Entry into a Material Definitive Agreement

On May 24, 2024 Allogene Therapeutics, Inc. (the "Company"), Overland Pharmaceuticals (CY) Inc. ("Overland") and Allogene Overland Biopharm (CY) Limited (the "JV Company") reported to have entered into a Share Exchange Agreement pursuant to which Overland’s cell therapy business merged into the JV Company (the "Organizational Restructuring").

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As background, the JV Company was originally formed on December 14, 2020 by Overland and the Company. Upon formation of the JV Company, the Company contributed an exclusive license to develop, manufacture and commercialize specific Company product candidates targeting BCMA, CD70, FLT3 and DLL3 (the "Licensed Products") in China, Taiwan, South Korea and Singapore (the "Territory"), with the Company retaining exclusive rights to the Licensed Products outside the Territory (the "Exclusive License Agreement"), and Overland contributed $117 million in upfront and certain quarterly cash payments. In return, the Company received a $40 million upfront payment and Seed Preferred Shares representing 49% of the JV Company’s outstanding stock and Overland received Seed Preferred Shares representing 51% of the JV Company’s outstanding stock.

Under the Share Exchange Agreement, the JV Company acquired from Overland a 100% equity interest in Overland Pharmaceuticals (US) Inc. ("Overland US"). Overland US includes certain research and development, clinical, and general and administrative staff, as well as select cell therapy assets, including its lead program, OL-101, an autologous GPRC5D-BCMA bispecific dual targeting CAR-T for refractory multiple myeloma. Upon completion of the closing of the share exchange, Overland US became a wholly owned subsidiary of the JV Company, Overland’s ownership increased to 81.54%, the Company’s ownership decreased to 18%, and the Ordinary Shares issuable under the share incentive plan of the JV Company equaled 0.46% of the capitalization of the JV Company on an as-converted and fully-diluted basis. In addition, the JV Company increased the total number of Ordinary Shares issuable under its share incentive plan, which resulted in diluting Overland’s and the Company’s ownership to 69.63% and 15.37%, respectively, and the Ordinary Shares issuable under the share incentive plan of the JV Company were increased to 15% of the capitalization of the JV Company on an as-converted and fully-diluted basis.

Under a separate agreement between Overland and HH BioPharma Holdings Ltd. ("HBP") executed on May 24, 2024, Overland distributed all Series Seed Preferred Shares of the JV Company held by Overland to HBP and HBP has assumed all rights and obligations attached to such Shares and all rights and obligations of Overland under the Share Exchange Agreement.

In connection with the Organizational Restructuring, on May 24, 2024, the Company and Allogene Overland BioPharm (PRC) Co., Limited (the "Licensee"), an indirect wholly owned subsidiary of the JV Company, entered into a First Amendment to Exclusive License Agreement (the "Amendment") to amend and supplement certain provisions of the Exclusive License Agreement dated December 14, 2020 between the Company and the JV Company which has since assigned all of its rights and obligations under the Exclusive License Agreement to the Licensee. Under the Amendment, the Company continues to grant the JV Company an exclusive license to develop, manufacture, and commercialize the Licensed Products in the Territory, with the Company retaining exclusive rights to the Licensed Products outside the Territory, and the royalty obligations to the Company were amended to a flat mid single-digit royalty on net sales in the Territory that are no longer subject to reductions as previously provided. The Amendment also provides the Company with additional rights to terminate the Exclusive License Agreement in its entirety or with respect to the relevant Licensed Product(s) if the Licensee fails to initiate manufacturing technology transfer with respect to a Licensed Product as agreed in the Amendment, or if HBP commits a funding default or a material breach of its representations, warranties, or covenants under the Share Exchange Agreement. The Amendment also provides that the Exclusive License Agreement will terminate automatically if the Company’s ownership in the JV Company falls below 7.5% (other than due to the Company’s sale of the Shares of the JV Company), unless at that time the JV Company and the Company have mutually agreed on the manufacturing technology transfer plan for the Licensed Product(s) and the JV Company elects to continue the license for such Licensed Product(s) with increased milestones and royalties. Under the Amendment terms such increased milestones and royalties consist of up to $115 million in milestone payments for each Licensed Product and tiered mid single-digit to low double-digit royalties on net sales in the Territory.

