On December 10, 2018 Constellation Pharmaceuticals, Inc. (Nasdaq: CNST), a clinical-stage biopharmaceutical company using its expertise in epigenetics to discover and develop novel therapeutics, reported an update of the ProSTAR study, its ongoing Phase 1b/2 clinical trial of CPI-1205 in patients with metastatic castration-resistant prostate cancer (mCRPC) (Press release, Constellation Pharmaceuticals, DEC 10, 2018, View Source [SID1234532000]).

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The ProSTAR study is evaluating CPI-1205, Constellation’s potent and highly selective small-molecule EZH2 inhibitor, in combination with either enzalutamide or abiraterone / prednisone ("abiraterone"), in mCRPC patients who experienced disease progression while receiving the other ARS inhibitor. Based on encouraging results from the Phase 1b portion of ProSTAR, the Company has initiated dosing in the randomized Phase 2 portion studying CPI-1205 in combination with enzalutamide versus enzalutamide alone. Constellation has also decided to expand the Phase 2 portion of the study by adding an arm evaluating CPI-1205 in combination with abiraterone in the second-line setting.

"We are pleased that CPI-1205 achieved its Phase 1b endpoints in ProSTAR, demonstrating an encouraging safety profile and evidence of clinical activity in both arms," said Adrian Senderowicz, Chief Medical Officer of Constellation

Pharmaceuticals. "As we advance into the Phase 2 portion of the study, we believe combination therapy with CPI-1205 may provide a meaningful second-line treatment option to patients with metastatic castration-resistant prostate cancer, an area of significant unmet medical need. We are excited about expanding our opportunity to include an arm evaluating CPI-1205 in combination with abiraterone in the second-line setting, given that very few patients experience a 50% reduction in PSAs on second-line treatment with abiraterone and that time to progression in this setting is typically short."

Initiation and Expansion of Phase 2 Portion of ProSTAR

As planned, Constellation has already begun dosing patients in the Phase 2 portion of the study, evaluating CPI-1205 in combination with enzalutamide versus enzalutamide alone. The Company continues to expect enrollment of up to 35 patients in both the treatment and the control arms.

Additionally, Constellation is expanding the trial to include a separate Phase 2 arm evaluating CPI-1205 in combination with abiraterone in up to 30 mCRPC patients who progressed on prior enzalutamide therapy. This arm, which will soon begin dosing patients, will not be randomized against a control arm due to the low response rate and lack of durability seen with abiraterone in the second-line setting.

In a recent randomized cross-over trial, only 4% of patients taking abiraterone after disease progression on enzalutamide, and only 31% of patients taking enzalutamide after disease progression on abiraterone, achieved a 50% reduction in PSA levels. Time to PSA progression was only 1.3 months and 2.7 months, respectively. Time to disease progression was only 1.6 months and 2.7 months, respectively.1

Constellation continues to expect to determine proof of concept for CPI-1205 in mid-2019.

1 D. Khalaf et al, Phase 2 randomized cross-over trial of abiraterone + prednisone (ABI) vs enzalutamide (ENZ) for patients (pts) with metastatic castration resistant prostate cancer (mCRPC): results for 2nd-line therapy, poster presented at 2018 American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) meeting.

About mCRPC

mCRPC is an advanced form of prostate cancer and is defined by disease progression despite treatment with androgen depletion therapy (ADT). mCRPC may present as one or any combination of the following: a continuous rise in serum levels of PSA, progression of known metastases, or appearance of new metastases. Prognosis is associated with several factors, including the

ability to perform certain daily activities and the presence of bone pain. Additional symptoms commonly include anemia (low healthy red blood cell levels), weight loss, fatigue, hypercoagulability (abnormal blood coagulation), and increased susceptibility to infection. mCRPC presents as a spectrum of disease ranging from patients without symptoms but rising PSA levels despite ADT, to patients with metastases and significant debilitation.

On December 10, 2018 Nascent Biotech, Inc. (OTC: NBIO) reported that it Received US Food and Drug Administration (FDA) Clearance to begin Phase 1 Clinical Trials effective December 7th, 2018 (Press release, Nascent Biotech, DEC 10, 2018, View Source [SID1234532016]).

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Nascent CEO Sean Carrick stated, "On Friday December 7, 2018, Nascent Biotech received a letter from the FDA moving the Company’s IND filing from Full Clinical Hold to Partial Clinical Hold, which frees the Company to immediately begin Phase 1 Human Clinical Trials with its present drug lot." "There are additional product testing criteria required by the FDA, which we believe are very achievable and have already begun to respond," stated Executive Vice President Dr. Brandon Price.

