Rac-Aminopterin: Next Generation Oral Antifolate in Oncology and Inflammation

Transcription

1 Rac-Aminopterin: ext Generation Oral Antifolate in Oncology and Inflammation John A. Zebala, M.D., Ph.D. President and CEO Syntrix Biosystems, Inc. CI SBIR/STTR Investor Forum Boston University, ovember 2009

2 Company Syntrix Biosystems, Inc. (Auburn, WA) Privately held clinical-stage pharmaceutical company since 2002 Market-Driven Pipeline Strategy: Opportunistic for low- to moderate-risk small-molecule development programs that address high-value unmet needs Therapeutic Markets: oncology, rheumatology, dermatology and pulmonary disease Monetization Strategy: Move pipeline through key value inflections (> clinical Phase 2) to catalyze deal flow and maximize deal valuations

3 Management and Key Personnel Dr. John A. Zebala, President and CEO (presenter) Setting and overseeing preclinical, clinical, intellectual property and regulatory development strategies MD and PhD (Molecular Biology), Weill Cornell Medical School BS (Biomedical Engineering), University of Southern California Dr. Stuart Kahn, Medical Director Clinical trial management MD, University of Medicine and Dentistry of ew Jersey MS (Biochemistry), Rutgers University / BA, Beloit College Dr. Dean Y. Maeda, Director Medicinal Chemistry Management of preclinical development programs PhD (Pharmaceutical Chemistry), Oregon State Univ. BS (Chemistry), Willamette University Dr. Jeffrey B. Oster, Intellectual Property Corporate IP attorney PhD (Biochemistry, Dr. Joe Bertino), University of Pennsylvania JD, Rutgers University

4 Extended etwork of Integrated Expertise between Company management and key CMOs and CROs

5 Company Pipeline Snapshot SX957 (pre-id), oral non-opioid analgesic Indication: Analgesia Position: Eliminates genetic tramadol resistance Opportunity: Capture $281M existing tramadol market SX576 (pre-id), oral CXCR2 inhibitor, active, HLBI Indication: Melanoma, COPD Position: First-in-class Opportunity: >$1B COPD market Racemic-aminopterin* (clinical phase 2), oral antifolate Indication: oncology and inflammation Position: Replaces methotrexate (MTX) and anti-tf biologics in key high-value markets *Highlighted company pipeline asset

6 Highlighted Pipeline Product: Rac-AMT Syntrix rac-amt disodium 0.25 mg tablets (cgmp trial material) Racemic-Aminopterin (rac-amt) is a mixture of the active L- isomer (L-AMT) and the inactive D-isomer (D-AMT) At low (anti-inflammatory) or high (oncology) doses, L-AMT and MTX are converted to polyglutamates (PG) that remain permanently trapped inside cells PG formation correlates with treatment efficacy in cancer, rheumatoid arthritis and psoriasis PG formation is 30-fold greater for L-AMT than for MTX The enhanced PG formation of rac-amt forms the rationale for superior clinical activity and its clinical testing

7 Clinical eed for a ew-generation Oral Antifolate in Oncology and Inflammation MTX is a backbone therapeutic in oncology and highvalue inflammatory disorders Millions of patients with cancer, rheumatoid arthritis (RA) and psoriasis are treated with MTX annually However, MTX fails in numerous patients because of poor oral bioavailability and incomplete PG formation Costly anti-tf biologics ($20-$40k/yr) are used to treat MTX RA/psoriasis failures. High-value opportunity A superior oral antifolate with otherwise identical prescribing to MTX would meet the clinical needs of many patients and be adopted quickly by physicians

8 Market Opportunity for Rac-AMT There were 3,969,000 MTX prescriptions in 2006 The total domestic rac-amt market in oncology and inflammation estimated at $1.1 to $2.6 billion

9 Competitive Advantages

10 Clinical Milestones Oncology Phase 1 Trial Phase 1 single-agent (monotherapy) pharmacokinetic trial in patients with refractory malignancies (=20) Oral bioavailability of 83.5% + 8.3% (=12 matched) Maximally-tolerated dose (MTD) of 2 mg/m 2 x 2 q12hr per week Dose-limiting toxicity was mucositis One CR in endometrial adenocarcinoma 11+ months

11 Clinical Milestones Oncology Phase 2 Trial Phase 2 single-agent (monotherapy) trial in refractory/relapsed acute lymphoblastic leukemia (ALL), including previous MTX Cancer cells in vitro formed significantly more PG-AMT than PG-MTX with fewer AMT uptake failures Consistent with in vitro uptake predicting disease response, response rate in patients < 21 years of age was impressive 30.4% (95% CI, 12-49%, =23). Rationale for MTX failures

