TG Therapeutics Announces Positive DSMB Recommendation for Continuation of the UNITY-CLL Phase 3 Trial

On November 22, 2016 TG Therapeutics, Inc. (NASDAQ:TGTX), reported that the independent Data Safety Monitoring Board (DSMB) providing oversight for the UNITY-CLL Phase 3 trial reviewed the cumulative safety data from the ongoing clinical study and informed the Company that it has identified no safety concerns, and recommended the continuation of the study with no modifications (Press release, TG Therapeutics, NOV 22, 2016, View Source [SID1234516760]).

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Per the protocol’s pre-specified DSMB charter, the DSMB is scheduled to meet approximately every 6-9 months to review cumulative safety data. "We are encouraged by the positive outcome of the first DSMB safety review, especially since over two-thirds of the patients currently enrolled in the study are treatment naive CLL patients. Many may recall, as reported by Dr. Jennifer Brown at last year’s ASH (Free ASH Whitepaper) meeting, and published earlier this year in Blood, that idelalisib in treatment naive CLL patients was observed to cause rapid (most within < 5 weeks) and profound (Grade 3/4) liver toxicity in approximately 50% of the patients treated. Given those findings, we are pleased to report that the DSMB did not find any safety concerns and recommended the study continue without modification," stated Michael S. Weiss, the Company’s Executive Chairman and Interim Chief Executive Officer. Mr. Weiss continued, "We are also excited to report that the UNITY-CLL study continues to enroll well and we are still targeting completion of enrollment in the first half of 2018."

AstraZeneca head and neck cancer trials resume new patient enrolment as FDA lifts partial clinical hold

On November 22, 2016 AstraZeneca reported that the US FDA has lifted the partial clinical hold on the enrolment of new patients with head and neck squamous cell carcinoma (HNSCC) for clinical trials of durvalumab as monotherapy and in combination with tremelimumab or other potential medicines (Press release, AstraZeneca, NOV 22, 2016, View Source [SID1234516738]).

The Phase III KESTREL trial has already re-opened for new patient enrolment at some clinical study sites and the EAGLE trial is expected to resume recruitment shortly, without amendments to either protocol. AstraZeneca will progressively resume enrolment for all HNSCC trials across the participating sites in the US and globally, subject to national health authority and ethics committee approval where required. The status of active recruitment will be reflected on clinicaltrials.gov in the coming days.

The partial clinical hold on new patient enrolment was communicated on 27 October, after preliminary findings from ongoing clinical trials related specifically to head and neck cancer. The FDA lifted the partial clinical hold following a review of the comprehensive analysis provided by AstraZeneca of bleeding events that were observed as part of the routine safety monitoring of the Phase III KESTREL (NCT02551159) and EAGLE (NCT02369874) trials.

Monitoring of safety signals is an integral part of the development process for new medicines. Bleeding is a known complication in treatments of head and neck cancers primarily due to the nature of the underlying disease, the proximity of tumours to major blood vessels and use of prior cancer therapies, which may involve surgery and radiation.

10-Q – Quarterly report [Sections 13 or 15(d)]

Oncbiomune has filed a 10-Q – Quarterly report [Sections 13 or 15(d)] with the U.S. Securities and Exchange Commission (Filing, 10-Q, OncBioMune Pharmaceuticals, 2017, NOV 21, 2016, View Source [SID1234522125]).

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Clinical and Pre-Clinical Data on Mustang Bio’s MB-101 (IL13Ra2-specific CAR T cells) for the Treatment of Glioblastoma (GBM) Presented at the 21st Annual Meeting and Education Day of the Society for Neuro-Oncology

On November 21, 2016 Mustang Bio, Inc. ("Mustang"), a Fortress Biotech (NASDAQ: FBIO) Company, reported that Phase 1 clinical data and pre‐clinical data on its MB‐101 (IL13Rα2‐specific Chimeric Antigen Receptor–engineered CAR T cells (CAR T cells)) product candidate in development for the treatment of glioblastoma were presented by investigators from the City of Hope ("COH") in oral sessions at the 21st Annual Meeting and Education Day of the Society for Neuro‐Oncology ("SNO") in Scottsdale, AZ (Press release, Fortress Biotech, NOV 21, 2016, View Source;FID=1500093635 [SID1234516780]).   

