On January 10, 2021 Theseus Pharmaceuticals, Inc. (Theseus) (NASDAQ: THRX), a biopharmaceutical company focused on improving the lives of cancer patients through the discovery, development and commercialization of transformative targeted therapies, reported that the first patient has been treated in the Phase 1 portion of Theseus’ ongoing Phase 1/2 study to evaluate lead candidate, THE-630, in patients with advanced gastrointestinal stromal tumors (GIST) (Press release, Theseus Pharmaceuticals, JAN 10, 2022, View Source [SID1234598510]).

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THE-630 is a pan-variant inhibitor of the receptor tyrosine kinase KIT. It is designed for patients with advanced GIST whose cancer has developed resistance to earlier lines of therapy by accruing mutations that render those therapies ineffective. In GIST, these mutations occur most often in the KIT protein, where a patient can have multiple KIT mutations simultaneously, leading to complex disease heterogeneity. Pan-variant inhibitors like THE-630 are single therapeutic molecules designed to inhibit all known, clinically relevant mutations of a target protein to address the problem of disease heterogeneity that contributes to treatment resistance. In preclinical studies, THE-630 demonstrated potent in vitro and in vivo activity against all major classes of KIT activating and resistance mutations in GIST. Moreover, THE-630 achieved predicted pan-variant KIT inhibitory blood concentrations at tolerable doses and was associated with significant anti-tumor activity.

"Patients with unresectable or metastatic GIST who have exhausted standard therapies have limited treatment options and poor clinical outcomes. GIST disease progression remains largely KIT-dependent even after multiple lines of therapy, and a significant unmet need remains for these patients," said Suzanne George, M.D., Clinical Director, Center for Sarcoma and Bone Oncology at Dana-Farber Cancer Institute. "I am excited to work with Theseus on this first-in-human trial of THE-630, and I look forward to evaluating its clinical potential to address the needs of patients with advanced GIST."

"The initiation of our Phase 1/2 trial in patients with previously-treated advanced GIST is an important milestone as we begin to characterize THE-630 in the clinic," said David Kerstein, M.D., Chief Medical Officer at Theseus. "We believe THE-630 has a differentiated profile of pan-variant activity against KIT and we look forward to exploring a number of GIST settings where pan-variant inhibition may translate into meaningful clinical benefit–from the fifth-line, where no standard therapies exist, to earlier lines of therapy, such as the second-line, where current standard of care yields less than optimal outcomes."

About the Phase 1/2 study and clinical development plan

Study THE630-21-101 is a Phase 1/2 open label, multicenter, first-in-human dose-escalation and expansion study designed to evaluate the safety, pharmacokinetics, and anti-tumor activity of oral THE-630 (NCT Number: NCT05160168). The study is expected to be conducted in two parts: a dose escalation phase, followed by an expansion phase. The patient population of the initial dose escalation phase (Phase 1) of the trial will include patients with unresectable or metastatic GIST who had disease progression on or are intolerant to imatinib therapy and have also received at least one of the following: sunitinib, regorafenib, ripretinib, or avapritinib. The primary objective of the dose escalation phase is to determine the safety profile of THE-630, including the dose limiting toxicities, maximum tolerated dose, and the recommended Phase 2 dose.

Once a recommended dose has been determined in the escalation phase, the expansion phase (Phase 2) will enroll patients with unresectable or metastatic GIST into cohorts defined by prior therapy from a

second-line population to a fifth-line population. The primary objective of the expansion phase is to evaluate the anti-tumor activity of THE-630 in these GIST patient populations.

Data from the Phase 1/2 clinical trial is expected to inform further clinical development of THE-630 including the design of an initial registrational trial in fifth-line GIST, where there is currently no available therapy and therefore a significant unmet need. THE-630 is also expected to be evaluated in second-line GIST, where a pan-KIT inhibitor with activity against all major classes of activating, or cancer-causing, and resistance mutations has the potential to deliver meaningful clinical benefit over the current standard of care.

Initial data from the Phase 1 portion of the clinical trial is expected to be presented at a scientific meeting in the first half of 2023.

About GIST

GIST is the most common sarcoma of the gastrointestinal tract with an estimated 4,000 to 6,000 new cases diagnosed in the United States each year. Approximately eighty percent of GIST cases are driven by mutations that activate the kinase activity of the receptor tyrosine kinase KIT, and up to ninety percent of all relapse cases are driven by secondary resistance mutations in KIT.

