Viracta Therapeutics Announces First Clinical Response in Epstein-Barr Virus-Positive (EBV+) Solid Tumor Setting and Outlines Key 2023 Clinical Objectives

On January 8, 2023 Viracta Therapeutics, Inc. (Nasdaq: VIRX), a precision oncology company focused on the treatment and prevention of virus-associated cancers that impact patients worldwide, reported its new clinical data from the Phase 1b/2 trial of Nana-val in patients with EBV+ R/M NPC and other EBV+ solid tumors and outlined its key 2023 clinical objectives (Press release, Viracta Therapeutics, JAN 8, 2023, View Source [SID1234626117]).

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"We begin 2023 with important new data from our advanced EBV-positive solid tumor trial. A partial response at this point in the dose escalation phase is highly encouraging, particularly given the safety data to-date and the lack of dose-limiting toxicities in the first three dose levels. We are now enrolling patients into the trial’s fourth dose level, with a further update expected after the completion of the dose escalation portion of the study," said Mark Rothera, President and Chief Executive Officer of Viracta. "Combined with our Phase 1b/2 results in lymphoma, these early data in recurrent or metastatic nasopharyngeal carcinoma support our ambition to develop Nana-val as a tumor-agnostic therapy for EBV-associated cancers, particularly in indications of high unmet medical need. Seeing our first clinical response outside of lymphoma gives us confidence as we work toward our 2023 objectives in solid tumors, which include establishing a recommended Phase 2 dose and exploring Nana-val in additional EBV-positive solid tumor indications. We believe our team, clinical strategy and strong balance sheet leave us well positioned to advance Nana-val’s development through multiple milestones in both the lymphoma and solid tumor settings in 2023 and beyond."

New Phase 1b data on Nana-val in patients with EBV+ R/M NPC

One PR and one disease progression were reported in evaluable patients in the third dose level
Preliminary safety data from the first three dose levels was previously presented at the European Society for Medical Oncology Immuno-Oncology Congress (ESMO-IO) in December 2022, showing Nana-val was well-tolerated with no dose limiting toxicities
Enrollment in the fourth dose level is ongoing
Key 2023 Clinical Objectives

Nana-val in patients with EBV+ R/R lymphoma

Pivotal NAVAL-1 study open for enrollment at more than 60 sites globally; the study footprint is expected to expand further in 2023
Anticipate providing an update on NAVAL-1’s first lymphoma subtype that may advance from Stage 1 to Stage 2 in the first half of 2023
Expect to provide additional updates from other lymphoma subtype(s) throughout 2023
Nana-val in patients with advanced EBV+ solid tumors

Anticipate completion of the Phase 1b dose escalation portion of the trial and selection of the recommended Phase 2 dose (RP2D) in 2023
Anticipate initiating the Phase 2 randomized expansion portion of the trial, designed to evaluate Nana-val at the RP2D with or without pembrolizumab in patients with EBV+ R/M NPC, in the second half of 2023
Anticipate initiating the exploratory Phase 1b cohort designed to evaluate Nana-val at the RP2D in other EBV+ solid tumors in the second half of 2023

Cash Position and Anticipated Runway

Viracta strengthened its balance sheet by exercising its option to draw the $20 million tranche from its non-dilutive $50 million credit facility with Silicon Valley Bank (SVB) and Oxford Finance LLC (Oxford). Viracta intends to use this additional capital to support Nana-val’s development in EBV+ R/M NPC and to explore its potential in other advanced EBV+ solid tumor indications. As a result, Viracta ended 2022 with over $90 million in cash, cash equivalents, and investments, and has an anticipated cash runway into late 2024.

About Nana-val (Nanatinostat and Valganciclovir)

Nanatinostat is an orally available histone deacetylase (HDAC) inhibitor being developed by Viracta. Nanatinostat is selective for specific isoforms of Class I HDACs, which are key to inducing viral genes that are epigenetically silenced in Epstein-Barr virus (EBV)-associated malignancies. Nanatinostat is currently being investigated in combination with the antiviral agent valganciclovir as an all-oral combination therapy, Nana-val, in various subtypes of EBV-associated malignancies. Ongoing trials include a pivotal, global, multicenter, open-label Phase 2 basket trial in multiple subtypes of relapsed/refractory EBV+ lymphoma (NAVAL-1) as well as a multinational Phase 1b/2 trial in patients with EBV+ recurrent or metastatic nasopharyngeal carcinoma and other EBV+ solid tumors.

