeloma, ovarian cancer, breast cancer.

On December 1, 2021 Zymeworks Inc. (NYSE: ZYME), a clinical-stage biopharmaceutical company developing multifunctional biotherapeutics, reported that Janssen Biotech, Inc. ("Janssen") dosed the first patient with JNJ-78306358, a bispecific antibody developed using Zymeworks’ Azymetric and EFECT therapeutic platforms (Press release, Zymeworks, DEC 1, 2021, View Source [SID1234596333]). This is the second Janssen bispecific program utilizing Zymeworks’ proprietary technology platforms to enter the clinic this year, following the announcement in August of Janssen’s dosing of the first patient with JNJ-78278343.

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"At Zymeworks, we are delighted to see our collaborator’s therapies reaching patients in the clinic, and we extend our congratulations to everyone at Janssen on this achievement," said Ali Tehrani, Ph.D., Zymeworks’ President & CEO. "Today, our therapeutic platforms are being leveraged through strategic partnerships with nine biopharmaceutical companies, with a total of six novel therapeutics having entered clinical development to date."

Zymeworks will receive a payment in connection with this milestone under Zymeworks’ 2017 licensing agreement with Janssen. Under the terms of that agreement, Zymeworks provided Janssen with a worldwide, royalty-bearing license to research, develop and commercialize up to six bispecific antibodies directed to Janssen therapeutic targets using Zymeworks’ Azymetric and EFECT platforms. Janssen is responsible for all research, development, and commercial activities under the licensing agreement. Zymeworks received an upfront payment of US$50 million and is eligible to potentially receive up to US$282 million in development milestone payments and up to US$1.12 billion in commercial milestone payments, as well as tiered royalties on potential sales.

About the Azymetric Platform

The Azymetric platform enables the transformation of monospecific antibodies into bispecific and multispecific antibodies, allowing simultaneous binding to several different disease targets. This unique technology enables the development of multifunctional therapeutics that can block multiple signaling pathways, recruit immune cells to tumors, enhance receptor clustering and internalization and increase tumor-specific targeting. These features are designed to enhance efficacy while reducing toxicities and the potential for drug resistance. Azymetric therapeutics have been engineered to retain the desirable drug-like qualities of naturally occurring antibodies, including low immunogenicity, long half-life and high stability. In addition, they are compatible with standard manufacturing processes that deliver high yields and purity, potentially reducing drug development costs and timelines.

About the EFECT Platform

The EFECT platform is a library of antibody Fc modifications engineered to activate or suppress the antibody-mediated immune response. This platform, which is compatible with traditional monoclonal as well as Azymetric bispecific antibodies, further enables the customization and optimization of therapeutic responses for different diseases.

On December 1, 2021 Rubius Therapeutics, Inc. (Nasdaq: RUBY), a clinical-stage biopharmaceutical company that is genetically engineering red blood cells to create an entirely new class of cellular medicines called Red Cell Therapeutics for the treatment of cancer and autoimmune diseases, reported that it will host a virtual investor and analyst event focused on the company’s RED PLATFORM and preclinical pipeline in oncology and autoimmunity, in particular type 1 diabetes (Press release, Rubius Therapeutics, DEC 1, 2021, View Source [SID1234596332]). The event will be held from 11:00 a.m. to 1:00 p.m. ET on Thursday, December 16, 2021. This will be the first of a series of investor and analyst events that the company plans to host periodically.

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The event will feature presentations from Rubius management, providing an overview of the Company’s RED PLATFORM and the translation of the platform into a pipeline of preclinical programs in oncology and autoimmune diseases. In addition, Dr. Gerald T. Nepom, M.D., PhD., will provide an overview of the current and emerging treatment landscape and unmet needs in type 1 diabetes. Dr. Nepom is the Director of the Immune Tolerance Network, sponsored by the National Institutes of Health, and former Director and founder of the Benaroya Research Institute, in Seattle WA, USA. His primary research interests focus on CD4 T cell response in autoimmunity, with an emphasis on type 1 diabetes, as well as the translation of immunological intervention strategies into innovative clinical trials. The Rubius management team and Dr. Nepom will host a Q&A session following the presentations.

A live audio webcast will be available within the Investors & Media section of the Rubius Therapeutics website. An archived replay will be accessible for 90 days following the event.

On December 1, 2021 Inhibrx, Inc. (Nasdaq: INBX), a biotechnology company with four clinical programs in development and a strong emerging pipeline, reported that the U.S. Food and Drug Administration, or FDA, has granted orphan-drug designation for INBRX-109 for the treatment of chondrosarcoma (Press release, Inhibrx, DEC 1, 2021, View Source [SID1234596331]).

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"We believe orphan-drug designation underscores the recognition of INBRX-109 as a promising therapeutic for patients with metastatic or unresectable chondrosarcoma, a patient community currently with no other viable options," said Inhibrx Chief Executive Officer Mark Lappe.

The FDA’s Office of Orphan Products Development grants orphan designation status to drugs and biologics that are intended for the safe and effective treatment, diagnosis or prevention of rare diseases, or conditions that affect fewer than 200,000 people in the U.S. Orphan-drug designation provides certain benefits, including financial incentives to support clinical development and the potential for up to seven years of market exclusivity in the U.S. upon regulatory approval.

About Chondrosarcoma

Chondrosarcoma is an orphan bone cancer with approximately 2,800 new patients diagnosed annually in the United States and the European Union. There are currently no therapeutics approved for the treatment of chondrosarcoma.

About INBRX-109

INBRX-109 is a precision-engineered, tetravalent death receptor 5 (DR5) agonist antibody designed to exploit the tumor-biased cell death induced by DR5 activation.
In January 2021, the FDA granted Fast Track designation to INBRX-109 for the treatment of patients with unresectable or metastatic conventional chondrosarcoma.
In November 2021, Inhibrx provided updated results from its ongoing Phase 1 clinical trial evaluating the efficacy and safety of INBRX-109 in patients with conventional chondrosarcoma. Preliminary disease control was observed in 16 of the 18 evaluable patients (89%) measured by RECISTv1.1, with two of the 18 achieving partial responses (11%). Based on preliminary results of the ongoing Phase 1 trial, the median progression-free survival (PFS) is 7.4 months, and the median overall survival has not been reached. Three patients have exceeded 61 weeks on treatment with INBRX-109, with 77 weeks being the longest duration of stable disease observed to date.

In June 2021, Inhibrx initiated a randomized, blinded, placebo-controlled, potential registration-enabling Phase 2 trial of INBRX-109 in conventional chondrosarcoma.