On January 10, 2021 BioCryst Pharmaceuticals, Inc. (Nasdaq:BCRX) reported preliminary, unaudited ORLADEYO (berotralstat) revenue for the fourth quarter and full year 2021 and provided new guidance for full year 2022 ORLADEYO net revenue and expected peak ORLADEYO sales (Press release, BioCryst Pharmaceuticals, JAN 10, 2022, View Source [SID1234598509]).

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"Following 12 months of a successful launch through a global pandemic, we have a clear picture of the continued commercial trajectory for ORLADEYO based on a very attractive product profile, leading to strong patient demand to switch from injectable therapies to our oral, once-daily medicine, with 70 percent patient retention through the first year. Building on our substantial 2021 patient base, we are confident that ORLADEYO will achieve no less than $250 million of net revenue in 2022 and that ORLADEYO will become the market leader as the most prescribed prophylactic therapy with peak sales of $1 billion," said Jon Stonehouse, president and chief executive officer of BioCryst.

Fourth Quarter 2021 (Q4 2021) ORLADEYO Launch Dynamics

Preliminary, unaudited ORLADEYO net revenue in Q4 2021 was $45.6 million. Preliminary, unaudited ORLADEYO net revenue for full year 2021 (FY 2021) was $122 million.

New patient demand for ORLADEYO remains strong and consistent, with a similar number of new patients added in Q4 2021 as in each of the previous three quarters of the year. Patients switching from other prophylactic therapies and acute-only therapy continue to drive the launch. More than half of patients new to ORLADEYO since launch had a previous prophylactic medicine prior to ORLADEYO and most of the remainder were from acute-only treatment.

Most patients are well-controlled on ORLADEYO and remain on therapy. Approximately 70 percent of patients starting ORLADEYO, including those switching from injectable prophylaxis, remain on ORLADEYO in the first year.

ORLADEYO is now covered by all major payors and national and regional pharmacy benefit managers, which will lead to more patients being reimbursed quickly.

The ORLADEYO prescriber base continues to grow significantly. The number of new physicians prescribing ORLADEYO in Q4 2021 was similar to the number added in Q3 2021. In market research, 60 U.S. physicians, who treat an average of seven HAE patients each, reported that they expect to double their use of ORLADEYO, and that ORLADEYO will become their most prescribed prophylactic treatment in the next 12 months.
"We expect ORLADEYO revenues in 2022 to more than double in our second year of launch as we benefit from a full year of reimbursement and continued strong demand from patients and physicians. ORLADEYO is transforming the lives of HAE patients, which is why ORLADEYO is on a trajectory to become the market leader in HAE prophylaxis," said Charlie Gayer, chief commercial officer of BioCryst.

Pipeline Update: BCX9930 Pivotal Trials in PNH Now Enrolling

BioCryst is currently enrolling patients in two global pivotal trials, REDEEM-1 and REDEEM-2, with the company’s oral Factor D inhibitor, BCX9930 (500 mg bid), in patients with paroxysmal nocturnal hemoglobinuria (PNH). The company also has begun screening patients in a proof of concept (PoC) basket trial of BCX9930 (500 mg bid) in patients with C3 glomerulopathy (C3G), IgA nephropathy (IgAN) and primary membranous nephropathy (PMN).

BioCryst plans to further advance and expand its Factor D program over the next two years by achieving the following:

Complete and report data from REDEEM-1 and REDEEM-2
Prepare to submit regulatory approval filings in PNH
Complete the renal PoC basket trial and advance to pivotal trials in C3G, IgAN and PMN
Commence PoC trials in other complement-mediated diseases
"Following the discovery, development and commercialization of ORLADEYO, the BioCryst team plans to repeat this success as we leverage our platform to bring new oral medicines to patients suffering from other rare diseases. BCX9930 is especially exciting because the clinical data we have reported so far provides confidence that we can help patients in PNH, and across many complement-mediated diseases, with this pipeline in a molecule," said Dr. Helen Thackray, chief research and development officer of BioCryst.

Presentation Today at 40th Annual J.P. Morgan Healthcare Conference

Today at 9:45 a.m. ET, the company will present at the 40th Annual J.P. Morgan Healthcare Conference, which is being conducted as a virtual event. Links to a live audio webcast and replay of the presentation may be accessed in the Investors section of BioCryst’s website at https://www.biocryst.com/.

