AKESO’S LIGUFALIMAB AND IVONESCIMAB OBTAINED APPROVAL TO INITIATE A PHASE II TRIAL

On January 30, 2022 Akeso, Inc. (9926.HK) reported that the Ligufalimab (CD47 monoclonal antibody, research and development code: AK117, the novel immuno-oncology drug independently developed by the Company) and Ivonescimab (PD-1/VEGF bi-specific antibody, research and development code: AK112) has obtained approval from the Center for Drug Evaluation (CDE) of the National Medical Products Administration of the People’s Republic of China (”China”) to initiate a phase II clinical trial with chemotherapy as first-line therapy for unresectable locally advanced or metastatic triplenegative breast cancer (Press release, Akeso Biopharma, JAN 30, 2022, View Source [SID1234607495]).

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This clinical trial is an open and multi-center phase II clinical trial, which plans to include patients who have not received systemic anti-tumor therapy, are not suitable for radical surgical resection or local therapy, or subjects with locally advanced or metastatic triple-negative breast cancer whose disease progresses after surgical resection or local therapy.

Breast cancer is the most prevalent malignant tumor in women worldwide and in China, among which triple-negative breast cancer (that is, negative for progesterone receptor, estrogen receptor and human epidermal growth factor receptor 2) is highly aggressive and has a high recurrence rate, with a relatively poor prognosis. It is the subtype with the highest recurrence rate and mortality in breast cancer, accounting for approximately 15% of all breast cancers.

Related studies have shown that the mechanisms by which tumor cells evade the innate and adaptive immune systems play a key role in the occurrence and development of recurrent and/or metastatic tumors. An important mechanism of immune escape in triple-negative breast cancer is the expression of CD47. CD47 inhibits the phagocytosis of macrophages by releasing a ”don’t eat me” signal, and at the same time suppresses adaptive immunity by interacting with dendritic cells.

Under the tumor microenvironment, there is a strong correlation between VEGF and PD-1 expression. Therefore, the use of a bi-specific antibody to block PD-1 and VEGF simultaneously can provide a type of drug with more targets in the tumor microenvironment.

Related studies have also shown that the up-regulation of CD47 can inhibit the phagocytosis of macrophages and the anti-tumor effect of VEGF/VEGFR inhibitors. It can also induce the up-regulation of CD47 during anti-angiogenesis therapy. Therefore, blocking both VEGF and CD47 can effectively inhibit the immunosuppressive pathway induced by antiangiogenesis therapy (up-regulation of CD47) while enhancing the phagocytosis of macrophages to improve the anti-tumor efficacy.

Therefore, the combination therapy of Ivonescimab and Ligufalimab is expected to activate both innate and adaptive immune pathways and enhance the targeted recognition of tumors by the immune system, which can create a synergy effect of immunity, anti-angiogenesis and chemotherapy. It is expected to achieve better anti-tumor effects in subjects with advanced triple-negative breast cancer.

LENVIMA®?LENVATINIB?IN COMBINATION WITH KEYTRUDA®?PEMBROLIZUMAB?APPROVED IN TAIWAN FOR THE FIRST-LINE TREATMENT OF PATIENTS WITH ADVANCED RENAL CELL CARCINOMA

On January 30, 2022 Eisai Co., Ltd. (Headquarters: Tokyo, CEO: Haruo Naito, "Eisai") reported that LENVIMA (generic name: lenvatinib mesylate), the multiple receptor tyrosine kinase inhibitor discovered by Eisai, in combination with Merck & Co., Inc., Kenilworth, N.J., U.S.A.’s KEYTRUDA (generic name: pembrolizumab) has been approved in Taiwan for the first-line treatment of patients with advanced renal cell carcinoma (RCC) (Press release, Eisai, JAN 30, 2022, View Source [SID1234607492]). This marks the first approval for LENVIMA which will be used in combination with KEYTRUDA for advanced RCC in Asia.

