−Removed: are a clinical-stage biopharmaceutical company developing T-cell therapies with the capacity to address treatment challenges for patients
−Removed: with cancers and autoimmune diseases.
−Removed: The Company was originally incorporated as Estrella Biopharma, Inc.
−Removed: in the State of Delaware on
−Removed: March 30, 2022, by Eureka Therapeutics, Inc.
−Removed: (“Eureka”), which was established in California in February 2006 and reincorporated
−Removed: in Delaware in March 2018.
−Removed: On June 28, 2022, Estrella entered into a Contribution Agreement with Eureka, under which Eureka contributed
−Removed: certain assets related to T-cell therapies targeting CD19 and CD22 proteins in exchange for 105,000,000 shares of Estrella’s Series
−Removed: AA Preferred Stock (the “Separation”).
−Removed: This Separation included Estrella entering into a License Agreement with Eureka and
−Removed: Eureka Therapeutics (Cayman) Ltd., granting Estrella an exclusive license to develop CD19 and CD22 targeted T-cell therapies using Eureka’s
−Removed: ARTEMIS® platform.
−Removed: Additionally, Estrella assumed the Collaboration Agreement between Eureka and Imugene Limited, which covers the
−Removed: development of solid tumor treatments using Imugene’s CF33-CD19t in conjunction with Estrella’s EB103 therapy.
−Removed: September 29, 2023, Estrella consummated a business combination (the “Business Combination”) with TradeUP Acquisition
−Removed: (“UPTD”), a blank-check company, pursuant to the Agreement and Plan of Merger dated September 30, 2022 (the
−Removed: “Merger Agreement”).
−Removed: Under the terms of the Merger Agreement, Tradeup Merger Sub Inc., a wholly-owned subsidiary of
−Removed: UPTD, merged with and into Estrella, resulting in Estrella becoming a wholly-owned subsidiary of UPTD.
−Removed: Following the closing of the
−Removed: business combination, UPTD was renamed Estrella Immunopharma, Inc.
−Removed: On June 26, 2024, Estrella Immunopharma, Inc.
−Removed: filed a Certificate
−Removed: of Ownership and Merger with the Delaware Secretary of State to effect a merger with its wholly-owned subsidiary, Estrella
−Removed: Biopharma, Inc.
−Removed: under Section 253 of the Delaware General Corporation Law.
−Removed: This merger, effective at 11:59 PM Eastern Time on June
−Removed: 30, 2024, was approved by the unanimous written consent of the Company’s board of directors.
−Removed: As a result of the merger, the
−Removed: separate existence of Estrella ceased, and Estrella Immunopharma, Inc.
−Removed: became the surviving corporation, assuming all assets,
−Removed: liabilities, and obligations of Estrella.
−Removed: believe T-cell therapy continues to represent a revolutionary step towards providing a potential solution for many forms of cancer, including
−Removed: cancers poorly addressed by current approaches.
−Removed: Existing chimeric antigen receptor T-cell, or CAR-T, therapies, the initial class of
−Removed: T-cell therapies, have demonstrated remarkable efficacy and significant survival benefit in certain CD19-positive blood cancers like
−Removed: lymphomas and leukemias.
−Removed: CD19 is a protein expressed on the surface of almost all B-cell leukemias and lymphomas.
−Removed: Current CAR-T cell
−Removed: therapies, however, have limitations that may preclude broad adoption, including potentially life-threatening side effects like the hypersecretion
−Removed: of inflammatory cytokines known as Cytokine Release Syndrome (“CRS”) and immune effector cell-associated neurotoxicity syndrome
−Removed: This side effect, however, is considered addressable with other treatment if the net effect is to target and kill
−Removed: cancer cells in the body.
−Removed: Additionally, CAR-T therapies target and kill all cells expressing CD19 (including healthy B-cells).
−Removed: side effects have limited currently approved CAR-T therapies to specialized cancer centers and later lines of treatment for patients
−Removed: that have undergone other types of treatment unsuccessfully.
−Removed: mission is to harness the evolutionary power of the human immune system to transform the lives of patients fighting cancer and autoimmune
−Removed: disease with safe, effective therapies.
−Removed: To accomplish this mission, our lead product candidate, EB103, which is a T-cell therapy we also
−Removed: call “CD19-Redirected ARTEMIS ® T-Cell Therapy,” utilizes Eureka’s ARTEMIS ® technology
−Removed: to target CD19.
−Removed: Unlike a traditional CAR-T cell, the unique design of an ARTEMIS ® T-Cell, like EB103 T-cells, allows it
−Removed: to be activated and regulated upon engagement with cancer targets that use a cellular mechanism more closely resembling the one from
−Removed: the endogenous T-cell receptor (TCR).
−Removed: EB103 is currently undergoing a Phase I/II clinical trial (STARLIGHT-1) to assess safety and determine
−Removed: the Recommended Phase II Dose (RP2D) in patients with relapsed/refractory B-cell Non-Hodgkin’s Lymphomas.
−Removed: As of September 2024,
−Removed: two patients have been treated in the STARLIGHT-1 clinical trial.
−Removed: are also developing EB104, a T-cell therapy we also call “CD19/22 Dual-Targeting ARTEMIS ® T-Cell Therapy.”
−Removed: Like EB103, EB104 utilizes Eureka’s ARTEMIS ® technology to target not only CD19, but also CD22, a protein that,
−Removed: like CD19, is expressed on the surface of most B-cell malignancies.
−Removed: EB104’s dual-targeting strategy has the potential to more effectively
−Removed: treat patients with lower surface CD19 density or a greater prevalence of CD22, and reduce relapse due to CD19 antigen loss.
−Removed: tumors represent approximately 90% of all cancers.
−Removed: To date, T-cell therapy such as CAR-T has demonstrated limited success treating solid
−Removed: One major barrier limiting the potential of T-cell therapy is the lack of tumor-specific targets.
−Removed: We believe that, in collaboration
−Removed: with Imugene and Imugene’s product candidate, CF33-CD19t, an oncolytic virus, EB103 T-cells have the potential to overcome this
−Removed: barrier using a “mark and kill” strategy.
−Removed: This “mark and kill” strategy entails using CF33-CD19t, to induce solid
−Removed: tumor cells into expressing the CD19 protein on the cell surface.
−Removed: Our EB103 T-cells can then pursue and kill the now CD19-expressing
−Removed: solid tumor cells, offering a potential treatment to cancers that lack solid tumor-specific targets.
−Removed: Hematological
−Removed: Hematological
−Removed: cancers, or blood cancers, are cancers that begin in blood-forming tissue, such as the bone marrow, or in the cells of the body’s
−Removed: immune system.
−Removed: Examples of hematologic cancers are leukemia, lymphoma, and multiple myeloma.
−Removed: Leukemia is a broad term for cancers of
−Removed: the blood cells.
−Removed: The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly.
−Removed: occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15.
+Added: We are a clinical-stage biopharmaceutical
+Added: company developing T-cell therapies to address treatment challenges for patients with cancers and autoimmune diseases.
+Added: Our strategy is
+Added: to harness the evolutionary power of the human immune system to provide patients with potentially safer, more efficacious T-cell therapies
+Added: compared to traditional CAR-T therapies.
+Added: Leveraging cutting-edge cellular engineering technologies, we aim to overcome the limitations
+Added: of current CAR-T therapies, such as high toxicity and prohibitive costs, so that T-cell therapy treatments can be accessible to a larger
+Added: patient population.
+Added: Lead Program Status
+Added: Our innovative ARTEMIS ®
+Added: T Cell Receptor Platform uniquely designs T cells that, unlike a traditional CAR-T cell, are activated and regulated upon engagement with
+Added: cancer targets using cellular mechanisms more resembling those from the endogenous T-cell receptor (TCR).
+Added: Our lead product candidate,
+Added: EB103, is a CD19-directed ARTEMIS T-cell therapy designed to address the unmet medical needs of patients with relapsed or refractory B-cell
+Added: malignancies, especially those who are not eligible for currently approved T-cell therapies.
+Added: EB103 is currently in the dose expansion
+Added: portion of a Phase I/II clinical trial (STARLIGHT-1) in patients with relapsed/refractory B-cell Non-Hodgkin’s Lymphomas.
+Added: December 2025, we have completed the second dose cohort in the Phase I dose-escalation portion of our STARLIGHT-1 Phase I/II clinical
+Added: trial of EB103, and an independent Data Safety Monitoring Board (DSMB) has completed its review of safety data from the Phase I dose-escalation
+Added: phase (n=9) and recommended advancing the trial into the Phase II expansion phase at the recommended Phase II dose (RP2D).
+Added: I dose-escalation phase, no treatment-related serious adverse events were reported, and the high-dose cohort achieved a 100% complete
+Added: response rate at Month 1 in all evaluable patients, a majority of whom were considered high-risk and ineligible for currently available
+Added: commercial CD19 products.
+Added: Additional Product Candidates
+Added: We are also developing EB104,
+Added: which are T-cells that utilize ARTEMIS ® technology to target not only CD19, but also CD22.
+Added: Like CD19, CD22 is expressed
+Added: on the surface of most B-cell malignancies.
+Added: EB104’s dual-targeting strategy has the potential to more effectively treat patients
+Added: with lower surface CD19 density or a greater prevalence of CD22, thus potentially reducing relapse due to CD19 antigen loss.
+Added: Solid tumors represent approximately
+Added: 90% of all cancers.
+Added: To date, T-cell therapy such as CAR-T has demonstrated limited success in treating solid tumors.
+Added: One major barrier
+Added: limiting the potential of T-cell therapy is the lack of tumor-specific targets.
+Added: We believe that, in collaboration with Imugene and Imugene’s
+Added: product candidate, CF33-CD19t, an oncolytic virus, EB103 T-cells have the potential to overcome this barrier using a “mark and kill”
+Added: This “mark and kill” strategy entails using CF33-CD19t, to induce solid tumor cells into expressing the CD19 protein
+Added: on the cell surface.
+Added: Our EB103 T-cells can then pursue and kill the solid tumor cells expressing exogenous CD19, offering a potential
+Added: treatment to cancers that lack solid tumor-specific targets.
+Added: Corporate History
+Added: On June 28, 2022, pursuant to a Contribution Agreement between Estrella and Eureka, Eureka contributed certain
+Added: assets related to T-cell therapies targeting CD19 and CD22 in exchange for 105,000,000 shares of Estrella’s Series AA Preferred
+Added: Stock (“Separation”),
+Added: On September 29, 2023, Estrella
+Added: completed a business combination (the “Business Combination”) with TradeUP Acquisition Corp.
+Added: (“UPTD”), a blank-check
+Added: company, under the terms of the Agreement and Plan of Merger dated September 30, 2022.
+Added: Following the merger, Estrella became a wholly
+Added: owned subsidiary of UPTD, and UPTD was renamed Estrella Immunopharma, Inc.
+Added: On June 26, 2024, Estrella
+Added: Immunopharma, Inc.
+Added: merged with its wholly owned subsidiary, Estrella Biopharma, Inc., under Section 253 of the Delaware General Corporation
+Added: The merger, effective on June 30, 2024, was approved by the Board of Directors and resulted in Estrella Immunopharma, Inc.
+Added: all assets, liabilities, and obligations of Estrella Biopharma, Inc.
+Added: On November 27, 2024, the Company established a wholly owned
+Added: subsidiary in Hong Kong.
+Added: Key elements of our business
+Added: strategy include:
+Added: Effectively progress EB103, our lead product candidate, through clinical development.
+Added: We believe our autologous T-cell therapies have the potential to overcome major limitations of currently approved CAR-T cells with superior safety and efficacy, allowing access to significantly more patients.
+Added: As of December 2025, we have completed the dosing of nine patients in the Phase I dose escalation phase of STARLIGHT-1 and have initiated Phase II dose expansion phase at the RP2D.
+Added: We anticipate completing the Phase II portion of the STARLIGHT-1 clinical trial in 1H2027.
+Added: Total Addressable Market (TAM) in CD19-positive cancers through the demonstration of safety and efficacy of ARTEMIS T-cell in clinical
+Added: settings for patients not eligible for currently approved T-cell therapies:
+Added: EB103’s safety profile positions it for potential
+Added: use in earlier-line treatments, broader adoption in community hospital settings rather than being restricted to specialized medical centers,
+Added: and the ability to treat high-risk patient groups, thereby increasing market penetration and patient accessibility.
+Added: our second product candidate, EB104, into clinical development.
+Added: We are compiling
+Added: an Investigational New Drug (IND) filing for EB104 for the treatment of relapsed/refractory
+Added: and high-risk B cell malignancies.
+Added: Phase I trials may not commence until the FDA has approved
+Added: the Investigational New Drug (“IND”) Application for EB104.
+Added: the use of EB103 in conjunction with CF33-CD19t for multiple indications of solid tumors through clinical development.
+Added: Phase I/II Starlight-1 Clinical Trial is successful, we plan to submit an IND filing for the use of EB103 in conjunction with CF33-CD19t
+Added: in the future.
+Added: At this time, we have not determined the solid tumor indications to target or an exact timeframe for filing our IND application.
+Added: to innovate to develop and advance a novel T-cell therapy pipeline.
+Added: We are committed to developing more disruptive therapies
+Added: that have the potential to be adopted in earlier lines of treatment and to be delivered in community outpatient settings, as well as
+Added: treat patients in diverse indications beyond cancer, such as autoimmune diseases.
+Added: Our Pipeline of Clinical Programs
+Added: We intend to initially focus
+Added: on advancing our CD19-Redirected ARTEMIS T Cell programs in relapsed/refractory and high-risk blood cancers.
+Added: Meanwhile, we are advancing
+Added: a robust pipeline for other hematologic malignancies, solid tumor and autoimmune disease.
+Added: Our commitment to safety, accessibility, and
+Added: cost-effectiveness positions us to redefine the T-cell therapy paradigm and deliver transformative solutions to more patients.
+Added: The following
+Added: chart summarizes our clinical programs:
+Added: Our Therapeutic Focus
+Added: Our primary focus is on developing
+Added: innovative therapies for CD19-positive cancers, a significant subset of hematologic malignancies with high unmet medical needs.
+Added: approved therapies, such as Kymriah® (Novartis) and Yescarta® (Kite Pharma), have demonstrated efficacy in relapsed or refractory
+Added: B-cell malignancies but face limitations due to:
+Added: High rates of Cytokine Release Syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), often
+Added: requiring hospitalization and intensive management.
+Added: Complex and individualized manufacturing processes that result in significant financial burdens.
+Added: Limited availability in specialized tertiary care centers.
+Added: EB103 aims to address these challenges by enhancing safety, scalability, and accessibility.
+Added: Its excellent safety
+Added: profile allows for broader patient eligibility, including individuals with comorbidities or advanced age and potentially expands
+Added: treatment access to community settings.
+Added: Our streamlined production process also enables us to lower the cost of manufacturing.
+Added: Opportunities for Increasing Total Accessible
+Added: Market (TAM) for Blood Cancers with a Best-in-Class CD19 T-cell Therapy
+Added: Hematological Cancers
+Added: Hematological cancers, or
+Added: blood cancers, are cancers that begin in blood-forming tissues, such as the bone marrow, or in the body’s immune cells.
+Added: of hematologic cancers are leukemia, lymphoma, and multiple myeloma.
+Added: Leukemia is a broad term for cancers of the blood cells.
+Added: of leukemia depends on the type of blood cell that becomes cancerous and whether it grows quickly or slowly.
The National Cancer Institute
−Removed: estimates that there will be over 60,000 new cases of leukemia in the United States in 2022, representing approximately 3.2% of all new
−Removed: cancer cases.
+Added: (NCI) estimates 66,890 new cases of leukemia in the United States in 2025, representing approximately 3.3% of
+Added: all new cancer cases.
B-cell lymphoma is a type of cancer that forms in B-cells (a type of immune system cell).
−Removed: B-cell lymphomas may be either
−Removed: indolent (slow-growing) or aggressive (fast-growing).
−Removed: Non-Hodgkin lymphoma (NHL) has an incidence rate of 19.0 per 100,000 per year and
+Added: B-cell lymphomas may be
+Added: either indolent (slow-growing) or aggressive (fast-growing).
+Added: NCI estimates 80,350 new cases of non-Hodgkin lymphoma (NHL) in 2025, and
B-cell lymphomas make up most (about 85%) of NHL in the United States.
2 unchanged sentences
(DLBCL), follicular lymphoma (FL), and mantle cell lymphoma (MCL).
−Removed: field of immunotherapy has evolved rapidly over the past few decades, and we believe that we are positioned to build upon previous research
−Removed: to harness the potential of immunotherapy to drive significant advances in cancer treatment.
−Removed: T-cells are white blood cells in the body’s
−Removed: immune system that fight infections and tumor cells.
−Removed: T-cells also act to signal other immune cells to respond to threats.
−Removed: ideally suited for immuno-oncology applications based on several characteristics.
−Removed: T-cells recognize their targets because they are created
−Removed: in a way that allows them to specifically recognize foreign antigens on the surface of other cells.
−Removed: T-cells are extremely specific, able
−Removed: to recognize a cancer cell and kill it, while ignoring an almost identical healthy cell.
−Removed: However, tumor cells sometimes evolve to escape
−Removed: killing by T-cells by activating a number of pathways that suppress T-cell function.
−Removed: The goal with T-cell immunotherapy is to reprogram
−Removed: a patient’s own T-cells so that the T-cells can seek out and destroy cancer cells wherever they are hiding in the body, despite
−Removed: normal tumor suppressive mechanisms.
−Removed: T-cell therapy is also referred to as T-cell transfer therapy, adoptive cell therapy, adoptive immunotherapy
−Removed: and immune cell therapy.
−Removed: therapies involve collecting a patient’s own T-cells, growing large numbers of these T-cells in a lab, and then giving the cells
−Removed: back to the patient through a needle in the patient’s vein.
−Removed: During the process of growing a patient’s T-cells in a lab environment,
−Removed: a patient may have treatment with chemotherapy and, maybe, radiation therapy to eliminate other immune cells, as reducing the patient’s
−Removed: immune cells can help the transferred T-cells to be more effective.
−Removed: type of T-cell therapy for treating cancer, CAR-T cell therapy, uses T-cells reprogrammed to express chimeric antigen receptors (CAR)
−Removed: directed at a certain target (“CAR-T cells”), allowing the CAR-T cells to attach to specific proteins on the surface of cancer
−Removed: cells, improving their ability to attack the cancer cells.
−Removed: THERAPY PROCESS
−Removed: and Development of T-cell Therapies
−Removed: the past 20 years, using T-cells to treat cancer has moved from a radical ideal to clinical reality, with the first major successes occurring
−Removed: around 2010, when small clinical trials produced dramatically positive results in fighting aggressive blood cancers.
−Removed: The first T-cell
−Removed: trials were conducted in the mid-1990s targeting HIV CAR-T cells — the initial class of T-cell therapy.
−Removed: The effects of these first
−Removed: trials to fight HIV were mild, but the effort ended with the creation of successful HIV drug cocktails and, importantly, revealed that
−Removed: CAR-T-cells survived for more than 17 years in patients following treatment.
−Removed: In the mid-2000s, clinical trials using CAR-T-cells to treat
−Removed: solid tumors were largely unsuccessful.
−Removed: A few years later, trials for CAR-T-cells that targeted a surface protein called CD19, which
−Removed: is found only on the immune system’s B cells and mutate to cause certain types of leukemia and lymphoma, showed positive results
−Removed: in three patients with leukemia.
−Removed: Those trials, however, also had the unexpected result of triggering CRS, in which the reengineered T-cells
−Removed: trigger the release of inflammatory signaling molecules called cytokines, causing severe fever, nausea, fatigue and body aches that can
−Removed: be life-threatening.
−Removed: Over the past decade, clinicians developed strategies to treat the side effects of T-cell therapies.
−Removed: Still, because
−Removed: of risks associated with CRS and ICANS, nearly all T-cell therapies to treat cancer must be administered at dedicated cancer centers.
−Removed: data that accumulated in the mid-2010s from trials by pharmaceutical companies Novartis and Kite Pharma was compelling, and in 2017,
−Removed: the FDA approved Novartis’ Kymriah™ for adult patients with relapsed or refractory follicular lymphoma after two or more
−Removed: lines of systemic therapy and Kite Pharma’s Yescarta™ for patients with large-B-cell lymphomas whose cancer had progressed
−Removed: after receiving at least two prior treatment regimens.
−Removed: Since 2017, four additional CAR-T therapies have been approved by the FDA.
−Removed: on T-cell Therapies
−Removed: approvals of CAR-T therapies over the past five years demonstrate the viability of T-cell therapies as a new class of cancer immunotherapies.
−Removed: Analogous to the advent of monoclonal antibodies, we believe that T-cell therapies have the potential to become some of the most impactful
−Removed: cancer immunotherapy products over the next decade, but will first need to overcome certain limitations that have constrained widespread
−Removed: use over the past five years.
−Removed: In particular, we believe the existing classes of commercially approved T-cell therapies may be unable
−Removed: to realize their full potential due to the following limitations:
+Added: Limitations of Currently Approved T-cell
+Added: The approvals of CAR-T therapies
+Added: over the recent years demonstrate the viability of T-cell therapies as a new class of cancer immunotherapies.
+Added: Analogous to the advent
+Added: of monoclonal antibodies, we believe that T-cell therapies have the potential to become some of the most impactful cancer immunotherapy
+Added: products over the next decade, but will first need to overcome certain limitations that have constrained widespread use:
● Hyperactivation
of T-Cells Resulting in Severe Toxicities.
−Removed: The uncontrolled activation of T-cells
−Removed: can lead to CRS.
−Removed: Currently marketed CAR-T therapies include a boxed warning citing fatal
−Removed: or life-threatening risks of CRS and ICANS.
−Removed: We believe these severe toxicity risks will likely
−Removed: limit the incorporation of these therapies into earlier lines of therapy and their adoption
−Removed: in community outpatient settings.
+Added: The uncontrolled activation of T-cells can lead to CRS.
+Added: Currently marketed CAR-T therapies
+Added: include a boxed warning citing fatal or life-threatening risks of CRS and ICANS.
+Added: We believe these severe toxicity risks will likely limit
+Added: the incorporation of these therapies into earlier lines of therapy and their adoption in community outpatient settings.
Costs and Consequences of Toxicities.
−Removed: CRS and ICANS are very costly side effects
−Removed: The risk of these occurrences results in standard treatment protocols that can
−Removed: add significant indirect costs on top of direct reimbursement costs and are burdensome to
−Removed: patients and the healthcare system overall.
−Removed: Experimental clinical strategies aimed at mitigating
−Removed: these risks include utilization of restrictive enrollment screening criteria to reduce the
−Removed: potential for CAR-T related toxicities.
−Removed: Such screening tactics would decrease the number
−Removed: of patients eligible for these therapies and could also increase the overall burden and cost
−Removed: of treatment.
+Added: CRS and ICANS are very costly side effects to manage.
+Added: The risk of these occurrences results
+Added: in standard treatment protocols that can add significant indirect costs on top of direct reimbursement costs and are burdensome to patients
+Added: and the healthcare system overall.
Currently, the average cost of standard CAR-T cell treatment plans is approximately $400,000.
in the Treatment of Solid Tumor Cancers.
−Removed: Due to its ability to target cancer-specific
−Removed: intracellular antigens, the currently preferred T-cell therapy platform to target solid tumors
−Removed: is engineered T-Cell Receptor T-cells, or TCR-T.
+Added: Due to its ability to target cancer-specific intracellular antigens, the currently preferred
+Added: T-cell therapy platform to target solid tumors is engineered T-Cell Receptor T-cells, or TCR-T.
However, TCR-T therapies face the following
(i) T-cell receptors, or TCRs, have a suboptimal affinity for their target antigens;
−Removed: (ii) enhancing TCRs’ affinity for therapeutic purposes can introduce off-target toxicity;
+Added: (ii) enhancing TCRs’ affinity
+Added: for therapeutic purposes can introduce off-target toxicity;
and (iii) engineered TCRs can mis-pair with endogenous TCRs, leading to cross-reactivity
with unknown consequences.
−Removed: believe that EB103 and EB104 have the potential to overcome these limitations through providing a more selective immune response, limiting
+Added: According to Grand View Research,
+Added: the global CAR T-cell therapy market size was estimated at $5.82 billion in 2025 and is projected to reach $22.36 billion by 2033, growing
+Added: at a compounded annual growth rate of 18.06% from 2026 to 2033.
+Added: However, currently only about 20% of eligible patients are treated by
+Added: current CAR-T therapies, due to their various limitations described above.
+Added: We believe that EB103 and EB104 programs have the potential to
+Added: overcome these limitations and capture the vast majority of untapped TAM through providing a more selective immune response, limiting
tertiary costs associated with side effects of treatment, and attacking solid tumors with a “mark and kill” strategy.
−Removed: opportunities in expanding the curative capacity of T-cell therapy to autoimmune diseases
−Removed: diseases occur when the immune system, which normally defends the body against harmful invaders, mistakenly attacks healthy tissues.
−Removed: These diseases can affect various organs, leading to chronic inflammation, tissue damage, and in some cases, life-threatening complications.
−Removed: Common examples include systemic lupus erythematosus (SLE), rheumatoid arthritis, and multiple sclerosis.
−Removed: The cause is often an overactive
−Removed: immune response, particularly involving autoreactive B cells that produce antibodies targeting the body’s own tissues.
−Removed: treatments for autoimmune diseases have focused on controlling symptoms and slowing disease progression.
−Removed: B-cell depletion therapies,
−Removed: such as CD20-targeting antibodies (e.g., Rituximab, Ocrelizumab) and BAFF inhibitors (e.g., Belimumab), have provided some relief for
−Removed: conditions like lupus and multiple sclerosis.