About ORLADEYO (berotralstat)
ORLADEYO (berotralstat) is the first and only oral therapy designed specifically to prevent attacks of hereditary angioedema (HAE) in adult and pediatric patients 12 years and older. One capsule of ORLADEYO per day works to prevent HAE attacks by decreasing the activity of plasma kallikrein.

U.S. Indication and Important Safety Information

INDICATION
ORLADEYO (berotralstat) is a plasma kallikrein inhibitor indicated for prophylaxis to prevent attacks of hereditary angioedema (HAE) in adults and pediatric patients 12 years and older.

Limitations of use
The safety and effectiveness of ORLADEYO for the treatment of acute HAE attacks have not been established. ORLADEYO should not be used for the treatment of acute HAE attacks. Additional doses or dosages of ORLADEYO higher than 150 mg once daily are not recommended due to the potential for QT prolongation.

IMPORTANT SAFETY INFORMATION
An increase in QT prolongation was observed at dosages higher than the recommended 150 mg once-daily dosage and was concentration dependent.

The most common adverse reactions (≥10 percent and higher than placebo) in patients receiving ORLADEYO were abdominal pain, vomiting, diarrhea, back pain, and gastroesophageal reflux disease.

A reduced dosage of 110 mg taken orally once daily with food is recommended in patients with moderate or severe hepatic impairment (Child-Pugh B or C) and in patients taking chronically administered P-glycoprotein (P-gp) or breast cancer resistance protein (BCRP) inhibitors (eg, cyclosporine).

Berotralstat is a substrate of P-gp and BCRP. P-gp inducers (eg, rifampin, St. John’s wort) may decrease berotralstat plasma concentration, leading to reduced efficacy of ORLADEYO. The use of P-gp inducers is not recommended with ORLADEYO.

ORLADEYO at a dose of 150 mg is a moderate inhibitor of CYP2D6 and CYP3A4. For concomitant medications with a narrow therapeutic index that are predominantly metabolized by CYP2D6 or CYP3A4, appropriate monitoring and dose titration is recommended. ORLADEYO at a dose of 300 mg is a P-gp inhibitor. Appropriate monitoring and dose titration is recommended for P-gp substrates (eg, digoxin) when coadministering with ORLADEYO.

The safety and effectiveness of ORLADEYO in pediatric patients <12 years of age have not been established.

There are insufficient data available to inform drug-related risks with ORLADEYO use in pregnancy. There are no data on the presence of berotralstat in human milk, its effects on the breastfed infant, or its effects on milk production.

On January 10, 2022 Black Diamond Therapeutics, Inc. (Nasdaq: BDTX), a precision oncology medicine company pioneering the discovery and development of MasterKey therapies, reported a strategic pipeline update and outlined its expected upcoming milestones (Press release, Black Diamond Therapeutics, JAN 10, 2022, View Source [SID1234598508]).

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"MasterKey inhibitors target mutation families and are designed to address the unmet medical need of cancer patients with genetically defined cancers for whom precision therapies are not available," said David Epstein, Ph.D., Chief Executive Officer of Black Diamond Therapeutics. "We are incredibly pleased to have submitted the IND ahead of schedule for BDTX-1535, a next generation CNS penetrant MasterKey inhibitor designed to target EGFR driver mutations found in certain patients with GBM and NSCLC. The oncogenic alterations of EGFR, particularly those associated with GBM, result in distinct conformations which impart unique pharmacology and drug resistance. BDTX-1535 is designed to exploit this mechanism as a critical point of attack. We believe Black Diamond is uniquely positioned to deliver a pipeline of truly differentiated MasterKey programs as we leverage our expertise in cancer genomics, onco-protein function and drug discovery."

"As a result of the rapid evolution of the treatment landscape in NSCLC harboring EGFR or HER2 Exon 20 insertion mutations, we have decided to obtain further clinical data from the BDTX-189 safety expansion cohort at the recommended Phase 2 dose in 2022 in order to inform the future development of our BDTX-189 program, gating the start of a Phase 2 trial. The revised strategy enables near-term prioritization of BDTX-1535 clinical development and further investment in our pipeline, while allowing us to obtain more clinical data on BDTX-189, and simultaneously extends our cash runway into 2024."