In connection with the Organizational Restructuring, on May 24, 2024, the Company, HBP, and the JV Company also entered into an Amended and Restated Shareholders’ Agreement which amends and restates the prior Shareholders’ Agreement dated December 14, 2020 among the Company, Overland, and the JV Company in its entirety. Pursuant to the Amended and Restated Shareholders’ Agreement, the board of directors of the JV Company will be comprised of five directors, with three directors designated by HBP, one director designated by the Company, and one director serving as the chief executive officer of the JV Company. The Amended and Restated Shareholders’ Agreement provides each of the Company and HBP certain shareholder-level consent rights, certain director-level consent rights, registration rights, information rights, and pre-emptive rights for future equity issuances. The Amended and Restated Shareholders’ Agreement shall terminate upon the consent of the parties, provided that its provisions with respect to director designation rights, shareholder-level consent rights, director-level consent rights, information rights, and pre-emptive rights shall terminate upon a qualified IPO or sale of the JV Company or its assets.

The foregoing description of the material terms of the Share Exchange Agreement, the Amended and Restated Shareholders’ Agreement and the Amendment is qualified in its entirety by reference to the complete text of such agreements, which the Company intends to file with the Securities and Exchange Commission as exhibits to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30, 2024.

Bio-Path Holdings to Present Data at 2024 European Hematology Association Congress

On May 24, 2024 Bio-Path Holdings, Inc., (NASDAQ:BPTH), a biotechnology company leveraging its proprietary DNAbilize liposomal delivery and antisense technology to develop a portfolio of targeted nucleic acid cancer drugs, reported an upcoming poster presentation at the 2024 European Hematology Association (EHA) (Free EHA Whitepaper) Congress, taking place June 13-16, 2024 in Madrid, Spain (Press release, Bio-Path Holdings, MAY 24, 2024, View Source [SID1234643777]).

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Jorge Cortes, M.D., Director of the Georgia Cancer Center, will present interim results from the Company’s Phase 2 study of prexigebersen (BP1001) in combination with decitabine and venetoclax for the treatment of acute myeloid leukemia (AML). The data show prexigebersen continues to be well-tolerated and has now demonstrated compelling efficacy results in two reporting cohorts including evaluable newly diagnosed AML patients and evaluable refractory/relapsed AML patients, both of which exceeded outcomes with frontline therapy.

"We look forward to Dr. Cortes’ presentation of these very compelling data, which continue to demonstrate prexigebersen’s potential as a safe and effective treatment for AML," said Peter Nielsen, Chief Executive Officer of Bio-Path. "We are particularly enthusiastic with its improvement over frontline therapy and are eager to have these data presented before an audience of the world’s leading hematologists at EHA (Free EHA Whitepaper)."

Details for the poster presentation are as follows:

Title: Interim Safety and Efficacy of BP1001 in a Phase II Acute Myeloid Leukemia
Study Date and Time: Friday, June 14, 2024 at 6:00 PM CEST
Location: IFEMA Madrid Recinto Ferial, Hall 7
Abstract Number: P536

Innate Pharma Highlights Abstracts Selected for ASCO 2024 Annual Meeting

On May 24, 2024 Innate Pharma SA (Euronext Paris: IPH; Nasdaq: IPHA) ("Innate" or the "Company") reported that five abstracts with Innate’s drug candidates have been accepted for the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) 2024 Annual Meeting, taking place May 31-June 4, 2024 in Chicago, Illinois (Press release, Innate Pharma, MAY 24, 2024, View Source [SID1234643704]).

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ASCO abstract details:

Lacutamab

Abstract: 7082
Abstract Title: Lacutamab in patients with relapsed and/or refractory mycosis fungoides: results from the TELLOMAK Phase 2 trial
First Author: Pierluigi Porcu
Session Type: Poster Session
Session Title: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia
Session Date and Time: Monday June 3, 2024 – 9:00 AM – 12:00 PM

IPH6501

Abstract: TPS7095
Abstract Title: A Phase 1/2, Open-Label, Multicenter Trial Investigating the Safety, Tolerability, and Preliminary Antineoplastic Activity of IPH6501 in Patients With Relapsed and/or Refractory CD20-expressing Non-Hodgkin Lymphoma
First Author: Lorenzo Falchi
Session Type: Poster Session
Session Title: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia
Session Date and Time: Monday June 3, 2024 – 9:00 AM – 12:00 PM