12 Clinical Milestones Oncology Phase 2B Trial Phase 2B multi-agent trial in ALL for 64 weeks AMT (=33, high risk) and MTX (=20 standard risk) arms AMT Arm: At 45 months (median), 3-year EFS was 83% ± 7%; and 87% ± 7% (dotted line) in patients yrs AMT-treated patients had significant sparing of the liver (SGOT/SGPT), erythropoiesis and CSF. Rationale for being bettter tolerated; MTX liver tox key in RA/psoriasis

13 Preclinical & Clinical Progress Inflammation FIG 1 FIG 2 Preclinical AMT 43-fold more potent than MTX in murine model (fig 1) AMT active in canine model of atopic dermatitis (CAD, fig 2) Expanded trial ongoing (=75) targets companion pet market Stereoselective absorption in canine of L-isomer Psoriasis Phase 1 trial (=20) open (CT clinicaltrials.gov) PK study of rac-amt vs. L-isomer. To complete early 2010 Rheumatoid Arthritis Phase 2 discontinuation trial (=260) to open late 2010 Study to demonstrate activity of rac-amt in MTX failures

14 Milestones Chemistry Manufacturing and Controls (CMC) H 2 OH H O Folic Acid H CO 2 H CO 2 H p-tsoh, TMS 2 pyridine 110 deg C, 24 hrs closed reactor H 2 H 2 H rac-amt O H CO 2 H CO 2 H Cytotoxic suite 60,000 Tablet Batch 9/2004 Single-step process from folic acid (U.S. 7,235,660) cgmp process produces rac-amt in > 99% purity cgmp rac-amt tablets (0.25 mg) via proprietary topspray granulation/direct compression method

15 Rac-AMT Intellectual Property IP Strategy and Protection. Worldwide exclusive rights to U.S. and International patents protecting rac-amt composition of matter, newly discovered properties, methods of use, methods of making, and new dosage formulations Issued Patents. 7,235,660; 7,312,217; 11/078,614 Patent Protection Term. Until at least 2025.

16 Rac-AMT Regulatory Strategy and Protection Registration Mechanism. Drug registration for any indication will require an DA, and will employ section 505(b)(2) of the Act. Section 505(c)(3)(E). Statutory ew Chemical Entity (CE) entitled to 5 years Hatch-Waxman marketing exclusivity under section 505(c)(3)(E) for any indication that will run concurrent with any patent term exclusivity. Orphan Exclusivity. Entitled to 7 years of marketing exclusivity for qualifying oncology indications that include for example, ALL and PTCL. Generic Competition. There is no existing label that would form the regulatory basis for a generic (ADA) application from a competitor.

17 Significant Publications Ratliff, A.F., et al., Phase I and pharmacokinetic trial of aminopterin in patients with refractory malignancies. J Clin Oncol, (4): p Cole, P.D., et al., Phase II trial of oral aminopterin for adults and children with refractory acute leukemia. Clin Cancer Res, (22): p Cole, P.D., et al., Phase 2B trial of aminopterin in multiagent therapy for children with newly diagnosed acute lymphoblastic leukemia. Cancer Chemother Pharmacol, (1): p Cole, P.D., et al., Pharmacodynamic properties of methotrexate and aminopterin during weekly therapy. Cancer Chemother Pharmacol, (6): p Olivry, T., et al., A pilot open trial evaluating the efficacy of lowdose aminopterin in the canine homologue of human atopic dermatitis. Br J Dermatol, (5): p

18 Rac-AMT Month Development Plan on-clinical 1. CMC process development per cgmp for toxicology and phase 2/3 clinical trials on-clinical 2. GLP toxicology to support further clinical trials. on-clinical 3. Canine atopic dermatitis (CAD) trial (ongoing). Clinical 1. Phase 1 PK study in psoriasis (ongoing). Clinical 2. Phase 2 randomized discontinuation trial in RA in MTX failures (beginning). Clinical 3. Two-stage Simon phase 2 trial of rac-amt in PTCL with a national cooperative group (=~30, planning stage).

19 Fundraising Since inception, Syntrix Biosystems has been awarded over $15M in non-dilutive financing from the IH in support of its development efforts. early $6M Federal dollars for rac-amt alone. ext fundraising steps for rac-amt: $30-$50M capital To establish pivotal efficacy and safety database in phase 2/3 clinical trials; points of major upward value inflection Potential Sources: (a) private/public sale of equity and/or (b) a partnering/licensing/development deal

20 Conclusions/Summary There is a need in the current pharmacopeia for an antifolate that provides superior clinical efficacy and less toxicity than methotrexate in oncology and inflammatory indications Rac-AMT is a proprietary clinical-stage (Phase 2) antifolate with data suggesting it offers a significant therapeutic advance as a better methotrexate in oncology and inflammation Rac-AMT offers a high-value alternative to costly anti-tf therapy in MTX failures The domestic rac-amt market is estimated at $1.1B to $2.6B The U.S. Patent term is until 2030 without consideration to Hatch-Waxman extension Further capital is required to support clinical studies to advance rac-amt to become the next-generation antifolate