The EndoPredict® Test Significantly Outperforms the First-Generation Test in Predicting the Risk of Node-Negative and Node-Positive Breast Cancer Recurrence

On December 9, 2016 Myriad Genetics, Inc. (NASDAQ:MYGN), a leader in molecular diagnostics and personalized medicine, reported results of a large head-to-head study comparing the efficacy of six tests used to predict the recurrence of breast cancer (Press release, Myriad Genetics, DEC 9, 2016, View Source [SID1234517014]). A key finding was that EndoPredict (EPclin), a second-generation test, was superior to Oncotype Dx (RS), a first-generation test, in predicting the long-term recurrence of breast cancer. The results are being featured today in a podium presentation at the 2016 San Antonio Breast Cancer Symposium (SABCS) in San Antonio, Texas.

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"In this important study, EndoPredict more accurately predicted the risk of breast cancer recurrence than the first-generation Oncotype Dx test, particularly in years five to 10 following surgery when half of breast cancer recurrences will happen," said Johnathan Lancaster, M.D., Ph.D., chief medical officer, Myriad Genetic Laboratories. "Clinicians can consider using EndoPredict to identify patients who can forgo chemotherapy with confidence, knowing they have a low risk of recurrence over 10 years."

Podium Presentation
Title: Comprehensive comparison of prognostic signatures for breast cancer in TransATAC.
Presenter: Ivana Sestak, Ph.D.
Date: Friday, Dec.9, 2016: 4:15 p.m. CT.
Location: S6-05; General Session 6 – Hall 3.

This study was led by scientists at the Institute of Cancer Research in London. The analysis included 818 women with ER+/HER2- breast cancer (591 node-negative; 227 node-positive) from the TransATAC study and compared the power of six predictive signatures, including: clinical treatment score, immunohistochemical markers, Oncotype Dx recurrence score (RS), breast cancer index (BCI), Prosigna and EndoPredict (EPClin). Distant recurrence of breast cancer was the primary endpoint and the median follow-up period was 10 years.

Overall, each of the three second-generation tests evaluated (breast cancer index, Prosigna and EndoPredict) outperformed Oncotype Dx in this cohort in predicting the recurrence of breast cancer in both node-negative and node-positive patients across both zero to 10 and five to 10 years post-surgery. In a head-to-head comparison between EndoPredict and Oncotype Dx in this study:

EndoPredict offered more predictive power than Oncotype Dx across zero to 10 years.
The data show that the likelihood ratio (LRx2, a common measure of predictive power) for EndoPredict was almost double that of Oncotype Dx in node-negative patients (EndoPredict: LRX2= 40.6; Oncotype: LRX2=22.8) and was five times higher in node-positive patients (EndoPredict: LRX2= 35.6; Oncotype: LRX2=6.4).

EndoPredict had superior predictive power over Oncotype Dx between five to 10 years.
The likelihood ratio for EndoPredict was seven times higher than for Oncotype Dx in node-negative patients (EndoPredict: LRX2= 24.0; Oncotype: LRX2=3.4) and 13 times higher in node-positive patients (EndoPredict: LRX2= 14.9; Oncotype: LRX2=1.1). Importantly, the likelihood ratio for Oncotype DX failed to achieve statistical significance in predicting cancer recurrence in years five to 10 for either node-positive or node-negative patients, indicating an inability to predict distant recurrence over the five to 10 year timeframe.

EndoPredict was superior in classifying node-positive patients as low-risk compared to Oncotype Dx.
Node-positive patients classified as low risk by EndoPredict had a substantially lower 10-year recurrence rate (5.6 percent) than patients classified as low risk by Oncotype Dx (26.2 percent) as well as a lower five to 10 year recurrence rate (3.3 percent for EndoPredict vs 17.9 percent for Oncotype Dx).
"Myriad is committed to research that improves care for patients with breast cancer. Patients at high risk of cancer recurrence are candidates for adjuvant chemotherapy after surgery, while those at low risk can be spared chemotherapy and the side effects," said Lancaster. "We believe EndoPredict will help clinicians and patients understand the risk of breast cancer recurrence and identify more patients who can safely forgo chemotherapy. Additionally, EndoPredict does not contain an intermediate risk category and each patient receives a clear test result, allowing oncologists to confidently develop their treatment plan."

The TransATAC study, in part, was previously published in the Journal of the National Cancer Institute (View Source). The current presentation at SABCS expands on that article and provides a comprehensive comparison of prognostic signatures for breast cancer. Follow Myriad on Twitter via @MyriadGenetics and stay informed about symposium news and updates by using the hashtag #SABCS16.