Pipeline Updates and Expected Milestones:
BDTX-1535

Black Diamond announced ahead of schedule the submission of its Investigational New Drug (IND) application to the US Food and Drug Administration (FDA) for BDTX-1535 and expects to initiate the Phase 1 study of BDTX-1535 in the first quarter of 2022, subject to allowance of the IND by the FDA.
BDTX-1535 is designed as a potent, selective, brain-penetrant and irreversible MasterKey inhibitor of epidermal growth factor receptor (EGFR) mutations expressed in glioblastoma multiforme (GBM) and of intrinsic and acquired resistance EGFR mutations to third generation EGFR inhibitors in NSCLC.
In pre-clinical studies, Black Diamond has demonstrated that oncogenic alterations of EGFR, particularly those associated with GBM, result in distinct conformations which impart unique pharmacology and drug resistance. BDTX-1535 is designed to exploit this mechanism and has demonstrated anti-cancer activity and growth regressions across a panel of patient-derived xenograft models including intracranial tumor models.
It is estimated that approximately 50% of GBM patients harbor an oncogenic EGFR alteration that has the potential to be addressed by BDTX-1535, representing a potential patient population of greater than 60,000 patients annually across the US, EU, Japan and China.
It is estimated that across the US, EU, Japan and China there are approximately 20,000 patients who are diagnosed annually with non-small cell lung cancer (NSCLC) harboring an EGFR intrinsic or acquired resistance mutation.
The Company expects to provide a clinical data update on BDTX-1535 in the second half of 2023.
BDTX-189

BDTX-189 is designed as a MasterKey inhibitor targeting families of oncogenic mutations in EGFR and HER2.
Clinical data obtained from the MasterKey-01 study to date have demonstrated a favorable safety profile for BDTX-189 and early signs of clinical activity in patients whose tumors are driven by MasterKey mutation families, including two confirmed partial responses in heavily pretreated patients who have remained on treatment for more than 10 months.
Due to the rapid evolution of the treatment landscape in NSCLC harboring either EGFR or HER2 Exon 20 insertion mutations, the Company has decided to gate the initiation of the Phase 2 portion of the MasterKey-01 study and determine next steps in development based on further clinical data obtained from the safety expansion cohort at the recommended Phase 2 dose.
The Company expects to provide further guidance on the BDTX-189 program in 2022.
BRAF Program

Black Diamond is developing a CNS-penetrant BRAF inhibitor against a family of Class I, II, III canonical and non-canonical mutations. The Company’s lead BRAF compound is designed to be highly selective, potent and to avoid paradoxical activation.
In cell-based assays, Black Diamond’s lead BRAF compound demonstrated potent inhibition of a wide spectrum of BRAF mutations and fusions and exhibited dose-dependent inhibition of protein kinase RNA-like endoplasmic reticulum kinase downstream signaling.
In preclinical BRAF-driven tumor models, daily dosing of the lead compound demonstrated dose-dependent tumor growth inhibition, tumor regression and survival consistent with potent on-target and on-pathway inhibition.
The Company’s lead BRAF compound demonstrated robust brain penetration properties and achieved intracranial tumor growth inhibition in pre-clinical studies.
It is estimated that across the US, EU, and Japan there are approximately 190,000 patients with solid tumors who are diagnosed annually with BRAF oncogenic mutations.
Black Diamond anticipates the initiation of IND-enabling studies for the BRAF program in 2022.
MAP Discovery Engine

The Company continues to focus on building its Mutation-Allostery-Pharmacology (MAP) Discovery Engine to exploit mutant onco-protein conformations for the delivery of selective MasterKey therapies, with a focus on developing a MasterKey inhibitor that spares wild type fibroblast growth factor receptor 1 ( FGFR1) while inhibiting FGFR2 and FGFR3 mutant families, as well as other preclinical stage programs.
The Company plans to integrate new molecular dynamic modeling tools from its strategic partnership with OpenEye Scientific.
Financial Guidance

Black Diamond ended 2021 with approximately $210 million in cash, cash equivalents and investments, which the Company believes is sufficient to fund its anticipated operating expenses and capital expenditure requirements into 2024.

On January 10, 2022 Karyopharm Therapeutics Inc. (Nasdaq: KPTI), a commercial-stage pharmaceutical company pioneering novel cancer therapies, reported preliminary unaudited fourth quarter and full year 2021 net product revenue estimates for XPOVIO, the Company’s first-in-class, oral XPO1 inhibitor, and outlined its 2021 achievements and 2022 objectives (Press release, Karyopharm, JAN 10, 2022, View Source [SID1234598507]).