+Added: Emerging opportunities in expanding the
+Added: curative capacity of T-cell therapy to autoimmune diseases
+Added: Autoimmune diseases occur
+Added: when the immune system, which normally defends the body against harmful invaders, mistakenly attacks healthy tissues.
+Added: These diseases can
+Added: affect various organs, leading to chronic inflammation, tissue damage, and in some cases, life-threatening complications.
+Added: Common examples
+Added: include systemic lupus erythematosus (SLE), rheumatoid arthritis, and multiple sclerosis.
+Added: The cause is often an overactive immune response,
+Added: particularly involving autoreactive B cells that produce antibodies targeting the body’s own tissues.
+Added: Traditional treatments for
+Added: autoimmune diseases have focused on controlling symptoms and slowing disease progression.
+Added: B-cell depletion therapies, such as CD20-targeting
+Added: antibodies (e.g., Rituximab, Ocrelizumab) and BAFF inhibitors (e.g., Belimumab), have provided some relief for conditions like lupus and
+Added: multiple sclerosis.
These therapies aim to reduce the number of autoreactive B cells.
−Removed: However, they have limitations.
−Removed: Most existing treatments only manage symptoms and are rarely curative.
−Removed: Long-term administration is often required, and patients may experience
−Removed: serious side effects, while the underlying disease continues to progress or return.
−Removed: believe CD19-redirected T-cell therapy offers a promising new approach to treating autoimmune diseases.
−Removed: In recent clinical studies, CD19-redirected
−Removed: CAR T-cell therapy has shown the potential to go beyond symptom management by depleting the entire population of autoreactive B cells,
−Removed: leading to rapid and durable disease remission.
−Removed: A notable study in lupus patients demonstrated that a single dose of CD19-targeting CAR
−Removed: T-cells resulted in significant improvements, with most patients entering remission and experiencing long-lasting benefits.
−Removed: are expanding our clinical investigation of our CD19-redirected ARTEMIS T-cell therapy into autoimmune diseases.
−Removed: Our EB201 program, in
−Removed: preclinical development, is being explored as a potential therapeutic approach targeting Systemic Lupus Erythematosus (SLE).
−Removed: Cell Receptor Platform
−Removed: has granted us an exclusive license relating to targeted T-cell therapies, which we are developing, in the Licensed Territory.
−Removed: using Eureka’s ARTEMIS ® ( A ntibody R edirected T -Cells with E ndogenous M odular
−Removed: I mmune S ignaling) platform technology to develop such targeted T-cell therapies.
−Removed: The ARTEMIS ® platform builds
−Removed: on successes of current CAR-T therapies by using T-cells engineered to use a cellular mechanism more closely resembling one from an endogenous
−Removed: T-cell receptor, producing a more natural and restrained immune response.
−Removed: key units of ARTEMIS ® T-cells comprise of an antibody-T-cell-receptor (AbTCR) and a co-stimulatory molecule.
−Removed: serves as the core component featuring a target-binding domain derived from an antibody fragment antigen-binding (Fab) region and an
−Removed: effector domain derived from portions of a human gamma/delta (γδ) TCR.
−Removed: Given that the AbTCR includes portions of a human
−Removed: TCR, the AbTCR by its nature associates with the endogenous CD3 complex.
−Removed: This enables the AbTCR to use the same activation and regulatory
−Removed: pathways employed by natural TCRs.
−Removed: The co-stimulatory molecule is an additional key component featuring a target-binding domain derived
−Removed: from a single-chain variable fragment (scFv) and co-stimulatory domain derived from portions of a human co-stimulatory receptor.
−Removed: preclinical data from Eureka’s 2018 paper published in Cell Discovery (the “2018 Paper”), ARTEMIS ®
−Removed: T-cells expressing an AbTCR construct targeting CD19 functionally matched the potency of CAR-T cells, but released lower levels
−Removed: of cytokines upon the killing of target-positive cells in both in vitro and tumor xenograft mouse models.
−Removed: The 2018 Paper explored ARTEMIS ®
−Removed: T-cells expressing only the AbTCR receptor, as the co-stimulatory molecule was added (and the current form of EB103 was created)
−Removed: in late 2018.
−Removed: conducted the study at Children’s Hospital of Philadelphia (CHOP) and Lumigenics (Richmond, CA) using female NSG mice aged eight
−Removed: to ten weeks.
−Removed: To compare the phenotypes between AbTCR-T cells and CAR-T cells, Eureka engineered a single-chain variable fragment and
−Removed: fused it with a widely-used CAR T-cell (also called a “second generation” CAR T-cell).
−Removed: This allowed Eureka to evaluate AbTCR-T
−Removed: cells in comparison to an existing CAR-T platform that is widely used clinically.
−Removed: T-cell manufacturing, AbTCR-T cells expanded with similar growth kinetics as the CAR T-cells and yielded T-cell populations with similar
−Removed: transduction efficiencies and the composition of CD4+ T-cells and CD8+ T-cells, which are subsets of T-cells, which is a well-accepted
−Removed: metric for evaluating the subsets of manufactured T-cells.
−Removed: and CAR T- were cultured and the number of cells determined at the indicated time points.
−Removed: (b) Proportions
−Removed: of CD4/CD8 within receptor+ cells.
−Removed: Retrospective
−Removed: analysis from published CAR-T clinical studies have found that T-cells that are more naive, less differentiated, and less exhausted correlate
−Removed: with improved efficacy.
−Removed: After T-cell “expansion”, where T-cells proliferate multiple times during an immune reaction to fight
−Removed: disease, but before antigen engagement, AbTCR-T cells in the study displayed a more naive and stem cell memory T-cell phenotype compared
−Removed: to the CAR T-cells.
−Removed: (c) Frequency
−Removed: of naïve (CCR7+ CD45RA+), central memory (CM;
−Removed: CCR7+ CD45RA−), effector memory
−Removed: CCR7- CD45RA-) and effector (E;
−Removed: CCR7- CD45RA+) T cells within CD8+ receptor+ cells.
−Removed: (d) Frequency
−Removed: of stem cell memory (SCM;
−Removed: CCR7+ CD45RO- CD95+ CD122+) T cells within CD8+ receptor+ cells.
−Removed: together with the shifts in increased CD28, which is a protein expressed on T-cells that provides co-stimulatory signals required for
−Removed: T-cell activation, and lower granzyme B, which is a biomarker of immune cell activation, on CD8+ AbTCR-T cells, the increased CCR7 (a
−Removed: biomarker for naïve and stem cell memory T-cells) expression indicates that T-cells engineered with AbTCR are less differentiated.
−Removed: Furthermore, expression of programmed cell death-1 (“PD-1”) and T-cell immunoglobulin mucin-3 (“TIM-3”), which
−Removed: are both markers of T-cell exhaustion, and TIM-3 were lower on AbTCR-T cells than in CAR-T cells.
−Removed: (e) Expression
−Removed: of T cell differentiation markers CD28, CCR7, and granzyme B.
−Removed: (f) Expression
−Removed: of T cell exhaustion markers PD-1, LAG-3, and TIM-3.
−Removed: next characterized the T-cell phenotypes resulting from activation through the AbTCR.
−Removed: Eureka co-incubated the CAR T-cells with Raji cells,
−Removed: which are from a human B lymphoblastoid cell line originally derived from a patient with Burkitt Lymphoma.
−Removed: The Raji cells were either
−Removed: CD19-positive (“CD19+”) cells or cells in which CD19 was not present, or “knocked out” (“CD19ko”)
−Removed: using CRISPR technology, which allows for genetic material to be added, removed, or altered.
−Removed: Upon engagement with CD19+ cells, the AbTCR
−Removed: T-cells expressed activation markers CD69 and CD25, demonstrating the ability of the ET190L1-AbTCR to trigger T-cell activation in an
−Removed: antigen-dependent manner.
−Removed: accumulation of CD107a, a marker for T-cell degranulation following stimulation, was determined as a measure of cellular degranulation,
−Removed: a prerequisite for T-cell-mediated bursting of tumor cells, or cytolysis.
−Removed: T-cells degranulated when the AbTCR was stimulated with CD19+
−Removed: addition, when AbTCR-T cells were co-incubated with CD19+ cells, the analysis with intracellular flow cytometry showed that cytokines,
−Removed: such as TNFα, IL-2, and IFNγ, are induced in response to CD19 antigen.
−Removed: Importantly, no cytokines were produced when the AbTCR-T
−Removed: cells were co-cultured with CD19ko cells.
−Removed: These data demonstrate the ability of the AbTCR to trigger T-cell activation in an antigen-dependent
−Removed: better characterize the activities of AbTCR-T cells, Eureka set up experiments to directly compare phenotypes of the AbTCR-T cells with
−Removed: the CAR-T cells.
−Removed: The percentage of AbTCR-positive and CAR-positive T cells were matched by dilutions with un-transduced mock T-cells
−Removed: and co-cultured with multiple tumor cell lines.
−Removed: were incubated with target cells for 16 hours at an effector to target ratio of 2:1.
−Removed: Cytotoxicity was measured by lactate dehydrogenase
−Removed: release assay (n = 3 technical replicates).
−Removed: lysis, or disintegration, of only CD19+ tumor lines confirmed the antigen specificity of both the AbTCR-T cells and CAR-T cells while
−Removed: demonstrating comparable cellular cytotoxicity and degranulation.
−Removed: In addition, specific lysis across a range of effector to target (“E:T”)
−Removed: ratios, or ratios of AbTCR T-cells versus tumor cells, also showed comparable T-cell killing at low E:T ratios, further demonstrating
−Removed: the cytotoxic potential of using the AbTCR.
−Removed: capacity of therapeutic T-cell in leukemia patients has been reported to be a key predictive biomarker for clinical efficacy.
−Removed: used a fluorescent dye-based (or CFSE-based) assay to assess in vitro T-cell proliferation upon antigen stimulation.
−Removed: As shown in the
−Removed: graphic below, AbTCR-T cells divided in response to antigen with kinetics comparable to that observed with CAR-T cells.
−Removed: a slight increase in the expression of CD69 and CD25 activation markers, which show T-cell activation levels, on tumor stimulated AbTCR-T
−Removed: cells compared to CAR-T cells, AbTCR CD4+ T-cells expressed lower levels of the PD-1 exhaustion marker, than CAR-T CD4+ cells, and, in
−Removed: both CD4+ and CD8+ AbTCR-T cells, lymphocyte-activation gene 3, or LAG-3, which is an immune checkpoint receptor protein found on the
−Removed: cell surface of T-cells that has been found to inhibit the activation of T-cells and suppress immune response, was lower.
−Removed: while AbTCR-T cells have comparable cytotoxicity and proliferative potential compared to existing CAR-T cells, the AbTCR-T cells released
−Removed: lower levels of inflammatory cytokines, including TNF-α, IL-2, IFN-γ, and GM-CSF, after a 16 hour in vitro killing test.
−Removed: between TCR-T and CAR-T cells have previously shown that activation through the TCR can comparatively reduce cytokine release while simultaneously
−Removed: increasing antigen sensitivity.
−Removed: Although the CAR construct incorporates a covalently-linked CD28 costimulatory domain, Raji cells express
−Removed: CD80 and CD86 and thus provide CD28 costimulation to both CAR-T cells and AbTCR-T cells.
−Removed: The study suggests that the cytokine secretion
−Removed: and exhaustion differences between AbTCR and CAR-T cells stem from the utilization of endogenous signaling pathways by the γδTCR
−Removed: effector domain of the AbTCR receptor.
−Removed: the potential of AbTCR-T cells to reduce the secretion of several inflammatory cytokines has exciting clinical possibilities, the discovery
−Removed: that tocilizumab, an anti-IL6R antibody, alleviates CRS pathology, singles out interleukin 6 receptors (IL6R) with particular clinical
−Removed: significance.
−Removed: Because the majority of IL-6 is produced by antigen-presenting cells, including monocytes, macrophages, and dendritic cells,
−Removed: Eureka performed a co-culture assay to measure IL-6 concentrations.
−Removed: The experiment separated T-cells and tumor cells from monocyte-lineage
−Removed: Next, the AbTCR-T cells were compared to one of the anti-CD19 CAR-T cells that had been extensively studied and FDA-approved (CTL019,
−Removed: a research grade version of Kymriah™).
−Removed: In addition, CTL019 uses CD137 (4-1BB), a costimulatory receptor, for costimulation, thus
−Removed: offering an opportunity to compare the AbTCR to a CD137-based CAR-T cell.
−Removed: to the observed differences in cytokine release between the AbTCR-T cells and CAR-T cells, the AbTCR-T cells released lower levels of
−Removed: TNF-α, IL-2, IFN-γ, GM-CSF compared to CTL019-T cells.
−Removed: In the figure below, the purple bar indicates CTL019 targeting NALM-6
−Removed: (B cell precursor leukemia) plus APCs (monocyte-lineage cells).
−Removed: The green bar indicates AbTCR T cells targeting NALM-6 plus APCs.
−Removed: blue bar indicates plain T cells (without engineering) targeting NALM-6 plus APCs.
−Removed: study found that AbTCR-T cells induced monocyte-lineage cells to release substantially less IL-6 than CTL019-T cells.
−Removed: To test if the
−Removed: reduced cytokine release had an effect on in vivo anti-tumor activity, Eureka used AbTCR-T cells to treat a patient-derived xenograft
−Removed: (PDX) mouse model of primary B-ALL (CHP105R1, which has fewer cytokines due to lack of CD28 ligand for co-stimulation) and observed similar
−Removed: tumor inhibition between mice treated with the AbTCR and CTL019-T cells.
−Removed: consistent with the in vitro studies described above, the study concluded that T-cells engineered with AbTCR reduced cytokine release
−Removed: without a loss of anti-tumor activity in a PDX tumor model that lacked CD80 and CD86 costimulation.
−Removed: study next tested the in vivo anti-tumor activity of the AbTCR-T cells in an established human CD19+ Raji B-cell lymphoma xenograft model.
−Removed: As shown in the figures below, the study found that both the AbTCR and ET190L1 T-cell treatments resulted in tumor regression and long-lasting
−Removed: tumor rejection.
−Removed: At the time when mice treated with mock T-cells had to be euthanized, tumor burden was on average approximately 1000-fold
−Removed: less in mice treated with ET190L1 T-cells than in the mock-treated mice and on average approximately 5300-fold less in mice treated with
−Removed: AbTCR-T cells than in the mock arm in the experiment.
−Removed: The figure below shows bioluminescent images (left) and total flux (right) over
−Removed: time of three groups of six to eight Raji-implanted mice intravenously administered with 5 × 10 6 (1) un-transduced donor-matched
−Removed: T-cells (“Mock”), (2) ET190L1-CAR-T cells (“CAR”), or (3) AbTCR-T cells (“AbTCR”).
−Removed: Doses were based
−Removed: on number of receptor-positive cells.
−Removed: ability of persisting AbTCR-T cells to prevent growth of “newly-introduced” tumor cells was tested by re-injecting mice with
−Removed: tumor cells weeks after the T-cells had cleared the initial tumor burden.
−Removed: While tumors grew rapidly in control mice, two to three mice
−Removed: in each of the six groups treated previously with either AbTCR-T cells or CAR-T cells were resistant to Raji lymphoma re-challenge (left).
−Removed: Furthermore, a set of two to three mice in each of the six groups were re-challenged with NALM-6 cancer cells (right), which is CD80
−Removed: and CD86 negative.
−Removed: The resistance of tumor growth showed that AbTCR T-cells can be used for tumor types which do not express CD28 relevant
−Removed: study found that in vivo cytokine release and exhaustion markers on T-cells recapitulated in vitro findings.
−Removed: Whereas ET190L1 T-cell treatment
−Removed: caused marked elevation of inflammatory cytokines, including IL-2, IL-10, IFN-γ, and TNF-α, lower levels of these cytokines
−Removed: were released following AbTCR treatment.
−Removed: Serum cytokine levels were collected and measured from six to eight Raji-bearing mice 24 hours
−Removed: after T-cell dosing.
−Removed: collected from peripheral blood nine days and 15 days post-T-cell dosing also revealed that AbTCR-T cells expressed lower levels of PD-1
−Removed: than CAR-T cells.
−Removed: PD-1 expression levels (measured by mean fluorescent intensity) are shown below on the CAR-T cells and AbTCR T-cells
−Removed: at select times from six to eight Raji-bearing mice after T-cell infusion.
−Removed: Collectively,
−Removed: the data from the study suggested that AbTCR T-cells exhibited potent in vitro and in vivo anti-tumor activity, yet released lower levels
−Removed: of inflammatory cytokines and expressed lower levels of exhaustion markers than CAR-T cells.
−Removed: the study, to further augment AbTCR signaling, Eureka subsequently optimized the ARTEMIS ® cell receptor platform to include
−Removed: the co-stimulatory molecule.
−Removed: Importantly, the co-stimulatory molecule is provided as a separate molecule and not directly fused to the
−Removed: This is in contrast to conventional CARs, which include the direct fusion of the target-binding domain to the co-stimulatory and
−Removed: CD3ζ domains, which drives sustained T-cell activation and, often, subsequent release of large amounts of inflammatory cytokines.
−Removed: Thus, unlike the linear CAR design of traditional CAR-T cell platforms, the configuration of the ARTEMIS ® cell receptor
−Removed: platform resembles the endogenous TCR/co-stimulatory receptor architecture in which co-stimulation is provided through separate receptors
−Removed: and acts as a potent synergistic signal that is naturally regulated by the body.
−Removed: the manufacturing process, our EB103 T-cells are engineered to express ARTEMIS ® cell receptors (i.e., the AbTCR and co-stimulatory
−Removed: molecule) on their cell surfaces.
−Removed: Both the AbTCR and co-stimulatory molecule of EB103 are designed to recognize and bind the CD19 antigen.
−Removed: The resulting EB103 T-cells are expanded and then cryopreserved for delivery into the patient.
−Removed: Once infused, EB103 T-cells engage CD19-positive
−Removed: cancer cells.
−Removed: The AbTCR expressed on the EB103 T-cell by its nature associates, via its effector domain (γδ TCR chains),
−Removed: with the endogenous CD3 complex.
−Removed: When the AbTCR binds to its target, CD19, expressed on the cancer cell, AbTCR/CD3 complex-mediated signal
−Removed: transduction within the EB103 T-cell is initiated.
−Removed: This signal transduction process ultimately leads to the activation of the EB103 T-cell.
−Removed: A second “enhancement” signal is generated when the co-stimulatory molecule expressed on the EB103 T-cells binds to its target,
−Removed: CD19, expressed on the cancer cell.
−Removed: The main function of the co-stimulatory molecule is to “boost” AbTCR signaling, resulting
−Removed: in increased expansion and survival of EB103 T-cells inside the body.
−Removed: The co-stimulatory molecule has also been optimized to provide
−Removed: EB103 T-cells with enhanced T-cell activation.
−Removed: In summary, EB103 T-cells seek out CD19-positive cancer cells, bind to these cells, and
−Removed: destroy them.
−Removed: Clinical Studies
−Removed: Affiliated Investigator-Initiated Study
−Removed: November 2018 to April 2021, the First Affiliated Hospital of Xi’an Jiaotong University (“First Affiliated”) conducted
−Removed: an exploratory, single-arm, open-label, non-randomized early investigator-initiated study (“IIS”) to assess the safety and
−Removed: feasibility of administering EB103 T-cells to patients with CD19-positive relapsed/refractory(r/r) B-cell lymphoma.
−Removed: Unlike studies conducted
−Removed: by pharmaceutical companies, IISs are clinical studies initiated and managed by nonpharmaceutical company researchers who could be an
−Removed: individual investigator, an institution, or a group of institutions, a collaborative study group, or a cooperative group.
−Removed: this case, IIS studies are exploratory in nature.
−Removed: Generally, IISs are reviewed and approved by review boards or ethics committees at
−Removed: First Affiliated sponsored the IIS study in collaboration with Eureka and conducted the study at First Affiliated.
−Removed: provided EB103-related information to support the IIS study application and gave comments to the investigator on the IIS study design
−Removed: and clinical protocol.
−Removed: The Ethics Committee of First Affiliated reviewed preclinical data and approved the clinical protocol.
−Removed: was registered at www.clinicaltrials.gov as #NCT03642496.All participants in the study provided written informed consent.
−Removed: study results were published in 2022 in the Journal of Cancer Research and Clinical Oncology.
−Removed: were eligible for the study if they had histologically confirmed CD19-positive r/r B-cell lymphoma.
−Removed: Previous therapy must have included
−Removed: at least one cycle of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) or a similar R-CHOP, like chemotherapy.
−Removed: Eligibility also required measurable disease as defined by at least one measurable node of which the longest diameter (LDi) is greater
−Removed: than 1.5 cm or at least one measurable extra nodal lesion of which the LDi is greater than 1.0 cm.
−Removed: In addition, an Eastern Cooperative
−Removed: Oncology Group (ECOG) performance status, which is used by doctors and researchers to assess how a patient’s disease is progressing,
−Removed: how the disease affects the daily living abilities of the patient, and determine appropriate treatment and prognosis, of less than or
−Removed: equal to two was required.
−Removed: primary endpoints included the tolerability of EB103 T-cell therapy and the cellular kinetics (i.e., expansion and persistence, which
−Removed: refers to the number of T-cells and continuous presence of T-cells in vivo after infusion) of EB103 T-cells after infusion.
−Removed: endpoints and other terms used in the study are explained below:
−Removed: Response (CR):
−Removed: The disappearance of all signs of cancer in response to treatment.
−Removed: also called complete remission.
−Removed: For tumor assessments after EB103 treatment, a CR indicated
−Removed: the disappearance of measurable disease via computerized tomography (CT) scan or residual
−Removed: masses that are positron emission tomography (PET)-negative.
−Removed: Response (PR):
−Removed: A decrease in the size of a tumor, or in the extent of cancer in the body,
−Removed: in response to treatment.
−Removed: It is also called partial remission.
−Removed: For tumor assessments after
−Removed: EB103 treatment, a PR indicates at least 50% decrease in tumor burden with ongoing PET avidity.
−Removed: Response Rate (ORR):
−Removed: The proportion of patients with a complete response (CR) or partial
−Removed: response (PR) to treatment.
−Removed: of Response (DoR):
−Removed: the length of time that a tumor continues to respond to treatment without
−Removed: the cancer growing or spreading.
−Removed: For tumor assessment after EB103 treatment, DoR is the time
−Removed: from the first documented disease response (CR or PR) to the date of first documented progression
−Removed: A decrease in or
−Removed: disappearance of signs and symptoms of cancer.
−Removed: In partial remission, some, but not all, signs and symptoms of cancer have
−Removed: In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the
−Removed: Cancer that is neither decreasing nor increasing in extent or severity.
−Removed: ● Progressive
−Removed: Cancer that is growing, spreading, or getting worse.
−Removed: assessments were conducted at one, two, three, six, nine, 12, 18, and 24 months after initial infusion and response to treatment was
−Removed: assessed by the principal investigator and radiologist according to the Lugano Classification 2014 (“Lugano Criteria”), which
−Removed: is the most recent guideline to assess the presence of lymphoma, measure response to therapeutics intervention, and evaluate imaging
−Removed: and clinical data.
−Removed: By the Lugano Criteria, a CR indicates the disappearance of measurable disease via computerized tomography (CT) scan
−Removed: or residual masses that are positron emission tomography (PET)-negative.
−Removed: PR indicates at least a 50% decrease in tumor burden via PET
−Removed: November 2018, and April 2021, 16 patients were enrolled, and a total of 12 patients received EB103 T-cells.
−Removed: Four patients did not receive
−Removed: an infusion because of an inability to manufacture T-cells as a result of the patient’s poor T-cell activation (one patient), high
−Removed: tumor burden (one patient), or active infection (two patients).
−Removed: As of the data cutoff date in April 2021, the median duration of follow-up
−Removed: was 128 days (range:
−Removed: 34 to 728 days).
−Removed: Of the 12 patients treated, six patients (50%) achieved a CR, and four (33%) achieved a PR, with
−Removed: a best ORR of 83%.
−Removed: CRs were durable, including two patients with ongoing CRs for over 22 months.
−Removed: was well-tolerated by patients in the IIS study.
−Removed: No patients experienced severe (grade > 3, based on the standards set by the
−Removed: American Society for Transplantation and Cellular Therapy) CRS, and only one patient experienced ICANS of any grade.
−Removed: In addition, heightened
−Removed: elevations of cytokine levels were not seen, even in patients with a marked expansion of EB103 T-cells.
−Removed: For the small patient population
−Removed: size, a P-value is not available.
−Removed: additional studies are required to confirm the results of this small, exploratory IIS study, the findings are consistent with the design
−Removed: of the ARTEMIS ® platform as a potential alternative to other engineered T-cell therapies, such as CAR T-cell therapies.
−Removed: The results from this early IIS study were disclosed to the FDA as supplementary supporting information for the IND application of EB103
−Removed: in malignant B-cell lymphoma treatment.
−Removed: Responses to EB103
−Removed: (a) Treatment
−Removed: response and duration of response after initial infusion of EB103 T-cells.
−Removed: Black arrows indicate
−Removed: ongoing remission and follow-up.
−Removed: (b) Best response for the 12 patients.
−Removed: Best response was
−Removed: defined as the best response (i.e., CR > PR > SD > PD) the patient achieved at any
−Removed: time after receiving EB103.
−Removed: CR — complete response, PR — partial response, SD
−Removed: — stable disease, PD — progressive disease.
−Removed: (c) Representative radiographic images
−Removed: of two responders (BH05-P10 and BH05-P19) at baseline and the indicated time points after
−Removed: Red or yellow arrows mark the tumor lesions.
−Removed: Full body images are PET-CT scans.
−Removed: Cross-sectional
−Removed: images are PET scans (top rows) and CT scans (bottom rows).