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Dr. Lindsay A. Rosenwald, Fortress Biotech’s Chairman, President and Chief Executive Officer commented, "CAR T cell therapy has shown promise in treating certain forms of hematological cancers.  However, translating that activity into solid tumors has been challenging to date.  The clinical data presented at SNO by the investigators from COH suggest MB‐101 is safe and well‐tolerated, and capable of eliciting a potent anti‐tumor response in patients with glioblastoma (GBM), a disease that is almost universally fatal.  We believe this is the first evidence of activity of CAR T cells in the treatment of GBM.  We are very encouraged by the early evidence of anti‐tumor activity with MB‐101 with five of seven post‐surgical resection patients showing stable disease for >8 weeks and, in particular, one patient showing complete response for 7.5 months. Interestingly, this patient was the only patient of the seven to receive, on a compassionate use basis, the dual delivery of CAR T cells by both intracavitary and via intraventricular administration, which provides systemic CNS delivery of the CAR T cells.  We look forward to continuing to advance MB‐101 in Phase 1 studies and further exploring the dual delivery approach beyond this single patient experience."

The following summarizes the oral presentations on November 18, 2016 at SNO:

Phase I Study of Chimeric Antigen Receptor–Engineered T cells Targeting IL13Rα2 for the Treatment of Glioblastoma

Presenter: Christine E. Brown, PhD, Heritage Provider Network Professor of Immunotherapy, Associate Director, T Cell Therapeutics Research Laboratory, City of Hope National Medical Center/Beckman Research Institute

The Phase I study presented showed early clinical data evaluating IL13Rα2‐targeted CAR T cell therapy for the treatment of glioblastoma.  On this study, patients are treated on a four‐week therapeutic regimen consisting of three weekly intracranial infusions of IL13Rα2‐specific CAR T cells followed by one rest week for toxicity and disease assessment.  To date, seven patients have been treated with local intracavitary delivery of the CAR T cells following surgical resection.
Some highlights from the presentation included:
The treatment was well‐tolerated in all patients treated – with No DLTs or therapy‐related SAEs
No grade 3 or higher toxicities attributed to the therapy were observed
No CRS or Neurotoxicity was observed
Only grade  < 2 fevers, headaches, myalgia, chills
Best Response: 2 PD, 4 SD for >8‐weeks, 1 SD CR following intraventricular CAR T therapy for 7.5 months

Development of murine IL13Rα2‐targeted CAR T cells (mIL13BBζ) for assessment of CAR T cell therapy in syngeneic glioma models

Presenter: Darya Alizadeh, PhD, City of Hope National Medical Center/Beckman Research Institute

The pre‐clinical research program presented discussed a murine IL13Rα2‐targeted CAR T cell platform that was developed to evaluate parameters that impact the efficacy of CAR T cell therapy. Overall, the development of mIL13BBζ CAR T cells and its applications will allow researchers to assess factors that may impact the efficacy of CAR T cells and provide invaluable information critical for combination therapies and clinical trial design.  These studies may also provide important insights for improving therapeutic outcomes for patients with glioblastoma.

About Glioblastoma multiforme (GBM)
Glioblastomas (GBM) are tumors that arise from astrocytes cells that make up the supportive tissue of the brain. These tumors are usually highly malignant (cancerous) because the cellsreproduce quickly and they are supported by a large network of blood vessels. GBM isthe most common brain and central nervoussystem (CNS) malignancy, accounting for 15.1 percent of all primary brain tumors and 55.1 percent of all gliomas. There will be an estimated 12,120 new glioblastoma casesin the U.S. in 2016. Malignant brain tumors are the most common cause of cancer‐ related deaths in adolescents and young adults aged 15‐39, and the most common cancer occurring among 15‐19 year olds in the U.S. (Brain Tumor Statistics. American Brain Tumor Association.  December 2015). While GBM is a rare disease (2‐3 cases per 100,000 person life years in the U.S. and EU), it is quite lethal with five‐year survival rates historically lessthan 10 percent. Chemotherapy with temozolomide and radiation are shown to extend mean survival from approximately 12 to 15 months, while surgery remains the standard of care. GBM remains difficult to treat due to the inherent resistance of the tumor to conventional therapies. Treatment is further complicated by the susceptibility of the brain to damage, difficulty of the brain to repair itself and limitation to drugs crossing the blood brain barrier. Immunotherapy approaches targeting brain tumors offer promise over conventional treatments.

About MB‐101 (IL13Rα2‐specific CAR T cells)
IL13Rα2 is an attractive target for CAR T therapy as it has limited expression in normal tissue but is over‐expressed on the surface of the majority of GBM. CAR T cells are designed to express a membrane‐tethered IL‐13 receptor ligand (IL‐13) incorporating a single point mutation that provides high affinity for IL13Rα2 and reduces binding to IL13Rα1 in order to reduce healthy tissue targeting.  

