−Removed: objective is to develop and commercialize our product candidates to treat diseases where the innate immune system is not functioning
−Removed: normally and contributing to the patient’s disease.
−Removed: This can be in cancer where Natural Killer (“NK”) cells
−Removed: are inactive and contribute to a tumor’s evasion of the immune system and/or disease progression while expression of MUC4
−Removed: and cells of the tumor microenvironment such as Myeloid Derived Suppressor Cells (“MDSC”) proliferate to protect the
−Removed: tumor from attack by the patient’s immune system or this can be other diseases such as neurologic and metabolic diseases
−Removed: where chronic inflammation results in innate immune system dysfunction and disease progression or infectious disease where cytokine
−Removed: storm causes a hypermetabolic state that causes the need to seek medical attention.
−Removed: Our initial focus will be the treatment of
−Removed: cancer, treatment of Alzheimer’s Disease (“AD”), treatment of Treatment Resistant Depression (“TRD”),
−Removed: treatment of immune mediated complications due to COVID-19 and non-alcoholic steatohepatitis (“NASH”).
−Removed: we plan to pursue two parallel development programs:
−Removed: (1) with INKmune we will initially focus on treating resistant disease women
−Removed: with relapse refractory ovarian carcinoma and patients with high-risk myelodysplastic syndrome (high risk MDS);
−Removed: (2) with INB03,
−Removed: we will treat patients with advanced cancers with elevated biomarkers of inflammation in their blood and evidence of disease that
−Removed: is resistant to immunotherapy including women with MUC4 expressing HER2+ breast cancer.
−Removed: Our third drug candidate XPro1595, targets
−Removed: Alzheimer’s Disease and TRD.
−Removed: XPro1595 for AD is progressing through Phase I trials and is being prepared for Phase II trials.
−Removed: XPro1595 for TRD is being prepared for Phase II trials.
−Removed: Our fourth drug candidate, LIVNate, will be used to treat patients with
−Removed: Our final drug, Quellor is in Phase II trials for the treatment of pulmonary complications due to COVID-19 infection.
−Removed: principal components of our strategy to achieve this objective are to:
−Removed: development strategies and regulatory approval pathways that allow the treatment of oncology patients with our lead product
−Removed: candidates, INKmune and INB03;
−Removed: pursue development
−Removed: strategies and regulatory approval pathways that allow the treatment of neurodegenerative diseases in patients with our lead
−Removed: product candidates, XPro1595;
−Removed: pursue development
−Removed: strategies and regulatory approval pathways that allow the treatment of pulmonary complications from COVID-19 infection patients
−Removed: with our lead product candidate, Quellor;
−Removed: development strategies and regulatory approval pathways that allow the treatment of NASH in patients with our lead product candidates,
−Removed: a product development strategy that solidifies our existing intellectual property (“IP”) to prevent competition
−Removed: and expand our IP suite into related immunotherapeutic areas;
−Removed: clear value propositions to third-party payers, such as managed care companies or government programs like Medicare, to merit
−Removed: reimbursement for our product candidates;
−Removed: with other pharmaceutical companies with respect to, among other things, our INKmune and the DN-TNF platform that includes
−Removed: INB03, XPro1595, Quellor and LIVNate product candidates and other products that will benefit from development or marketing
−Removed: beyond our current resources.
−Removed: development and regulatory approval pathways.
−Removed: We believe Quellor, INKmune, INB03 and XPro1595 may be approvable under pathways
−Removed: that are potentially shorter than those typically available for drug products based on novel active ingredients, including as
−Removed: an orphan drug under the Orphan Drug Act and approval under the Food and Drug Administration (the “FDA”) Accelerated
−Removed: Approval Program (see “Government Regulation”).
−Removed: We have not yet had a discussion with the Medicines and Healthcare
−Removed: Products Regulatory Agency (“MHRA”) and/or FDA regarding such designation, but plan to do so in the future.
−Removed: both our INB03 HER2+ metastatic breast cancer program, high risk MDS and ovarian carcinoma treatment programs and our program
−Removed: Quellor to treat respiratory complications due to COVID19 infection fit the criteria used by the FDA to grant these regulatory
−Removed: designations.
−Removed: We believe that it would take a minimum of six months to receive Orphan Drug status once we submit an application
−Removed: and a minimum of 12 months to receive a designation once we submit an application.
−Removed: We might never have these discussions, submit
−Removed: applications under the Orphan Drug Act as the FDA Accelerated Approval Program or have these applications approved if we do.
−Removed: a two-pronged patent strategy.
−Removed: We are pursuing a two-pronged product development strategy that will seek to solidify our existing
−Removed: IP to prevent competition and expand our IP suite into related therapeutic areas.
−Removed: We are confident that our core in-licensed IP
−Removed: (see “Intellectual Property”) will allow us both freedom-to-operate and provide robust protection from outside competition.
−Removed: We will continue to invest in expanding our patent suite.
−Removed: We will also seek to further to strengthen our IP position by looking
−Removed: to in-license IP related to our focus on the innate immune system.
−Removed: clear value propositions to third-party payors to merit reimbursement for our product candidates .
−Removed: We are designing our clinical
−Removed: development programs to demonstrate compelling, competitive advantages to patients and prescribers, and to demonstrate value propositions
−Removed: to third-party payors.
−Removed: We believe the use of INKmune and/or INB03 in patients with a high risk of tumor progression and death
−Removed: from tumor should prolong survival, improve the patient’s quality of life and decrease the total cost of care for patients
−Removed: with these lethal malignancies.
−Removed: For example, ovarian cancer patients relapse frequently.
−Removed: Each relapse requires an expensive, hospital-based
−Removed: treatment regimen that has decreasing benefits.
−Removed: Treatment with INKmune as an out-patient may provide a more durable remission
−Removed: and limit the need for treatment-associated hospitalizations.
−Removed: At the patient level, we believe INKmune and INB03 therapy, once
−Removed: approved, should improve survival and quality of life.
−Removed: At the payor level, we believe INKmune, once approved, should provide more
−Removed: predictable costs and outcomes.
−Removed: Therapies for Alzheimer’s disease are needed for medical, social and economic reasons.
−Removed: cost of Alzheimer’s disease to the government is large and growing.
−Removed: The cost to families and care givers is real and burdensome.
−Removed: We believe treatment of patients with dementia, including Alzheimer’s disease, may provide a strategy to alter the costly
−Removed: dynamic of this disease in society today.
−Removed: NASH, a silent epidemic in the US due to the high incidence of obesity, is expected
−Removed: to be the most common cause of liver transplant 2030.
−Removed: There are no approved therapies for the NASH at this time.
−Removed: We believe treatment
−Removed: of patients requiring hospitalization due to medical complications of COVID-19 infection may alter the arc of the pandemic.
−Removed: effective, Quellor should allow patients to be discharged from the hospital more quickly and decrease the risk of respiratory
−Removed: failure requiring mechanical ventilation.
−Removed: to maximize the value of our technology .
+Added: Our objective is to develop and commercialize our product candidates
+Added: to treat diseases where the innate immune system is not functioning normally and contributing to the patient’s disease.
+Added: be in cancer where Natural Killer (“NK”) cells are inactive and contribute to a tumor’s evasion of the immune system
+Added: and/or disease progression while expression of MUC4 and immunosuppressive cells of the tumor microenvironment proliferate to protect the
+Added: tumor from attack by the patient’s immune system or this can be other diseases such as neurologic and metabolic diseases where chronic
+Added: inflammation results in innate immune system dysfunction.
+Added: Our initial focus will be the treatment of cancer, treatment of Alzheimer’s
+Added: Disease (“AD”), and the treatment of Treatment Resistant Depression (“TRD”).
+Added: In cancer, we plan to pursue two
+Added: parallel development programs:
+Added: (1) with INKmune we will initially focus on treating women with resistant disease relapse refractory ovarian
+Added: carcinoma and patients with high-risk myelodysplastic syndrome (high risk MDS);
+Added: (2) with INB03, we will treat patients with cancers that
+Added: express MUC4, a mucinous polyglucan on the surface of some epithelial cancer cells, that appears to predict resistant to immunotherapy
+Added: including women with MUC4 expressing HER2+ breast cancer.
+Added: Our third drug candidate XPro1595 (“XPro"), targets Alzheimer’s
+Added: Disease and TRD.
+Added: XPro for AD has completed Phase I trials and is being prepared for Phase II trials.
+Added: XPro for TRD is being prepared for
+Added: Phase II trials.
+Added: During 2021, we closed our Phase II clinical trial for treatment of pulmonary complications due to COVID-19 infection
+Added: as the Company determined it was a high-risk, low reward program due to the development of vaccinations and therapies which were not available
+Added: when we started the clinical trial.
+Added: The principal components of our strategy to achieve this objective are to:
+Added: pursue development strategies and regulatory approval pathways that allow the treatment of oncology patients with our lead product candidates, INKmune and INB03;
+Added: pursue development strategies
+Added: and regulatory approval pathways that allow the treatment of neurodegenerative diseases in patients with our lead product candidates,
+Added: adopt a product development strategy that solidifies our existing intellectual property (“IP”) to prevent competition and expand our IP suite into related immunotherapeutic areas;
+Added: provide clear value propositions to third-party payers, such as managed care companies or government programs like Medicare, to merit reimbursement for our product candidates;
+Added: with other pharmaceutical companies with respect to, among other things, our INKmune and the DN-TNF platform that includes INB03 and
+Added: XPro product candidates and other products that will benefit from development or marketing beyond our current resources.
+Added: Pursue development and
+Added: regulatory approval pathways.
+Added: We believe INKmune, INB03 and XPro may be approvable under pathways that are potentially shorter
+Added: than those typically available for drug products based on novel active ingredients, including as an orphan drug under the Orphan Drug
+Added: Act and approval under the Food and Drug Administration (the “FDA”) Accelerated Approval Program (see “Government Regulation”).
+Added: We have not yet had a discussion with the Medicines and Healthcare Products Regulatory Agency (“MHRA”) and/or FDA regarding
+Added: such designation, but plan to do so in the future.
+Added: We believe the INKmune MDS cancer program may qualify for orphan status.
+Added: that it would take a minimum of six months to receive Orphan Drug status once we submit an application and a minimum of 12 months
+Added: to receive a designation once we submit an application.
+Added: We might never have these discussions, submit applications under the Orphan Drug
+Added: Act as the FDA Accelerated Approval Program or have these applications approved if we do.
+Added: Adopt a two-pronged patent
+Added: We are pursuing a two-pronged product development strategy that will seek to solidify our existing IP to prevent competition
+Added: and expand our IP suite into related therapeutic areas.
+Added: We are confident that our core in-licensed IP (see “Intellectual Property”)
+Added: will allow us both freedom-to-operate and provide robust protection from outside competition.
+Added: We will continue to invest in expanding
+Added: our patent suite.
+Added: We will also seek to further to strengthen our IP position by looking to in-license IP related to our focus on the innate
+Added: immune system.
+Added: Provide clear value propositions
+Added: to third-party payors to merit reimbursement for our product candidates .
+Added: We are designing our clinical development programs to demonstrate
+Added: compelling, competitive advantages to patients and prescribers, and to demonstrate value propositions to third-party payors.
+Added: the use of INKmune and/or INB03 in patients with a high risk of tumor progression and death from tumor should prolong survival, improve
+Added: the patient’s quality of life and decrease the total cost of care for patients with these lethal malignancies.
+Added: For example, ovarian
+Added: cancer patients relapse frequently.
+Added: Each relapse requires a complex treatment regimen that has decreasing benefits.
+Added: Treatment with INKmune
+Added: as an out-patient may provide a more durable remission and limit the need for treatment-associated hospitalizations.
+Added: At the patient level,
+Added: we believe INKmune and INB03 therapy, once approved, should improve survival and quality of life.
+Added: At the payor level, we believe INKmune,
+Added: once approved, should provide more predictable costs and outcomes.
+Added: Therapies for Alzheimer’s disease are needed for medical, social
+Added: and economic reasons.
+Added: The cost of Alzheimer’s disease to the government is large and growing.
+Added: The cost to families and care givers
+Added: is real and burdensome.
+Added: We believe treatment of patients with dementia, including Alzheimer’s disease, may provide a strategy to
+Added: alter the costly dynamic of this disease in society today.
+Added: Collaborate to maximize
+Added: the value of our technology .
We believe there are two reasons for us to enter collaborations with other companies.
−Removed: The first is the further development of INKmune, INB03, Quellor, LIVNate and XPro1595 by either providing additional innovations
−Removed: to the product, including combination therapy strategies, and/or providing resources to improve the speed and breadth of the development
−Removed: The second is to optimize the commercialization of our products either globally or regionally.
−Removed: The ideal partner will
−Removed: benefit us in both ways.
−Removed: continue to look for ways to utilize our unique capabilities to optimize clinical application of cell therapies.
−Removed: We believe that
−Removed: we have identified a way to manufacture human mesenchymal stem cells for the medical research and biotech community that offers
−Removed: large volumes of high-quality, low passage human umbilical cord mesenchymal stem cells with minimal batch-to-batch variability.
−Removed: We believe this may solve the problem associated with supplying an adequate supply of human mesenchymal stem cells for clinical
−Removed: applications.
−Removed: The process to produce pooled, human umbilical cord mesenchymal stem cells was developed at University College London.
−Removed: We have established a reliable supply of human umbilical cords based on our agreement with the Anthony Nolan Cord Blood Bank in
−Removed: the United Kingdom.
−Removed: We have developed a validated manufacturing process that reliably produces contract manufacturer of the clinical
−Removed: grade (“cGMP”) quality mesenchymal stem cells.
−Removed: The manufacturing process can be performed at a contract manufacturing
−Removed: site under the direction of Mark Lowdell, the Company’s CSO.
−Removed: We have negotiated an exclusive 10-year license to the manufacturing
−Removed: process from University College London Business, the licensing organization of University College London.
+Added: The first is the
+Added: further development of INKmune, INB03 and XPro by either providing additional innovations to the product, including combination therapy
+Added: strategies, and/or providing resources to improve the speed and breadth of the development process.
+Added: The second is to optimize the commercialization
+Added: of our products either globally or regionally.
+Added: The ideal partner will benefit us in both ways.
+Added: We continue to look for ways to utilize our unique capabilities to
+Added: optimize clinical application of cell therapies.
+Added: We believe that we have identified a way to manufacture human mesenchymal stem cells
+Added: for the medical research and biotech community that offers large volumes of high-quality, low passage human umbilical cord mesenchymal
+Added: stem cells with minimal batch-to-batch variability.
+Added: We believe this may solve the problem associated with supplying an adequate supply
+Added: of human mesenchymal stem cells for clinical applications.
+Added: We have established a reliable supply of human umbilical cords based on our
+Added: agreement with the Anthony Nolan Cord Blood Bank in the United Kingdom.
+Added: We have developed a validated manufacturing process that reliably
+Added: produces contract manufacturer of the clinical grade (“cGMP”) quality mesenchymal stem cells that we call CORDstrom.
+Added: The manufacturing
+Added: process can be performed at a contract manufacturing site under the direction of Mark Lowdell, the Company’s CSO.
We will seek academic
−Removed: laboratories and biopharma companies who need a reliable source of high quality pooled human umbilical cord mesenchymal stem cells
−Removed: for research of and development of clinical products.
−Removed: Once identified, we plan to act as a cGMP for the development of therapeutic
−Removed: products by utilizing contract manufacturers.
−Removed: Because the production of the product is not continuous, we do not expect to engage
−Removed: a contract manufacturer until we have a customer identified.
−Removed: We have identified several contract manufacturers in the UK that
−Removed: have the capability to produce cGMP stem cells.
−Removed: We expect the commercial arrangement with academic laboratories or biopharma companies
−Removed: to be a combination of fee-for-service and licensing that does not require additional investment by us.
+Added: laboratories and biopharma companies who need a reliable source of high quality pooled human umbilical cord mesenchymal stem cells for
+Added: research of and development of clinical products.
+Added: Once identified, we plan to act as a cGMP for the development of therapeutic products
+Added: by utilizing contract manufacturers.
+Added: Because the production of the product is not continuous, we do not expect to engage a contract manufacturer
+Added: until we have a customer identified.
+Added: To date, we are supporting two academic clinical trials with CORDstrom.
+Added: One program is a Phase 2
+Added: trial sponsored by the Great Ormond Street Children’s Hospital in the UK treating children with erythematous bullousa, a disfiguring
+Added: skin disease in children that is similar to a second degree burn and the second program is treatment of system lupus in adults.
+Added: studies are ongoing.
+Added: INmune Bio is supplying the clinical product for treatment of these patients.
+Added: The Company does not know the results
+Added: of these trials until they are announced by the principle investigators at the clinical sites.
+Added: We have identified contract manufacturers
+Added: in the UK that have the capability to produce cGMP stem cells.
+Added: We expect the commercial arrangement with academic laboratories or biopharma
+Added: companies to be a combination of fee-for-service and licensing that does not require additional investment by us.
We will be opportunistic
in pursuing therapeutic opportunities for our own portfolio with this platform in the future if resources become available.
−Removed: regulatory path for therapeutic applications of the mesenchymal stem cell products is well established and similar to the regulatory
−Removed: approval process for other cell therapies.
−Removed: We will only be responsible for regulatory compliance related to manufacturing of the
−Removed: mesenchymal stem cells when the product is being developed by a third party.
−Removed: When developing a therapeutic product for the Company’s
−Removed: commercial portfolio, the Company will be responsible for all aspects of the regulatory process.
−Removed: of Immunotherapy for Cancer
−Removed: immune system has two parts, innate and adaptive.
−Removed: The innate immune system is the body’s first line of defense against an
−Removed: infection, providing immediate, non-specific responses to eliminate harmful cells in the body.
−Removed: Components of the innate immune
−Removed: system include cytokines, chemokines, macrophages, neutrophils and NK cells, among others.
−Removed: adaptive immune system is often initially triggered by the innate immune system, mounts a delayed response against diseased cells
−Removed: and plays a role protecting against re-infection.
−Removed: An adaptive immune response is highly specific to a pathogen or antigen and
−Removed: is developed or learned from prior exposure.
−Removed: Key components of the adaptive immune system include antibodies which bind to antigens
−Removed: and mark them for destruction by other immune cells, B-cells which produce these antibodies upon exposure to antigens, and T-cells
−Removed: which attack and eliminate the diseased cells.
−Removed: biopharmaceutical industry has made significant advances in harnessing specific components of innate and adaptive immune systems
−Removed: for therapeutic use.
−Removed: Some of these approaches are summarized below.
−Removed: One of the early applications of immunotherapy is the use of cytokines, including interferons and interleukin-2 (“IL-2”).
−Removed: Interferons are molecules that inhibit the growth and replication of diseased cells and stimulate innate immune cells to attack
−Removed: They have been used as standard of care for hepatitis B and C and multiple sclerosis, and to a lesser extent, as treatment
−Removed: for certain cancers, including chronic myeloid leukemia, cutaneous T-cell lymphoma, myeloma and non-Hodgkin’s lymphoma.
−Removed: However, the use of interferons has generally decreased over the years due to serious adverse events ( e.g.
−Removed: , flu-like symptoms
−Removed: and dramatic weight loss) and introduction of new therapies with higher efficacy, better safety profiles and more convenient administration
−Removed: although Alpha-interferon remains the treatment of choice for some hematological conditions such as polycythemia.
−Removed: IL-2 activates
−Removed: T-cells and NK cells to attack diseased cells.
−Removed: IL-2 has been used to treat select cancers, but due to its relatively poor safety
−Removed: profile, physicians often only resort to this therapy for the most advanced settings.
−Removed: Tumor Necrosis Factor alpha (“TNF”)
−Removed: is the focus of INB03.
−Removed: TNF biology has four elements that include two cytokines, soluble TNF and trans-membrane TNF (“sTNF”
−Removed: and “tmTNF,”
−Removed: respectively), and two receptors, TNF Receptor 1 and 2 (“TNFR1”
−Removed: and “TNFR2”).
−Removed: The biology of TNF ligation of TNFR varies dramatically based on what elements of the TNF system that are used.
−Removed: sTNF binding to
−Removed: TNFR1 is responsible for inflammation and cell death while sTNF binding to TNFR2 promotes proliferation of regulatory T cells
−Removed: (“Treg”).
−Removed: In patients with advanced cancers, increased sTNF is not favorable to long-term survival because it promotes
−Removed: epithelial-mesenchymal transformation and metastasis while making the tumor microenvironment more immunosuppressive promoting
−Removed: resistance to therapy.
+Added: The regulatory
+Added: path for therapeutic applications of the mesenchymal stem cell products is well established and similar to the regulatory approval process
+Added: for other cell therapies.
+Added: We will only be responsible for regulatory compliance related to manufacturing of the mesenchymal stem cells
+Added: when the product is being developed by a third party.
+Added: When developing a therapeutic product for the Company’s commercial portfolio,
+Added: the Company will be responsible for all aspects of the regulatory process.
+Added: Overview of Immunotherapy for Cancer
+Added: The immune system has two
+Added: parts, innate and adaptive.
+Added: The innate immune system is the body’s first line of defense against an infection, providing immediate,
+Added: non-specific responses to eliminate harmful cells in the body.
+Added: Components of the innate immune system include cytokines, chemokines, macrophages,
+Added: neutrophils and NK cells, among others.
+Added: The adaptive immune system
+Added: is often initially triggered by the innate immune system, mounts a delayed response against diseased cells and plays a role protecting
+Added: against re-infection.
+Added: An adaptive immune response is highly specific to a pathogen or antigen and is developed or learned from prior exposure.
+Added: Key components of the adaptive immune system include antibodies which bind to antigens and mark them for destruction by other immune cells,
+Added: B-cells which produce these antibodies upon exposure to antigens, and T-cells which attack and eliminate the diseased cells.
+Added: The biopharmaceutical industry
+Added: has made significant advances in harnessing specific components of innate and adaptive immune systems for therapeutic use.
+Added: Some of these
+Added: approaches are summarized below.
+Added: of the early applications of immunotherapy is the use of cytokines, including interferons and interleukin-2 (“IL-2”).
+Added: are molecules that inhibit the growth and replication of diseased cells and stimulate innate immune cells to attack them.
+Added: They have been
+Added: used as standard of care for hepatitis B and C and multiple sclerosis, and to a lesser extent, as treatment for certain cancers, including
+Added: chronic myeloid leukemia, cutaneous T-cell lymphoma, myeloma and non-Hodgkin’s lymphoma.
+Added: However, the use of interferons has generally
+Added: decreased over the years due to serious adverse events ( e.g.
+Added: , flu-like symptoms and dramatic weight loss) and introduction of new
+Added: therapies with higher efficacy, better safety profiles and more convenient administration although Alpha-interferon remains the treatment
+Added: of choice for some hematological conditions such as polycythemia.
+Added: IL-2 activates T-cells and NK cells to attack diseased cells.
+Added: been used to treat select cancers, but due to its relatively poor safety profile, physicians often only resort to this therapy for the
+Added: most advanced settings.
+Added: Tumor Necrosis Factor alpha (“TNF”) is the focus of INB03.
+Added: TNF biology has four elements that include
+Added: two cytokines, soluble TNF and trans-membrane TNF (“sTNF” and “tmTNF,” respectively), and two receptors, TNF Receptor
+Added: 1 and 2 (“TNFR1” and “TNFR2”).
+Added: The biology of TNF ligation of TNFR varies dramatically based on what elements
+Added: of the TNF system that are used.
+Added: sTNF binding to TNFR1 is responsible for inflammation and cell death while sTNF binding to TNFR2 promotes
+Added: proliferation of regulatory T cells (“Treg”).
+Added: In patients with advanced cancers, increased sTNF is not favorable to long-term
+Added: survival because it promotes epithelial-mesenchymal transformation and metastasis while making the tumor microenvironment more immunosuppressive
+Added: promoting resistance to therapy.
In the CNS, sTNF promotes neuronal cell death, demyelination and synaptic pruning while tmTNF promotes
nerve cell survival, improves synaptic function and stimulates remyelination.
−Removed: In brief, sTNF is the “bad”
−Removed: tmTNF is the “good”
−Removed: In patients with cancer, infection or neurologic disease, blockade of tmTNF function has
−Removed: negative consequences such as immunosuppression, increased infection, synaptic dysfunction and demyelination.
+Added: In brief, sTNF is the “bad” TNF and tmTNF is
+Added: the “good” TNF.
+Added: In patients with cancer, infection or neurologic disease, blockade of tmTNF function has negative consequences
+Added: such as immunosuppression, increased infection, synaptic dysfunction and demyelination.
+Added: Antibody therapy.
Antibodies exist in three formats:
−Removed: monoclonals (“mAbs”), oligo/polyclonal and antibody-drug conjugates.
−Removed: mAbs represent an effective therapeutic modality and are important to the treatment paradigm of various diseases.
−Removed: Drug manufacturers
−Removed: have leveraged mAbs’
−Removed: ability to induce an antibody-dependent cell-mediated cytotoxicity, or ADCC effect to develop better
−Removed: treatments that prolong survival and quality of life of patients.
−Removed: In addition, mAbs designed to inhibit specific checkpoints in
−Removed: the immune system have overcome in vivo immune suppression and the resulting immune responses have led to profound therapeutic
−Removed: benefit in some patients.
+Added: monoclonals (“mAbs”),
+Added: oligo/polyclonal and antibody-drug conjugates.
+Added: mAbs represent an effective therapeutic modality and are important to the treatment paradigm
+Added: of various diseases.
+Added: Drug manufacturers have leveraged mAbs’ ability to induce an antibody-dependent cell-mediated cytotoxicity,
+Added: or ADCC effect to develop better treatments that prolong survival and quality of life of patients.
+Added: In addition, mAbs designed to inhibit
+Added: specific checkpoints in the immune system have overcome in vivo immune suppression and the resulting immune responses have led to profound
+Added: therapeutic benefit in some patients.
However, the degree of efficacy of these therapies is heavily reliant on the immune system of patients,
many of whom are severely immuno-compromised.
−Removed: For example, despite over $1.0 billion of sales generated by recently launched PD-1
−Removed: and PDL1 checkpoint inhibitors, they are reported to be generally only effective in approximately 10% to 25% of the addressable
−Removed: patient population.
−Removed: In addition, mAbs are manufactured through a complex process that requires purification of cell products created
−Removed: from a cell line.
−Removed: Polyspecific antibodies, for example bi-specific antibodies, are able to target more than one antigen.
−Removed: are often used to bring and effector T cell in contact with a target cell.
−Removed: Antibody drug conjugates are mAbs attached to a toxin,
−Removed: chemotherapy or radio therapy that delivers the cancer killing payload directly to the cancer.
−Removed: Cell Therapies.
−Removed: This approach is designed to indirectly stimulate a patient’s T-cells by leveraging the role of
−Removed: dendritic cells in presenting antigens to T-cells.
+Added: In addition, mAbs are manufactured through a complex process that requires purification
+Added: of cell products created from a cell line.
+Added: Polyspecific antibodies, for example bi-specific antibodies, are able to target more than one
+Added: These are often used to bring and effector T cell in contact with a target cell.
+Added: Antibody drug conjugates are mAbs attached to
+Added: a toxin, chemotherapy or radio therapy that delivers the cancer killing payload directly to the cancer.
+Added: Dendritic Cell Therapies.
+Added: This approach is designed to indirectly stimulate a patient’s T-cells by leveraging the role of dendritic cells in presenting antigens
Cancer vaccines are the most common application of dendritic cells.
−Removed: FDA-approved dendritic cell therapy is PROVENGE, which entails collecting monocytes from the patient, maturing them into dendritic
−Removed: cells, “loading”
−Removed: ex vivo with the patient’s cancer antigens, and then re-infusing in the patient.
−Removed: this process is cumbersome and expensive, and again, relies on an intact and effective immune system of the patient.
−Removed: additional ongoing preclinical studies and clinical trials being conducted by our competitors aimed at addressing certain of the
−Removed: limitations associated with this approach.
−Removed: To date, current clinical results of dendritic cell therapies have been mixed.
−Removed: and TCR Therapies.
−Removed: T-cells recognize diseased cells by receptors engaging with antigens that are present on or inside
−Removed: the diseased cells.
−Removed: CAR-T therapy entails genetically engineering T-cells to express synthetic CARs that direct T-cells to antigens
−Removed: on the surface of cancer cells.
−Removed: TCR therapy modifies T-cells to express high-affinity tumor specific TCRs that recognize intra-cellular
−Removed: antigens that must be presented on the surface of target cells.
−Removed: In early clinical trials, CAR-T and TCR therapies have demonstrated
−Removed: impressive anti-tumor activity in a narrow spectrum of hematologic cancers and garnered significant attention by research institutions
−Removed: and biopharmaceutical companies.
−Removed: We believe a key limitation of adaptive autologous immunotherapy is the need to retrieve non-compromised
−Removed: immune cells from a cancer patient which requires a complex and costly manufacturing process to develop the therapy.
−Removed: The complexity
−Removed: of this personalized process is reflected in the price of the two approved therapies.
−Removed: CAR-T therapies - tisagenlecleucel and axicabtagene
−Removed: ciloleucel for advanced leukemia and lymphoma respectively.
+Added: The only FDA-approved dendritic cell therapy is PROVENGE,
+Added: which entails collecting monocytes from the patient, maturing them into dendritic cells, “loading” ex vivo with the
+Added: patient’s cancer antigens, and then re-infusing in the patient.
+Added: Currently, this process is cumbersome and expensive, and again,
+Added: relies on an intact and effective immune system of the patient.
+Added: There are additional ongoing preclinical studies and clinical trials being
+Added: conducted by our competitors aimed at addressing certain of the limitations associated with this approach.
+Added: To date, current clinical results
+Added: of dendritic cell therapies have been mixed.
+Added: CAR-T and TCR Therapies.
+Added: T-cells recognize diseased cells by receptors engaging with antigens that are present on or inside the diseased cells.
+Added: CAR-T therapy entails
+Added: genetically engineering T-cells to express synthetic CARs that direct T-cells to antigens on the surface of cancer cells.
+Added: modifies T-cells to express high-affinity tumor specific TCRs that recognize intra-cellular antigens that must be presented on the surface
+Added: of target cells.
+Added: In early clinical trials, CAR-T and TCR therapies have demonstrated impressive anti-tumor activity in a narrow spectrum
+Added: of hematologic cancers and garnered significant attention by research institutions and biopharmaceutical companies.
+Added: We believe a key limitation
+Added: of adaptive autologous immunotherapy is the need to retrieve non-compromised immune cells from a cancer patient which requires a complex
+Added: and costly manufacturing process to develop the therapy.
+Added: The complexity of this personalized process is reflected in the price of the
+Added: two approved therapies.
+Added: CAR-T therapies - tisagenlecleucel and axicabtagene ciloleucel for advanced leukemia and lymphoma respectively.
The cost of a single therapy is many hundreds of thousands of dollars.
−Removed: As a consequence of this need to harvest active T-cells, current Phase I clinical trials for autologous CAR-T cell therapy in
−Removed: large part enroll patients from highly selected, often relatively early-stage disease in a narrow spectrum of cancers, including
−Removed: bulky hematological cancers.
−Removed: In addition, Phase I clinical trials of CAR-T cell immunotherapy have reported severe adverse toxicities
−Removed: of cytokine release syndrome and neurotoxicity, requiring hospitalization, pre-conditioning and, in some instances, intensive
−Removed: care unit admission following side effects associated with cytokine release syndrome.
−Removed: As a result, though our competitors continue
−Removed: to develop their CAR-T and TCR product candidates with the goal of addressing certain of the limitations associated with these
−Removed: approaches, we believe these serious challenges may limit their potential and use in a variety of indications, including solid
+Added: As a consequence of this need to harvest active T-cells, current
+Added: Phase I clinical trials for autologous CAR-T cell therapy in large part enroll patients from highly selected, often relatively early-stage
+Added: disease in a narrow spectrum of cancers, including bulky hematological cancers.