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The approval is based on results from the CLEAR (Study 307)/KEYNOTE-581 trial evaluating the combination for the first-line treatment of patients with advanced RCC. These results were presented at the 2021 Genitourinary Cancers Symposium (ASCO GU) and simultaneously published in the New England Journal of Medicine. 1 In this trial, LENVIMA plus KEYTRUDA demonstrated statistically significant improvements in the primary efficacy outcome measure of progression-free survival (PFS), as well as the key secondary efficacy outcome measures of overall survival (OS) and objective response rate (ORR) versus sunitinib. For PFS, LENVIMA plus KEYTRUDA reduced the risk of disease progression or death by 61% (HR=0.39 [95% CI: 0.32-0.49]; p<0.0001) with a median PFS of 23.9 months versus 9.2 months for sunitinib. For OS, LENVIMA plus KEYTRUDA reduced the risk of death by 34% (HR=0.66 [95% CI: 0.49-0.88]; p=0.0049) versus sunitinib. Additionally, the confirmed ORR was 71% (95% CI: 66-76) (n=252) for patients who received LENVIMA plus KEYTRUDA versus 36% with sunitinib (95% CI: 31-41) (n=129). LENVIMA plus KEYTRUDA achieved a complete response (CR) rate of 16% and partial response (PR) rate of 55% versus a CR rate of 4% and a PR rate of 32% for those who received sunitinib. 2 In this trial, the five most common adverse reactions (any grade) observed in the LENVIMA plus KEYTRUDA combination arm were fatigue, diarrhea, musculoskeletal disorders, hypothyroidism and hypertension. 2

Worldwide, it is estimated there were more than 430,000 new cases of kidney cancer diagnosed and more than 180,000 deaths from the disease in 2020. 3 In Taiwan, there were more than 1,400 new cases and more than 600 deaths in 2018. 4 Renal cell carcinoma is by far the most common type of kidney cancer; about nine out of 10 kidney cancer diagnoses are RCC. 5 Most cases of RCC are discovered incidentally during imaging tests for other abdominal diseases. 6 Approximately 30% of patients with RCC will have metastatic disease at diagnosis, and as many as 40% will develop metastases after primary surgical treatment for localized RCC. 7,8  The prognosis for these patients is poor as survival is highly dependent on the stage at diagnosis, and the five-year survival rate is 12% for patients diagnosed with metastatic disease. 8

Eisai positions oncology as a key therapeutic area and is aiming to discover innovative new medicines with the potential to cure cancer. Eisai is committed to expanding the potential clinical benefits of lenvatinib for cancer treatment, as it seeks to contribute to addressing the diverse needs of, and increasing the benefits provided to, patients with cancer, their families and healthcare professionals.

*In March 2018, Eisai and Merck & Co., Inc., Kenilworth, N.J., U.S.A., through an affiliate, entered into a strategic collaboration for the worldwide co-development and co-commercialization of lenvatinib, both as monotherapy and in combination with the anti-PD-1 therapy pembrolizumab from Merck & Co., Inc., Kenilworth, N.J., U.S.A.

Q2 FY 2022 Quarterly Activity Report

On January 28, 2022 Race Oncology reported the December 2021 quarter (Q2 FY 2022) was highlighted by new pre-clinical findings that Zantrene reduces anthracycline and carfilzomib-induced heart damage, while also improving the cancer cell killing effects of both drugs (ASX announcements: 22 November 2021 & 8 December 2021) (Press release, Race Oncology, JAN 28, 2022, View Source [SID1234610000]).

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A second highlight was the strong support of our shareholders in funding the new and expanded Three Pillar strategy shared at Race’s Annual General Meeting (ASX announcement: 23 November 2021). This support enables the Company to progress the following clinical programs: Phase 1b/2 FTO solid tumour clinical trial ($8.0 million); cardio-protection Phase 2b clinical trial in breast cancer patients ($7.5m); Phase 2 Extramedullary Acute Myeloid Leukaemia (AML) / Myelodysplastic syndrome (MDS) clinical trial in Europe ($9.2 million); enhanced formulations of Zantrene ($3.2 million); preclinical cardio-protection studies ($1.0 million) and the development of new molecules ($0.8 million). Shareholder subscriptions of $44 million were received with $29.7 million accepted (ASX announcement: 21 December 2021) in line with the full case funding proposal. More broadly the team made continued progress in its Australian EMD AML program announcing the ethics documentation submission (ASX announcement: 1 November 2021), the securing of two additional USA patents (ASX announcements: 6 October 2021 & 19 October 2021) and adding new R&D development capability via a collaboration with the University of Wollongong (ASX announcement: 9 November 2021) to further support formulation and new drug developments. In sum, the quarter saw considerable progress and the Race team is now appropriately funded to progress and accelerate the expanded clinical and preclinical program.