Abstract: 7030
Abstract Title: Preclinical assessment of IPH6501, a first-in-class IL2v-armed tetraspecific NK Cell Engager directed against CD20 for R/R B-NHL, in comparison to a CD20-targeting T Cell Engager
First Author: Olivier Demaria
Session Type: Poster Session
Session Title: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia
Session Date and Time: Monday June 3, 2024 – 9:00 AM – 12:00 PM

Monalizumab (partnered with AstraZeneca)

Abstract: 8046
Abstract Title: Updated results from COAST, a phase 2 study of durvalumab (D) ± oleclumab (O) or monalizumab (M) in patients (pts) with stage III unresectable non-small cell lung cancer (uNSCLC)
First Author: Charu Aggarwal
Session Type: Poster Session
Session Title: Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers
Session Date and Time: Monday June 3, 2024 – 1:30 PM – 4:30 PM

Abstract: TPS8129
Abstract Title: A phase II trial of monalizumab in combination with durvalumab (MEDI4736) plus platinum-based chemotherapy for first-line treatment of extensive stage small cell lung cancer (MOZART): Hoosier Cancer Research Network LUN21-530 study.
First Author: Hirva Mamdani
Session Type: Poster Session
Session Title: Lung Cancer—Non-Small Cell Local-Regional/Small Cell/Other Thoracic Cancers
Session Date and Time: Monday June 3, 2024 – 1:30 PM – 4:30 PM

Foundation Medicine Announces Details of Over 20 Presentations at the 2024 ASCO® Annual Meeting

On May 24, 2024 Foundation Medicine, Inc., reported that 22 new pieces of research from its robust oncology diagnostics portfolio will be presented at the 2024 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting from May 31 to June 4 in Chicago (Press release, Foundation Medicine, MAY 24, 2024, View Source [SID1234643703]).

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Early/Late Stage Pipeline Development - Target Scouting - Clinical Biomarkers - Indication Selection & Expansion - BD&L Contacts - Conference Reports - Combinatorial Drug Settings - Companion Diagnostics - Drug Repositioning - First-in-class Analysis - Competitive Analysis - Deals & Licensing

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Emerging Applications of Liquid Biopsy Using FoundationOneLiquid CDx and FoundationOneTracker

Utility of circulating tumor DNA (ctDNA) to inform treatment of patients with metastatic breast cancer (Abstract #1042)
Use of circulating tumor DNA (ctDNA) to affect the adjuvant or post-adjuvant treatment of patients with stage III and high-risk stage II resected colon cancer: The ERASE-CRC project by GONO (Abstract #TPS3644)
Utility of ctDNA burden as a prognostic biomarker for efficacy in TALAPRO-2: A phase 3 study of talazoparib (TALA) + enzalutamide (ENZA) vs placebo (PBO) + ENZA as first-line (1L) treatment in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) (Abstract #5020)
Prognostic value of baseline circulating tumor DNA (ctDNA) tumor fraction (TF) in metastatic hormone-sensitive prostate cancer (mHSPC) (Abstract #5085)
BRCA1/2 reversion mutations (BRCArev) in advanced prostate cancer in the absence of prior PARP inhibitor (PARPi) therapy (Abstract #5056)
Utility of CGP in Earlier Stages of Disease, Rare Cancers, and Using RNA Sequencing

Preliminary results of the Lung Cancer Mutation Consortium LCMC4 evaluation of actionable drivers in early-stage lung cancer (LEADER) screening trial (Abstract #8068)
Impact of alterations in tumor suppressor genes (TSG-alt) on survival outcomes in patients (pts) with de novo metastatic castration-sensitive prostate cancer (dn-mCSPC) receiving androgen deprivation therapy (ADT) with androgen receptor pathway inhibition (ARPI) or docetaxel (Abstract #5091)
On the right TRACK: Providing comprehensive genomic profiling (CGP) and molecular tumor board (MTB) for patients (pts) with rare cancers (Abstract #3127)
New soft tissue sarcoma (STS) transcriptomic clusters to unveil STS subsets with unique biological characteristics and refine the accuracy of overall survival (OS) prediction (Abstract #11545)
New CGP Biomarkers, Including Homologous Recombination Deficiency (HRD) Signature and Methyl Thioadenosine Phosphorylase (MTAP) Genomic Loss