Calithera Biosciences to Host Conference Call and Webcast to Review Data Presented at the San Antonio Breast Cancer Symposium and EORTC-NCI-AACR Symposium

On December 9, 2016 Calithera Biosciences, Inc. (Nasdaq:CALA), a clinical stage biotechnology company focused on the development of novel cancer therapeutics, reported that the company will host a live conference call and webcast on Monday, December 12, 2016 at 8:30 a.m. EST (5:30 a.m. PST) to discuss recent CB-839 clinical data presentations at the San Antonio Breast Cancer Symposium, the EORTC-NCI-AACR (Free EORTC-NCI-AACR Whitepaper) Symposium, and other recent corporate highlights and business developments (Press release, Calithera Biosciences, DEC 9, 2016, View Source;p=RssLanding&cat=news&id=2228746 [SID1234517011]).

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The live audio webcast can be accessed via the Investor section of the Company’s website at www.calithera.com. The conference call can be accessed by dialing (855) 783-2599 (domestic) or (631) 485-4877 (international) and refer to conference ID 36690670. Please log in approximately 5-10 minutes before the event to ensure a timely connection. The archived webcast will remain available for replay on Calithera’s website for 30 days.

BioInvent terminates current BI-505 Phase II study

On December 9, 2016 BioInvent International (OMXS: BINV) reported that it has decided to terminate its current clinical Phase II study with BI-505 in multiple myeloma (Press release, BioInvent, DEC 9, 2016, http://www.bioinvent.com/media-centre/press-releases/release/?ReleaseID=D31A6036F0928688 [SID1234517021]). The decision follows BioInvent’s review and discussion with the US Food & Drug Administration (FDA), who put BI-505 on full clinical hold in November 2016.

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The terminated trial, which was performed in collaboration with Penn Medicine, targeted a specific population of multiple myeloma patients undergoing autologous stem cell transplantation with high-dose melphalan.

US FDA accepts first biologics license application for AstraZeneca’s durvalumab in bladder cancer

On December 9, 2016 AstraZeneca and its global biologics research and development arm, MedImmune, reported that the US Food and Drug Administration (FDA) has accepted the first Biologics License Application (BLA) for durvalumab, a PD-L1 human monoclonal antibody (mAb), and granted priority review status with a Prescription Drug User Fee Act (PDUFA) set for the second quarter of 2017 (Press release, AstraZeneca, DEC 9, 2016, View Source [SID1234517018]).

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The BLA submission, for the treatment of patients with locally advanced or metastatic urothelial carcinoma (UC) whose disease has progressed during or after one standard platinum‑based regimen, is based on the results of the UC cohort of Study 1108 and follows the FDA’s February 2016 Breakthrough Therapy Designation for durvalumab.

Sean Bohen, Executive Vice President, Global Medicines Development and Chief Medical Officer at AstraZeneca, said: "The BLA acceptance of durvalumab in urothelial cancer is an important milestone for patients who still face considerable unmet medical need in this area. It also represents an exciting advance for our Immuno-Oncology medicines as we continue to develop chemotherapy-free treatments based on the potential clinical benefits of durvalumab, both as monotherapy and in combination."

As part of a broad development programme, durvalumab is being tested as monotherapy and in combination with tremelimumab (CTLA-4 mAb) in the Phase III DANUBE trial as 1st-line treatment for patients with metastatic UC, regardless of eligibility for cisplatin-based chemotherapy.

The combination of durvalumab and tremelimumab is also being studied in Phase III trials in non-small cell lung cancer (NSCLC), head and neck squamous cell carcinoma (HNSCC) and in Phase II and earlier trials in gastric cancer, pancreatic cancer, hepatocellular carcinoma (HCC) and blood cancers. AstraZeneca currently has more than 30 ongoing durvalumab clinical trials in combination with other IO agents and targeted therapies.

About Study 1108

Study 1108 is a Phase I/II multicentre, open-label dose-escalation and dose-expansion study investigating the safety and efficacy of durvalumab in adult patients with inoperable or metastatic solid tumours.

About Urothelial Cancer (UC)

Urothelial cancer develops in the cells of the bladder lining (urothelium) and is the most common type of bladder cancer. UC accounts for more than 90% of all cases of bladder cancer worldwide and is an area of significant unmet medical need. Current standard of care for UC patients with inoperable or advanced metastatic disease is systemic platinum-based chemotherapy, introduced nearly 30 years ago.

About Durvalumab

Durvalumab is an investigational human monoclonal antibody directed against programmed death ligand-1 (PD-L1). PD-L1 expression enables tumours to evade detection from the immune system through binding to PD-1 on cytotoxic T lymphocytes. Durvalumab blocks PD-L1 interaction with both PD-1 and CD80 on T cells, countering the tumour’s immune- evading tactics and activating the patient’s immune system to attack the cancer. Durvalumab received FDA Breakthrough Therapy Designation in patients with PD-L1 positive inoperable or metastatic UC in 2016 and Fast Track Designation in 2015 for the treatment of patients with PD-L1 positive metastatic head and neck squamous cell carcinoma.

