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FDA Grants Orphan Drug Designation to Tigilanol Tiglate for Soft Tissue Sarcoma Treatment

  • The FDA has awarded orphan drug designation to tigilanol tiglate (Stelfonta), an intratumoral injection, for treating soft tissue sarcoma, a rare cancer affecting both adults and children.
  • The designation provides QBiotics with important regulatory incentives including tax credits, user fee exemptions, and potential seven years of market exclusivity following approval.
  • Tigilanol tiglate is currently being evaluated in a phase 2 trial at Memorial Sloan Kettering Cancer Center, with preliminary phase 1 data showing responses in 6 of 22 patients.
  • Soft tissue sarcomas comprise more than 80 subtypes with unfavorable prognosis in advanced stages, highlighting the urgent need for new treatment options in this rare disease area.

ADI-PEG20 Quadruples Three-Year Survival in Phase 3 Mesothelioma Trial

  • A phase 3 trial of ADI-PEG20 combined with chemotherapy increased median survival by 1.6 months and quadrupled three-year survival rates in 249 patients with pleural mesothelioma.
  • The drug works by depleting arginine levels in the bloodstream, starving tumor cells that cannot manufacture their own arginine due to missing ASS1 protein.
  • This represents the first successful combination therapy breakthrough for mesothelioma in 20 years, offering new hope for patients with one of the world's worst cancer survival rates.
  • The international ATOMIC-meso trial was conducted across 43 centers in five countries between 2017 and 2021, demonstrating the treatment was well tolerated with no new safety signals.

Bispecific Antibodies: Promising Advances Amid Adoption Challenges in Cancer Treatment

  • Bispecific antibodies represent a significant advancement in cancer immunotherapy, targeting both tumor antigens and immune cells to enhance cytotoxicity without requiring patient-derived cells like CAR-T therapy.
  • Despite clinical promise with nine FDA-approved bispecific antibodies, adoption faces challenges including transition between inpatient/outpatient settings, insurance coverage, adverse event management, and financial barriers in community settings.
  • Recent approvals of Mosunetuzumab, Glofitamab, and Epcoritamab have shown impressive response rates in relapsed/refractory indolent B-cell lymphomas, with manageable toxicity profiles when using step-up dosing strategies.
NCT05529524Completed
The Lymphoma Academic Research Organisation
Posted 11/7/2022
NCT04889716RecruitingPhase 2
Abramson Cancer Center at Penn Medicine
Posted 11/5/2021
NCT05994235RecruitingPhase 2
Weill Medical College of Cornell University
Posted 11/1/2023

Clarity's 64Cu-SAR-bisPSMA Shows Promise in Detecting Prostate Cancer Recurrence in COBRA Trial

  • Initial results from Clarity Pharmaceuticals' Phase 1/2 COBRA trial demonstrate that 64Cu-SAR-bisPSMA safely and effectively detects prostate cancer lesions in patients with biochemical recurrence who had negative standard-of-care imaging.
  • The novel radiopharmaceutical identified lesions in up to 80% of patients on next-day imaging, with the number of detected lesions almost doubling compared to same-day imaging, highlighting a unique benefit of copper-64's longer half-life.
  • Clinicians reported they would change treatment plans for approximately 50% of patients based on 64Cu-SAR-bisPSMA scan results, with two-thirds of these patients subsequently receiving focal or systemic therapy.

Kisqali Shows Enhanced Efficacy in Younger Breast Cancer Patients with 33% Risk Reduction

  • Novartis' NATALEE trial subgroup analysis reveals Kisqali plus endocrine therapy reduced invasive disease risk by 33% in pre-menopausal early breast cancer patients at 44.2 months median follow-up.
  • Pre-menopausal and younger patients experienced greater risk reductions and fewer treatment discontinuations due to adverse events compared to post-menopausal patients.
  • A separate real-world analysis highlighted significant treatment disparities, showing Black patients with early breast cancer had worse outcomes despite meeting NATALEE eligibility criteria.
  • The findings underscore the importance of CDK4/6 inhibitor therapy for vulnerable populations, including younger and Black patients who face more aggressive disease characteristics.