Pathological complete response (pCR) association with a novel homologous recombination deficiency HRD signature (HRDsig) in patients with triple-negative breast cancer (TNBC) receiving neoadjuvant therapy (Tx) (Abstract #591)
Characterization of diverse targetable ERBB2 alterations in 512,993 patients with solid tumors (Abstract #3129)
Nature and distribution of methyl thioadenosine phosphorylase (MTAP) genomic loss in human tumors (Abstract #3067)
Genomic alterations (GA) in ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(-) patients (pts) with metastatic breast cancer (MBC): Co-occurrence and prevalence along treatment course (Abstract #1060)
Impact of Ancestry on the Genomic Alteration Landscape

Genetic ancestry-associated differences in genomic profiling and treatment patterns in pancreatic ductal adenocarcinoma (PDAC) (Abstract #4138)
Endometrial cancer (EC) by ERBB2 amplification (ERBB2amp) status: Differences in molecular subtypes, ancestry, and real-world outcomes (Abstract #5614)
"Our data at this year’s ASCO (Free ASCO Whitepaper) annual meeting reflects Foundation Medicine’s progress in making genomic profiling indispensable to cancer care and research, particularly in lung, breast and prostate cancers where there is an increasing number of targeted therapies for health care providers to consider for these patients," says Mia Levy, MD, PhD, Chief Medical Officer at Foundation Medicine. "We are also excited to demonstrate our new RNA sequencing capabilities and spotlight the expanding utility of ctDNA to inform treatment decision making through a simple blood sample."

The following is a complete list of Foundation Medicine abstracts that will be presented. To access the abstracts being presented at ASCO (Free ASCO Whitepaper), please visit ASCO (Free ASCO Whitepaper).org/abstracts.

Follow Foundation Medicine on LinkedIn, X and Instagram for more updates from #ASCO24 and visit us in person at Booth #22031.

Abstract #

Title

Collaborator

Products

Posters

Abstract #3127
6/1/2024 9:00 AM-
12:00 PM

On the right TRACK: Providing comprehensive genomic profiling (CGP) and molecular tumor board (MTB) for patients (pts) with rare cancers

TargetCancer Foundation, UC San Diego Moores Cancer Center, University of California, San Diego, Medical College of Wisconsin (MCW) Cancer Center, The Sidney Kimmel Comprehensive Cancer Center at The Johns Hopkins Hospital, The University of Texas MD Anderson Cancer Center, Department of Pharmacy, Rutgers New Jersey Medical School, Medication Acquisition, Inc., Sarah Cannon Research Institute, University of Nebraska, WIN Consortium for Precision Medicine

FoundationOneCDx
FoundationOneLiquid CDx

Abstract #3129
6/1/2024 9:00 AM-
12:00 PM CDT

Characterization of diverse targetable ERBB2 alterations in 512,993 patients with solid tumors

Memorial Sloan Kettering Cancer Center

FoundationOneCDx
FoundationOneLiquid CDx

Abstract #4138
6/1/2024 1:30 PM-
4:30 PM CDT

Genetic ancestry-associated differences in genomic profiling and treatment patterns in pancreatic ductal adenocarcinoma (PDAC)

Yale Cancer Center, New York University Perlmutter Cancer Center

FoundationOneCDx
Flatiron Health-Foundation
Medicine Clinico-Genomic
Database (CGDB)

Abstract #TPS3644
6/1/2024 1:30 PM-
4:30 PM CDT

Use of circulating tumor DNA (ctDNA) to affect the adjuvant or post-adjuvant treatment of patients with stage III and high-risk stage II resected colon cancer: The ERASE-CRC project by GONO

University of Pisa, Italy

FoundationOneTracker

Abstract #11545
6/1/2024 1:30 PM-
4:30 PM CDT

New soft tissue sarcoma (STS) transcriptomic clusters to unveil STS subsets with unique biological characteristics and refine the accuracy of overall survival (OS) prediction

