On August 8, 2023 Fusion Pharmaceuticals Inc. (Nasdaq: FUSN), a clinical-stage oncology company focused on developing next-generation radiopharmaceuticals as precision medicines, reported financial results for the second quarter ended June 30, 2023 and provided an update on clinical and corporate developments (Press release, Fusion Pharmaceuticals, AUG 8, 2023, View Source [SID1234633969]).
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Chief Executive Officer John Valliant, Ph.D. commented, "In the second quarter, we achieved progress across our clinical pipeline of targeted alpha therapies (TATs). Patient enrollment is ongoing for the Phase 2 clinical trial of FPI-2265, a small molecule-based TAT targeting prostate specific membrane antigen (PSMA) for the treatment of metastatic castration-resistant prostate cancer (mCRPC), and we are on track to report data in the first quarter of 2024. Patient enrollment is also ongoing in the Phase 1 study of FPI-2059 targeting neurotensin receptor 1 (NTSR1). Additionally, the U.S. Food and Drug Administration (FDA) cleared the Investigational New Drug (IND) application for FPI-2068, a bispecific TAT jointly developed with AstraZeneca for the treatment of various solid tumors that express EGFR-cMET.
Dr. Valliant continued, "We are encouraged by the interim safety, dosimetry and PK data from the dose escalation portion of the Phase 1 trial of FPI-1434 in patients with solid tumors expressing IGF-1R presented at the Society for Nuclear Medicine and Molecular Imaging (SNMMI) Annual Meeting in June. These data showed pre-administration of cold antibody has the potential to significantly enhance the therapeutic index by driving more active drug to tumor sites with an improved safety profile compared to hot-only dosing, reinforcing our belief that targeted alpha therapies (TATs) could be next generation antibody drug conjugates (ADCs) for a broad array of tumor types in areas of high unmet medical need. We are evaluating the cold/hot regimen at the next dose level in Cohort 2 and look forward to sharing data around the end of this year."
Portfolio Update
FPI-2265
In February 2023, Fusion acquired an investigational new drug application (IND) for an ongoing Phase 2 clinical trial (the "TATCIST" trial) evaluating 225Ac-PSMA I&T, a small molecule targeting PSMA expressed in prostate cancers. Following completion of the acquisition from RadioMedix, the IND was transferred to Fusion. The alpha-emitting radiopharmaceutical being evaluated in the TATCIST trial is now known as FPI-2265.
The TATCIST trial is designed to evaluate patients with mCRPC with progressive disease, including patients who are naïve to PSMA-targeted radiopharmaceuticals and those who have been pre-treated with 177Lu-based PSMA radiopharmaceuticals such as PLUVICTO. Fusion expects to report data on approximately 20 to 30 patients in the first quarter of 2024.
FPI-1434
The Phase 1, multi-center, open-label clinical trial is designed to investigate the safety, tolerability and pharmacokinetics of FPI-1434 in patients with solid tumors expressing IGF-1R. The trial is also designed to establish the maximum tolerated dose for FPI-1434 and the recommended Phase 2 dose. As part of the precision medicine approach, prior to receiving the therapeutic injection of FPI-1434, patients are administered an indium-111 imaging analogue, [111In]-FPI-1547 (FPI-1547). The images collected are used to confirm the presence of tumor uptake and ensure that estimated radiation doses to organs and tissues are below protocol-specified safety limits.