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Based on preliminary unaudited financial information, Karyopharm expects net product revenues of XPOVIO to be approximately $29.7 million for the fourth quarter and approximately $98.3 million for the full year 2021.

"For 2022, we are focused on making significant advances across our pipeline, beginning with top-line results from the Phase 3 SIENDO study evaluating selinexor as a maintenance therapy following front-line chemotherapy in patients with advanced or metastatic endometrial cancer, which remain on track to be reported this quarter," said Richard Paulson, President and Chief Executive Officer of Karyopharm. "Building on the strong revenue growth in the second half of 2021, we will continue to prioritize driving sales and the adoption of XPOVIO in multiple myeloma. I am extremely pleased with the continued progress of our pipeline in key additional indications of multiple myeloma, myelodysplastic syndromes and myelofibrosis and our ability to further expand our impact on patients globally with our recent partnership with Menarini."

Key Program Achievements in 2021

Selinexor in Multiple Myeloma

Launched XPOVIO in the U.S. in second line multiple myeloma and strengthened the commercial team, resulting in continued strong net product revenue growth.
Generated compelling clinical data supporting selinexor’s efficacy, durability and tolerability when combined with the approved agents Velcade (bortezomib), Pomalyst (pomalidomide) or Kyprolis (carfilzomib) in patients who have been previously exposed to anti-CD38 monoclonal antibody treatment, where there is a substantial unmet need for a new class of therapy. These results were reported at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) 2021 Annual Meeting, the European Hematology Association (EHA) (Free EHA Whitepaper) 2021 Annual Meeting and at the American Society of Hematology (ASH) (Free ASH Whitepaper) 2021 Annual Meeting.
Multiple XPOVIO-based regimens are listed on the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) for the treatment of second and later line multiple myeloma, including selinexor, pomalidomide and dexamethasone (SPd), which is an all-oral regimen, selinexor, daratumumab and dexamethasone (SDd), and selinexor, carfilzomib and dexamethasone (SKd).
The European Commission (EC) and the United Kingdom’s Medicines & Healthcare Products Regulatory Agency (MHRA) both granted conditional marketing authorization for NEXPOVIO (selinexor) for the treatment of relapsed or refractory multiple myeloma in patients who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, two immunomodulatory agents, and an anti-CD38 monoclonal antibody, and who have demonstrated disease progression on the last therapy.
Karyopharm’s Marketing Authorization Application (MAA) for NEXPOVIO in combination with Velcade (bortezomib) and low-dose dexamethasone for the treatment of multiple myeloma following at least one prior therapy has been validated by the European Medicines Agency (EMA) and is currently under review by the Committee for Medicinal Products for Human Use (CHMP).
Karyopharm’s global partners Antengene and Promedico, a member of the Neopharm Group, obtained approvals and conditional approvals for XPOVIO in multiple new geographies and indications, including in China, South Korea and Israel in penta-refractory multiple myeloma and relapsed and refractory diffuse large B-cell lymphoma (DLBCL).
Earned $10.0 million in milestone payments from Antengene in the third quarter of 2021 following the July 2021 approval of selinexor in South Korea for the treatment of patients with multiple myeloma and DLBCL.
Selinexor in Endometrial Cancer

Completed recruitment in the Phase 3 SIENDO study evaluating the efficacy and safety for front-line maintenance therapy with selinexor in patients with advanced or recurrent endometrial cancer.
Eltanexor in Myelodysplastic Syndromes (MDS)

Reported positive data from an investigator-sponsored Phase 1 study evaluating single-agent eltanexor in patients with hypomethylating agent (HMA)-refractory MDS, where eltanexor demonstrated a 53% overall response rate and median overall survival of 9.9 months. This compares favorably to historical survival of four to six months for HMA-refractory MDS patients.
Commenced dosing in a company-sponsored Phase 2 study evaluating single-agent eltanexor in patients with intermediate or high-risk HMA-refractory MDS.
Selinexor in Myelofibrosis (MF)

Reported positive data from an investigator-sponsored Phase 2 study evaluating single-agent selinexor in patients with MF previously treated with JAK inhibition. In this study, 40% of patients who received at least 24 weeks of selinexor treatment achieved a response, defined as ≥35% spleen volume reduction. Responses were durable with a median treatment duration of 11 months.
Commenced dosing in a company-sponsored Phase 2 study evaluating single-agent selinexor versus physician’s choice in patients with MF previously treated with a JAK 1/2 inhibitor.
Commenced dosing in a company-sponsored Phase 1/2 study evaluating selinexor in combination with Jakafi (ruxolitinib) in patients with treatment-naïve MF.
Corporate and Financial Highlights