Universitario Lisboa Norte, Institute Portugues de Oncologia de Lisboa Francisco Gentil, Institute Superior Tecnico, Universidade de Lisboa, Institute de Medicina Molecular Joao Lobo Antunes, Faculdade de Medicina da Universidade de Lisboa, F. Hoffmann-La Roche AG, Institute Superior Tecnico (1ST), Universidade de Lisboa, Hospital CUF Descobertas

FoundationOneRNA for
research use

Abstract #3067

6/1/2024 9:00 AM-
12:00 PM CDT

Nature and distribution of methyl thioadenosine phosphorylase (MTAP) genomic loss in human tumors

San Raffaele Hospital and Scientific Institute, Italy

FoundationOne
FoundationOneCDx

Abstract #1060
6/2/2024 9:00 AM-
12:00 PM CDT

Genomic alterations (GA) in ESR1, PIK3CA, AKT1, and PTEN in HR(+)HER2(-) patients (pts) with metastatic breast cancer (MBC): co-occurrence and prevalence along treatment course

Emory University

FoundationOneCDx
FoundationOneLiquid CDx
Flatiron Health-Foundation
Medicine Clinico-Genomic
Database (CGDB)

Abstract #591
6/2/2024 9:00 AM-
12:00 PM CDT

Pathological complete response (pCR) association with a novel homologous recombination deficiency HRD signature (HRDsig) in patients with triple-negative breast cancer (TNBC) receiving neoadjuvant therapy (Tx)

Stanford University

FoundationOneCDx
Flatiron Health-Foundation
Medicine Clinico-Genomic
Database (CGDB)

Abstract #5056
6/2/2024 9:00 AM-
12:00 PM CDT

BRCA1/2 reversion mutations in advanced prostate cancer in the absence of prior PARP inhibitor (PARPi) therapy

Cedars-Sinai Medical Center, Upstate University Medical Center, University of California – San Diego

FoundationOneLiquid CDx

Abstract #1042
6/2/2024 9:00 AM-
12:00 PM CDT

Utility of circulating tumor DNA (ctDNA) to inform treatment of patients with metastatic breast cancer

Johns Hopkins University School of Medicine, Vanderbilt University Medical Center, Allegheny Health Network, Weill Cornell Medicine and New York-Presbyterian Hospital

FoundationOneLiquid CDx

Abstract #5091
6/2/2024 9:00 AM-
12:00 PM CDT

Impact of alterations in tumor suppressor genes (TSG-alt) on survival outcomes in patients (pts) with de novo metastatic castration-sensitive prostate cancer (dn-mCSPC) receiving androgen deprivation therapy (ADT) with androgen receptor pathway inhibition (ARPI) or docetaxel

Huntsman Cancer Institute, Masonic Cancer Center

Flatiron Health-Foundation
Medicine Clinico-Genomic
Database (CGDB)

Abstract #5085
6/2/2024 9:00 AM-
12:00 PM CDT

Prognostic value of baseline circulating tumor DNA (ctDNA) tumor fraction (TF) in metastatic hormone-sensitive prostate cancer (mHSPC)

Rogel Comprehensive Cancer Center, University of Michigan, Karmanos Cancer Institute, Wayne State University

FoundationOneLiquid CDx

Abstract #5020
6/2/2024 9:00 AM-
12:00 PM CDT

Utility of ctDNA burden as a prognostic biomarker for efficacy in TALAPRO-2: A phase 3 study of talazoparib (TALA) + enzalutamide (ENZA) vs placebo (PBO) + ENZA as first-line (1L) treatment in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC)

Peter MacCallum Cancer Centre, Department of Medical Oncology, Institut Gustave Roussy, University of Paris-Saclay, Pfizer Inc., National Cancer Center Hospital East, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori, Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, The Urology Center of Colorado, National Cancer Center, Tom Baker Cancer Centre, University of Calgary, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Huntsman Cancer Institute (NCI-CCC), University of Utah

FoundationOneLiquid CDx
FoundationOneMonitor for
Research Use

Abstract #3626
6/2/2024 9:00 AM-
12:00 PM CDT

Contrasting comprehensive genomic profiles of adenocarcinomas of the appendix in younger versus older patients