Race Oncology Ltd ABN 61 149 318 749 Registered office: L36, 1 Macquarie Place, Sydney NSW 2000 www.raceoncology.com Key events of the quarter § On 6 & 19 October 2021, Race announced that it had been granted its fifth and sixth USA patents, providing additional protection around the use, formulation, and compositions of Zantrene for improving the efficacy of related treatments. § On 27 October 2021, Race announced a FTO biomarker research collaboration with Chaim Sheba Hospital, Israel. This research program will see analysis of clinical patient samples by Dr Dom Dominissini, to assess FTO biomarker and m6A RNA methylation status in patients treated with Zantrene. § On 1 November 2021, Race announced submission of its human ethics application to commence a Phase 1b/2 extramedullary AML & MDS trial. This clinical program underpins future registration trials in the EU and US for Zantrene. The study is led by Associate Professor Anoop Enjeti (Calvary Mater Hospital Newcastle) with the support of the Contract Research Organisation, Parexel. §

On 3 November 2021, Race initiated a collaboration study to develop a genomicsbased companion diagnostic for Zantrene to support its use as a precision oncology drug. This study will be led by the experienced genomics researcher Professor Murray Cairns at the University of Newcastle. The study will utilise the latest RNA genomics tools to identify genetic biomarkers associated with a cancer’s sensitivity to Zantrene at the patient specific level. § On 9 November 2021, Race announced initiation of a strategic collaboration with The University of Wollongong, focused on the optimisation of new formulations to support long-acting peripheral intravenous delivery (IV) delivery of Zantrene.

This collaboration will also pursue the development of an oral formulation of Zantrene. The collaboration will be led by experienced oncology formulator, Professor Marie Ranson in collaboration with Race’s Principal Scientist, Professor Michael Kelso, and is supported with the appointment of Race’s Senior Scientist, Dr Ben Buckley. § On 22 November 2021, Race announced a preclinical breakthrough heart protection discovery for Zantrene. While anthracyclines are effective anti-cancer drugs they carry a serious risk of causing permanent heart damage. Zantrene was shown to protect heart muscle from anthracycline-induced cell death when used in combination. Furthermore, a Zantrene/doxorubicin combination was also found to better kill cancer cells.

This effect was independent of Zantrene FTO inhibiting activity, and provides Race with an entirely novel commercial opportunity. § On 23 November 2021, Race announced an update to its "Three Pillar" Strategy at the Company’s AGM, along with a Share Purchase Plan (SPP) designed to fund plans enabling execution of the new strategy and capitalising on Zantrene’s expanded commercial potential, by pursuing the following activities: Race Oncology Ltd ABN 61 149 318 749 Registered office: L36, 1 Macquarie Place, Sydney NSW 2000 www.raceoncology.com

Pillar 1 – Current Zantrene, by expanding the EMD AML & FTO clinical programs, initiating a US IND, and progressing the cardio-protective opportunity.
Pillar 2 – Optimises Zantrene, with formulation development to improve utility via an improved IV formulation, oral formulation, and associated IP.
Pillar 3 – Beyond Zantrene, utilises team capabilities to pursue new RNA targeting molecules, via internal development, partnership, or acquisition.

The SPP was announced with three levels of potential funding to support an expanded FTO-targeted clinical program in solid tumours, improved formulations, a cardioprotection clinical program, new drug development, and expansion of the Phase 1b/2 EMD AML program into Europe. The SPP was launched at $3.00 per share to shareholders of record on 22 November 2021, closing 17 December 2021, with the maximum raise capped at $29.7 million. § On 8 December, Race announced an additional heart protection preclinical discovery. Zantrene was found to protect heart muscle cells from damage caused by the Multiple Myeloma drug, carfilzomib (Kyprolis) while synergising to improve anticancer effects. This cardio-protective observation broadens the formulation and potential commercial opportunities for Zantrene via the potential development of new Zantrene/carfilzomib formulations.