+Added: In addition, Phase I clinical trials of CAR-T cell immunotherapy
+Added: have reported severe adverse toxicities of cytokine release syndrome and neurotoxicity, requiring hospitalization, pre-conditioning and,
+Added: in some instances, intensive care unit admission following side effects associated with cytokine release syndrome.
+Added: As a result, though
+Added: our competitors continue to develop their CAR-T and TCR product candidates with the goal of addressing certain of the limitations associated
+Added: with these approaches, we believe these serious challenges may limit their potential and use in a variety of indications, including solid
+Added: Checkpoint Inhibitors.
Immune cells express proteins that are immune checkpoints that control and down-regulate the immune response.
−Removed: These are best defined in T lymphocytes and include PD-1, CTLA-4, TIM-3 and LAG3.
+Added: These are best defined
+Added: in T lymphocytes and include PD-1, CTLA-4, TIM-3 and LAG3.
Tumor cells express the ligands to these receptors.
−Removed: When T cells bind the ligand to these proteins on the tumor cells, the T cell is turned off and does not attempt to attack the
−Removed: Thus, checkpoint inhibitors (“CPI”) are part of the complex strategy used by the tumor to evade the patient’s
−Removed: immune system and are responsible for resistance to immunotherapy.
−Removed: Biopharmaceutical companies have successfully developed CPI
−Removed: that block the receptor/ligand interaction to promote the adaptive immune response to the tumor.
−Removed: Six CPI are currently approved,
−Removed: pembrolizumab, nivolumab, atezolizumab, avelumab, durvalumab, and ipilimumab for a wide variety of solid tumors including melanoma,
−Removed: lung, bladder, gastric cancers and others.
−Removed: More CPI are in development and more tumor types will be added to the list of sensitive
−Removed: tumors over the next years.
−Removed: CPI have become the backbone of cancer therapy and are expected to be the best -selling class of drugs
−Removed: NK cells typically represent approximately 2% to 13% of circulating lymphocytes and are a critical component of
−Removed: the immune system responsible for innate immunity.
−Removed: Unlike adaptive immune cells, they are ever present and ready to attack, having
−Removed: the inherent ability to detect and eliminate diseased cells without the need for antigen presentation, which is why they are called
−Removed: “natural killers.”
−Removed: cells bind to stress ligands expressed by the diseased cells and directly eliminate them.
−Removed: This binding induces NK cells to release
−Removed: cytokines, including, interferons and GM-CSF, which are integral in recruiting additional innate and adaptive immune responses
−Removed: NK cells also represent a critical effector cell for ADCC, whereby target cells bound with human antibodies, whether
−Removed: made by the patient’s body or administered, are selectively destroyed by the NK cells.
−Removed: MDSC are present in very low quantities in healthy patients.
−Removed: MDSC develop and proliferate in patients with chronic
−Removed: infection and with cancer.
−Removed: In cancer, MDSC are a unique and well-defined cell population that home to the cancer and secrete immunosuppressive
−Removed: cytokines that provide a protective, immunosuppressive shield to the tumor.
−Removed: This protective immunosuppressive shield prevents
−Removed: the patient’s immune system from attacking the tumor.
−Removed: The presence of MDSC in the tumor microenvironment and/or circulating
−Removed: in the patient’s blood predict for more advanced disease, resistance to immunotherapy and a worse patient survival.
−Removed: Innate Immune Dominant-Negative TNF product candidate
−Removed: renamed XPro1595, which we license from Xencor, to INB03 when it is used for cancer related indications.
−Removed: We will continue
−Removed: to call the drug XPro1595 when used for treatment of neuropsychiatric diseases, including Alzheimer’s disease and TRD discussed
−Removed: We call the drug Quellor and LIVNate respectively for treatment of pulmonary complications of COVID-19 and NASH respectively.
−Removed: Quellor, LIVNate, INB03 and XPro1595 are the same drug with different names for marketing purposes.
−Removed: INB03 is a novel innate immune
−Removed: system check-point inhibitor that we believe decreases expression of MUC4 by the tumor, an important resistance mechanism to immunotherapy,
−Removed: decreases proliferation of MDSC and decreases the secretion of immunosuppressive cytokines that protect the tumor from the patient’s
−Removed: immunologic attack and help make the tumor resistant to immunotherapy.
−Removed: INB03, by inhibiting soluble TNF without inhibiting trans-membrane
−Removed: TNF or TNF receptors (“tmTNF”
−Removed: and “TNFR”
−Removed: respectively), decreases expression of MUC4, alters the immunoregulatory
−Removed: cell and cytokine profile of the tumor microenvironment to decrease the population of MDSC, decrease immunosuppressive cytokines
−Removed: and increase immunoregulatory cytokines that changes the patient’s immune response to their tumor with improved NK/DC crosstalk
−Removed: that causes expansion of the immune response including recruitment of the adaptive immune system with an increase in effector
−Removed: and cytotoxic T cells that attack the cancer allowing for decreased resistance to immunotherapy including immune checkpoint inhibitors
−Removed: (CPR), anti-HER2 immunotherapy such as Herceptin and kinase inhibitors such as lapatinib.
−Removed: By using INB03 as part of combination
−Removed: therapy for cancer, we believe the patient’s dysregulated immune response, a hallmark of cancer progression and resistance
−Removed: to therapy, to be converted to a coordinated immune response that can overcome resistance mechanisms to immunotherapy.
−Removed: responses have been studied in two animal models.
−Removed: In a murine model of an inflammatory cancer, where 3-methylcholanthrese is given
−Removed: to mice in a subcutaneous injection that causes the development of multiple cutaneous fibrosarcoma.
−Removed: This model was developed by
−Removed: Y Akamatsu in 1967 while working at the National Cancer Institute of the NIH.
−Removed: In research published by Professor Nikola Vujanovic
−Removed: in Cancer Immunology Research in 2016, treatment with INB03 resulted in smaller and fewer cancers with increased
−Removed: INB03 is an engineered PEGylated protein that neutralizes human soluble TNF, a human inflammatory cytokine that is increased
−Removed: in patients with advanced cancer.
−Removed: By specifically neutralizing the cytokine, there is decreased phosphorylation of STAT3, an essential
−Removed: step required for the proliferation of the MDSC population, and secretion of the immunosuppressive cytokines.
−Removed: The combination
−Removed: of decreased MDSC proliferation and decreased immunosuppressive cytokines allows the immune system to respond to the tumor.
−Removed: data was published in an article entitled Inhibition of Soluble Tumor Necrosis Factor Prevents Chemically Induced Carcinogenesis
−Removed: in Mice in Cancer Immunology Research in Cancer Immunology Research 2016.
−Removed: In summary, INB03 functions as an innate
−Removed: immune system checkpoint inhibitor by eliminating the population of MDSC that provides an immunosuppressive shield protecting
−Removed: the tumor, the patient’s immune system is able to function normally to the benefit of the patient –
−Removed: it can attack
−Removed: TNF plays an important role in breast cancer (Schillaci R, Front.
−Removed: Oncol., 22 April 2020 | https://doi.org/10.3389/fonc.2020.00584 ).
−Removed: In a murine model of trastuzumab resistant breast cancer using JMIT-1 cells, a human cell line of HER2 positive breast cancer
−Removed: resistant to trastuzumab placed into immunocompromised mice, INB03 downregulates MUC4 from the surface of the JMIT-1 HER2+ breast
−Removed: cancer cells to allow the trastuzumab resistant cells to become trastuzumab sensitive (Figure A from Bruni, NYAS 2020) to decrease
−Removed: tumor growth (from Schillaci SABCS 2018, Figure B).
−Removed: JMIT-1 cells are also resistant to lapatinib, a TKI inhibitor used as a second
−Removed: line therapy in women with trastuzumab resistant HER2+ breast cancer.
−Removed: The addition of INB03 to lapatinib in the animal model reverses
−Removed: lapatinib resistance in part by decreasing expression of MUC4 (from Bruni NYAS 2020, Figure C).
−Removed: In addition to decreasing resistance
−Removed: to trastuzumab by decreasing MUC4 expression, INB03 decreases the immunosuppressive tumor microenvironment (Schillaci SABCS 2018,
−Removed: Bruni NYAS 2020).
−Removed: These data are relevant to all tumors that express HER2 and MUC4 including upper gastrointestinal malignancies
−Removed: such as gastric and pancreatic cancer.
−Removed: INB03 targets the patient’s immune system and not the tumor, we believe INB03 is an immunotherapy that can be used to treat
−Removed: many types of hematologic malignancies and solid tumors as part of combination therapy.
−Removed: The decision to use INB03 in a patient
−Removed: will be based on biomarkers that should predict that a patient will benefit from treatment with the drug.
−Removed: MDSC rarely exist in
−Removed: patients without cancer or chronic inflammation.
−Removed: Because MDSC can be measured in the tumor and/or blood of patients with immune
−Removed: dysregulation and chronic inflammation caused by their cancer, MDSC blood levels i) have prognostic value predicting cancer stage
−Removed: and risk of dying from cancer;
−Removed: ii) may be used as a biomarker to target patients who will benefit from INB03 therapy and iii)
−Removed: should be biomarkers demonstrating a pharmacodynamic effect of INB03.
−Removed: Other biomarkers of inflammation may be useful in predicting
−Removed: if a patient will benefit from therapy with INB03 such as Our Phase I clinical trial focused on using INB03 as monotherapy.
−Removed: is a typical Phase I clinical trial design for first-in-man trials in cancer.
−Removed: We expect to use INB03 as part of combination therapy
−Removed: with approved cancer therapies as part of Phase II development.
−Removed: We do not expect to need to modify INB03 therapy to treat each
−Removed: different type of cancer, because INB03 therapy targets the immune system, not the cancer.
−Removed: We do expect to develop the INB03 beyond
−Removed: Phase II to target a specific type of cancer to meet the current system of regulatory approval.
−Removed: For instance, INB03 may be approved
−Removed: to treat patients with elevated MDSC who have lung cancer.
−Removed: To get subsequent approval for the treatment of patients with renal
−Removed: cell cancer who have increased MDSC, we will need to perform a pivotal trial in patients with renal cancer.
−Removed: Likewise, if we want
−Removed: to get approval of treatment of women with HER2 positive breast cancer who express MUC4, we will need to perform a trial in those
−Removed: patients and the results of that trial may be independent of MDSC levels.
−Removed: After the first regulatory approval, if and when achieved,
−Removed: we believe the difficulty and cost of achieving these labels extensions will decline with each successive approval.
−Removed: At this time,
−Removed: we cannot predict if patients without biomarkers of inflammation, elevated MDSC or cytokines, or increased expression of MUC4
−Removed: will benefit from treatment with INB03.
−Removed: Those studies may be performed in the future, but they are not a priority.
−Removed: neutralizes soluble TNF in the brain in exactly the same way INB03 neutralizes soluble TNF in the tumor microenvironment but the
−Removed: effects of soluble TNF neutralization in the brain are different.
−Removed: The cause of the destructive neuroinflammation in the brain
−Removed: are microglial and astroglial cells.
−Removed: The glial cell are two of four cells in the neural unit that also includes oligodentrocytes
−Removed: and nerve cells.
−Removed: Activated microglial cells are considered the resident macrophages of the brain.
−Removed: The primary role of microglial
−Removed: cells is to protect the neural unit from infection.
−Removed: When innate immune dysfunction causes chronic inflammation, activated microglial
−Removed: cells produce soluble TNF that activates astrocytes.
−Removed: Activated glial cells cause nerve cell and oligodrocyte dysfunction that
−Removed: results in synaptic pruning, nerve cell death and demyelination of neurons.
−Removed: These pathologies contribute, in part, to neurodegenerative
−Removed: diseases such as AD, Parkinson’s disease, ALS, MS, Huntington’s disease, glaucoma and TBI (traumatic brain injury)
−Removed: may contribute to neuropsychiatric diseases such as depression, bi-polar disease, sleep disorders, autism, schizophrenia and PTSD.
−Removed: In the setting of AD, microglial activation causes dendritic pruning, synaptic dysfunction and nerve cell death that contributes
−Removed: to cognitive decline and the behavioral manifestations of AD including depression, aggressiveness, sleep disorders, hallucinations
−Removed: and anhedonia.
+Added: When T cells bind the ligand
+Added: to these proteins on the tumor cells, the T cell is turned off and does not attempt to attack the tumor cell.
+Added: Thus, checkpoint inhibitors
+Added: (“CPI”) are part of the complex strategy used by the tumor to evade the patient’s immune system and are responsible
+Added: for resistance to immunotherapy.
+Added: Biopharmaceutical companies have successfully developed CPI that block the receptor/ligand interaction
+Added: to promote the adaptive immune response to the tumor.
+Added: Six CPI are currently approved, pembrolizumab, nivolumab, atezolizumab, avelumab,
+Added: durvalumab, and ipilimumab for a wide variety of solid tumors including melanoma, lung, bladder, gastric cancers and others.
+Added: are in development and more tumor types will be added to the list of sensitive tumors over the next years.
+Added: CPI have become the backbone
+Added: of cancer therapy and are expected to be the best -selling class of drugs by 2027.
+Added: cells typically represent approximately 2% to 13% of circulating lymphocytes and are a critical component of the immune system responsible
+Added: for innate immunity.
+Added: Unlike adaptive immune cells, they are ever present and ready to attack, having the inherent ability to detect and
+Added: eliminate diseased cells without the need for antigen presentation, which is why they are called “natural killers.”
+Added: NK cells bind to stress ligands
+Added: expressed by the diseased cells and directly eliminate them.
+Added: This binding induces NK cells to release cytokines, including, interferons
+Added: and GM-CSF, which are integral in recruiting additional innate and adaptive immune responses by the host.
+Added: NK cells also represent a critical
+Added: effector cell for ADCC, whereby target cells bound with human antibodies, whether made by the patient’s body or administered, are
+Added: selectively destroyed by the NK cells.
+Added: Our Innate Immune Dominant-Negative
+Added: TNF product candidate
+Added: We renamed XPro, which
+Added: we license from Xencor, to INB03 when it is used for cancer related indications.
+Added: We will continue to call the drug XPro when
+Added: used for treatment of neuropsychiatric diseases, including Alzheimer’s disease and TRD discussed below.
+Added: INB03 and XPro are the
+Added: same drug with different names for marketing purposes.
+Added: INB03 is a novel innate immune system check-point inhibitor that we believe
+Added: decreases expression of MUC4 by the tumor, an important resistance mechanism to immunotherapy, decreases proliferation of MDSC,
+Added: promotes recruitment of cytotoxic T cells to the TME and may convert immunosuppressive tumor macrophages into tumor phagocytic
+Added: In murine models, these changes make the tumor reverse resistance to treatment with immunotherapy alone or in
+Added: combination with tyrosine kinase inhibitors (TKI) such a lapatinib.
+Added: MUC4 expression is increased by sTNF.
+Added: Resistance to trastuzumab
+Added: therapy by MUC4 expressing HER2+ breast and gastric cancer cells is driven by steric hinderance.
+Added: By neutralizing sTNF with INB03,
+Added: MUC4 expression decreases allow trastuzumab to bind HER2/neu.
+Added: The mechanism by which combination of INB03 with TKI improves efficacy
+Added: over TKI alone remains under investigation.
+Added: By using INB03 as part of combination therapy for cancer, we believe the patient’s
+Added: dysregulated immune response, a hallmark of cancer progression and resistance to therapy, to be converted to a coordinated immune
+Added: response that can overcome resistance mechanisms to immunotherapy.
+Added: These immune responses have been studied in at least two animal
+Added: In a murine model of an inflammatory cancer, where 3-methylcholanthrese is given to mice in a subcutaneous injection that
+Added: causes the development of multiple cutaneous fibrosarcoma.
+Added: This model was developed by Y Akamatsu in 1967 while working at the
+Added: National Cancer Institute of the NIH.
+Added: In research published by Professor Nikola Vujanovic in Cancer Immunology
+Added: Research in 2016, treatment with INB03 resulted in smaller and fewer cancers with increased survival.
+Added: INB03 is an engineered
+Added: PEGylated protein that neutralizes human soluble TNF, a human inflammatory cytokine that is increased in patients with advanced
+Added: By specifically neutralizing the cytokine, there is decreased phosphorylation of STAT3, an essential step required for the
+Added: proliferation of the MDSC population, and secretion of the immunosuppressive cytokines.
+Added: The combination of decreased MDSC
+Added: proliferation and decreased immunosuppressive cytokines allows the immune system to respond to the tumor.
+Added: This data was published in
+Added: an article entitled Inhibition of Soluble Tumor Necrosis Factor Prevents Chemically Induced Carcinogenesis in Mice in Cancer
+Added: Immunology Research in Cancer Immunology Research 2016.
+Added: In summary, INB03 functions as an innate immune system
+Added: checkpoint inhibitor by eliminating the population of MDSC that provides an immunosuppressive shield protecting the tumor, the
+Added: patient’s immune system is able to function normally to the benefit of the patient – it can attack the tumor.
+Added: an important role in breast cancer (Schillaci R, Front.
+Added: Oncol., 22 April 2020
+Added: | https://doi.org/10.3389/fonc.2020.00584 ).
+Added: In a murine model of trastuzumab resistant breast cancer using JMIT-1 cells,
+Added: a human cell line of HER2 positive breast cancer resistant to trastuzumab placed into immunocompromised mice, INB03 downregulates
+Added: MUC4 from the surface of the JMIT-1 HER2+ breast cancer cells to allow the trastuzumab resistant cells to become trastuzumab
+Added: sensitive (Figure A from Bruni, NYAS 2020) to decrease tumor growth (from Schillaci SABCS 2018, Figure B).
+Added: JMIT-1 cells are also
+Added: resistant to lapatinib, a TKI inhibitor used as a second line therapy in women with trastuzumab resistant HER2+ breast cancer.
+Added: addition of INB03 to lapatinib in the animal model reverses lapatinib resistance in part by decreasing expression of MUC4 (from
+Added: Bruni NYAS 2020, Figure C).
+Added: In addition to decreasing resistance to trastuzumab by decreasing MUC4 expression, INB03 decreases the
+Added: immunosuppressive tumor microenvironment (Schillaci SABCS 2018, Bruni NYAS 2020).
+Added: Recently, Dr.
+Added: Schillaci reported the MUC4
+Added: expressing triple negative breast (TNBC) cancer patients have a worse overall survival.
+Added: (Schillaci SABCS 2021).
+Added: These data may be
+Added: relevant to all tumors that express HER2 or MUC4 including upper gastrointestinal malignancies such as gastric and pancreatic
+Added: We believe MUC4 expression is a biomarker of resistance that may dictate changes therapeutic strategy by clinical teams
+Added: Because INB03 targets the
+Added: patient’s immune system and not the tumor, we believe INB03 is an immunotherapy that can be used to treat many types of hematologic
+Added: malignancies and solid tumors as part of combination therapy.
+Added: The decision to use INB03 in a patient will be based on biomarkers that
+Added: should predict that a patient will benefit from treatment with the drug.
+Added: We believe the ideal biomarker is easy to use and is determined
+Added: before treatment begins.
+Added: MUC4 expression by epithelial tumors is an example of this type of biomarker.
+Added: Our Phase I clinical trial preceded
+Added: the identification of MUC4 as a biomarker and focused on using INB03 as monotherapy.
+Added: This is a typical Phase I clinical trial design for
+Added: first-in-man trials in cancer.
+Added: We expect to use INB03 as part of combination therapy with approved cancer therapies as part of Phase II
+Added: We do not expect to need to modify INB03 therapy to treat each different type of cancer, because INB03 therapy targets the
+Added: immune system, not the cancer.
+Added: We do expect to develop the INB03 beyond Phase II to target a specific type of cancer to meet the current
+Added: system of regulatory approval.
+Added: For instance, INB03 may be approved to treat patients with HER2+/MUC4+ breast cancer.
+Added: To get subsequent
+Added: approval for the treatment of patients with MUC4+ TNBC or MUC4+ pancreatic cancer, we will need to perform a pivotal trial in patients
+Added: with TNBC and pancreatic cancer respectively.
+Added: After the first regulatory approval, if and when achieved, we believe the difficulty and
+Added: cost of achieving these labels extensions will decline with each successive approval.
+Added: At this time, we cannot predict if patients without
+Added: biomarkers of inflammation, elevated MDSC or cytokines, or increased expression of MUC4 will benefit from treatment with INB03.
+Added: studies may be performed in the future, but they are not a priority.
+Added: XPro neutralizes soluble
+Added: TNF in the brain in exactly the same way INB03 neutralizes soluble TNF in the tumor microenvironment but the effects of soluble TNF neutralization
+Added: in the brain are different.
+Added: The cause of the destructive neuroinflammation in the brain are microglial and astroglial cells.
+Added: cell are two of four cells in the neural unit that also includes oligodentrocytes and nerve cells.
+Added: Activated microglial cells are considered
+Added: the resident macrophages of the brain.
+Added: The primary role of microglial cells is to protect the neural unit from infection.
+Added: immune dysfunction causes chronic inflammation, activated microglial cells produce soluble TNF that activates astrocytes.
+Added: Activated glial
+Added: cells cause nerve cell and oligodrocyte dysfunction that results in synaptic pruning, nerve cell death and demyelination of neurons.
+Added: pathologies contribute, in part, to neurodegenerative diseases such as AD, Parkinson’s disease, ALS, MS, Huntington’s disease,
+Added: glaucoma and TBI (traumatic brain injury) may contribute to neuropsychiatric diseases such as depression, bi-polar disease, sleep disorders,
+Added: autism, schizophrenia and PTSD.
+Added: In the setting of AD, microglial activation causes dendritic pruning, synaptic dysfunction and nerve cell
+Added: death that contributes to cognitive decline and the behavioral manifestations of AD including depression, aggressiveness, sleep disorders,
+Added: hallucinations and anhedonia.
Elimination of microglial activation should reverse these symptoms.
−Removed: Because soluble TNF is the apex cytokine in
−Removed: the inflammatory cytokine cascade, neutralization of soluble TNF with XPro1595 should prevent glial activation and normalizes
−Removed: function of the neural unit.
−Removed: Company has an on-going Phase I trial using XPro1595 to reverse neuroinflammation in patients with Alzheimer’s disease.
−Removed: The trial is being performed in Australia and is partially funded by a $1M USD Part-the-Cloud Award from the Alzheimer’s
−Removed: The clinical trial is the first in the Company’s development program for the treatment of dementia.
−Removed: label, dose escalation trial in patients with Alzheimer’s disease with biomarkers of peripheral inflammation (one of CRP>1.5mg/L,
−Removed: HgbA1c>6.0, ESR>10sec or have ApoE4) treats the patients with XPro1595 as a once-a-week subcutaneous injection for 3 months.
−Removed: Patients have multiple biomarkers of neuroinflammation tested before and during therapy including soluble biomarkers in blood
−Removed: and cerebral spinal fluid, volatile biomarkers in breath, behavioral biomarkers (neuropsychiatric symptoms of AD) and neuroimaging
−Removed: biomarkers using MRI.
−Removed: The primary goal of this short, open label study is to demonstrate that treatment with XPro1595 decreases
−Removed: neuroinflammation safely and to define the dose of XPro1595 to use in the Phase II trial.
−Removed: Studies of cognitive function are performed
−Removed: on the patients but are not expected to show significant change because of the short duration of the trial and the wide range
−Removed: of disability in patients enrolled in the clinical trial (MMSE range:
−Removed: The goal of the planned Phase II trial will be to
−Removed: demonstrate the prolonged control of neuroinflammation in patients with dementia will help control cognitive decline.
−Removed: the trial has not been designed, we expect the trial be of a longer duration than the Phase I trial.
−Removed: trial continues to enroll patients.
−Removed: More than half of the expected 18 patients have been enrolled.
−Removed: Preliminary data was presented
−Removed: in a webinar on 13 July 2020.
+Added: Because soluble TNF is the apex cytokine
+Added: in the inflammatory cytokine cascade, neutralization of soluble TNF with XPro should prevent glial activation and normalizes function
+Added: of the neural unit.
+Added: The Company has completed a Phase I trial using XPro to reverse neuroinflammation
+Added: in patients with Alzheimer’s disease.
+Added: The trial was performed in Australia and is partially funded by a $1M USD Part-the-Cloud Award
+Added: from the Alzheimer’s Association.
+Added: The clinical trial is the first in the Company’s development program for the treatment of
+Added: The open label, dose escalation trial in patients with Alzheimer’s disease with biomarkers of peripheral inflammation
+Added: (one of CRP>1.5mg/L, HgbA1c>6.0, ESR>10sec or have ApoE4) treats the patients with XPro as a once-a-week subcutaneous injection
+Added: for 3 months.
+Added: Patients have multiple biomarkers of neuroinflammation tested before and during therapy including soluble biomarkers in
+Added: blood and cerebral spinal fluid, behavioral biomarkers (neuropsychiatric symptoms of AD) and neuroimaging biomarkers using MRI.
+Added: goal of this short, open label study is to demonstrate that treatment with XPro decreases neuroinflammation safely and to define the dose
+Added: of XPro to use in the Phase II trial.
+Added: Studies of cognitive function are performed on the patients but are not expected to show significant
+Added: change because of the short duration of the trial and the wide range of disability in patients enrolled in the clinical trial (MMSE range:
+Added: The goal of the planned Phase II trial will be to demonstrate the prolonged control of neuroinflammation in patients with dementia
+Added: will help control cognitive decline.
+Added: The Company plans two Phase II trials, one each in mild cognitive impairment (MCI) and mild AD.
+Added: trial enrolled 18 patients at doses of 0.3, 0.6 and 1.0mg/kg given once a week as subcutaneous injection for three months.
+Added: the 10mg/kg group were offered extended us of the drug for up to 12 months.
+Added: Three patients remained on XPro for 12 months.
+Added: data was presented in a webinar on 13 July 2020.
Neuroimaging data from six patients were presented in the figure below.
−Removed: In summary, treatment with
−Removed: XPro1595 at either 0.3 or 1.0mg/kg once-a-week as a subcutaneous injection (low and high dose respectively) decreased white matter
−Removed: free water (WMFW) as measured by MRI.
+Added: treatment with XPro at either 0.3 or 1.0mg/kg once-a-week as a subcutaneous injection (low and target dose respectively) decreased white
+Added: matter free water (WMFW) as measured by MRI.
WMFW is a validated biomarker of neuroinflammation.
Although the number of patients is low,
−Removed: there was a dose response with a greater decrease in WMFW in the high dose compared to the low dose group.
+Added: there was a dose response with a greater decrease in WMFW in the target dose compared to the low dose group.
An analysis of inflammation
in white matter tracts demonstrated a significant decrease in WMFW (40%;
−Removed: range 20-52%) in the arcute fasciculus, a white matter
−Removed: tract important in the control of language and short-term memory (Figure D).
−Removed: These data suggest XPro1595 is decreasing neuroinflammation
−Removed: in patients with Alzheimer’s disease who have biomarkers of peripheral inflammation.
−Removed: data was presented on January 21, 2021.
−Removed: The goal of the January 21 data release was to show a correlation between the white matter
−Removed: free water, a novel biomarker of inflammation with cerebral spinal fluid (“CSF”) cytokines and chemokine levels, a
−Removed: traditional measure neuroinflammation.
−Removed: CSF cytokine/chemokines were measure in 9 patients before and after 12 weeks of weekly
−Removed: therapy with XPro1595 using a panel from OLINK Target 48 Cytokine ( https://www.olink.com/products/olink-target-48-cytokine/ ),
+Added: range 20-52%) in the arcute fasciculus, a white matter tract
+Added: important in the control of language and short-term memory (Figure D).
+Added: These data suggest XPro is decreasing neuroinflammation in patients
+Added: with Alzheimer’s disease who have biomarkers of peripheral inflammation.
+Added: Additional data was presented on January 21, 2021.
+Added: The goal of the
+Added: January 21 data release was to show a correlation between the white matter free water, a novel biomarker of inflammation with cerebral
+Added: spinal fluid (“CSF”) cytokines and chemokine levels, a traditional measure neuroinflammation.
+Added: CSF cytokine/chemokines were
+Added: measure in 9 patients before and after 12 weeks of weekly therapy with XPro using a panel from OLINK Target 48 Cytokine ( https://www.olink.com/products/olink-target-48-cytokine/ ),
that measures 45 (Figure AD1).
−Removed: the 6 patients in the 1mg/kg per week dose, only one cytokine and chemokine, interferon gamma (INFg) did not change in the CSF
−Removed: of patients, the remainder all decreased on average of 15%.
−Removed: Using data from all patients treated for 12 weeks (3 low dose, 6 high
−Removed: dose), a high correlation (R 2 =.7561) between the white matter free water safe mase and the inflammation composite score
−Removed: is shown in figure AD2.
−Removed: The data analyzed provides evidence that XPro1595 decreases neuroinflammation in patients with Alzheimer’s
−Removed: We believe these data
−Removed: support the use of XPro1595 to treat other diseases where neuroinflammation is a part of the pathophysiology of the disease.
−Removed: company studied the consequences of decreasing neuroinflammation in the 6 patients from high dose group (XPro1595 1mg/kg for 12
−Removed: weeks) be looking at the CSF proteome using technology for Proteome Sciences using their TMT Calibrator™
−Removed: platform ( https://www.proteomics.com/services/tmtcalibrator-workflow ).
−Removed: A large data set of proteins were identified.
−Removed: Early analysis of the data focusing on 26 AD related proteins demonstrated changes
−Removed: in inflammation, neuronal and synaptic proteins caused by decreasing neuroinflammation after treatment with XPro1595 (Figure AD3).
−Removed: The proteome also demonstrated a clear dose response with a greater number of proteins being affected by the high dose compared
−Removed: to low dose XPro1595 therapy (0.3 vs 1.0 mg/kg/week for 12 weeks) (Figure AD4).
+Added: In the 6 patients in the 1mg/kg per week dose, only one cytokine and
+Added: chemokine, interferon gamma (INFg) did not change in the CSF of patients, the remainder all decreased on average of 15%.
+Added: Using data from
+Added: all patients treated for 12 weeks (3 low dose, 6 target dose), a high correlation (R 2 =.7561) between the white matter free
+Added: water safe mask and the inflammation composite score is shown in figure AD2.
+Added: The data analyzed provides evidence that XPro decreases neuroinflammation
+Added: in patients with Alzheimer’s disease.
+Added: We believe these data support the use of XPro to treat other diseases
+Added: where neuroinflammation is a part of the pathophysiology of the disease.
+Added: The company studied the consequences of decreasing neuroinflammation
+Added: in the 6 patients from target dose group (XPro 1mg/kg for 12 weeks) be looking at the CSF proteome using technology for Proteome Sciences
+Added: using their TMT Calibrator™ platform ( https://www.proteomics.com/services/tmtcalibrator-workflow ).
+Added: A large data set of proteins
+Added: were identified.
+Added: Early analysis of the data focusing on 26 AD related proteins demonstrated changes in inflammation, neuronal and synaptic
+Added: proteins caused by decreasing neuroinflammation after treatment with XPro (Figure AD3).
+Added: The proteome also demonstrated a clear dose response
+Added: with a greater number of proteins being affected by the target dose compared to low dose XPro therapy (0.3 vs 1.0 mg/kg/week for 12 weeks)
+Added: (Figure AD4).
The CSF proteome data is only partially analyzed.
Additional data may result from these ongoing analytics.
−Removed: In summary, these data allow the Company to commit to initiating a blinded
−Removed: randomized Phase II trial in Alzheimer’s disease patients with peripheral biomarkers of inflammation in the second half of
−Removed: The design of the trial has not been finalized nor has the Company had discussions with the FDA.
−Removed: Hence the precise start
−Removed: date depends on gaining regulatory approval for trial initiation by the FDA and resolution of the COVID19 pandemic.
−Removed: infection causes a cytokine storm in many patients.
−Removed: The cytokine storm includes elevated levels of TNF, IL6, IL1 and other pro-inflammatory
−Removed: cytokines in the patient’s blood.
−Removed: The cytokine storm correlates with symptoms of COVID19 of one or more organ systems -
−Removed: neurologic, gastrointestinal, pulmonary, cardiovascular and renal.
