CNS Pharmaceuticals has announced the primary analysis results from its clinical trial evaluating Berubicin for the treatment of recurrent or progressive Glioblastoma Multiforme (GBM), revealing that the drug did not meet its primary endpoint of demonstrating statistically significant superiority in overall survival compared to Lomustine, a current standard of care.
The multicenter, open-label, randomized controlled study enrolled 252 patients across North America and Europe, with participants randomized to receive either Berubicin or Lomustine in a 2:1 ratio. Despite missing the primary endpoint, the company reported that Berubicin showed comparable results to Lomustine in clinically important measures including overall survival (OS) and progression-free survival (PFS) across all treated patients.
Safety Profile Shows Promising Advantages
A notable finding from the trial was Berubicin's favorable safety profile. The drug demonstrated no cardiotoxicity, a significant limitation that typically restricts the use of other anthracyclines in cancer treatment. This absence of cardiac side effects was observed even in patients who received Berubicin for more than a year.
"Because of the cardiotoxicity associated with other anthracyclines, the fact that this study showed no cardiotoxicity with Berubicin, even in those receiving the drug for over a year, suggests Berubicin could be a valuable recourse for patients with recurrent or progressive cancers," said Dr. Sandra Silberman, Chief Medical Officer of CNS Pharmaceuticals.
Dr. Silberman further noted that "Berubicin also did not exhibit the pulmonary toxicity or the thrombocytopenia associated with Lomustine, suggesting it could be a way for patients to avoid those side effects during treatment. Furthermore, its primary mechanism of action, topoisomerase II inhibition, is agnostic to specific tumor histology, making it a potentially more generalizable therapy."
Clinical Significance for GBM Patients
Glioblastoma multiforme is an aggressive and typically fatal form of brain cancer with limited treatment options, particularly for recurrent cases. The standard second-line treatment, Lomustine, is associated with significant toxicities that can limit its use in some patients.
Dr. Erin Dunbar, a Principal Investigator and the Director of the Piedmont Brain Tumor Center in Atlanta, Georgia, who participated in the trial, commented on her observations: "As the longest accruing Investigator, I have witnessed rapid imaging responses and excellent clinical tolerability throughout the trial. I hope to see continued investigation of Berubicin to further evaluate its potential as an important tool to treat primary and/or metastatic cancer patients of all ages who urgently need additional options."
Unique Properties of Berubicin
Berubicin represents a potential breakthrough as the first anthracycline demonstrated to extensively cross the blood-brain barrier (BBB), a critical factor in treating brain cancers. Anthracyclines are among the most powerful chemotherapy drugs available and are effective against numerous cancer types, but their utility in brain cancers has been limited by their inability to penetrate the BBB effectively.
The drug was developed by Dr. Waldemar Priebe, Professor of Medicinal Chemistry at The University of Texas MD Anderson Cancer Center. In a previous Phase 1 human clinical trial conducted by Reata Pharmaceuticals, Berubicin treatment appeared to demonstrate positive responses, including one durable complete response.
Future Directions
Despite not meeting its primary endpoint, CNS Pharmaceuticals is continuing to analyze the trial data, including advanced imaging review, pharmacokinetics, and additional clinical endpoints. The company is also exploring further development opportunities for Berubicin.
John Climaco, CEO of CNS Pharmaceuticals, indicated that the company is evaluating opportunities to apply the methodology and strategy from this program to other drugs for CNS malignancies, including their proprietary drug TPI 287, a taxane-derivative with published clinical data showing activity in GBM.
"We are exploring further Berubicin development as well as evaluating opportunities for applying the methodology and strategy from this program to other drugs for CNS malignancies, including our proprietary drug TPI 287," said Climaco. "TPI 287 is a taxane-derivative with published clinical and radiologic data showing activity in Glioblastoma Multiforme, as well as a favorable safety profile in hundreds of patients to date."
Financial Position
As of February 26, 2025, CNS Pharmaceuticals reported a cash position of $14 million. Based on current projections, management believes this is sufficient to fund operations into 2026, providing runway for continued development efforts.
The company's stock (NASDAQ: CNSP) experienced a significant decline following the announcement, dropping 59.9% to $1.37 per share, reflecting investor disappointment in the trial not meeting its primary endpoint despite the potential safety advantages demonstrated.
The trial is ongoing, with continuation of patients on treatment and follow-up for overall survival proceeding. Final data will be included in a future analysis, which may provide additional insights into Berubicin's potential role in treating this challenging disease.
