On April 17, 2018 Euronext Paris: FR0010331421 – IPH) reported preliminary data from an ongoing Phase I/II trial evaluating the safety and efficacy of the combination of monalizumab, a first-in-class monoclonal antibody targeting NK checkpoint receptor NKG2A, with cetuximab (anti-EGFR) in previously treated patients with recurrent and/or metastatic squamous cell carcinoma of the head & neck (R/M SCCHN) (Press release, Innate Pharma, APR 17, 2018, View Source [SID1234525441]). These data are highlighted in a poster presentation at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting, April 14-18, in Chicago.

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Roger B. Cohen, Prof. of Medicine at the Hospital of the University of Pennsylvania, Associate Director of Clinical Research, Abramson Cancer Center Philadelphia and the lead investigator of the study, commented: "The data so far show that this therapy is active in patients with advanced head and neck cancer. The activity of cetuximab in patients previously treated with platinum salts is limited, with a response rate of around 13%. The addition of monalizumab appears to increase the response rate without potentiating the side effects of cetuximab. Since monalizumab targets a checkpoint that is different from other currently targeted immune checkpoints, it’s an interesting option as a combination partner for a variety of novel immunotherapeutic approaches".

Pierre Dodion, Chief Medical Officer of Innate Pharma, added: "While PD-1/L1 therapy is quickly changing the treatment paradigm of SCCHN, there remains a high unmet medical need for the majority of patients who don’t benefit from checkpoint inhibitor therapy. These preliminary data support further investigation of this novel combination in third line recurrent and metastatic SCCHN. We look forward to sharing updated data from the ongoing trial at medical conferences during 2018."

The highest dose tested for monalizumab in the dose-escalation portion of the study (10 mg/kg every 2 weeks) was given in combination with the approved dose and schedule of cetuximab (400 mg/m² load, then 250 mg/m² weekly) in the Phase II cohort expansion. Patients could be either HPV (-) or HPV (+) and had progressed after platinum-based therapy with a maximum of 2 prior systemic treatment regimens for R/M disease. Prior cetuximab treatment (when used for the definitive treatment of locally advanced disease in combination with radiation) and prior immuno-oncology (IO) therapy were allowed.

Among the 31 patients enrolled in the expansion part, the combination was well tolerated, consistent with previously presented data at AACR (Free AACR Whitepaper) 2017, with no additional safety concerns compared to monalizumab or cetuximab given alone. The majority of adverse events (AE) were of Grade 1-2 severity, rapidly reversible and easily manageable. No infusion-related reactions or treatment-related deaths occurred. The most frequent AEs (skin disorders) described with cetuximab were not potentiated by the combination with monalizumab.
Among the patients enrolled, as per study design, all had been previously treated with platin-containing regimens. In addition, 14 patients had been previously treated with PD-1 antibodies and 3 with prior cetuximab.
Twenty-six patients were evaluable for efficacy; the other 5 patients are too early on study to have had a post-baseline assessment. At the cut-off date of March 9, 2018, there were 8 confirmed RECIST partial responses (31%) with median time to follow-up of 129 days, achieving the predefined number of 8 responses needed to declare the trial positive. 14 patients (54%) had stable disease. Median duration of response has not yet been reached; six responders are still on treatment. The trial has now enrolled all planned patients (n=40). Further follow-up is needed to evaluate the duration of response, progression-free survival (PFS) and overall survival (OS).

On April 17, 2018 Chugai Pharmaceutical Co., Ltd. (TOKYO: 4519) reported that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy Designation for its anti-coagulation factor IXa/X humanized bispecific monoclonal antibody / coagulation factor VIII substitute, "HEMLIBRA" [US generic name: emicizumab-kxwh] for people with hemophilia A without factor VIII inhibitors (Press release, Chugai, APR 17, 2018, View Source [SID1234525404]). Development and distribution of the drug in the US is conducted by Genentech, a member of Roche Group.

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"We are thrilled that HEMLIBRA has been granted its second Breakthrough Therapy Designation," said Chugai’s Executive Vice President, Co-Head of Project & Lifecycle Management Unit, Dr. Yasushi Ito. "This will allow us to expedite potential delivery of this new therapy we created to people with hemophilia A without inhibitors in the US following the previous designation for inhibitors. We continue to work closely with Genentech to enable this line extension as soon as possible."

This designation is based on the global phase III HAVEN 3 (NCT02847637) study evaluating HEMLIBRA subcutaneous injection once a week and once every two weeks in people with hemophilia A (12 years of age or older) without inhibitors to factor VIII.