−Removed: In 20% of patients, the cytokine storm causes severe enough
−Removed: symptoms to require hospitalization.
−Removed: Targeting soluble TNF may have benefit in hospitalized patients with cytokine storm for two
−Removed: TNF may be the “master cytokine”.
−Removed: Up-regulation of TNF is required for expression of IL6 and IL1, the two
−Removed: other prominent cytokines of the cytokine storm.
−Removed: TNF activates endothelial cells to upregulate Tissue Factor that cause the formation
−Removed: of blood clots.
−Removed: Aberant blood clots contribute to the pathology in patients with COVID-19 infection.
−Removed: Company initiated a blinded randomized trial using Quellor to treat hospitalized patients with respiratory symptoms due to a COVID-19
−Removed: The 366-patient trial is being perform under an FDA IND#151,834 in multiple centers in the US.
−Removed: The trial includes a
−Removed: Go/NoGo decision by the Data Safety Monitoring Board (“DSMB”) after the first 100 patients.
−Removed: No data will be released
−Removed: by the DSMB other than the trial should continue or be closed.
−Removed: The trial enrolls patients admitted to the hospital who are considered
−Removed: high risk for developing the need for mechanical respiratory support.
−Removed: Patients are randomized to receive a single dose of Quellor,
−Removed: 1mg/kg as a subcutaneous injection or placebo.
−Removed: If patients remain in the hospital for one week, they may get a second dose of
−Removed: the investigational product.
−Removed: The primary end-point is the need for mechanical ventilation or death by 28 days.
−Removed: The final safety
−Removed: visit is at or about day 40.
−Removed: Quellor is identical to XPro1595, INB03 and LIVNate.
−Removed: The trial is listed on www.clinicaltrials.gov .
−Removed: therapy for TRD is a large unmet need.
−Removed: Twenty percent of patients with a Major Depressive Disorder have TRD.
−Removed: Once third of TRD
−Removed: patients have peripheral biomarkers to inflammation (elevated CRP).
−Removed: This is a large patient population.
−Removed: The role of TNF and anti-TNF
−Removed: therapeutics was explored in a small open label clinical trial by Prof.
−Removed: Andrew Miller, MD of Emory University demonstrated the
−Removed: patients have elevated TNF levels and treatment with infliximab treated their depression (Miller, 2011).
−Removed: The Company received
−Removed: a $2.9M USD award from the National Institute of Mental Health (“NIMH”) to treat TRD with XPro1595.
−Removed: The blinded, randomized
−Removed: Phase II trial will use a biomarkers of peripheral inflammation to select patients with TRD for enrollment.
+Added: The results of the Phase I study demonstrates that XPro safely decreases
+Added: neuroinflammation in patients with AD who have biomarkers of peripheral inflammation or are ApoE4 positive when given for at least 3 months
+Added: at the 1mg/kg once a week dose.
+Added: Decreasing neuroinflammation with XPro appears to decrease neurodegeneration and improve synaptic function
+Added: and promote remyelination.
+Added: The biologic characteristics suggests XPro therapy in patients with peripheral biomarkers of inflammation or
+Added: ApoE4 allele(s) may impact cognitive decline.
+Added: Although there were anecdotes of improved cognitive function in patients receiving the target
+Added: dose of XPro, this cannot be verified because the trial was not a blinded, randomized trial.
+Added: The impact on cognition of controlling neuroinflammation
+Added: with XPro will be studied in the Phase II programs.
+Added: The Company plans two Phase
+Added: II trials in patients with AD with biomarkers of inflammation.
+Added: A blinded randomized trial in patients with mild AD plans to enroll 201
+Added: patients in a 2:1 ratio (XPro:placebo) at 1mg/kg once a week.
+Added: Patients will be treated for 6 months.
+Added: A patient enrichment strategy will
+Added: be used to ensure patients have neuroinflammation – patients must have at least two of elevated CRP, hemoglobinA1c, ESR or have
+Added: an ApoE4 allele.
+Added: The primary end-point is Early/Mild Alzheimer’s Cognitive Composite (EMACC), a sensitive cognitive end-point validated
+Added: for use in patients with early AD.
+Added: Secondary cognitive (ADAS-Cog13, CDR-SB and NPI) and functional (GAS, ADCS-ADL) end-points will be
+Added: Biomarkers of inflammation using white and gray matter analytics measured by MRI DTI similar to those used in the Phase I trial
+Added: will also be used.
+Added: All patients will be eligible to continue on XPro for at least 6 additional months.
+Added: Clinical and MRI metrics will be
+Added: followed during the extension trial.
+Added: The second Phase II trial will be a blinded randomized trial in patients
+Added: with MCI in which the Company plans to enroll 60 patients in two arms in a 2:1 ratio (1mg/kg/week XPro, placebo).
Patients will be treated
−Removed: Primary end-points include both clinical and neuroimaging measures.
−Removed: The final trial design is ongoing and discussions
−Removed: with the FDA are not complete.
−Removed: The Company anticipates receiving authorization to initiate the clinical trial in the second half
−Removed: neutralizes soluble TNF in the treatment of NASH the same way that INB03 and XPro1595 neutralize soluble TNF for the treatment
−Removed: of cancer and neurodegenerative diseases respectively.
−Removed: NASH is a complex disease with inflammatory, metabolic and fibrotic components
−Removed: that contribute to disease progression.
−Removed: The effects of LIVNate on NASH are diverse.
−Removed: Based on murine data, we believe there are
−Removed: 3 major pathologic cycles that contribute to NASH.
−Removed: The peripheral pathologic cycle is metabolic with obesity and insulin resistance
−Removed: contributing to the inflammatory and metabolic process that drives NASH.
−Removed: The regional pathologic cycle includes intestinal inflammation
−Removed: with resulting leaky gut that drives the development mesenteric fat.
−Removed: All three elements contribute to a highly inflammatory mileau
−Removed: delivered directly to the liver via the portal vein.
−Removed: The local pathologic loop includes lipotoxicity and innate immune dysfunction
−Removed: caused by activated hepatic stellate cell, natural killer cells and hepatocytes.
−Removed: These pathologic cycles cause hepatocyte death,
−Removed: inflammation and fibrosis –
−Removed: the pathologic hallmarks of NASH.
−Removed: In murine models of NASH, LIVNate has effects on each pathologic
−Removed: cycle decreasing insulin resistance, intestinal inflammation and leak, hepatic inflammation, hepatocyte death and fibrosis.
−Removed: results must be confirmed in humans.
−Removed: XPro1595, Quellor and LIVNate, are delivered as a subcutaneous injection, similar to an insulin treatment, given one to three
−Removed: times per week.
−Removed: Because this is a simple subcutaneous injection similar to an insulin injection (the therapy patients give themselves
−Removed: for treatment of Type 1 diabetes mellitus), we expect patients to administer the therapy to themselves and not require expensive
−Removed: or logistically challenging clinic visits to receive the therapy.
−Removed: step process to preparation for INB03, XPro1595, Quellor and LIVNate for human clinical trials:
−Removed: of INB03, XPro1595, Quellor and LIVNate drug supply
−Removed: DN-TNF product (INB03, XPro1595, Quellor and LIVNate) are available for clinical development after completion of release testing.
−Removed: The annual process for release testing was completed in February 2018, January 2019, December 2019 and November 2020.
−Removed: of DN-TNF product is limited, but enough to complete the planned Phase I study in Alzheimer’s disease and Phase II studies
−Removed: in hospitalized patients with COVID-19.
−Removed: The re-release dossier has been submitted to the regulatory authorities in Australia and
−Removed: the US (the FDA).
−Removed: We received notification on May 2018 that the INB03 can be used for oncology clinical trials and in May 2019
−Removed: that XPro1595 can be used in Alzheimer’s disease clinical trials in AUS and in August 2020 that Quellor can be used for
−Removed: the COVID-19 clinical trial in the US.
−Removed: For future trials, new batches of INB03, XPro1595, Quellor and LIVNate will need to be
−Removed: We plan to use a two-step approach to production of the new drug supply.
−Removed: We hope to improve the yield of the drug product
−Removed: using the existing E.coli based system.
−Removed: Once the new process is validated and functional, we will perform a manufacturing
−Removed: campaign drug for future clinical trials.
−Removed: This process has started at our manufacturing vendor KBI.
−Removed: The company expects the first
−Removed: batches of new drug to be available 4Q21 assuming that manufacturing materials remain available and are not consumed by COVID-19
−Removed: vaccine manufacturers.
−Removed: We expect the existing drug supply to support clinical development program until mid-2021.
−Removed: New drug supply
−Removed: may not be available before the existing drug supply has been exhausted.
−Removed: with Regulatory Authorities Regarding INB03, XPro1595 and LIVNate Development
−Removed: We have completed a
−Removed: Phase I trial with INB03 in oncology.
−Removed: We are enrolling patients in a Phase I trial with XPro1595 in patients with Alzheimer’s
−Removed: disease and a Phase II trial with Quellor to treat hospitalized patients with respiratory complications from COVID-19.
−Removed: II program with Alzheimer’s disease will start after completion of the on-going Phase I program.
−Removed: The Phase I trial with XPro1595
−Removed: in patients with Alzheimer’s disease is performed in Australia under the regulatory authority of the TGA using the Clinical
−Removed: Trials Exemption (“CTX”) scheme.
−Removed: Our first interaction with the regulatory body occurred in March 2018.
−Removed: received approval to initiate the Phase I trial with INB03 in patients with advanced solid tumors on May 21, 2018.
−Removed: interaction with the regulatory body occurred in March 2019.
+Added: for 3 months.
+Added: Patients must have at least one ApoE4 allele to qualify for the trial.
+Added: The primary end-point is EMACC, a sensitive cognitive
+Added: end-point validated for use in patients with early AD.
+Added: Secondary clinical endpoints include the CDR-SB, Cogstate Battery, E-Cog, NPI,
+Added: and ADCS-ADL.
+Added: Imaging endpoints of neuroinflammation (White matter free water), white matter integrity (apparent fiber density, radial
+Added: diffusivity), and gray matter quality (cortical disarray measurement) will be assessed via MRI.
+Added: Changes in brain metabolism will be assessed
+Added: Additional secondary measures of function include EEG, and speech and language.
+Added: All patients will be eligible to continue
+Added: on XPro for at least 9 additional months.
+Added: Clinical and MRI metrics will be followed during the extension trial.
+Added: The Company may
+Added: amend the clinical trial design from time-to-time to improve the quality of the data or the probability of success.
+Added: Effective therapy for TRD is a large unmet need.
+Added: Twenty percent of
+Added: patients with a Major Depressive Disorder have TRD.
+Added: Once third of TRD patients have peripheral biomarkers to inflammation (elevated CRP).
+Added: This is a large patient population.
+Added: The role of TNF and anti-TNF therapeutics was explored in a small open label clinical trial by Prof.
+Added: Andrew Miller, MD of Emory University whereby it was demonstrated that patients which have elevated TNF levels responded to treatment
+Added: with infliximab (Miller, 2011).
+Added: The Company received a $2.9M
+Added: USD award from the National Institute of Mental Health (“NIMH”) to treat TRD with XPro.
+Added: The blinded, randomized Phase II trial
+Added: will use a biomarkers of peripheral inflammation to select patients with TRD for enrollment.
+Added: Patients will be treated for 6 weeks.
+Added: end-points include both clinical and neuroimaging measures.
+Added: The final trial design is ongoing and discussions with the FDA are not complete.
+Added: The Company anticipates receiving authorization to initiate the clinical trial in the second half of 2022.
+Added: INB03 and XPro are delivered
+Added: as a subcutaneous injection, similar to an insulin treatment, given one to three times per week.
+Added: Because this is a simple subcutaneous
+Added: injection similar to an insulin injection (the therapy patients give themselves for treatment of Type 1 diabetes mellitus), we expect
+Added: patients to administer the therapy to themselves and not require expensive or logistically challenging clinic visits to receive the therapy.
+Added: Three step process to preparation
+Added: for INB03 and XPro for human clinical trials:
+Added: Release of INB03 and XPro drug supply
+Added: GMP DN-TNF product (INB03 and XPro) are available for clinical development
+Added: after completion of release testing.
+Added: The annual process for release testing was completed in February 2018, January 2019, December 2019
+Added: and November 2020.
+Added: The supply of DN-TNF product is limited, but allowed completion of the Phase I study in Alzheimer’s disease and
+Added: support of patients in the extension study.
+Added: For future trials, new batches of XPro have been produced.
+Added: The Company engaged KBI Biopharma
+Added: to manufacture 6 lots of XPro/INB03 at the Boulder, Colorado facility using the original master cell bank and updated manufacturing process.
+Added: Two lots have been converted into drug product using the US fill/finish facility of Vetter Pharma.
+Added: Two of the lots are frozen as drug
+Added: substance at -80C with a plan to convert to drug product the second half of 2023.
+Added: The final two lots are frozen as a cell paste with a
+Added: plan to process to drug substance in during 2023 or 2024 as needed to support the clinical trials.
+Added: We plan to use a two-step approach
+Added: to improve the yield of the drug substance from the fermentation process.
+Added: We hope to improve the yield of the drug product using the existing E.coli
+Added: based system.
+Added: Once the new process is validated and functional, we will perform a manufacturing campaign drug for future clinical trials.
+Added: In the future, the Company may consider a strain change to improve yield of the fermentation step further.
+Added: The decision for strain improvements
+Added: and strain change will be made in the future as clinical development programs proceed.
+Added: Interaction with Regulatory Authorities Regarding
+Added: INB03 and XPro Development
+Added: We have completed a Phase I trial with INB03 in oncology and a Phase
+Added: I trial with XPro in patients with Alzheimer’s disease.
+Added: The Phase II program with Alzheimer’s disease will start first half
+Added: The Phase I trial with XPro in patients with Alzheimer’s disease is performed in Australia under the regulatory authority
+Added: of the TGA using the Clinical Trials Exemption (“CTX”) scheme.
+Added: Our first interaction with the regulatory body occurred in
+Added: The Company received approval to initiate the Phase I trial with INB03 in patients with advanced solid tumors on May 21, 2018.
+Added: second interaction with the regulatory body occurred in March 2019.
The Company received approval to initiate the Phase I trial with
−Removed: XPro1595 in patients with Alzheimer’s disease in May 2019.
−Removed: Our first interaction with the FDA occurred in July 2020.
−Removed: We received authorization to begin enrolling patients in the COVID19 trial late August 2020.
−Removed: We plan to discuss the Phase II Alzheimer’s
−Removed: disease and Phase II TRD clinical trials with the FDA during the first half of 2021.
−Removed: Product Development Path:
−Removed: Proposed Phase II Studies in patients with cancer
−Removed: I open label study in patients with advance solid tumors has been completed.
−Removed: All future studies cancer will use INB03 as part
−Removed: of combination therapy.
−Removed: Based on the results of the Phase I study and work performed and reported by Prof.
−Removed: Roxana Schillaci, we
−Removed: are planning a study of INB03 in combination with currently approved second line therapy for treatment of tumors that express
−Removed: This may include a study in women with trastuzumab resistant HER2+ metastatic breast cancer where primary or secondary resistance
−Removed: to trastuzumab is common and may include women with brain metastasis.
−Removed: Alternatively, a combination therapy trial in MUC4 expressing
−Removed: tumors of the upper gastrointestinal tract such as gastric or pancreatic cancer may be performed.
−Removed: These trials will not be initiated
−Removed: until the COVID-19 pandemic has run its course.
−Removed: We do not expect to treat patients in a Phase II trial with INB03 before 2022.
−Removed: Registration Studies and/or Partnering
−Removed: plan to pursue an efficient registration strategy using INB03 to improve the lives of patients with cancer and biomarkers of inflammation.
−Removed: We believe that this strategy has use across many types of solid tumors including patients who have failed CPI, tyrosine kinase
−Removed: inhibitors (“TKI”) and anti-cancer antibody therapy We have an active partnering position as it relates to INB03 development
−Removed: in cancer, although no partnering discussion are underway at this time.
−Removed: We do not expect partnering discussions to begin until
−Removed: Phase II data demonstrating efficacy of INB03 as part of combination therapy for cancer are available.
−Removed: INB03 platform can be used in cancer patients in many ways.
−Removed: The Phase I trial suggests the drug should not be used alone to treat
−Removed: cancer but used in combination with, but not limited to, other cancer therapies including cytotoxic chemotherapy, immunotherapy,
−Removed: radiation and surgery.
−Removed: We believe that INB03 can also be used to treat many types of hematologic and epithelial cancers.
−Removed: XPro1595, Quellor and LIVNate Regulatory Strategy
−Removed: from the DN-TNF platform will be developed using adequately powered, well designed studies with the goal to demonstrate a meaningful
−Removed: clinical benefit to patients.
−Removed: In general, these will be blinded, randomized clinical trials using validated end-points that have
−Removed: been authorized by a regulatory authority –
−Removed: the FDA, TGA, MHRA, EMA, etc.
−Removed: Currently, all planned studies will be performed
−Removed: in North America, AUS and/or the UK.
−Removed: Studies will be expanded to Europe and beyond as resources permit and development needs expand.
−Removed: Because there are no therapies similar to INB03, XPro1595, Quellor or LIVNate approved in any market and no therapies approved
−Removed: for the treatment of the diseases we are pursuing, we plan to take advantage of the regulatory opportunities afforded to therapies
−Removed: that treat markets with a high unmet need.
−Removed: In the U.S., this includes Orphan Drug Designation and expedited programs for approval
−Removed: including Accelerated Approval, Breakthrough Therapy Designation, Fast Track Designation, and priority review (see “Government
−Removed: Regulation”), and in the setting of COVID-19, Emergency Use Authorization.
−Removed: We cannot predict which, if any, of these programs
−Removed: we will benefit from without further discussions with the FDA.
+Added: XPro in patients with Alzheimer’s disease in May 2019 and received authorization to start the Phase II trial in patients with mild
+Added: AD on January 5, 2022.
+Added: Our first interaction with the FDA occurred in July 2020 as part of the Phase II Quellor program to treat respiratory
+Added: failure in patients hospitalized with COVID19 infection.
+Added: We plan to complete the regulatory process for the Phase II clinical trials in
+Added: patients with Alzheimer’s disease and Phase II TRD clinical trials with the FDA during the first half of 2022.
+Added: INB03 Product Development Path:
+Added: Proposed Phase
+Added: II Studies in patients with cancer
+Added: Phase I open label study in
+Added: patients with advance solid tumors has been completed.
+Added: All future studies cancer will use INB03 as part of combination therapy.
+Added: on the results of the Phase I study and work performed and reported by Prof.
+Added: Roxana Schillaci, we are planning a study of INB03 in combination
+Added: with currently approved second line therapy for treatment of tumors that express MUC4.
+Added: This may include a study in women with trastuzumab
+Added: resistant HER2+ metastatic breast cancer where primary or secondary resistance to trastuzumab is common and may include women with brain
+Added: Alternatively, the Phase II trial may include women with MUC4+ TNBC or patients with MUC4+/HER2+ gastric cancer or MUC4+ pancreatic
+Added: These trials will not be initiated until the COVID-19 pandemic has run its course.
+Added: We do not expect to treat patients in an oncology
+Added: INB03 Phase II trial with INB03 before 2023.
+Added: Pre-clinical studies of INB03 in MUC4 expressing tumors continue.
+Added: INB03 Registration Studies and/or Partnering
+Added: We plan to pursue an efficient
+Added: registration strategy using INB03 to improve the lives of patients with cancer and biomarkers of inflammation such as MUC4.
+Added: that this strategy has use across many types of solid tumors including patients who have failed CPI, tyrosine kinase inhibitors (“TKI”)
+Added: and anti-cancer antibody therapy such as trastuzumab monoclonal antibodies and trastuzumab based antibody drug conjugates.
+Added: active partnering position as it relates to INB03 development in cancer, although no partnering discussion are underway at this time.
+Added: We do not expect partnering discussions to begin until Phase II data demonstrating efficacy of INB03 as part of combination therapy for
+Added: cancer are available.
+Added: Our INB03 platform can be
+Added: used in cancer patients in many ways.
+Added: The Phase I trial suggests the drug should not be used alone to treat cancer but used in combination
+Added: with, but not limited to, other cancer therapies including cytotoxic chemotherapy, immunotherapy, radiation and surgery.
+Added: We believe that
+Added: INB03 can also be used to treat many types of hematologic and epithelial cancers.
+Added: INB03 and XPro Regulatory Strategy
+Added: Drugs from the DN-TNF platform will be developed using adequately powered,
+Added: well designed studies with the goal to demonstrate a meaningful clinical benefit to patients.
+Added: Beyond Phase I, these will be blinded, randomized
+Added: clinical trials using validated end-points that have been authorized by a regulatory authority – the FDA, TGA, MHRA, EMA, etc.
+Added: all planned studies will be performed in North America, AUS and/or the UK.
+Added: Studies will be expanded to Europe and beyond as resources
+Added: permit and development needs expand.
+Added: Because there are no therapies similar to INB03 or XPro approved in any market and no therapies approved
+Added: for the treatment of the diseases we are pursuing, we plan to take advantage of the regulatory opportunities afforded to therapies that
+Added: treat markets with a high unmet need.
+Added: In the U.S., this includes Orphan Drug Designation and expedited programs for approval including
+Added: Accelerated Approval, Breakthrough Therapy Designation, Fast Track Designation, and priority review (see “Government Regulation”),
+Added: and in the setting of COVID-19, Emergency Use Authorization.
+Added: We cannot predict which, if any, of these programs we will benefit from without
+Added: further discussions with the FDA.
Similar programs exist in the EU with the EMA.
−Removed: We will engage the
−Removed: EMA once we have initiated Phase II trials in the United States and Australia.
−Removed: Immunotherapy
−Removed: for Treatment of Alzheimer’s Disease
−Removed: is being developed for the treatment of Alzheimer’s disease.
−Removed: XPro1595 is identical to INB03, Quellor and LIVNate in every
−Removed: way but name.
−Removed: The name XPro1595 will be used as the drug name in the Alzheimer’s disease development program.
−Removed: activation and neuroinflammation are important causes of the synaptic dysfunction and nerve cell death that causes cognitive decline
−Removed: in patient with dementia and Alzheimer’s disease.
−Removed: The relationship between β
−Removed: amyloid plaques and tau neurofibrillary
−Removed: tangles, the traditional targets in AD drug development and neuroinflammation is complex.
−Removed: We believe targeting plaques and tangles
−Removed: is not an effective treatment strategy, but that targeting neuroinflammation, the final common pathway of synaptic dysfunction
−Removed: and nerve cell death is.
−Removed: Substantial direct pre-clinical data supports the use of XPro1595 in murine models of AD.
−Removed: indirect data supports use of XPro1595 in humans including a decreased risk of AD in patients treated with non-selective TNF inhibitors
−Removed: for rheumatoid arthritis and treatment using direct injection into paraspinous venous plexus.
−Removed: Because of different mechanism of
−Removed: action of XPro1595 compared to the non-selective TNF inhibitors, we expect a lower risk of immunosuppression and demyelinating
−Removed: diseases such as MS.
−Removed: The Company reported preliminary data on July 13, 2020 and January 21, 2021 supporting the use of XPro1595
−Removed: to decrease neuroinflammation in patients with Alzheimer’s disease and biomarkers of peripheral inflammation (see above)
−Removed: continue to enroll patients into an open label, biomarker directed, Phase I clinical trial in AUS that approaches AD as an immunologic
−Removed: Patients with dementia who have the diagnosis of AD with biomarkers of chronic inflammation that includes at least one
−Removed: of a hs-CRP>1.5 mg/L, a ESR>10 mm/h, a HbgA1C>6.0% or are ApoE4 positive will be treated with XPro1595 for 12 weeks.
−Removed: Three dosing cohorts were planned –
+Added: We will engage the EMA once we have initiated Phase II
+Added: trials in the United States and Australia.
+Added: Immunotherapy for Treatment of Alzheimer’s Disease
+Added: XPro is being developed for
+Added: the treatment of Alzheimer’s disease.
+Added: Microglial activation and neuroinflammation are important causes of the synaptic dysfunction
+Added: and nerve cell death that causes cognitive decline in patient with dementia and Alzheimer’s disease.
+Added: The relationship between β
+Added: amyloid plaques and tau neurofibrillary tangles, the traditional targets in AD drug development and neuroinflammation is complex.
+Added: targeting plaques and tangles is not an effective treatment strategy, but that targeting neuroinflammation, the common pathway leading
+Added: to synaptic dysfunction and nerve cell death, may be an effective treatment strategy.
+Added: Substantial pre-clinical data supports the use of
+Added: XPro in murine models of AD.
+Added: Substantial indirect data supports use of XPro in humans including a decreased risk of AD in patients treated
+Added: with non-selective TNF inhibitors for rheumatoid arthritis and treatment using direct injection into paraspinous venous plexus.
+Added: of different mechanism of action of XPro compared to the non-selective TNF inhibitors, we expect a lower risk of immunosuppression and
+Added: demyelinating complications such as multiple sclerosis (MS).
+Added: The Company reported preliminary data on July 13, 2020 and January 21, 2021
+Added: supporting the use of XPro to decrease neuroinflammation in patients with Alzheimer’s disease and biomarkers of peripheral inflammation
+Added: We completed enrollment of
+Added: patients into an open label, biomarker directed, Phase I clinical trial in AUS that approaches AD as an immunologic disease.
+Added: with dementia with the diagnosis of AD with biomarkers of chronic inflammation that includes at least one of a hs-CRP>1.5 mg/L, a ESR>10
+Added: mm/h, a HbgA1C>6.0% or are ApoE4 positive will be treated with XPro for 12 weeks.
+Added: Three dosing cohorts were preformed – 0.3,
0.6 and 1.0 mg per week as a subcutaneous injection.
−Removed: Patients will have 5 groups
−Removed: of inflammatory biomarkers test before therapy, at 6 weeks and at 12 weeks.
−Removed: Biomarkers will be tested in blood and cerebral spinal
−Removed: fluid, white matter free water will be determined by MRI and a “breath test”
−Removed: measuring exhaled volatile organ compounds
−Removed: will be used to determine a signature of inflammation in AD patients.
−Removed: Finally, behavioral biomarkers of fatigue, depression aggression,
−Removed: anhedonia and sleep disorders, behaviors that are very sensitive to neuroinflammation, will be cataloged using validated scales
−Removed: to determine if these behaviors improve as neuroinflammation is brought under control.
−Removed: The first patient was enrolled in the low
−Removed: dose 0.3mg/kg/week cohort in the last week of November 2019.
+Added: Patients had multiple inflammatory biomarkers test before therapy, at 6 weeks and
+Added: Biomarkers were reported in blood and cerebral spinal fluid, MRI measures of white matter tract neuroinflammation, axonal
+Added: quality and axon myelin, and MRI measures of gray matter quality after XPro therapy.
+Added: Cognitive end-points were not the focus of the Phase
+Added: 1 clinical trial because of the wide range of disease severity enrolled and lack of a placebo group.
+Added: Patients enrolled in the Phase I
+Added: trial had MMSE ranging from 24 to 12.
+Added: This wide range of disease severity at the time of enrollment and the lack of a blinded concurrent
+Added: control group did not allow for determination of cognitive benefit beyond several anecdotal reports.
+Added: The first patient was enrolled in
+Added: the low dose 0.3mg/kg/week cohort in the last week of November 2019.
The Safety Review Committee met by teleconference on January 7, 2020
to review the course of the patients in the first cohort and voted to open the second cohort, 1.0mg/kg/week, to enrollment.
−Removed: first patients were enrolled in the cohort the second week of February 2020.
−Removed: Based on preliminary data released on July 13, 2020
−Removed: and January 21, 2021, we are confident that the clinical trial will be closed after completion of a 0.6mg/kg treatment group.
−Removed: We have canceled plans to treat patients with 3.0mg/kg.
−Removed: If safety is confirmed, the data from the Phase I trial will allow the
−Removed: Company to choose a dose to bring forward into the Phase II trial and select biomarkers for that trial.
−Removed: We plan to meet with the
−Removed: FDA to present our plans for the Phase II study in patients with AD in the first half of 2021.
−Removed: If those meetings and subsequent
−Removed: regulatory filings are successful, we plan to start treating patients in the Phase II trial in the second half of 2021.
−Removed: Registration Studies and/or Partnering
−Removed: plan to aggressively pursue an efficient registration strategy using XPro1595 to improve the lives of patients with AD with biomarkers
−Removed: of inflammation.
−Removed: We believe AD is not the only indication for XPro1595 in neurodegenerative and neuropsychiatric diseases.
−Removed: plan to pursue other indications in neurodegenerative diseases as resources become available.
−Removed: We have received NIMH funding to
−Removed: support a Phase II TRD program that hopes to start patient enrollment in the second half of 2021.
−Removed: We have an active partnering
−Removed: position as it relates to XPro1595 development in neurodegenerative and neuropshyciatric diseases, although no partnering discussion
−Removed: are underway at this time.
−Removed: There are two partnering opportunities with this novel immunotherapy for the treatment of neurologic
−Removed: and psychiatric diseases.
−Removed: The first is a traditional partnership focused on the developing the drug for all neurodegenerative
−Removed: and neuropsychiatric applications.
−Removed: The second is a more focused partnership developing XPro1595 as part of a combination therapy
−Removed: for a company’s existing therapy.
+Added: patients were enrolled in the cohort the second week of February 2020.
+Added: Based on preliminary data released on July 13, 2020 and January
+Added: 21, 2021, we closed after completion of a 0.6mg/kg treatment group.
+Added: We canceled plans to treat patients with 3.0mg/kg.
+Added: The data from the
+Added: Phase I trial allow the Company to choose a design the Phase II trials described above.
+Added: XPro Registration Studies and/or Partnering
+Added: We plan to aggressively pursue an efficient registration strategy using
+Added: XPro to improve the lives of patients with ADi.
+Added: We define ADi as Alzheimer’s disease with biomarkers of inflammation.
+Added: ADi is not the only indication for XPro in neurodegenerative and neuropsychiatric diseases.
+Added: We plan to pursue other indications in neurodegenerative
+Added: diseases as resources become available.
+Added: We have received NIMH funding to support a Phase II TRD program that hopes to start patient enrollment
+Added: in the second half of 2022.
+Added: We have an active partnering position as it relates to XPro development in neurodegenerative and neuropshyciatric
+Added: diseases, although no partnering discussion are underway at this time.
+Added: There are two partnering opportunities with this novel immunotherapy
+Added: for the treatment of neurologic and psychiatric diseases.
+Added: The first is a traditional partnership focused on the developing the drug for
+Added: all neurodegenerative and neuropsychiatric applications.
+Added: The second is a more focused partnership developing XPro as part of a combination
+Added: therapy for a company’s existing therapy.
After completion of proof-of-concept Phase II studies, we will decide what the most efficient
registration strategy is available to the company with XPro.
−Removed: We may to have biopharma partners participate in this decision
−Removed: We may also seek to be acquired at this stage.
−Removed: Immunotherapy
−Removed: for the treatment of NASH
−Removed: is being developed for the treatment of NASH.
−Removed: LIVNate is identical to INB03, Quellor and XPro1595 in every way but name.
−Removed: LIVNate will be used as the drug name in the NASH development program.
−Removed: NASH is a pleiotropic disease with elements of metabolic,
−Removed: immunologic and fibrotic pathophysiology contributing to disease development and progression.
−Removed: The Company believes targeting the
−Removed: metabolic and immunologic pathology is the best way to treat NASH.
−Removed: Furthermore, we believe there are three pathologic drivers
−Removed: of NASH, two which originate beyond the liver (refer to Figure 7 below).
−Removed: The peripheral pathologic loop includes obesity and insulin
−Removed: The regional pathologic loop includes intestinal inflammation, intestinal leak and mesenteric fat, a source of inflammatory
−Removed: factors that are concentrated in portal blood.
−Removed: Finally, the local pathologic loop is caused by lipotoxicity and innate immune
−Removed: activation in the liver that results in hepatocyte death, hepatitis and fibrosis, the hallmarks of NASH.