Mustang is developing an optimized CAR T product incorporating enhancements in CAR design and T cell engineering to improve antitumor potency and T cell persistence. We include a second‐generation hinge optimized CAR containing mutations in the IgG4 linker to reduce off‐target Fc interactions, as well as the 41BB (CD137) co‐stimulatory signaling domain forimproved persistence of CAR T cells, and extracellular domain of CD19 as a selection/safety marker. In order to further improve persistence, central memory T cells are enriched and genetically engineered using a manufacturing process that limits ex vivo expansion in order to reduce T cell exhaustion and maintain a memory T cell phenotype.

Ruga Corporation Announces Move to Houston with $20 Million Grant from CPRIT and Name Change to Aravive Biologics

On November 21, 2016 Ruga Corporation reported the company’s name change to Aravive Biologics, Inc., and the relocation of its business operations to Houston, Texas (Press release, Aravive Biologics, NOV 21, 2016, View Source [SID1234516733]). The move follows the company’s award of a $20 million grant from the Cancer Prevention & Research Institute of Texas (CPRIT), which is supporting the development of a novel drug candidate, Aravive-S6, as a potential treatment for acute myelogenous leukemia (AML) and solid tumors including ovarian, pancreatic, and breast cancers.

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"We are very pleased to be selected to receive this significant funding from CPRIT and look forward to building our business in Houston’s Texas Medical Center," said Ray Tabibiazar, M.D., President and Chief Executive Officer of Aravive Biologics. "Houston’s vibrant biomedical community is home to many of the top cancer researchers in the United States, including noted experts on AML, our lead hematologic cancer indication. We look forward to accessing this outstanding expertise and growing our presence within the local biomedical community as we advance Aravive-S6 into clinical trials."

"Investing in Aravive Biologics’ clinical development program was an easy decision for CPRIT," said Michael Lang, Chief Product Development Officer of CPRIT. "Aravive-S6 is an innovative compound that has exhibited strong preclinical proof-of-principal, and it addresses a critical unmet medical need. The company also has experienced management with an excellent track record in oncology drug development. Aravive team members are well positioned for success, and we welcome them to the Houston biomedical community."

Aravive-S6 is a novel high-affinity, soluble Fc-fusion protein designed to block the activation of the GAS6- AXL signaling pathway by serving as a decoy that prevents the binding of GAS6 to the AXL receptor on the surface of tumor cells. The AXL receptor, when activated through GAS6 binding, has been shown to act as a "survival switch," a key driver of invasiveness and metastasis, and a critical regulator of therapeutic resistance to cytotoxic chemotherapeutic drugs.

Aravive Biologics has robust and compelling data demonstrating the in vivo efficacy and tolerability of its lead drug candidate in preclinical models of ovarian, renal, breast, and pancreatic cancer, and AML. Aravive-S6 provides high specificity and selectivity for the AXL/GAS6 pathway that other anti-AXL and anti-GAS6 inhibitors have been unable to match; it has greater than 100-fold tighter affinity for GAS6 compared to other anti-AXL and anti-GAS6 antibody candidates in development. Aravive Biologics has also developed a proprietary complementary diagnostic tool that may enable the identification of patients with cancers exhibiting elevated GAS6 levels, which would allow the company to match its drug candidate to those patients most likely to benefit from therapy.

AML is a cancer that begins in bone marrow and affects cells intended to mature into different types of blood cells. Research shows that interaction between the AXL receptor and its GAS6 ligand leads to more severe and invasive cases of AML.

"As patients with AML tend to be older (over 60 years of age) and possibly also in poorer health, they are often unable to tolerate standard, intensive chemotherapy regimens and thus must undergo less rigorous treatment, said Amato Giaccia, Ph.D., Chief Scientific Officer and co-founder of Aravive. "We envision that Aravive-S6 might be administered either as a single agent or as a complement to standard chemotherapy that assists in reducing the survival of cancer cells, which have become "addicted" to AXL/GAS6 signaling, while attempting to achieve or maintain remission."

Each year, approximately 19,950 new cases of AML are diagnosed, primarily in adults, and about 10,430 deaths from the disease, nearly all in adults. About 35% of AML cases exhibit active GAS6/AXL signaling, an incidence which may potentially qualify Aravive-S6 for Orphan Drug Designation.