PellePharm Launches with Financing from BridgeBio Pharma to Develop Topical Therapy for Basal Cell Carcinomas and Gorlin Syndrome

On December 8, 2016 PellePharm, a clinical-stage biopharmaceutical company committed to developing patidegib, a topical hedgehog inhibitor to treat basal cell carcinomas (BCCs), including those in Gorlin Syndrome, a devastating orphan disease, reported its launch with financing from BridgeBio Pharma (Press release, BridgeBio, DEC 8, 2016, View Source [SID1234527852]). This financing supports the development of topical patidegib through the completion of two phase 2 clinical trials that are underway, including a clinical trial in Gorlin Syndrome that just completed enrollment. In addition, the company has a drawable pool of capital from BridgeBio Pharma that enables it to finance future clinical trials through registration.

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PellePharm was founded by a team of globally recognized experts in dermatology, oncology and hedgehog signaling and is managed by a team of industry experts. The company is dedicated to finding an effective therapy to manage the extensive tumor burden in Gorlin Syndrome, a rare genetic disease that causes patients to develop multiple BCCs. Gorlin Syndrome affects about 10,000 people in the United States and 15,000 people in the European Union. The disease results from a mutation in a tumor-suppressor gene, which acts as the primary inhibitor of the hedgehog signaling pathway. PellePharm’s founders developed a topical gel formulation of a proprietary hedgehog inhibitor that it exclusively licensed from Infinity Pharmaceuticals to help mitigate certain adverse events observed with oral hedgehog inhibitors.

"It made sense that a potent inhibitor of the hedgehog pathway should provide a therapeutic benefit for patients suffering from Gorlin Syndrome, but we needed an approach that would allow us to target the disease at its source without eliciting harmful toxicity reactions," said Ervin Epstein, M.D., co-founder of PellePharm. "We are hopeful that patidegib will provide the balance of targeted treatment without the adverse events associated with oral formulations."

PellePharm’s approach attracted the attention of industry veterans Mark de Souza, Ph.D. and Karl Beutner, M.D., Ph.D. who joined the team. "It’s not often that you find a program as attractive as PellePharm’s patidegib," said de Souza, executive chairman of PellePharm. "This investigational treatment has the potential to address a very high unmet need among patients with Gorlin Syndrome, whose current standard of care is to undergo multiple surgeries each year to manage their symptoms. We know that hedgehog pathway inhibitors have therapeutic potential for this condition, and we believe PellePharm’s topical formulation may offer a truly effective treatment option for these patients."

PellePharm is currently conducting two double-blinded, placebo-controlled, randomized, phase 2 clinical trials that are evaluating the safety, tolerability and effect of topical patidegib on both pre-existing tumors and the frequency of the development of new tumors. A U.K.-based study is evaluating 18 patients with Gorlin syndrome to determine whether the product shrinks the tumors present at the beginning of the study and reduces the number of new tumors that develop during the trial. A U.S.-based study is evaluating 36 patients with sporadic BCCs to determine whether tumor diameter decreases after 12 weeks of treatment. Both studies also will evaluate safety and tolerability, as well as a biomarker (GLI-1) of hedgehog signaling. Enrollment in the U.K. trial is complete and topline data is expected in the second quarter of 2017.

"PellePharm is really at the intersection of precision oncology and monogenic dermatology – these are the types of assets we look for at BridgeBio Pharma," said Frank McCormick, investment committee member of BridgeBio Pharma and board member of PellePharm. "Gorlin Syndrome is a well-researched disease that can be treated directly at its source. We have had the privilege of knowing the founding and operating team of PellePharm for years and look forward to working with them to bring patidegib to patients in need."

Founders and Scientific Advisory Board Members
PellePharm was founded by a group of globally recognized experts in dermatology, oncology and hedgehog signaling who continue to lend expertise and counsel to the PellePharm management team. Founders and scientific advisory board members include:

Philip Beachy, Ph.D., professor of biochemistry and developmental biology, Stanford University
Ervin Epstein, M.D., senior scientist, Children’s Hospital of Oakland Research Institute
Jean Tang, M.D., Ph.D., associate professor of dermatology, Stanford University
About Basal Cell Carcinomas (BCCs) and Gorlin Syndrome
Basal cell carcinomas (BCCs) are a type of skin cancer that begins when one of the skin cells spontaneously develops a mutation in its DNA, usually due to UV radiation (sunlight, tanning lamps). They commonly occur in sun-exposed areas like the face and neck and generally in people of European descent with lighter skin and in the elderly and in people with chronic sun exposure. There are more than four million BCCs diagnosed in the United States each year. BCCs are usually treated with surgery, which can leave disfiguring scars.

Gorlin Syndrome, also known as nevoid basal cell carcinoma syndrome, is a rare genetic disease where patients develop many BCCs. Patients with Gorlin Syndrome have heritable mutations in the tumor suppressor gene encoding Patched1 (PTCH1), which acts as the primary inhibitor of the hedgehog signaling pathway; this leads to hundreds of BCCs, especially on the face and sun-exposed areas. The standard of care is surgery, as there are no FDA-approved drugs for Gorlin Syndrome. Individuals who have severe Gorlin Syndrome have as many as 30 surgeries per year, many of which can be scarring.