NanoString Provides Preliminary Financial and Operational Highlights for Fourth Quarter and FY 2022

On January 8, 2023 NanoString Technologies, Inc. (NASDAQ:NSTG), a leading provider of life science tools for discovery and translational research, reported preliminary financial and operational highlights for the fourth quarter and fiscal year ended December 31, 2022 (Press release, NanoString Technologies, JAN 9, 2023, View Source [SID1234626086]).

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"NanoString continued to build on our strong spatial biology franchise in 2022, capturing a record 105+ new system orders in the fourth quarter, bringing growth in spatial biology system orders to 50% for the full year," said Brad Gray, President and CEO of NanoString. "We shipped our first CosMx systems to customers in December, and our CosMx order backlog of approximately $40 million at year end provides the foundation for revenue growth in 2023."
Q4 and 2022 Highlights

Spatial Biology

•Secured customer orders for more than 105 spatial biology systems in Q4, including approximately 80 for CosMx Spatial Molecular Imagers (SMI) and over 25 for GeoMx Digital Spatial Profilers (DSP), an increase of 50% as compared to 2021 for both the fourth quarter and full year 2022
•CosMx SMI highlighted on the cover of the December 2022 issue of Nature Biotechnology, demonstrating high-resolution, single cell imaging of RNA and protein
•CosMx SMI featured in the January 2023 issue of National Geographic. Researchers at Wake Forest used CosMx to perform high-resolution imaging of brain tissue in their ongoing Alzheimer’s research. They were able to discover rare senescence cells that contribute to neurodegeneration
•Total peer-reviewed publications featuring our spatial biology platforms were approximately 195 as of December 2022, representing an increase of approximately 105 publications in the last 12 months
•NanoString was named the Gold Sponsor for 2023 Advances in Genome Biology and Technology (AGBT) meeting, where we will host a workshop on February 7, 2023 highlighting advances in our spatial biology platforms and showcasing research conducted by our collaborators and customers
nCounter
•Concluded 2022 with an nCounter installed base of approximately 1,120 systems, an increase of approximately 7% as compared to 2021
•Total peer-reviewed publications featuring nCounter were approximately 6,520 as of December 2022, representing an increase of approximately 1,320 publications in the last 12 months
Preliminary Financial Results
•For the fourth quarter of 2022, product and service revenue is expected to be over $34 million, within our guidance range of $33 to $35 million
•For the full year 2022, product and service revenue is expected to be approximately $127 million, within our guidance range of $125 to $127 million
•As of December 31, 2022, cash, cash equivalents and short-term investments is expected to total more than $195 million

These preliminary results are based on management’s initial analysis of operations for the quarter and year ended December 31, 2022 and are subject to further internal review and audit by the company’s external auditors.

Exelixis Announces Preliminary Fourth Quarter and Full Year 2022 Financial Results, Provides 2023 Financial Guidance, and Outlines Key Priorities and Milestones for 2023

On January 08, 2023 Exelixis, Inc. (Nasdaq: EXEL) reported its preliminary unaudited financial results for the fourth quarter and full year 2022, provided financial guidance for full year 2023, and delivered an update on its business. Exelixis expects 2023 to be a year of significant growth and execution as it continues to expand and develop its pipeline of promising biotherapeutics and small molecules and pursues potential near-term label-expansion opportunities for CABOMETYX (cabozantinib) (Press release, Exelixis, JAN 8, 2023, View Source [SID1234626058]).