−Removed: In murine studies of
−Removed: NASH, LIVNate reverses insulin resistance, intestinal inflammation and decreases the NAS (“NAFLD Activity Score”)
−Removed: and Fibrosis score suggesting that LIVNate may be an effective therapy for the treatment of NASH.
−Removed: are planning an open label Phase II study of patients with NASH.
−Removed: The study is planned as a proof-of-concept study in patients
−Removed: with F3/F3 disease defined by non-invasive laboratory and imaging studies.
−Removed: Patients will be treated with LIVNate for 6 months
−Removed: by once a week subcutaneous injection.
−Removed: We do not plan to perform liver biopsies as any part of the study.
−Removed: If the study is positive,
−Removed: further development of LIVNate in NASH will be considered.
−Removed: Further development may include additional clinical trials alone or
−Removed: with a partner or divesting the program.
−Removed: This clinical trial has been delayed due to the COVID-19 pandemic.
−Removed: We do not expect to
−Removed: enroll patients into a NASH Phase II clinical trial until 2022 at the earliest.
−Removed: Registration Studies and/or Partnering Programs
−Removed: NASH is an exceptionally dynamic area of drug development, the Company will decide on a development and/or partnering program
−Removed: after the completion of the Phase II study.
−Removed: At this time, it is impossible to predict the development and commercial landscape
−Removed: or to know if LIVNate can be used to treat NASH as a stand-alone drug or as part of combination therapy.
−Removed: Finally, the market for
−Removed: treatments of metabolic and inflammatory liver diseases may expand to include non-alcoholic fatty liver disease (“NAFLD”)
−Removed: in the near future.
−Removed: This market expansion may impact the Company’s development plans for LIVNate.
+Added: We may to have biopharma partners participate in this decision making.
+Added: may also seek to be acquired at this stage.
Our NK cell Directed Product Candidate
−Removed: is our lead product candidate that converts resting NK cells into primed NK cells, an essential step in them becoming activated
−Removed: cancer-killing NK cells.
−Removed: We have shown this works ex vivo in human tissue cell cultures, and we believe that this will work in
−Removed: vivo which is the purpose of our planned clinical trials.
−Removed: grow and relapse because they evade the immune system.
−Removed: NK cells are the most important cell for the elimination of residual
−Removed: disease that causes cancer relapse.
−Removed: NK cells target cells based on a series of complex antigens on the cancer cell surface
−Removed: that signal the NK cells to activate and kill the cancer cell.
−Removed: We call these cancer antigens “priming signals”
−Removed: and “triggering signals”
−Removed: respectively.
−Removed: An NK cell must receive a series of multiple signals through a network
−Removed: of cell surface receptors constituting of both priming and triggering signals.
−Removed: Crucially, we have shown that the priming signals
−Removed: can be delivered independent of the triggering such that one cell, such as INKmune, may deliver priming signals and the patient
−Removed: cancer cell deliver the second set and induce killing.
−Removed: Cancer cells defective in priming signals evade NK killing so the cancer
−Removed: cell survives and grows.
−Removed: Both priming and triggering signals are not a single surface molecule on the NK cell, but a complex
−Removed: combination of signals from multiple cell surface ligands which lead to NK priming and triggering respectively.
−Removed: also express molecules which can inhibit NK cell priming and triggering and the final outcome of the NK-cancer cell conjugation
−Removed: is a balance of all of these signals.
−Removed: In summary, INKmune shifts that balance of stimulating and inhibitory signals to enhance
−Removed: the ability of resting NK cells to kill a wide range of patient cancers.
−Removed: [Sabry Lowdell Frontiers, North et al JI and Sabry
−Removed: et al JI and Tsirogianni et al AmJ Hematol].
−Removed: This concept is shown in the schematic form in Figure 1 below.
−Removed: main “job”
−Removed: of a cancer cell is to survive and grow.
−Removed: Unfortunately, the “successful”
−Removed: cancer cell ultimately
−Removed: kills the host.
−Removed: The first priority for survival is to evade NK cell killing.
−Removed: The vast majority, >98%, of cancer cells do
−Removed: this by downregulating expression of priming ligands.
−Removed: When an NK cell interrogates a cancer cell lacking sufficient priming
−Removed: signals the NK cell is unable to trigger lysis.
−Removed: This allows the cancer to evade NK cell killing to grow, and, we believe,
−Removed: is one of the causes of cancer relapse.
−Removed: have described the functional biology underlying the interaction of NK cells and cancer cells.
−Removed: We believe that we have learned
−Removed: to counteract the loss of the priming signals by artificially providing these signaling ligands to the resting NK cell by
−Removed: exposure to a proprietary tumor cell line which constitutively expresses them.
−Removed: We call this product candidate INKmune.
−Removed: we deliver INKmune to a resting NK cell, it provides priming signals to convert the resting NK cell into a tumor primed NK
−Removed: cell (“TpNK”).
−Removed: TpNK are poised to kill any cancer cell that expresses adequate triggering ligands.
−Removed: extensive pre-clinical testing, we believe this covers a large and heterogenous array of primary human cancers including hematologic
−Removed: malignancies such as acute myelogenous leukemia, multiple myeloma, lymphoma, and solid tumors such as breast, prostate, renal,
−Removed: lung, and ovarian cancer.
−Removed: The TpNK binds to the cancer cell, becomes an activated NK cell that will kill the cancer cell that
−Removed: was previously resistant to NK cell killing.
−Removed: Based on the pre-clinical data, we believe INKmune will convert the patient’s
−Removed: resting NK cells to primed NK cells will allow the patient’s NK cells to kill their tumor.
−Removed: believe there are advantages of NK cells primed with INKmune (“TpNK”) compared to cytokine primed NK cells (“LAK”)
−Removed: or monoclonal antibody targeted NK cells (“MabNK”).
−Removed: Both LAK and MabNK require the priming/targeting agent to
−Removed: be present at all times for the NK cell to be a cancer killing cell.
−Removed: As soon as the cytokine or Mab are removed, the NK cell
−Removed: becomes a resting NK cell that cannot kill the cancer cell.
−Removed: INKmune provides a sustained “on”
−Removed: switch even after
−Removed: the INKmune reagent has been removed.
−Removed: Once INKmune causes the resting NK cell to become a TpNK, the NK cell remains primed
−Removed: and ready to kill until its lytic capacity has been exhausted by lysis of tumor cells.
−Removed: The second advantage is that TpNK can
−Removed: prime resting NK cells by contact-dependent activation and thus enhance the initial INKmune-mediated priming.
−Removed: do not require a specific target compared to MabNK.
−Removed: Trastuzumab (Herceptin™), a Mab targeting HER2 on breast cancer
−Removed: is an illustrative example.
−Removed: Women with HER2 positive breast cancer, 20% of all women with breast cancer, can be treated with
−Removed: and benefit from Herceptin immunotherapy.
−Removed: Unfortunately, the other 80% who are HER2 negative, have a worse survival rate because
−Removed: they can not avail themselves to Trastuzumab immunotherapy.
−Removed: INKmune may benefit the women with HER2 negative breast cancer.
−Removed: We believe the pre-clinical and clinical data using tumor primed NK cells indicates that signals delivered by cancer cells
−Removed: are adequate to provide priming and activation of NK cells to kill the cancer and possibly eliminate the need for MabNK.
−Removed: have demonstrated TpNK killing of many tumor types in laboratory studies.
−Removed: Tumor priming is effective regardless of the source
−Removed: of the NK cells and in many types of tumors –
−Removed: both cell lines and primary tumors from patients.
−Removed: The principle of TpNK
−Removed: killing has also been demonstrated in two Phase I trials in patient with acute myelogenous leukemia (“AML”).
−Removed: trials were not supported by us and used a first-generation personalized cell therapy product.
−Removed: In these trials, haplo-identical
−Removed: NK cells obtained from a first degree relative by leukapheresis were primed ex-vivo using a lysate of the parent cell line
−Removed: from which we derived INB16 - INKmune.
−Removed: Once the TpNK therapy has been produced and passed quality testing, the patient received
−Removed: conditioning therapy with chemotherapy (cyclophosphamide and fludarabine), the primed haplo-identical NK cells were given
−Removed: to patients by intravenous infusion.
−Removed: Two Phase I clinical trials have been performed using the first-generation treatment
−Removed: An investigator initiated trial performed at the Royal Free Hospital in London 2009 was funded by a UK charity.
+Added: INKmune is our lead product candidate that converts the patient’s
+Added: resting NK cells into cancer memory like NK cells, an essential step to allow them to participate in the immune control the patient’s
+Added: We have shown this works ex vivo in human tissue cell cultures, and we believe that this will work in vivo which is the purpose
+Added: of our planned clinical trials.
+Added: Cancers grow and relapse
+Added: because they evade the immune system.
+Added: In many cancers, NK cells are the most important cell for the elimination of residual disease that
+Added: causes cancer relapse.
+Added: NK cells target cells based on a series of complex antigens on the cancer cell surface that signal the NK cells
+Added: to activate and kill the cancer cell.
+Added: NK cells develop a memory like NK cell phenotype to enhance killing of cancer cells.
+Added: This phenotype
+Added: requires multiple simultaneous signals to be delivered to the NK cells.
+Added: A cocktail of three cytokines, IL12, IL15 and IL18 can be used
+Added: to convert a resting NK cell to cytokine induced memory like NK cells (CIML) [Fehneger 2016 ] or by INKmune priming with INB16 (TpNK
+Added: – tumor primed NK cells).
+Added: Although the intracellular biology if these two strategies has yet to be worked out, they do not appear
+Added: to be identical.
+Added: In summary, INKmune converts resting NK cells in to tumor killing memory like NK cells.
+Added: (Figure 1 below).
+Added: The ability of NK cells to kill tumor cells depends on the strength
+Added: and duration of the cell-cell interaction.
+Added: This is call avidity.
+Added: The higher the avidity the greater the tumor cell killing.
+Added: Cytokine stimulation
+Added: may increase avidity of NK binding to some cancer cells whereas, in all experiments to date, INKmune priming enhances NK binding to all
+Added: cancer cells tested.
+Added: The relative increase in avidity to specific cancer cells is cytokine specific;
+Added: as shown below, IL15 increases NK
+Added: avidity for the ovarian cancer line SKOV-3 whereas IL2 has a limited effect.
+Added: IL15 primed NK cells lyse SKOV-3 cells whereas IL2 primed
+Added: INKmune primed NK (TpNK) showed the highest avidity for the tumor cells and the highest level of cytotoxicity.
+Added: that the use of multiple cytokines will achieve the same level of avidity and cytotoxicity as INKmune but studies with multiple cytokines
+Added: have not yet been performed (Figure below).
+Added: We have demonstrated TpNK
+Added: killing of many tumor types in laboratory studies.
+Added: Tumor priming is effective regardless of the source of the NK cells (normal volunteers
+Added: or patients with cancer) and in many types of tumors – both cell lines and primary tumors from patients.
+Added: The principle of TpNK killing
+Added: has also been demonstrated in two Phase I trials in patient with acute myelogenous leukemia (“AML”).
+Added: These trials were not
+Added: supported by us and used a first-generation personalized cell therapy product and treatment strategy that is different from the INKmune
+Added: product and treatment strategy.
+Added: In these trials, haplo-identical NK cells obtained from a first degree relative by leukapheresis were
+Added: primed ex-vivo using a lysate of the parent cell line from which we derived INB16 - INKmune.
+Added: Once the TpNK therapy has been produced and
+Added: passed quality testing, the patient received conditioning therapy with chemotherapy (cyclophosphamide and fludarabine), the primed haplo-identical
+Added: NK cells were given to patients by intravenous infusion.
+Added: Two Phase I clinical trials have been performed using that first-generation adoptive
+Added: cell therapy treatment strategy.
+Added: An investigator initiated trial performed at the Royal Free Hospital in London 2009 was funded by a UK
Fifteen patients with relapsed, high-risk AML were enrolled in the trial.
−Removed: Because of drop-out due to disease progression,
−Removed: delays in product production and complications of conditioning therapy, only 7 of the fifteen patients were treated with the
−Removed: TpNK cell product.
−Removed: Four of seven patients showed clear benefit from the treatment with the TpNK product with prolonged relapse
−Removed: free remission and, in one patient, conversion of a partial remission to full remission.
+Added: Because of drop-out due to disease progression, delays
+Added: in product production and complications of conditioning therapy, only 7 of the fifteen patients were treated with the TpNK cell product.
+Added: Four of seven patients showed clear benefit from the treatment with the TpNK product with prolonged relapse free remission and, in one
+Added: patient, conversion of a partial remission to full remission.
None of the remissions were durable;
−Removed: all patients ultimately died from disease progression.
−Removed: The safety of the product was found to be a combination of toxicity
−Removed: from the chemotherapy conditioning regimen and the TpNK therapy.
−Removed: In general, the complications were well tolerated although
−Removed: did require medical intervention including prolonged periods of aplasia in two heavily pretreated patients that resolved with
−Removed: supportive care.
−Removed: The results of this study have been published in a medical journal (PLoS One.
+Added: all patients ultimately died from disease
+Added: The safety of the product was found to be a combination of toxicity from the chemotherapy/radiotherapy conditioning regimen
+Added: and the TpNK therapy.
+Added: In general, the complications were well tolerated although did require medical intervention including prolonged
+Added: periods of aplasia in two heavily pretreated patients that resolved with supportive care.
+Added: The results of this study have been published
+Added: in a medical journal (PLoS One.
2015 Jun 10;10(6):e0123416.
1 unchanged sentence
eCollection 2015).
−Removed: In 2013, a second open label, multi-center trial was performed in the
−Removed: US using virtually the same product and procedures but targeting a slightly different patient population.
−Removed: In the second trial,
−Removed: 12 patients in first remission with AML were treated with the haplo-identical TpNK product produced using the first generation
−Removed: ex-vivo priming process.
−Removed: After conditioning with chemotherapy, the patients received TpNK in three dosing cohorts –
−Removed: 3x10^5, 1x10^6 or 3x10^6 TpNK per kilogram.
+Added: In 2013, a second open
+Added: label, multi-center trial was performed in the US using the same product and procedures but targeting a slightly different patient population.
+Added: In the second trial, 12 patients in first remission with AML were treated with the haplo-identical TpNK product produced using the first
+Added: generation ex-vivo priming process.
+Added: After conditioning with chemotherapy alone, the patients received TpNK in three dosing cohorts –
+Added: 3x10^5, 1x10^6 or 3x10^6 TpNK per kilogram.
Patients were followed for safety and relapse free survival.
−Removed: This trial confirmed
−Removed: the safety of the TpNK treatment in patients with AML and reinforced many of the efficacy findings seen in the first trial
−Removed: with none of the previously experienced side effects.
−Removed: Patients benefited from haplo-identical TpNK therapy with prolonged
−Removed: relapse free survival including two patients that remain in remission more than 42 months after treatment.
−Removed: This trial has
−Removed: been published.
+Added: This trial confirmed the safety
+Added: of the TpNK treatment in patients with AML and reinforced many of the efficacy findings seen in the first trial with none of the previously
+Added: experienced side effects.
+Added: Patients benefited from haplo-identical TpNK therapy with prolonged relapse free survival including two patients
+Added: that remain in remission more than 42 months after treatment.
+Added: This trial has been published.
(Biol Blood Marrow Transplant.
S1083-8791(18)30132-0.
−Removed: 10.1016/j.bbmt.2018.03.019.)
−Removed: The results of the laboratory and Phase I studies provide evidence that our strategy for treating residual disease is sensible
−Removed: but unproven.
−Removed: Because INKmune
−Removed: primes NK cells to target naturally occurring antigens, we believe INKmune can be used in to treat a wide variety of cancers
−Removed: including hematologic malignancy (AML, MM, CML, high risk MDS) and solid tumors (renal, prostate, breast, ovarian, pancreas
−Removed: We expect the list of INKmune sensitive tumors to continue to expand.
−Removed: The primary role
−Removed: for INKmune will be an immunotherapy targeting residual disease in patients after debulking cancer therapies such as cytotoxic
−Removed: chemotherapy and surgery.
−Removed: At this time, we plan to give INKmune as monotherapy.
−Removed: We do not rule out the possibility of using
−Removed: INKmune as part of combination therapy in the future.
−Removed: We do not expect to need to modify INKmune to treat these additional
−Removed: types of cancer, because we believe INKmune is a universal cancer therapy where “one size fits all”.
−Removed: for INKmune to receive regulatory approval for each cancer indication, clinical trials will need to be performed which demonstrate
−Removed: its safety and effectiveness as a treatment for each such cancer.
−Removed: We believe the difficulty and cost of achieving these labels
−Removed: extensions will decline with each successive approval, if and when achieved.
−Removed: For example, if INKmune is proven to be effective
−Removed: therapy in patients with ovarian cancer and high-risk MDS, we will need to perform separate pivotal trials for approval in
−Removed: lung, prostate or renal cancer.
−Removed: step process to preparation for INKmune human clinical trials:
−Removed: GMP scale-up for Phase I/II clinical material
−Removed: working cell banks and individual INKmune product to be used in the patients for the clinical trial have been produced at the
−Removed: Royal Free Hospital in the CCGTT to full cGMP (MHRA MIA(IMP)11149).
−Removed: All manufacturing has been under the direction of Professor
−Removed: Mark Lowdell.
−Removed: The Company can produce enough INKmune to complete both Phase I clinical trials in women with ovarian cancer and
−Removed: in patients with high-risk MDS.
−Removed: We have validated storage of INKmune for up to 12 months in vapor phase nitrogen and have a fully
−Removed: scalable, closed system manufacturing process which can produce up to 6 patient doses per week during phase I and II trials.
−Removed: intermediate scale we can manufacture 40 doses per week in a single 80 liter bioreactor.
−Removed: Importantly, we have validated the storage
−Removed: of INKmune at -80oC for up to three months which greatly facilitates the delivery and local storage of the drug for clinical trials
−Removed: and post commercialization.
−Removed: In contrast, as far as we know all other NK cell therapies and T cell therapies require complex shipping
−Removed: of drug products in vapor phase nitrogen below -150 o C and specialized arrangements for ongoing storage at the clinical
+Added: 10.1016/j.bbmt.2018.03.019.) The results of the laboratory and Phase I studies provide evidence that
+Added: our strategy for treating residual disease is sensible but unproven.
+Added: Because INKmune primes NK cells to target naturally
+Added: occurring antigens, we believe INKmune can be used in to treat a wide variety of cancers including hematologic malignancy (AML, MM, CML,
+Added: high risk MDS) and solid tumors (renal, prostate, breast, ovarian, pancreas and lung).
+Added: We expect the list of INKmune sensitive tumors
+Added: to continue to expand.
+Added: The primary role for INKmune will be an immunotherapy
+Added: targeting residual disease in patients after debulking cancer therapies such as cytotoxic chemotherapy and surgery.
+Added: At this time, we plan
+Added: to give INKmune as monotherapy.
+Added: We do not rule out the possibility of using INKmune as part of combination therapy in the future.
+Added: not expect to need to modify INKmune to treat these additional types of cancer, because we believe INKmune is a universal cancer therapy
+Added: where “one size fits all”.
+Added: We believe for INKmune to receive regulatory approval for each cancer indication, clinical trials
+Added: will need to be performed which demonstrate its safety and effectiveness as a treatment for each such cancer.
+Added: We believe the difficulty
+Added: and cost of achieving these labels extensions will decline with each successive approval, if and when achieved.
+Added: For example, if INKmune
+Added: is proven to be effective therapy in patients with ovarian cancer and high-risk MDS, we will need to perform separate pivotal trials for
+Added: approval in lung, prostate or renal cancer.
+Added: Three step process to preparation for INKmune
+Added: human clinical trials:
+Added: INKmune GMP scale-up for Phase I/II clinical
+Added: The working cell banks and
+Added: individual INKmune product to be used in the patients for the clinical trial have been produced at the Centre for Cell, Gene & Tissue
+Added: Therapeutics at Royal Free Hospital / University College London to full cGMP (MHRA MIA(IMP)11149).
+Added: All manufacturing has been under the
+Added: direction of Professor Mark Lowdell.
+Added: The Company can produce enough INKmune to complete both Phase I clinical trials in women with ovarian
+Added: cancer and in patients with high-risk MDS.
+Added: We have validated storage of INKmune for up over 3 years in vapor phase nitrogen and have a
+Added: fully scalable, closed system manufacturing process in validation which can produce up to 6 patient doses per week during phase I and
+Added: At intermediate scale we can manufacture 40 doses per week in a single 80 liter bioreactor.
+Added: Importantly, we have validated
+Added: the storage of INKmune at -80 o C for up to 27 days which greatly facilitates the delivery and local storage of the drug for
+Added: clinical trials and post commercialization use.
+Added: In contrast, as far as we know all other NK cell therapies and T cell therapies require
+Added: complex shipping of drug products in vapor phase nitrogen below -150 o C and specialized arrangements for ongoing storage at
+Added: the clinical sites.
We may need additional INKmune for future clinical trials.
−Removed: Biomarker Development Program
−Removed: have discovered two biomarker strategies that we believe can be used to demonstrate:
+Added: INKmune Biomarker Development Program
+Added: We have discovered two biomarker
+Added: strategies that we believe can be used to demonstrate:
i) who should receive INKmune therapy;
−Removed: if the INKmune therapy is working;
−Removed: and iii) when INKmune therapy should be repeated.
−Removed: For the initial Phase I/II trials in patients
−Removed: with ovarian cancer and high-risk MDS, we expect the biomarker testing will be performed in a single laboratory under our direction.
−Removed: In the near future, we will develop assay systems with standard operating procedures to ensure uniform testing of the biomarker
−Removed: across clinical sites.
−Removed: This will facilitate expansion of the clinical programs to multiple sites.
−Removed: We anticipate that, in the future,
−Removed: the biomarker program may be a surrogate marker for both clinical effectiveness and marketing purposes.
−Removed: with Regulatory Authorities Regarding INKmune Development
−Removed: INKmune Phase I studies in high-risk MDS and ovarian cancer will be performed in the UK.
+Added: ii) if the INKmune therapy is working;
+Added: iii) when INKmune therapy should be repeated.
+Added: For the initial Phase I/II trials in patients with ovarian cancer and high-risk MDS, we
+Added: expect the biomarker testing will be performed in a single laboratory under our direction.
+Added: We may develop training programs for our standard
+Added: operating procedures to ensure uniform testing of the biomarkers to facilitate expansion of the clinical programs to multiple sites.
+Added: anticipate that, in the future, the biomarker program may be a surrogate marker for both clinical effectiveness and marketing purposes.
+Added: Interaction with Regulatory Authorities Regarding
+Added: INKmune Development
+Added: INKmune Phase I studies in high-risk MDS and ovarian cancer will be performed in the UK and US.
We met with the Medicines and Healthcare
−Removed: Products Regulatory Agency (“MHRA”), the UK version of the FDA as part of a Scientific Advice Meetings in preparation
−Removed: for submitting the CTA for each program.
−Removed: The purpose of the meeting was to explain to the MHRA our manufacturing process and clinical
−Removed: plan for the development of INKmune in a Phase I relapse/refractory ovarian cancer and high risk MDS respectively.
−Removed: Product Development Path Proposed Phase I Study in patients with ovarian cancer
−Removed: the evolution of the COVID-19 pandemic in 2021, we plan to initiate an open label Phase I cancer study in patients with ovarian
−Removed: Patients will be enrolled who have a low burden of relapse refractory disease and have peripheral blood or ascites
−Removed: NK cells which can respond to INKmune in a laboratory test on NK function.
−Removed: The study design agreed upon after discussion with
−Removed: the MHRA on September 12, 2017 was for a two-step Phase I/II study but this has been modified to an classic Phase I study followed
−Removed: by a randomized phase II.
−Removed: At present we anticipate the Phase I to be performed under the modified CTA at a single UK site, Sheffield
−Removed: University Hospital.
−Removed: We expect to initiate trial by the third quarter of 2021.
−Removed: In the Phase I trial, women with relapse refractory
−Removed: ovarian cancer will be treated with INKmune, given as an intra-peritoneal infusion through an indwelling peritoneal catheter in
−Removed: a traditional open label study to demonstrate safety and determine the dose of INKmune to be carried into the larger Phase II
−Removed: portion of the study.
+Added: Products Regulatory Agency (“MHRA”), the UK version of the FDA as part of a Scientific Advice Meetings in preparation for
+Added: submitting the CTA for our first planned program.
+Added: The purpose of the meeting was to explain to the MHRA our manufacturing process and
+Added: clinical plan for the development of INKmune in a Phase I relapse/refractory ovarian cancer.
+Added: We plan to expand the MDS program beyond
+Added: This may include sites in the EU and the US.
+Added: We will need to work with the relevant regulatory authorities as we make those expansions.
+Added: We will seek regulatory approval to start the ovarian cancer program in the US after the first cohort of patients have been treated in
+Added: INKmune Product Development Path Proposed Phase
+Added: I Study in patients with ovarian cancer
+Added: Pending the resolution of
+Added: the COVID-19 pandemic in 2022, we plan to initiate an open label Phase I cancer study in patients with ovarian carcinoma.
+Added: Patients will
+Added: be enrolled who have a low burden of relapse refractory disease and have peripheral blood or ascites NK cells which can respond to INKmune
+Added: in a laboratory test on NK function.
+Added: The study design agreed upon after discussion with the MHRA on September 12, 2017 was for a two-step
+Added: Phase I/II study but this has been modified to an classic Phase I study followed by a randomized phase II.
+Added: At present we anticipate the
+Added: Phase I to be performed under the modified CTA at a single UK site, Sheffield University Hospital.
+Added: We expect to initiate trial by the
+Added: third quarter of 2022.
+Added: In the Phase I trial, women with relapse refractory ovarian cancer will be treated with INKmune, given as an intravenous
+Added: infusion in a traditional open label study to demonstrate safety and determine the dose of INKmune to be carried into the larger Phase
+Added: II portion of the study.
Based on pre-clinical studies that indicate that women with relapsed/refractory ovarian cancer have NK cells
−Removed: in their peritoneal cavity that response to INKmune to kill SKOV3, an NK-resistant ovarian cell line, we believe intra-peritoneal
−Removed: delivery of INKmune will be therapeutically effective.
−Removed: Three clinical trials support this observation.
−Removed: Two clinical trials have
−Removed: been performed using the first generation haplo-identical TpNK product in patients with AML.
−Removed: Both of those studies have been published
−Removed: 2015 Jun 10;10(6):e0123416.
−Removed: 10.1371/journal.pone.0123416.
−Removed: eCollection 2015) and (Biol Blood Marrow Transplant.
−Removed: S1083-8791(18)30132-0.
−Removed: 10.1016/j.bbmt.2018.03.019.).
−Removed: In summary, the studies showed that TpNK therapy,
−Removed: when delivered by intravenous infusion after conditioning therapy, was effective in providing prolong remissions with a toxicity
−Removed: profile that was manageable.
−Removed: TpNK therapy has not been delivered via intraperitoneal infusion, but a similar treatment strategy
−Removed: is used for the delivery of TALL-104 cells.
−Removed: TALL-104 is a replication incompetent human MHC non-restricted cytotoxic T-cell leukemic
−Removed: cell line that has been extensively studied and used to treat a number of cancers.
−Removed: Currently, Galileo Research, an Italian biotech
−Removed: company, has used TALL-104 in a Phase II clinical trial to treat women with ovarian cancer (http://www.galileoresearch.it/en/pipeline/TALL-104.html).
−Removed: In that study, TALL-104 is delivered via intraperitoneal infusion.
−Removed: Although the efficacy of the therapy is not yet known, the
−Removed: therapy is well tolerated with toxicities mainly related to the infusion catheter, not related to the TALL-104 infusion.
−Removed: end points of the INKmune Phase I trial are safety and determining the dose of INKmune to take into the Phase II portion of the
−Removed: clinical trial.
−Removed: The key secondary efficacy end-points to be studied are i) increased NK cell priming as determined by multicolor
−Removed: flow cytometry of NK cells from the patient;
−Removed: ii) increased NK cell killing of SKOV3 tumor in a bioassay as shown in Figure 2 below;
+Added: in their peritoneal cavity that response to INKmune to kill SKOV3, an NK-resistant ovarian cell line, we believe intravenous delivery
+Added: of INKmune will be therapeutically effective in treating intra-peritoneal disease.
+Added: The key secondary efficacy end-points to be studied
+Added: are i) increased NK cell priming as determined by multicolor flow cytometry of NK cells from the patient;
+Added: ii) increased NK cell killing
+Added: of SKOV3 tumor in a bioassay as shown in Figure 2 below;
and iii) a decrease in tumor burden as measured by CA125 levels in the blood.
−Removed: Once safety and the optimal INKmune dose have been
−Removed: determined, a randomized study of women treated with INKmune will be compared to a group of control patients who receive only
−Removed: standard of care.
−Removed: We expect to treat six patients in the Phase I portion of the trial, but this number can increase by as many
−Removed: Product Development Path Proposed Phase I Study in patients with high-risk MDS
−Removed: 2021, we plan to initiate an open label Phase I cancer study in patients with high-risk myelodysplastic syndrome (“MDS”).
−Removed: Patients will be enrolled who have a low burden of disease after completion of conventional therapy and have peripheral blood
−Removed: NK cells which can respond to INKmune in a laboratory test of NK function.
−Removed: At present we anticipate the Phase I to be performed
−Removed: at a single UK site, University Hospital Southampton.
−Removed: A UK contract research organization has been appointed and we expect to
−Removed: initiate trial by the third quarter of 2021.
−Removed: In the Phase I trial, patients with detectable residual disease in bone marrow and/or
−Removed: peripheral blood (<15% blasts by conventional tests) will be treated with intravenous infusions of INKmune and monitored for
−Removed: changes in peripheral blood NK activation, NK function and changes in residual blast counts in blood and bone marrow.
−Removed: We and others
−Removed: have previously shown that MDS patients with inadequate NK function have statistically significantly poorer prognosis than matched
−Removed: patients with normal levels of NK function (Tsirogianni et al 2019) and we have shown in laboratory experiments that the functional
−Removed: activity of NK cells from MDS patients can be enhanced by exposure to INKmune.
−Removed: Moreover, INKmune-primed NK cells are not inhibited
−Removed: by the hypoxic conditions of the diseased bone marrow microenvironment.
−Removed: Because both INKmune programs are being run in the UK,
−Removed: delays due to the COVID-19 pandemic may delay initiation of the clinical trial.
−Removed: Registration Studies and/or Partnering
−Removed: completion of proof-of-concept Phase II studies with INKmune, we will decide whether to continue to develop INKmune as a treatment
−Removed: for ovarian carcinoma indication and/or high risk MDS.
−Removed: Other solid cancers are of interest including nasopharyngeal cancer (“NPC”)
−Removed: which is a known target for NK cells and an important unmet clinical need in emerging markets such as mainland China.
−Removed: to have biopharma partners participate in this decision.
+Added: Once safety and the optimal INKmune dose have been determined, a randomized study of women treated with INKmune will be compared to a
+Added: group of control patients who receive only standard of care.
+Added: We expect to treat six patients in the Phase I portion of the trial, but
+Added: this number can increase by as many as 18.
+Added: INKmune Product Development Path Proposed Phase
+Added: I Study in patients with high-risk MDS
+Added: During 2021, we initiated an open label Phase I cancer study in patients
+Added: with high-risk myelodysplastic syndrome (“MDS”).
+Added: Patients are being enrolled who have a low burden of disease after completion
+Added: of conventional therapy.
+Added: At present we anticipate the Phase I to be performed at two sites UK site and will expand into additional sites
+Added: in EU and/or US during 2022.
+Added: The first patients was enrolled in the first quarter of 2021.
+Added: In the Phase I trial, patients with detectable
+Added: residual disease in bone marrow and/or peripheral blood (<15% blasts by conventional tests) will be treated with intravenous infusions
+Added: of INKmune and monitored for changes in peripheral blood NK activation, NK function and changes in residual blast counts in blood and
+Added: We and others have previously shown that MDS patients with inadequate NK function have statistically significantly poorer
+Added: prognosis than matched patients with normal levels of NK function (Tsirogianni et al 2019) and we have shown in laboratory experiments
+Added: that the functional activity of NK cells from MDS patients can be enhanced by exposure to INKmune.