Following results from an imaging sub-study evaluating pre-administration of cold antibody prior to each dose of FPI-1547 that demonstrated a favorable gain in tumor lesion uptake versus normal tissue, the Company amended the Phase 1 trial protocol to evaluate both the hot only and cold/hot dosing regimens. Interim Phase 1 data were presented at the SNMMI Annual Meeting in June 2023. Three patients were dosed in Cohort 1 at a dose of 15 kBq/kg following pre-administration of cold antibody. In this first cohort, cold/hot dosing was observed to be safe with no treatment-related serious adverse events (SAEs) or dose limiting toxicities (DLTs). Results demonstrated pre-administration of cold antibody improved tumor uptake while also reducing hematological toxicity observed in the hot only dosing arm, potentially enhancing the therapeutic index. When normalized to 15 kBq/kg, the average lesion absorbed dose and dose/volume in the cold/hot arm were nearly double the level compared to hot only. Further, the 15 kBq/kg cold/hot dosing arm showed comparable systemic exposure to approximately 40 kBq/kg of a hot only dose but with an improved hematological profile as measured by changes in platelet count. Based on these results, Fusion has discontinued the hot-only dosing portion of the study and is currently enrolling Cohort 2 in the cold/hot dosing regimen at 25 kBq/kg. The Company expects to report data from this cohort around year-end 2023.
FPI-2059
The Phase 1, multi-center, open-label clinical trial is designed to investigate the safety, tolerability, dosimetry, biodistribution, and pharmacokinetics of FPI-2059 as well as preliminary anti-tumor activity in participants with NTSR1 expressing advanced metastatic solid tumors. Patient enrollment and dosing are ongoing. Fusion plans to provide guidance on timing for pharmacokinetic, imaging and safety data following early experience with FPI-2059 patient screening and enrollment.
FPI-2068
In April 2023, Fusion announced FDA clearance of IND applications for [225Ac]-FPI-2068 (FPI-2068) and corresponding imaging analogue [111In]-FPI-2107 (FPI-2107). Fusion is jointly developing FPI-2068 with AstraZeneca under the companies’ multi-asset collaboration agreement. FPI-2068 is a bispecific TAT designed to deliver actinium-225 to various solid tumors that express EGFR-cMET. EGFR and cMET are both validated targets that are co-expressed in multiple tumor types, including head and neck squamous cell carcinoma, non-small cell lung cancer, colorectal cancer, and pancreatic ductal adenocarcinoma. Fusion plans to provide additional guidance on timelines for the FPI-2068 program following initial experience with patient screening to better predict the cadence of patient enrollment.
Recent News
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In June, Fusion presented at SNMMI interim data from the Phase 1 Trial of FPI-1434 in patients with solid tumors expressing IGF-1R.
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In May, Fusion announced the opening of its state-of-the-art radiopharmaceutical manufacturing facility. The 27,000 square foot good manufacturing practice (GMP) compliant facility, which is located adjacent to the Company’s research and development labs, has clinical and commercial manufacturing scale capabilities designed to support the Company’s growing pipeline of targeted alpha therapies (TATs). The facility is expected to be fully operational in 2024.
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In April, Fusion announced the clearance of IND applications for FPI-2068 and corresponding imaging analogue FPI-2107 to the FDA.
Second Quarter 2023 Financial Results
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Cash and Investments: As of June 30, 2023, Fusion held cash, cash equivalents and investments of $226.5 million, compared to cash, cash equivalents and investments of $186.6 million as of December 31, 2022. Fusion expects its existing cash, cash equivalents and investments as of June 30, 2023 will be sufficient to fund operations into the second quarter of 2025.
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Collaboration Revenue: For the second quarter of 2023, Fusion recorded less than $0.1 million of revenue under the AstraZeneca collaboration agreement, compared to $0.6 million for the same period in 2022.
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R&D Expenses: Research and development expenses for the second quarter of 2023 were $19.0 million, compared to $12.1 million for the same period in 2022. The increase was primarily due to costs associated with the Phase 2 clinical trial of FPI-2265, as well as the wind down of FPI-1966 program-related activities and study close out costs, and an increase in personnel-related costs.
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G&A Expenses: General and administrative expenses for the second quarter of 2023 and 2022 each were $7.8 million.
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Net Loss: For the second quarter of 2023, Fusion reported a net loss of $25.2 million, or $0.38 per share, compared with a net loss of $19.1 million, or $0.44 per share, for the same period in 2022.