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Preliminary Fourth Quarter and Full Year 2022 Financial Results & 2023 Financial Guidance

Exelixis is providing the following preliminary unaudited 2022 financial results and financial guidance for 2023:

Fourth Quarter 2022

Full Year 2022

Full Year 2023 Guidance

Total revenues

~ $415 million

~ $1,600 million

$1,775 million – $1,875 million

Net product revenues

~ $375 million

~ $1,400 million

$1,575 million – $1,675 million

Cost of goods sold

~ 4.1%

~ 4.1%

4.0% – 5.0%

Research and development expenses

~ $340 million (1)

~ $895 million(2)

$1,000 million – $1,050 million(3)

Selling, general and administrative expenses

~ $120 million(4)

~ $460 million(5)

$475 million – $525 million(6)

Effective tax rate

n/a(7)

n/a(7)

20% – 22%

(1) Includes $10 million of non-cash stock-based compensation expense.

(2) Includes $45 million of non-cash stock-based compensation expense.

(3) Includes $45 million of non-cash stock-based compensation expense.

(4) Includes $15 million of non-cash stock-based compensation expense.

(5) Includes $62 million of non-cash stock-based compensation expense.

(6) Includes $55 million of non-cash stock-based compensation expense.

(7) Preliminary results not yet available.

The preliminary 2022 financial information presented in this press release has not been audited and is subject to change. The complete Exelixis Fourth Quarter and Full Year 2022 Financial Results are planned for release after market on Tuesday, February 7, 2023.

"In 2023, Exelixis is advancing our diverse, high-impact pipeline of small molecule and biologic agents for oncology fueled by the continued growth of the cabozantinib commercial franchise," said Michael M. Morrissey, Ph.D., President and Chief Executive Officer, Exelixis. "We expect to report data from two pivotal trials of cabozantinib, initiate the next wave of phase 3 studies of zanzalintinib (XL092), advance XB002 into full development and add new agents to our portfolio from internal discovery and collaborative efforts. Importantly, we’ll continue to pursue additional in-licensing and strategic opportunities to enhance the breadth and depth of our pipeline so that we can make an even greater impact on our mission to help cancer patients recover stronger and live longer."

Anticipated Pipeline Milestones

Exelixis made significant progress in establishing the potential of and adding new assets to the company’s pipeline in 2022. In 2022, Exelixis presented data sets for: zanzalintinib (XL092), its next-generation oral tyrosine kinase inhibitor; XB002, its most advanced antibody-drug conjugate (ADC); and XL102, a selective and irreversible cyclin-dependent kinase 7 (CDK7) inhibitor. Three promising biotherapeutics, XB010, XB014 and XB628, from internal discovery efforts are currently being evaluated in preclinical development, and collaborations were initiated with Cybrexa Therapeutics (Cybrexa) and Sairopa B.V. (Sairopa) to advance the CBX-12 and ADU-1805 programs, respectively, which were the subject of exclusive clinical option and license agreements signed in the fourth quarter of 2022.

Expansion of pivotal trial program for zanzalintinib: In 2023, Exelixis plans to expand the phase 3 development program for zanzalintinib (XL092) with multiple new phase 3 pivotal trial initiations of zanzalintinib in combination with several immuno-oncology (IO) therapies. In 2022, Exelixis initiated STELLAR-303, which evaluates zanzalintinib in combination with atezolizumab versus regorafenib in patients with colorectal cancer (CRC) that is not microsatellite instability-high or mismatch repair-deficient, who have progressed after or are intolerant to the current standard of care, as well as STELLAR-304, which evaluates zanzalintinib in combination with nivolumab versus sunitinib in patients with advanced non-clear cell renal cell carcinoma. As previously stated, Exelixis intends to develop zanzalintinib in novel combination regimens in a broad array of future potential indications, including those where cabozantinib has demonstrated anti-tumor activity.

Advancement of the XB002 JEWEL development program: In 2023, Exelixis intends to accelerate the development of XB002, its next-generation tissue factor-targeting ADC, both as a monotherapy and in combination with IO and other targeted therapies, across a wide range of tumor types. The dose-escalation stage of JEWEL-101, the first-in-human phase 1 study evaluating XB002 as a single agent and in combination with nivolumab, is ongoing and the company expects to initiate the cohort expansion stage of the study after the recommended dose and/or the maximum-tolerated dose for XB002 have been determined, as well as advance additional combination cohorts in the study to identify sensitive tumor types. Anticipated tumor cohorts across the trial include forms of non-small cell lung, ovarian, cervical, urothelial, squamous cell head and neck, pancreatic, esophageal, prostate, and breast. In October 2022, Exelixis presented promising initial results from the ongoing dose-escalation stage of JEWEL-101, demonstrating that XB002 was well-tolerated across multiple dose levels with a pharmacokinetic analysis supporting the ability of XB002 to remain stable after infusion with low levels of free payload in circulation. The company expects to move into full development by year-end.