§ On 10 December 2021, Race announced an extension to its heart protection collaboration with the University of Newcastle. This program plans to assess Zantrene’s cardio-protective potential with additional anti-cancer drugs, where heart damage is a known treatment risk. § On 21 December 2021, Race announced raising the full $29.7 million target in a heavily oversubscribed SPP. This allows progression of the FTO solid tumour Phase 1b/2 clinical trial, cardio protective pre-clinical and clinical Phase 2b trial, expansion of the EMD AML Phase 2 trial into Europe, improved Zantrene formulations, and new molecule development. Summary of cash flow and quarterly activity As of 30 December 2021, Race held cash and equivalents of $37.10 million, compared with $8.94 million on 30 September 2021. The expansion in cash reserves reflects receipts from the SPP, exercise of options and an acceleration in research spending concurrent with expanded programs ($1.79m vs $0.93m in the prior quarter). Listing rule 4.7C.3 Payments during the quarter to Related Parties amounted to $313k, comprising payments of salaries, bonuses, and superannuation to executive directors of $270k and board fees to non-executive directors of $43k.

Race Oncology Ltd ABN 61 149 318 749 Registered office: L36, 1 Macquarie Place, Sydney NSW 2000 www.raceoncology.com Shareholders by holding range Race is pleased to share that shareholder numbers had increased to 9,420 on December 31, 2021, up from 9,198 on September 30, 2021, confirming continued new shareholder interest in Race’s progress.Post quarter news § On 18 January 2022, Race announced receiving its FY2021 R&D Tax refund of $708k, reflecting additional investment by Race in Australian R&D activities.

This support is an important source of non-dilutive capital and encouragement to maximise the use of Australia as a hub for research. § Post quarter, a new independent scientific publication was released in the journal Cells1, further confirming that Zantrene (bisantrene dihydrochloride) is a highly effective inhibitor of the Fat Mass and Obesity associated protein (FTO). The investigators at the University of Lille assessed the utility of Zantrene in Type 2 diabetes (T2D), a disease that is characterized by chronic high blood sugar and impaired pancreatic insulin secretion. The University of Lille team demonstrated that FTO plays a critical role in driving T2D and that inhibition of FTO by Zantrene at low concentration (100 nM); i.e. well below the level observed to cause toxicity in previous studies, increases the production of insulin by more than 20-fold from human and mouse diabetic pancreatic tissues. This third independent confirmation that Zantrene is able to target FTO2,3, this time in the pancreas, and reverse the impaired insulin secretion seen in Type 2 diabetes, is of major significance.

While further study is needed, it does emphasise the importance of FTO and m6 A dysregulation in human metabolic diseases beyond cancer.Expected news In the current quarter, shareholders can expect updates on the following activities: § Pre-clinical in vitro-updates on the progress of FTO-directed preclinical programs underway in melanoma, clear cell renal cell carcinoma and extramedullary AML. § Pre-clinical in vivo – mouse model studies are underway exploring the use of Zantrene in combination with anti-PD-1 in melanoma and in combination with decitabine for EMD AML, with results to be announced. § Clinical – Human ethics approval for EMD AML Phase 1b/2 trial. Subject to patient recruitment, an update on the AML R/R Israel trial progress, once the dose escalation phase (6-12 patients) is complete.

Management commentary Race CEO Phillip Lynch said: "The most recent quarter has been significant. We now have an entirely novel and large opportunity in cardio-protection, an evolved and strategic "Three Pillar" program and importantly the required capital and human resources to deliver against these opportunities. Thanks go to our shareholders, for their support and belief in our plans as reflected through their SPP participation" Race CSO Daniel Tillett said: "I would like to thank all the shareholders who participated in the SPP for their continued support of Race. We have been given an amazing opportunity with Zantrene, but it is one that can only be taken into the clinic with the support of our shareholders.

We are looking forward to updating our investors on the rapid progress we are making over 2022 and beyond. We are further encouraged by the newly released independent study showing Zantrene’s potential to inhibit FTO in Type 2 Diabetes. While this is not our primary area of focus, it is important in that it builds upon the original identification of Zantrene as a potent FTO inhibitor by Professor Chen and his team at the City of Hope Hospital (2020), which was later confirmed by Professor He’s team at the University of Chicago (2021).

" Race Chairman John Cullity said: "The exceptional work of our team and collaborators continues to unlock Zantrene’s potential. I’m particularly impressed by candidate clinical applications in the cardio-protection setting, which might recalibrate anthracycline therapeutics. On behalf of the Board, my particular thanks to our shareholders for supporting the recent SPP, and to Phil and Daniel for driving that process."

HER-Vaxx Immunotherapy Patent Granted in Europe

On January 28 2022 Imugene Limited (ASX:IMU) a clinical stage immuno-oncology company reported it has received a Notice of Grant from the European Patent Office for Patent Application number 16779340.5 (granted patent number 1111/3283105) which protects its HER-Vaxx immunotherapy, currently in development for HER-2 positive gastric cancer (Press release, Imugene, JAN 28, 2022, View Source [SID1234607524]).