−Removed: black, 20 cm;
−Removed: of cytokines and serum inflammatory markers after EB103 T-cell infusion
−Removed: (b) Serum c-reactive protein (CRP) and ferritin levels in patients during the first
−Removed: month of EB103.
−Removed: Horizontal lines denote median values.
−Removed: Patients’ best responses are
−Removed: denoted by color of the symbols:
−Removed: CR (red), PR (blue), SD (green), and PD (black).
−Removed: Hospital Clinical Study
−Removed: July 2019 to August 2022, Union Hospital affiliated to Huazhong University of Science and Technology in Wuhan, China (“Union Hospital”),
−Removed: in collaboration with Eureka, conducted the first-in-human, single-center investigator-initiated study designed to evaluate the safety
−Removed: and efficacy of EB103 T-cells in patients with CD19 malignancies.
−Removed: Eight patients with relapsed or refractory diffuse large B-cell lymphoma
−Removed: (RR DLBCL) were reported in the study.
−Removed: The Medical Ethics Committee of Union Hospital approved the study.
−Removed: The study was performed at
−Removed: Union Hospital in Wuhan, China.
−Removed: The study was registered at www.clinicaltrials.gov as #NCT04014894.
−Removed: The study results were published
−Removed: on January 21, 2023 in the Journal of Hematology & Oncology.
−Removed: collaborated with Union Hospital to support the study.
−Removed: The fully human anti-CD19 antibody was selected from Eureka Therapeutics E-ALPHA ®
−Removed: phage display library.
−Removed: Cheng Liu, Eureka’s President, CEO and Chairman, and Qi Chang, an employee of Eureka, supervised
−Removed: EB103 production and conducted the preclinical research.
−Removed: Cheng Liu and Qi Chang are two of the twenty-one listed authors of the report,
−Removed: and each’s employment by Eureka was disclosed as a competing interest.
−Removed: No other competing interests were declared.
−Removed: and Exclusion Criteria
−Removed: inclusion criteria for the study were as follows:
−Removed: (i) patient or his or her legal guardian voluntarily participates in and signs an informed
−Removed: consent form;
−Removed: (ii) male or female, aged 18 to 75 years;
−Removed: (iii) pathologically confirmed CD19+ B-cell malignancies, and patients met the
−Removed: following criteria for refractory or relapsed B-cell malignancies:
−Removed: (a) refractory/relapsed B-cell lymphoblastic leukemia (meeting one
−Removed: of the following):
−Removed: (1) recurrence within six months after first remission;
−Removed: (2) primary refractory disease which cannot achieve complete
−Removed: remission after two cycles of standardized chemotherapy regimen;
−Removed: (3) failure to achieve complete remission or relapse after one line
−Removed: or multiple lines of salvage chemotherapy;
−Removed: or (4) not suitable for hematopoietic stem cell transplantation (HSCT), abandonment of HSCT
−Removed: due to various restrictions, or relapse after HSCT;
−Removed: or (b) refractory/relapsed B-cell lymphoma (meeting one of the following three items
−Removed: plus item four):
−Removed: (1) tumor shrinkage less than 50% or disease progression after four cycles of standard chemotherapy or (2) achieved
−Removed: complete remission after standard chemotherapy, but relapsed within six months or (3) two or more relapses after complete remission plus
−Removed: (4) subjects must have received adequate treatment in the past, including anti-CD20 monoclonal antibody and combination chemotherapy
−Removed: with anthracyclines;
−Removed: (iv) having a measurable or evaluable lesion:
−Removed: (a) patients with lymphoma require a single lesion greater than or
−Removed: equal to 15 mm or two or more lesions greater than or equal to 10mm or (b) patients with leukemia require persistent positive or positive
−Removed: relapse of bone marrow MRD;
−Removed: (v) patient’s main organs functioning well:
−Removed: (a) liver function:
−Removed: ALT/AST less than or equal to 3 times
−Removed: the upper limit of normal (ULN) and total bilirubin less than two times ULN;
−Removed: (b) renal function:
−Removed: creatinine less than 220μmol/L;
−Removed: pulmonary function:
−Removed: indoor oxygen saturation greater than or equal to 95% and (d) cardiac function:
−Removed: left ventricular ejection fraction
−Removed: (LVEF) greater than or equal to 50%;
−Removed: (vi) greater than or equal to two weeks since prior therapy at the time of enrollment, and the toxicity
−Removed: related to previous treatments returned to less than grade 1 (except for low grade toxicity such as alopecia);
−Removed: (vii) ECOG score less
−Removed: than or equal to two;
−Removed: and (viii) estimated survival time greater than or equal to three months.
−Removed: exclusion criteria for the study were as follows:
−Removed: (i) women who are pregnant or breastfeeding;
−Removed: (ii) women of child-bearing potential
−Removed: and all male participants can’t use effective methods of contraception for at least 12 months following infusion;
−Removed: (iii) patients
−Removed: fail to collect enough PBMC;
−Removed: (iv) patients with other uncontrolled diseases, such as active infection;
−Removed: (v) active hepatitis B or active
−Removed: (vi) known HIV positive patients;
−Removed: (vii) patients with active autoimmune diseases requiring systemic immunosuppressive therapy;
−Removed: (viii) participants with other active malignancies (except non-melanoma skin cancer and cervical cancer) within three years;
−Removed: (ix) patients
−Removed: with severe mental disorder or disorders of consciousness;
−Removed: (x) patients who need immediate treatment to control tumor progression or
−Removed: relieve tumor burden;
−Removed: (xi) patients participated in other clinical treatments within six weeks;
−Removed: (xii) patients with drug addiction;
−Removed: (xiii) patients with poor treatment compliance.
−Removed: primary objectives were incidence of adverse events (AEs) and ORR.
−Removed: CRS and ICANS were graded using the American Society for Transplantation
−Removed: and Cellular Therapy consensus grading.
−Removed: All other AEs were graded according to the Common Terminology Criteria for Adverse Events.
−Removed: Dose-limiting
−Removed: toxicities (DLTs) were defined as EB103-related AEs within 30 days after infusion and included ≥ grade 3 cardiac, hepatic, pulmonary,
−Removed: and renal toxicities, and ≥ grade 3 CRS and ICANS that lasted over 72 hours after treatment.
−Removed: Exceptions to this definition were not
−Removed: counted as a DLT.
−Removed: Response was assessed using the Lugano Criteria.
−Removed: secondary objectives included Duration of Response (DoR), progression-free survival (PFS), overall survival (OS), and expansion and persistence
−Removed: of EB103 T-cells, and serum cytokines in the peripheral blood (PB) after infusion.
−Removed: PB refers to the blood circulating in the body’s
−Removed: blood vessels.
−Removed: DoR, PFS, and OS were defined per the revised response criteria for malignant lymphoma.
−Removed: Under the criteria, DoR is defined
−Removed: as from the time when criteria for response (CR or PR) are met, for which the event is the first documentation of relapse or progression.
−Removed: PFS is defined as the time from entry into a study until lymphoma progression or death as a result of any cause.
−Removed: OS is defined as the
−Removed: time from entry onto the clinical trial until death as a result of any cause.
−Removed: Only the first infusion was included in the main analyses
−Removed: of safety and efficacy.
−Removed: Exploratory endpoints included the safety and efficacy among patients retreated with EB103 T-cells.
−Removed: and pathological examination
−Removed: F-fluorodeoxyglucose
−Removed: positron emission tomography-computed tomography (PET-CT), computed tomography (CT), magnetic resonance imaging (MRI), cerebrospinal
−Removed: fluid (CSF) assessment, and biopsies were performed on the patients following the Lugano Criteria.
−Removed: The assessments of tumor tissue were
−Removed: conducted and reviewed by two independent pathologists.
−Removed: eight patients who received the infusion were included in the analyses.
−Removed: Descriptive statistics include means with 95% confidence interval
−Removed: (CI) or medians with minimum and maximum (range) for continuous variables and counts and percentages for categorical variables.
−Removed: data were not imputed.
−Removed: Continuous variables were compared using paired t-test when the data were normally distributed.
−Removed: Otherwise, the
−Removed: Wilcoxon test was used.
−Removed: DoR, PFS, OS, and associated 95% CI were determined by the Kaplan — Meier methods and compared with the
−Removed: log-rank test between subgroups.
−Removed: Analysis was performed using Graphpad Prism version 8.0.
−Removed: P values less than 0.05 (two-tailed) were considered
−Removed: eight patients experienced adverse events (AEs) of grade 3 or higher.
−Removed: Three patients (37.5%) experienced grade 1 CRS that resolved spontaneously,
−Removed: with a median onset of four days (range:
−Removed: two to nine days) and a median duration of three days (range:
−Removed: one to eight days).
−Removed: developed grade 3 ICANS after CRS, which manifested as confusion, barylalia, tremor, and agitation, but Patient Two responded to treatment
−Removed: with corticosteroids.
−Removed: ICANS occurred on the ninth day following infusion and lasted for nine days;
−Removed: thus, it was judged as a DLT.
−Removed: from Patient Two, DLTs were not observed in the patient cohort.
−Removed: Patient Eight had a pulmonary infection on day 15 that lasted for four
−Removed: days after antibiotic treatment.
−Removed: Other infectious complications were not observed within one month due to the administration of antiviral
−Removed: and antifungal preventative medicines in these patients.
−Removed: Patient Four had lymphoma involvement in the intestinal tract and suffered an
−Removed: acute intestinal perforation, resulting in emergency surgery 16 days after infusion.
−Removed: Ultimately, all acute AEs were reversible with supportive
−Removed: an anti-IL6R antibody, which can alleviate CRS.
−Removed: Was not administered.
−Removed: The increase in inflammatory cytokines from baseline to peak were
−Removed: modest, except for the elevation of IL6R levels in Patients Two, Four, and Eight, which were greater than tenfold the baseline value.
−Removed: This elevation generally coincided with serum C-reactive protein levels and was concurrent with the onset of CRS and ICANS in Patient
−Removed: Two, intestinal perforation in Patient Four, and pulmonary infection in Patient Eight.
−Removed: Therefore, the study concluded that there might
−Removed: be alternative causes for the elevated inflammatory markers in these three patients other than the EB103 treatment.
−Removed: toxicities were the most common AEs, including low levels of white blood cells (neutropenia) and low levels of platelets of grade 3 or
−Removed: 4 in seven (87.5%), six (75%), and two (25%) patients after EB103 infusion, respectively.
−Removed: Severe anemia was not observed.
−Removed: The preconditioning
−Removed: regimens exhibited significant adverse effects on leucocytes, lymphocytes, monocytes (all types of blood cells), and hemoglobin levels,
−Removed: but not on platelets and neutrophils (a type of white blood cell).
−Removed: The median time from infusion to recovery of ≤ grade 2 neutropenia
−Removed: and leukopenia (low levels of leukocytes) was 13 days (range, four to 26) days and 13 (range, four to 26) days, respectively.
−Removed: recovery from severe thrombocytopenia (platelet deficiency) was observed in Patient Two for over two months.
−Removed: aplasia, defined as CD19+ B-cells representing less than three percent of lymphocytes in peripheral blood (PB), was observed in all patients
−Removed: The preconditioning chemotherapy exhibited significant inhibition on T cells and NK cells (another type of immune cell)
−Removed: in the PB, and EB103 cells showed effects on T cells.
−Removed: CD4+ T cells and CD8+ T cells decreased significantly after the preconditioning
−Removed: chemotherapy and expanded on day 14 after EB103 infusion.
−Removed: Three patients (37.5%) had preexisting hypogammaglobulinemia, a disorder caused
−Removed: by low serum immunoglobulin (a type of antibody) levels, defined as serum IgG less than 800 mg/dL, IgM less than 50 mg/dL, and IgA less
−Removed: than 100 mg/dL.
−Removed: Serum IgG, IgM, and IgA are all types of antibodies.
−Removed: The reduction of serum IgG, IgA, and IgM after EB103 infusion was
−Removed: observed in seven (87.5%), eight (100%), and six (75%) patients, respectively.
−Removed: The recovery of serum IgG, IgA, and IgM to their normal
−Removed: levels during follow-up was observed in three (42.8%), two (25%), and four (66.7%) patients respectively.
−Removed: One experienced two treatable long-term AEs:
−Removed: viral encephalitis at month 18 and MOG + encephalomyelitis at month 30.
−Removed: At the time of these
−Removed: AEs, EB103 cells were undetectable in the patient.
−Removed: As such, the authors of the study believed that these delayed AEs were not directly
−Removed: caused by EB103 cells.
−Removed: the clinical study, clinical responses were achieved by 87.5% of patients, with 75% achieving CR and 62.5% having ongoing CR.
−Removed: The Kaplan-Meier
−Removed: estimated OS at 12-36 months was 75.0% (95% CI:
−Removed: The Kaplan-Meier estimated progression-free survival (PFS) at 12-36 months
−Removed: was 62.5% (95% CI:
−Removed: 22.9-86.1), with a DoR at 12-36 months of 71.4% (95% CI:25.8-92.0).
−Removed: One with primary central nervous system lymphoma had been refractory to eight previous lines of therapies.
−Removed: She experienced a continuing
−Removed: CR for over three years after EB103 infusion.
−Removed: Numerous EB103 cells were detectable in both the PB and CSF after infusion (See Figure
−Removed: 4B below), indicating that EB103 cells could sufficiently traffic from the periphery to the central nervous system.
−Removed: Patient Two had extensive
−Removed: lesions and attained a quick PR at month one, but the diseases progressed at month two.
−Removed: A second tissue biopsy demonstrated DLBCL.
−Removed: patient received a second infusion with poor expansion, and the diseases progressed on day 14;
−Removed: consequently, the patient withdrew from
−Removed: the study for other salvage therapy.
−Removed: Patient Three had two major lesions in the right eyeball and the pelvic cavity, and she attained
−Removed: a PR on day 14 and an ongoing CR for over two years.
−Removed: Patient Four achieved a CR at month two and kept CR for over two years.
−Removed: Five’s EB103 cells exhibited rapid clearance and durable control of a bulky tumor.
−Removed: Patient Six, with lymphoma mainly in the abdominal
−Removed: cavity, did not respond to EB103 treatment and withdrew from the study at month two.
−Removed: Patient Seven had extensive lesions mainly in the
−Removed: lung and the abdominal cavity and attained a CR at month five.
−Removed: However, new lesions appeared at month nine, and a second infusion failed.
−Removed: Patient Eight had two lymph node lesions in the left heart diaphragm angle and retroperitoneal space, and obtained a CR on day 24, and
−Removed: kept durable CR at month 24.
−Removed: Two, Five and Seven received a second infusion.
−Removed: Patients Two and Seven received a second infusion as salvage therapy after disease progression
−Removed: but did not respond.
−Removed: Patient Five maintained CR according to the Lugano Criteria at month six, but PET-CT scans showed minimal residual
−Removed: lesions in the hepatogastric space-pancreatic head.
−Removed: Despite low levels of EB103 cells in peripheral blood, Patient Five received a repeated
−Removed: infusion without preconditioning chemotherapy and experienced self-limiting severe neutropenia, leukopenia, and thrombocytopenia.
−Removed: from hematologic toxicities observed in Patients Two and Five, no other adverse events were reported.
−Removed: and persistence of EB103
−Removed: being infused into a patient, EB103 cells showed maximum expansion between nine and 21 days.
−Removed: At their peak, these cells reached a median
−Removed: count of 318 cells per milliliter (mL) of PB, with a range of 32 to 4,308,109 cells/mL.
−Removed: The number of EB103 cells in PB was determined
−Removed: through flow cytometry, which is a technique used to measure the characteristics of cells.
−Removed: Additionally, quantitative polymerase chain
−Removed: reaction (qPCR) measurements showed a median count of 76,897 copies per microgram (µg) of genomic DNA with a range of 21,278 to
−Removed: 273,032 copies/µg.
−Removed: qPCR is a method used to measure the amount of specific DNA sequences in a sample.
−Removed: The median area under the
−Removed: curve from day 0 to day 28 post-infusion was calculated to be 585,493.5 copies/µg × days.
−Removed: This value represents the total
−Removed: amount of EB103 cells present in the patient over time.
−Removed: At the end of the first year following infusion, EB103 cells were still detectable
−Removed: in PB in half of the patients.
−Removed: However, expansion was poor during second infusions.
−Removed: authors of the study concluded that the data suggest that EB103 T-cells represent a novel and potentially potent therapeutic option for
−Removed: the patient population being studied.
−Removed: However, the authors noted that the findings were limited by the small sample size, and a recommended
−Removed: phase 2 dose was not identified.
−Removed: The authors also stated that larger and multi-center trials are needed to verify the long-term safety
−Removed: and efficacy of CD19-specific T cells in RR DLBCL.
−Removed: are four figures from the clinical study report related to the findings described above.
−Removed: in serum inflammatory markers within 1 month after EB103 infusion
−Removed: Fold changes of inflammatory cytokines from baseline to peak (n = 10).
−Removed: Patient Five received the repeated infusions in the outpatient
−Removed: department and data were not available.
−Removed: (B-I) Changes in the serum interleukin (IL)-6, C-reactive protein (CRP), IL-2, IL-4, IL-10, interferon-γ
−Removed: (IFN-γ), tumor necrosis factor-α (TNF-α) and ferritin in individuals.
−Removed: (J) Changes in serum IL-6, CRP, and EB103 counts
−Removed: and copies in peripheral blood (PB) of Patients Two, Four, and Eight.
−Removed: plot and long-term outcomes of the treated patients
−Removed: Swimmer’s plot of the eight treated patients.
−Removed: (B-D) Kaplan — Meier estimates of the OS, PFS and DoR.
−Removed: responses of EB103 cells
−Removed: Changes in cranial MRI scans of Patient One.
−Removed: (B) EB103 copies per microgram (µg) of genomic DNA in PB and CSF and body temperature
−Removed: changes in Patient One within one month after infusion.
−Removed: (C) Changes in PET-CT scans of Patient Two.
−Removed: (D) Changes in ocular enhanced MRI
−Removed: and abdominal-enhanced CT of Patient Three.
−Removed: (E) Changes in PET-CT scans of Patient Seven.
−Removed: vivo kinetics of EB103 cells
−Removed: EB103 expansion and persistence were measured as copies per microgram (µg) of the genomic DNA by qPCR in the eight treated patients
−Removed: within one year.
−Removed: The detectable threshold was 100 copies per µg of the genomic DNA.
−Removed: The black arrow indicates the second infusion.
−Removed: (B) The violin plot of peak EB103 cells per milliliter of PB (cells/mL PB) as measured by flow cytometry, peak copies per µg of
−Removed: genomic DNA (copies/µg DNA) as measured by qPCR and area under the curve from 0 to 28 days after infusion (AUC 0 – 28d ).
+Added: However, most existing treatments only manage symptoms
+Added: and are rarely curative.
+Added: Long-term administration is often required, and patients may experience serious side effects, while the underlying
+Added: disease continues to progress or return.
+Added: We believe CD19-redirected
+Added: T-cell therapy offers a promising new approach to treating autoimmune diseases.
+Added: In recent clinical studies, CD19-redirected CAR T-cell
+Added: therapy has demonstrated the potential to go beyond symptom management by depleting the entire population of autoreactive B cells, leading
+Added: to rapid and durable disease remission.
+Added: A notable study in lupus patients demonstrated that a single dose of CD19-targeting CAR T-cells
+Added: resulted in significant improvements, with most patients entering remission and experiencing long-lasting benefits.
+Added: We plan to expand our clinical
+Added: investigation of our CD19-redirected ARTEMIS T-cell therapy into autoimmune diseases.
+Added: Our EB201 program, in preclinical development, is
+Added: being explored as a potential therapeutic approach targeting Systemic Lupus Erythematosus (SLE).
+Added: Our Technology Platform:
+Added: The ARTEMIS® T-Cell Receptor System
+Added: We hold an exclusive license from Eureka Therapeutics
+Added: (“Eureka”) to utilize the proprietary ARTEMIS® Cell Receptor platform to develop and commercialize T-cell therapies targeting
+Added: CD19 and CD22 for the treatment of hematologic malignancies.
+Added: Under our License Agreement, we hold exclusive rights to develop and commercialize
+Added: ARTEMIS-based products targeting CD19 and CD22 in all territories worldwide, excluding Greater China and Association of Southeast Asian
+Added: Nations (ASEAN) countries, which are retained by Eureka.
+Added: The ARTEMIS platform utilizes
+Added: an Antibody-T Cell Receptor (AbTCR) architecture designed to potentially overcome limitations associated with conventional chimeric antigen
+Added: receptor (CAR) T-cell therapies, such as toxicity and exhaustion.
+Added: Unlike conventional second-generation CAR-T therapies, which rely on
+Added: synthetic fusion proteins that can drive chronic hyperactivation (tonic signaling) and premature T-cell exhaustion, the ARTEMIS AbTCR
+Added: is designed to mimic the natural regulation of native T-cells by recruiting endogenous CD3 complex to initiate T-cell activation.
+Added: differentiating feature of our platform is that the co-stimulatory molecule is provided as a separate protein rather than being covalently
+Added: linked to the activation domain.
+Added: By separating these signals, the ARTEMIS platform is designed to mimic the body’s natural immune
+Added: regulation, potentially limiting T-cell hyperactivation.
+Added: Based on Eureka’s internal
+Added: and published studies in Cell Discovery 1 (with CHOP/UPenn) and Cell Reports Medicine 2 (with NCI),
+Added: we believe the ARTEMIS platform offers distinct advantages over conventional CAR-T constructs:
+Added: ● Improved Safety Profile and Economic Potential :
+Added: head-to-head comparisons with market-standard CAR-T constructs, ARTEMIS T-cells demonstrated comparable or superior antitumor potency
+Added: with significantly reduced release of inflammatory cytokines, such as IL-6, which are drivers of cytokine release syndrome (CRS) and
+Added: neurotoxicity.
+Added: We believe this improved safety profile has the potential to allow for the administration of our therapies in outpatient
+Added: settings rather than dedicated cancer centers, thereby decreasing the costs associated with patient monitoring and hospital stays.
+Added: Discovery 4, 62 (2018):
+Added: doi:10.1038/s41421-018-0066-6
+Added: Reports Medicine 6, 102378 (2025) doi:
+Added: 10.1016/j.xcrm.2025.102378.
+Added: ● Efficacy in Low-Antigen Density Tumors :
+Added: CAR-T therapies often fail when tumor cells express low levels of target antigen, leading to tumor escape.
+Added: The NCI studies from 2025
+Added: (conducted with the ARTEMIS platform targeting GPC2 in solid tumors) demonstrated that ARTEMIS T-cells maintain cytotoxic function at
+Added: antigen densities below the threshold required to activate conventional CAR-T cells.
+Added: The ability for ARTEMIS T-cells to function at a
+Added: lower antigen level can potentially expand the addressable patient population and reduce the risk of relapse.
+Added: ● Superior T cell Phenotype :
+Added: Preclinical data indicates
+Added: that the ARTEMIS architecture promotes the expansion of stem-like memory T-cells (T SCM ) and reduces exhaustion markers compared
+Added: to standard CAR-T constructs.
+Added: The T SCM subset of T cells have been reported to be associated with long-term persistence and
+Added: durability of clinical response.
+Added: US Phase I/II Clinical Trial of EB103
+Added: EB103 is our lead CD19-targeted
+Added: ARTEMIS® T-cell therapy product candidate designed to address high unmet medical needs in patients with relapsed or refractory aggressive
+Added: B-cell non-Hodgkin lymphoma (r/r B-NHL).
+Added: We are currently evaluating EB103 in an open-label, dose escalation, multi-center, Phase I/II
+Added: clinical trial in the U.S.
+Added: (STARLIGHT-1, NCT06343311) in adult subjects (≥ 18 years of age) with relapsed/refractory (R/R) B-cell NHL.
+Added: The study includes a dose escalation phase followed by an expansion phase.
+Added: A traditional dose escalation model was used to determine the
+Added: The trial began enrolling patients in 2024, with UC Davis Comprehensive Cancer Center as the first clinical site.
+Added: A second site
+Added: (Baylor Scott and White Research Institute in Texas) was activated in April 2025.
+Added: As of December 2025, the
+Added: Phase I dose escalation phase has been completed.
+Added: The enrolled patient population (n=9) was heavily pretreated, with a median of three
+Added: prior lines of therapy.
+Added: Approximately 80% of the enrolled patients were considered high-risk, including patients with primary refractory
+Added: disease, high-grade B-cell lymphoma, and primary CNS lymphoma.
+Added: Notably, 33% of patients had undergone prior autologous stem cell transplantation,
+Added: and 89% had received two or more prior regimens.
+Added: Two dose levels were evaluated in Phase I:
+Added: Dose Level 1 (DL1, n=3) at 2.5 million receptor-positive
+Added: T cells/kg, and Dose Level 2 (DL2, n=6) at 5 million receptor-positive T-cells/kg.
+Added: Among the 9 patients in Phase I, no treatment-related
+Added: serious adverse events were reported, and the high-dose cohort achieved a 100% complete response rate at Month 1 in all 5 evaluable patients.
+Added: Safety and tolerability
+Added: EB103 has a favorable and
+Added: manageable safety profile in the nine patients treated in Phase I.
+Added: While Cytokine Release Syndrome (CRS) was observed in all treated patients,
+Added: all CRS events were low grade (Grade 1 or 2) and managed with standard of care.
+Added: There were no instances of Grade 3 or higher CRS observed
+Added: at either dose level.
+Added: A majority of patients also experienced transient low grade ICANS, though the clinical symptoms were easily managed
+Added: and the median duration of the events was only two days
+Added: Clinical Efficacy
+Added: In the Phase I study the
+Added: high-dose cohort (DL2) achieved a 100% (n=5/5) complete response rate at Month 1 in all evaluable patients.