Upstate Medical University

FoundationOne
FoundationOneCDx

Abstract #4588
6/2/2024 9:00 AM-
12:00 PM CDT

FGFR3-mutated urothelial carcinoma of bladder and upper tract including ureter and renal pelvis: A comparative genomic profiling study

Upstate Medical University, University of California – Los Angeles, University of Washington, Huntsman Cancer Center, Moffitt Cancer Center, MD Anderson Cancer Center, Cleveland Clinic, San Rafael University

FoundationOne
FoundationOneCDx

Abstract #8032
6/2/2024 9:00 AM-
12:00 PM CDT

Retrospective analysis of change in frequency of STK11 mutation in lung adenocarcinomas over a 10-year period

Upstate Medical University

FoundationOne
FoundationOneCDx

Abstract #1092
6/2/2024 9:00 AM-
12:00 PM CDT

Impact of HER2 low status on genomic signatures in triple negative breast cancer (TNBC)

Yale University

FoundationOne
FoundationOneCDx

Abstract #11575
6/2/2024 9:00 AM-
12:00 PM CDT

Intimal sarcomas (ISarc) of the cardiac chambers (CC) of the heart and great vessels (GV): A comprehensive genomic profiling (CGP) study

Upstate Medical University

FoundationOne
FoundationOneCDx

Abstract #6036
6/2/2024 9:00 AM-
12:00 PM CDT

Clinical, molecular, and immunologic profiling of brain metastases (BM) in head and neck squamous cell carcinoma (HNSCC)

Dana-Farber Cancer Institute, University of California – San Diego, Phase Genomics

Abstract #5614
6/3/2024 9:00 AM-
12:00 PM CDT

Endometrial cancer (EC) by ERBB2 amplification (ERBB2amp) status: Differences in molecular subtypes, ancestry, and real-world outcomes

University of Colorado Health, Mount Sinai

FoundationOneCDx

Abstract #8068
6/3/2024 1:30 PM-
4:30 PM CDT

Preliminary results of the Lung Cancer Mutation Consortium LCMC4 evaluation of actionable drivers in early-stage lung cancer (LEADER) screening trial

Baylor College of Medicine, Harvard University, University of Michigan, University of Missouri, University of Washington, University of California – Los Angeles, University of Colorado, Memorial Sloan Kettering

FoundationOneCDx
FoundationOneLiquid CDx

Abstract #8532
6/3/2024 1:30 PM-
4:30 PM CDT

Molecular profiling across histologies in lung cancer: Time to change WHO nomenclature?

Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, Papardo Hospital, Roche Sequencing Solutions

FoundationOneCDx

Verastem Oncology Announces the Initiation of a Rolling Submission of NDA to FDA Seeking Accelerated Approval of Avutometinib and Defactinib Combination for the Treatment of Adult Patients with Recurrent KRAS Mutant Low-Grade Serous Ovarian Cancer

On May 24, 2024 Verastem Oncology (Nasdaq: VSTM), a biopharmaceutical company committed to advancing new medicines for patients with cancer, reported that it has initiated the rolling submission of a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) seeking accelerated approval of the combination of avutometinib, a RAF/MEK clamp, and defactinib, a selective FAK inhibitor, for adult patients with recurrent KRAS mutant (KRAS mt) low-grade serous ovarian cancer (LGSOC), who received at least one prior systemic therapy (Press release, Verastem, MAY 24, 2024, View Source [SID1234643702]). The rolling review process allows the Company to submit completed sections of an application for review by the FDA before all sections become available. The initial sections of the application will include the nonclinical and quality sections. In discussions with the FDA, Verastem reached agreement to submit a primary efficacy analysis based on the RAMP 201 study with 12 months of follow up. Based on discussions with the FDA, we understand that the proposed indication for final submission of the clinical module can be expanded in the event Verastem provides data that demonstrates a substantial improvement over available therapy in the KRAS wild-type (KRAS wt) population. FDA has accepted Verastem’s plan to submit the clinical module in the second half of 2024 to complete the NDA application. Previously, the FDA granted Breakthrough Therapy Designation (BTD) for the combination for treatment of patients with recurrent LGSOC, regardless of KRAS status, following one or more previous lines of therapy and Orphan Drug Designation (ODD) for the combination in certain LGSOC indications. The Company plans to request a priority review of the NDA. Currently, there are no FDA-approved treatments specifically for recurrent LGSOC.