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The patent titled "A VACCINE COMPOSITION AND USES THEREOF" protects the method of composition and method of use of Imugene’s HER-Vaxx immunotherapy to 2036.

Imugene’s M.D. & CEO, Ms Leslie Chong said, "Attaining the key European patent is an important milestone and is another major pharmaceutical market to grant patent protection for HER-Vaxx until 2036."

Imugene’s HER-Vaxx is a B-cell activating immunotherapy designed to treat tumours that over-express the HER-2/neu receptor, such as gastric, breast, ovarian, lung and pancreatic cancers. The immunotherapy is constructed from several B cell epitopes derived from the extracellular domain of HER-2/neu. It has been shown in pre-clinical studies, in Phase I and now Phase 2 studies to stimulate a potent polyclonal antibody response to HER-2/neu, a well-known and validated cancer target.

Clinical Trial Supply Agreement with Imugene and Roche to Evaluate PD1-Vaxx in Combination with an Immune Checkpoint Inhibitor for Treatment of Lung Cancer

On January 28, 2022 Imugene (ASX: IMU) reported a new clinical trial supply agreement with Roche to evaluate the safety and efficacy of Imugene’s PD1-Vaxx, a B-cell activating immunotherapy, in combination with atezolizumab (Tecentriq), an immune checkpoint inhibitor targeting PD-L1, in patients with non-small cell lung cancer (NSCLC) (Press release, Imugene, JAN 28, 2022, View Source [SID1234607523]).

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The objectives of the phase 1b trial, "An Open Label, Multi-Center, Dose Escalation/Expansion, Phase 1 Study of IMU-201 (PD1-Vaxx), a B-Cell Immunotherapy as monotherapy or in combination with atezolizumab, in Adults with Non-Small Cell Lung Cancer," are to determine safety, efficacy, and optimal dose of PD1-Vaxx in combination with atezolizumab as either first-line therapy in ICI treatmentnaïve NSCLC patients or ICI pretreated patients. The study will be conducted at sites in USA and Australia.

Dual targeting of the PD-1/PD-L1 axis is an area of considerable interest with ongoing clinical results providing treatment options for patients with cancer. Combination with PD1-Vaxx may overcome treatment resistance to ICIs with dual inhibition of the PD-1/PD-L1 axis extending the treatment benefit of atezolizumab. In contrast to combination of two monoclonal antibodies, PD1-Vaxx has the advantage that it induces a unique polyclonal immune response which may increase response rates for the combination therapy.

Tecentriq has previously shown clinically meaningful benefit in various types of lung cancer, with six currently approved indications in the US. In addition to becoming the first approved cancer immunotherapy for adjuvant NSCLC, Tecentriq was also the first approved cancer immunotherapy for front-line treatment of adults with extensive-stage small cell lung cancer (SCLC) in combination with carboplatin and etoposide (chemotherapy). Tecentriq also has four approved indications in advanced NSCLC as either a single agent or in combination with targeted therapies and/or chemotherapies.

"It’s an outstanding accomplishment to see Imugene collaborate with Roche, in combination with our PD1-Vaxx drug. PD1-Vaxx has shown a tolerable safety profile and encouraging efficacy in patients with NSCLC, and we are looking forward to evaluating PD1-Vaxx with atezolizumab in ICI treatment-naïve and pretreated NSCLC patients." said Leslie Chong, Managing Director & Chief Executive Officer of Imugene.

Imugene and Roche have entered into a supply agreement for a period of up to five years for the supply of atezolizumab. Imugene will be the sponsor of the study and will fund the clinical study from existing budgets and resources. Roche will supply atezolizumab for the duration of the study. In accordance with the terms of the supply agreement, all data generated in the performance of the study shall be the property of Imugene as the sponsor and all rights to all inventions and discoveries made or conceived in the course of the study relating to the combination of atezolizumab and PD1-Vaxx shall belong jointly to Roche and Imugene.

About NSCLC
Lung cancer is one of the leading causes of cancer death globally Each year 1.8 million people die as a
result of the disease; this translates into more than 4,900 deaths worldwide every day. Lung cancer
can be broadly divided into two major types: NSCLC and SCLC. NSCLC is the most prevalent type,
accounting for around 85% of all cases.