+Added: One patient in the DL2 cohort
+Added: experienced Grade 5 sepsis on Day 18;
+Added: this event was determined by the investigator to be unrelated to the EB103 therapy.
+Added: Consequently,
+Added: this patient was not evaluable for efficacy response.
+Added: Responses for all evaluable patients have been durable to date, with all patients
+Added: remaining in remission as of the data cutoff date on January 28, 2026.
+Added: Pharmacokinetics
+Added: Analysis of peripheral blood
+Added: samples confirmed robust cellular expansion of EB103.
+Added: Pharmacokinetic data determined by quantification of the EB103 transgene vector
+Added: copy number showed a median C max of 77,693 copies/ug gDNA with a median T max of 8 days.
+Added: Development Plan
+Added: In December 2025, an independent
+Added: Data Safety Monitoring Board (DSMB) completed its review of safety data from the Phase I dose-escalation phase (n=9) and recommended advancing
+Added: the trial into the Phase II expansion phase at the recommended Phase II dose (RP2D).
+Added: Patient dosing for Phase II has commenced in January
+Added: 2026 to further evaluate EB103 at RP2D in a larger patient cohort to confirm the Phase I results.
Manufacturing
−Removed: to the Services Agreement and Statement of Work #001, among other services, Eureka agreed to provide Estrella with access to Eureka’s
+Added: Pursuant to the
+Added: Services Agreement and Statement of Work #001, among other services, Eureka agreed to provide Estrella with access to Eureka’s
T-cell manufacturing and lentiviral vector (LVV) processes in connection with the IND application and clinical trials for EB103.
−Removed: “— Materia l Agreements — Services Agreement and Statement of Work #001 ” below for additional information
−Removed: regarding the terms of the agreements.
−Removed: and Advantages
−Removed: developed the ARTEMIS ® platform in response to significant tolerability issues, including potentially fatal side effects
−Removed: CRS and ICANS, observed after CAR-T-cell infusions in patients with hematological cancers.
−Removed: We believe that the ARTEMIS ®
−Removed: platform and our EB103 T-cell Therapy are superior to current T-cell therapy technologies based on three key features:
−Removed: Antibody-based target recognition
−Removed: The ability to achieve
−Removed: high specificity and binding affinity to intended cancer target when compared to TCRs.
−Removed: AbTCR includes portions of a human
−Removed: The AbTCR associates
−Removed: with the endogenous CD3 complex enabling the AbTCR to use the same activation and regulatory signaling pathways employed by natural
−Removed: This feature may lead to a decreased risk of side effects in patients.
−Removed: Co-stimulation provided as a separate
−Removed: The AbTCR construct
−Removed: does not include an intracellular signaling domain covalently-linked to a co-stimulatory domain, and thus has the potential to eliminate
−Removed: T-cell hyperactivation and consequently, lower the risk of CRS and ICANS commonly observed with CAR-T therapy.
−Removed: addition to the advantages provided above, we believe that the decreased risks of side effects of our EB103 T-cells have the potential
−Removed: to allow for patients to receive treatments in locations other than dedicated cancer centers.
−Removed: This would allow for more patients to be
−Removed: able to receive EB103 T-cells and would ultimately decrease the costs associated with monitoring for side effects following treatment,
−Removed: hospital stays, and other miscellaneous expenses associated with current treatments.
−Removed: to Vision Research Reports, the cancer immunotherapy market size is expected to grow at a CAGR of 10.6% during the forecasted period
−Removed: of 2022 to 2030 and is expected to grow to $130.6 billion in 2030 compared to $60.1 billion in 2020.
−Removed: Generally, T-cell treatments for
−Removed: blood cancers is covered by insurance, and each treatment costs an average of $400,000.
−Removed: T-cells are engineered to express ARTEMIS ® cell receptors (i.e., the AbTCR and co-stimulatory molecule) on their cell
−Removed: surfaces in a manner similar to EB103.
−Removed: Like EB103, both the AbTCR and co-stimulatory molecule of EB104 are designed to recognize and
−Removed: bind the CD19 antigen.
−Removed: In addition, the AbTCR in EB104 T-cells recognizes and binds the CD22 antigen as well.
−Removed: Once infused, EB104 T-cells
−Removed: are able to engage CD19- and CD22-positive cancer cells.
−Removed: The AbTCR expressed on the EB104 T-cell by its nature associates, via its effector
−Removed: domain (γδ TCR chains), with the endogenous CD3 complex.
−Removed: When the AbTCR binds to its target, CD19 or CD22, expressed on the
−Removed: cancer cell, AbTCR/CD3 complex-mediated signal transduction within the EB104 T-cell is initiated.
−Removed: This signal transduction process ultimately
−Removed: leads to the activation of the EB104 T-cell.
−Removed: A second “enhancement” signal is generated when the co-stimulatory molecule
−Removed: expressed on the EB104 T-cells binds to its target, CD19, expressed on the cancer cell.
−Removed: Although the co-stimulatory molecule expressed
−Removed: on EB104 T-cells cannot bind to CD22, EB104 T-cells are able to engage CD19 or CD22 (with the AbTCR) while the co-stimulatory molecule
−Removed: binds to CD19.
−Removed: Like EB103, the main function of the co-stimulatory molecule is to “boost” AbTCR signaling, resulting in increased
−Removed: expansion and survival of EB104 T-cells inside the body, and the co-stimulatory molecule has also been optimized to provide EB104 T-cells
−Removed: with enhanced T-cell activation.
−Removed: In summary, EB104 T-cells seek out CD19 and CD22-positive cancer cells, bind to these cells, and destroy
−Removed: impressive outcomes of CAR-T cell treatments over the past five years, more than 50% of patients treated with CD19-targeted CAR-T cell
−Removed: therapy experience progressive disease.
−Removed: In addition, many patients treated with CD19-target CAR-T cell therapies subsequently show absent
−Removed: Further, disease progression associated with loss of cell surface CD19 has been reported in 30 – 95% of relapses after
−Removed: CD19-targeted CAR-T therapy in B-cell acute lymphoblastic leukemia.
−Removed: We believe that this obstacle can be addressed by dual-targeting
−Removed: both CD19 and CD22 with EB104.
−Removed: For patients that may exhibit lower CD19 surface density, EB104 has the potential to bind to both CD19
−Removed: and CD22 to increase the odds of effective T-cell therapy.
−Removed: Preclinical Data
−Removed: test the anti-tumor activity of EB104 towards low or no CD19 surface expression cancer cells, in 2019, Eureka constructed a Nalm-6-CD19ko
−Removed: cell line, which is a B-cell precursor leukemia cell line, with the “knockout” of CD19 gene expression.
+Added: “ Material Agreements - Services Agreement and Statement of Work #001 ” below for additional information regarding
+Added: the terms of the agreements.
+Added: EB104 T-cells
+Added: EB104 T-cells are engineered
+Added: to express ARTEMIS ® cell receptors (i.e., the AbTCR and co-stimulatory molecule) on their cell surfaces in a manner similar
+Added: Like EB103, both the AbTCR and co-stimulatory molecule of EB104 are designed to recognize and bind the CD19 antigen.
+Added: the AbTCR in EB104 T-cells recognizes and binds the CD22 antigen as well.
+Added: Once infused, EB104 T-cells are able to engage CD19- and CD22-positive
+Added: cancer cells.
+Added: The AbTCR expressed on the EB104 T-cell by its nature associates, via its effector domain (γδ TCR chains), with
+Added: the endogenous CD3 complex.
+Added: When the AbTCR binds to its target, CD19 or CD22, expressed on the cancer cell, AbTCR/CD3 complex-mediated
+Added: signal transduction within the EB104 T-cell is initiated.
+Added: This signal transduction process ultimately leads to the activation of the EB104
+Added: A second “enhancement” signal is generated when the co-stimulatory molecule expressed on the EB104 T-cells binds to
+Added: its target, CD19, expressed on the cancer cell.
+Added: Although the co-stimulatory molecule expressed on EB104 T-cells cannot bind to CD22, EB104
+Added: T-cells are able to engage CD19 or CD22 (with the AbTCR) while the co-stimulatory molecule binds to CD19.
+Added: Like EB103, the main function
+Added: of the co-stimulatory molecule is to “boost” AbTCR signaling, resulting in increased expansion and survival of EB104 T-cells
+Added: inside the body, and the co-stimulatory molecule has also been optimized to provide EB104 T-cells with enhanced T-cell activation.
+Added: summary, EB104 T-cells seek out CD19 and CD22-positive cancer cells, bind to these cells, and destroy them.
+Added: Despite impressive outcomes
+Added: of CAR-T cell treatments over the past five years, more than 50% of patients treated with CD19-targeted CAR-T cell therapy experience
+Added: progressive disease.
+Added: In addition, many patients treated with CD19-target CAR-T cell therapies subsequently show absent or low CD19.
+Added: disease progression associated with loss of cell surface CD19 has been reported in 30 – 95% of relapses after CD19-targeted CAR-T
+Added: therapy in B-cell acute lymphoblastic leukemia.
+Added: We believe that this obstacle can be addressed by dual-targeting both CD19 and CD22 with
+Added: For patients that may exhibit lower CD19 surface density, EB104 has the potential to bind to both CD19 and CD22 to increase the
+Added: odds of effective T-cell therapy.
+Added: EB104 Preclinical Data
+Added: To test the anti-tumor
+Added: activity of EB104 towards low or no CD19 surface expression cancer cells, in 2019, Eureka constructed a Nalm-6-CD19ko cell line,
+Added: which is a B-cell precursor leukemia cell line, with the “knockout” of CD19 gene expression.
This cell line mimics
patients’ diminished CD19 surface expression after CD19-directed immunotherapies.
−Removed: To confirm if EB104 T-cells have the potential
−Removed: to overcome CD19 antigen loss in cancer cells, Eureka tested the activity of EB104 as well as EB103 cells in mice using NSG™ xenograft
−Removed: models (which are highly immunodeficient mice) of leukemia with Nalm-6 and Nalm-6-CD19ko cells with a bioluminescence reporter.
−Removed: flux from the bioluminescence reporter measured the tumor growth.
−Removed: In the experiments shown below, Eureka tested EB104, EB103, and mock
−Removed: T-cells head-to-head, against the NSG™ xenograft model, with six mice for each treatment group, respectively.
−Removed: Four days before
−Removed: the T-cells were infused, 0.5x106 leukemia cells Nalm-6 (expressing both CD19 and CD22) with bioluminescence reporter were injected into
−Removed: Four days later, the mice were infused with a total of T-cells containing EB103 or EB104, or mock T cells, using the mock T-cells
−Removed: as the control group.
−Removed: The infusion of EB103 and EB104 showed tumor control until day 21, while the control group showed rapid tumor growth.
−Removed: EB104 showed potentially better tumor control compared to EB103.
−Removed: At day 21, Nalm-6 cells with 1% Nalm-6-CD19ko (expressing CD22, but
−Removed: not CD19) cells were injected into mice that were previously treated by EB103 or EB104 as re-challenge.
−Removed: This re-challenge experiment
−Removed: mimicked the tumor relapse in patients due to CD19 antigen escape.
−Removed: Mice treated with EB104 showed “durable” tumor control,
−Removed: meaning that the tumor continued to respond to treatment without the cancer growing or spreading, and “clearance” of tumors,
−Removed: which refers to the complete killing of tumor cells, for a total of more than 60 days or 40 days after the re-challenge.
−Removed: However, mice
−Removed: treated with EB103 showed rapid tumor growth after the re-challenge.
−Removed: pre-clinical results showed that EB104 T-cells have the potential to eradicate Nalm-6 Primary Tumors and Nalm-6-CD19ko re-challenge tumors
−Removed: in the xenograft model, suggesting that EB104 T-cells have the potential to control the growth of tumor cells that do not express CD19.
−Removed: Collaboration with Imugene and CF33-CD19t
−Removed: major challenge for current T-cell therapies is the identification of antigens that are expressed only on tumors and not in healthy tissue.
−Removed: In the absence of such restricted expression, CAR-T cell therapy poses considerable safety concerns and potentially narrows therapeutic
−Removed: window for their application against solid tumors.
−Removed: CD19 has been an ideal target for CAR-T cells against hematological malignancies for
−Removed: several reasons, including its highly restricted expression on B cells and acceptable off-tumor and on-target properties.
−Removed: to the shared expression of solid tumor antigens on normal tissue, most of these antigens also have heterogeneous and nonuniform expression
−Removed: patterns in tumors, limiting the potential for effective and durable antitumor responses.
−Removed: Many solid tumors, including triple-negative
−Removed: breast cancers and liver cancers, lack amenable tumor antigens for CAR-T cell development.
−Removed: To potentially address the issue of the lack
−Removed: of solid tumor-specific targets, we are collaborating with Imugene and its product candidate, CF33-CD19t, to research the use of EB103
−Removed: in conjunction with CF33-CD19t to treat solid tumors using a “mark and kill” strategy.
−Removed: “mark and kill” strategy entails first using CF33-CD19t to infect solid tumor cells which induces them to express the CD19
−Removed: protein on the cell surface, thereby labeling the tumor cell as a target for EB103 T-Cells.
−Removed: The EB103 T-cells are then infused into the
−Removed: patient where they would target and kill the now CD19-positive solid tumor cells.
−Removed: Collaboration
−Removed: October 29, 2021, Eureka entered into a collaboration agreement (the “Collaboration Agreement”) with Imugene, a clinical
−Removed: stage immuno-oncology company, to evaluate the use of CF33-CD19t in conjunction with Eureka’s CD19 ARTEMIS T-cell therapy for the
−Removed: treatment of solid tumors.
−Removed: July 28, 2022, as part of the Separation, Eureka contributed and assigned the Collaboration Agreement to Estrella.
+Added: To confirm if EB104 T-cells have the
+Added: potential to overcome CD19 antigen loss in cancer cells, Eureka tested the activity of EB104 as well as EB103 cells in mice using
+Added: NSG™ xenograft models (which are highly immunodeficient mice) of leukemia with Nalm-6 and Nalm-6-CD19ko cells with a
+Added: bioluminescence reporter.
+Added: The total flux from the bioluminescence reporter measured the tumor growth.
+Added: In the experiments shown
+Added: below, Eureka tested EB104, EB103, and mock T-cells head-to-head, against the NSG™ xenograft model, with six mice for each
+Added: treatment group, respectively.
+Added: Four days before the T-cells were infused, 0.5x106 leukemia cells Nalm-6 (expressing both CD19 and
+Added: CD22) with bioluminescence reporter were injected into mice.
+Added: Four days later, the mice were infused with a total of T-cells
+Added: containing EB103 or EB104, or mock T cells, using the mock T-cells as the control group.
+Added: The infusion of EB103 and EB104 showed
+Added: tumor control until day 21, while the control group showed rapid tumor growth.
+Added: Furthermore, EB104 showed
+Added: potentially better tumor control compared to EB103.
+Added: At day 21, Nalm-6 cells with 1% Nalm-6-CD19ko (expressing CD22, but not CD19) cells
+Added: were injected into mice that were previously treated by EB103 or EB104 as re-challenge.
+Added: This re-challenge experiment mimicked the tumor
+Added: relapse in patients due to CD19 antigen escape.
+Added: Mice treated with EB104 showed “durable” tumor control, meaning that the tumor
+Added: continued to respond to treatment without the cancer growing or spreading, and “clearance” of tumors, which refers to the
+Added: complete killing of tumor cells, for a total of more than 60 days, or 40 days after the re-challenge.
+Added: However, mice treated with EB103
+Added: showed rapid tumor growth after the re-challenge.
+Added: These pre-clinical results
+Added: showed that EB104 T-cells have the potential to eradicate Nalm-6 Primary Tumors and Nalm-6-CD19ko re-challenge tumors in the xenograft
+Added: model, suggesting that EB104 T-cells have the potential to control the growth of tumor cells that do not express CD19.
+Added: Our Collaboration with Imugene and CF33-CD19t
+Added: CF33-CD19t and EB103
+Added: A major challenge for current
+Added: T-cell therapies is the identification of antigens that are expressed only on tumors and not in healthy tissue.
+Added: In the absence of such
+Added: restricted expression, CAR-T cell therapy poses considerable safety concerns and potentially narrows therapeutic window for their application
+Added: against solid tumors.
+Added: CD19 has been an ideal target for CAR-T cells against hematological malignancies for several reasons, including
+Added: its highly restricted expression on B cells and acceptable off-tumor and on-target properties.
+Added: In addition to the shared expression of
+Added: solid tumor antigens on normal tissue, most of these antigens also have heterogeneous and nonuniform expression patterns in tumors, limiting
+Added: the potential for effective and durable antitumor responses.
+Added: Many solid tumors, including triple-negative breast cancers and liver cancers,
+Added: lack amenable tumor antigens for CAR-T cell development.
+Added: To potentially address the issue of the lack of solid tumor-specific targets,
+Added: we are collaborating with Imugene and its product candidate, CF33-CD19t, to research the use of EB103 in conjunction with CF33-CD19t to
+Added: treat solid tumors using a “mark and kill” strategy.
+Added: This “mark and kill”
+Added: strategy entails first using CF33-CD19t to infect solid tumor cells which induces them to express the CD19 protein on the cell surface,
+Added: thereby labeling the tumor cell as a target for EB103 T-Cells.
+Added: The EB103 T-cells are then infused into the patient where they would target
+Added: and kill the now CD19-positive solid tumor cells.
+Added: Collaboration Agreement
+Added: On October 29, 2021, Eureka
+Added: entered into a collaboration agreement (the “Collaboration Agreement”) with Imugene, a clinical stage immuno-oncology company,
+Added: to evaluate the use of CF33-CD19t in conjunction with Eureka’s CD19 ARTEMIS T-cell therapy for the treatment of solid tumors.
+Added: On July 28, 2022, as
+Added: part of the Separation, Eureka contributed and assigned the Collaboration Agreement to Estrella.
Pursuant to the Collaboration
−Removed: Agreement, Estrella and Imugene have each granted to the other a royalty free, non-exclusive, worldwide license, with the right to grant
−Removed: and authorize sublicenses, to their respective technologies to conduct the research activities each is responsible for performing under
−Removed: the research plan set forth in the Collaboration Agreement.
−Removed: The research plan is required to be reviewed no less frequently than every
−Removed: six to eight months by a joint steering committee comprised of participants from each of Estrella and Imugene.
−Removed: the completion of the research activities performed under the research plan in accordance with the Collaboration Agreement, Estrella
−Removed: and Imugene will be required to discuss whether they want to jointly develop or commercialize the construct that is the subject of the
−Removed: research plan (and all products that include such construct).
−Removed: Notwithstanding the foregoing, neither Estrella nor Imugene will be required
−Removed: to enter into any joint development agreement concerning such construct or any results, records, or reports that are generated by or
−Removed: on behalf of either Estrella or Imugene while performing such research activities.
−Removed: Additionally,
−Removed: while Estrella and Imugene each retain their intellectual property rights with respect to their respective technologies and any improvements
−Removed: that relate solely to their respective technologies, in the event that new intellectual property is generated from the collaboration
−Removed: (each a “Joint Collaboration Patent Right”), Estrella and Imugene are required to jointly decide the strategy, and with respect
−Removed: to any Joint Collaboration Patent Rights, the preparation, filing, prosecution, and maintenance of all Joint Collaboration Patent Rights
−Removed: throughout the world.
−Removed: Estrella and Imugene are required to share equally in the costs and expenses incurred in preparing, filing, prosecuting,
−Removed: and maintaining such Joint Collaboration Patent Rights.
−Removed: If only one of Estrella or Imugene wishes to file a patent on any Joint Collaboration
−Removed: Patent Rights, then such party will assume all of the costs related to such patent, and the other party will assign all rights to such
−Removed: patent to the prosecuting party as if they were an improvement of that party’s technology, and the other party may only use such
−Removed: patent rights for internal research purposes.
−Removed: Collaboration Agreement will continue to be in full force and effect as long as there are research activities being performed under the
−Removed: research plan set forth therein, unless further extended by written consent of Estrella and Imugene, or unless earlier terminated as
−Removed: (i) by written agreement of each of Estrella and Imugene;
−Removed: (ii) from and after October 29, 2022 (or the termination of all research
−Removed: under the research plan set forth therein, whichever occurs first), by either Estrella or Imugene effective upon 60 days’ prior
−Removed: written notice to the other party;
−Removed: or (iii) by either Estrella or Imugene, if the other party materially breaches the Collaboration Agreement
−Removed: and fails to cure such breach within 60 days after receiving written notice thereof.
−Removed: Uses and Expansion/Market
−Removed: tumors represent approximately 1,600,000 new cancer cases, or 90% of total cancer diagnoses in the United States, each year.
−Removed: time, there are no FDA-approved CAR or TCR-T cell therapies approved for the treatment of solid tumors.
−Removed: Accordingly, it is currently
−Removed: difficult to estimate specific market projections and the potential for our “mark and kill” strategy.
−Removed: elements of our strategy include:
−Removed: our lead product candidate, EB103, through clinical development.
−Removed: On March 2, 2023,
−Removed: the FDA cleared our IND for EB103, allowing us to initiate the Phase I/II Starlight-1 Clinical
−Removed: Trial, which dosed its first patient in July 2024.
−Removed: our second product candidate, EB104, for clinical development.
−Removed: We are compiling an
−Removed: IND filing for EB104 for the treatment of relapsed/refractory and high-risk blood cancers.
−Removed: Phase I trials may not commence until the FDA has approved the IND for EB104.
−Removed: researching the use of EB103 in conjunction with CF33-CD19t for multiple indications of solid
−Removed: tumors through clinical development.
−Removed: The FDA cleared our IND for EB103 on March 2,
−Removed: 2023, and the Starlight Phase I/II clinical trial for EB103 dosed its first patient in July
−Removed: If the Phase I/II Starlight-1 Clinical Trial is successful, we plan to submit an IND
−Removed: filing for the use of EB103 in conjunction with CF33-CD19t in the future.
−Removed: At this time, we
−Removed: have not determined the specific indications of solid tumors to be researched or an exact
−Removed: timeframe for filing our IND application.
−Removed: to develop a pipeline of T-cell therapies.
−Removed: To address certain of the tolerability
−Removed: shortcomings of currently approved CAR-T therapies, we intend to continue pursue development
−Removed: of therapies that may be able to be adopted in earlier lines of treatment and to be delivered
−Removed: in community outpatient settings.
−Removed: Pipeline of Clinical Programs
−Removed: approach is to advance our CD19-Redirected ARTEMIS T Cell programs in relapsed/refractory and high-risk blood cancers first.
−Removed: we are also developing multiple pipeline candidates against solid tumor and autoimmune disease.
−Removed: The following chart summarizes our clinical
−Removed: Team and Investors
−Removed: to the Services Agreement, we are supported by Eureka’s scientific team, which is comprised of leaders in the biopharmaceutical,
−Removed: oncology, and T-cell cancer immunotherapy areas.
−Removed: We have leveraged their expertise to analyze preclinical data and design and implement
−Removed: our clinical trials.
−Removed: Our CEO and President, Dr.
−Removed: Cheng Liu, and members of our scientific advisory board are pioneers in their respective
−Removed: fields, each having spent their careers advancing next-generation technologies and providing treatments in these areas.
−Removed: our Chief Financial Officer, Peter Xu, brings years of executive experience and investment management abilities.
−Removed: Board includes experienced industry leaders and investors who have been involved with many early-stage companies.
−Removed: Furthermore, we are
−Removed: supported by investors who share our belief that the world needs smarter medical treatments and our long-term vision that T-cell therapies
−Removed: have the potential to transform the way we fight cancer.
−Removed: biotechnology and pharmaceutical industries are characterized by rapid, unpredictable technological advancement and significant competition.
−Removed: These industries dedicate significant resources to developing novel and proprietary therapies for the treatment of cancer, which often
−Removed: incorporate innovative technologies and incorporate valuable intellectual property.
−Removed: We compete with companies in the cell therapy and
−Removed: immunotherapy space, as well as with companies developing other novel targeted therapies for cancer.
−Removed: If approved, our product candidates
−Removed: will compete with commercially available and development-stage innovative products in the fields of cell and immunotherapy, as well as
−Removed: against existing products generally accepted as the standard-of-care for indications in which we plan to seek marketing approval.
−Removed: anticipate that we will face intense and increasing competition from many different sources, including new and established biotechnology
−Removed: and pharmaceutical companies, academic research institutions, governmental agencies, and public and private research institutions.
−Removed: product candidates cover both hematological malignancies and solid tumors, and we expect to face direct competition in both areas from
−Removed: companies focused on CAR-T and other cell-based therapies.
−Removed: There are currently eight total FDA-approved drugs or therapies targeting
−Removed: CD19, four of which are CD19-targeting T-cell therapies:
−Removed: FIRST APPROVED
−Removed: Acute lymphocytic
−Removed: diffuse large B-cell lymphoma;
−Removed: follicular lymphoma
−Removed: US, EU, UK, Japan,
−Removed: Australia, Canada, South Korea
+Added: Agreement, Estrella and Imugene have each granted to the other a royalty free, non-exclusive, worldwide license, with the right to
+Added: grant and authorize sublicenses, to their respective technologies to conduct the research activities each is responsible for
+Added: performing under the research plan set forth in the Collaboration Agreement.
+Added: The research plan under the Collaboration Agreement was
+Added: completed as of August 30, 2023.
+Added: Potential Uses and Expansion/Market
+Added: Solid tumors represent approximately
+Added: 1,600,000 new cancer cases, or 90% of total cancer diagnoses in the United States, each year.
+Added: At this time, there are no FDA-approved
+Added: CAR or TCR-T cell therapies approved for the treatment of solid tumors.