Advancement of the XL102 QUARTZ development program: In 2023, Exelixis intends to advance the first-in-human QUARTZ-101 phase 1 trial evaluating XL102, its potent, selective, irreversible and orally bioavailable small molecule CDK7 inhibitor into the cohort expansion and potential combination cohorts. The phase 1 QUARTZ-101 study is evaluating the safety, tolerability, pharmacokinetics, anti-tumor activity and effect on biomarkers of XL102 administered alone and in multiple combination regimens in patients with advanced solid tumors. In December 2022, Exelixis presented initial dose-escalation results from the QUARTZ-101 study, demonstrating that XL102 was well-tolerated at evaluated dose levels with a pharmacokinetic analysis showing rapid absorption of XL102 and an elimination half-life of 5-9 hours. Exelixis expects to evaluate the anti-tumor activity and efficacy of XL102 in additional patients in the single-agent dose-escalation cohorts, in the tumor-specific cohort-expansion stage and in planned combination cohorts. In the cohort-expansion stage of QUARTZ-101, XL102 will be evaluated in patients with certain types of ovarian, breast and prostate cancers.

Advancement of CBX-12 clinical program in collaboration with Cybrexa: Exelixis expects its partner Cybrexa to continue to advance its phase 1 clinical study program for CBX-12 throughout 2023, including dose-expansion cohorts. CBX-12 is a clinical-stage, first-in-class peptide-drug conjugate that utilizes Cybrexa’s proprietary alphalex technology to enhance delivery of exatecan to tumor cells. It is designed to increase the therapeutic index of topoisomerase I inhibition by delivering exatecan, a highly potent, second-generation topoisomerase I inhibitor, directly to the tumor cells using a target independent approach activated by the acidic microenvironment of solid tumors. Under the terms of the agreement announced in November 2022, Exelixis has the option to acquire CBX-12 upon evaluation of a pre-specified clinical data package that includes certain phase 1 results.

Planned Investigational New Drug (IND) filing for ADU-1805 program, in collaboration with Sairopa: In the first quarter of 2023, Exelixis expects its partner Sairopa to file an IND for ADU-1805, a potential best-in-class monoclonal antibody targeting SIRPα to block the SIRPα–CD47 checkpoint. Blocking SIRPα has the potential to improve the immune system’s ability to attack tumors by addressing a significant immune-suppressive component of the tumor microenvironment. ADU-1805 is active against all human alleles of SIRPα, which may allow it to address a broader patient population than other SIRPα-directed therapies, and has been optimized to bind preferentially to SIRPα vs. other SIRP family members, which may enhance its ability to stimulate immune cells. Under the terms of the clinical development and option agreement announced in November 2022, Exelixis has the option to obtain an exclusive, worldwide license to develop and commercialize ADU-1805 and other anti-SIRPα antibodies upon review of data from prespecified phase 1 clinical studies of ADU-1805 to be completed by Sairopa during the option period.

Advancement of Development Candidates (DCs) XB010 and XB014 toward IND filing: In 2023, Exelixis plans to advance XB010, the first custom ADC generated through the company’s biotherapeutics network of collaborations, and XB014, the company’s first bispecific antibody designated as a DC in August 2022, through preclinical development and IND-enabling studies, toward potential IND filings in early 2024. XB010 targets the oncofetal antigen 5T4, which is overexpressed on a broad array of solid tumors including non-small cell lung cancer, head and neck squamous cell carcinomas, and gastric and breast carcinomas, and utilizes the SMARTag site specific conjugation platform from Catalent, Inc. to produce a homogeneous ADC with a defined drug-antibody ratio coupled to a high affinity antibody Exelixis sourced from Invenra, Inc. (Invenra). XB014 consists of a bispecific antibody, with a PDL1 targeting arm along with a CD47 targeting arm to block a macrophage checkpoint, also developed through Exelixis’ collaboration with Invenra.