+Added: Moreover, INKmune-primed NK cells are
+Added: not inhibited by the hypoxic conditions of the diseased bone marrow microenvironment.
+Added: The first patient was treated in the second quarter of 2021.
+Added: is now more than 6 months out from therapy with INKmune.
+Added: The patient, part of the first cohort, received 1x10^8 INKmune cells on day 1,8
+Added: and 15 as an in-patient.
+Added: The patient did not require any type of conditioning therapy or cytokine support.
+Added: The patient tolerated the three
+Added: infusions without any problems.
+Added: The patient underwent intensive monitoring over 120 days.
+Added: There are 4 observations from this first patient.
+Added: The patient has dramatically increased the number of activated, “memory-like” NK cells in circulation.
+Added: Memory-like NK cells
+Added: (mlNK) are activated NK cells with a unique cell surface protein phenotype and which show enhanced lysis of tumor cell in vitro.
+Added: treatment with INKmune, elevated levels of mlNK cells were present in the patients in the peripheral blood for more than 119 days when
+Added: trial follow-up ceased.
+Added: The patient mlNK actively kill NK resistant cancer targets in vitro.
+Added: Finally, the patient has had a significant
+Added: clinical improvement with a reduction of his ECOG score from 2 to 0 and a significant reduction in blood product support.
+Added: Two compassionate use cases
+Added: have also been treated.
+Added: Both were young patients with AML who had failed previous hematopoietic stem cell transplants (HSCT).
+Added: compassionate-treatment patient showed such improved neutrophil and platelet counts that she was discharged from hospital for the first
+Added: time in six months.
+Added: She remains well and at home three months under the care of her clinical team.
+Added: The second patient treated compassionately
+Added: had failed two high risk HSCT and entered the course of INKmune therapy with high percentage of blasts in his bone marrow.
+Added: NK cells responded in differentiation into mlNK as hoped but it is too early to determine if INKmune has provide any clinical benefit.
+Added: Because both INKmune programs
+Added: are being run in the UK, delays due to the COVID-19 pandemic continues to delay enrolment into the MDS clinical trial and is delaying
+Added: site initiation for the ovarian cancer trial.
+Added: INKmune Registration Studies and/or Partnering
+Added: After completion of proof-of-concept
+Added: Phase II studies with INKmune, we will decide whether to continue to develop INKmune as a treatment for ovarian carcinoma indication and/or
+Added: high risk MDS.
+Added: Other solid cancers are of interest including nasopharyngeal cancer (“NPC”) which is a known target for NK
+Added: cells and an important unmet clinical need in emerging markets such as mainland China.
+Added: Renal cell carcinoma is also a known target for
+Added: We expect to have biopharma partners participate in this decision.
We may also seek to be acquired at this stage or partner INKmune.
−Removed: our development strategy is focused on North America and Europe, we believe INKmune will also be attractive for markets on the
−Removed: Pacific Rim, South Asia and South America, but will wait for partners to help with the development in those regions, however,
−Removed: at this time, we are not negotiating with any potential partners.
−Removed: we have published data demonstrating INKmune efficacy at priming allogeneic NK cells ex-vivo (described above) and this includes
−Removed: priming of NK cells differentiated from cord-blood derived hematopoietic stem cells (Domogala et al Cytotherapy 2017:
−Removed: Numerous companies are developing therapeutic strategies using cord blood derived NK cell products and one or more may wish to
−Removed: partner with us to potentiate their product by co-incubation or co-administration with INKmune.
−Removed: Regulatory Strategy
−Removed: is a new therapy for the treatment of cancer that will need to be proven safe and effective by well-designed clinical trials that
−Removed: show a meaningful clinical benefit to patients.
−Removed: We believe that registration trials will need to be designed as randomized trials
−Removed: in patients with cancer where one group of patients received INKmune and another receive best available care.
−Removed: We received advice
−Removed: from the MHRA on September 12, 2017 on the design clinical trial for ovarian cancer.
−Removed: And have used that advice to plan both current
−Removed: phase I trials.
−Removed: We plan to perform the Phase I trials with INKmune in the United Kingdom under two clinical trials authorizations
−Removed: (“CTA”) –
−Removed: one for each indication.
−Removed: If either phase I elicits “positive”
−Removed: data we plan to open one
−Removed: or more Phase II programs to additional sites in the United Kingdom and the US.
−Removed: We will meet with the FDA once we have data from
−Removed: the Phase I trials.
−Removed: Because there are no therapies similar to INKmune approved in any market, we plan to take advantage of the
−Removed: regulatory opportunities afforded to therapies that treat small markets with a high unmet need.
−Removed: In the U.S., this includes Orphan
−Removed: Drug Designation and expedited programs for approval including Accelerated Approval, Breakthrough Therapy Designation, Fast Track
−Removed: Designation, and priority review (see “Government Regulation”).
−Removed: We cannot predict which of these programs we will
−Removed: benefit from, if any at all, without further discussions with the FDA.
−Removed: Similar programs exist in the EU with the European Medicines
−Removed: Agencies (“EMA”).
−Removed: Market Opportunity
−Removed: cancer therapy market is large, diverse and competitive.
−Removed: Although the concept of immunotherapy with monoclonal antibodies has
−Removed: been around for more than 20 years, the concept that patient derived immunosuppressive factors was a barrier to effective cancer
−Removed: treatment was recently recognized and had its first therapy approved just four years ago (ipilimumab, Yervoy, BMS, March 2011).
−Removed: Since then, five additional “check point”
−Removed: inhibitors have been approved, but the market is in its infancy.
−Removed: the focus on strategies for modulating tumor-based immunosuppression focus is on the adaptive immune system (“T-cells”).
−Removed: The role of, and the importance of manipulating the innate immune system has more recently become a target of therapeutic development.
−Removed: NK cells are part of the innate immune system and are critical in both tumor surveillance (prevention) and treatment (killing).
−Removed: MDSCs are part of the innate immune system that only appear once the patient has chronic inflammation, a common occurrence in
−Removed: patients with cancer.
−Removed: The main role of the MDSC is to protect the tumor from attack by the patient’s immune system.
−Removed: T-cell focused strategies do not have an effect on the innate immune system, patient’s receiving such treatments may fail
−Removed: to recruit half of the patient’s immune system, the innate immune system, to attack the patient’s cancer.
−Removed: increasingly recognize that durable responses to cancer require a coordinated attack by the patient’s adaptive and innate
−Removed: immune system.
+Added: Although our development strategy is focused on North America and Europe, we believe INKmune will also be attractive for markets on the
+Added: Pacific Rim, South Asia and South America, but will wait for partners to help with the development in those regions, however, at this
+Added: time, we are not negotiating with any potential partners.
+Added: Importantly, we have published
+Added: data demonstrating INKmune efficacy at priming allogeneic NK cells ex-vivo (described above) and this includes priming of NK cells differentiated
+Added: from cord-blood derived hematopoietic stem cells (Domogala et al Cytotherapy 2017:
+Added: Numerous companies are developing
+Added: therapeutic strategies using cord blood derived NK cell products and one or more may wish to partner with us to potentiate their product
+Added: by co-incubation or co-administration with INKmune.
+Added: We are also aware of companies developing cytokine primed NK cells (CIML) for the
+Added: treatment of cancer.
+Added: We believe tumor primed NK cells are superior to ex vivo or in vivo cytokine strategies.
+Added: Data to support this belief
+Added: should be presented in 2022.
+Added: INKmune Regulatory Strategy
+Added: INKmune is a new therapy for the treatment of cancer that will need
+Added: to be proven safe and effective by well-designed clinical trials that show a meaningful clinical benefit to patients.
+Added: We believe that
+Added: registration trials will need to be designed as randomized trials in patients with cancer where one group of patients received INKmune
+Added: and another receive best available care.
+Added: We received advice from the MHRA on September 12, 2017 on the design the Phase I clinical trial
+Added: for ovarian cancer.
+Added: And have used that advice to plan both current phase I trials.
+Added: We plan to initiate the Phase I trials with INKmune
+Added: in the United Kingdom under two clinical trials authorizations (“CTA”) – one for each indication.
+Added: Both trials will be
+Added: expanded to sites in the US after opening of an IND.
+Added: We expect those IND’s to be open by the end of 2022.
+Added: If either phase I elicits
+Added: “positive” data we plan to open one or more Phase II programs to additional sites in the United Kingdom, EU and/or US.
+Added: each regulatory jurisdiction outside of the UK, the competent regulatory authority will need to be engaged.
+Added: In the US, that is the FDA.
+Added: In the EU, it will be the country specific regulatory authority.
+Added: These follow-on regulatory submissions will include data from the patients
+Added: treated in the UK in the clinical trials or as part of compassionate use.
+Added: Because there are no therapies similar to INKmune approved in
+Added: any market, we plan to take advantage of the regulatory opportunities afforded to therapies that treat small markets with a high unmet
+Added: In the U.S., this includes Orphan Drug Designation and expedited programs for approval including Accelerated Approval, Breakthrough
+Added: Therapy Designation, Fast Track Designation, and priority review (see “Government Regulation”).
+Added: We cannot predict which of
+Added: these programs we will benefit from, if any at all, without further discussions with the FDA.
+Added: Similar programs exist in the EU with the
+Added: European Medicines Agencies (“EMA”) and in the UK with the MHRA.
+Added: Emerging Market Opportunity
+Added: The cancer therapy market
+Added: is large, diverse and competitive.
+Added: Although the concept of immunotherapy with monoclonal antibodies has been around for more than 20 years,
+Added: the concept that patient derived immunosuppressive factors was a barrier to effective cancer treatment was recently recognized and had
+Added: its first therapy approved just four years ago (ipilimumab, Yervoy, BMS, March 2011).
+Added: Since then, more than five additional “check
+Added: point” inhibitors have been approved, but the market is in its infancy.
+Added: Most of the focus on strategies for modulating tumor-based
+Added: immunosuppression focus is on the adaptive immune system (“T-cells”).
+Added: The role of, and the importance of manipulating the
+Added: innate immune system has more recently become a target of therapeutic development.
+Added: NK cells are part of the innate immune system and are
+Added: critical in both tumor surveillance (prevention) and treatment (killing).
+Added: MDSCs and Tumor Associated Macrophages (TAM) are part of the
+Added: innate immune system that only appear in the TME of patients with cancer.
+Added: The main role of the MDSC and TAM is to protect the tumor from
+Added: attack by the patient’s immune system.
+Added: Because T-cell focused strategies do not have an effect on the innate immune system, patient’s
+Added: receiving such treatments may fail to recruit half of the patient’s immune system, the innate immune system, to attack the patient’s
+Added: Clinicians increasingly recognize that durable responses to cancer require a coordinated attack by the patient’s adaptive
+Added: and innate immune system.
Normalizing the response of the innate immune system requires eliminating the dysregulated innate immune response
−Removed: that decreases the patient’s ability to see and attack the cancer as well as mechanisms the protect the cancer from immunologic
+Added: that decreases the patient’s ability to see and attack the cancer as well as mechanisms the protect the cancer from immunologic
attack (effector and protector function respectively).
1 unchanged sentence
INB03, by decreasing
−Removed: the proliferation and function of MDSC, will lessen the immunosuppressive shield that protects the tumor from immunologic attack
−Removed: and, through NK/DC crosstalk, recruit the adaptive immune system to the fight.
−Removed: in the Market for Our Product Candidates
−Removed: market for new oncology therapies is busy, complicated, and rapidly evolving.
−Removed: We will be competing with companies that are older,
−Removed: larger, better financed and have greater experience.
−Removed: There are two types of drug companies –
−Removed: development companies and commercial
−Removed: Development companies take the risk of developing new products to proof-of-concept.
−Removed: Once proof-of-concept has been
−Removed: achieved, if the drug provides clinical benefit, the product is usually acquired by a commercial company, which completes the
−Removed: drug’s clinical development and markets the product.
−Removed: We are a development company which will seek to develop products such
−Removed: as INKmune from the bench to the bedside to demonstrate proof-of-concept.
−Removed: The goal for us is to successfully develop such products
−Removed: to the point where they are attractive targets for potential partners/acquirers.
−Removed: to a recent Markets and Markets report, the immunotherapy market is growing rapidly at an annual rate of over 13%.
−Removed: Recently, the
−Removed: market is biased towards T cell-based immunotherapies including bi-specific antibody therapies, checkpoint inhibitors and CAR-T
−Removed: cell-based therapies.
−Removed: There are substantial numbers of clinical trials that are focused on the adaptive immune system versus clinical
−Removed: trials that are focused on the innate immune system for the treatment of cancer.
−Removed: Our challenge will be to educate partners on
−Removed: the value of NK cell-based therapeutic strategies.
+Added: the immunosuppressive function of MDSC and TAM, will lessen the immunosuppressive shield that protects the tumor from immunologic attack
+Added: and, through NK/DC crosstalk, recruit the adaptive immune system to the fight and potentially increase local innate anti-tumor effects
+Added: such as improved NK cell function and anti-tumor macrophage phagocytic activity.
+Added: Challenges in the Market for Our Product Candidates
+Added: The market for new oncology
+Added: therapies is busy, complicated, and rapidly evolving.
+Added: We will be competing with companies that are older, larger, better financed and
+Added: have greater experience.
+Added: There are two types of drug companies – development companies and commercial companies.
+Added: Development companies
+Added: take the risk of developing new products to proof-of-concept.
+Added: Once proof-of-concept has been achieved, if the drug provides clinical benefit,
+Added: the product is usually acquired by a commercial company, which completes the drug’s clinical development and markets the product.
+Added: We are a development company which will seek to develop products such as INKmune from the bench to the bedside to demonstrate proof-of-concept.
+Added: The goal for us is to successfully develop such products to the point where they are attractive targets for potential partners/acquirers.
+Added: According to a recent Markets
+Added: and Markets report, the immunotherapy market is growing rapidly at an annual rate of over 13%.
+Added: Recently, the market is biased towards
+Added: T cell-based immunotherapies including bi-specific antibody therapies, checkpoint inhibitors and CAR-T cell-based therapies.
+Added: substantial numbers of clinical trials that are focused on the adaptive immune system versus clinical trials that are focused on the innate
+Added: immune system for the treatment of cancer.
+Added: Our challenge will be to educate partners on the value of NK cell-based therapeutic strategies.
The need to educate people of the importance of INB03 is equally challenging.
−Removed: At the academic level, there is recognition that therapies targeting MDSC are needed to improve the results of immunotherapies.
−Removed: Investors and potential partners are only now learning about MDSC.
−Removed: We will be responsible for educating them on the importance
−Removed: of MDSC and why INB03 may be an important addition to the oncologist’s armamentarium.
−Removed: We believe educating investors and
−Removed: partners about new therapeutic opportunities is an easier task than trying to differentiate our company from the many other cancer
−Removed: immunotherapy companies.
−Removed: We plan to use a combination of publication, presentation and investor relations to promote INKmune and
−Removed: INB03 and to educate the clinical, biopharma and investor community on the value of these novel therapeutic approaches.
−Removed: our knowledge, there are no other innate immune system check-point inhibitors in development that combine the characteristics
−Removed: of neutralizing soluble TNF, decreasing the population and function of MDSC while promoting NK/DC crosstalk that expands, decreases
−Removed: expression of MUC4 and recruits the adaptive immune response to attack the patient’s tumor.
−Removed: Lilly is developing LY3022855,
−Removed: a human IgG1 monoclonal antibody designed to target the CSF1R that should inhibit MDSC from receiving CSF1 signals, decreasing
−Removed: their survival and relieving the effect of MDSC in the tumor.
−Removed: Daiichi Sankyo Inc., in collaboration with Bristol Myers Squibb,
−Removed: is testing DS-8273a, a TRIAL-R2 agonistic antibody in combination with a PDL1 inhibitor to decrease the number of MDSC in patients
−Removed: with colorectal cancer.
−Removed: Rgenix Inc., is developing RGX-104, an orally bioavailable small molecule immunotherapy that targets LXR
−Removed: (liver X Receptor).
+Added: At the academic and investor level, there is little recognition
+Added: of the role MUC4 plays in causing resistance to immunotherapy.
+Added: The concept of adding a drug to modify the immunosuppressive environment
+Added: of the TME to allow immunotherapy to be effective is also new.
+Added: We will be responsible for educating them on the importance of MUC4 expression,
+Added: TAM, MDSC and why INB03 may be an important addition to the oncologist’s armamentarium.
+Added: We believe educating investors and partners
+Added: about new therapeutic opportunities is an easier task than trying to differentiate our company from the many other cancer immunotherapy
+Added: We plan to use a combination of publication, presentation and investor relations to promote INKmune and INB03 and to educate
+Added: the clinical, biopharma and investor community on the value of these novel therapeutic approaches.
+Added: DN-TNF Competition
+Added: To our knowledge, there are
+Added: no other innate immune system check-point inhibitors in development that combine the characteristics of neutralizing soluble TNF, decreasing
+Added: the population and function of MDSC while promoting NK/DC crosstalk that expands, decreases expression of MUC4 and recruits the adaptive
+Added: immune response to attack the patient’s tumor.
+Added: Lilly is developing LY3022855, a human IgG1 monoclonal antibody designed to target
+Added: the CSF1R that should inhibit MDSC from receiving CSF1 signals, decreasing their survival and relieving the effect of MDSC in the tumor.
+Added: Daiichi Sankyo Inc., in collaboration with Bristol Myers Squibb, is testing DS-8273a, a TRIAL-R2 agonistic antibody in combination with
+Added: a PDL1 inhibitor to decrease the number of MDSC in patients with colorectal cancer.
+Added: Rgenix Inc., is developing RGX-104, an orally bioavailable
+Added: small molecule immunotherapy that targets LXR (liver X Receptor).
RGX-104 reportedly depletes MDSC.
Syntrix Biosystems is developing SX-682.
−Removed: SX-682 is a small-molecule dual-inhibitor
−Removed: of CXCR1 and CXCR2, the chemokine receptors pivotal to tumor metastasis, therapy-resistance, and myeloid cell suppression of cancer
−Removed: surveillance by the adaptive immune system.
−Removed: By blocking the CXCR1/2 pathway, SX-682 may prevent recruitment of MDSC to the tumor
−Removed: microenvironment.
−Removed: The University of Minnesota has a trivalent antibody program aimed at treating patients with advanced hematologic
−Removed: malignancies.
+Added: SX-682 is a small-molecule dual-inhibitor of CXCR1 and CXCR2, the chemokine receptors pivotal to tumor metastasis, therapy-resistance,
+Added: and myeloid cell suppression of cancer surveillance by the adaptive immune system.
+Added: By blocking the CXCR1/2 pathway, SX-682 may prevent
+Added: recruitment of MDSC to the tumor microenvironment.
+Added: The University of Minnesota has a trivalent antibody program aimed at treating patients
+Added: with advanced hematologic malignancies.
This CD16/IL-15/CD33 (161533) Tri-Specific Killer Engagers (TriKes) product may target CD33+ MDSC.
−Removed: Siamab Therapeutics
−Removed: is developing an anti-sialyl-Tn monoclonal antibody that targets MDSC in some tumor types.
−Removed: Clathera Biosciences, in collaboration
−Removed: with Incyte, a US based biotech, is developing CB-1158 (INCB01158), an arginase inhibitor to decreases MDSC.
−Removed: A Phase II clinical
−Removed: trial is open that combines CB-1158 with nivolumab, an anti-PD1 CPI marketed by Bristol Myers Squib.
+Added: Siamab Therapeutics is developing an anti-sialyl-Tn monoclonal antibody that targets MDSC in some tumor types.
+Added: Clathera Biosciences, in
+Added: collaboration with Incyte, a US based biotech, is developing CB-1158 (INCB01158), an arginase inhibitor to decreases MDSC.
+Added: clinical trial is open that combines CB-1158 with nivolumab, an anti-PD1 CPI marketed by Bristol Myers Squib.
Reata Pharmaceuticals is
−Removed: testing omaveloxolone (RTA 408) in the phase Ib/II REVEAL trial in combination with either ipilimumab (Yervoy) or nivolumab (Opdivoo)
−Removed: in patients with advanced unresectable or metastatic melanoma.
−Removed: Currently approved non-selective TNF inhibitors, infliximab, etanercept,
−Removed: adalimumab and others, are not considered direct competitors of INB03 in the treatment of cancer because of their mechanism of
−Removed: action and safety side effects.
+Added: testing omaveloxolone (RTA 408) in the phase Ib/II REVEAL trial in combination with either ipilimumab (Yervoy) or nivolumab (Opdivo) in
+Added: patients with advanced unresectable or metastatic melanoma.
+Added: Currently approved non-selective TNF inhibitors, infliximab, etanercept, adalimumab
+Added: and others, are not considered direct competitors of INB03 in the treatment of cancer because of their mechanism of action and safety
+Added: side effects.
Non- selective TNF inhibitors block the function of both sTNF and tmTNF.
−Removed: Blockade of tmTNF is
−Removed: immunosuppressive increasing the risk of infection and cancer in patients.
−Removed: This is shown in Figure 3 below where maintaining function
−Removed: to tmTNF by genetic or pharmacologic means results in an immunocompetent animal that can protect itself against infection.
−Removed: or knock-out of both sTNF and tmTNF results in death from infection.
−Removed: industry is highly competitive and subject to rapid and significant technological change.
−Removed: Our potential competitors include large
−Removed: pharmaceutical and biotechnology companies, specialty pharmaceutical and generic drug companies, academic institutions, government
−Removed: agencies and research institutions.
−Removed: We believe that key competitive factors that will affect the development and commercial success
−Removed: of our product candidates are efficacy, safety, tolerability, reliability, price, and reimbursement level.
−Removed: Many of our potential
−Removed: competitors, including many of the organizations named below, have substantially greater financial, technical, and human resources
−Removed: than we do and significantly greater experience in the discovery and development of product candidates, obtaining FDA and other
−Removed: regulatory approvals of products and the commercialization of those products.
−Removed: Accordingly, our competitors may be more successful
−Removed: than us in obtaining FDA approval for and achieving widespread market acceptance of their drugs.
−Removed: Our competitors’
−Removed: may be more effective, or more effectively marketed and sold, than any drug we may commercialize and may render our product candidates
−Removed: obsolete or non-competitive before we can recover the expenses of developing and commercializing any of our product candidates.
−Removed: We anticipate that we will face intense and increasing competition as new drugs enter the market and advanced technologies become
−Removed: Further, the development of new treatment methods for the conditions we are targeting could render our drugs non-competitive
−Removed: is an immunotherapy that harnesses the biology of NK cells for the treatment of cancer.
−Removed: There is a long list of immunotherapy
−Removed: strategies for the treatment of cancer and the immunotherapy for cancer market is growing rapidly.
−Removed: There are at least three ways
−Removed: to classify immunotherapy for cancer.
−Removed: The list below classifies immunotherapy strategies beginning with those that are most closely
−Removed: related to INKmune:
−Removed: Companies in the
−Removed: NK cell therapy business;
−Removed: Companies in the
−Removed: personalized immune-oncology business;
−Removed: Companies in the
−Removed: precision immuno-oncology business.
−Removed: are not aware of any approved treatments that are classified as NK cell therapies.
−Removed: We are aware of public companies in the NK
−Removed: cell therapy business such as NantKwest, Nkarta, Fate Therapeutics and Glycostem.
−Removed: These companies are developing products that
−Removed: involve replacing or supplementing NK cells of the patient for the treatment cancer.
−Removed: Their product requires extensive ex-vivo
−Removed: cell manipulations which, with respect to NantKwest and Fate Therapeutics, may include gene therapy.
−Removed: The next larger group of
−Removed: companies are in the personalized immuno-oncology business with products focused on T cell activation strategies.
−Removed: The most popular
−Removed: are the CAR-T cell therapies which are a patient specific ex-vivo gene therapy approach to a single disease (for example:
−Removed: CAR-T therapy has become wildly popular of late and includes many private companies, newer public companies such as Bluebird,
−Removed: Juno Therapeutics and Mustang Bio as well as established companies such as Novartis and Gilead.
−Removed: For many of the companies, CAR-T
−Removed: cell therapies is their only business.
−Removed: For the latter two, CAR-T cell therapies is a newly in-licensed program with marketing
−Removed: authorization in the US.
−Removed: Finally, the precision immune-oncology category also includes companies with anti-cancer antibody products
−Removed: and the newer “check-point”
−Removed: Antibody therapies are all about “illuminating”
−Removed: the cancer to
−Removed: the innate immune system (NK cells).
−Removed: Monoclonal antibodies were the original immunotherapy that drove the growth of well-known
−Removed: biopharma companies including Genentech/Roche, Amgen, Merck and others.
−Removed: Each of these products is disease specific (ie:
−Removed: only HER2+ breast cancer).
−Removed: Modern therapeutic antibodies are much more complicated bi-specific and tri-specific antibodies that
−Removed: attempt to connect the cancer with activated T-cells of the adaptive immune system.
−Removed: Check-point inhibitors are currently the most
−Removed: rapidly expanding product category in immuno-oncology.
+Added: Blockade of tmTNF is immunosuppressive increasing
+Added: the risk of infection and cancer in patients.
+Added: This is shown in Figure 3 below where maintaining function to tmTNF by genetic or pharmacologic
+Added: means results in an immunocompetent animal that can protect itself against infection.
+Added: Blockade or knock-out of both sTNF and tmTNF results
+Added: in death from infection.
+Added: INKmune Competition
+Added: Our industry is highly competitive
+Added: and subject to rapid and significant technological change.
+Added: Our potential competitors include large pharmaceutical and biotechnology companies,
+Added: specialty pharmaceutical and generic drug companies, academic institutions, government agencies and research institutions.
+Added: that key competitive factors that will affect the development and commercial success of our product candidates are efficacy, safety, tolerability,
+Added: reliability, price, and reimbursement level.
+Added: Many of our potential competitors, including many of the organizations named below, have
+Added: substantially greater financial, technical, and human resources than we do and significantly greater experience in the discovery and development
+Added: of product candidates, obtaining FDA and other regulatory approvals of products and the commercialization of those products.
+Added: our competitors may be more successful than us in obtaining FDA approval for and achieving widespread market acceptance of their drugs.
+Added: Our competitors’ drugs may be more effective, or more effectively marketed and sold, than any drug we may commercialize and may
+Added: render our product candidates obsolete or non-competitive before we can recover the expenses of developing and commercializing any of
+Added: our product candidates.
+Added: We anticipate that we will face intense and increasing competition as new drugs enter the market and advanced
+Added: technologies become available.
+Added: Further, the development of new treatment methods for the conditions we are targeting could render our
+Added: drugs non-competitive or obsolete.
+Added: INKmune is an immunotherapy
+Added: that harnesses the biology of NK cells for the treatment of cancer.
+Added: There is a long list of immunotherapy strategies for the treatment
+Added: of cancer and the immunotherapy for cancer market is growing rapidly.
+Added: There are at least three ways to classify immunotherapy for cancer.
+Added: The list below classifies immunotherapy strategies beginning with those that are most closely related to INKmune:
+Added: Companies in the NK cell therapy business;
+Added: Companies in the personalized immune-oncology business;
+Added: Companies in the precision immuno-oncology business.
+Added: We are not aware of any approved
+Added: treatments that are classified as NK cell therapies.
+Added: We are aware of public companies in the NK cell therapy business such as Century
+Added: Therapeutics, Immunity Bio, Nkarta, Fate Therapeutics, Glycostem and others.
+Added: These companies are developing products that involve replacing
+Added: or supplementing NK cells of the patient for the treatment cancer.
+Added: Their product requires extensive ex-vivo cell manipulations which,
+Added: with respect to Century Therapeutics and Fate Therapeutics, may include gene therapy.
+Added: The next larger group of companies are in the personalized
+Added: immuno-oncology business with products focused on T cell activation strategies.
+Added: The most popular are the CAR-T cell therapies which are
+Added: a patient specific ex-vivo gene therapy approach to a single disease (for example:
+Added: pediatric ALL).
+Added: CAR-T therapy has become wildly popular
+Added: of late and includes many private companies, newer public companies such as Bluebird, Juno Therapeutics and Mustang Bio as well as established
+Added: companies such as Novartis and Gilead.
+Added: For many of the companies, CAR-T cell therapies is their only business.
+Added: For the latter two, CAR-T
+Added: cell therapies is a newly in-licensed program with marketing authorization in the US.
+Added: Finally, the precision immune-oncology category
+Added: also includes companies with anti-cancer antibody products and the newer “check-point” inhibitors.
+Added: Antibody therapies are
+Added: all about “illuminating” the cancer to the innate immune system (NK cells).
+Added: Monoclonal antibodies were the original immunotherapy
+Added: that drove the growth of well-known biopharma companies including Genentech/Roche, Amgen, Merck and others.
+Added: Each of these products is
+Added: disease specific (ie:
+Added: treat only HER2+ breast cancer).
+Added: Modern therapeutic antibodies are much more complicated bi-specific and tri-specific
+Added: antibodies that attempt to connect the cancer with activated T-cells of the adaptive immune system.
+Added: Check-point inhibitors are currently
+Added: the most rapidly expanding product category in immuno-oncology.
These CTLA-4 (ipilimumab) and PD-1 inhibitors (pembrolizumab and nivolumab)
2 unchanged sentences
and GSK (ipilimumab and nivolumab).
−Removed: There are many others trying to join this promising therapeutic area including large companies
−Removed: such as BMS and Roche.
−Removed: are several FDA approved drugs that improve the ability of the innate immune system (NK-cells) to treat cancer including mono-clonal
−Removed: antibody therapies (for example:
−Removed: Rituximab®;
−Removed: and Herceptin®
−Removed: marketed by Roche/Genentech);
−Removed: and “check-point”
−Removed: inhibitors (Yervoy®
−Removed: and Opdivo®, BMS, Keytruda®, Merck and others).
−Removed: There is a large amount of development activity
−Removed: in the immune checkpoint inhibitor field from both pharmaceutical giants including AstraZeneca, Merck & Co, Pfizer, Merck
−Removed: KGaA, Roche, GSK, Novartis and Amgen and many start-ups, small companies and university spin-offs which have emerged in the past
−Removed: Examples (in alphabetical order) include Agenus, Alligator Bioscience, Ambrx, AnaptysBio, argenx, Bioceros, BioNovion,
−Removed: Cellerant Therapeutics, Checkpoint Therapeutics, Compugen, CureTech, Enumeral, Five Prime Therapeutics, Genmab, GITR, ImmuNext,
−Removed: IOmet Pharma, iTeos Therapeutics, Jounce Therapeutics, KAHR Medical, Multimeric Biotherapeutics, Nativis, Orega Biotech, Pelican
−Removed: Therapeutics, Pieris Pharmaceuticals, Prima BioMed, Redx Pharma, Sorrento Therapeutics, Tesaro, TG Therapeutics, Theravectys and
−Removed: ToleroTech active in the field.
−Removed: The list of companies with poly-specific antibodies that attempt to link the cancer with a cytotoxic
−Removed: T cell is long, includes both private and public companies (Amgen, Xencor, F-Star, Merus and many others).
−Removed: Finally, two CAR-T
−Removed: cell therapies were just approved for the treatment of ALL –
−Removed: Kymriah™
−Removed: (Novartis) and Yescarta™
−Removed: expect additional drugs to gain marketing authorization in the immune-oncology space.
−Removed: our knowledge, there are no innate immune check-point inhibitors in development that have the unique characteristics of INB03
−Removed: that neutralize sTNF to:
−Removed: i) decreases the proliferation of MDSC;
−Removed: ii) decreasing local and systemic immunosuppression caused by
−Removed: MDSC by stopping production of immunosuppressive cytokines and;
−Removed: iii) improving NK/DC cross-talk to recruit the adaptive immune
−Removed: system to fight the cancer.