+Added: Accordingly, it is currently difficult to estimate specific market
+Added: projections and the potential for our “mark and kill” strategy.
+Added: Our Team and Investors
+Added: Pursuant to the
+Added: Services Agreement entered into on June 28, 2022 and Statement of Work entered into on March 4, 2024, we are supported by
+Added: Eureka’s scientific team, which is comprised of leaders in the biopharmaceutical, oncology, and T-cell cancer immunotherapy
+Added: We have leveraged their expertise to analyze preclinical data and design and implement our clinical trials.
+Added: President, Dr.
+Added: Cheng Liu, and members of our scientific advisory board are pioneers in their respective fields, each having spent
+Added: their careers advancing next-generation technologies and providing treatments in these areas.
+Added: Our Chief Financial Officer, Peter Xu,
+Added: brings years of executive experience and investment management abilities.
+Added: In August 2024 we welcomed Ms.
+Added: Hong Zhang as our
+Added: Chairperson of the Board.
+Added: Zhang is a highly accomplished executive with over 25 years of experience in financial and corporate
+Added: We believe the addition of Ms.
+Added: Zhang to our Board will bring new opportunities to the company’s fundraising
+Added: Our Board includes experienced
+Added: industry leaders and investors who have been involved with many early-stage companies.
+Added: Furthermore, we are supported by investors who
+Added: share our belief that the world needs smarter medical treatments and our long-term vision that T-cell therapies have the potential to
+Added: transform the way we fight cancer.
+Added: The biotechnology and pharmaceutical
+Added: industries are characterized by rapid, unpredictable technological advancement and significant competition.
+Added: These industries dedicate
+Added: significant resources to developing novel and proprietary therapies for the treatment of cancer, which often incorporate innovative technologies
+Added: and incorporate valuable intellectual property.
+Added: We compete with companies in the cell therapy and immunotherapy space, as well as with
+Added: companies developing other novel targeted therapies for cancer.
+Added: If approved, our product candidates will compete with commercially available
+Added: and development-stage innovative products in the fields of cell and immunotherapy, as well as against existing products generally accepted
+Added: as the standard-of-care for indications in which we plan to seek marketing approval.
+Added: We anticipate that we will face intense and increasing
+Added: competition from many different sources, including new and established biotechnology and pharmaceutical companies, academic research institutions,
+Added: governmental agencies, and public and private research institutions.
+Added: Our product candidates cover both hematological malignancies and solid
+Added: tumors, and we expect to face direct competition in both areas from companies focused on CAR-T and other cell-based therapies.
+Added: currently ten total FDA-approved drugs or therapies targeting CD19, five of which are CD19-targeting T-cell therapies:
+Added: Pediatric/Young Adult B-ALL;
+Added: R/R Follicular Lymphoma
Kite Pharma (Gilead)
−Removed: Diffuse large B-cell
−Removed: non-Hodgkin’s lymphoma;
−Removed: follicular lymphoma
−Removed: US, EU, UK, Japan,
−Removed: Canada, China
+Added: R/R Large B-cell Lymphoma;
+Added: R/R Follicular Lymphoma;
+Added: R/R Primary CNS Lymphoma
Kite Pharma (Gilead)
−Removed: Mantel cell lymphoma;
−Removed: acute lymphocytic leukemia
+Added: R/R Mantle Cell Lymphoma (MCL);
Juno (Bristol Myers Squibb)
−Removed: Diffuse large B-cell
Follicular Lymphoma;
−Removed: US, Japan, EU, UK,
−Removed: competitors operating in the T-cell therapy space include, but are not limited to:
−Removed: Yescarta and Tecartus)
+Added: Mantle Cell Lymphoma;
+Added: Marginal Zone Lymphoma
+Added: Adult Relapsed/Refractory B-cell precursor Acute Lymphoblastic Leukemia (ALL)
+Added: Our competitors operating
+Added: in the T-cell therapy space include, but are not limited to:
+Added: Kite Pharma, Inc.
+Added: Yescarta, Tecartus, KITE-753 and KITE-363)
Therapeutics Inc.
2 unchanged sentences
Carteyva/Relma-cel)
−Removed: ● Adaptimmune
−Removed: Therapeutics PLC (Product Candidate:
−Removed: ADP-A2M4CD8 SPEAR)
−Removed: Therapeutics (Product Candidate:
−Removed: Therapeutics (Product Candidates:
−Removed: P-BCMA-ALLO1, P-MUC1C-ALLO1, and P-PSMA-ALLO1)
+Added: Allogene Therapeutics (Product:
+Added: Mustang Bio (Product:
+Added: Poseida Therapeutics (Product Candidates:
+Added: P-MUC1C-ALLO1, and P-CD19CD20-ALLO1)
Therapeutics PLC (Product Candidates:
obe-cel and Auto1/22)
−Removed: competitors pursuing CD19 targeted drugs outside of the T-cell therapy space include, but are not limited to:
−Removed: Therapeutics plc (Product:
+Added: Our competitors pursuing
+Added: CD19 targeted drugs outside of the T-cell therapy space include, but are not limited to:
+Added: ● Amgen, Inc.
+Added: Blincyto and Uplizna)
+Added: AG (Novartis) (Product:
Therapeutics SA (Product:
−Removed: and research institutes have been a proven new technology source in the field as well.
−Removed: We also face competition from treatments in the
−Removed: field of immunotherapy which are being developed and/or commercialized by several biotechnology companies as well as by large pharmaceutical
−Removed: Such companies, whose immuno-oncology programs focus on the same indications or antigen targets as our current pipeline.
−Removed: known types of immunotherapy, including but not limited to checkpoint inhibition and cancer vaccines, are not currently direct competitors
−Removed: to T-cell-based therapeutics.
−Removed: However, we cannot predict whether these other types of immunotherapy may eventually show efficacy in the
−Removed: indications for which we may seek marketing approval, and it is possible that we may face direct and substantial competition from such
−Removed: sources in the future.
−Removed: of our current or potential competitors, either alone or with a strategic partner, have significantly greater financial, technical, and
−Removed: human resources, as well as more expertise in research and development, manufacturing, preclinical testing, conducting clinical studies
−Removed: and trials and commercializing and marketing approved products.
−Removed: Competitors may compete with us in hiring scientific and management personnel,
−Removed: establishing clinical study sites, registering patients for clinical studies and acquiring technologies complementary to, or necessary
−Removed: for, our programs.
−Removed: Mergers and acquisitions in the biotechnology and pharmaceutical industries may result in even more resources being
−Removed: concentrated among a smaller number of competitors.
−Removed: Smaller or early-stage companies may also prove to be significant competitors, particularly
−Removed: through collaborative arrangements with large and established companies.
−Removed: own certain unregistered intellectual property rights that we use in connection with our business, including a common law trademark for
−Removed: We also own certain plasmids, cell lines, and materials related to CD19 and CD22 in connection with the ARTEMIS ®
−Removed: platform, and trade secrets and other intellectual property rights related thereto.
−Removed: A material portion of the intellectual property
−Removed: we use in our business is in-licensed from Eureka, as described below.
−Removed: We are also party to the Collaboration Agreement with Imugene,
−Removed: as described above, to conduct certain preclinical research projects to investigate the use of EB103 in conjunction with CF33-CD19t for
−Removed: efficacy in solid tumors.
−Removed: Agreement with Eureka
−Removed: June 28, 2022, we entered into the License Agreement with Eureka and Eureka Therapeutics (Cayman), Inc.
−Removed: to license certain functions
−Removed: related to any T-cell products that incorporate (a) the ARTEMIS ® platform and (b)(i) the CD19 binder and/or (ii) the CD22
−Removed: binder identified in the License Agreement (the “Licensed Product”).
−Removed: The License Agreement provides that, during the term,
−Removed: Eureka grants Estrella an exclusive license, with the right to grant sublicenses through multiple tiers to (a) make, import, use, sell
−Removed: or offer to sell the Licensed Products, (b) develop the Licensed Products solely for the purpose of obtaining regulatory approval of
−Removed: such Licensed Products, (c) commercialize such Licensed products and (d) manufacture the Licensed Products solely for the purposes of
−Removed: developing the Licensed Products for purposed of obtaining regulatory approval of such Licensed Products and for commercializing such
−Removed: Licensed Products.
−Removed: to the terms of the License Agreement, in partial consideration of Eureka’s grant of the rights and licenses to Estrella, Estrella
−Removed: agreed to pay Eureka a one-time, non-refundable, non-creditable payment of $1,000,000.
−Removed: As of October 2023, $1,000,000 has been paid to
−Removed: is eligible to receive up to five one-time development milestone payments from Estrella in the aggregate amount of $60,150,000 if all
−Removed: five development milestones are achieved.
−Removed: Effective as of March 1, 2023, the parties further amended the License Agreement to provide
−Removed: that if any development milestone is achieved prior to the Closing of the Business Combination, the corresponding development milestone
−Removed: payment will not be due to Eureka until the Closing of the Business Combination.
−Removed: On January 30, 2023, one development milestone payment
−Removed: in the amount of $50,000 related to the submission of EB103 to the FDA was earned by Eureka under the Agreement, which became due and
−Removed: payable to Eureka upon the Closing of the Business Combination.
−Removed: is also eligible to receive up to four one-time sales milestone payments from Estrella based on the aggregate net sales of all Licensed
−Removed: Products by or on behalf of Estrella or any of its affiliates or sublicensees in the Licensed Territory during any consecutive 12-month
−Removed: period in the aggregate amount of $225,000,000 if all four sales milestones are achieved.
−Removed: Each sales milestone payment will only be paid
−Removed: once, regardless of the number of Licensed Products or the number of times a given sales milestone has been achieved.
−Removed: Estrella is also
−Removed: responsible (with input from Eureka) for the preparation, filing, prosecution, and maintenance of the patent rights, including all associated
−Removed: addition, during the applicable royalty term, Estrella will be required to pay to Eureka royalties in the amount of a single digit percentage
−Removed: of the aggregate Net Sales of all Licensed Products sold by or on behalf of Estrella or its affiliates or sublicensees in the Licensed
−Removed: Territory during a calendar year.
−Removed: Such amount is subject to certain reductions (not to exceed 50% of the amount otherwise payable) due
−Removed: to the expiration of valid claims of a licensed patent right in a given country in the Licensed Territory or due to 50% or greater declines
−Removed: in sales as a result of generic product competition in a given country in the Licensed Territory.
−Removed: The royalty term begins upon the first
−Removed: commercial sale of a Licensed Product in a country in the Licensed Territory and continues until the later of (a) the date on which such
−Removed: Licensed Product is no longer covered by a valid claim within Eureka’s licensed patent rights in such country, (b) the expiration
−Removed: of all exclusive marketing rights or data protection or other exclusivity rights (other than patent rights) conferred by any regulatory
−Removed: authority with respect to a product in a country or jurisdiction that prohibits the commercialization of a generic product, including
−Removed: orphan drug exclusivity or pediatric exclusivity for such licensed product in such country, and (c) 12 years after the first commercial
−Removed: sale of such licensed product in such country.
−Removed: License Agreement will remain in effect on a licensed product-by-licensed product and country-by-country basis, until the expiration
−Removed: of the royalty term for a licensed product in a country and will finally expire upon expiration of the royalty term for the final Licensed
−Removed: Estrella may terminate the License Agreement for any reason or no reason upon 120 days’ prior written notice to Eureka.
−Removed: Either party has the right to terminate the License Agreement upon material breach of the other party that is not cured within 90 days
−Removed: after the breaching party receives written notice of such breach from the non-breaching party.
−Removed: of June 30, 2024, we have fully paid the $1,000,000 license fee to Eureka.
−Removed: January 30, 2023, one development milestone payment in the amount of $50,000 related to the submission of EB103 to the FDA was earned
−Removed: by Eureka under the Agreement, which was paid on October 10, 2023.
−Removed: No other development milestone, sales milestone, or royalty payment
−Removed: has been earned as of June 30, 2024, as we do not have any product candidates approved for sale and have not generated any revenue from
−Removed: product sales.
−Removed: With the dosing of the first patient in July 2024 in the STARLIGHT-1 clinical trial, the development milestone pursuant
−Removed: to Section 8.2.1 (First Patient Dosed in the First Clinical Trial of a Licensed Product) in the Licensing Agreement with Eureka was met.
−Removed: As a result, Estrella made a payment of $50,000 to Eureka for reaching this milestone.
−Removed: As of September 2024, two patients have been dosed
−Removed: in the STARLIGHT-1 clinical trial.
−Removed: Patent Information
−Removed: table below sets forth patents owned by Eureka relating to EB103 and EB104.
−Removed: The expiration date for each patent is October 21, 2036.
−Removed: OF PATENT PROT.
−Removed: CANDIDATES COVERED
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: 4/27/173001137A1
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: 8/29/183365364
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: 5/31/18258405
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: 201817012671 A
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: 2022 – 050431
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: JP2019 – 500848A
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: – 2018 – 7014004
−Removed: 10 – 2018 – 0063325
−Removed: OF PATENT PROT.
−Removed: CANDIDATES COVERED
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: MX/a/2018/004721
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: 4/27/18741052
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: Antibody/T-cell
−Removed: Receptor Chimeric Constructs and Uses Thereof
−Removed: US – 2019 – 0022216
−Removed: Food and Drug Administration, or FDA, and other regulatory authorities at federal, state and local levels, as well as in foreign
−Removed: countries, extensively regulate, among other things, the research, development, testing, manufacture, quality control, import, export,
−Removed: safety, effectiveness, labeling, packaging, storage, distribution, record keeping, approval, advertising, promotion, marketing, sampling
−Removed: post-approval monitoring and post-approval reporting of biologics such as those we are developing.
−Removed: Any product candidates that we develop
−Removed: must be approved by the FDA before they may be legally marketed in the United States and by the appropriate foreign regulatory agency
−Removed: before they may be legally marketed in those foreign countries.
−Removed: Generally, our activities in other countries will be subject to regulation
−Removed: that is similar in nature and scope as that imposed in the United States, although there can be important differences.
−Removed: Development Process
−Removed: the United States, biological products are subject to regulation under the Federal Food, Drug, and Cosmetic Act, the Public Health Service
−Removed: Act, and other federal, state, local and foreign statutes and their implementing regulations.
+Added: Universities and research
+Added: institutes have been a proven new technology source in the field as well.
+Added: We also face competition from treatments in the field of immunotherapy
+Added: which are being developed and/or commercialized by several biotechnology companies as well as by large pharmaceutical companies, whose immuno-oncology programs focus on the same indications or antigen targets as our current pipeline.
+Added: Other known types
+Added: of immunotherapy, including but not limited to checkpoint inhibition and cancer vaccines, are not currently direct competitors to T-cell-based
+Added: therapeutics.
+Added: However, we cannot predict whether these other types of immunotherapy may eventually show efficacy in the indications for
+Added: which we may seek marketing approval, and it is possible that we may face direct and substantial competition from such sources in the
+Added: Many of our current or potential
+Added: competitors, either alone or with a strategic partner, have significantly greater financial, technical, and human resources, as well as
+Added: more expertise in research and development, manufacturing, preclinical testing, conducting clinical studies and trials and commercializing
+Added: and marketing approved products.
+Added: Competitors may compete with us in hiring scientific and management personnel, establishing clinical
+Added: study sites, registering patients for clinical studies and acquiring technologies complementary to, or necessary for, our programs.
+Added: and acquisitions in the biotechnology and pharmaceutical industries may result in even more resources being concentrated among a smaller
+Added: number of competitors.
+Added: Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative
+Added: arrangements with large and established companies.
+Added: Intellectual Property
+Added: We own certain unregistered
+Added: intellectual property rights that we use in connection with our business, including a common law trademark for Estrella™.
+Added: own certain plasmids, cell lines, and materials related to CD19 and CD22 in connection with the ARTEMIS ® platform, and
+Added: trade secrets and other intellectual property rights related thereto.
+Added: A material portion of the intellectual property we use in our business
+Added: is in-licensed from Eureka, as described below.
+Added: License Agreement with Eureka
+Added: On June 28, 2022, we entered into the License Agreement with Eureka
+Added: and Eureka Therapeutics (Cayman), Inc.
+Added: (the “License Agreement”) , under which Eureka granted the Company an exclusive license
+Added: to certain intellectual property within all territories worldwide, excluding Greater China and the Association of Southeast Asian Nations
+Added: (ASEAN) countries (“Licensed Territory”).
+Added: This agreement provides the Company with the right to certain functions related
+Added: to any T-cell products that incorporate (a) the ARTEMIS ® platform and (b)(i) the CD19 binder and/or (ii) the CD22 binder
+Added: identified in the License Agreement (the “Licensed Product”).
+Added: The License Agreement provides that, during the term, Eureka
+Added: grants Estrella an exclusive license, with the right to grant sublicenses through multiple tiers to (a) make, import, use, sell or offer
+Added: to sell the Licensed Products, (b) develop the Licensed Products solely for the purpose of obtaining regulatory approval of such Licensed
+Added: Products, (c) commercialize such Licensed products and (d) manufacture the Licensed Products solely for developing the Licensed Products
+Added: for the purposes of obtaining regulatory approval of such Licensed Products and for commercializing such Licensed Products.
+Added: Pursuant to the terms of the License Agreement, in partial consideration
+Added: of Eureka’s grant of the rights and licenses to Estrella, Estrella agreed to pay Eureka a one-time, non-refundable, non-creditable
+Added: payment of $1.0 million.
+Added: As of December 31, 2025, $1.0 million has been paid to Eureka.
+Added: Eureka is eligible to receive up to five one-time development milestone
+Added: payments from Estrella in the aggregate amount of approximately $60.2 million if all five development milestones are achieved.
+Added: as of March 1, 2023, the parties further amended the License Agreement to provide that if any development milestone is achieved prior
+Added: to the Closing of the Business Combination, the corresponding development milestone payment will not be due to Eureka until the Closing
+Added: of the Business Combination.
+Added: Eureka is also eligible to
+Added: receive up to four one-time sales milestone payments from Estrella based on the aggregate net sales of all Licensed Products by or on
+Added: behalf of Estrella or any of its affiliates or sublicensees in the Licensed Territory during any consecutive 12-month period in the aggregate
+Added: amount of $225.0 million if all four sales milestones are achieved.
+Added: Each sales milestone payment will only be paid once, regardless of
+Added: the number of Licensed Products or the number of times a given sales milestone has been achieved.
+Added: Estrella is also responsible (with input
+Added: from Eureka) for the preparation, filing, prosecution, and maintenance of the patent rights, including all associated costs.
+Added: In addition, during the applicable royalty term, Estrella will be required
+Added: to pay to Eureka royalties in the amount of a single digit percentage of the aggregate Net Sales of all Licensed Products sold by or on
+Added: behalf of Estrella or its affiliates or sublicensees in the Licensed Territory during a calendar year.
+Added: Such amount is subject to certain
+Added: reductions (not to exceed 50% of the amount otherwise payable) due to the expiration of valid claims of a licensed patent right in a given
+Added: country in the Licensed Territory or due to 50% or greater declines in sales as a result of generic product competition in a given country
+Added: in the Licensed Territory.
+Added: The royalty term begins upon the first commercial sale of a Licensed Product in a country in the Licensed Territory
+Added: and continues until the later of (a) the date on which such Licensed Product is no longer covered by a valid claim within Eureka’s
+Added: licensed patent rights in such country, (b) the expiration of all exclusive marketing rights or data protection or other exclusivity rights
+Added: (other than patent rights) conferred by any regulatory authority with respect to a product in a country or jurisdiction that prohibits
+Added: the commercialization of a generic product, including orphan drug exclusivity or pediatric exclusivity for such Licensed Product in such
+Added: country, and (c) 12 years after the first commercial sale of such Licensed Product in such country.
+Added: The License Agreement will remain in effect on a Licensed Product-by-Licensed
+Added: Product and country-by-country basis, until the expiration of the royalty term for a Licensed Product in a country and will finally expire
+Added: upon expiration of the royalty term for the final Licensed Product.
+Added: Estrella may terminate the License Agreement for any reason or no
+Added: reason upon 120 days’ prior written notice to Eureka.
+Added: Either party has the right to terminate the License Agreement upon material
+Added: breach of the other party that is not cured within 90 days after the breaching party receives written notice of such breach from the non-breaching
+Added: On January 30, 2023, one development milestone payment in the amount
+Added: of $50,000 related to the submission of EB103 to the FDA was earned by Eureka under the Agreement, which was paid on October 10, 2023.
+Added: With the dosing of the first patient in July 2024 in the STARLIGHT-1 clinical trial, the development milestone pursuant to Section 8.2.1
+Added: (First Patient Dosed in the First Clinical Trial of a Licensed Product) in the Licensing Agreement with Eureka was met.
+Added: As a result, Estrella
+Added: made a payment of $50,000 to Eureka for reaching this milestone.
+Added: As of December 31, 2025, nine patients have been dosed in the STARLIGHT-1
+Added: clinical trial.
+Added: No other development milestone, sales milestone, or royalty payment has been earned as of December 31, 2025, as we do
+Added: not have any product candidates approved for sale and have not generated any revenue from product sales.
+Added: Eureka Patent Information
+Added: The patents owned by Eureka relating to EB103 and
+Added: EB104 cover compositions of matter, uses, and processes in various jurisdictions, including Australia, Canada, Europe, Israel, India,
+Added: Japan, Korea, Mexico, New Zealand, Russia, and the United States.
+Added: These patents expire on October 21, 2036.
+Added: Government Regulation
+Added: Food and Drug Administration,
+Added: or FDA, and other regulatory authorities at federal, state and local levels, as well as in foreign countries, extensively regulate, among
+Added: other things, the research, development, testing, manufacture, quality control, import, export, safety, effectiveness, labeling, packaging,
+Added: storage, distribution, record keeping, approval, advertising, promotion, marketing, sampling post-approval monitoring and post-approval
+Added: reporting of biologics such as those we are developing.
+Added: Any product candidates that we develop must be approved by the FDA before they
+Added: may be legally marketed in the United States and by the appropriate foreign regulatory agency before they may be legally marketed in those
+Added: foreign countries.
+Added: Generally, our activities in other countries will be subject to regulation that is similar in nature and scope as that
+Added: imposed in the United States, although there can be important differences.
+Added: Biologic Development
+Added: In the United States,
+Added: biological products are subject to regulation under the Federal Food, Drug, and Cosmetic Act, the Public Health Service Act, and
+Added: other federal, state, local and foreign statutes and their implementing regulations.
The process of obtaining regulatory approvals
1 unchanged sentence
substantial time and financial resources.
−Removed: The process required by the FDA before biologics may be marketed in the United States generally
−Removed: involves the following:
−Removed: of preclinical laboratory tests and animal studies performed in accordance with the FDA’s
−Removed: Good Laboratory Practice requirements, or GLP;
−Removed: to the FDA of an IND, which must become effective before clinical trials may begin;
−Removed: by an institutional review board, or IRB, or ethics committee at each clinical site before
−Removed: the trial is commenced;
−Removed: ● performance
−Removed: of adequate and well-controlled human clinical trials according to the FDA’s regulations
−Removed: commonly referred to as good clinical practice, or GCP, regulations and any additional requirements
−Removed: for the protection of human research subjects and their health information to establish the
−Removed: safety, purity, and potency of the proposed biologic product candidate for its intended purpose;
−Removed: ● preparation
−Removed: of and submission to the FDA of a Biologics License Application, or BLA, after completion
−Removed: of all pivotal clinical trials;
−Removed: ● satisfactory
−Removed: completion of an FDA Advisory Committee review, if applicable;
−Removed: determination by the FDA within 60 days of its receipt of a BLA to file the application for
−Removed: ● satisfactory
−Removed: completion of an FDA pre-approval inspection of the manufacturing facility or facilities
−Removed: at which the proposed product is produced to assess compliance with cGMP, and to assure that
−Removed: the facilities, methods and controls are adequate to preserve the biological product’s
−Removed: continued safety, purity, and potency and, if applicable, to assess compliance with the FDA’s
−Removed: current Good Tissue Practice, or cGTP, requirements for the use of human cellular and tissue
−Removed: products, and of selected clinical investigation sites to assess compliance with GCPs;
−Removed: FDA audit of the nonclinical and clinical study sites that generated the data in support
−Removed: review and approval of the BLA to permit commercial marketing of the product for particular
−Removed: indications for use in the United States.
−Removed: testing any biological product candidate in humans, the product candidate enters the preclinical testing stage.
−Removed: Preclinical tests, also
−Removed: referred to as nonclinical studies, include laboratory evaluations of product chemistry, toxicity and formulation, as well as animal
−Removed: studies to assess the potential safety and activity of the product candidate.
−Removed: The conduct of the preclinical tests must comply with federal
−Removed: regulations and requirements including GLPs.
−Removed: to beginning the first clinical trial with a product candidate in the United States, we must submit an IND to the FDA.
−Removed: An IND is a request
−Removed: for authorization from the FDA to administer an investigational new drug to humans.
−Removed: The central focus of an IND submission is on the
−Removed: general investigational plan and the protocol(s) for clinical studies.
