Differentiation of true-progression from pseudoprogression in glioblastoma treated with radiation therapy and concomitant temozolomide by GLCM texture analysis of conventional MRI.

Twenty-two patients with pathologically confirmed glioblastoma who had received concurrent CCRT with TMZ underwent conventional MRI including T1-weighted imaging(T1WI), T2-weighted imaging(T2WI), fluid attenuated inversion recovery(FLAIR)and contrast-enhanced T1WI(T1Ce). Five GLCM texture maps of contrast, energy, entropy, correlation and homogeneity were generated for each MRI series. Of the aforementioned 5 texture features, the most significant features were contrast and correlation on T2WI with areas under ROC curve of 0.883 and 0.892, respectively, and they had the same sensitivity of 75%, specificity of 100%, accuracy of 86.4%, PPV of 100% and NPV of 76.9% in differentiation true progression from pseudoprogression.
Copyright © 2015. Published by Elsevier Inc.

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MacroGenics Presents Data from Five Preclinical Programs at AACR Annual Meeting 2016

On April 19, 2016 MacroGenics, Inc. (NASDAQ: MGNX), a clinical-stage biopharmaceutical company focused on discovering and developing innovative monoclonal antibody-based therapeutics for the treatment of cancer, as well as autoimmune disorders and infectious diseases, reported the presentation of preclinical data from five programs at the 2016 American Association for Cancer Research (AACR) (Free AACR Whitepaper) Annual Meeting in New Orleans, Louisiana (Press release, MacroGenics, APR 19, 2016, View Source [SID:1234511059]). Four of the five presented posters were from studies based on MacroGenics’ Dual-Affinity Re-Targeting, or DART, bispecific technology. MacroGenics also presented data from its preclinical anti-B7-H3 antibody-drug conjugate program within the company’s B7-H3 franchise.

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"MacroGenics is encouraged by the promising preclinical data from these five programs," said Scott Koenig, M.D., Ph.D., President and CEO of MacroGenics. "With a focus on developing innovative medicines for patients in need, our company is bolstered by early-stage, positive preliminary data from these programs targeting various cancers. With eight molecules in clinical development across immuno-oncology and autoimmune disorders today and plans to expand into infectious diseases, the MacroGenics team is making progress towards our mission of bringing new breakthrough treatments to patients suffering from a range of diseases."

MacroGenics AACR (Free AACR Whitepaper) 2016 Poster Presentations

Each of MacroGenics’ poster presentations described below may be accessed under "Events & Presentations" in the Investors section of the company’s website at View Source

B7-H3 Franchise: As previously reported, MacroGenics is developing a portfolio of therapeutics that target B7-H3, a member of the B7 family of molecules involved in immune regulation, through complementary mechanisms of action that also take advantage of the antigen’s broad expression across multiple solid tumor types. In the presentation titled "Anti-B7-H3 antibody-drug conjugates as potential therapeutics for solid cancer," MacroGenics evaluated the therapeutic potential of anti-B7-H3 antibody-drug conjugates (ADCs) in multiple in vitro and in vivo tumor cell line cases representing human cancer types that overexpress B7-H3. Several anti-B7-H3 ADCs exhibited specific, dose-dependent cytotoxicity toward B7-H3-positive tumor cell lines in vitro and in vivo, including breast, lung, ovarian, pancreatic, and prostate cancer lines as well as melanoma. The study results show the potential of B7-H3-targeted ADCs for the treatment of solid cancers that express B7-H3.

MGD013: MGD013, a compound developed using MacroGenics’ DART platform, is a single agent designed to block PD-1 and LAG-3, two immune checkpoint molecules that are co-expressed on T cells. Published work in nonclinical models has shown that combining LAG-3 blockade with PD-1 checkpoint inhibition can further boost the anti-tumor response observed with anti-PD-1 alone. In the presentation titled "MGD013, a bispecific PD-1 x LAG-3 Dual-Affinity Re-Targeting (DART) protein with T-cell immunomodulatory activity for cancer treatment," MacroGenics demonstrated that MGD013 has the potential to promote anti-tumor activity by simultaneously blocking both PD-1 and LAG-3. In the study, monoclonal antibodies (mAbs) against PD-1 and LAG-3 were engineered into MGD013, an Fc-bearing DART molecule. MGD013 was shown to block PD-1/PD-L1, PD-1/PD-L2 and LAG-3/MHC-II interactions to levels comparable to those observed with its independent constituents. Furthermore, MGD013 enhanced T-cell response (upon antigen re-challenge), as measured by cytokine secretion, to an extent greater extent than that observed with the independent blockade of each pathway or even when both pathways were inhibited with a combination of anti-PD-1 and anti-LAG-3 mAbs. The results of the study helped support further clinical development of MGD013. MacroGenics plans to submit an Investigational New Drug (IND) application for MGD013 in 2017.