DC designation for XB628: Today, Exelixis announced it has designated XB628 as its latest DC and plans to advance the program through preclinical development in 2023, toward a potential IND filing in 2024. Comprising a PDL1 targeting arm and an NKG2A targeting arm, XB628 is the company’s second bispecific antibody program developed through its collaboration with Invenra.

Discovery Expansion and Anticipated Milestones

In 2022, Exelixis enhanced the capacity and capabilities of its small molecule discovery efforts and utilized its broad collaboration network to build a differentiated biotherapeutics platform focused on the identification and optimization of next-generation ADCs, bispecific antibodies and other biologics with promising preclinical activity. In 2023, Exelixis is advancing more than 10 discovery programs through internal and collaborative efforts and expects to progress up to five new development candidates into preclinical development, encompassing multiple modalities and mechanisms across small molecules and biotherapeutics.

Anticipated Cabozantinib Milestones

"In the ten years since its initial FDA approval, cabozantinib has evolved from an orphan indication to a global oncology franchise that benefits tens of thousands of patients annually," said Michael M. Morrissey, Ph.D., President and Chief Executive Officer, Exelixis. "In 2022, cabozantinib generated approximately $1.4 billion in preliminary U.S. net product revenues, further reinforcing its status as a leading therapy for forms of renal, liver, and thyroid cancer. We’re committed to maximizing cabozantinib’s clinical and commercial potential – including through the ongoing CONTACT clinical trials, which represent the final Exelixis-sponsored pivotal trials of the compound – as our pipeline buildout proceeds."

Pivotal trial progress and data readouts anticipated in 2023: During the first half of the year, Exelixis expects to report top-line results for the progression-free survival endpoint from CONTACT-03, the phase 3 pivotal trial sponsored by Roche evaluating the combination of cabozantinib and atezolizumab versus cabozantinib monotherapy in a form of renal cell carcinoma (RCC) in patients who progressed during or following treatment with an immune checkpoint inhibitor as the immediate preceding line of therapy. In the second half of the year, the company anticipates completion of enrollment and expects to report top-line results for the progression-free survival endpoint for CONTACT-02, the phase 3 pivotal trial sponsored by Exelixis evaluating the combination of cabozantinib and atezolizumab in patients with metastatic castration-resistant prostate cancer who have been previously treated with one novel hormonal therapy. Also expected in 2023 is the next overall survival analysis from COSMIC-313, the phase 3 pivotal trial evaluating the triplet combination of cabozantinib, nivolumab and ipilimumab versus the combination of nivolumab and ipilimumab in patients with previously untreated advanced intermediate- or poor-risk RCC.

Cabozantinib Abbreviated New Drug Application (ANDA) Litigation: The United States District Court for the District of Delaware has scheduled a second bench trial for Exelixis’ ongoing ANDA lawsuit against MSN Pharmaceuticals, Inc. for October 2023. Exelixis is confident in its cabozantinib patent estate and will vigorously defend the patents at issue.

Presentation and Webcast

Exelixis President and Chief Executive Officer Michael M. Morrissey, Ph.D., will provide a corporate overview and discuss the company’s preliminary fourth quarter and full year 2022 financial results, 2023 financial guidance, and key priorities and milestones for 2023 during the company’s presentation at the J.P. Morgan Healthcare Conference beginning at 8:15 p.m. ET / 5:15 p.m. PT on Monday, January 9, 2022.

To access the webcast link, log onto www.exelixis.com and proceed to the News & Events / Event Calendar page under the Investors & Media heading. Please connect to the company’s website at least 15 minutes prior to the presentation to ensure adequate time for any software download that may be required to listen to the webcast. A replay will also be available at the same location for at least 30 days.

Castle Biosciences Announces Preliminary Fourth Quarter and Full-Year 2022 Results

On January 08, 2023 Castle Biosciences, Inc. (Nasdaq: CSTL), a company improving health through innovative tests that guide patient care, reported certain unaudited preliminary performance results for the fourth quarter and full-year ended Dec. 31, 2022 (Press release, Castle Biosciences, JAN 8, 2023, View Source [SID1234626043]).