+Added: The process required by the FDA before biologics may be marketed in the United States
+Added: generally involves the following:
+Added: completion of preclinical laboratory tests and animal studies performed in accordance with the FDA’s Good Laboratory Practice requirements, or GLP;
+Added: submission to the FDA of an IND, which must become effective before clinical trials may begin;
+Added: approval by an institutional review board, or IRB, or ethics committee at each clinical site before the trial is commenced;
+Added: performance of adequate and well-controlled human clinical trials according to the FDA’s regulations commonly referred to as good clinical practice, or GCP, regulations and any additional requirements for the protection of human research subjects and their health information to establish the safety, purity, and potency of the proposed biologic product candidate for its intended purpose;
+Added: preparation of and submission to the FDA of a Biologics License Application, or BLA, after completion of all pivotal clinical trials;
+Added: satisfactory completion of an FDA Advisory Committee review, if applicable;
+Added: a determination by the FDA within 60 days of its receipt of a BLA to file the application for review;
+Added: satisfactory completion of an FDA pre-approval inspection of the manufacturing facility or facilities at which the proposed product is produced to assess compliance with cGMP, and to assure that the facilities, methods and controls are adequate to preserve the biological product’s continued safety, purity, and potency and, if applicable, to assess compliance with the FDA’s current Good Tissue Practice, or cGTP, requirements for the use of human cellular and tissue products, and of selected clinical investigation sites to assess compliance with GCPs;
+Added: potential FDA audit of the nonclinical and clinical study sites that generated the data in support of the BLA;
+Added: FDA review and approval of the BLA to permit commercial marketing of the product for particular indications for use in the United States.
+Added: Before testing any biological
+Added: product candidate in humans, the product candidate enters the preclinical testing stage.
+Added: Preclinical tests, also referred to as nonclinical
+Added: studies, include laboratory evaluations of product chemistry, toxicity and formulation, as well as animal studies to assess the potential
+Added: safety and activity of the product candidate.
+Added: The conduct of the preclinical tests must comply with federal regulations and requirements
+Added: including GLPs.
+Added: Prior to beginning the first
+Added: clinical trial with a product candidate in the United States, we must submit an IND to the FDA.
+Added: An IND is a request for authorization
+Added: from the FDA to administer an investigational new drug to humans.
+Added: The central focus of an IND submission is on the general investigational
+Added: plan and the protocol(s) for clinical studies.
Some preclinical testing may continue even after the IND is submitted.
−Removed: The IND also includes results of animal and in vitro studies assessing the toxicology, pharmacokinetics, pharmacology and pharmacodynamic
−Removed: characteristics of the product;
+Added: The IND also includes
+Added: results of animal and in vitro studies assessing the toxicology, pharmacokinetics, pharmacology and pharmacodynamic characteristics
+Added: of the product;
chemistry, manufacturing, and controls information;
−Removed: and any available human data or literature to support
−Removed: the use of the investigational product.
+Added: and any available human data or literature to support the use of the
+Added: investigational product.
An IND must become effective before human clinical trials may begin.
−Removed: The IND automatically becomes
−Removed: effective 30 days after receipt by the FDA, unless the FDA, within the 30-day time period, raises safety concerns or questions about
−Removed: the proposed clinical trial.
−Removed: In such a case, the IND may be placed on clinical hold and the IND sponsor and the FDA must resolve any
−Removed: outstanding concerns or questions before the clinical trial can begin.
−Removed: Submission of an IND therefore may or may not result in FDA authorization
−Removed: to begin a clinical trial.
−Removed: addition to the submission of an IND to the FDA before initiation of a clinical trial in the United States, certain human clinical trials
−Removed: involving recombinant or synthetic nucleic acid molecules are subject to oversight of institutional biosafety committees, or IBCs, as
−Removed: set forth in the National Institutes of Health, or NIH, Guidelines for Research Involving Recombinant DNA Molecules, or the NIH Guidelines.
−Removed: Specifically, under the NIH Guidelines, supervision of human gene transfer trials includes evaluation and assessment by an IBC, a local
−Removed: institutional committee that reviews and oversees research utilizing recombinant or synthetic nucleic acid molecules at that institution.
−Removed: The IBC assesses the safety of the research and identifies any potential risk to public health or the environment, and such review may
−Removed: result in some delay before initiation of a clinical trial.
−Removed: While the NIH Guidelines are not mandatory unless the research in question
−Removed: is being conducted at or sponsored by institutions receiving NIH funding of recombinant or synthetic nucleic acid molecule research,
−Removed: many companies and other institutions not otherwise subject to the NIH Guidelines voluntarily follow them.
−Removed: trials involve the administration of the investigational product to human subjects under the supervision of qualified investigators in
−Removed: accordance with GCPs, which include the requirement that all research subjects provide their informed consent for their participation
−Removed: in any clinical study.
−Removed: Clinical trials are conducted under protocols detailing, among other things, the objectives of the study, the
−Removed: parameters to be used in monitoring safety and the effectiveness criteria to be evaluated.
−Removed: A separate submission to the existing IND
−Removed: must be made for each successive clinical trial conducted during product development and for any subsequent protocol amendments.
−Removed: an independent IRB for each site proposing to conduct the clinical trial must review and approve the plan for any clinical trial and
−Removed: its informed consent form before the clinical trial begins at that site, and must monitor the study until completed.
−Removed: An IRB is charged
−Removed: with protecting the welfare and rights of trial participants and considers such items as whether the risks to individuals participating
−Removed: in the clinical trials are minimized and are reasonable in relation to anticipated benefits.
−Removed: The IRB also approves the informed consent
−Removed: form that must be provided to each clinical trial subject or his or her legal representative and must monitor the clinical trial until
−Removed: Regulatory authorities, the IRB or the sponsor may suspend a clinical trial at any time on various grounds, including a finding
−Removed: that the subjects are being exposed to an unacceptable health risk or that the trial is unlikely to meet its stated objectives.
−Removed: studies also include oversight by an independent group of qualified experts organized by the clinical study sponsor, known as a data
−Removed: safety monitoring board, which provides authorization for whether or not a study may move forward at designated check points based on
−Removed: access to certain data from the study and may halt the clinical trial if it determines that there is an unacceptable safety risk for
−Removed: subjects or other grounds, such as no demonstration of efficacy.
−Removed: There are also requirements governing the reporting of ongoing clinical
−Removed: studies and clinical study results to public registries.
−Removed: purposes of BLA approval, human clinical trials are typically conducted in three sequential phases that may overlap or be combined:
−Removed: 1 — The investigational product is initially introduced into healthy human subjects
−Removed: or patients with the target disease or condition.
−Removed: These studies are designed to test the
−Removed: safety, dosage tolerance, absorption, metabolism, and distribution of the investigational
−Removed: product in humans, the side effects associated with increasing doses, and, if possible, to
−Removed: gain early evidence on effectiveness.
−Removed: In the case of some products for severe or life-threatening
−Removed: diseases, such as cancer, especially when the product may be too inherently toxic to ethically
−Removed: administer to healthy volunteers, the initial human testing is often conducted in patients.
−Removed: 2 — The investigational product is administered to a limited patient population with
−Removed: a specified disease or condition to evaluate the preliminary efficacy, optimal dosages, dose
−Removed: tolerance, and dosing schedule and to identify possible adverse side effects and safety risks.
−Removed: Multiple Phase 2 clinical trials may be conducted to obtain information prior to beginning
−Removed: larger and more expensive Phase 3 clinical trials.
−Removed: 3 — The investigational product is administered to an expanded patient population to
−Removed: further evaluate dosage, to provide statistically significant evidence of clinical efficacy
−Removed: and to further test for safety, generally at multiple geographically dispersed clinical trial
−Removed: These clinical trials are intended to establish the overall risk/benefit ratio of
−Removed: the investigational product and to provide an adequate basis for product approval.
−Removed: two adequate and well-controlled Phase 3 clinical trials are required by the FDA for approval
−Removed: some cases, the FDA may require, or companies may voluntarily pursue, additional clinical trials after a product is approved to gain
−Removed: more information about the product in the intended therapeutic indication, particularly for long-term safety follow-up.
−Removed: Completion of
−Removed: these so-called Phase 4 studies may also be made a condition to approval of the BLA.
−Removed: with clinical trials, companies may complete additional animal studies and develop additional information about the biological characteristics
−Removed: of the product candidate, and must finalize a process for manufacturing the product in commercial quantities in accordance with cGMP
−Removed: requirements.
−Removed: The manufacturing process must be capable of consistently producing quality batches of the product candidate and, among
−Removed: other things, must develop methods for testing the safety, purity, and potency of the final product.
−Removed: Additionally, appropriate packaging
−Removed: must be selected and tested, and stability studies must be conducted to demonstrate that the product candidate does not undergo unacceptable
−Removed: deterioration over its shelf life.
−Removed: Submission and Review by the FDA
−Removed: successful completion of all required testing in accordance with all applicable regulatory requirements, the results of product development,
−Removed: nonclinical studies and clinical trials are submitted to the FDA as part of a BLA requesting approval to market the product for one or
−Removed: more indications.
−Removed: The BLA must include all relevant data available from preclinical and clinical studies, including negative or ambiguous
−Removed: results as well as positive findings, together with detailed information relating to the product’s chemistry, manufacturing, controls,
−Removed: and proposed labeling, among other things.
−Removed: Data can come from company-sponsored clinical studies intended to test the safety and effectiveness
−Removed: of a use of the product, or from a number of alternative sources, including studies initiated by independent investigators.
−Removed: marketing approval, the data submitted must be sufficient in quality and quantity to establish the safety and effectiveness of the investigational
+Added: The IND automatically becomes effective
+Added: 30 days after receipt by the FDA, unless the FDA, within the 30-day time period, raises safety concerns or questions about the proposed
+Added: clinical trial.
+Added: In such a case, the IND may be placed on clinical hold and the IND sponsor and the FDA must resolve any outstanding concerns
+Added: or questions before the clinical trial can begin.
+Added: Submission of an IND therefore may or may not result in FDA authorization to begin a
+Added: clinical trial.
+Added: In addition to the
+Added: submission of an IND to the FDA before initiation of a clinical trial in the United States, certain human clinical trials involving
+Added: recombinant or synthetic nucleic acid molecules are subject to oversight of institutional biosafety committees, or IBCs, as set
+Added: forth in the National Institutes of Health, or NIH, Guidelines for Research Involving Recombinant DNA Molecules, or the NIH
+Added: Specifically, under the NIH Guidelines, supervision of human gene transfer trials includes evaluation and assessment by
+Added: an IBC, a local institutional committee that reviews and oversees research utilizing recombinant or synthetic nucleic acid molecules
+Added: at that institution.
+Added: The IBC assesses the safety of the research and identifies any potential risk to public health or the
+Added: environment, and such review may result in some delay before initiation of a clinical trial.
+Added: While the NIH Guidelines are not
+Added: mandatory unless the research in question is being conducted at or sponsored by institutions receiving NIH funding of recombinant or
+Added: synthetic nucleic acid molecule research, many companies and other institutions not otherwise subject to the NIH Guidelines
+Added: voluntarily follow them.
+Added: Clinical trials involve the
+Added: administration of the investigational product to human subjects under the supervision of qualified investigators in accordance with GCPs,
+Added: which include the requirement that all research subjects provide their informed consent for their participation in any clinical study.
+Added: Clinical trials are conducted under protocols detailing, among other things, the objectives of the study, the parameters to be used in
+Added: monitoring safety and the effectiveness criteria to be evaluated.
+Added: A separate submission to the existing IND must be made for each successive
+Added: clinical trial conducted during product development and for any subsequent protocol amendments.
+Added: Furthermore, an independent IRB for each
+Added: site proposing to conduct the clinical trial must review and approve the plan for any clinical trial and its informed consent form before
+Added: the clinical trial begins at that site, and must monitor the study until completed.
+Added: An IRB is charged with protecting the welfare and
+Added: rights of trial participants and considers such items as whether the risks to individuals participating in the clinical trials are minimized
+Added: and are reasonable in relation to anticipated benefits.
+Added: The IRB also approves the informed consent form that must be provided to each
+Added: clinical trial subject or his or her legal representative and must monitor the clinical trial until completed.
+Added: Regulatory authorities,
+Added: the IRB or the sponsor may suspend a clinical trial at any time on various grounds, including a finding that the subjects are being exposed
+Added: to an unacceptable health risk or that the trial is unlikely to meet its stated objectives.
+Added: Some studies also include oversight by an
+Added: independent group of qualified experts organized by the clinical study sponsor, known as a data safety monitoring board, which provides
+Added: authorization for whether or not a study may move forward at designated check points based on access to certain data from the study and
+Added: may halt the clinical trial if it determines that there is an unacceptable safety risk for subjects or other grounds, such as no demonstration
+Added: There are also requirements governing the reporting of ongoing clinical studies and clinical study results to public registries.
+Added: For purposes of BLA approval,
+Added: human clinical trials are typically conducted in three sequential phases that may overlap or be combined:
+Added: Phase 1 — The investigational product is initially introduced into healthy human subjects or patients with the target disease or condition.
+Added: These studies are designed to test the safety, dosage tolerance, absorption, metabolism, and distribution of the investigational product in humans, the side effects associated with increasing doses, and, if possible, to gain early evidence on effectiveness.
+Added: In the case of some products for severe or life-threatening diseases, such as cancer, especially when the product may be too inherently toxic to ethically administer to healthy volunteers, the initial human testing is often conducted in patients.
+Added: Phase 2 — The investigational product is administered to a limited patient population with a specified disease or condition to evaluate the preliminary efficacy, optimal dosages, dose tolerance, and dosing schedule and to identify possible adverse side effects and safety risks.
+Added: Multiple Phase 2 clinical trials may be conducted to obtain information prior to beginning larger and more expensive Phase 3 clinical trials.
+Added: Phase 3 — The investigational product is administered to an expanded patient population to further evaluate dosage, to provide statistically significant evidence of clinical efficacy and to further test for safety, generally at multiple geographically dispersed clinical trial sites.
+Added: These clinical trials are intended to establish the overall risk/benefit ratio of the investigational product and to provide an adequate basis for product approval.
+Added: Generally, two adequate and well-controlled Phase 3 clinical trials are required by the FDA for approval of a BLA.
+Added: In some cases, the FDA may
+Added: require, or companies may voluntarily pursue, additional clinical trials after a product is approved to gain more information about the
+Added: product in the intended therapeutic indication, particularly for long-term safety follow-up.
+Added: Completion of these so-called Phase 4 studies
+Added: may also be made a condition to approval of the BLA.
+Added: Concurrent with clinical trials,
+Added: companies may complete additional animal studies and develop additional information about the biological characteristics of the product
+Added: candidate, and must finalize a process for manufacturing the product in commercial quantities in accordance with cGMP requirements.
+Added: manufacturing process must be capable of consistently producing quality batches of the product candidate and, among other things, must
+Added: develop methods for testing the safety, purity, and potency of the final product.
+Added: Additionally, appropriate packaging must be selected
+Added: and tested, and stability studies must be conducted to demonstrate that the product candidate does not undergo unacceptable deterioration
+Added: over its shelf life.
+Added: BLA Submission and Review by the FDA
+Added: Assuming successful completion
+Added: of all required testing in accordance with all applicable regulatory requirements, the results of product development, nonclinical studies
+Added: and clinical trials are submitted to the FDA as part of a BLA requesting approval to market the product for one or more indications.
+Added: BLA must include all relevant data available from preclinical and clinical studies, including negative or ambiguous results as well as
+Added: positive findings, together with detailed information relating to the product’s chemistry, manufacturing, controls, and proposed
+Added: labeling, among other things.
+Added: Data can come from company-sponsored clinical studies intended to test the safety and effectiveness of a
+Added: use of the product, or from a number of alternative sources, including studies initiated by independent investigators.
+Added: To support marketing
+Added: approval, the data submitted must be sufficient in quality and quantity to establish the safety and effectiveness of the investigational
drug product to the satisfaction of the FDA.
1 unchanged sentence
unless a waiver or exemption applies.
−Removed: 60 days following submission of the application, the FDA reviews a BLA submitted to determine if it is substantially complete before
−Removed: the FDA accepts it for filing.
−Removed: The FDA may refuse to file any BLA that it deems incomplete or not properly reviewable at the time of
−Removed: submission and may request additional information.
+Added: Within 60 days following submission
+Added: of the application, the FDA reviews a BLA submitted to determine if it is substantially complete before the FDA accepts it for filing.
+Added: The FDA may refuse to file any BLA that it deems incomplete or not properly reviewable at the time of submission and may request additional
In this event, the BLA must be resubmitted with the additional information.
−Removed: The resubmitted
−Removed: application also is subject to review before the FDA accepts it for filing.
−Removed: a BLA has been accepted for filing, the FDA’s goal is to review standard applications within ten months after the filing date,
−Removed: or, if the application qualifies for priority review, six months after the FDA accepts the application for filing.
−Removed: In both standard and
−Removed: priority reviews, the review process may also be extended by FDA requests for additional information or clarification.
−Removed: The FDA reviews
−Removed: a BLA to determine, among other things, whether a product is safe, pure, and potent and the facility in which it is manufactured, processed,
−Removed: packed, or held meets standards designed to assure the product’s continued safety, purity and potency.
−Removed: The FDA may also convene
−Removed: an advisory committee to provide clinical insight on application review questions.
−Removed: An advisory committee is a panel of independent experts,
−Removed: including clinicians and other scientific experts, that reviews, evaluates and provides a recommendation as to whether the application
−Removed: should be approved and under what conditions.
−Removed: The FDA is not bound by the recommendations of an advisory committee, but it considers
−Removed: such recommendations carefully when making decisions.
−Removed: approving a BLA, the FDA will typically inspect the facility or facilities where the product is manufactured.
−Removed: The FDA will not approve
−Removed: an application unless it determines that the manufacturing processes and facilities are in compliance with cGMP and adequate to assure
−Removed: consistent production of the product within required specifications.
−Removed: For a product candidate that is also a human cellular or tissue
−Removed: product, the FDA also will not approve the application if the manufacturer is not in compliance with cGTPs.
−Removed: These are FDA regulations
−Removed: that govern the methods used in, and the facilities and controls used for, the manufacture of human cells, tissues, and cellular and
−Removed: tissue based products, or HCT/Ps, which are human cells or tissue intended for implantation, transplant, infusion, or transfer into a
−Removed: human recipient.
−Removed: The primary intent of the GTP requirements is to ensure that cell and tissue based products are manufactured in a manner
−Removed: designed to prevent the introduction, transmission and spread of communicable disease.
−Removed: FDA regulations also require tissue establishments
−Removed: to register and list their HCT/Ps with the FDA and, when applicable, to evaluate donors through screening and testing.
−Removed: Additionally,
−Removed: before approving a BLA, the FDA will typically inspect one or more clinical sites to assure compliance with GCP.
−Removed: If the FDA determines
−Removed: that the application, manufacturing process or manufacturing facilities are not acceptable, it will outline the deficiencies in the submission
−Removed: and often will request additional testing or information.
−Removed: Notwithstanding the submission of any requested additional information, the
−Removed: FDA ultimately may decide that the application does not satisfy the regulatory criteria for approval.
−Removed: the FDA evaluates a BLA and conducts inspections of manufacturing facilities where the investigational product and/or its drug substance
−Removed: will be produced, the FDA may issue an approval letter or a Complete Response Letter, or CRL.
−Removed: An approval letter authorizes commercial
−Removed: marketing of the product with specific prescribing information for specific indications.
−Removed: A CRL indicates that the review cycle of the
−Removed: application is complete, and the application will not be approved in its present form.
−Removed: A CRL will describe all of the deficiencies that
−Removed: the FDA has identified in the BLA, except that where the FDA determines that the data supporting the application are inadequate to support
−Removed: approval, the FDA may issue the CRL without first conducting required inspections, testing submitted product lots, and/or reviewing proposed
−Removed: In issuing the CRL, the FDA may recommend actions that the applicant might take to place the BLA in condition for approval,
−Removed: including requests for additional information or clarification.
−Removed: The FDA may delay or refuse approval of a BLA if applicable regulatory
−Removed: criteria are not satisfied, require additional testing or information and/or require post-marketing testing and surveillance to monitor
−Removed: safety or efficacy of a product.
−Removed: If a CRL is issued, the sponsor must resubmit the BLA, addressing all of the deficiencies identified
−Removed: in the letter, or withdraw the application.
−Removed: Even if such data and information are submitted, the FDA may decide that the BLA does not
−Removed: satisfy the criteria for approval.
−Removed: regulatory approval of a product is granted, such approval will be granted for particular indications and may entail limitations on the
−Removed: indicated uses for which such product may be marketed.
−Removed: For example, the FDA may approve the BLA with a Risk Evaluation and Mitigation
−Removed: Strategy, or REMS, to ensure the benefits of the product outweigh its risks, or otherwise limit the scope of any approval.
−Removed: a safety strategy implemented to manage a known or potential serious risk associated with a product and to enable patients to have continued
−Removed: access to such medicines by managing their safe use, and could include medication guides, physician communication plans or elements to
−Removed: assure safe use, such as restricted distribution methods, patient registries and other risk minimization tools.
−Removed: The FDA also may condition
−Removed: approval on, among other things, changes to proposed labeling or the development of adequate controls and specifications.
−Removed: Once approved,
−Removed: the FDA may withdraw the product approval if compliance with pre- and post-marketing requirements is not maintained or if problems occur
−Removed: after the product reaches the marketplace.
−Removed: The FDA may require one or more Phase 4 post-market studies and surveillance to further assess
−Removed: and monitor the product’s safety and effectiveness after commercialization, and may limit further marketing of the product based
−Removed: on the results of these post-marketing studies.
−Removed: Development and Review Programs
−Removed: FDA offers a number of expedited development and review programs for qualifying product candidates.
−Removed: For example, new biological products
−Removed: are eligible for fast track designation if they are intended to treat a serious or life-threatening disease or condition and demonstrate
−Removed: the potential to address unmet medical needs for the disease or condition.
−Removed: Fast track designation applies to the combination of the product
−Removed: and the specific indication for which it is being studied.
−Removed: The sponsor of a new biologic may request that the FDA designate the biologic
−Removed: as a fast track product at any time during the clinical development of the product.
−Removed: The sponsor of a fast track product has opportunities
−Removed: for more frequent interactions with the applicable FDA review team during product development and, once a BLA is submitted, the product
−Removed: candidate may be eligible for priority review.
−Removed: A fast track product may also be eligible for rolling review, where the FDA may consider
−Removed: for review sections of the BLA on a rolling basis before the complete application is submitted, if the sponsor provides a schedule for
−Removed: the submission of the sections of the BLA, the FDA agrees to accept sections of the BLA and determines that the schedule is acceptable,
−Removed: and the sponsor pays any required user fees upon submission of the first section of the BLA.
−Removed: product candidate intended to treat a serious or life-threatening disease or condition may also be eligible for breakthrough therapy
−Removed: designation to expedite its development and review.
−Removed: A product candidate can receive breakthrough therapy designation if preliminary clinical
−Removed: evidence indicates that the product candidate, alone or in combination with one or more other drugs or biologics, may demonstrate substantial
−Removed: improvement over existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early
−Removed: in clinical development.
−Removed: The designation includes all of the fast track program features, as well as more intensive FDA interaction and
−Removed: guidance beginning as early as Phase 1 and an organizational commitment to expedite the development and review of the product candidate,
−Removed: including involvement of senior managers.
−Removed: marketing application for a biologic submitted to the FDA for approval, including a product candidate with a fast track designation and/or
−Removed: breakthrough therapy designation, may be eligible for other types of FDA programs intended to expedite development and review, such as
−Removed: priority review and accelerated approval.
−Removed: A product candidate is eligible for priority review if it has the potential to provide safe
−Removed: and effective therapy where no satisfactory alternative therapy exists or a significant improvement in the treatment, diagnosis or prevention
−Removed: of a disease compared to marketed products.
−Removed: The FDA will attempt to direct additional resources to the evaluation of an application for
−Removed: a new biological product designated for priority review in an effort to facilitate the review.
−Removed: For original BLAs, priority review designation
−Removed: means the FDA’s goal is to take action on the marketing application within six months of the 60-day filing date (as compared to
−Removed: ten months under standard review).
−Removed: Additionally,
−Removed: product candidates studied for their safety and effectiveness in treating serious or life-threatening diseases or conditions may receive
−Removed: accelerated approval upon a determination that the product has an effect on a surrogate endpoint that is reasonably likely to predict
−Removed: clinical benefit, or on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that is reasonably
−Removed: likely to predict an effect on irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity
−Removed: or prevalence of the condition and the availability or lack of alternative treatments.
−Removed: As a condition of accelerated approval, the FDA
−Removed: will generally require the sponsor to perform adequate and well-controlled post-marketing clinical studies to verify and describe the
−Removed: anticipated effect on irreversible morbidity or mortality or other clinical benefit.
−Removed: Products receiving accelerated approval may be subject
−Removed: to expedited withdrawal procedures if the sponsor fails to conduct the required post-marketing studies or if such studies fail to verify
−Removed: the predicted clinical benefit.
−Removed: In addition, for products being considered for accelerated approval, the FDA generally requires, unless
−Removed: otherwise informed by FDA, that all advertising and promotional materials intended for dissemination or publication within 120 days of
−Removed: marketing approval be submitted to FDA for review during the pre-approval period.
−Removed: 2017, the FDA established a new regenerative medicine advanced therapy, or RMAT, designation, which is intended to facilitate an efficient
−Removed: development program for, and expedite review of, any biologic that meets the following criteria:
−Removed: (i) the biologic qualifies as a RMAT,
−Removed: which is defined as a cell therapy, therapeutic tissue engineering product, human cell and tissue product, or any combination product
−Removed: using such therapies or products, with limited exceptions;
−Removed: (ii) the biologic is intended to treat, modify, reverse, or cure a serious
−Removed: or life-threatening disease or condition;
−Removed: and (iii) preliminary clinical evidence indicates that the biologic has the potential to address
−Removed: unmet medical needs for such a disease or condition.
−Removed: RMAT designation provides all the benefits of breakthrough therapy designation,
−Removed: including more frequent meetings with the FDA to discuss the development plan for the product candidate and eligibility for rolling review
−Removed: and priority review.
−Removed: Product candidates granted RMAT designation may also be eligible for accelerated approval on the basis of a surrogate
−Removed: or intermediate endpoint reasonably likely to predict long-term clinical benefit, or reliance upon data obtained from a meaningful number
−Removed: of clinical trial sites, including through expansion of trials to additional sites.
