On February 27, 2024 SpringWorks Therapeutics, Inc. (Nasdaq: SWTX), a commercial-stage biopharmaceutical company focused on severe rare diseases and cancer, reported financial results for the fourth quarter and full year periods ended December 31, 2023 and provided an update on recent company developments (Press release, SpringWorks Therapeutics, FEB 27, 2024, View Source [SID1234640531]).

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"In 2023, OGSIVEO became the first FDA-approved therapy for adults with desmoid tumors with our approval in November and we are very pleased with the initial progress of our launch. We are also very excited by our opportunity in NF1-PN based on the positive topline data from our pivotal Phase 2b ReNeu trial, which demonstrated mirdametinib’s best-in-class potential for both children and adults with these devastating tumors. In addition, we made strong progress across our broader pipeline and continued to strengthen our financial position and our intellectual property protection for our lead assets," said Saqib Islam, Chief Executive Officer of SpringWorks. "Our focus for 2024 is to continue delivering a successful U.S. launch for OGSIVEO in desmoid tumors, to file our NDA for mirdametinib with the goal of having our second approval by 2025, to make progress towards expanding the reach of OGSIVEO into additional geographies outside of the U.S., and to unlock additional opportunities across our emerging portfolio."

Recent Business Highlights and Upcoming Milestones

OGSIVEO (Nirogacestat)

Received U.S. Food and Drug Administration (FDA) approval for OGSIVEO, an oral gamma secretase inhibitor, for the treatment of adult patients with progressing desmoid tumors who require systemic treatment on November 27, 2023.
Launched OGSIVEO in the U.S. and achieved net product revenue of $5.4 million in the first partial quarter of the launch. To date, OGSIVEO has been reimbursed by payers representing over 98% of commercial lives, as well as by Medicare and Medicaid, with coverage aligned to the FDA-approved label.
Highlighted the update of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) in December 2023 which recommend nirogacestat as an NCCN Category 1, Preferred treatment option for desmoid tumors.
Submitted a Marketing Authorization Application (MAA) for nirogacestat for the treatment of adult patients with desmoid tumors to the European Medicines Agency (EMA) in February 2024.
Presented additional patient-reported outcome data from the Phase 3 DeFi trial at the 2023 Connective Tissue Oncology Society Annual Meeting.
On track to report initial data from the Phase 2 trial evaluating nirogacestat as a monotherapy in patients with recurrent ovarian granulosa cell tumors in the second half of 2024.
Continuing to support several industry and academic collaborator studies evaluating nirogacestat as part of B-cell maturation antigen (BCMA) combination therapy regimens across treatment lines in patients with multiple myeloma.
Mirdametinib

Presented positive topline data from the pediatric and adult cohorts of the Phase 2b ReNeu trial evaluating mirdametinib, an investigational MEK inhibitor, in NF1-associated plexiform neurofibromas (NF1-PN) in November 2023. The confirmed objective response rate was 52% in pediatric patients and 41% in adult patients, as assessed by Blinded Independent Central Review, which was the primary endpoint of the study. Mirdametinib treatment also showed deep and durable responses and demonstrated significant improvements in key secondary patient-reported outcome measures. Mirdametinib was generally well tolerated in the trial, with the majority of adverse events (AEs) being Grade 1 or Grade 2. The most frequently reported AEs were rash, diarrhea, and vomiting in the pediatric cohort and rash, diarrhea, and nausea in the adult cohort.
On track to submit an New Drug Application (NDA) to the FDA for mirdametinib for the treatment of children and adults with NF1-PN in the first half of 2024.
Expect to present data from the pediatric and adult cohorts of the ReNeu trial at a medical congress in the first half of 2024 and to submit the trial results for publication in a peer-reviewed journal in 2024.
Emerging Pipeline

On track to present additional data from the dose expansion portion of the Phase 1b trial evaluating brimarafenib (BGB-3245) in adult patients with RAF mutant solid tumors in the second half of 2024. Brimarafenib is an investigational, selective RAF dimer inhibitor being developed by MapKure, LLC, a joint venture between SpringWorks and BeiGene, Ltd.
Patients continue to be enrolled in the dose escalation phase of the SpringWorks-sponsored Phase 1/2a combination study of brimarafenib and mirdametinib.
The FDA cleared the Investigational New Drug (IND) application submitted by MapKure for a combination study of brimarafenib with panitumumab, a monoclonal antibody targeting EGFR, in colorectal and pancreatic cancer patients with known MAPK pathway mutations. MapKure expects to initiate a Phase 1b trial in the first quarter of 2024.
Dose expansion cohort is ongoing in the BeiGene-sponsored Phase 1b/2 trial evaluating mirdametinib in combination with BeiGene’s RAF dimer inhibitor, lifirafenib, in adult patients with NRAS mutant solid tumors.
The FDA cleared the IND application for SW-682, a novel, oral, potent, and selective TEA Domain inhibitor designed to treat tumors driven by Hippo pathway mutations. SpringWorks plans to initiate a Phase 1a trial of SW-682 in Hippo mutant solid tumors in the first half of 2024.
General Corporate

Strengthened balance sheet with upsized public offering in December 2023; gross proceeds from the offering, before deducting underwriting discounts and commissions and offering expenses, were approximately $316.2 million.
The United States Patent and Trademark Office has recently issued four new patents for OGSIVEO and one new patent for mirdametinib, extending protection for both products into 2043. The U.S. patent portfolio for OGSIVEO includes 16 Orange Book listed patents; the U.S. patent portfolio for mirdametinib includes 10 patents that are expected to be Orange Book listed.
Fourth Quarter and Full Year 2023 Financial Results

Revenues: OGSIVEO net product revenues were $5.4 million in the fourth quarter of 2023, the first partial quarter of the U.S. launch.
Research and Development (R&D) Expenses: R&D expenses were $43.7 million and $150.5 million for the fourth quarter and full year 2023, respectively, compared to $37.9 million and $146.1 million for the comparable periods of 2022. The increase in R&D expense for the fourth quarter and year ended 2023 was primarily attributable to an increase in employee costs associated with head count growth, partially offset by a decrease in costs related to drug manufacturing, clinical trials and other research.
Selling, General and Administrative (SG&A) Expenses: SG&A expenses were $59.8 million and $197.6 million for the fourth quarter and full year 2023, respectively, compared to $40.5 million and $134.6 million for the comparable periods of 2022. The increase in SG&A expense for the fourth quarter and the full year 2023 were largely attributable to commercial readiness activities to support the U.S. launch of OGSIVEO.
Net Loss Attributable to Common Stockholders: SpringWorks reported a net loss of $94.3 million, or $1.44 per share, for the fourth quarter of 2023 and a net loss of $325.1 million, or $5.15 loss per share, for the year ended December 31, 2023. This compares to a net loss of $74.2 million, or $1.19 per share, for the fourth quarter of 2022 and a net loss of $277.4 million, or $5.21 per share for the year ended December 31, 2022.
Cash Position: Cash, cash equivalents and marketable securities were $662.6 million as of December 31, 2023.