Nascent founder, Dr. Mark Glassy, commented, "It is gratifying that the FDA will allow Nascent to test the value of Pritumumab in the treatment of advanced brain cancer – a disease with few treatment options and very poor outcomes."

On December 8, 2018 Context Therapeutics, a clinical-stage biotechnology company, reported new preclinical data on Apristor (onapristone extended release), its first-in-class full progesterone receptor antagonist, showing that the investigational medicine inhibits tumor cell line growth in hormone receptor positive (HR+) breast cancer cell lines (Press release, Context Therapeutics, DEC 8, 2018, View Source [SID1234531939]). Additionally, it was shown that Apristor is synergistic with current standard of care therapies for HR+ metastatic breast cancer, including the Cdk4/6 inhibitor Ibrance (palbociclib) and the selective estrogen receptor degrader Faslodex (fulvestrant).

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"Progesterone receptor is the forgotten target", said Carol Lange, PhD, Professor of Medicine at the University of Minnesota and principal investigator of the research presentation. "HR+ breast cancer is driven by two hormones, estrogen and progesterone. While there are over half a dozen approved medicines to block estrogen and estrogen-related signaling, there are no FDA approved medicines in cancer to block progesterone. The data presented shows that blocking progesterone-related signaling via Apristor is not only active alone in tumor models but it also enhances the activity of medicines that either directly or indirectly target estrogen."

The data presented shows that:

Progesterone / progesterone peceptor (PR) is a unique target distinct from estrogen / estrogen receptor

PR is critical for in vitro growth of HR+ breast cancer cells

PR antagonism via Apristor reduces the expression of cancer promoting genes

PR antagonism is synergistic with Cdk4/6 inhibitors and a SERD

"We are encouraged by these new preclinical data, which speak to the important role PR plays in facilitating HR+ breast cancer disease progression," said Deepak Lala, PhD, Chief Technology Officer of Context. "This is the first study to show that PR antagonism is synergistic with new treatment modalities, including Cdk4/6 inhibition. "

About Apristor

Apristor (onapristone extended release) is Context’s wholly owned, first-in-class, orally active extended release formulation of onapristone, a full progesterone receptor antagonist. Progesterone receptor [PR] plays a critical role in facilitating breast cancer disease progression as well as therapeutic resistance to first line antiestrogen and/or Cdk4/6 inhibitor therapies. Apristor is the only full PR antagonist that is being developed to target breast cancer. Apristor has the potential to transform the treatment of breast cancer, through the potent inhibition of PR signaling thereby blocking breast cancer cell proliferation and overcoming resistance to first line antiestrogen and Cdk4/6 inhibitor therapy.

On December 8, 2018 Samsung Bioepis Co., Ltd. reported the results of an additional one-year follow-up study comparing event-free survival (EFS) of SB3, a biosimilar candidate referencing HERCEPTIN 1 (trastuzumab), to reference trastuzumab (TRZ) by antibody-dependent cell-mediated cytotoxicity (ADCC) activity (Press release, Samsung Bioepis, DEC 8, 2018, View Source [SID1234531973]). ADCC is a key mechanism of action for trastuzumab. The study results are being presented at the 2018 San Antonio Breast Cancer Symposium (SABCS) which is being held December 4-8, 2018 in San Antonio, Texas.

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For the study, patients with HER2 positive early or locally advanced breast cancer were randomly assigned to receive SB3 or TRZ concurrently with chemotherapy. Patients then underwent surgery followed by treatment with SB3 or TRZ. Following completion of such therapy, 367 patients participated in a long-term follow-up study, 186 of whom were treated with SB3 and 181 of whom were treated with TRZ. Within the group of 181 patients who received TRZ, 126 patients who were exposed to at least one kit from the TRZ lots with expiry dates between August 2018 and December 2019 during neoadjuvant period were considered "Exposed," while the remaining 55 patients were considered "Unexposed." Upon monitoring the quality attributes of TRZ for the development of SB3, a marked downward shift in ADCC activity was observed in some of the TRZ lots with expiry dates between August 2018 and December 2019.