−Removed: RMAT-designated products that receive accelerated
−Removed: approval may, as appropriate, fulfill their post-approval requirements through submission of clinical evidence, clinical studies, patient
−Removed: registries, or other sources of real-world evidence (such as electronic health records);
−Removed: through the collection of larger confirmatory
−Removed: or via post-approval monitoring of all patients treated with such therapy prior to approval of such therapy.
−Removed: track designation, breakthrough therapy designation, priority review, accelerated approval, and RMAT designation do not change the standards
−Removed: for approval but may expedite the development or approval process.
−Removed: Even if a product candidate qualifies for one or more of these programs,
−Removed: the FDA may later decide that the product no longer meets the conditions for qualification or decide that the time period for FDA review
−Removed: or approval will not be shortened.
−Removed: Drug Designation and Exclusivity
−Removed: the Orphan Drug Act, the FDA may grant orphan designation to a biologic intended to treat a rare disease or condition, defined as a disease
−Removed: or condition with a patient population of fewer than 200,000 individuals in the United States, or a patient population greater than 200,000
−Removed: individuals in the United States and when there is no reasonable expectation that the cost of developing and making available the drug
−Removed: or biologic in the United States will be recovered from sales in the United States for that biologic.
−Removed: Orphan drug designation must be
−Removed: requested before submitting a BLA.
−Removed: After the FDA grants orphan drug designation, the generic identity of therapeutic agent and its potential
−Removed: orphan use are disclosed publicly by the FDA.
−Removed: Orphan drug designation does not convey any advantage in or shorten the duration of the
−Removed: regulatory review and approval process.
−Removed: the United States, orphan drug designation entitles a party to financial incentives such as opportunities for grant funding towards clinical
−Removed: trial costs, tax advantages and user-fee waivers.
−Removed: In addition, if a product that has orphan drug designation subsequently receives the
−Removed: first FDA approval for a particular drug or biologic for the disease for which it has such designation, the product is entitled to orphan
−Removed: product exclusivity, which means that the FDA may not approve any other applications, including a full BLA, to market the same biologic
−Removed: for the same indication for seven years, except in limited circumstances, such as a showing of clinical superiority to the product with
−Removed: orphan drug exclusivity or if the FDA finds that the holder of the orphan drug exclusivity has not shown that it can assure the availability
−Removed: of sufficient quantities of the orphan drug to meet the needs of patients with the disease or condition for which the drug was designated.
−Removed: Orphan drug exclusivity does not prevent the FDA from approving a different drug or biologic for the same disease or condition, or the
−Removed: same drug or biologic for a different disease or condition.
−Removed: Competitors may receive approval of different products for the indication
−Removed: for which the orphan product has exclusivity or obtain approval for the same product but for a different indication for which the orphan
−Removed: product has exclusivity.
−Removed: Orphan product exclusivity also could block the approval of one of our products for seven years if a competitor
−Removed: obtains approval of the same biological product as defined by the FDA or if our product candidate is determined to be contained within
−Removed: the competitor’s product for the same indication or disease.
−Removed: designated orphan drug may not receive orphan drug exclusivity if it is approved for a use that is broader than the indication for which
−Removed: it received orphan designation.
−Removed: In addition, orphan drug exclusive marketing rights in the United States may be lost if the FDA later
−Removed: determines that the request for designation was materially defective or, as noted above, if a second applicant demonstrates that its
−Removed: product is clinically superior to the approved product with orphan exclusivity or the manufacturer of the approved product is unable
−Removed: to assure sufficient quantities of the product to meet the needs of patients with the rare disease or condition.
+Added: The resubmitted application also is subject to
+Added: review before the FDA accepts it for filing.
+Added: Once a BLA has been accepted
+Added: for filing, the FDA’s goal is to review standard applications within ten months after the filing date, or, if the application qualifies
+Added: for priority review, six months after the FDA accepts the application for filing.
+Added: In both standard and priority reviews, the review process
+Added: may also be extended by FDA requests for additional information or clarification.
+Added: The FDA reviews a BLA to determine, among other things,
+Added: whether a product is safe, pure, and potent and the facility in which it is manufactured, processed, packed, or held meets standards designed
+Added: to assure the product’s continued safety, purity and potency.
+Added: The FDA may also convene an advisory committee to provide clinical
+Added: insight on application review questions.
+Added: An advisory committee is a panel of independent experts, including clinicians and other scientific
+Added: experts, that reviews, evaluates and provides a recommendation as to whether the application should be approved and under what conditions.
+Added: The FDA is not bound by the recommendations of an advisory committee, but it considers such recommendations carefully when making decisions.
+Added: Before approving a BLA,
+Added: the FDA will typically inspect the facility or facilities where the product is manufactured.
+Added: The FDA will not approve an application
+Added: unless it determines that the manufacturing processes and facilities are in compliance with cGMP and adequate to assure consistent
+Added: production of the product within required specifications.
+Added: For a product candidate that is also a human cellular or tissue product,
+Added: the FDA also will not approve the application if the manufacturer is not in compliance with cGTPs.
+Added: These are FDA regulations that
+Added: govern the methods used in, and the facilities and controls used for, the manufacture of human cells, tissues, and cellular and
+Added: tissue based products, or HCT/Ps, which are human cells or tissue intended for implantation, transplant, infusion, or transfer into
+Added: a human recipient.
+Added: The primary intent of the GTP requirements is to ensure that cell and tissue based products are manufactured in a
+Added: manner designed to prevent the introduction, transmission and spread of communicable disease.
+Added: FDA regulations also require tissue
+Added: establishments to register and list their HCT/Ps with the FDA and, when applicable, to evaluate donors through screening and
+Added: Additionally, before approving a BLA, the FDA will typically inspect one or more clinical sites to assure compliance with
+Added: If the FDA determines that the application, manufacturing process or manufacturing facilities are not acceptable, it will
+Added: outline the deficiencies in the submission and often will request additional testing or information.
+Added: Notwithstanding the submission
+Added: of any requested additional information, the FDA ultimately may decide that the application does not satisfy the regulatory criteria
+Added: for approval.
+Added: After the FDA evaluates a
+Added: BLA and conducts inspections of manufacturing facilities where the investigational product and/or its drug substance will be produced,
+Added: the FDA may issue an approval letter or a Complete Response Letter, or CRL.
+Added: An approval letter authorizes commercial marketing of the
+Added: product with specific prescribing information for specific indications.
+Added: A CRL indicates that the review cycle of the application is complete,
+Added: and the application will not be approved in its present form.
+Added: A CRL will describe all of the deficiencies that the FDA has identified
+Added: in the BLA, except that where the FDA determines that the data supporting the application are inadequate to support approval, the FDA
+Added: may issue the CRL without first conducting required inspections, testing submitted product lots, and/or reviewing proposed labeling.
+Added: issuing the CRL, the FDA may recommend actions that the applicant might take to place the BLA in condition for approval, including requests
+Added: for additional information or clarification.
+Added: The FDA may delay or refuse approval of a BLA if applicable regulatory criteria are not satisfied,
+Added: require additional testing or information and/or require post-marketing testing and surveillance to monitor safety or efficacy of a product.
+Added: If a CRL is issued, the sponsor must resubmit the BLA, addressing all of the deficiencies identified in the letter, or withdraw the application.
+Added: Even if such data and information are submitted, the FDA may decide that the BLA does not satisfy the criteria for approval.
+Added: If regulatory approval of
+Added: a product is granted, such approval will be granted for particular indications and may entail limitations on the indicated uses for which
+Added: such product may be marketed.
+Added: For example, the FDA may approve the BLA with a Risk Evaluation and Mitigation Strategy, or REMS, to ensure
+Added: the benefits of the product outweigh its risks, or otherwise limit the scope of any approval.
+Added: A REMS is a safety strategy implemented
+Added: to manage a known or potential serious risk associated with a product and to enable patients to have continued access to such medicines
+Added: by managing their safe use, and could include medication guides, physician communication plans or elements to assure safe use, such as
+Added: restricted distribution methods, patient registries and other risk minimization tools.
+Added: The FDA also may condition approval on, among other
+Added: things, changes to proposed labeling or the development of adequate controls and specifications.
+Added: Once approved, the FDA may withdraw the
+Added: product approval if compliance with pre- and post-marketing requirements is not maintained or if problems occur after the product reaches
+Added: the marketplace.
+Added: The FDA may require one or more Phase 4 post-market studies and surveillance to further assess and monitor the product’s
+Added: safety and effectiveness after commercialization, and may limit further marketing of the product based on the results of these post-marketing
+Added: Expedited Development and Review Programs
+Added: The FDA offers a number of
+Added: expedited development and review programs for qualifying product candidates.
+Added: For example, new biological products are eligible for fast
+Added: track designation if they are intended to treat a serious or life-threatening disease or condition and demonstrate the potential to address
+Added: unmet medical needs for the disease or condition.
+Added: Fast track designation applies to the combination of the product and the specific indication
+Added: for which it is being studied.
+Added: The sponsor of a new biologic may request that the FDA designate the biologic as a fast track product at
+Added: any time during the clinical development of the product.
+Added: The sponsor of a fast track product has opportunities for more frequent interactions
+Added: with the applicable FDA review team during product development and, once a BLA is submitted, the product candidate may be eligible for
+Added: priority review.
+Added: A fast track product may also be eligible for rolling review, where the FDA may consider for review sections of the BLA
+Added: on a rolling basis before the complete application is submitted, if the sponsor provides a schedule for the submission of the sections
+Added: of the BLA, the FDA agrees to accept sections of the BLA and determines that the schedule is acceptable, and the sponsor pays any required
+Added: user fees upon submission of the first section of the BLA.
+Added: A product candidate intended
+Added: to treat a serious or life-threatening disease or condition may also be eligible for breakthrough therapy designation to expedite its
+Added: development and review.
+Added: A product candidate can receive breakthrough therapy designation if preliminary clinical evidence indicates that
+Added: the product candidate, alone or in combination with one or more other drugs or biologics, may demonstrate substantial improvement over
+Added: existing therapies on one or more clinically significant endpoints, such as substantial treatment effects observed early in clinical development.
+Added: The designation includes all of the fast track program features, as well as more intensive FDA interaction and guidance beginning as early
+Added: as Phase 1 and an organizational commitment to expedite the development and review of the product candidate, including involvement of
+Added: senior managers.
+Added: Any marketing application
+Added: for a biologic submitted to the FDA for approval, including a product candidate with a fast track designation and/or breakthrough therapy
+Added: designation, may be eligible for other types of FDA programs intended to expedite development and review, such as priority review and
+Added: accelerated approval.
+Added: A product candidate is eligible for priority review if it has the potential to provide safe and effective therapy
+Added: where no satisfactory alternative therapy exists or a significant improvement in the treatment, diagnosis or prevention of a disease compared
+Added: to marketed products.
+Added: The FDA will attempt to direct additional resources to the evaluation of an application for a new biological product
+Added: designated for priority review in an effort to facilitate the review.
+Added: For original BLAs, priority review designation means the FDA’s
+Added: goal is to take action on the marketing application within six months of the 60-day filing date (as compared to ten months under standard
+Added: Additionally, product candidates
+Added: studied for their safety and effectiveness in treating serious or life-threatening diseases or conditions may receive accelerated approval
+Added: upon a determination that the product has an effect on a surrogate endpoint that is reasonably likely to predict clinical benefit, or
+Added: on a clinical endpoint that can be measured earlier than irreversible morbidity or mortality, that is reasonably likely to predict an
+Added: effect on irreversible morbidity or mortality or other clinical benefit, taking into account the severity, rarity or prevalence of the
+Added: condition and the availability or lack of alternative treatments.
+Added: As a condition of accelerated approval, the FDA will generally require
+Added: the sponsor to perform adequate and well-controlled post-marketing clinical studies to verify and describe the anticipated effect on irreversible
+Added: morbidity or mortality or other clinical benefit.
+Added: Products receiving accelerated approval may be subject to expedited withdrawal procedures
+Added: if the sponsor fails to conduct the required post-marketing studies or if such studies fail to verify the predicted clinical benefit.
+Added: In addition, for products being considered for accelerated approval, the FDA generally requires, unless otherwise informed by FDA, that
+Added: all advertising and promotional materials intended for dissemination or publication within 120 days of marketing approval be submitted
+Added: to FDA for review during the pre-approval period.
+Added: In 2017, the FDA established
+Added: a new regenerative medicine advanced therapy, or RMAT, designation, which is intended to facilitate an efficient development program for,
+Added: and expedite review of, any biologic that meets the following criteria:
+Added: (i) the biologic qualifies as a RMAT, which is defined as a cell
+Added: therapy, therapeutic tissue engineering product, human cell and tissue product, or any combination product using such therapies or products,
+Added: with limited exceptions;
+Added: (ii) the biologic is intended to treat, modify, reverse, or cure a serious or life-threatening disease or condition;
+Added: and (iii) preliminary clinical evidence indicates that the biologic has the potential to address unmet medical needs for such a disease
+Added: or condition.
+Added: RMAT designation provides all the benefits of breakthrough therapy designation, including more frequent meetings with the
+Added: FDA to discuss the development plan for the product candidate and eligibility for rolling review and priority review.
+Added: Product candidates
+Added: granted RMAT designation may also be eligible for accelerated approval on the basis of a surrogate or intermediate endpoint reasonably
+Added: likely to predict long-term clinical benefit, or reliance upon data obtained from a meaningful number of clinical trial sites, including
+Added: through expansion of trials to additional sites.
+Added: RMAT-designated products that receive accelerated approval may, as appropriate, fulfill
+Added: their post-approval requirements through submission of clinical evidence, clinical studies, patient registries, or other sources of real-world
+Added: evidence (such as electronic health records);
+Added: through the collection of larger confirmatory data sets;
+Added: or via post-approval monitoring
+Added: of all patients treated with such therapy prior to approval of such therapy.
+Added: Fast track designation, breakthrough
+Added: therapy designation, priority review, accelerated approval, and RMAT designation do not change the standards for approval but may expedite
+Added: the development or approval process.
+Added: Even if a product candidate qualifies for one or more of these programs, the FDA may later decide
+Added: that the product no longer meets the conditions for qualification or decide that the time period for FDA review or approval will not be
+Added: Orphan Drug Designation and Exclusivity
+Added: Under the Orphan Drug
+Added: Act, the FDA may grant orphan designation to a biologic intended to treat a rare disease or condition, defined as a disease or
+Added: condition with a patient population of fewer than 200,000 individuals in the United States, or a patient population greater than
+Added: 200,000 individuals in the United States and when there is no reasonable expectation that the cost of developing and making
+Added: available the drug or biologic in the United States will be recovered from sales in the United States for that biologic.
+Added: designation must be requested before submitting a BLA.
+Added: After the FDA grants orphan drug designation, the generic identity of
+Added: therapeutic agent and its potential orphan use are disclosed publicly by the FDA.
+Added: Orphan drug designation does not convey any
+Added: advantage in or shorten the duration of the regulatory review and approval process.
+Added: In the United States, orphan
+Added: drug designation entitles a party to financial incentives such as opportunities for grant funding towards clinical trial costs, tax advantages
+Added: and user-fee waivers.
+Added: In addition, if a product that has orphan drug designation subsequently receives the first FDA approval for a particular
+Added: drug or biologic for the disease for which it has such designation, the product is entitled to orphan product exclusivity, which means
+Added: that the FDA may not approve any other applications, including a full BLA, to market the same biologic for the same indication for seven
+Added: years, except in limited circumstances, such as a showing of clinical superiority to the product with orphan drug exclusivity or if the
+Added: FDA finds that the holder of the orphan drug exclusivity has not shown that it can assure the availability of sufficient quantities of
+Added: the orphan drug to meet the needs of patients with the disease or condition for which the drug was designated.
+Added: Orphan drug exclusivity
+Added: does not prevent the FDA from approving a different drug or biologic for the same disease or condition, or the same drug or biologic for
+Added: a different disease or condition.
+Added: Competitors may receive approval of different products for the indication for which the orphan product
+Added: has exclusivity or obtain approval for the same product but for a different indication for which the orphan product has exclusivity.
+Added: product exclusivity also could block the approval of one of our products for seven years if a competitor obtains approval of the same
+Added: biological product as defined by the FDA or if our product candidate is determined to be contained within the competitor’s product
+Added: for the same indication or disease.
+Added: A designated orphan drug may
+Added: not receive orphan drug exclusivity if it is approved for a use that is broader than the indication for which it received orphan designation.
+Added: In addition, orphan drug exclusive marketing rights in the United States may be lost if the FDA later determines that the request for
+Added: designation was materially defective or, as noted above, if a second applicant demonstrates that its product is clinically superior to
+Added: the approved product with orphan exclusivity or the manufacturer of the approved product is unable to assure sufficient quantities of
+Added: the product to meet the needs of patients with the rare disease or condition.
Post-Approval Requirements
31 unchanged sentences
Other potential consequences include, among other things:
−Removed: ● restrictions on the marketing or manufacturing of the product, complete withdrawal of the product from
−Removed: the market or product recalls;
+Added: restrictions on the marketing or manufacturing of the product, complete withdrawal of the product from the market or product recalls;
fines, warning letters, or untitled letters;
clinical holds on clinical studies;
−Removed: ● refusal of the FDA to approve pending applications or supplements to approved applications, or suspension
−Removed: or revocation of product license approvals;
+Added: refusal of the FDA to approve pending applications or supplements to approved applications, or suspension or revocation of product license approvals;
product seizure or detention, or refusal to permit the import or export of products;
1 unchanged sentence
mandated modification of promotional materials and labeling and the issuance of corrective information;
−Removed: ● the issuance of safety alerts, Dear Healthcare Provider letters, press releases and other communications
−Removed: containing warnings or other safety information about the product;
+Added: the issuance of safety alerts, Dear Healthcare Provider letters, press releases and other communications containing warnings or other safety information about the product;
injunctions or the imposition of civil or criminal penalties.
32 unchanged sentences
of off-label use of their products.
−Removed: Biosimilars and
−Removed: Reference Product Exclusivity
+Added: Biosimilars and Reference Product Exclusivity
The Affordable Care Act, signed
36 unchanged sentences
As a result, the ultimate impact, implementation, and impact of the BPCIA is subject to significant
−Removed: Government Regulation
−Removed: Outside of the United States
+Added: Government Regulation Outside of the United
In addition to regulations
17 unchanged sentences
their origin in the Declaration of Helsinki.
−Removed: To obtain regulatory approval
−Removed: of an investigational biological product under European Union regulatory systems, we must submit a marketing authorization application.
−Removed: The application used to file the BLA in the United States is similar to that required in the European Union, with the exception of, among
−Removed: other things, country-specific document requirements.
−Removed: The European Union also provides opportunities for market exclusivity.
−Removed: in the European Union, upon receiving marketing authorization, new chemical entities generally receive eight years of data exclusivity
−Removed: and an additional two years of market exclusivity.
−Removed: If granted, data exclusivity prevents regulatory authorities in the European Union
−Removed: from referencing the innovator’s data to assess a generic application.
−Removed: During the additional two-year period of market exclusivity,
−Removed: a generic marketing authorization can be submitted, and the innovator’s data may be referenced, but no generic product can be marketed
−Removed: until the expiration of the market exclusivity.
−Removed: However, there is no guarantee that a product will be considered by the European Union’s
−Removed: regulatory authorities to be a new chemical entity, and products may not qualify for data exclusivity.
−Removed: Products receiving orphan designation
−Removed: in the European Union can receive ten years of market exclusivity, during which time no similar medicinal product for the same indication
−Removed: may be placed on the market.
−Removed: An orphan product can also obtain an additional two years of market exclusivity in the European Union for
−Removed: pediatric studies.
−Removed: No extension to any supplementary protection certificate can be granted on the basis of pediatric studies for orphan
+Added: To obtain regulatory
+Added: approval of an investigational biological product under European Union regulatory systems, we must submit a marketing authorization
+Added: The application used to file the BLA in the United States is similar to that required in the European Union, with the
+Added: exception of, among other things, country-specific document requirements.
+Added: The European Union also provides opportunities for market
+Added: For example, in the European Union, upon receiving marketing authorization, new chemical entities generally receive
+Added: eight years of data exclusivity and an additional two years of market exclusivity.
+Added: If granted, data exclusivity prevents regulatory
+Added: authorities in the European Union from referencing the innovator’s data to assess a generic application.
+Added: During the additional
+Added: two-year period of market exclusivity, a generic marketing authorization can be submitted, and the innovator’s data may be
+Added: referenced, but no generic product can be marketed until the expiration of the market exclusivity.
+Added: However, there is no guarantee
+Added: that a product will be considered by the European Union’s regulatory authorities to be a new chemical entity, and products may
+Added: not qualify for data exclusivity.
+Added: Products receiving orphan designation in the European Union can receive ten years of market
+Added: exclusivity, during which time no similar medicinal product for the same indication may be placed on the market.
+Added: An orphan product
+Added: can also obtain an additional two years of market exclusivity in the European Union for pediatric studies.
+Added: No extension to any
+Added: supplementary protection certificate can be granted on the basis of pediatric studies for orphan indications.
The criteria for designating
22 unchanged sentences
authorization may be granted to a similar product for the same indication at any time if:
−Removed: ● The second applicant can establish that its product, although similar, is safer, more effective, or otherwise
−Removed: clinically superior;
+Added: The second applicant can establish that its product, although similar, is safer, more effective, or otherwise clinically superior;
The applicant consents to a second orphan medicinal product application;
8 unchanged sentences
product recalls, seizure of products, operating restrictions and criminal prosecution.
−Removed: Other Healthcare
+Added: Other Healthcare Laws
Pharmaceutical companies are
58 unchanged sentences
to the health care system that could impact our ability to sell our products profitably.
−Removed: In the United States, in March
−Removed: 2010, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, each as amended,
−Removed: collectively known as the ACA, was enacted, which substantially changed the way healthcare is financed by both governmental and private
−Removed: insurers, and significantly affected the pharmaceutical industry.
−Removed: The ACA contained a number of provisions, including those governing
−Removed: enrollment in federal healthcare programs, reimbursement adjustments and changes to fraud and abuse laws.
−Removed: For example, the ACA:
−Removed: ● increased the minimum level of Medicaid rebates payable by manufacturers of brand name drugs from 15.1%
−Removed: to 23.1% of the average manufacturer price;
+Added: In the United States, in
+Added: March 2010, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, each as
+Added: amended, collectively known as the ACA, was enacted, which substantially changed the way healthcare is financed by both governmental
+Added: and private insurers, and significantly affected the pharmaceutical industry.
+Added: The ACA contained a number of provisions, including
+Added: those governing enrollment in federal healthcare programs, reimbursement adjustments and changes to fraud and abuse laws.
+Added: example, the ACA:
+Added: increased the minimum level of Medicaid rebates payable by manufacturers of brand name drugs from 15.1% to 23.1% of the average manufacturer price;
required collection of rebates for drugs paid by Medicaid managed care organizations;
−Removed: ● required manufacturers to participate in a coverage gap discount program, under which they must now agree
−Removed: to offer 70% point-of-sale discounts off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap
−Removed: period, as a condition for the manufacturer’s outpatient drugs to be covered under Medicare Part D;
−Removed: ● imposed a non-deductible annual fee on pharmaceutical manufacturers or importers who sell “branded
−Removed: prescription drugs” to specified federal government programs.
+Added: required manufacturers to participate in a coverage gap discount program, under which they must now agree to offer 70% point-of-sale discounts off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for the manufacturer’s outpatient drugs to be covered under Medicare Part D;
+Added: imposed a non-deductible annual fee on pharmaceutical manufacturers or importers who sell “branded prescription drugs” to specified federal government programs.
On June 17, 2021, the U.S.
8 unchanged sentences
reform measures of the Biden administrations or other efforts, if any, to challenge repeal or replace the ACA, will impact our business.
−Removed: Other legislative changes
−Removed: have been proposed and adopted in the United States since the Affordable Care Act was enacted.
−Removed: For example, on March 11, 2021, President
−Removed: Biden signed the American Rescue Plan Act of 2021 into law, which eliminates the statutory Medicaid drug rebate cap, currently set at
−Removed: 100% of a drug’s average manufacturer price, for single source and innovator multiple source drugs, beginning January 1, 2024.
−Removed: in August 2011, the Budget Control Act of 2011, among other things, created measures for spending reductions by Congress.
−Removed: A Joint Select
−Removed: Committee on Deficit Reduction, tasked with recommending a targeted deficit reduction of at least $1.2 trillion for the years 2013 through
−Removed: 2021, was unable to reach required goals, thereby triggering the legislation’s automatic reduction to several government programs,
−Removed: including aggregate reductions of Medicare payments to providers of 2% per fiscal year.
−Removed: These reductions went into effect in April 2013
−Removed: and, due to subsequent legislative amendments to the statute, will remain in effect through 2030 unless additional action is taken by
−Removed: Pursuant to the Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act, as well as subsequent legislation,
−Removed: these reductions have been suspended from May 1, 2020 through December 31, 2021 due to the COVID-19 pandemic.
+Added: Other legislative
+Added: changes have been proposed and adopted in the United States since the Affordable Care Act was enacted.
+Added: For example, on March 11,
+Added: 2021, President Biden signed the American Rescue Plan Act of 2021 into law, which eliminates the statutory Medicaid drug rebate cap,
+Added: previously set at 100% of a drug’s average manufacturer price, for single source and innovator multiple source drugs,
+Added: effective since January 1, 2024.
+Added: Further, in August 2011, the Budget Control Act of 2011, among other things, created measures for
+Added: spending reductions by Congress.