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Early/Late Stage Pipeline Development - Target Scouting - Clinical Biomarkers - Indication Selection & Expansion - BD&L Contacts - Conference Reports - Combinatorial Drug Settings - Companion Diagnostics - Drug Repositioning - First-in-class Analysis - Competitive Analysis - Deals & Licensing

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"The initiation of our rolling NDA submission of the avutometinib and defactinib combination for accelerated approval, is an important step towards addressing the significant unmet needs that patients face living with KRAS mutant low-grade serous ovarian cancer,"​ said Dan Paterson, president and chief executive officer of Verastem Oncology. "The data from our ongoing RAMP 201 trial continues to support our belief that the avutometinib and defactinib combination has the potential to be a new standard of care in patients with recurrent low-grade serous ovarian cancer, if approved. In the second half of this year, we anticipate completing our NDA submission with the mature data from the RAMP 201 trial and discussing with the FDA a path forward for patients with KRAS wild-type disease. We also expect to present the mature dataset at a medical meeting in the second half of 2024."​

RAMP 201 is a Phase 2 registration-directed study evaluating avutometinib and defactinib combination in patients with recurrent LGSOC. The enrollment in RAMP 201 is completed, with 115 patients being treated at the recommended Phase 2 dose (RP2D) of avutometinib 3.2 mg twice weekly and defactinib 200 mg twice daily for 3 out of every 4 weeks, and follow-up continues. Verastem expects to complete the NDA submission after obtaining mature safety and efficacy data from the RAMP 201 trial, including 12 months of follow-up, anticipated in the second half of 2024. Verastem also plans to further discuss the KRAS wt data with FDA to inform the potential path forward for approval for this patient population. The Company plans to present the mature dataset from RAMP 201 at a medical meeting in the second half of 2024.​ As of February 2024, the interim data continued to show robust overall response rates (ORR) and durable responses with low discontinuation rates due to adverse events (AEs) in patients from RAMP 201 Parts A, B, C, who had a minimum follow-up of five (5) months.

The FDA granted Breakthrough Therapy Designation of the investigational combination of avutometinib and defactinib for the treatment of all patients with recurrent LGSOC regardless of KRAS status after one or more prior lines of therapy, including platinum-based chemotherapy in May 2021. Avutometinib alone or in combination with defactinib was also granted Orphan Drug Designation by the FDA for the treatment of LGSOC in March 2024. The Company believes that this Orphan Drug Designation signifies that LGSOC is a rare ovarian cancer that is a distinct and different disease from other forms of ovarian cancer such as high-grade serous ovarian cancer (HGSOC). LGSOC is highly recurrent and fatal, with no FDA-approved treatment options, and the current standard of care treatments include hormonal therapy or chemotherapy, which have demonstrated an ORR between 6-13% with discontinuation due to AEs of 17-30%. ​

The Company is currently enrolling patients and activating sites for RAMP 301, an international confirmatory Phase 3 trial, evaluating the avutometinib and defactinib combination versus standard of care chemotherapy or hormonal therapy for the treatment of patients with KRAS mt and KRAS wt recurrent LGSOC.

Conference Call and Webcast Information

Verastem will hold an investor conference call and webcast on Friday, May 24 at 8:00 am EDT, to review the initiation of the NDA submission and limited, topline data from the RAMP 201 trial, with a minimum follow-up of five (5) months and the RAMP 205 data. The call will feature members of Verastem’s management team. To access the conference call, please dial (844) 763-8274 (local) or (412) 717-9224 (international) at least 10 minutes prior to the start time and ask to be joined into the Verastem Oncology conference call. A live audio webcast of the call, along with accompany slides, will be accessible here. The Company expects to file an 8-K pertaining to this update.