−Removed: seek to protect our therapeutic programs by continuously developing patent properties covering novel compositions, formulations,
−Removed: purpose-limited compositions, combination treatments, methods of medical treatment, and other inventions in the United States
−Removed: Patent & Trademark Office (the “USPTO”), the World Intellectual Property Organization (“WIPO”) under
−Removed: the Patent Cooperation Treaty (“PCT”), and in patent offices for various foreign jurisdictions.
−Removed: While each invention
−Removed: is unique and territories for protection are decided on a case by case basis, we generally pursue patents in Australia, Canada,
−Removed: Europe, Japan, and the United States, and sometimes in Brazil, China and/or Korea.
−Removed: The following sections and corresponding tables
−Removed: summarize, for each of our current therapeutic programs, our pending and granted patent positions, to the extent publicly available,
−Removed: as of the time of preparing this document:
−Removed: Platform Technology (Cancer, Neurologic Diseases, Metabolic Diseases, COVID-19)
−Removed: The DN-TNF Platform
−Removed: Technology covers a variety of dominant negative tumor necrosis factor (“DN-TNF”) variant proteins, including the pegylated
−Removed: DN-TNF protein variants known as XPro1595, INB03, LIVNate, and Quellor.
−Removed: These DN-TNF protein variants can be considered a platform
−Removed: technology for treating the underlying immune dysfunction associated with many disease manifestations.
−Removed: The following table summarizes
−Removed: current IP covering our DN-TNF Platform Technology:
−Removed: PROTEIN BASED TNF-ALPHA
−Removed: VARIANTS FOR THE TREATMENT OF TNF-ALPHA RELATED DISORDERS
−Removed: PROTEIN BASED TNF-ALPHA
−Removed: VARIANTS FOR THE TREATMENT OF TNF-ALPHA RELATED DISORDERS
−Removed: METHODS FOR RATIONAL
−Removed: PEGYLATION OF PROTEINS
−Removed: PEGYLATED TNF-a VARIANT
−Removed: (Neurologic Diseases)
−Removed: The patent suite for
−Removed: XPro1595 includes the DN-TNF patents (above) and other patents and patent applications directed to methods of treatment of disease.
−Removed: This patent suite continues to expand with active prosecution on use of XPro1595 (a DN-TNF variant) in neurologic diseases.
−Removed: following table summarizes current IP expanding our DN-TNF Platform Technology for CNS-related methods of treatment:
−Removed: EP 2892547 B1
−Removed: A DOMINANT NEGATIVE
−Removed: TNF-ALPHA INHIBITOR FOR USE IN TREATING NEUROLOGICAL DISORDERS OF THE CNS
−Removed: EP 20178121 A
−Removed: METHODS OF TREATING
−Removed: NEUROLOGICAL DISEASES
−Removed: METHODS OF TREATING
−Removed: NEUROLOGICAL DISEASES
−Removed: METHODS OF TREATING
−Removed: NEUROLOGICAL DISEASES
−Removed: patent suite for INB03 includes the DN-TNF patents (above) and other patents and patent applications directed to methods of treatment
−Removed: This patent suite continues to expand with active prosecution on use of INB03 (a DN-TNF variant) in oncology.
−Removed: following table summarizes current IP expanding our DN-TNF Platform Technology for oncology-related methods of treatment:
−Removed: US 10,543,264
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: “CANCER PREVENTION
−Removed: AND THERAPY BY INHIBITING SOLUBLE TUMOR NECROSIS FACTOR”
−Removed: (Metabolic Diseases)
−Removed: patent suite for LIVNate includes the DN-TNF patents (above) and other patents and patent applications directed to methods of
−Removed: treatment of disease.
−Removed: This patent suite continues to expand with active prosecution on use of LIVNate (a DN-TNF variant) for treating
−Removed: metabolic diseases.
−Removed: The following table summarizes current IP expanding our DN-TNF Platform Technology for metabolic disease -related
−Removed: methods of treatment:
−Removed: TREATMENT OF COMPLICATIONS
−Removed: RELATED TO ACUTE OR CHRONIC HYPERGLYCEMIA
−Removed: Jointly-Owned
−Removed: PCT/US20/32649
−Removed: TREATMENT OF NON-ALCOHOLIC
−Removed: STEATOHEPATITIS
−Removed: (CRS and COVID-19)
−Removed: patent suite for Quellor includes the DN-TNF patents (above) and other patents and patent applications directed to methods of
−Removed: treatment of disease.
−Removed: This patent suite continues to expand with active prosecution on use of Quellor (a DN-TNF variant) for treating
−Removed: cytokine release syndrome (CRS) and complications of COVID-19.
−Removed: We have two patent properties pending as of the date of this document.
−Removed: INKmune program is directed to compositions and methods of treating cancer.
−Removed: INKmune comprises cells and/or membrane portions of
−Removed: cells derived from a cancer cell line expressing a unique biological signature (that is often downregulated in many cancers),
−Removed: which cells/membrane portions are inactivated to prevent proliferation, and which are administered to a patient.
−Removed: Once administered,
−Removed: the inactivated cells/membranes (INKmune) are presented in vivo to the patient’s own resting NK cells, thereby providing
−Removed: the unique biological signature, and resulting in what we call “NK cell priming,”
−Removed: that is, the change of a resting
−Removed: NK cell to a non-naturally occurring state, or “primed NK cell,”
−Removed: wherein the primed NK cell has received the signals
−Removed: often downregulated by cancer cells.
−Removed: Now having the often-downregulated signals, a primed NK cell can subsequently contact, adhere
−Removed: and commence killing of the patient’s cancer cells.
−Removed: The following table summarizes current IP covering INKmune:
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: CN201880028522A
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: KR20197030017A
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: “IN VIVO PRIMING
−Removed: OF NATURAL KILLER CELLS”
−Removed: commercial success depends in part on obtaining and maintaining patent protection and trade secret protection of our current and
−Removed: future product candidates and the methods used to manufacture them, as well as successfully defending these patents against third-party
−Removed: Our ability to stop third parties from making, using, selling, offering to sell or importing our products depends
−Removed: on the extent to which we have rights under valid and enforceable patents or trade secrets that cover these activities.
−Removed: assure you that our pending patent applications will result in issued patents.
−Removed: “N/A”
−Removed: when used above with respect to provisional patent applications and international PCT patent applications, each of which is
−Removed: only temporary in nature, and does not mature into a valid enforceable patent by itself, but instead serves to establish a
−Removed: chain of priority rights for subsequently filed patent applications.
−Removed: “TBD”
−Removed: when used above with respect to pending patent applications which are undergoing ordinary patent prosecution and may eventually
−Removed: issue as a valid enforceable patent.
−Removed: International
−Removed: PCT patent applications cover all 152 nations which are signatories of the PCT.
−Removed: However, our IP strategy generally recognizes
−Removed: the United States, United Kingdom, European Union, Canada, Japan, Australia and China as targets for extending patent protection
−Removed: under the PCT.
−Removed: Decisions regarding which countries to extend patent coverage under the PCT is taken on a case by case basis, subject
−Removed: to normal business considerations such as value and return on investment.
−Removed: of the above-identified patents and patent applications is subject to change based on strategic patent portfolio building decisions,
−Removed: which may include refiling and reissue, certain abandonments, including those in favor of continuing patent applications, maturations
−Removed: from provisional to non-provisional filings, and other regular patent prosecution activities.
−Removed: following table summarizes trademark applications and registrations used or intended for use in connection with products in our
−Removed: / Registration
−Removed: of the above-identified trademark applications is subject to change as the trademark portfolio develops and we begin to perfect
−Removed: these registrations with actual use after receiving marketing authorization.
−Removed: Ventures, LLC License Agreement
−Removed: October 29, 2015, the Company entered into an exclusive license agreement (the “INKmune License Agreement”) with Immune
−Removed: Ventures, LLC (“Immune Ventures”).
−Removed: Pursuant to the INKmune License Agreement, we were granted exclusive worldwide,
−Removed: sub-licensable, royalty-bearing licenses (collectively “Patent Rights”) as well as all applications (the “Field”)
−Removed: of the Patent Rights, including rights to incorporate any improvements or additions to the patents that may be developed in the
−Removed: future to the following patents and patent applications:
−Removed: Applications:
−Removed: Application Serial No.
−Removed: US 62/219,652
−Removed: IN VIVO ACTIVATION
−Removed: OF NATURAL KILLER CELLS
−Removed: US 62/263,951
−Removed: IN VIVO ACTIVATION
−Removed: OF NATURAL KILLER CELLS
−Removed: US 15/268,399
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: PCT/US2016/061835
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: US 62/471,953
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: EP 16847576.2
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: JP 2018-534524
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: PCT/US2018/022722
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: AU 2018203469
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: CN 201880028522
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: KR 20197030017
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: EP 18768024.4
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: US 16/494,713
−Removed: IN VIVO PRIMING OF
−Removed: NATURAL KILLER CELLS
−Removed: consideration for the Patent Rights, we agreed to the following milestone payments (of which none have been incurred as of December
−Removed: Each Phase I initiation
−Removed: Each Phase II initiation
−Removed: Each Phase III initiation
−Removed: Each NDA/EMA filing
−Removed: Each NDA/EMA awarded
−Removed: addition, we agreed to pay the licensor a royalty of 1% of net sales during the life of each patent granted to us.
−Removed: is owned by Raymond J.
−Removed: Tesi, our President and a member of our Board of Directors, David Moss, our Chief Financial Officer and
−Removed: Treasurer and Mark Lowdell, our Chief Scientific Officer.
−Removed: In countries where a claim of an issued and unexpired patent or a pending
−Removed: claim in a pending patent application within the Patent Rights exists a royalty of nine percent of net sales of each of each licensed
−Removed: product shall be paid for the remaining life of each patent on a country by country basis.
−Removed: term of the agreement began on October 29, 2015 and, if not terminated sooner pursuant to the agreement, ends on a country-by-country
−Removed: basis on the date of the expiration of the last to expire patent rights where patent rights exists.
−Removed: Upon the termination of the
−Removed: agreement we shall have a fully paid up, perpetual, royalty-free license without further obligation to Immune Ventures.
−Removed: The agreement
−Removed: can be terminated by Immune Ventures if, after 60 days from the Company’s receipt of notice that the Company has not made
−Removed: a payment under the agreement, and the Company still does not make this payment.
−Removed: On July 20, 2018, the parties amended the
−Removed: agreement under which the Company was required achieve milestones pursuant to the agreement.
+Added: There are many others trying to join this promising therapeutic area including large companies such
+Added: as BMS and Roche.
+Added: There are several FDA approved
+Added: drugs that improve the ability of the innate immune system (NK-cells) to treat cancer including mono-clonal antibody therapies (for example:
+Added: Avastin® and Herceptin® marketed by Roche/Genentech);
+Added: and “check-point” inhibitors (Yervoy® and
+Added: Opdivo®, BMS, Keytruda®, Merck and others).
+Added: There is a large amount of development activity in the immune checkpoint inhibitor
+Added: field from both pharmaceutical giants including AstraZeneca, Merck & Co, Pfizer, Merck KGaA, Roche, GSK, Novartis and Amgen and many
+Added: start-ups, small companies and university spin-offs which have emerged in the past two years.
+Added: Examples (in alphabetical order) include
+Added: Agenus, Alligator Bioscience, Ambrx, AnaptysBio, argenx, Bioceros, BioNovion, Cellerant Therapeutics, Checkpoint Therapeutics, Compugen,
+Added: CureTech, Enumeral, Five Prime Therapeutics, Genmab, GITR, ImmuNext, IOmet Pharma, iTeos Therapeutics, Jounce Therapeutics, KAHR Medical,
+Added: Multimeric Biotherapeutics, Nativis, Orega Biotech, Pelican Therapeutics, Pieris Pharmaceuticals, Prima BioMed, Redx Pharma, Sorrento
+Added: Therapeutics, Tesaro, TG Therapeutics, Theravectys and ToleroTech active in the field.
+Added: The list of companies with poly-specific antibodies
+Added: that attempt to link the cancer with a cytotoxic T cell is long, includes both private and public companies (Amgen, Xencor, F-Star, Merus
+Added: and many others).
+Added: Finally, two CAR-T cell therapies were just approved for the treatment of ALL – Kymriah™ (Novartis) and
+Added: Yescarta™ (Gilead).
+Added: We expect additional drugs to gain marketing authorization in the immune-oncology space.
+Added: To our knowledge, there are
+Added: no innate immune check-point inhibitors in development that have the unique characteristics of INB03 that neutralize sTNF to:
+Added: the proliferation of MDSC;
+Added: ii) decreasing local and systemic immunosuppression caused by MDSC by stopping production of immunosuppressive
+Added: cytokines and;
+Added: iii) improving NK/DC cross-talk to recruit the adaptive immune system to fight the cancer.
+Added: Intellectual Property
+Added: We seek to protect our therapeutic
+Added: programs by continuously developing patent properties covering novel compositions, formulations, purpose-limited compositions, combination
+Added: treatments, methods of medical treatment, and other inventions, whether created internally or in-licensed, in the United States Patent
+Added: & Trademark Office (the “USPTO”), the World Intellectual Property Organization (“WIPO”) under the Patent Cooperation
+Added: Treaty (“PCT”), and in patent offices for various foreign jurisdictions.
+Added: While each invention is unique and territories for
+Added: protection are decided on a case-by-case basis, we generally pursue patents in Australia, Canada, Europe, Japan, and the United States,
+Added: and sometimes in Brazil, China and/or Korea.
+Added: We currently have in our portfolio eleven (11) issued patents and forty-seven (47) pending
+Added: patent applications, including both company-owned and in-licensed properties.
+Added: The following sections and corresponding tables summarize,
+Added: for each of our current therapeutic programs, our pending and granted patent positions, to the extent publicly available, as of the time
+Added: of preparing this document:
+Added: DN-TNF Platform Technology (Oncology, Central
+Added: Nervous System Disorders, Acute and Chronic Peripheral Diseases)
+Added: The DN-TNF Platform Technology
+Added: covers a variety of dominant negative tumor necrosis factor (“DN-TNF”) variant proteins, including the pegylated DN-TNF protein
+Added: variants known as XPro, INB03, LIVNate.
+Added: These DN-TNF protein variants can be considered a platform technology for treating the underlying
+Added: immune dysfunction associated with many disease manifestations.
+Added: Unlike approved anti-TNF therapeutics, DNTNF selectively targets and neutralizes
+Added: soluble TNF, and is therefore not immunosuppressive.
+Added: Additionally, XPro has been shown to cross the blood brain barrier after peripheral
+Added: administration, making it attractive for use in treating CNS disorders.
+Added: The following table summarizes current IP covering our DN-TNF
+Added: Platform Technology:
+Added: Subject Matter / Compound
+Added: Nominal Patent
+Added: DNTNF compositions and formulations
+Added: Use of DNTNF for treating disease
+Added: INB-16 / INKmune (Oncology)
+Added: INKmune is a replication-incompetent
+Added: derivative of our proprietary INB-16 cell line.
+Added: One commercial application of INKmune includes use as a therapeutic composition designed
+Added: to enhance the ability of a patient’s own NK cells to seek, recognize and eliminate cancer.
+Added: Another commercial application of INKmune
+Added: includes use as a cytokine-like (“pseudokine”) agent for enhancing NK cell killing specificity, potency, and efficacy of NK
+Added: cell -based therapeutics.
+Added: INKmune, as a therapeutic, is intended for provision as an I.V.
+Added: -infused product containing replication-incompetent
+Added: bio substrate units, each of which is adapted to present an aggregate of protein ligands and/or receptors to a patient’s own NK
+Added: cells, in vivo .
+Added: Upon contacting the patient’s NK cells, INKmune converts resting NK cells into what we call “primed”
+Added: NK cells (“pNKs”).
+Added: Data suggests that pNKs demonstrate enhanced killing of tumor cells, thus INKmune may indirectly improve
+Added: a patient’s own immune response to cancer.
+Added: As a pseudokine agent, INKmune can be used to contact the NK cells of an NK cell therapeutic
+Added: product in vitro , e.g., during manufacturing, for enhancing characteristics of the NK cell therapeutic and rendering an improved
+Added: The following table summarizes current IP covering INB-16 / INKmune:
+Added: Subject Matter / Compound
+Added: Nominal Patent
+Added: INB-16 / INKmune compositions
+Added: Use of INKmune for treating disease
+Added: Use of INKmune for enhancing NK cell therapeutics
+Added: General IP Disclosures
+Added: Our commercial success depends
+Added: in part on obtaining and maintaining patent and trade secret protections, where applicable, of our current and future product candidates
+Added: and the methods used to manufacture them, as well as successfully defending our patents against third-party challenges.
+Added: Our ability to stop third
+Added: parties from making, using, selling, offering to sell or importing our products depends on the extent to which we have rights under valid
+Added: and enforceable patents or trade secrets that cover these activities, and whether we are able to enforce such rights.
+Added: We cannot assure
+Added: you that our pending patent applications will result in issued patents, or that any or all rights will be enforceable in every jurisdiction
+Added: whether or not patent rights are sought.
+Added: International PCT patent applications
+Added: cover all 152 nations which are signatories of the PCT.
+Added: However, our global IP strategy generally targets Australia, Canada, Europe, Japan,
+Added: and the United States, and sometimes Brazil, China and/or Korea, as targets for extending patent protection under the PCT.
+Added: Decisions regarding
+Added: which countries to extend patent coverage under the PCT is taken on a case-by-case basis, subject to normal business considerations such
+Added: as value and return on investment.
+Added: Given the markets for products we are developing, we consider the foregoing jurisdictions to amount
+Added: to “global” coverage as used herein as it relates to IP.
+Added: The above disclosures related
+Added: to patents and patent applications are subject to change based on strategic patent portfolio building decisions, which may include refiling
+Added: and reissue, certain abandonments, including those in favor of continuing patent applications, maturations from provisional to non-provisional
+Added: filings, and other regular patent prosecution activities.
+Added: The designations INMUNE BIO TM ,
+Added: INB16 TM , INKmune TM , PSEUDOKINE TM , and XPro TM are trademarks of INmune Bio, Inc.
+Added: of these trademarks may be protected by applications pending at the USPTO and other trademark registration authorities globally.
+Added: of the trademark registration process, we may be required to submit a statement of use evidencing bona fide use of each mark in
+Added: By nature of being in the biopharmaceutical business, certain regulatory requirements must be met in connection with certain
+Added: products and/or services prior to receiving marketing authorization from a regulatory agency, and thus it may take some time before products
+Added: and/or services are offered for sale and a statement of use can be submitted for perfecting trademark registration.
+Added: For these reasons,
+Added: we may be required to obtain extensions of time, or to refile applications, seeking registration of trademarks.
+Added: We cannot guarantee that
+Added: a given trademark application will be allowed or issued in a respective office for each jurisdiction.
+Added: IP License Agreements
+Added: Immune Ventures, LLC License Agreement
+Added: On October 29, 2015, the Company
+Added: entered into an exclusive license agreement (the “INKmune License Agreement”) with Immune Ventures, LLC (“Immune Ventures”).
+Added: Pursuant to the INKmune License Agreement, we were granted an exclusive worldwide, sub-licensable, royalty-bearing license to commercialize
+Added: INKmune (the “INKmune License”).
+Added: In consideration for the INKmune License, we are obligated to pay Immune Ventures certain
+Added: milestone and royalty payments.
+Added: The term of the Immune Ventures Agreement began on October 29, 2015
+Added: and, if not terminated sooner pursuant to the agreement, ends on a country-by-country basis on the date of the expiration of the last
+Added: to expire patent rights where patent rights exists.
+Added: Subject to granting, prosecution-related patent term adjustments, and requirements
+Added: for maintenance and renewals, the latest to expire patent is scheduled to expire on March 15, 2038 (“Natural Expiration”).
+Added: Upon Natural Expiration of the Immune Ventures Agreement, we shall have a fully paid up, perpetual, royalty-free license without further
+Added: obligation to Immune Ventures.
+Added: The Immune Ventures Agreement can be terminated by Immune Ventures if, after 60 days from our receipt of
+Added: notice that we have not made a payment under the Immune Ventures Agreement we still do not make this payment.
+Added: On July 18, 2018, the parties
+Added: amended the agreement under which the Company was required to achieve milestones pursuant to the agreement.
On October 30, 2020, the parties
executed an additional amendment to the agreement under which the Company is required to achieve the following milestones:
−Removed: of Phase 1 clinical or equivalent trials by October 29, 2021
−Removed: of Phase II clinical trials or equivalent by October 29, 2023
−Removed: of Phase III clinical trials or equivalent by October 29, 2025
−Removed: of NDA or equivalent by October 29, 2026 or equivalent
−Removed: the Company doesn’t achieve the above milestones, it is required to negotiate in good faith with Immune Ventures to determine
−Removed: how it can either remedy the failure or achieve an alternate development.
−Removed: If the Company fails to make any required efforts, or
−Removed: if the efforts do not remedy the situation within 60 days of written notice by Immune Ventures, then Immune Ventures may provide
−Removed: notice to terminate the license or convert it to a non-exclusive license.
−Removed: of Pittsburg License Agreement
−Removed: October 3, 2017, the Company entered into an Assignment and Assumption Agreement with Immune Ventures related to intellectual
−Removed: property licensed from the University of Pittsburgh.
−Removed: Pursuant to the Assignment and Assumption Agreement (the “Assignment
−Removed: Agreement”), Immune Ventures assigned all of its rights, obligations and liabilities under an Exclusive License Agreement
−Removed: between the University of Pittsburgh –
−Removed: Of the Commonwealth System of Higher Education (“Licensor”) and Immune
−Removed: Ventures to INmune Bio (“Licensee”), (the “PITT Agreement”).
−Removed: Consideration
−Removed: under the PITT Agreement includes:
−Removed: (i) annual maintenance fees, (ii) royalty payments based on the sale of products making use
−Removed: of the licensed technology, and (iii) milestone payments.
−Removed: maintenance fees under the PITT Agreement include:
−Removed: $5,000 due June 26 of each year 2020-2022;
−Removed: $10,000 due on June 26 of each year
−Removed: and $25,000 due on June 26 of each year 2025 and annually thereafter until first commercial sale.
−Removed: As of December 31,
−Removed: 2020, the Company has no amounts owed pursuant to the PITT Agreement.
−Removed: The Company is current on its annual maintenance fees pursuant
−Removed: to the PITT Agreement.
−Removed: June 26 of each year 2020-2022
−Removed: June 26 of each year 2023-2024
−Removed: June 26 of each year 2025 until first commercial sale
−Removed: first commercial sale of a product making use of the licensed technology under the PITT Agreement, the Licensee is required to
−Removed: pay royalties equal to 2.5% of Net Sales each calendar quarter.
−Removed: under the PITT Agreement the Licensee is required to make milestone payments as follows:
−Removed: Each Phase I initiation
−Removed: Each Phase III initiation
−Removed: First commercial sale of product making use of licensed technology
−Removed: Company made a $50,000 milestone payment to the University of Pittsburgh in March 2019 as a result of the initiation of a Phase
−Removed: I clinical trial.
−Removed: The PITT Agreement expires upon the earlier of:
−Removed: (i) expiration of the last claim of the Patent Rights forming
−Removed: the subject matter of the PITT Agreement;
−Removed: or (ii) the date that is 20 years from the effective date of the agreement (June 26,
−Removed: Company may terminate the PITT Agreement upon 3 months prior written notice provided all payments under the license are current.
−Removed: Licensor may terminate the PITT Agreement upon written notice if:
−Removed: (i) the Company defaults as to performance of material obligations
−Removed: which have not been cured within 60 days after receiving written notice;
−Removed: or (ii) the Company ceases to carry out its business,
−Removed: becomes bankrupt or insolvent, applies for or consents to the appointment of a trustee, receiver or liquidator of its assets or
−Removed: seeks relief under any law for the aid of debtors.
−Removed: License Agreement
−Removed: October 3, 2017, the Company entered into a license agreement with Xencor, Inc.
−Removed: (“Xencor”), which has discovered and
−Removed: developed a proprietary biological molecule that inhibits soluble tumor necrosis factor (the “Xencor Agreement”).
−Removed: Pursuant to the Xencor Agreement, Xencor granted the Company an exclusive worldwide, royalty-bearing license in licensed patent
−Removed: rights, licensed know-how and licensed materials (as defined in the Xencor Agreement) to make, develop, use, sell and import any
−Removed: pharmaceutical product that comprises, contains, or incorporates Xencor’s proprietary protein known as “XPro1595”
−Removed: that inhibits soluble tumor necrosis factor (or all modifications, formulations and variants of the licensed protein that specifically
−Removed: bind soluble tumor necrosis factor) alone or in combination with one or more active ingredients, in any dosage or formulation.
−Removed: In connection with the Xencor Agreement, we paid Xencor a one-time non-creditable and non-refundable fee of $100,000 and agreed
−Removed: to issue Xencor 1,585,000 shares of our common stock.
−Removed: We also issued warrants to Xencor which are discussed below.
−Removed: also agreed to pay Xencor a royalty of 5% on net sales of all Licensed Products in a given calendar year, which are payable on
−Removed: a country-by- country and licensed product by licensed product basis until the date that is the later of (a) the expiration of
−Removed: the last to expire valid claim covering any pharmaceutical product that contains, comprises, or incorporates Xencor’s proprietary
−Removed: protein known as XPro1595 alone or in combination with one or more active ingredients, in any dosage or formulation.
−Removed: (“Licensed
−Removed: Product”) in such country or (b) ten years following the first sale to a third party of the licensed product in such country.
−Removed: Net Sales with respect to any Licensed Product is the gross amounts invoiced by us for sales of the Licensed Products less deductions
−Removed: actually incurred.
−Removed: the Xencor Agreement, we also agreed to pay Xencor a percentage of any sublicensing revenue that it receives equal to (i) 60%
−Removed: of sublicensing revenue received in respect of any sublicense granted prior to initiation of a Phase 1 Clinical Trial of a Licensed
−Removed: Product in the applications for the treatment of disease in humans (the “Field”); (ii) 30% of Sublicensing Revenue
−Removed: received in respect of any sublicense granted on or after initiation of a Phase 1 Clinical Trial of a Licensed Product in the
−Removed: Field and prior to initiation of a Phase 2 Clinical Trial of a Licensed Product in the Field; (iii) 15% of Sublicensing Revenue
−Removed: received in respect of any sublicense granted on or after initiation of a Phase 2 Clinical Trial of a Licensed Product in the
−Removed: Field and prior to initiation of a Phase 3 Clinical Trial of a Licensed Product in the Field; (iv) 10% of Sublicensing Revenue
−Removed: received in respect of any sublicense granted on or after initiation of a Phase 3 Clinical Trial of a Licensed Product in the
−Removed: Field and prior filing of the first NDA application for any Licensed Product in the Field; and (v) 5% of Sublicensing Revenue
−Removed: received in respect of any sublicense granted on or after the approval of the first NDA application for any Licensed Product in
−Removed: For clarity, initiation of a clinical trial shall mean dosing of a first patient in said clinical trial.
−Removed: valid claim is an issued, unexpired or pending claim with the patent rights that Xencor controls as of October 3, 2017 which
−Removed: patent rights are necessary to make, develop, use, sell, have sold, offer for sale and import a Licensed Product in the Field
−Removed: (the Field means all applications for the treatment of diseases in humans) or the Product Patent Rights, which claim has not lapsed,
−Removed: been abandoned, been revoked or been held to be unpatentable, invalid or unenforceable by a final judgment of a court or other
−Removed: governmental agency or competent jurisdiction from which no appeal can be or is taken within the time allowed for appeal and which
−Removed: has not been admitted to be invalid or unenforceable through reissue, re-examination, disclaimer or otherwise.
−Removed: Product Patent
−Removed: Rights shall mean any and all our patent rights that are necessary to make, develop, use, sell, have sold, offer for sale and
−Removed: import a Licensed Product in the Field, including any improvements or patent rights directed to the Licensed Product.
−Removed: may terminate the Xencor Agreement upon 60 days’
−Removed: (10 days for any payment default) prior written notice to the other party
−Removed: after the breach of any material provision of the agreement by the other party if the breaching party has not cured the breach
−Removed: within the 60-day period (10-day period for any payment default) following written notice of termination by the non-breaching
−Removed: We can terminate the Xencor Agreement upon 180 days prior written notice to Xencor.
−Removed: Xencor may terminate the Xencor Agreement
−Removed: in its entirety or with respect to any specific Licensed Product upon written notice in the event that we contest, oppose or challenge
−Removed: or assist any party in contesting, opposing or challenging, Xencor’s ownership of, or the enforceability or validity of
−Removed: the Patent Rights that Xencor controls as of October 3, 2017 which Patent Rights are necessary to make develop, use, sell, have
−Removed: sold, offered for sale and import a Licensed Product in the Field.
−Removed: Either party may terminate the Xencor Agreement upon written
−Removed: notice to the other party upon or after the insolvency, bankruptcy, dissolution or winding up of such other party or the making
−Removed: or seeking to make or arrange an assignment for the benefit of creditors of such other party or the initiation of proceedings
−Removed: in voluntary or involuntary bankruptcy which proceeding or action remains undismissed or unstayed for a period of more than 60
−Removed: connection with the Xencor Agreement, we entered into a stock issuance agreement with Xencor pursuant to which it agreed to issue
−Removed: Xencor 1,585,000 shares of its common stock and fully vested warrants to purchase an additional number of shares of common stock
−Removed: equal to 10% our the fully diluted company shares immediately following such purchase.
−Removed: In August 2018, we entered into a First
−Removed: Amendment to Stock Issuance Agreement.
−Removed: Pursuant to the amendment, the purchase price for the additional shares may only be paid
−Removed: College London License Agreement –
−Removed: July 19, 2019, the Company entered into license agreement with UCL Business PLC (“UCLB”) with a ten-year term.
−Removed: to the license agreement, the Company acquired an exclusive license (and a right to sub-license) to the technology and know-how
−Removed: relating to an isolation and commercial scale expansion methodology of GMP grade human umbilical cord mesenchymal stem/stromal
−Removed: cells (“MSC”).
−Removed: exchange for the license agreement, the Company paid UCLB an initial license fee of approximately $10,000 and shall pay annual
−Removed: licensing fees of approximately $13,000 per year for the remaining term of the agreement beginning in July 2020.
−Removed: The Company will
−Removed: pay UCLB a royalty of 3-3.5% of the net sales value (as defined in the agreement) of all licensed products sold or used by the
−Removed: As of December 31, 2020, no amounts are owed to UCLB pursuant to this license agreement.
−Removed: In the event the Company sub-licenses
−Removed: the technology and know-how, the Company will pay UCLB a royalty of 12 percent of the consideration (cash or non-cash) received
−Removed: by the Company in relation to the development or sub-licensing of any of the technology and know-how.
−Removed: Research and Development
−Removed: expect to use third parties to conduct our preclinical and clinical trials under the direct supervision of management.
−Removed: Manufacturing
−Removed: intend to contract with third parties for the manufacture of our compounds for investigational purposes, for preclinical and clinical
−Removed: testing and for any FDA approved products for commercial sale.
−Removed: Pre-clinical and clinical material for the early clinical trials
−Removed: with INKmune has been manufactured under the direction of Mark Lowdell at a licensed Good Manufacturing Practice (“GMP”)
−Removed: The master cell bank, working cell bank and individual product doses were completed in July 2018.
−Removed: This clinical material
−Removed: is planned for use in the Phase I/II clinical trials in ovarian cancer.
−Removed: If we raise adequate capital to initiate the high-risk
−Removed: MDS Phase I/II trials, additional working cell banks and therapeutic product will be produced from the existing master cell bank.
−Removed: This process takes approximately 6 months and is not anticipated to delay the initiation of the high-risk MDS Phase I/II trials.
−Removed: We may transfer the manufacturing to a different commercial contract manufacturing organization after completion of these Phase
−Removed: Mesenchymal Stem Cells
−Removed: November 2017, we entered into a Material Transfer and License Agreement with the Anthony Nolan Cord Blood Bank (“AN”),
−Removed: the oldest and largest non-directed cord blood bank in the United Kingdom for the supply the starting material for the mesenchymal
−Removed: stem cells - umbilical cords not used after cord blood harvest.