+Added: A Joint Select Committee on Deficit Reduction, tasked with recommending a targeted deficit
+Added: reduction of at least $1.2 trillion for the years 2013 through 2021, was unable to reach required goals, thereby triggering the
+Added: legislation’s automatic reduction to several government programs, including aggregate reductions of Medicare payments to
+Added: providers of 2% per fiscal year.
+Added: These reductions went into effect in April 2013 and, due to subsequent legislative amendments to
+Added: the statute, will remain in effect through 2032 unless additional action is taken by Congress.
+Added: Pursuant to the Coronavirus Aid,
+Added: Relief, and Economic Security Act, also known as the CARES Act, as well as subsequent legislation, these reductions were suspended
+Added: from May 1, 2020 through March 31, 2022 due to the COVID-19 pandemic;
+Added: they were limited to 1% from April 1, 2022 through June 30,
+Added: 2022, and fully reinstated at 2% thereafter.
+Added: However, under the Statutory Pay-As-You-Go Act of 2010, additional sequestration
+Added: reductions of up to 4% have been triggered for 2026 in response to federal spending increases, resulting in a total effective
+Added: reduction of 4% for Medicare payments in that year, as Medicare cuts are capped at 4% under the law.
Further, on May 30, 2018,
6 unchanged sentences
eligible patients as a result of the Right to Try Act.
−Removed: Moreover, there has recently
−Removed: been heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, which has resulted
−Removed: in several Congressional inquiries, proposed and enacted legislation and executive orders issued by the previous administration designed
−Removed: to, among other things, bring more transparency to product pricing, review the relationship between pricing and manufacturer patient programs,
−Removed: and reform government program reimbursement methodologies for drug products.
−Removed: The likelihood of success of these and other measures initiated
−Removed: by the previous administration is uncertain, particularly in light of the new Biden administration.
−Removed: It is also possible that additional
−Removed: governmental action is taken in response to the COVID-19 pandemic.
−Removed: Individual states in the United States have also become increasingly
−Removed: active in implementing regulations designed to control pharmaceutical product pricing, including price or patient reimbursement constraints,
−Removed: discounts, restrictions on certain product access and marketing cost disclosure and transparency measures, and, in some cases, designed
−Removed: to encourage importation from other countries and bulk purchasing.
−Removed: Data Privacy and
−Removed: Security Laws
+Added: Moreover, there has been
+Added: heightened governmental scrutiny over the manner in which manufacturers set prices for their marketed products, which has resulted
+Added: in several Congressional inquiries, proposed and enacted legislation, and executive orders designed to, among other things, bring
+Added: more transparency to product pricing, review the relationship between pricing and manufacturer patient programs, and reform
+Added: government program reimbursement methodologies for drug products.
+Added: Key developments include the Inflation Reduction Act of 2022,
+Added: which authorizes the Secretary of Health and Human Services to negotiate maximum fair prices for certain high-cost drugs covered
+Added: under Medicare Part D starting in 2026 and Part B starting in 2028.
+Added: The first set of negotiated prices for 10 Part D drugs took
+Added: effect on January 1, 2026, resulting in discounts ranging from 38% to 79% off 2023 list prices and estimated annual savings of $6
+Added: billion for Medicare and $1.5 billion in out-of-pocket costs for beneficiaries.
+Added: Additional cycles of negotiation are ongoing, with
+Added: prices for 15 more Part D drugs effective in 2027 and the inclusion of Part B drugs in 2028.
+Added: Further, in February 2026, Congress
+Added: passed bipartisan legislation reforming pharmacy benefit managers (PBMs), banning spread pricing in Medicaid and requiring 100%
+Added: rebate pass-throughs to employers, with PBM compensation shifting to flat fees starting in 2028.
+Added: Under the current Trump
+Added: administration, executive actions have advanced most-favored-nation (MFN) pricing, with agreements announced in December 2025 for
+Added: nine pharmaceutical companies to align U.S.
+Added: prices with those in other developed nations for certain products, extending to Medicaid
+Added: In January 2026, the Department of Health and Human Services issued guidance allowing manufacturers to offer lower-cost
+Added: drugs directly to patients, including Medicare and Medicaid enrollees, under safeguards to comply with anti-kickback statutes.
+Added: Individual states in the United States have also become increasingly active in implementing regulations designed to control
+Added: pharmaceutical product pricing, including price or patient reimbursement constraints, discounts, restrictions on certain product
+Added: access and marketing cost disclosure and transparency measures, and, in some cases, designed to encourage importation from other
+Added: countries and bulk purchasing.
+Added: Data Privacy and Security Laws
We also are or will become
6 unchanged sentences
further conditions of their own, including limitations which could limit our ability to collect, use and share personal data.
−Removed: The GDPR imposes onerous accountability
−Removed: obligations requiring data controllers and processors to maintain a record of their data processing and implement policies as part of
−Removed: its mandated privacy governance framework.
−Removed: It also requires data controllers to be transparent and disclose to data subjects (in a concise,
−Removed: intelligible and easily accessible form) how their personal information is to be used;
−Removed: imposes limitations on retention of personal data;
+Added: The GDPR imposes onerous
+Added: accountability obligations requiring data controllers and processors to maintain a record of their data processing and implement
+Added: policies as part of its mandated privacy governance framework.
+Added: It also requires data controllers to be transparent and disclose to
+Added: data subjects (in a concise, intelligible and easily accessible form) how their personal information is to be used;
+Added: limitations on retention of personal data;
defines pseudonymized (i.e., key-coded) data;
−Removed: introduces mandatory data breach notification requirements;
−Removed: and sets higher standards for
−Removed: data controllers to demonstrate that they have obtained valid consent for certain data processing activities.
−Removed: Fines for certain breaches
−Removed: of the GDPR are significant:
−Removed: up to the greater of €20 million or 4% of total global annual turnover.
−Removed: A breach of the GDPR or other
−Removed: applicable privacy and data protection laws and regulations could also result in regulatory investigations, reputational damage, orders
−Removed: to cease/change our use of data, enforcement notices, or potential civil claims including class action type litigation.
−Removed: Further, from
−Removed: January 1, 2021, we have to comply with the GDPR and separately the UK GDPR, which, together with the amended UK Data Protection Act 2018,
−Removed: retains the GDPR in UK national law.
−Removed: The GDPR and the UK GDPR each have the ability to fine up to the greater of €20 million/£17
−Removed: million or 4% of global turnover.
−Removed: Further, the relationship between the United Kingdom and the European Union in relation to certain aspects
−Removed: of data protection law remains unclear, including how data transfers between European Union member states and the United Kingdom will
−Removed: be treated and how United Kingdom data protection laws and regulations will develop in the medium to longer term.
−Removed: Currently there is a
−Removed: four to six-month grace period agreed in the European Union and United Kingdom Trade and Cooperation Agreement, ending June 30, 2021 at
−Removed: the latest, whilst the parties discuss an adequacy decision.
−Removed: The European Commission published a draft adequacy decision on February 19,
−Removed: If adopted, the decision will enable data transfers from European Union member states to the United Kingdom for a four-year period,
−Removed: subject to subsequent extensions.
−Removed: These changes may lead to additional compliance costs and could increase our overall risk.
−Removed: In addition, the GDPR places
−Removed: restrictions on cross-border data transfers.
−Removed: Certain aspects of cross-border data transfers under the GDPR are uncertain as the result
−Removed: of legal proceedings in the European Union, including a recent decision by the Court of Justice for the European Union that invalidated
−Removed: Privacy Shield and, to some extent, called into question the efficacy and legality of using standard contractual clauses.
−Removed: This may increase the complexity of transferring personal data across borders.
−Removed: The GDPR will increase our responsibility and liability
−Removed: in relation to personal data that we process where such processing is subject to the GDPR, and we may be required to put in place additional
−Removed: mechanisms to ensure compliance with the GDPR, including as implemented by individual countries.
−Removed: We are also subject to European Union
−Removed: rules with respect to cross-border transfers of personal data out of the EEA.
−Removed: Recent legal developments in the European Union have created
−Removed: complexity and uncertainty regarding transfers of personal data from the EEA to other countries whose data protection standards have not
−Removed: been deemed “adequate” by the European Commission (including the United States).
−Removed: On July 16, 2020, the Court of Justice of
−Removed: the European Union, or CJEU, invalidated the EU-US Privacy Shield Framework, or Privacy Shield, under which personal data could be transferred
−Removed: from the EEA to US entities who had self-certified under the Privacy Shield scheme.
−Removed: While the CJEU upheld the adequacy, subject to certain
−Removed: conditions, of the standard contractual clauses (a standard form of contract approved by the European Commission as an adequate personal
−Removed: data transfer mechanism), future regulatory guidance could result in changes to the use of standard contractual clauses.
−Removed: As supervisory
−Removed: authorities issue further guidance on personal data export mechanisms, including circumstances where the standard contractual clauses
−Removed: cannot be used, and/or start taking enforcement action, we could suffer additional costs, complaints and/or regulatory investigations
−Removed: or fines, and/or if we are otherwise unable to transfer personal data between and among countries and regions in which we operate, it
−Removed: could affect the manner in which we provide our services, the geographical location or segregation of our relevant systems and operations,
−Removed: and could adversely affect our financial results.
+Added: introduces mandatory data breach
+Added: notification requirements;
+Added: and sets higher standards for data controllers to demonstrate that they have obtained valid consent for
+Added: certain data processing activities.
+Added: Fines for certain breaches of the GDPR are significant:
+Added: up to the greater of €20 million or
+Added: 4% of total global annual turnover.
+Added: A breach of the GDPR or other applicable privacy and data protection laws and regulations could
+Added: also result in regulatory investigations, reputational damage, orders to cease/change our use of data, enforcement notices, or
+Added: potential civil claims including class action type litigation.
+Added: Further, we comply with the GDPR and separately the UK GDPR, which,
+Added: together with the amended UK Data Protection Act 2018, retains the GDPR in UK national law.
+Added: The GDPR and the UK GDPR each have the
+Added: ability to fine up to the greater of €20 million/£17 million or 4% of global turnover.
+Added: The European Commission renewed
+Added: the UK adequacy decisions under the GDPR and the Law Enforcement Directive in December 2025, extending them until December 2031,
+Added: enabling continued free flow of personal data from EEA member states to the UK.
+Added: These decisions are subject to a mid-term review
+Added: after four years and may be renewed further based on ongoing assessments.
+Added: These frameworks may lead to additional compliance costs
+Added: and could increase our overall risk.
+Added: In addition, the GDPR
+Added: places restrictions on cross-border data transfers.
+Added: Certain aspects of cross-border data transfers under the GDPR remain subject to
+Added: ongoing regulatory guidance and enforcement.
+Added: The GDPR will increase our responsibility and liability in relation to personal data
+Added: that we process where such processing is subject to the GDPR, and we may be required to put in place additional mechanisms to ensure
+Added: compliance with the GDPR, including as implemented by individual countries.
+Added: We are also subject to European Union rules with respect
+Added: to cross-border transfers of personal data out of the EEA.
+Added: Recent legal developments in the European Union have created complexity
+Added: and uncertainty regarding transfers of personal data from the EEA to other countries whose data protection standards have not been
+Added: deemed “adequate” by the European Commission (including the United States).
+Added: On July 10, 2023, the European Commission
+Added: adopted an adequacy decision for the EU-US Data Privacy Framework, which remains in effect as of February 2026 and enables transfers
+Added: of personal data from the EEA to US entities certified under the framework.
+Added: As supervisory authorities issue further guidance on
+Added: personal data export mechanisms, we could suffer additional costs, complaints and/or regulatory investigations or fines, and/or if
+Added: we are otherwise unable to transfer personal data between and among countries and regions in which we operate, it could affect the
+Added: manner in which we provide our services, the geographical location or segregation of our relevant systems and operations, and could
+Added: adversely affect our financial results.
Further, the exit of the United
1 unchanged sentence
Specifically, the UK exited the European Union on January 1, 2020, subject to a transition period that ended December 31, 2020.
−Removed: Under the post-Brexit Trade and Cooperation Agreement between the European Union and the UK, the UK and European Union have agreed that
+Added: Under the post-Brexit Trade and Cooperation Agreement between the European Union and the UK, the UK and European Union agreed that
transfers of personal data to the UK from EEA member states will not be treated as ‘restricted transfers’ to a non-EEA country.
−Removed: for a period of up to four months from January 1, 2021, plus a potential further two months extension, or the Extended Adequacy Assessment
−Removed: Although the current maximum duration of the Extended Adequacy Assessment Period is six months, it may end sooner, for example,
−Removed: in the event that the European Commission adopts an adequacy decision in respect of the UK, or the UK amends the UK GDPR and/or makes
−Removed: certain changes regarding data transfers under the UK GDPR/Data Protection Act 2018 without the consent of the European Union (unless
−Removed: those amendments or decisions are made simply to keep relevant UK laws aligned with the European Union’s data protection regime).
−Removed: If the European Commission does not adopt an ‘adequacy decision’ in respect of the UK prior to the expiry of the Extended
−Removed: Adequacy Assessment Period, from that point onwards the UK will be an ‘inadequate third country’ under the GDPR and transfers
−Removed: of personal data from the EEA to the UK will require a ‘transfer mechanism’ such as the Standard Contractual Clauses.
−Removed: In the United States, numerous
−Removed: federal and state laws and regulations, including data breach notification laws, health information privacy and security laws, including
−Removed: HIPAA, and federal and state consumer protection laws and regulations (e.g., Section 5 of the Federal Trade Commission Act) that govern
−Removed: the collection, use, disclosure, and protection of health-related and other personal information could apply to our operations or the
−Removed: operations of our partners.
−Removed: In addition, certain state laws govern the privacy and security of personal information, including health-related
−Removed: information in certain circumstances, some of which are more stringent than HIPAA and many of which differ from each other in significant
−Removed: ways and may not have the same effect, thus complicating compliance efforts.
−Removed: For example, California enacted the CCPA, which creates individual
−Removed: privacy rights for California consumers (as defined in the law) and places increased privacy and security obligations on entities handling
−Removed: certain personal data of consumers or households.
−Removed: The CCPA requires covered companies to provide new disclosure to consumers about such
−Removed: companies’ data collection, use and sharing practices, provide such consumers new ways to opt-out of certain sales or transfers
−Removed: of personal information, and provide consumers with additional causes of action.
−Removed: The CCPA provides for civil penalties for violations,
−Removed: as well as a private right of action for certain data breaches that result in the loss of personal information.
−Removed: This private right of
−Removed: action may increase the likelihood of, and risks associated with, data breach litigation.
−Removed: The CCPA became effective on January 1, 2020,
−Removed: and (a) allows the California Attorney General to impose civil penalties for violations and (b) authorizes private lawsuits to recover
−Removed: statutory damages for certain data breaches.
+Added: The European Commission renewed the UK adequacy decisions in December
+Added: 2025, extending them until December 2031, subject to a mid-term review after four years.
+Added: These decisions enable the free flow of personal
+Added: data from EEA member states to the UK without additional transfer mechanisms.
+Added: In the United States,
+Added: numerous federal and state laws and regulations, including data breach notification laws, health information privacy and security
+Added: laws, including HIPAA, and federal and state consumer protection laws and regulations (e.g., Section 5 of the Federal Trade
+Added: Commission Act) that govern the collection, use, disclosure, and protection of health-related and other personal information could
+Added: apply to our operations or the operations of our partners.
+Added: In addition, certain state laws govern the privacy and security of
+Added: personal information, including health-related information in certain circumstances, some of which are more stringent than HIPAA and
+Added: many of which differ from each other in significant ways and may not have the same effect, thus complicating compliance efforts.
+Added: example, California enacted the CCPA, which creates individual privacy rights for California consumers (as defined in the law) and
+Added: places increased privacy and security obligations on entities handling certain personal data of consumers or households.
+Added: requires covered companies to provide new disclosure to consumers about such companies’ data collection, use and sharing
+Added: practices, provide such consumers new ways to opt-out of certain sales or transfers of personal information, and provide consumers
+Added: with additional causes of action.
+Added: The CCPA provides for civil penalties for violations, as well as a private right of action for
+Added: certain data breaches that result in the loss of personal information.
+Added: This private right of action may increase the likelihood of,
+Added: and risks associated with, data breach litigation.
+Added: The CCPA became effective on January 1, 2020, and (a) allows the California
+Added: Attorney General to impose civil penalties for violations and (b) authorizes private lawsuits to recover statutory damages for
+Added: certain data breaches.
In addition, laws in all 50 U.S.
−Removed: states require businesses to provide notice to consumers
−Removed: whose personal information has been disclosed as a result of a data breach.
−Removed: State laws are changing rapidly and there is discussion in
+Added: states require businesses to provide notice to consumers whose personal
+Added: information has been disclosed as a result of a data breach.
+Added: State laws are changing rapidly and there is discussion in the U.S.
Congress of a new comprehensive federal data privacy law to which we would become subject if it is enacted.
−Removed: The CCPA may impact
−Removed: our business activities and exemplifies the vulnerability of our business to the evolving regulatory environment related to personal data
−Removed: and protected health information.
−Removed: Additionally, a new privacy law, the California Privacy Rights Act, or CPRA, recently passed in California.
−Removed: The CPRA significantly modifies the CCPA and imposes additional data protection obligations on covered businesses, including additional
−Removed: consumer rights processes, limitations on data uses, new audit requirements for higher risk data, and opt outs for certain uses of sensitive
−Removed: It will also expand the types of data breaches subject to the CCPA’s private right of action, provide for increased penalties
−Removed: for CPRA violations concerning California residents under the age of 16 and create a new California data protection agency authorized
−Removed: to issue substantive regulations, and could result in increased privacy and information security enforcement.
−Removed: The majority of the provisions
−Removed: will go into effect on January 1, 2023, and additional compliance investment and potential business process changes may be required.
−Removed: compliance with the CPRA could require us to incur additional costs and expenses.
−Removed: In order to distribute products
−Removed: commercially, we must comply with state laws that require the registration of manufacturers and wholesale distributors of pharmaceutical
−Removed: products in a state, including, in certain states, manufacturers and distributors who ship products into the state even if such manufacturers
−Removed: or distributors have no place of business within the state.
−Removed: Some states also impose requirements on manufacturers and distributors to
−Removed: establish the pedigree of product in the chain of distribution, including some states that require manufacturers and others to adopt new
−Removed: technology capable of tracking and tracing product as it moves through the distribution chain.
−Removed: Several states have enacted legislation
−Removed: requiring pharmaceutical companies to establish marketing compliance programs, file periodic reports with the state, make periodic public
−Removed: disclosures on sales, marketing, pricing, track and report gifts, compensation and other remuneration made to physicians and other healthcare
−Removed: providers, clinical trials and other activities, and/or register their sales representatives, as well as to prohibit pharmacies and other
−Removed: healthcare entities from providing certain physician prescribing data to pharmaceutical companies for use in sales and marketing, and
−Removed: to prohibit certain other sales and marketing practices.
−Removed: All of our activities are potentially subject to federal and state consumer protection
−Removed: and unfair competition laws.
+Added: The CCPA may impact our
+Added: business activities and exemplifies the vulnerability of our business to the evolving regulatory environment related to personal
+Added: data and protected health information.
+Added: Additionally, a new privacy law, the California Privacy Rights Act, or CPRA, has been in
+Added: effect since January 1, 2023.
+Added: The CPRA significantly modifies the CCPA and imposes additional data protection obligations on covered
+Added: businesses, including additional consumer rights processes, limitations on data uses, new audit requirements for higher risk data,
+Added: and opt outs for certain uses of sensitive data.
+Added: It also expands the types of data breaches subject to the CCPA’s private
+Added: right of action, provides for increased penalties for CPRA violations concerning California residents under the age of 16 and
+Added: creates a new California data protection agency authorized to issue substantive regulations, which has resulted in increased privacy
+Added: and information security enforcement.
+Added: New regulations under the CCPA and CPRA took effect on January 1, 2026, including requirements for risk assessments, cybersecurity audits, and opt-out confirmation mechanisms.
+Added: Ensuring compliance with the CPRA could require us to
+Added: incur additional costs and expenses.
+Added: In order to distribute
+Added: products commercially, we must comply with state laws that require the registration of manufacturers and wholesale distributors of
+Added: pharmaceutical products in a state, including, in certain states, manufacturers and distributors who ship products into the state
+Added: even if such manufacturers or distributors have no place of business within the state.
+Added: Some states also impose requirements on
+Added: manufacturers and distributors to establish the pedigree of product in the chain of distribution, including some states that require
+Added: manufacturers and others to adopt new technology capable of tracking and tracing product as it moves through the distribution chain.
+Added: Several states have enacted legislation requiring pharmaceutical companies to establish marketing compliance programs, file periodic
+Added: reports with the state, make periodic public disclosures on sales, marketing, pricing, track and report gifts, compensation and
+Added: other remuneration made to physicians and other healthcare providers, clinical trials and other activities, and/or register their
+Added: sales representatives, as well as to prohibit pharmacies and other healthcare entities from providing certain physician prescribing
+Added: data to pharmaceutical companies for use in sales and marketing, and to prohibit certain other sales and marketing practices.
+Added: our activities are potentially subject to federal and state consumer protection and unfair competition laws.
If our operations are found
10 unchanged sentences
Pursuant to the Services Agreement,
−Removed: we agreed to (i) pay Eureka $10,000,000 in connection with the services thereunder payable in 12 equal monthly installments and (ii) reimburse
−Removed: Eureka on a monthly basis for reasonable pass-through costs incurred or paid to providers by Eureka in providing the services.
−Removed: we will be charged for other services performed by Eureka outside the scope of the services set forth in the Services Agreement, at a
−Removed: flat rate, by time or materials or as mutually agreed upon the parties in writing.
−Removed: As of June 30, 2024, we had paid Eureka $10,000,000
−Removed: for the IND Application Services and $117,920 of pass-through costs for services provided pursuant to the Services Agreement.
+Added: we agreed to (i) pay Eureka $10.0 million in connection with the services thereunder payable in 12 equal monthly installments and (ii)
+Added: reimburse Eureka on a monthly basis for reasonable pass-through costs incurred or paid to providers by Eureka in providing the services.
+Added: In addition, we will be charged for other services performed by Eureka outside the scope of the services set forth in the Services Agreement,
+Added: at a flat rate, by time or materials or as mutually agreed upon the parties in writing.
+Added: As of December 31, 2025, we have settled all amounts
+Added: owed under this agreement.
Statement of Work #001
Pursuant to the Statement
−Removed: of Work #001, effective March 4, 2024, as amended, we committed to paying Eureka $33,000,000 for services related to the Phase I/II clinical
−Removed: trial of EB103, a T-cell therapy targeting CD19 using ARTEMIS® T-cell technology.
−Removed: As of June 30, 2024, Estrella has paid $3,500,000
−Removed: to Eureka for the fees associated with milestones achieved.
−Removed: The amended SOW clarifies that, if Estrella exercises its right to terminate
−Removed: or suspend the engagement with Eureka by providing written notice, Estrella will only be obligated to compensate Eureka for (i) services
−Removed: provided in connection with milestones achieved prior to the termination notice, (ii) reasonable and documented pass-through costs incurred
−Removed: prior to the termination notice, and (iii) amounts payable to third parties for commitments reasonably entered into prior to the termination
−Removed: notice, provided that Eureka makes commercially reasonable efforts to cancel or reduce such commitments.
−Removed: Collaboration Agreement
−Removed: An overview of the Collaboration
−Removed: Agreement with Imugene is provided above under “ Business — CF33-CD19t and EB103 .”
+Added: of Work #001 (“SOW”), effective March 4, 2024, as amended, we committed to paying Eureka $33.0 million for services related
+Added: to the Phase I/II clinical trial of EB103, a T-cell therapy targeting CD19 using ARTEMIS® T-cell technology.
+Added: As of December 31, 2025,
+Added: Estrella has paid $3.5 million to Eureka for the fees associated with milestones achieved, and deposited $1.5 million for patient treatment
+Added: expenses, which will be applied to the final invoice, with any unused portion refunded once all fees are settled.
+Added: In addition, nine patient
+Added: dosing and second site activation milestones have been completed as of December 31, 2025, and the Company has accrued approximately $12.4
+Added: million in accrued liability - related party and recorded $0.5 million in accounts payable – related party, for the corresponding
+Added: dosing milestones.
+Added: The amended SOW, as entered
+Added: on May 13, 2024, clarifies that, in the event Estrella exercises its right to terminate or suspend the engagement with Eureka by providing
+Added: written notice, Estrella will only be obligated to compensate Eureka for (i) services provided in connection with milestones achieved
+Added: prior to the termination notice, (ii) reasonable and documented pass-through costs incurred prior to the termination notice, and (iii)
+Added: amounts payable to third parties for commitments reasonably entered into prior to the termination notice, provided that Eureka makes commercially
+Added: reasonable efforts to cancel or reduce such commitments.
License Agreement
8 unchanged sentences
Most of our day-to-day operations
−Removed: to date have been related to preparing for the Business Combination and technology research and development.
+Added: to date have been related to technology research and development, including the clinical development of our lead product candidates.
Many of the operational tasks
4 unchanged sentences
Estrella Immunopharma, Inc.
−Removed: files reports with
−Removed: the Securities and Exchange Commission (SEC), including annual reports on Form 10-K, quarterly reports on Form 10-Q, and current reports
+Added: files reports with the Securities and Exchange Commission (SEC), including annual reports on Form 10-K, quarterly reports on Form 10-Q,
+Added: and current reports on Form 8-K.
These filings are available on the SEC’s website at www.sec.gov.
−Removed: Estrella’s own website www.estrellabio.com also provides
−Removed: access to these reports free of charge as soon as reasonably practicable after filing with the SEC.
+Added: Estrella’s own website www.estrellabio.com
+Added: also provides access to these reports free of charge as soon as reasonably practicable after filing with the SEC.
Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.