On June 2, 2024 CatalYm reported positive new follow-up results from its ongoing "GDFATHER" Phase 1/2a trial (GDF-15 Antibody-mediaTed Human Effector Cell Relocation Phase 1/2a) (NCT04725474) in an oral presentation at the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) Annual Meeting 2024 in Chicago (Press release, Catalym, JUN 2, 2024, View Source;to-Last-Line-Metastatic-NSCLC-Urothelial-and-Hepatocellular-Cancer-Patients-Treated-with-VisugromabNivolumab-Combination [SID1234643958]). Featuring matured data from the non-small cell lung cancer (NSCLC) and urothelial cancer (UC) cohorts, as well as novel, early data for the hepatocellular carcinoma (HCC) cohort and an additional biomarker cohort, the presentation highlighted that treatment with a combination of CatalYm’s lead candidate, visugromab, combined with the anti-PD-1 antibody nivolumab achieves compelling deep and durable anti-tumoral activity in anti-PD-1/PD-L1 relapsed/refractory patients as defined by strict criteria. The combination of visugromab and nivolumab further demonstrates an excellent safety and tolerability profile. Visugromab is a monoclonal antibody designed to neutralize the tumor-produced Growth Differentiation Factor-15 (GDF-15), a central mediator of immune resistance to cancer therapies.

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The oral presentation by International Coordinating Investigator Prof. Ignacio Melero, MD, PhD, Co-Director of Immunology and Immunotherapy (CIMA) at the Universidad de Navarra, Pamplona/Spain, provides further evidence for the potential of visugromab to improve the clinical response depth and duration for patients with advanced, metastatic tumors.

"These recent data continue to impress us with the significant ability to generate deep partial and complete responses with enormous durability in heavily pretreated patients that have failed their approved therapies including prior anti-PD-(L)1 treatment as defined by strict criteria," said Prof. Dr. Eugen Leo, Chief Medical Officer at CatalYm. "Remarkably, more than half of all responders experienced a response level/depth as per RECIST 1.1 (up to lasting CR) that had not been achieved on their prior/initial anti-PD-(L)1 treatment. This demonstrates that GDF-15 blockade by visugromab can induce a remission depth and durability, and long-term immunologic tumor control that other cancer immunotherapies could not induce. Visugromab may have the potential to bring us a major step closer to finally providing deep long-term tumor control and potentially cure for metastatic solid tumor patients with non-squamous NSCLC, UC, and HCC."

Summary of Key Clinical Results:

The matured results from the Phase 2a indication-specific cohorts for NSCLC, UC, and all HCC so far treated show the following Objective Response Rates (ORR):
non-squamous NSCLC: ORR of 19.0% (4/21), with 2 partial responses (PR) and 2 complete responses (CR)
UC: ORR of 19.2% (5/26), with 4 PR and 1 CR
HCC: ORR of 20.0% (4/20), with 3 PR and 1 CR in the primary early readout
The DoR results indicate that visugromab may have a significant impact on deepening and prolonging responses to checkpoint inhibitor (CPI) therapy:
non-squamous NSCLC and UC: mean DoR surpassed 15 and 14 months, respectively, with 7/9 responses ongoing
HCC: data still maturing with 12 patients ongoing on study treatment at data cut-off in the newly initiated cohort
Overall, in a total of 90 patients with the above indications treated in various cohorts (including a biomarker-oriented cohort with varying tumor types), an ORR of 16.7% across all three main tumor types is currently observed, with data partly maturing further.
In totality, 8/15 RECIST 1.1 responders (53.3%) experienced a response level/depth (PR, CR) that had not been achieved with their initial CPI therapy:
Complete responses (CRs): Among the 4 patients who achieved CR, 3 had no prior CR on any treatment regimen, including previous CPI treatments.
Partial responses (PRs): 5/11 patients who achieved PR had no RECIST 1.1 response at all on prior CPI treatments.
The combination of visugromab with nivolumab showed excellent overall tolerability, with a safety profile very similar to nivolumab treatment alone:
most Treatment-Emergent Adverse Events (TEAEs) were mild to moderate
only 8.1% of patients experienced severe TEAEs (Grade ≥ 3)
Patient sample analyses strongly support the involvement of GDF-15 in the creation of an immunosuppressed tumor microenvironment and highlight the therapeutic potential of GDF-15 neutralization in these indications:
Elevated serum levels of GDF-15 were shown to correlate inversely with intratumoral T cell numbers and their proliferation in samples of patients with non-squamous NSCLC, UC, and HCC.
Blockade of GDF-15 by visugromab, in combination with nivolumab treatment, resulted in the rise of serum interferon-γ levels, a critical cytokine for the stimulation of an immune response, in NSCLC and UC patients.
Blockade of GDF-15 by visugromab, in combination with nivolumab treatment, resulted in the rise of serum interferon-γ inducible chemokines CXCL9 and CXCL10 which remained significantly elevated over the monitoring period of six weeks.
Additional preclinical studies indicated that GDF-15 was significantly elevated by standard cancer treatments, specifically e.g. platinum-based chemotherapies, checkpoint inhibitor treatment, and respective combinations. This is another layer of support for the significant role of GDF-15 in the development of immune resistance to these treatment regimens and reason to develop visugromab in the first- and second- line settings where these agents are in standard use.
"We have designed a broad Phase 2b development plan to thoroughly investigate where visugromab can have its biggest impact for patients. These new results further confirm that neutralizing GDF-15 may be a critical strategy in overcoming cancer therapy resistance by breaking immunosuppressive barriers that currently limit therapeutic outcomes," said Phil L’Huillier, Managing Director and Chief Executing Officer at CatalYm. "Validated by the strong clinical and preclinical data on visugromab’s mechanism of action and GDF-15’s relevance in therapeutic resistance to date, we will now investigate the clinical benefit of visugromab in first- and second-line treatment and there in combination with standard-of-care that has been shown to increase GDF-15 levels further on top of the tumoral production of GDF-15. It is our goal to significantly improve patient responses and establish a new benchmark in cancer care."

The Phase 2a GDFATHER-2 program was initiated in March 2022. The ongoing study consists of two segments with up to seven cohorts and is expected to enroll over 200 patients in various cohorts. An evaluation of potential response-predictive biomarker(s) is ongoing. Based on a previous positive readout presented at the ESMO (Free ESMO Whitepaper) IO Congress in 12/2023, CatalYm is in preparations to launch randomized, controlled studies in several major cancer indications in combination with checkpoint inhibitors and standard-of-care in first- and second-line treatment in the first half of 2025.

Presentation Details

Title: Effects of neutralization of tumor-derived immunosuppressant GDF-15 on anti-PD-1 activity in anti-PD-(L)1 relapsed/refractory non-squamous NSCLC, urothelial, and hepatocellular cancer

Presenter: Dr. Ignacio Melero Bermejo, MD | Clinica Universidad de Navarra

Abstract Number: 2513

Date and time: Sunday, June 2, 2024, from 11:30 AM – 1:00 PM CDT

About the GDFATHER-2 Trials

The GDFATHER-2 trial (GDF-15 Antibody-mediaTed Human Effector cell Relocation Phase 2) (NCT04725474) is the Phase 2a part of the ongoing Phase 1/2a trial with several cohorts investigating the effect of visugromab (CTL-002) in combination with a PD-1 checkpoint inhibitor in patients in various advanced-stage/last-line and by strict criteria anti-PD1/PD-L1 relapsed/refractory solid tumor types. The study can enroll up to 200 patients and has extensive biomarker-evaluations integrated to assess for potential responder patient population identification or similar.

About Visugromab (CTL-002)

Visugromab is a monoclonal antibody that neutralizes the tumor-derived Growth Differentiation Factor-15 (GDF-15), a locally acting immunosuppressant fostering immunotherapy resistance. Neutralizing GDF-15 with visugromab reverses key cancer resistance mechanisms to reinstate an efficient anti-tumor response by reenabling immune cell activation and tumor infiltration. Visugromab has demonstrated a good safety profile and potent and durable anti-tumor efficacy in combination with anti-PD-1 treatment in advanced cancer patients The antibody is currently being investigated in ongoing Phase 2a studies in multiple solid tumor indications.