−Removed: Mark Lowdell’s research group developed and validated a
−Removed: methodology for producing large numbers of clinical-grade pooled human umbilical cord derived mesenchymal stem cells (“HucMSC”).
−Removed: We believe the reproducible and reliable supply of large quantities of high-quality a may solve one of the major problems associated
−Removed: with the development of mesenchymal stem cell therapies for medicine.
−Removed: Under this agreement we were granted a license to produce
−Removed: and sell these cells for medical research, including clinical trials.
−Removed: The agreement provides that Immune Bio Internal shall pay
−Removed: to AN £200 plus VAT (if applicable) for each umbilical cord tissue sample (and any intellectual property, developed, or
−Removed: conceived by Immune Bio International in exercising its rights under the agreement (“Licensed Product”)) Immune Bio
−Removed: International receives pursuant to the agreement.
−Removed: Additionally, during the entire term of the agreement, Immune Bio International
−Removed: shall pay AN a royalty of 2% of the net sales of the Licensed Product.
−Removed: We believe we are well positioned to become a preferred
−Removed: manufacturing partner for companies who need MSC for clinical programs.
−Removed: Manufacture of HucMSC is performed under the direction
−Removed: of Mark Lowdell in a licensed GMP facility that is contracted to the Company as part of existing research and development agreements.
+Added: Initiation of Phase II clinical
+Added: trials or equivalent by October 29, 2023;
+Added: Initiation of Phase III
+Added: clinical trials or equivalent by October 29, 2025;
+Added: Filing of NDA or equivalent by October 29, 2026 or equivalent.
+Added: If we don’t achieve
+Added: the above milestones, we are required to negotiate in good faith with Immune Ventures to determine how we can either remedy the failure
+Added: or achieve an alternate development.
+Added: If we fail to make any required efforts or if the efforts do not remedy the situation within 60 days
+Added: of written notice by Immune Ventures then Immune Ventures may provide notice to terminate the license or convert it to a non-exclusive
+Added: University of Pittsburg License Agreement
+Added: On October 3, 2017, the
+Added: Company entered into an Assignment and Assumption Agreement with Immune Ventures related to intellectual property licensed from the University
+Added: of Pittsburgh.
+Added: Pursuant to the Assignment and Assumption Agreement (the “Assignment Agreement”), Immune Ventures assigned
+Added: all of its rights, obligations and liabilities under an Exclusive License Agreement between the University of Pittsburgh – Of the
+Added: Commonwealth System of Higher Education (“Licensor”) and Immune Ventures to INmune Bio (“Licensee”), (the “PITT
+Added: As consideration under the
+Added: PITT Agreement, we are obligated to pay:
+Added: (i) annual maintenance fees, (ii) royalty payments based on the sale of products making use of
+Added: the licensed technology, and (iii) milestone payments.
+Added: In 2021, the company paid
+Added: $5,000 according to the PITT Agreement as an annual maintenance fee.
+Added: The PITT Agreement expires
+Added: upon the earlier of:
+Added: (i) expiration of the last claim of the Patent Rights forming the subject matter of the PITT Agreement;
+Added: date that is 20 years from the effective date of the agreement (June 26, 2037).
+Added: The Company may terminate
+Added: the PITT Agreement upon 3 months prior written notice provided all payments under the license are current.
+Added: Licensor may terminate the
+Added: PITT Agreement upon written notice if:
+Added: (i) the Company defaults as to performance of material obligations which have not been cured within
+Added: 60 days after receiving written notice;
+Added: or (ii) the Company ceases to carry out its business, becomes bankrupt or insolvent, applies for
+Added: or consents to the appointment of a trustee, receiver or liquidator of its assets or seeks relief under any law for the aid of debtors.
+Added: Xencor License Agreement
+Added: On October 3, 2017, the Company entered into a license agreement with
+Added: (“Xencor”), which has discovered and developed a proprietary biological molecule that inhibits soluble tumor
+Added: necrosis factor (the “Xencor Agreement”).
+Added: During June 2021, the Company entered into the First Amendment to License Agreement
+Added: Pursuant to the Xencor Agreement, Xencor granted the Company an exclusive worldwide, royalty-bearing license in licensed
+Added: patent rights, licensed know-how and licensed materials (as defined in the Xencor Agreement) to make, develop, use, sell and import any
+Added: pharmaceutical product that comprises, contains, or incorporates Xencor’s proprietary protein known as “XPro” that inhibits
+Added: soluble tumor necrosis factor (or all modifications, formulations and variants of the licensed protein that specifically bind soluble
+Added: tumor necrosis factor) alone or in combination with one or more active ingredients, in any dosage or formulation.
+Added: The Xencor Agreement
+Added: expires upon the later of:
+Added: (a) the expiration of the last to expire valid claim covering any pharmaceutical product that contains, comprises,
+Added: or incorporates Xencor’s proprietary protein known as XPro alone or in combination with one or more active ingredients, in any dosage
+Added: or formulation.
+Added: (“Licensed Product”) in such country or (b) ten years following the first sale to a third party of the licensed
+Added: product in such country.
+Added: Net Sales with respect to any Licensed Product is the gross amounts invoiced by us for sales of the Licensed
+Added: Products less deductions actually incurred.
+Added: A valid claim is an issued, unexpired or pending claim with the patent rights that Xencor
+Added: controls as of October 3, 2017 which patent rights are necessary to make, develop, use, sell, have sold, offer for sale and import a Licensed
+Added: Product in the Field (the Field means all applications for the treatment of diseases in humans) or the Product Patent Rights, which claim
+Added: has not lapsed, been abandoned, been revoked or been held to be unpatentable, invalid or unenforceable by a final judgment of a court
+Added: or other governmental agency or competent jurisdiction from which no appeal can be or is taken within the time allowed for appeal and
+Added: which has not been admitted to be invalid or unenforceable through reissue, re-examination, disclaimer or otherwise.
+Added: Product Patent Rights
+Added: shall mean any and all our patent rights that are necessary to make, develop, use, sell, have sold, offer for sale and import a Licensed
+Added: Product in the Field, including any improvements or patent rights directed to the Licensed Product.
+Added: Either party may terminate the Xencor
+Added: Agreement upon 60 days’ (10 days for any payment default) prior written notice to the other party after the breach of any material
+Added: provision of the agreement by the other party if the breaching party has not cured the breach within the 60-day period (10-day period
+Added: for any payment default) following written notice of termination by the non-breaching party.
+Added: We can terminate the Xencor Agreement upon
+Added: 180 days prior written notice to Xencor.
+Added: Xencor may terminate the Xencor Agreement in its entirety or with respect to any specific Licensed
+Added: Product upon written notice in the event that we contest, oppose or challenge or assist any party in contesting, opposing or challenging,
+Added: Xencor’s ownership of, or the enforceability or validity of the Patent Rights that Xencor controls as of October 3, 2017 which Patent
+Added: Rights are necessary to make develop, use, sell, have sold, offered for sale and import a Licensed Product in the Field.
+Added: may terminate the Xencor Agreement upon written notice to the other party upon or after the insolvency, bankruptcy, dissolution or winding
+Added: up of such other party or the making or seeking to make or arrange an assignment for the benefit of creditors of such other party or the
+Added: initiation of proceedings in voluntary or involuntary bankruptcy which proceeding or action remains undismissed or unstayed for a period
+Added: of more than 60 days.
+Added: In consideration of the
+Added: Xencor Agreement, we agreed to royalty payments and a percentage of any payments received in exchange for a sub-license.
+Added: University College London License Agreement
+Added: On July 19, 2019, the Company
+Added: entered into license agreement with UCL Business PLC (“UCLB”) with a ten (10) year term.
+Added: Pursuant to the license agreement,
+Added: the Company acquired an exclusive license (and a right to sub-license) to the technology and know-how relating to an isolation and commercial
+Added: scale expansion methodology of GMP grade human umbilical cord mesenchymal stem/stromal cells (“MSC”).
+Added: On July 16, 2021, we provided
+Added: notice of intent to terminate the agreement with UCLB, which per the agreement became effective August 15, 2021.
+Added: INKmune Research and Development
+Added: We expect to use third parties
+Added: to conduct our preclinical and clinical trials under the direct supervision of management.
+Added: INKmune Manufacturing
+Added: We intend to contract with third parties for the manufacture of our
+Added: compounds for investigational purposes, for preclinical and clinical testing and for any FDA approved products for commercial sale.
+Added: and clinical material for the early clinical trials with INKmune has been manufactured under the direction of Mark Lowdell at a licensed
+Added: Good Manufacturing Practice (“GMP”) facility.
+Added: The master cell bank, working cell bank and individual product doses were completed
+Added: in July 2018.
+Added: This clinical material is planned for use in the Phase I/II clinical trials in ovarian cancer.
+Added: As we progress in our clinical
+Added: programs, additional working cell banks and therapeutic product will be produced from the existing master cell bank.
+Added: This process takes
+Added: approximately 6 months and is not anticipated to delay the initiation of the high-risk MDS Phase I/II trials.
+Added: We may transfer the manufacturing
+Added: to a different commercial contract manufacturing organization after completion of these Phase II studies.
+Added: Human Mesenchymal Stem
+Added: In November 2017, we entered
+Added: into a Material Transfer and License Agreement with the Anthony Nolan Cord Blood Bank (“AN”), the oldest and largest non-directed
+Added: cord blood bank in the United Kingdom for the supply the starting material for the mesenchymal stem cells - umbilical cords not used after
+Added: cord blood harvest.
+Added: Mark Lowdell’s research group developed and validated a methodology for producing large numbers of clinical-grade
+Added: pooled human umbilical cord derived mesenchymal stem cells (“HucMSC”).
+Added: We believe the reproducible and reliable supply of
+Added: large quantities of high-quality a may solve one of the major problems associated with the development of mesenchymal stem cell therapies
+Added: for medicine.
+Added: We believe we are well positioned to become a preferred manufacturing partner for companies who need MSC for clinical programs.
+Added: Manufacture of HucMSC is performed under the direction of Mark Lowdell in a licensed GMP facility that is contracted to the Company as
+Added: part of existing research and development agreements.
The starting material for the HucMSC product is provided by the AN.
−Removed: The HucMSC product produced in this facility are fully qualified
−Removed: to be used for either research or clinical trials.
−Removed: Currently, we plan to supply HucMSC to third parties for their research use
−Removed: and in clinical trials as part of the development process for commercial pro/ducts.
−Removed: We may decide to expand this agreement in
−Removed: the future if the commercial and/or development opportunities warrant such expansion.
−Removed: At the current time, we expect this program
−Removed: to be funded by revenues from commercial sales.
+Added: The HucMSC product
+Added: produced in this facility are fully qualified to be used for either research or clinical trials.
+Added: We have developed a validated manufacturing
+Added: process that reliably produces contract manufacturer of the clinical grade (“cGMP”) quality mesenchymal stem cells that we
+Added: call CORDstrom.
+Added: To date, we are supporting two academic clinical trials with CORDstrom.
+Added: One program is a in the UK treating children with
+Added: erythematous bullousa, a disfiguring skin disease in children that is similar to a second degree burn and treatment of system lupus in
+Added: Both these studies are ongoing.
+Added: INmune Bio is supplying the clinical product for treatment of these patients.
+Added: The Company does
+Added: not know the results of these trials until they are announced by the principal investigators at the clinical sites.
+Added: Currently, we plan
+Added: to supply HucMSC to third parties for their research use and in clinical trials as part of the development process for commercial pro/ducts.
+Added: We may decide to expand this agreement in the future if the commercial and/or development opportunities warrant such expansion.
+Added: current time, we expect this program to be funded by revenues from commercial sales.
The agreement with AN terminates on November 29,
−Removed: AN may terminate the license
−Removed: on written notice to us, if a donor withdraws consent to the continued use of umbilical cord tissue samples that were obtained
−Removed: Additionally, either party may terminate the agreement on 30 days prior written notice to the other if that other party
−Removed: materially breach any term of the agreement and such breaches (to the extent it is remediable) is not remedied within 30 days
−Removed: of the written request to the other party to do so.
−Removed: in the Market for Immunotherapy Products
−Removed: FDA and other federal, state, local and foreign regulatory agencies impose substantial requirements upon the clinical development,
−Removed: approval, labeling, manufacture, marketing, and distribution of drug products.
−Removed: These agencies regulate, among other things, research
−Removed: and development activities and the testing, approval, manufacture, quality control, safety, effectiveness, labeling, storage,
−Removed: record keeping, advertising and promotion of our product candidates.
−Removed: The regulatory approval process is generally lengthy and
−Removed: expensive, with no guarantee of a positive result.
−Removed: Moreover, failure to comply with applicable FDA or other requirements may result
−Removed: in civil or criminal penalties, recall or seizure of products, injunctive relief including partial or total suspension of production,
−Removed: or withdrawal of a product from the market.
−Removed: regulatory authorities regulate, among other things, the research, manufacture, promotion, and distribution of drugs in the United
−Removed: States under the FDA and other statutes and implementing regulations.
−Removed: The process required by the FDA before prescription drug
−Removed: product candidates may be marketed in the United States generally involves the following:
−Removed: of extensive nonclinical laboratory tests, animal studies and formulation studies, all performed in accordance with the FDA’s
−Removed: Good Laboratory Practice regulations;
−Removed: to the FDA of an investigational new drug application, or IND, which must become effective before human clinical trials may
−Removed: some products, performance of adequate and well-controlled human clinical trials in accordance with the FDA’s regulations,
−Removed: including Good Clinical Practices, to establish the safety and efficacy of the product candidate for each proposed indication;
−Removed: to the FDA of a new drug application or NDA;
−Removed: completion of an FDA preapproval inspection of the manufacturing facilities at which the product is produced to assess compliance
−Removed: with current Good Manufacturing Practice, or cGMP, regulations;
−Removed: review and approval of the NDA prior to any commercial marketing, sale or shipment of the drug.
−Removed: testing and approval process requires substantial time, effort and financial resources, and we cannot be certain that any approvals
−Removed: for our product candidates will be granted on a timely basis, if at all.
−Removed: tests include laboratory evaluations of product chemistry, formulation and stability, as well as studies to evaluate toxicity
−Removed: in animals and other animal studies.
−Removed: The results of preclinical tests, together with manufacturing information and analytical
−Removed: data, are submitted as part of an IND to the FDA.
+Added: AN may terminate the license on written notice to us, if a donor withdraws consent to the continued use of umbilical cord tissue
+Added: samples that were obtained by AN.
+Added: Additionally, either party may terminate the agreement on 30 days prior written notice to the other
+Added: if that other party materially breach any term of the agreement and such breaches (to the extent it is remediable) is not remedied within
+Added: 30 days of the written request to the other party to do so.
+Added: Challenges in the Market for Immunotherapy
+Added: Government Regulation
+Added: The FDA and other federal,
+Added: state, local and foreign regulatory agencies impose substantial requirements upon the clinical development, approval, labeling, manufacture,
+Added: marketing, and distribution of drug products.
+Added: These agencies regulate, among other things, research and development activities and the
+Added: testing, approval, manufacture, quality control, safety, effectiveness, labeling, storage, record keeping, advertising and promotion of
+Added: our product candidates.
+Added: The regulatory approval process is generally lengthy and expensive, with no guarantee of a positive result.
+Added: failure to comply with applicable FDA or other requirements may result in civil or criminal penalties, recall or seizure of products,
+Added: injunctive relief including partial or total suspension of production, or withdrawal of a product from the market.
+Added: Various regulatory authorities
+Added: regulate, among other things, the research, manufacture, promotion, and distribution of drugs in the United States under the FDA and other
+Added: statutes and implementing regulations.
+Added: The process required by the FDA before prescription drug product candidates may be marketed in
+Added: the United States generally involves the following:
+Added: completion of extensive nonclinical laboratory tests, animal studies and formulation studies, all performed in accordance with the FDA’s Good Laboratory Practice regulations;
+Added: submission to the FDA of an investigational new drug application, or IND, which must become effective before human clinical trials may begin;
+Added: for some products, performance of adequate and well-controlled human clinical trials in accordance with the FDA’s regulations, including Good Clinical Practices, to establish the safety and efficacy of the product candidate for each proposed indication;
+Added: submission to the FDA of a new drug application or NDA;
+Added: satisfactory completion of an FDA preapproval inspection of the manufacturing facilities at which the product is produced to assess compliance with current Good Manufacturing Practice, or cGMP, regulations;
+Added: FDA review and approval of the NDA prior to any commercial marketing, sale or shipment of the drug.
+Added: The testing and approval process
+Added: requires substantial time, effort and financial resources, and we cannot be certain that any approvals for our product candidates will
+Added: be granted on a timely basis, if at all.
+Added: Preclinical tests include
+Added: laboratory evaluations of product chemistry, formulation and stability, as well as studies to evaluate toxicity in animals and other animal
+Added: The results of preclinical tests, together with manufacturing information and analytical data, are submitted as part of an IND
Some preclinical testing may continue even after an IND is submitted.
−Removed: also includes one or more protocols for the initial clinical trial or trials and an investigator’s brochure.
−Removed: An IND automatically
−Removed: becomes effective 30 days after receipt by the FDA, unless the FDA, within the 30-day time period, raises concerns or questions
−Removed: relating to the proposed clinical trials as outlined in the IND and places the clinical trial on a clinical hold.
−Removed: In such cases,
−Removed: the IND sponsor and the FDA must resolve any outstanding concerns or questions before any clinical trials can begin.
−Removed: trial holds also may be imposed at any time before or during studies due to safety concerns or non-compliance with regulatory
−Removed: requirements.
−Removed: An independent institutional review board, or IRB, at each of the clinical centers proposing to conduct the clinical
−Removed: trial must review and approve the plan for any clinical trial before it commences at that center.
−Removed: An IRB considers, among other
−Removed: things, whether the risks to individuals participating in the trials are minimized and are reasonable in relation to anticipated
−Removed: The IRB also approves the consent form signed by the trial participants and must monitor the study until completed.
−Removed: FDA offers several regulatory mechanisms that provide expedited or accelerated approval procedures for selected drugs in the indications
−Removed: on which we are focusing our efforts.
−Removed: These include accelerated approval under Subpart H of the agency’s NDA approval regulations,
−Removed: fast track drug development procedures and priority review.
−Removed: plan to seek orphan drug designation for INKmune for the treatment of ovarian carcinoma.
−Removed: The United States, European Union and
−Removed: other jurisdictions may grant orphan drug designation to drugs intended to treat a “rare disease or condition,”
−Removed: in the United States, is generally a disease or condition that affects no more than 200,000 individuals.
+Added: The IND also includes one or more protocols for the
+Added: initial clinical trial or trials and an investigator’s brochure.
+Added: An IND automatically becomes effective 30 days after receipt by
+Added: the FDA, unless the FDA, within the 30-day time period, raises concerns or questions relating to the proposed clinical trials as outlined
+Added: in the IND and places the clinical trial on a clinical hold.
+Added: In such cases, the IND sponsor and the FDA must resolve any outstanding concerns
+Added: or questions before any clinical trials can begin.
+Added: Clinical trial holds also may be imposed at any time before or during studies due to
+Added: safety concerns or non-compliance with regulatory requirements.
+Added: An independent institutional review board, or IRB, at each of the clinical
+Added: centers proposing to conduct the clinical trial must review and approve the plan for any clinical trial before it commences at that center.
+Added: An IRB considers, among other things, whether the risks to individuals participating in the trials are minimized and are reasonable in
+Added: relation to anticipated benefits.
+Added: The IRB also approves the consent form signed by the trial participants and must monitor the study until
+Added: The FDA offers several regulatory
+Added: mechanisms that provide expedited or accelerated approval procedures for selected drugs in the indications on which we are focusing our
+Added: These include accelerated approval under Subpart H of the agency’s NDA approval regulations, fast track drug development
+Added: procedures and priority review.
+Added: We plan to seek orphan drug
+Added: designation for INKmune for the treatment of high-risk MDS if the results of the clinical trials support this activity.
+Added: The United States,
+Added: European Union and other jurisdictions may grant orphan drug designation to drugs intended to treat a “rare disease or condition,”
+Added: which, in the United States, is generally a disease or condition that affects no more than 200,000 individuals.
In the European Union,
orphan drug designation can be granted if:
−Removed: the disease is life threatening or chronically debilitating and affects no more than
−Removed: 50 in 100,000 persons in the European Union;
−Removed: without incentive it is unlikely that the drug would generate sufficient return to
−Removed: justify the necessary investment;
−Removed: and no satisfactory method of treatment for the condition exists or, if it does, the new drug
−Removed: will provide a significant benefit to those affected by the condition.
−Removed: If a product that has an orphan drug designation subsequently
−Removed: receives the first regulatory approval for the indication for which it has such designation, the product is entitled to orphan
−Removed: exclusivity, meaning that the applicable regulatory authority may not approve any other applications to market the same drug for
−Removed: the same indication, except in limited circumstances, for a period of seven years in the United States and 10 years in the European
−Removed: Union Orphan drug designation does not prevent competitors from developing or marketing different drugs for the same indication
−Removed: or the same drug for different indications.
−Removed: Orphan drug designation must be requested before submitting an NDA.
−Removed: After orphan drug
−Removed: designation is granted, the identity of the therapeutic agent and its potential orphan use are publicly disclosed.
−Removed: designation does not convey an advantage in, or shorten the duration of, the review and approval process.
−Removed: However, this designation
−Removed: provides an exemption from marketing and authorization (NDA) fees.
−Removed: We plan to follow a similar path with INB03, although the precise
−Removed: indication cannot be determined until we are farther along in the development process.
−Removed: 1 clinical trials typically involve the initial introduction of the product candidate into healthy human volunteers.
−Removed: 1 clinical trials, the product candidate is typically tested for safety, dosage tolerance, absorption, metabolism, distribution,
−Removed: excretion and pharmacodynamics.
−Removed: 2 clinical trials are conducted in a limited patient population to gather evidence about the efficacy of the product candidate
−Removed: for specific, targeted indications;
+Added: the disease is life threatening or chronically debilitating and affects no more than 50 in
+Added: 100,000 persons in the European Union;
+Added: without incentive it is unlikely that the drug would generate sufficient return to justify the
+Added: necessary investment;
+Added: and no satisfactory method of treatment for the condition exists or, if it does, the new drug will provide a significant
+Added: benefit to those affected by the condition.
+Added: If a product that has an orphan drug designation subsequently receives the first regulatory
+Added: approval for the indication for which it has such designation, the product is entitled to orphan exclusivity, meaning that the applicable
+Added: regulatory authority may not approve any other applications to market the same drug for the same indication, except in limited circumstances,
+Added: for a period of seven years in the United States and 10 years in the European Union Orphan drug designation does not prevent competitors
+Added: from developing or marketing different drugs for the same indication or the same drug for different indications.
+Added: Orphan drug designation
+Added: must be requested before submitting an NDA.
+Added: After orphan drug designation is granted, the identity of the therapeutic agent and its potential
+Added: orphan use are publicly disclosed.
+Added: Orphan drug designation does not convey an advantage in, or shorten the duration of, the review and
+Added: approval process.
+Added: However, this designation provides an exemption from marketing and authorization (NDA) fees.
+Added: We plan to follow a similar
+Added: path with INB03 or XPro, although the precise indication cannot be determined until we are farther along in the development process.
+Added: Clinical Trials
+Added: Phase 1 clinical trials typically
+Added: involve the initial introduction of the product candidate into healthy human volunteers.
+Added: In Phase 1 clinical trials, the product candidate
+Added: is typically tested for safety, dosage tolerance, absorption, metabolism, distribution, excretion and pharmacodynamics.
+Added: Phase 2 clinical trials are
+Added: conducted in a limited patient population to gather evidence about the efficacy of the product candidate for specific, targeted indications;
to determine dosage tolerance and optimal dosage;
−Removed: and to identify possible adverse effects
−Removed: and safety risks.
−Removed: 3 clinical trials are undertaken to evaluate clinical efficacy and to test for safety in an expanded patient population at geographically
−Removed: dispersed clinical trial sites.
−Removed: The size of Phase 3 clinical trials depends upon clinical and statistical considerations for the
−Removed: product candidate and disease, but sometimes can include several thousand patients.
−Removed: Phase 3 clinical trials are intended to establish
−Removed: the overall risk-benefit ratio of the product candidate and provide an adequate basis for product labeling.
−Removed: trials involve the administration of the product candidate to human subjects under the supervision of qualified medical investigators
−Removed: according to approved protocols that detail the objectives of the study, dosing procedures, subject selection and exclusion criteria,
−Removed: and the parameters to be used to monitor participant safety.
−Removed: Regulatory procedures differ in each country we will be working in.,
−Removed: For example, in the US, each protocol is submitted, to the FDA as part of the IND for their review and consent before enrolling
−Removed: patients in the clinical trial.
−Removed: The US is not the only place to perform clinical trials.
−Removed: Most countries have systems in place
−Removed: to allow academics and companies to sponsor clinical trials of novel therapies in patients.
−Removed: For financial and technical reasons,
−Removed: the Company will perform the Phase I clinical trials of our programs in the United Kingdom and Australia.
−Removed: The US will be included
−Removed: in the Phase II programs.
−Removed: Other venues such as Europe, Canada, Japan and other Pacific Rim countries may be included in the development
−Removed: program in the future.
−Removed: The first clinical trial with INKmune will be initiated in the United Kingdom.
−Removed: In the United Kingdom, the
−Removed: regulatory submission is made to the MHRA for a clinical trials authorization (“CTA”).
+Added: and to identify possible adverse effects and safety risks.
+Added: Phase 3 clinical trials are
+Added: undertaken to evaluate clinical efficacy and to test for safety in an expanded patient population at geographically dispersed clinical
+Added: The size of Phase 3 clinical trials depends upon clinical and statistical considerations for the product candidate and disease,
+Added: but sometimes can include several thousand patients.
+Added: Phase 3 clinical trials are intended to establish the overall risk-benefit ratio
+Added: of the product candidate and provide an adequate basis for product labeling.
+Added: Clinical trials involve the
+Added: administration of the product candidate to human subjects under the supervision of qualified medical investigators according to approved
+Added: protocols that detail the objectives of the study, dosing procedures, subject selection and exclusion criteria, and the parameters to
+Added: be used to monitor participant safety.
+Added: Regulatory procedures differ in each country we will be working in., For example, in the US, each
+Added: protocol is submitted, to the FDA as part of the IND for their review and consent before enrolling patients in the clinical trial.
+Added: US is not the only place to perform clinical trials.
+Added: Most countries have systems in place to allow academics and companies to sponsor
+Added: clinical trials of novel therapies in patients.
+Added: For financial and technical reasons, the Company will perform the Phase I clinical trials
+Added: of our programs in the United Kingdom and Australia.
+Added: The US will be included in the Phase II programs.
+Added: Other venues such as Europe, Canada,
+Added: Japan and other Pacific Rim countries may be included in the development program in the future.
+Added: The first clinical trial with INKmune
+Added: will be initiated in the United Kingdom.
+Added: In the United Kingdom, the regulatory submission is made to the MHRA for a clinical trials authorization
This is a multistep process.
−Removed: The Company had a Scientific Advice meeting with the MHRA in September 2017 to discuss the INKmune Phase I/II trial in women with
−Removed: relapse/refractory ovarian cancer including trial design, manufacturing processes and clinical trial execution.
−Removed: The MHRA gave
−Removed: recommendations on trial design, manufacturing controls and the regulatory procedures needed to initiate the clinical trial.
−Removed: received CTA approval from the MHRA for an INKmune trial in ovarian cancer on December 18, 2018.
−Removed: The approval allows for the execution
−Removed: of the Phase I/II INKmune clinical trial in the United Kingdom.
−Removed: We plan to have two cancer clinics referring the 6 patients needed
−Removed: for the Phase I portion of the trial.
−Removed: The patients will be treated at the Phase I unit a university hospital.
−Removed: We expect all of
−Removed: the Phase I sites to be in London, United Kingdom.
−Removed: If the Phase I trial proceeds as planned, we expect to open the Phase II portion
−Removed: of the trial in early 2020.
−Removed: The Phase II trial will include at least 3 other clinical sites in the United Kingdom and may include
−Removed: clinical sites in the US.
−Removed: Because 30 patients will be required to complete the Phase II portion of the trial, we expect to need
−Removed: sites in both the US and United Kingdom.
−Removed: The additional clinical sites in the United Kingdom or US have not been identified at
−Removed: No additional regulatory procedures will be needed to add sites in the United Kingdom.
−Removed: To add sites in the US, we will
−Removed: need to file an IND with the FDA.
−Removed: Once the FDA approves the IND, clinical sites can be opened.
−Removed: We have chosen relapsed/refractory
−Removed: ovarian cancer as the anticipated Phase 1 study for INKmune for a number of reasons.
−Removed: Relapsed refractory is a disease with poor
−Removed: treatment options.
−Removed: Our pre-clinical data suggests INKmune may have advantages over other immunotherapies in the treatment of ovarian
−Removed: Ovarian cancer has a sensitive and validated biomarker to measure disease burden –
−Removed: This allows the Company
−Removed: to accurately select patients for the clinical trial and determine if INKmune therapy is effective.
−Removed: We believe that intraperitoneal
−Removed: delivery of INKmune is a low-risk delivery strategy for a phase 1 study.
−Removed: The patients we plan to enroll in the trial have their
−Removed: disease concentrated in the peritoneal cavity further supporting the use of intra-peritoneal delivery.
−Removed: Finally, relapsed refractory
−Removed: ovarian cancer is an Orphan indication in the US.
+Added: The Company had a Scientific Advice meeting with the MHRA in September 2017 to discuss
+Added: the INKmune Phase I/II trial in women with relapse/refractory ovarian cancer including trial design, manufacturing processes and clinical
+Added: trial execution.
+Added: The MHRA gave recommendations on trial design, manufacturing controls and the regulatory procedures needed to initiate
+Added: the clinical trial.
+Added: We received CTA approval from the MHRA for an INKmune trial in ovarian cancer on December 18, 2018.
+Added: The approval allows
+Added: for the execution of the Phase I/II INKmune clinical trial in the United Kingdom.
+Added: We plan to have two cancer clinics referring the 6 patients
+Added: needed for the Phase I portion of the trial.
+Added: We expect the first Phase I sites to be in the United Kingdom.
+Added: If the first cohort of the
+Added: Phase I trial proceeds as planned, we expect to expand the clinical trial in the United Kingdom and may include clinical sites in the
+Added: Any Phase II program will start as a multi-national trial because at least 30 patients will be required to complete the Phase II program.
+Added: The additional clinical sites in the United Kingdom or US have not been identified at this time.
+Added: No additional regulatory procedures will
+Added: be needed to add sites in the United Kingdom.
+Added: To add sites in the US, we will need to file an IND with the FDA.
+Added: Once the FDA approves
+Added: the IND, clinical sites can be opened.
+Added: We have chosen relapsed/refractory ovarian cancer as the anticipated Phase 1 study for INKmune
+Added: for a number of reasons.
+Added: Relapsed refractory is a disease with poor treatment options.
+Added: Our pre-clinical data suggests INKmune may have
+Added: advantages over other immunotherapies in the treatment of ovarian cancer.
+Added: Ovarian cancer has a sensitive and validated biomarker to measure
+Added: disease burden – CA125.
+Added: This allows the Company to accurately select patients for the clinical trial and determine if INKmune therapy
+Added: is effective.
This provides regulatory advantages for registration of INKmune.
−Removed: follow a similar development strategy, but will use Australia for the Phase I programs.
−Removed: In Australia, clinical trials for INB03
−Removed: are performed under the clinical trials notification (“CTN”) scheme authorized by the Therapeutic Good Administration
−Removed: (“TGA”).
−Removed: The TGA is the equivalent agency to the FDA in the US and the MHRA in the United Kingdom.
−Removed: We filed an Australian
−Removed: Clinical Trial Notification, or CTN, for INB03 and XPro1595 during the second quarter of 2018 and 2019 respectively.