Following 30.1 months of SB3 treatment and 30.2 months of TRZ treatment, there was no statistically significant difference in EFS between SB3 (96.7%) and the Unexposed arm (98.2%) (HR 1.19, 95% CI 0.23-6.18; p-value=0.8376). However, the results did show statistically significant difference in EFS between the Unexposed (98.2%) and Exposed (92.5%) arms within the TRZ treatment group (HR 0.07, 95% CI 0.01-0.58, p-value=0.0137). In addition, while there was no statistically significant difference in events between SB3 (4.8%) and the Unexposed (3.6%) arms, there was statistically significant difference in events within the TRZ treatment group between the Unexposed (3.6%) and Exposed (10.3%) arms. An event was defined as disease recurrence or progression, or death due to any cause. The study authors are currently looking into longer-term effects of SB3 and hope to publish these results at a later date.

"This study builds on the robust evidence for SB3, and demonstrates the trastuzumab biosimilar candidate’s comparable efficacy and safety profiles to the reference biologic over a longer time period," said Chul Kim, Senior Vice President and Head of Clinical Science, Samsung Bioepis. "We remain committed to advancing our strong pipeline of biosimilar candidates, so that more patients and healthcare systems may be able to benefit from biosimilar medicines."

The poster for this study will be exhibited at SABCS, as follows:

[P6-17-09] EVENT-FREE SURVIVAL BY ADCC STATUS FROM A FOLLOW-UP STUDY COMPARING SB3 (TRASTUZUMAB BIOSIMILAR) WITH REFERENCE TRASTUZUMAB FOR HER2 POSITIVE BREAST CANCER IN NEOADJUVANT SETTING [POSTER SESSION 6, December 8, 2018, 07:00AM – 09:00AM]

On December 8, 2018 Generon BioMed Holding Ltd. (Generon), reported at the annual San Antonio Breast Cancer Symposium (SABCS), positive results from a placebo-controlled trial with F-627, a recombinant human Granulocyte Colony Stimulating Factor (rhG-CSF) protein, designed using Generon’s DikineTM technology platform (Press release, Generon (Shanghai), DEC 8, 2018, View Source [SID1234531974]).

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Led by Principle Investigator Dr. John Glaspy, Estelle, Abe and Marjorie Endowed Chair in Cancer Research at the Jonsson Comprehensive Cancer Center of UCLA, this global study of 122 woman with stage II-IV breast cancer receiving Myelotoxic chemotherapy demonstrates that subcutaneous administration of F-627 significantly reduced the duration of Grade 4 (severe) neutropenia in chemotherapy cycle 1 (P<0.0001); the mean treatment difference was 2.8 days (1.1 days vs. 3.9 days in the placebo arm). F-627 administration also resulted in lower incidence and shorter duration of Grade 4, Grade 3 and Grade 2 neutropenia. Other significant results included the finding that treatment with F-627 significantly reduced the incidence of febrile neutropenia (FN) (P<0.0016). The incidence of FN in the experimental arm was 4.8% and 28.2% in the placebo arm during cycle 1. Subjects in the experimental arm also had lower rates of antibiotic medication and pain medication use. In this study, F-627 was shown to be safe and well tolerated with no deaths, no injection site reactions and less gastrointestinal AEs (diarrhea, vomiting, stomatitis, and gastritis) than the placebo arm. During cycle 1 in the experimental arm, the five most common TEAEs (incidence rate >10%) were leukopenia, anemia, thrombocytopenia, nausea, and alopecia. Across all cycles, there were 17 SAEs from 15 subjects of which 15 were FN.

A single subcutaneous injection of F-627 significantly reduced the duration and incidence of severe neutropenia and febrile neutropenia while maintaining an excellent safety profile in patients with breast cancer undergoing high-dose chemotherapy.

Dr. Glaspy indicated that F-627 would provide an alternative treatment for patients with breast cancer and severe neutropenia secondary to myelotoxic chemotherapy. "The successful completion of this phase III trial exemplifies our continued commitment to developing innovative medicines on our various platforms that have the potential to treat patients with cancer" said Dr. William Daley, Generon’s Chief Medical Officer.

Dr. Daley also indicated that Yifan Pharmaceuticals, a controlling parent company of Generon, congratulated Generon’s team on the continued effort to develop innovative therapies. "This is yet another milestone and goal for Generon this year and is a significant step towards our mission of Innovating for Life. Generon is committed to bringing innovative oncology therapies to patients in China and the world" he commented.

About F-627

F-627, a rhG-CSF dimer, is a once-per-cycle therapy for the preventive management of neutropenia. Produced in Chinese Hamster Ovary (CHO) cells in serum-free cultures, F-627 leverages Generon’s proprietary Dimeric Cytokine (DiKineTM) technology platform to create an immunoglobulin-like dimeric structure, providing improved efficacy and a longer half-life. This product candidate is intended to treat cancer patients with neutropenia secondary to myelotoxic chemotherapy.