Dostarlimab Shows Superior Survival Outcomes Across Multiple Endometrial Cancer Molecular Subgroups in Phase 3 RUBY Trial

  • The phase 3 RUBY trial demonstrated that dostarlimab combined with carboplatin and paclitaxel significantly improved progression-free survival and overall survival in patients with advanced or recurrent endometrial cancer across multiple molecular subgroups.
  • Patients with dMMR/MSI-H tumors showed the most dramatic benefit, with progression-free survival rates of 57.0% versus 10.2% in the placebo arm and overall survival rates of 83.3% versus 58.7%.
  • The TP53 mutation subgroup also demonstrated significant clinical benefit, with progression-free survival rates of 32.4% versus 17.8% and overall survival rates of 70.8% versus 33.2% in the placebo arm.
  • These findings support dostarlimab plus carboplatin/paclitaxel as a new standard of care for patients with newly diagnosed primary advanced or recurrent endometrial cancer.

Merck and Daiichi Sankyo Form $22 Billion Alliance for Three Novel Antibody-Drug Conjugates

• Merck will pay Daiichi Sankyo $4 billion upfront plus $1.5 billion in continuation payments, with potential additional milestone payments reaching a total of $22 billion.
• The collaboration focuses on three investigational antibody-drug conjugates: patritumab deruxtecan (HER3-DXd), ifinatamab deruxtecan (I-DXd), and raludotatug deruxtecan (R-DXd), targeting multiple solid tumors.
• Patritumab deruxtecan has received Breakthrough Therapy Designation for EGFR-mutated non-small cell lung cancer, with a biologics license application planned by March 2024.

Eli Lilly Acquires Point Biopharma for $1.4 Billion to Expand Radioligand Therapy Portfolio

  • Eli Lilly announced the acquisition of Point Biopharma for $1.4 billion, paying $12.50 per share representing a 67% premium to strengthen its oncology pipeline with radioligand therapies.
  • The deal provides Lilly access to Point's lead asset PNT2002, a PSMA-targeted radioligand therapy in Phase III trials for metastatic castration-resistant prostate cancer with data expected in late 2023.
  • Point's pipeline includes PNT2003 for gastroenteropancreatic neuroendocrine tumors and earlier-stage assets, positioning Lilly to compete with established players like Novartis in the radioligand therapy space.
  • The acquisition represents Lilly's strategic entry into radiopharmaceuticals, which deliver targeted radiation directly to cancer cells while minimizing damage to healthy tissue.

Novel Targets and Strategic Sequencing: The Evolving Landscape of T-Cell Redirection Therapies in Multiple Myeloma

  • CAR T-cell therapies and bispecific antibodies targeting BCMA and GPRC5D are transforming multiple myeloma treatment, with ciltacabtagene autoleucel showing unprecedented efficacy with a median PFS of 34.9 months in heavily pretreated patients.
  • Disease progression rate is a critical factor in therapy selection, with rapidly progressing patients better suited for "off-the-shelf" bispecific antibodies, while patients with indolent disease may benefit more from CAR T-cell therapies despite longer manufacturing times.
  • Strategic sequencing of therapies is crucial, as prior BCMA-directed bispecific antibody treatment significantly reduces the efficacy of subsequent BCMA-targeted CAR T-cell therapy, highlighting the importance of preserving T-cell fitness and considering antigen loss.
NCT04634552RecruitingPhase 2
Janssen Research & Development, LLC
Posted 2/1/2021
NCT04557098Active, Not RecruitingPhase 2
Janssen Research & Development, LLC
Posted 9/17/2020
NCT05016778Active, Not RecruitingEarly Phase 1
Zhejiang University
Posted 6/8/2021
NCT04555551Active, Not RecruitingPhase 1
Memorial Sloan Kettering Cancer Center
Posted 9/8/2020
NCT05431608Active, Not RecruitingPhase 1
Memorial Sloan Kettering Cancer Center
Posted 6/20/2022
NCT03399799Active, Not RecruitingPhase 1
Janssen Research & Development, LLC
Posted 12/16/2017

Bispecific T-Cell Engagers Show Promise as Later-Line Therapies for Relapsed/Refractory DLBCL

  • Two bispecific T-cell engagers, epcoritamab-bysp and glofitamab-gxbm, received FDA accelerated approval in 2023 for relapsed/refractory diffuse large B-cell lymphoma, offering new treatment options for heavily pretreated patients.
  • Both agents demonstrate remarkable activity with overall response rates above 50-60% and complete response rates around 40% in patients with CAR T-cell therapy failure, addressing a significant unmet medical need.
  • Epcoritamab offers convenient subcutaneous administration in outpatient settings with manageable cytokine release syndrome rates below 3%, while glofitamab provides fixed-duration therapy with durable responses lasting over one year after treatment completion.
  • These bispecific antibodies may challenge the paradigm that CAR T-cell therapy is the only curative option for relapsed/refractory patients, with emerging data suggesting potential for long-term disease control.

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