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"2022 was a year of focused investment, and we believe our strong success across the organization, including in revenue and test report volume growth, was a result of exceptional execution on our initiatives," said Derek Maetzold, president and chief executive officer of Castle Biosciences. "These initiatives include our acquisitions and planned integration of both Cernostics and AltheaDx, continued evidence development to support our commercial and pipeline tests and the expansion of our commercial team. And as such, we expect to meet or exceed the top end of our 2022 revenue guidance of $132-137 million."

Preliminary, Unaudited Fourth Quarter Ended Dec. 31, 2022, Highlights
•Delivered 12,563 total test reports in the fourth quarter of 2022, compared to 8,242 in the same period of 2021, an increase of 52%:
◦DecisionDx-Melanoma test reports delivered in the quarter were 7,295, compared to 5,635 in the fourth quarter of 2021, an increase of 29%.
◦DecisionDx-SCC test reports delivered in the quarter were 1,844, compared to 1,265 in the fourth quarter of 2021, an increase of 46%.
◦MyPath Melanoma and DiffDx-Melanoma diagnostic gene expression profile (GEP) aggregate test reports delivered in the quarter were 822, compared to 904 in the fourth quarter of 2021, a decrease of 9%.
◦DecisionDx-UM test reports delivered in the quarter were 432, compared to 438 in the fourth quarter of 2021, a decrease of 1%.
◦TissueCypher Barrett’s Esophagus test reports delivered in the quarter were 996. No test reports were delivered by Castle in the fourth quarter of 2021.
◦IDgenetix test reports delivered in the quarter were 1,174. No test reports were delivered by Castle in the fourth quarter of 2021.

Preliminary, Unaudited Year- Ended Dec. 31, 2022, Highlights
•The Company expects to meet or exceed the top end of its previously guided range of $132–137 million for full-year 2022 total revenue.
•Total test reports delivered in 2022 were 44,338, compared to 28,118 in the same period of 2021, an increase of 58%:
◦DecisionDx-Melanoma test reports delivered in 2022 were 27,797, compared to 20,328 in 2021, an increase of 37%.
◦DecisionDx-SCC test reports delivered in 2022 were 5,966 compared to 3,510 in 2021, an increase of 70%.

◦MyPath Melanoma and DiffDx-Melanoma diagnostic GEP aggregate test reports delivered in 2022 were 3,561, compared to 2,662 in 2021, an increase of 34%.
◦DecisionDx-UM test reports delivered in 2022 were 1,711, compared to 1,618 in 2021, an increase of 6%.
◦TissueCypher Barrett’s Esophagus test reports delivered in 2022 were 2,094. No test reports were delivered by Castle in 2021.
◦IDgenetix test reports delivered in 2022 were 3,209. No test reports were delivered by Castle in 2021.

Revenues and Test Report Volumes Disclaimer

The effects of macroeconomic events and conditions, including inflation, the COVID-19 pandemic and geopolitical events, among others, continue to evolve and bring along with them a high level of uncertainty surrounding potential future effects. Therefore, trends in revenues and test report volumes are not necessarily indicative of the Company’s results of operations that can be expected for future fiscal periods.

Cash, Cash Equivalents and Marketable Investment Securities

Year-end 2022 cash and cash equivalents are expected to be approximately $123 million. Additionally, the Company expects to hold approximately $136 million in short-term investments.

Castle Biosciences has not completed the preparation of its financial statements for the fourth quarter or full-year-ended Dec. 31, 2022. The preliminary, unaudited information presented in this press release for the quarter and year-ended Dec. 31, 2022, is based on management’s initial review of the information presented and its current expectations, and is subject to adjustment as a result of, among other things, the completion of the Company’s end-of-period reporting processes and related activities, including the audit by the Company’s independent registered public accounting firm of the Company’s financial statements. As such, any financial information contained in this press release may differ materially from the information reflected in the Company’s financial statements as of and for the year-ended Dec. 31, 2022. Additional information and disclosures would be required for a more complete understanding of the Company’s financial position and results of operations as of and for the quarter and year-ended Dec. 31, 2022. Accordingly, undue reliance should not be placed on this preliminary information.