Hemophilia A is a disease presenting repeated severe bleeding symptoms. In this disease, the blood coagulation reaction does not proceed normally due to the deficiency or functional disorder of coagulation factor VIII. For people with hemophilia A without inhibitors, regular factor VIII replacement therapy has been widely used to prevent bleeding. HEMLIBRA is a bispecific monoclonal antibody, which was developed using Chugai’s proprietary antibody engineering technologies. The drug is designed to bind factor IXa and factor X. In doing so, HEMLIBRA provides the cofactor function of factor VIII in people with hemophilia A, who either lack or have impaired coagulation function of factor VIII1, 2). In the HAVEN 3 study, a statistically significant reduction in the frequency of bleeding episodes was observed with HEMLIBRA. With the convenience of subcutaneous administration and the lower frequency of administration, it is expected to be a new treatment option for hemophilia A.
This is the sixth Breakthrough Therapy Designation received for three drugs created by Chugai: ALECENSA (ALK-positive non-small cell lung cancer with disease progression on crizotinib, and first line treatment for ALK-positive non-small cell lung cancer), ACTEMRA (systemic sclerosis and giant cell arteritis), and HEMLIBRA (prophylactic treatment for patients 12 years or older with hemophilia A with factor VIII inhibitors).

Trademarks used or mentioned in this release are protected by law.
References
Kitazawa, et al. Nature Medicine 2012; 18(10): 1570
Sampei, et al. PLoS ONE 2013; 8: e57479
About Breakthrough Therapy
Breakthrough Therapy Designation was adopted as part of the FDA Safety and Innovation Act (FDASIA) enacted in July 2012 aiming at expediting the development and review of drugs for the treatment of severe or life-threatening diseases or symptoms. In order to grant Breakthrough Therapy Designation, preliminary clinical evidence is required demonstrating that the drug may have substantial improvement on at least one clinically significant endpoint over existing therapies. Breakthrough Therapy Designation includes the features of a Fast Track designation, with the addition of intensive guidance on efficient drug development as well organizational commitment from FDA.
Main approval status of the drug

US: In November 2017, the drug (US product name: HEMLIBRA; Genentech) was approved by the U.S. Food and Drug Administration and was marketed for "routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adult and pediatric patients with hemophilia A (congenital factor VIII deficiency) with factor VIII inhibitors."

EU: In Europe, the drug (EU product name: HEMLIBRA; Roche) obtained regulatory approval from the European Commission and was marketed for routine prophylaxis of bleeding episodes in people with hemophilia A with factor VIII inhibitors in February 2018.
Japan: The Ministry of Health, Labour and Welfare has approved HEMLIBRA for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in patients with congenital factor VIII deficiency (hemophilia A) with factor VIII inhibitors in March 2018.
About the results of HAVEN 3 study
Press release issued on November 20, 2017
View Source

On April 17, 2018 Myriad Genetics, Inc. (NASDAQ:MYGN), a leader in molecular diagnostics and personalized medicine, reported that it will hold its fiscal third-quarter 2018 sales and earnings conference call with investors and analysts at 7:30 a.m. ET on Tuesday, May 8, 2018 (Press release, Myriad Genetics, APR 17, 2018, View Source [SID1234525424]). During the call, Mark C. Capone, president and CEO and Bryan Riggsbee, CFO, will provide an overview of Myriad’s financial performance for the fiscal third-quarter and provide a business update. Additionally, Dr. Bryan Dechairo, executive vice president of Clinical Research, will discuss the data from the GeneSight randomized controlled trial. The clinical study data will first be presented as a late breaking poster in the exhibit hall at the American Psychiatric Association annual meeting on Monday, May 7, 2018 at 10:00 a.m. ET, and will be presented by the study principal investigator the same day at a satellite symposium at 6:30 p.m. ET at Hudson Mercantile at 500 W. 36th Street in New York City.

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To listen to the earnings call, interested parties in the United States may dial 800-699-0623 or +1 303-223-4362 for international callers. All callers will be asked to reference reservation number 21887258. The conference call also will be available through a live webcast and a slide presentation pertaining to the earnings call will also be available under the investor section of our website at www.myriad.com. A replay of the call will be available two hours after the end of the call for seven days and may be accessed by dialing 800-633-8284 within the United States or +1 402-977-9140 for international callers and entering reservation number 21887258.