About RAMP 201

RAMP 201 (ENGOTov60/GOG3052) is an adaptive, two-part multicenter, parallel cohort, randomized, open-label trial to evaluate the efficacy and safety of avutometinib alone and in combination with defactinib in patients with recurrent low-grade serous ovarian cancer. The first part of the study (Part A) determined the selection of the go forward regimen, which was the combination of avutometinib and defactinib versus avutometinib alone, based on overall response rates. The expansion phases of the trial (Parts B and C) are evaluating the safety and efficacy of the go forward regimen of avutometinib 3.2 mg twice weekly and defactinib 200 mg twice daily. The Part D portion of the trial is evaluating a low dose of avutometinib in combination with defactinib to inform individualized dose reduction.

About RAMP 301

RAMP 301 (GOG-3097; ENGOT-ov81/NCRI) is an international collaboration between The GOG Foundation, Inc. (GOG) and the European Network of Gynaecological Oncological Trial groups (ENGOT) sponsored by Verastem Oncology. The trial is expected to enroll a total of 270 patients in the U.S., Canada, the United Kingdom, Europe, Australia and South Korea, who will be randomized to either the combination of avutometinib and defactinib or investigator’s choice chemotherapy (pegylated liposomal doxorubicin, paclitaxel, topotecan) or hormone therapy (letrozole, anastrozole). The primary endpoint is progression free survival (PFS) by Blinded Independent Central Review. Secondary endpoints include ORR, duration of response​, disease control rate, safety and tolerability, patient reported outcomes, and overall survival.

About Low-Grade Serous Ovarian Cancer (LGSOC)

LGSOC is a rare ovarian cancer that is insidious, persistent and ultimately fatal. LGSOC is distinct and different from high-grade serous ovarian cancer (HGSOC) and requires different treatment. LGSOC is highly recurrent and less sensitive to chemotherapy compared to HGSOC. Approximately 6,000-8,000 women in the U.S. and 80,000 worldwide are living with this disease. LGSOC affects younger women with bimodal peaks of diagnosis at ages between 20-30 and 50-60 and has a median survival of approximately ten years. The majority of patients report negative impact of LGSOC on their mental and physical health, fertility, and long-term quality of life. The current standard of care for this disease includes hormone therapy and chemotherapy, but there are no treatments specifically approved by the U.S. Food and Drug Administration to treat LGSOC.

About the Avutometinib and Defactinib Combination

Avutometinib is a n investigational RAF/MEK clamp that is designed to induce inactive complexes of MEK with ARAF, BRAF and CRAF potentially creating a more complete and durable anti-tumor response through maximal RAS/MAPK pathway inhibition. Avutometinib is designed to block both MEK kinase activity and the ability of RAF to phosphorylate MEK. This differentiated proposed mechanism potentially allows avutometinib to block MEK signaling without the compensatory activation of MEK that appears to limit the efficacy of other MEK-only inhibitors. The U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation of the investigational combination of avutometinib and defactinib, a selective FAK inhibitor, for the treatment of all patients with recurrent low-grade serous ovarian cancer (LGSOC) regardless of KRAS status after one or more prior lines of therapy, including platinum-based chemotherapy. Avutometinib alone or in combination with defactinib was also granted Orphan Drug Designation by the FDA for the treatment of LGSOC.

Verastem Oncology is currently conducting clinical trials with avutometinib in RAS/MAPK driven tumors as part of its Raf And Mek Program or RAMP. RAMP 301 (NCT06072781) is an international Phase 3 confirmatory trial evaluating the combination of avutometinib and defactinib versus standard chemotherapy or hormonal therapy for the treatment of recurrent LGSOC. RAMP 201 (NCT04625270) is a Phase 2 registration-directed trial of avutometinib in combination with defactinib in patients with recurrent LGSOC and enrollment has been completed in each of the dose optimization and expansion phases and the low-dose evaluation.

Verastem Oncology has established clinical collaborations with Amgen and Mirati to evaluate LUMAKRAS (sotorasib) in combination with avutometinib and defactinib and KRAZATI (adagrasib) in combination with avutometinib in KRAS G12C mutant NSCLC as part of the RAMP 203 (NCT05074810) and RAMP 204 (NCT05375994) trials, respectively. The RAMP 205 (NCT05669482), a Phase 1b/2 clinical trial evaluating avutometinib and defactinib with gemcitabine/Nab-paclitaxel in patients with front-line metastatic pancreatic cancer, is supported by a PanCAN Therapeutic Accelerator Award.