ROR1 x CD3 DART: The receptor tyrosine kinase-like orphan receptor 1, ROR1, is overexpressed in chronic lymphocytic leukemia and a subset of solid tumors, including lung, breast, ovarian, colon, sarcoma and pancreatic cancers. In the presentation titled "Development of a humanized ROR1 x CD3 bispecific DART molecule for the treatment of solid and liquid tumors," MacroGenics demonstrated that a ROR1 x CD3 DART molecule was able to kill ROR1-expressing target cells in vitro. T-cell activation and cytokine release was strictly mediated upon target antigen engagement and not observed with leukocytes alone. The DART molecule also demonstrated anti-tumor activity in vivo, with high response rates in several mouse tumor xenograft models. The promising in vitro and in vivo study results support continued research on the use of ROR1 x CD3 DART molecules as a potential treatment option for cancer patients.

IL13Rα2 x CD3 DART: IL13Rα2 is a membrane-bound protein that has been found to be expressed in malignant tumors. "Development of an IL13Ralpha2 x CD3 bispecific DART protein for redirected T-cell killing of solid tumors" introduced the IL13Rα2 x CD3 DART molecule that re-targets cytotoxic T cells through its CD3 arm to IL13Rα2 on tumors cells, resulting in the killing of tumor cells. After selection from a range of IL13Rα2 x CD3 DART prototypes, a lead candidate was selected and converted into a humanized, Fc-bearing DART molecule that mediated potent redirected T-cell killing of tumor cells. The study further showed that administration of the Fc-bearing IL13Rα2 x CD3 DART molecule mediated potent anti-tumor activity in vivo in mice reconstituted with human immune cells. Further studies are underway to characterize the molecule as a potential development candidate for the treatment of IL13Rα2-positive cancers.

EphA2 x CD3 DART: MacroGenics has selected EphA2, a receptor tyrosine kinase that plays a critical role in cancer progression, as a potential therapeutic target for a new DART molecule designed to co-engage cytotoxic T cells (via their CD3 component) with EphA2-expressing tumor cells. In the presentation titled "Evaluation of EphA2 as a therapeutic target for redirected T-cell killing by DART bispecific molecules," MacroGenics researchers identified seven anti-EphA2 mAbs recognizing independent epitopes that were engineered into EphA2 x CD3 DART molecules showing a range of potency in redirecting T cells to kill EphA2-expressing target cells. A lead EphA2 x CD3 DART molecule was selected based on potency, engineered into an Fc-bearing DART molecule and shown to mediate target dependent anti-tumor activity in vitro and in vivo. MacroGenics has been encouraged by the results of this study and believes further preclinical assessment studies of EphA2 x CD3 DART molecules are warranted.
Background on DART Platform

MacroGenics’ DART platform enables the targeting of multiple antigens or cells by using a single molecule with an antibody-like structure. DART molecules can be configured for the potential treatment of cancer, autoimmune disorders and infectious diseases. These DART molecules can be tailored for either short or prolonged pharmacokinetics and have demonstrated good stability and attractive manufacturability. Six DART molecules, including programs being developed by MacroGenics and its collaborators, are currently being evaluated in Phase 1 clinical studies.

Phenotype of TPBG Gene Replacement in the Mouse and Impact on the Pharmacokinetics of an Antibody-Drug Conjugate.

The use of predictive preclinical models in drug discovery is critical for compound selection, optimization, preclinical to clinical translation, and strategic decision-making. Trophoblast glycoprotein (TPBG), also known as 5T4, is the therapeutic target of several anticancer agents currently in clinical development, largely due to its high expression in tumors and low expression in normal adult tissues. In this study, mice were engineered to express human TPBG under endogenous regulatory sequences by replacement of the murine Tpbg coding sequence. The gene replacement was considered functional since the hTPBG knockin (hTPBG-KI) mice did not exhibit clinical observations or histopathological phenotypes that are associated with Tpbg gene deletion, except in rare instances. The expression of hTPBG in certain epithelial cell types and in different microregions of the brain and spinal cord was consistent with previously reported phenotypes and expression patterns. In pharmacokinetic studies, the exposure of a clinical-stage anti-TPBG antibody-drug conjugate (ADC), A1mcMMAF, was lower in hTPBG-KI versus wild-type animals, which was evidence of target-related increased clearance in hTPBG-KI mice. Thus, the hTPBG-KI mice constitute an improved system for pharmacology studies with current and future TPBG-targeted therapies and can generate more precise pharmacokinetic and pharmacodynamic data. In general the strategy of employing gene replacement to improve pharmacokinetic assessments should be broadly applicable to the discovery and development of ADCs and other biotherapeutics.

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Non-clinical safety evaluation of single and repeated intramuscular administrations of MAGE-A3 Cancer Immunotherapeutic in rabbits and cynomolgus monkeys.