Entered into an exclusive license agreement with Menarini Group to commercialize NEXPOVIO in Europe, Latin America and other key global territories; received $75 million upfront and eligible to receive up to $202.5 million in future milestones, plus tiered, double-digit royalties on net sales.
Received $60 million in expanded royalty agreement with entities managed by HealthCare Royalty Management, LLC, with up to another $40 million in potential financing available.
Anticipated 2022 Catalysts and Operational Objectives

Leverage commercial capabilities and increase U.S. XPOVIO sales in 2022.
Report top-line data from Phase 3 SIENDO study evaluating selinexor as a maintenance therapy in endometrial cancer in 1Q 2022.
If SIENDO data are positive, submit supplemental New Drug Application for selinexor in endometrial cancer to the U.S. Food & Drug Administration in 1H 2022.
Dose first patient in Phase 3 study evaluating selinexor, pomalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma in 1Q 2022.
EMA decision expected in second-line multiple myeloma based on BOSTON study results in 1H 2022.
Realize further milestones and royalties from approvals and sales in ex-US territories in 2022.
The financial information presented in this press release may be adjusted as a result of the completion of customary quarterly and annual review and audit procedures.

Listen to the Webcast

These achievements and updates will be discussed during a webcast presentation at the 40th Annual J.P. Morgan Healthcare Conference to be held on Tuesday, January 11, 2022, at 3:45 p.m. ET, followed by a question-and-answer breakout session at 4:05 p.m. ET. A live webcast of the presentation and breakout session, along with accompanying slides, can be accessed under "Events & Presentations" in the Investor section of the Company’s website, View Source An archived replay will be available for 30 days following the event. The presentation slides will also be available on the Company’s website following the event.

About XPOVIO (selinexor)

XPOVIO is a first-in-class, oral exportin 1 (XPO1) inhibitor and the first of Karyopharm’s Selective Inhibitor of Nuclear Export (SINE) compounds to be approved for the treatment of cancer. XPOVIO functions by selectively binding to and inhibiting the nuclear export protein XPO1. XPOVIO is approved in the U.S. and marketed by Karyopharm in multiple oncology indications, including: (i) in combination with Velcade (bortezomib) and dexamethasone (XVd) in patients with multiple myeloma after at least one prior therapy; (ii) in combination with dexamethasone in patients with heavily pre-treated multiple myeloma; and (iii) in patients with diffuse large B-cell lymphoma (DLBCL), including DLBCL arising from follicular lymphoma, after at least two lines of systemic therapy. XPOVIO (also known as NEXPOVIO in certain countries) has received regulatory approvals in a growing number of ex-U.S. territories and countries, including Europe, the United Kingdom, China, South Korea and Israel, and is marketed in those areas by Karyopharm’s global partners. Selinexor is also being investigated in several other mid- and late-stage clinical trials across multiple high unmet need cancer indications, including in endometrial cancer, myelodysplastic syndromes and myelofibrosis.

For more information about Karyopharm’s products or clinical trials, please contact the Medical Information department at:

Tel: +1 (888) 209-9326
Email: [email protected]

XPOVIO (selinexor) is a prescription medicine approved:

In combination with bortezomib and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy (XVd).
In combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti–CD38 monoclonal antibody (Xd).
For the treatment of adult patients with relapsed or refractory diffuse large B–cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least 2 lines of systemic therapy. This indication is approved under accelerated approval based on response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trial(s).
SELECT IMPORTANT SAFETY INFORMATION