Alnylam Announces Preliminary* Fourth Quarter and Full Year 2022 Global Net Product Revenues and Provides Additional Updates

On January 8, 2023 Alnylam Pharmaceuticals, Inc. (Nasdaq: ALNY), the leading RNAi therapeutics company, reported its preliminary fourth quarter and full year 2022 global net product revenues for ONPATTRO, AMVUTTRA, GIVLAARI, and OXLUMO and provided additional updates on the products’ commercial launches (Press release, Alnylam, JAN 8, 2023, View Source [SID1234626028]).

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Preliminary Fourth Quarter and Full Year 2022 Commercial and Financial Performance*

Total TTR: ONPATTRO (patisiran) & AMVUTTRA (vutrisiran)

Preliminary global net product revenues for ONPATTRO and AMVUTTRA for the fourth quarter were approximately $122 million and $69 million, respectively, representing 12% total TTR quarterly growth compared to Q3 2022, and for the full year 2022 were approximately $558 million and $94 million, respectively, representing 37% total TTR annual growth compared to full year 2021.

As of year-end 2022, over 2,975 patients worldwide were receiving commercial ONPATTRO or AMVUTTRA.

* The preliminary selected financial results are unaudited, subject to adjustment, and provided as an approximation in advance of the Company’s announcement of complete financial results in February 2023.

** CER = Constant Exchange Rate, representing growth calculated as if the exchange rates had remained unchanged from those used during 2021. CER is a Non-GAAP financial measure.

GIVLAARI (givosiran)

Preliminary global net product revenues for the fourth quarter and full year 2022 were approximately $47 million and $173 million, respectively, representing quarterly and annual growth of 3% and 35% compared to Q3 2022 and full year 2021, respectively.

As of year-end 2022, over 520 patients worldwide were receiving commercial GIVLAARI.

OXLUMO (lumasiran)

Preliminary global net product revenues for the fourth quarter and full year 2022 were approximately $24 million and $70 million, respectively, representing quarterly and annual growth of 45% and 17% compared to Q3 2022 and full year 2021, respectively.

As of year-end 2022, over 280 patients worldwide were receiving commercial OXLUMO.

Further, at December 31, 2022, Alnylam had preliminary cash, cash equivalents, and marketable securities of approximately $2.2 billion, as compared to $2.4 billion at December 31, 2021.

"We are pleased to have closed out 2022 on a very strong note with continued execution across our commercial portfolio, delivering top-line revenue in line with our guidance range. These preliminary results reflect healthy patient demand for our transformative products and strong commercial execution by our teams in delivering these important medicines to patients in need around the world. In 2022 we were particularly excited to celebrate the approval and global launch of AMVUTTRA, which has demonstrated an impressive commercial performance in its first two full quarters of launch," said Yvonne Greenstreet, MBChB, Chief Executive Officer of Alnylam. "As we consider our commercial and financial performance, combined with robust execution on the R&D front, we believe we are well on our way to achieving our Alnylam P5x25 goals, positioning Alnylam as a top-tier, global, multi-product commercial company with a broad pipeline and organic platform poised to deliver sustainable innovation well into the future, a profile rarely seen in our industry."

Alnylam management will discuss these preliminary selected financial results and commercial updates during a webcast presentation at the 41st Annual J.P. Morgan Healthcare Conference in San Francisco, California tomorrow, Monday, January 9, 2023 at 9:45 a.m. PT (12:45 p.m. ET).

About RNAi Therapeutics

RNAi (RNA interference) is a natural cellular process of gene silencing that represents one of the most promising and rapidly advancing frontiers in biology and drug development today. Its discovery has been heralded as "a major scientific breakthrough that happens once every decade or so," and was recognized with the award of the 2006 Nobel Prize for Physiology or Medicine. By harnessing the natural biological process of RNAi occurring in our cells, a new class of medicines known as RNAi therapeutics is now a reality. Small interfering RNA (siRNA), the molecules that mediate RNAi and comprise Alnylam’s RNAi therapeutic platform, function upstream of today’s medicines by potently silencing messenger RNA (mRNA) – the genetic precursors – that encode for disease-causing or disease pathway proteins, thus preventing them from being made. This is a revolutionary approach with the potential to transform the care of patients with genetic and other diseases.