On June 28, 2022 BioLineRx Ltd. (NASDAQ: BLRX) (TASE: BLRX), a late clinical-stage biopharmaceutical company focused on oncology, reported that the Company has entered into a collaboration agreement with GenFleet Therapeutics, an immuno-oncology focused biopharmaceutical company based in China, to advance Motixafortide through a randomized Phase 2b clinical trial in pancreatic ductal adenocarcinoma, or PDAC (Press release, BioLineRx, JUN 28, 2022, View Source [SID1234616319]).

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Under the terms of the agreement, GenFleet will fully fund, design and execute a randomized Phase 2b clinical trial that will enroll approximately 200 first-line metastatic PDAC patients in China. This randomized controlled study will aim to evaluate the superiority of Motixafortide in combination with an anti-PD-1 and chemotherapy compared to chemotherapy alone, the current standard of care. As part of the collaboration, BioLineRx will supply Motixafortide, while GenFleet will supply the other study drugs for the trial. Trial oversight will be administered by a Joint Development Committee. GenFleet will be eligible to receive low-to-mid-single digit tiered percentage royalties on future Motixafortide sales, if approved.

"This collaboration is based on the highly encouraging results from our Phase 2a COMBAT/KEYNOTE-202 study of Motixafortide in combination with an anti-PD-1 and chemotherapy, which provide strong support for continued development in this very challenging disease," stated Philip Serlin, Chief Executive Officer of BioLineRx. "With its broad solid tumor oncology pipeline and highly experienced development team, we believe we have found an outstanding partner in GenFleet to execute a rigorously designed randomized Phase 2b trial."

"At the same time, we remain on track to submit our New Drug Application (NDA) for Motixafortide in stem cell mobilization in the U.S. in the next few months, and we are continuing our pre-launch activities in anticipation of potential FDA approval in 2023."

"Together, these programs demonstrate the potential versatility of Motixafortide and its promise of new combination therapies targeting both hematological and solid tumor cancers," Mr. Serlin concluded.

"The results of the COMBAT/KEYNOTE-202 Phase 2a study demonstrate the benefit of combining the CXCR4 inhibitor Motixafortide with an anti-PD-1 and chemotherapy in a second-line setting," said Qiang Lu, Chairman of GenFleet. "We believe that this combination could be beneficial to patients in a first-line setting as well, and we hope to confirm this in a randomized trial. We are thrilled to be partners with BioLineRx in the development of this late-stage clinical asset, and look forward to initiating this important trial as quickly as possible."

In parallel, BioLineRx is continuing its collaboration with Colombia University in an on-going Phase 2 investigator-initiated study (NCT04543071) to evaluate Motixafortide in combination with the anti-PD-1 LIBTAYO (cemiplimab) and standard-of-care chemotherapy (gemcitabine and nab-paclitaxel) in first-line PDAC patients.

MSQ Ventures served as advisor to BioLineRx on this transaction.

About Pancreatic Cancer

Pancreatic cancer has a low rate of early diagnosis and a poor prognosis. Its incidence rate in the US is estimated at 3.2% of new cancer cases. In 2022, approximately 495,000 individuals globally are expected to be diagnosed with this condition, 62,000 of them in the US; and the incidence of pancreatic cancer is expected to continue to increase. Symptoms are usually non-specific and as a result, pancreatic cancer is often not diagnosed until it reaches an advanced stage. Surgical resection does not offer adequate treatment since only 20% of patients have resectable tumors at the time of diagnosis. Even among patients who undergo resection for pancreatic cancer and have tumor-free margins, the five-year survival rate is only 10-25%. The overall five-year survival rate among pancreatic cancer patients is 8%, which constitutes the highest mortality rate among solid tumor malignancies. The overall median survival is less than one year from diagnosis, highlighting the need for the development of new therapeutic options.

Despite advances in chemotherapeutics and immunotherapy, increases in median and overall survival rates in pancreatic cancer have been modest. Pancreatic cancer remains an area of unmet medical need, with very limited new approved therapies for the majority of PDAC patients since the approval of nab-paclitaxel (Abraxane) in combination with gemcitabine for first-line treatment in 2013 and Onivyde in combination with fluorouracil and leucovorin for second-line treatment in 2015. The limited clinical benefits demonstrated by these existing standard treatment options reinforce the need for additional approaches.

About COMBAT/KEYNOTE-202

In December 2020, BioLineRx announced final positive results from its Phase 2a COMBAT/KEYNOTE-202 triple combination study of Motixafortide in second line PDAC. The highly encouraging results demonstrated improvement across all study endpoints, including overall survival, progression free survival and overall response rate, in the most challenging PDAC patients, as compared to historical data. All patients were diagnosed at Stage IV, and greater than 70% had liver metastases, a key determinant of poor prognoses in this patient population.