Warnings and Precautions

Thrombocytopenia: Monitor platelet counts throughout treatment. Manage with dose interruption and/or reduction and supportive care.
Neutropenia: Monitor neutrophil counts throughout treatment. Manage with dose interruption and/or reduction and granulocyte colony–stimulating factors.
Gastrointestinal Toxicity: Nausea, vomiting, diarrhea, anorexia, and weight loss may occur. Provide antiemetic prophylaxis. Manage with dose interruption and/or reduction, antiemetics, and supportive care.
Hyponatremia: Monitor serum sodium levels throughout treatment. Correct for concurrent hyperglycemia and high serum paraprotein levels. Manage with dose interruption, reduction, or discontinuation, and supportive care.
Serious Infection: Monitor for infection and treat promptly.
Neurological Toxicity: Advise patients to refrain from driving and engaging in hazardous occupations or activities until neurological toxicity resolves. Optimize hydration status and concomitant medications to avoid dizziness or mental status changes.
Embryo–Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential and males with a female partner of reproductive potential, of the potential risk to a fetus and use of effective contraception.
Cataract: Cataracts may develop or progress. Treatment of cataracts usually requires surgical removal of the cataract.
Adverse Reactions

The most common adverse reactions (≥20%) in patients with multiple myeloma who receive XVd are fatigue, nausea, decreased appetite, diarrhea, peripheral neuropathy, upper respiratory tract infection, decreased weight, cataract and vomiting. Grade 3–4 laboratory abnormalities (≥10%) are thrombocytopenia, lymphopenia, hypophosphatemia, anemia, hyponatremia and neutropenia. In the BOSTON trial, fatal adverse reactions occurred in 6% of patients within 30 days of last treatment. Serious adverse reactions occurred in 52% of patients. Treatment discontinuation rate due to adverse reactions was 19%.
The most common adverse reactions (≥20%) in patients with multiple myeloma who receive Xd are thrombocytopenia, fatigue, nausea, anemia, decreased appetite, decreased weight, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea and upper respiratory tract infection. In the STORM trial, fatal adverse reactions occurred in 9% of patients. Serious adverse reactions occurred in 58% of patients. Treatment discontinuation rate due to adverse reactions was 27%.
The most common adverse reactions (incidence ≥20%) in patients with DLBCL, excluding laboratory abnormalities, are fatigue, nausea, diarrhea, appetite decrease, weight decrease, constipation, vomiting, and pyrexia. Grade 3–4 laboratory abnormalities (≥15%) are thrombocytopenia, lymphopenia, neutropenia, anemia, and hyponatremia. In the SADAL trial, fatal adverse reactions occurred in 3.7% of patients within 30 days, and 5% of patients within 60 days of last treatment; the most frequent fatal adverse reactions was infection (4.5% of patients). Serious adverse reactions occurred in 46% of patients; the most frequent serious adverse reaction was infection (21% of patients). Discontinuation due to adverse reactions occurred in 17% of patients.

On January 10, 2022 Selecta Biosciences, Inc. (Nasdaq: SELB), a biotechnology company leveraging its clinically validated ImmTOR platform to develop tolerogenic therapies that selectively mitigate unwanted immune responses, and Ginkgo Bioworks (NYSE: DNA), the leading horizontal platform for cell programming, reported a collaboration to develop safer and more effective next-generation gene therapy viral capsids (Press release, Selecta Biosciences, JAN 10, 2022, View Source [SID1234598506]). This partnership leverages the unique platforms of both companies as they seek to develop next-generation viral capsids with improved transduction, enhanced tissue tropism and reduced immunogenicity. Ginkgo plans to design and engineer the capsids and Selecta will conduct all pre-clinical and clinical studies thereafter.

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"We are excited to continue our partnership with Ginkgo in a second collaboration that leverages Ginkgo’s leading cell engineering platform to design viral vector capsids with the goal of improved transduction, enhanced tissue tropism and reduced immunogenicity," said Carsten Brunn, CEO of Selecta Biosciences. "By combining ImmTOR with next-generation, fit-for-purpose AAV vectors, we hope to further improve the safety and efficacy of AAV-mediated gene therapies."

Jason Kelly, CEO of Ginkgo Bioworks, added, "Gene therapies utilize naturally occurring viral capsids that elicit immune responses and often exhibit safety and toxicity issues. We believe our collaboration with Selecta has the potential to confront major challenges within the gene therapy space and represents an important application of our cell programming platform. We look forward to executing on our shared vision and offering a potential solution for challenges in gene therapies in order to enable treatment for millions of patients."

Under the terms of the collaboration, Ginkgo is eligible to earn upfront research and development fees and milestone payments, including certain milestone payments in the form of Selecta common stock. In addition, Ginkgo is eligible to earn clinical, regulatory and commercial milestone payments of up to $200 million in cash for each of a specified number of products, which have the potential to total, in the aggregate, up to $1.1 billion. Ginkgo is also entitled to potential further downstream value in the form of royalties on sales.