On April 17, 2018 Spectrum Pharmaceuticals (NasdaqGS: SPPI), a biotechnology Company with fully integrated commercial and drug development operations with a primary focus in Hematology and Oncology, reported a poster presentation of data from preclinical and clinical studies evaluating poziotinib in HER2 exon 20 mutations in non-small cell lung cancer (NSCLC) and summarizing a dataset of the prevalence of HER2 exon 20 across solid tumors by scientists from the University of Texas MD Anderson Cancer Center at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) which is taking place in Chicago, Illinois, April 14-18, 2018 (Press release, Spectrum Pharmaceuticals, APR 17, 2018, View Source [SID1234525442]).

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"We are excited to see the first presentation of data for poziotinib in HER2 exon 20 mutations in NSCLC," said Joe Turgeon, President and Chief Executive Officer of Spectrum Pharmaceuticals. "These data build upon previous results from poziotinib studies and indicate that this drug could be effective in treating both EGFR and HER2 exon 20 mutations. Furthermore, new data from MD Anderson reveal that these mutations are found across a variety of solid tumors and there is strong rationale for evaluating poziotinib in a basket study."
"The pre-clinical and early clinical activity of poziotinib in EGFR and HER2 exon 20 mutant NSCLC suggests poziotinib could be a promising agent for the numerous cancer types driven by HER2 exon 20 mutations," said Jacqulyne Robichaux, Ph.D, Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center. "We have previously shown that poziotinib is an effective inhibitor of EGFR exon 20 insertion mutations in vitro and in vivo. These data show that poziotinib overcomes de novo resistance of HER2 exon 20 mutations in NSCLC and other cancers. Further evaluation of poziotinib in solid tumors is warranted."

About Poziotinib
Poziotinib is a novel, Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR TKI) that inhibits the tyrosine kinase activity of EGFR as well as HER2 and HER4. Importantly this, in turn, leads to the inhibition of the proliferation of tumor cells that overexpress these receptors. Mutations or overexpression/amplification of EGFR family receptors have been associated with a number of different cancers, including non-small cell lung cancer (NSCLC), breast cancer, and gastric cancer. Spectrum received exclusive license to develop, manufacture, and commercialize worldwide excluding Korea and China from Hanmi Pharmaceuticals. Poziotinib is currently being investigated by Spectrum and Hanmi in several mid-stage trials in multiple solid tumor indications.

On April 17, 2018 NewLink Genetics Corporation (NASDAQ:NLNK) reported that it presented a poster entitled "Indoximod modulates AhR-driven transcription of genes that control immune function" in the Immunomodulatory Agents and Interventions session at the American Association for Cancer Research (AACR) (Free AACR Whitepaper) 2018 Annual Meeting in Chicago (Press release, NewLink Genetics, APR 17, 2018, View Source [SID1234525425]).

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"The data demonstrate that indoximod has a unique mechanism of action, remarkably differentiated from IDO enzymatic inhibitors. This different mechanism may contribute to antitumor immune responses in the IDO pathway and through activity independent of IDO," said Charles J. Link, Jr., M.D., Chairman and Chief Executive Officer.

The data suggest that indoximod regulates the differentiation of helper T cells toward an immuno-stimulatory helper function and downregulates genes that control the differentiation of T cells into immuno-suppressive regulatory T cells (Tregs) in an AhR dependent manner. This leads to an increase in the ratio of helper T cells to Tregs. Additionally, it was shown that indoximod reduces the level of IDO protein in dendritic cells in vitro, leading to increased stimulation of CD8 T cell proliferation and reduced production of kynurenine. Moreover, indoximod stimulation of mTOR in T cells appears to increase the proliferation of effector T cells in an IDO and TDO-independent manner. Through this mechanism, indoximod may be able overcome the effects of Trp degradation mediated by both IDO and TDO. Thus, in addition to opposing immunosuppression mediated by the IDO pathway, indoximod may drive antitumor immune responses independent from IDO.

In summary, indoximod has immunostimulatory effects involving 4 main cell types: CD8+ T cells, T helper cells, T regulatory cells, and dendritic cells. Indoximod appears to function through three main mechanisms to inhibit the IDO pathway:

Reversing the effects of low tryptophan by increasing proliferation of effector T cells

Increasing the ratio of T helper to T regulatory cells by both favoring differentiation of activated CD4 T cells into helper T cells and directly reprogramming T regulatory cells into helper T cells

Downregulating IDO expression in dendritic cells

About Indoximod

Indoximod is an investigational, orally available small molecule targeting the IDO pathway. The IDO pathway is a key immuno-oncology target involved in regulating the tumor microenvironment and immune escape. Indoximod is being evaluated in combination with treatment regimens including anti-PD-1/PD-L1 agents, cancer vaccines, radiation and chemotherapy across solid and liquid tumors.