The MAGE-A3 recombinant protein combined with AS15 immunostimulant (MAGE-A3 Cancer Immunotherapeutic) is under development by GlaxoSmithKline for the treatment of lung cancer and melanoma. We performed non-clinical safety studies evaluating potential local and systemic toxic effects induced by MAGE-A3 Cancer Immunotherapeutic in rabbits (study 1) and cynomolgus monkeys (study 2). Animals were allocated to two groups to receive a single (rabbits) or 25 repeated (every 2 weeks) injections (monkeys) of MAGE-A3 Cancer Immunotherapeutic (treatment groups) or saline (control groups). All rabbits were sacrificed 3 days post-injection and monkeys 3 days following last injection (3/5 per gender per group) or after a 3-month treatment-free period (2/5 per gender per group). Local and systemic reactions and MAGE-A3-specific immune responses (monkeys) were assessed. Macroscopic and microscopic (for rabbits, injection site only) post-mortem examinations were performed on all animals. No systemic toxicity or unscheduled mortalities were recorded. Single (rabbits) and repeated (monkeys; up to four times at the same site) injections were well tolerated. Following five to seven repeated injections, limb circumferences increased up to 26% (5 h post-injection), but returned to normal after 1-8 days. Three days after the last injection, enlargements of iliac, popliteal, axillary and inguinal lymph nodes, and increased incidence or severity of mononuclear inflammatory cell infiltrates was observed in injected muscles of treated monkeys. No treatment-related macroscopic findings were recorded after the treatment-free period. MAGE-A3-specific antibody and T-cell responses were raised in all treated monkeys, confirming test item exposure. Single or repeated intramuscular injections of MAGE-A3 Cancer Immunotherapeutic were well tolerated in rabbits and monkeys.
Copyright © 2014 GlaxoSmithKline Vaccines. Journal of Applied Toxicology published by John Wiley & Sons, Ltd.

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Intravenous pegylated asparaginase versus intramuscular native Escherichia coli L-asparaginase in newly diagnosed childhood acute lymphoblastic leukaemia (DFCI 05-001): a randomised, open-label phase 3 trial.

l-asparaginase is a universal component of treatment for childhood acute lymphoblastic leukaemia, and is usually administered intramuscularly. Pegylated Escherichia coli asparaginase (PEG-asparaginase) has a longer half-life and is potentially less immunogenic than the native Escherichia coli (E coli) preparation, and can be more feasibly administered intravenously. The aim of the Dana-Farber Cancer Institute Acute Lymphoblastic Leukaemia Consortium Protocol 05-001 (DFCI 05-001) was to compare the relative toxicity and efficacy of intravenous PEG-asparaginase and intramuscular native E colil-asparaginase in children with newly diagnosed acute lymphoblastic leukaemia.
DFCI 05-001 enrolled patients aged 1-18 years with newly diagnosed acute lymphoblastic leukaemia from 11 consortium sites in the USA and Canada. Patients were assigned to an initial risk group on the basis of their baseline characteristics and then underwent 32 days of induction therapy. Those who achieved complete remission after induction therapy were assigned to a final risk group and were eligible to participate in a randomised comparison of intravenous PEG-asparaginase (15 doses of 2500 IU/m(2) every 2 weeks) or intramuscular native E colil-asparaginase (30 doses of 25 000 IU/m(2) weekly), beginning at week 7 after study entry. Randomisation (1:1) was unmasked, and was done by a statistician-generated allocation sequence using a permuted blocks algorithm (block size of 4), stratified by final risk group. The primary endpoint of the randomised comparison was the overall frequency of asparaginase-related toxicities (defined as allergy, pancreatitis, and thrombotic or bleeding complications). Predefined secondary endpoints were disease-free survival, serum asparaginase activity, and quality of life during therapy as assessed by PedsQL surveys. All analyses were done by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00400946.
Between April 22, 2005, and Feb 12, 2010, 551 eligible patients were enrolled. 526 patients achieved complete remission after induction, of whom 463 were randomly assigned to receive intramuscular native E colil-asparaginase (n=231) or intravenous PEG-asparaginase (n=232). The two treatment groups did not differ significantly in the overall frequency of asparaginase-related toxicities (65 [28%] of 232 patients in the intravenous PEG-asparaginase group vs 59 [26%] of 231 patients in the intramuscular native E colil-asparaginase group, p=0·60), or in the individual frequency of allergy (p=0·36), pancreatitis (p=0·55), or thrombotic or bleeding complications (p=0·26). Median follow-up was 6·0 years (IQR 5·0-7·1). 5-year disease-free survival was 90% (95% CI 86-94) for patients assigned to intravenous PEG-asparaginase and 89% (85-93) for those assigned to intramuscular native E colil-asparaginase (p=0·58). The median nadir serum asparaginase activity was significantly higher in patients who received intravenous PEG-asparaginase than in those who received intramuscular native E colil-asparaginase. Significantly more anxiety was reported by both patients and parent-proxy in the intramuscular native E colil-asparaginase group than in the intravenous PEG-asparaginase group. Scores for other domains were similar between the groups. The most common grade 3 or worse adverse events were bacterial or fungal infections (47 [20%] of 232 in the intravenous PEG-asparaginase group vs 51 [22%] of 231 patients in the intramuscular E colil-asparaginase group) and asparaginase-related allergic reactions (14 [6%] vs 6 [3%]).
Intravenous PEG-asparaginase was not more toxic than, was similarly efficacious to, and was associated with decreased anxiety compared with intramuscular native E colil-asparaginase, supporting its use as the front-line asparaginase preparation in children with newly diagnosed acute lymphoblastic leukaemia.
National Cancer Institute and Enzon Pharmaceuticals.
Copyright © 2015 Elsevier Ltd. All rights reserved.

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