−Removed: were accepted in May 2018 and 2019 to allow us to initiate the Phase I trials in cancer and Alzheimer’s disease respectively.
−Removed: We have completed the oncology Phase 1 open label dose escalation trial in patients with advanced solid tumors and biomarkers
−Removed: of inflammation in their blood.
−Removed: Phase I trial has been completed and provided evidence of safety and a pharmacodynamic drug affect, decrease of inflammatory biomarkers,
−Removed: needed to move the program to a Phase II clinical trial in cancer.
−Removed: The Phase II clinical trial that will combine INB03 with approved
−Removed: second line therapy in patients with brain metastasis in women with Her2+ breast cancer.
−Removed: This is a combination trial where the
−Removed: addition of INB03 to approved second line therapy may provide a therapeutic alternative in a disease without any drugs approved.
−Removed: The Company has not lost interest in combining INB03 with CPI, but competition for patients is fierce in this arena.
−Removed: is to pursue treatment of tumors that express MUC4 as our lead indication.
−Removed: Tumors that express MUC4 are resistant to all forms
−Removed: of immunotherapy due to a combination of increased MDSC in the tumor, decreased inflammation in the tumor (a “cold”
−Removed: tumor) and direct effects of MUC4 and soluble TNF on HER2 function.
−Removed: If combination therapy with INB03 decreases MUC4 expression
−Removed: and changes the TME to make the “cold”
−Removed: tumor “hot”, then addition of a CPI will be warranted.
−Removed: inhibitors are immunotherapy drugs that target proteins in the tumor and immune cells to improve the adaptive immune response
−Removed: to the tumor by reversing immunologic strategies the cancer uses to evade the immune system.
−Removed: These drugs target PD1, PDL-1 or
−Removed: As of April 2018, there are six checkpoint inhibitors approved in the US (Ipilimumab, Atezolizumab, Avelumab, Durvalumab,
−Removed: Pembrolizumab, and Nivolumab).
−Removed: Additional checkpoint inhibitors to new and existing targets are in development and will be approved
−Removed: in the coming years.
−Removed: Checkpoint inhibitors are having a significant impact on the treatment of cancer and are expected to be the
−Removed: largest selling class of cancer therapies by 2027.
−Removed: INB03 can impact the cancer market for CPI in two ways;
−Removed: i) increase the number
−Removed: of patients eligible for CPI by making “cold”
−Removed: tumors “hot”
−Removed: and ii) reverse resistance to CPI due to immunologic
−Removed: factors in the TME such as increased MDSC.
−Removed: Currently, only 25-30% of patients treated with currently approved checkpoint inhibitors
−Removed: respond to therapy and many of these become refractory after a period of treatment.
−Removed: This means at least 70% of patients are resistant
−Removed: to, or refractory to, checkpoint inhibitors.
−Removed: Experts agree that combination therapy is needed and necessary to improve the response
−Removed: to checkpoint inhibitor therapy in resistant and refractory patients.
−Removed: To that end, companies with approved checkpoint inhibitors
−Removed: are looking for companion drugs improve patient response and expand market opportunities.
−Removed: The INB03 development program in cancer
−Removed: is designed to take advantage of our pre-clinical data and the needs to the cancer community to improve the safety and efficacy
−Removed: of checkpoint inhibitors.
−Removed: At this time, the combination trial to treat trastuzumab resistant HER2+ expressing cancer is our lead
−Removed: registration strategy for INB03.
+Added: INB03 will follow a similar development strategy, but used
+Added: Australia for the Phase I programs.
+Added: In Australia, clinical trials for INB03 are performed under the clinical trials notification (“CTN”)
+Added: scheme authorized by the Therapeutic Good Administration (“TGA”).
+Added: The TGA is the equivalent agency to the FDA in the US and
+Added: the MHRA in the United Kingdom.
+Added: We filed an Australian Clinical Trial Notification, or CTN, for INB03 and XPro during the second quarter
+Added: of 2018 and 2019 respectively.
+Added: Applications were accepted in May 2018 and 2019 to allow us to initiate the Phase I trials in cancer and
+Added: Alzheimer’s disease respectively.
+Added: We have completed the oncology Phase 1 open label dose escalation trial in patients with advanced
+Added: solid tumors and biomarkers of inflammation in their blood.
+Added: The Phase I trial has been
+Added: completed and provided evidence of safety and a pharmacodynamic drug affect, decrease of inflammatory biomarkers, needed to move the program
+Added: to a Phase II clinical trial in cancer.
+Added: The Phase II clinical trial will combine INB03 with approved second line therapy in patients with
+Added: MUC4+ breast cancer with or without brain metastasis that have a measurable pharmacodynamic biomarker.
+Added: This is a combination trial where
+Added: the addition of INB03 to approved second line therapy may provide a therapeutic alternative in a disease without any drugs approved.
+Added: Company has not lost interest in combining INB03 with immune checkpoint inhibitors (CPI), but competition for patients is fierce in this
+Added: Our plan is to pursue treatment of tumors that express MUC4 as our lead indication.
+Added: Tumors that express MUC4 are resistant to all
+Added: forms of immunotherapy due to a combination of increased MDSC in the tumor, decrease tumor macrophage (TAM) phagocytosis, decreased inflammation
+Added: in the tumor (a “cold” tumor) and direct effects of MUC4 and soluble TNF on HER2/neu function.
+Added: If combination therapy with
+Added: INB03 decreases MUC4 expression and changes the TME to make the “cold” tumor “hot”, then addition of a CPI will
+Added: be warranted.
+Added: At this time, the combination trial to treat MUC4+ trastuzumab resistant HER2+ expressing cancer is our most probable registration
+Added: strategy for INB03.
+Added: This includes the combination of INB03 with trastuzumab antibody drug conjugate therapies such as ENHERTU (trastuzumab-deruxtecan;
+Added: (Daiichi-Sankyo).
Current therapies for trastuzumab resistant cancers are used on a trial by error approach.
−Removed: MUC4 expression as a biomarker for to predict trastuzumab resistance brings a precision medicine approach to this difficult clinical
−Removed: Addition of INB03 to the treatment regimen for treating HER2+ cancers may convert “cold”
−Removed: tumors to “hot”
−Removed: tumors making the eligible for treatment with CPI.
−Removed: Finally, the clinical development landscape for CPI combination therapies to
−Removed: treat CPI resistant therapies is chaotic.
−Removed: The design and successful completion of a Phase II trial is not guarantee of clinical
−Removed: relevance or commercial viability.
−Removed: There are multiple therapies on the market or in development for the treatment of trastuzumab
−Removed: resistant breast cancer.
−Removed: The most prominent of antibody conjugates including ado-trastuzumab emtansine (Kadycycla/T-DM1, Genentech/Roche)
−Removed: and trastuzumab deruxtecan (Enhertu, Daiichi Sankyo).
−Removed: To our knowledge, there are no drugs approved for the treatment of patients
−Removed: with HER2+ brain metastasis.
−Removed: CPI are not active in HER2+ cancers but there is considerable interest in attempting to modify the
−Removed: TME to allow effective use of CPI in patients with advanced disease.
−Removed: Checkpoint inhibitor companies announced large partnering
−Removed: deal with companies producing checkpoint inhibitor potentiators –
−Removed: BMS/IFM and Merck/Incyte.
−Removed: Experts agree that
−Removed: partnering in this arena will continue.
+Added: Using MUC4 expression as
+Added: a biomarker for to predict trastuzumab resistance brings a precision medicine approach to this difficult clinical scenario.
+Added: INB03 to the treatment regimen for treating HER2+ cancers may convert “cold” tumors to “hot” tumors making the
+Added: eligible for treatment with CPI.
+Added: Finally, the clinical development landscape for CPI combination therapies to treat CPI resistant therapies
+Added: The design and successful completion of a Phase II trial is not guarantee of clinical relevance or commercial viability.
+Added: are multiple therapies on the market or in development for the treatment of trastuzumab resistant breast cancer.
+Added: The most prominent are
+Added: antibody conjugates including ado-trastuzumab emtansine (Kadycycla/T-DM1, Genentech/Roche) and trastuzumab deruxtecan (Enhertu, Daiichi
The registration and development strategy for INB03 is multinational.
−Removed: The Phase II program
−Removed: may enroll patients in other countries, including the United States after submitting an Investigational New Drug application,
−Removed: or IND, to the U.S.
−Removed: Food and Drug Administration, or FDA.
−Removed: If partnering is successful at any stage of INB03 development, we expect
−Removed: the partner to influence the development and regulatory decisions needed with moving the drug to commercialization.
−Removed: Finally, combination
−Removed: therapy to treat patients resistant to trastuzumab or CPI are not the only oncology application for INB03.
−Removed: INB03 can be combined
−Removed: with other immune-oncology therapy to improve efficacy, safety or both.
−Removed: INB03 can be used as part of combination therapy with
−Removed: immuno-oncology drugs, paired with tradition therapies such as cytotoxic chemotherapy, kinase inhibitors, cell therapies or radiation
+Added: The Phase II program may enroll patients in other countries,
+Added: including the United States after submitting an Investigational New Drug application, or IND, to the U.S.
+Added: Food and Drug Administration,
+Added: If partnering is successful at any stage of INB03 development, we expect the partner to influence the development and regulatory
+Added: decisions needed with moving the drug to commercialization.
+Added: Finally, combination therapy to treat patients resistant to trastuzumab or
+Added: CPI are not the only oncology application for INB03.
+Added: INB03 can be combined with other immune-oncology therapy to improve efficacy, safety
+Added: INB03 can be used as part of combination therapy with immuno-oncology drugs, paired with tradition therapies such as cytotoxic
+Added: chemotherapy, kinase inhibitors, cell therapies or radiation therapy.
The company is pursuing pre-clinical data in some of these areas.
−Removed: When and if positive developments occur, we will communicate
−Removed: them to our shareholders.
−Removed: There are other regulatory venues that will be important for both our products –
−Removed: the largest and
−Removed: most important is Europe.
−Removed: In Europe, the European Medicines Agencies (“EMA”) is responsible for authorization of clinical
−Removed: trials in member states.
−Removed: In EU, there may be a requirement to get individual country authorization at the same time as EMA authorization.
−Removed: The initial development of INB03.
−Removed: XPro1595 and LIVNate will occur in AUS followed by trials in the US.
−Removed: The development of INKmune
−Removed: will occur primarily in the United Kingdom followed by trials in the US.
−Removed: XPro1595 is being developed for the treatment of Alzheimer’s
−Removed: disease under a Part-the-Cloud Award received Feb 2019.
−Removed: The biomarker directed Phase I trial is being performed in AUS using a
−Removed: regulatory strategy identical to that used for INB03 in cancer.
−Removed: Regulatory approval to initiate the trial was received on February
−Removed: XPro1595 treats microglial activation and innate immune dysregulation may be the cause with Alzheimer’s disease
−Removed: in some patients.
−Removed: To our knowledge, there are few companies using an anti-inflammatory strategy for the treatment of Alzheimer’s
+Added: When and if positive developments occur, we will communicate them to our shareholders.
+Added: There are other regulatory venues that will be
+Added: important for both our products – the largest and most important is Europe.
+Added: In Europe, the European Medicines Agencies (“EMA”)
+Added: is responsible for authorization of clinical trials in member states.
+Added: In EU, there may be a requirement to get individual country authorization
+Added: at the same time as EMA authorization.
+Added: The initial development of INB03 and XPro occurred in AUS followed by trials in other regulatory
+Added: jurisdictions including the US.
+Added: The development of INKmune will start in the United Kingdom followed by trials in the US.
+Added: XPro is being
+Added: developed for the treatment of Alzheimer’s disease under a Part-the-Cloud Award received Feb 2019.
+Added: The biomarker directed Phase
+Added: I trial is being performed in AUS using a regulatory strategy identical to that used for INB03 in cancer.
+Added: Regulatory approval to initiate
+Added: the trial was received on February 8, 2019.
+Added: XPro treats microglial activation and innate immune dysregulation may be the cause with Alzheimer’s
+Added: disease in some patients.
+Added: To our knowledge, there are few companies using an anti-inflammatory strategy for the treatment of Alzheimer’s
Those companies include Denali Therapeutics (NASDAQ:
−Removed: developing DNL747 that targets critical signaling proteins
−Removed: in the TNF pathway that regulate inflammation and cell death.
+Added: developing DNL747 that targets critical signaling proteins in the
+Added: TNF pathway that regulate inflammation and cell death.
Alector (NASDAQ:
−Removed: ALEC) in partnership with Abbvie is developing
−Removed: AL002 that targets TREM2 on microglial cells.
−Removed: Gliacure is targeting microglial cells in Alzheimer’s disease with a small
−Removed: molecule candidate GC021109.
−Removed: LIVNate is being developed for the treatment of NASH.
−Removed: The Phase II trial will occur in AUS and NZ,
−Removed: is expected to require fewer than 5 clinical sites to complete enrollment.
−Removed: LIVNate offers a unique therapeutic strategy for the
−Removed: treatment of NASH by targeting peripheral, regional and local cycles of pathology that contribute to the development and progression
−Removed: of the disease.
−Removed: There are many drugs in development for NASH classified in three groups –
−Removed: anti-fibrotic, metabolic and anti-inflammatory
−Removed: Drug development for the treatment of NASH has been difficult.
−Removed: In 2019, several programs failed in late stage development
−Removed: including seldapar (CYMABAY) and selonsertib (GILEAD).
−Removed: Currently, ocaliva by Intercept is expected to be the first drug to receive
−Removed: FDA approval for the treatment of NASH with by elafibranor by GENFIT is expected to be second.
−Removed: The list of companies with NASH
−Removed: therapies in earlier stages of development is long, including cenicriviroc by ALLERGAN, MGL-3196 by MADRIGAL, VK2809 by VIKING
−Removed: Therapeutics and belapectin by GALECTIN.
−Removed: To our knowledge, the only true anti-inflammatory strategy in development is an
−Removed: anti-IL11 being developed by Boheringer Ingelheim most likely as part of combination therapy.
−Removed: testing must satisfy extensive FDA regulations.
−Removed: Reports detailing the results of the clinical trials must be submitted at least
−Removed: annually to the FDA and safety reports must be submitted for serious and unexpected adverse events.
−Removed: Success in early stage clinical
−Removed: trials does not assure success in later stage clinical trials.
−Removed: The FDA, an IRB or we may suspend a clinical trial at any time
−Removed: on various grounds, including a finding that the research subjects or patients are being exposed to an unacceptable health risk.
−Removed: Drug Applications
−Removed: successful completion of the required clinical trials, the results of product development, preclinical studies and clinical trials
−Removed: are submitted to the FDA as part of an NDA.
−Removed: An NDA also must contain extensive manufacturing information, as well as proposed
−Removed: labeling for the finished product.
−Removed: An NDA applicant must develop information about the chemistry and physical characteristics
−Removed: of the drug and finalize a process for manufacturing the product in accordance with cGMP.
−Removed: The manufacturing process must be capable
−Removed: of consistently producing quality product within specifications approved by the FDA.
−Removed: The manufacturer must develop methods for
−Removed: testing the quality, purity and potency of the final product.
−Removed: In addition, appropriate packaging must be selected and tested and
−Removed: stability studies must be conducted to demonstrate that the product does not undergo unacceptable deterioration over its shelf
−Removed: Prior to approval, the FDA will conduct an inspection of the manufacturing facilities to assess compliance with cGMP.
−Removed: FDA reviews all NDAs submitted before it accepts them for filing.
−Removed: The FDA may request additional information rather than accept
−Removed: an NDA for filing.
−Removed: In this event, the NDA must be resubmitted with the additional information and is subject to review before
−Removed: the FDA accepts it for filing.
−Removed: After an application is filed, the FDA may refer the NDA to an advisory committee for review, evaluation
−Removed: and recommendation as to whether the application should be approved and under what conditions.
−Removed: The FDA is not bound by the recommendation
−Removed: of an advisory committee, but it considers them carefully when making decisions.
−Removed: The FDA may deny approval of an NDA if the applicable
−Removed: regulatory criteria are not satisfied.
−Removed: Data obtained from clinical trials are not always conclusive and the FDA may interpret
−Removed: data differently than we interpret the same data.
−Removed: The FDA may issue a complete response letter, which may require additional clinical
−Removed: or other data or impose other conditions that must be met in order to secure final approval of the NDA.
−Removed: If a product receives
−Removed: regulatory approval, the approval may be significantly limited to specific diseases and dosages or the indications for use may
−Removed: otherwise be limited, which could restrict the commercial value of the product.
−Removed: In addition, the FDA may require us to conduct
−Removed: Phase 4 testing which involves clinical trials designed to further assess a drug’s safety and effectiveness after NDA approval,
−Removed: and may require surveillance programs to monitor the safety of approved products which have been commercialized.
−Removed: the FDA may withdraw product approval if ongoing regulatory requirements are not met or if safety or efficacy questions are raised
−Removed: after the product reaches the market.
−Removed: Post-Approval
−Removed: products manufactured or distributed by us pursuant to FDA approvals are subject to pervasive and continuing regulation by the
−Removed: FDA, including, among other things, requirements relating to record-keeping, reporting of adverse experiences, periodic reporting,
−Removed: distribution, and advertising and promotion of the product.
−Removed: After approval, most changes to the approved product, such as adding
−Removed: new indications or other labeling claims, are subject to prior FDA review and approval.
−Removed: There also are continuing, annual user
−Removed: fee requirements for any marketed products and the establishments at which such products are manufactured, as well as new application
−Removed: fees for supplemental applications with clinical data.
−Removed: Pharmaceutical manufacturers and their subcontractors are required to register
−Removed: their establishments with the FDA and certain state agencies, and are subject to periodic unannounced inspections by the FDA and
−Removed: certain state agencies for compliance with GMP, which impose certain procedural and documentation requirements upon us and our
−Removed: third-party manufacturers.
−Removed: Changes to the manufacturing process are strictly regulated, and, depending on the significance of
−Removed: the change, may require prior FDA approval before being implemented.
−Removed: FDA regulations also require investigation and correction
−Removed: of any deviations from cGMP and impose reporting requirements upon us and any third-party manufacturers that we may decide to
−Removed: Accordingly, manufacturers must continue to expend time, money and effort in the area of production and quality control to
−Removed: maintain compliance with cGMP and other aspects of regulatory compliance.
+Added: ALEC) in partnership with Abbvie is developing AL002 that targets
+Added: TREM2 on microglial cells.
+Added: Gliacure is targeting microglial cells in Alzheimer’s disease with a small molecule candidate GC021109.
+Added: Clinical testing must satisfy
+Added: extensive FDA regulations.
+Added: Reports detailing the results of the clinical trials must be submitted at least annually to the FDA and safety
+Added: reports must be submitted for serious and unexpected adverse events.
+Added: Success in early stage clinical trials does not assure success in
+Added: later stage clinical trials.
+Added: The FDA, an IRB or we may suspend a clinical trial at any time on various grounds, including a finding that
+Added: the research subjects or patients are being exposed to an unacceptable health risk.
+Added: New Drug Applications
+Added: Assuming successful completion
+Added: of the required clinical trials, the results of product development, preclinical studies and clinical trials are submitted to the FDA
+Added: as part of an NDA.
+Added: An NDA also must contain extensive manufacturing information, as well as proposed labeling for the finished product.
+Added: An NDA applicant must develop information about the chemistry and physical characteristics of the drug and finalize a process for manufacturing
+Added: the product in accordance with cGMP.
+Added: The manufacturing process must be capable of consistently producing quality product within specifications
+Added: approved by the FDA.
+Added: The manufacturer must develop methods for testing the quality, purity and potency of the final product.
+Added: appropriate packaging must be selected and tested and stability studies must be conducted to demonstrate that the product does not undergo
+Added: unacceptable deterioration over its shelf life.
+Added: Prior to approval, the FDA will conduct an inspection of the manufacturing facilities
+Added: to assess compliance with cGMP.
+Added: The FDA reviews all NDAs submitted
+Added: before it accepts them for filing.
+Added: The FDA may request additional information rather than accept an NDA for filing.
+Added: In this event, the
+Added: NDA must be resubmitted with the additional information and is subject to review before the FDA accepts it for filing.
+Added: After an application
+Added: is filed, the FDA may refer the NDA to an advisory committee for review, evaluation and recommendation as to whether the application should
+Added: be approved and under what conditions.
+Added: The FDA is not bound by the recommendation of an advisory committee, but it considers them carefully
+Added: when making decisions.
+Added: The FDA may deny approval of an NDA if the applicable regulatory criteria are not satisfied.
+Added: Data obtained from
+Added: clinical trials are not always conclusive and the FDA may interpret data differently than we interpret the same data.
+Added: The FDA may issue
+Added: a complete response letter, which may require additional clinical or other data or impose other conditions that must be met in order to
+Added: secure final approval of the NDA.
+Added: If a product receives regulatory approval, the approval may be significantly limited to specific diseases
+Added: and dosages or the indications for use may otherwise be limited, which could restrict the commercial value of the product.
+Added: the FDA may require us to conduct Phase 4 testing which involves clinical trials designed to further assess a drug’s safety and
+Added: effectiveness after NDA approval, and may require surveillance programs to monitor the safety of approved products which have been commercialized.
+Added: Once issued, the FDA may withdraw product approval if ongoing regulatory requirements are not met or if safety or efficacy questions are
+Added: raised after the product reaches the market.
+Added: Post-Approval Requirements
+Added: Any products manufactured
+Added: or distributed by us pursuant to FDA approvals are subject to pervasive and continuing regulation by the FDA, including, among other things,
+Added: requirements relating to record-keeping, reporting of adverse experiences, periodic reporting, distribution, and advertising and promotion
+Added: of the product.
+Added: After approval, most changes to the approved product, such as adding new indications or other labeling claims, are subject
+Added: to prior FDA review and approval.
+Added: There also are continuing, annual user fee requirements for any marketed products and the establishments
+Added: at which such products are manufactured, as well as new application fees for supplemental applications with clinical data.
+Added: Pharmaceutical
+Added: manufacturers and their subcontractors are required to register their establishments with the FDA and certain state agencies, and are
+Added: subject to periodic unannounced inspections by the FDA and certain state agencies for compliance with GMP, which impose certain procedural
+Added: and documentation requirements upon us and our third-party manufacturers.
+Added: Changes to the manufacturing process are strictly regulated,
+Added: and, depending on the significance of the change, may require prior FDA approval before being implemented.
+Added: FDA regulations also require
+Added: investigation and correction of any deviations from cGMP and impose reporting requirements upon us and any third-party manufacturers that
+Added: we may decide to use.
+Added: Accordingly, manufacturers must continue to expend time, money and effort in the area of production and quality
+Added: control to maintain compliance with cGMP and other aspects of regulatory compliance.
If our future suppliers are not able to comply with
−Removed: these requirements, the FDA may, among other things, halt our clinical trials, require us to recall a product from distribution,
−Removed: or withdraw approval of the product.
−Removed: FDA may withdraw approval if compliance with regulatory requirements and standards is not maintained or if problems occur after
−Removed: the product reaches the market.
−Removed: Later discovery of previously unknown problems with a product, including adverse events of unanticipated
−Removed: severity or frequency, or with manufacturing processes, or failure to comply with regulatory requirements, may result in revisions
−Removed: to the approved labeling to add new safety information;
−Removed: imposition of post-market studies or clinical studies to assess new safety
−Removed: or imposition of distribution restrictions or other restrictions under a REMS program.
−Removed: FDA closely regulates the marketing, labeling, advertising and promotion of pharmaceutical products.
−Removed: A company can make only those
−Removed: claims relating to safety and efficacy, purity and potency that are approved by the FDA and in accordance with the provisions
−Removed: of the approved label.
−Removed: The FDA and other agencies actively enforce the laws and regulations prohibiting the promotion of off-label
−Removed: Failure to comply with these requirements can result in, among other things, adverse publicity, warning letters, corrective
−Removed: advertising and potential civil and criminal penalties.
−Removed: Physicians may prescribe legally available products for uses that are
−Removed: not described in the product’s labeling and that differ from those tested by us and approved by the FDA.
−Removed: Such off-label
−Removed: uses are common across medical specialties.
−Removed: Physicians may believe that such off-label uses are the best treatment for many patients
−Removed: in varied circumstances.
−Removed: The FDA does not regulate the behavior of physicians in their choice of treatments.
−Removed: The FDA does, however,
−Removed: restrict manufacturer’s communications on the subject of off-label use of their products.
−Removed: Healthcare Laws and Compliance Requirements
−Removed: sales, promotion, medical education, clinical research and other activities following product approval will be subject to regulation
−Removed: by numerous regulatory and law enforcement authorities in the United States in addition to FDA, including potentially the Federal
−Removed: Trade Commission, the Department of Justice, the Centers for Medicare and Medicaid Services, or CMS, other divisions of the U.S.
−Removed: Department of Health and Human Services and state and local governments.
−Removed: Our promotional and scientific/educational programs must
−Removed: comply with the federal Anti-Kickback Statute, the civil False Claims Act, physician payment transparency laws, privacy laws,
−Removed: security laws, and additional federal and state laws similar to the foregoing.
−Removed: federal Anti-Kickback Statute prohibits, among other things, the knowing and willing, direct or indirect offer, receipt, solicitation
−Removed: or payment of remuneration in exchange for or to induce the referral of patients, including the purchase, order or lease of any
−Removed: good, facility, item or service that would be paid for in whole or part by Medicare, Medicaid or other federal health care programs.
−Removed: Remuneration has been broadly defined to include anything of value, including cash, improper discounts, and free or reduced price
−Removed: items and services.
−Removed: The federal Anti-Kickback Statute has been interpreted to apply to arrangements between pharmaceutical manufacturers
−Removed: on one hand and prescribers, purchasers, formulary managers, and beneficiaries on the other.
−Removed: Although there are a number of statutory
−Removed: exceptions and regulatory safe harbors protecting some common activities from prosecution, the exceptions and safe harbors are
−Removed: drawn narrowly.
−Removed: Practices that involve remuneration that may be alleged to be intended to induce prescribing, purchases or recommendations
−Removed: may be subject to scrutiny if they do not qualify for an exception or safe harbor.
−Removed: Failure to meet all of the requirements of
−Removed: a particular applicable statutory exception or regulatory safe harbor does not make the conduct per se illegal under the federal
−Removed: Anti-Kickback Statute.
−Removed: Instead, the legality of the arrangement will be evaluated on a case-by-case basis based on a cumulative
−Removed: review of all its facts and circumstances.
−Removed: Several courts have interpreted the statute’s intent requirement to mean that
−Removed: if any one purpose of an arrangement involving remuneration is to induce referrals of federal healthcare covered business, the
−Removed: federal Anti-Kickback Statute has been violated.
−Removed: The government has enforced the federal Anti-Kickback Statute to reach large
−Removed: settlements with healthcare companies based on sham research or consulting and other financial arrangements with physicians.
−Removed: a person or entity does not need to have actual knowledge of the statute or specific intent to violate it to have committed a
−Removed: In addition, the government may assert that a claim including items or services resulting from a violation of the federal
−Removed: Anti-Kickback Statute constitutes a false or fraudulent claim for purposes of the False Claims Act.
−Removed: Many states have similar laws
−Removed: that apply to their state health care programs as well as private payors.
−Removed: false claims and false statement laws, including the federal civil False Claims Act, or FCA, imposes liability on persons or entities
−Removed: that, among other things, knowingly present or cause to be presented claims that are false or fraudulent or not provided as claimed
−Removed: for payment or approval by a federal health care program.
−Removed: The FCA has been used to prosecute persons or entities that “cause”
−Removed: the submission of claims for payment that are inaccurate or fraudulent, by, for example, providing inaccurate billing or coding
−Removed: information to customers, promoting a product off-label, submitting claims for services not provided as claimed, or submitting
−Removed: claims for services that were provided but not medically necessary.
−Removed: Actions under the FCA may be brought by the Attorney General
−Removed: or as a qui tam action by a private individual in the name of the government.
−Removed: Violations of the FCA can result in significant
−Removed: monetary penalties and treble damages.
−Removed: The federal government is using the FCA, and the accompanying threat of significant liability,
−Removed: in its investigation and prosecution of pharmaceutical and biotechnology companies throughout the country, for example, in connection
−Removed: with the promotion of products for unapproved uses and other illegal sales and marketing practices.
−Removed: The government has obtained
−Removed: multi-million and multibillion dollar settlements under the FCA in addition to individual criminal convictions under applicable
−Removed: criminal statutes.
−Removed: In addition, certain companies that were found to be in violation of the FCA have been forced to implement
−Removed: extensive corrective action plans, and have often become subject to consent decrees or corporate integrity agreements, restricting
−Removed: the manner in which they conduct their business.
−Removed: federal Health Insurance Portability and Accountability Act of 1996, or HIPAA, created additional federal criminal statutes that
−Removed: prohibit, among other things, knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare
−Removed: benefit program, including private third-party payors;
−Removed: knowingly and willfully falsifying, concealing or covering up a material
−Removed: fact or making any materially false, fictitious or fraudulent statement in connection with the delivery of or payment for healthcare
−Removed: benefits, items or services;
−Removed: and willfully obstructing a criminal investigation of a healthcare offense.
−Removed: Like the federal Anti-Kickback
−Removed: Statute, the Affordable Care Act amended the intent standard for certain healthcare fraud statutes under HIPAA such that a person
−Removed: or entity no longer needs to have actual knowledge of the statute or specific intent to violate it in order to have committed
−Removed: the significant size of actual and potential settlements, we expect that the government will continue to devote substantial resources
−Removed: to investigating healthcare providers’
−Removed: and manufacturers’
−Removed: compliance with applicable fraud and abuse laws.
−Removed: states have similar fraud and abuse statutes or regulations that may be broader in scope and may apply regardless of payor, in
−Removed: addition to items and services reimbursed under Medicaid and other state programs.
−Removed: Additionally, to the extent that our products,
−Removed: once commercialized, are sold in a foreign country, we may be subject to similar foreign laws.
−Removed: addition, there has been a recent trend of increased federal and state regulation of payments made to physicians and other healthcare
−Removed: The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, or
−Removed: collectively, the Affordable Care Act, among other things, imposed new reporting requirements on certain manufacturers of drugs,
−Removed: devices, biologics and medical supplies for which payment is available under Medicare, Medicaid or the Children’s Health
−Removed: Insurance Program, with specific exceptions, for payments or other transfers of value made by them to physicians and teaching
−Removed: hospitals, as well as ownership and investment interests held by physicians and their immediate family members.
−Removed: Covered manufacturers
−Removed: are required to collect and report detailed payment data and submit legal attestation to the accuracy of such data to the government
−Removed: Failure to submit required information may result in civil monetary penalties of up to an aggregate of $150,000 per
−Removed: year (or up to an aggregate of $1 million per year for “knowing failures”), for all payments, transfers of value or
−Removed: ownership or investment interests that are not timely, accurately and completely reported in an annual submission.
−Removed: Additionally,
−Removed: entities that do not comply with mandatory reporting requirements may be subject to a corporate integrity agreement.
−Removed: Certain states
−Removed: also mandate implementation of commercial compliance programs, impose restrictions on covered manufacturers’
−Removed: marketing practices
−Removed: and/or require the tracking and reporting of gifts, compensation and other remuneration to physicians and other healthcare professionals.
−Removed: may also be subject to data privacy and security regulation by both the federal government and the states in which we conduct
−Removed: our business.
−Removed: HIPAA, as amended by the Health Information Technology and Clinical Health Act, or HITECH, and their respective
−Removed: implementing regulations, imposes specified requirements on certain health care providers, plans and clearinghouses (collectively,
−Removed: “covered entities”) and their “business associates,”
−Removed: relating to the privacy, security and transmission
−Removed: of individually identifiable health information.
−Removed: Among other things, HITECH makes HIPAA’s security standards directly applicable
−Removed: to “business associates,”
−Removed: defined as independent contractors or agents of covered entities that create, receive, maintain
−Removed: or transmit protected health information in connection with providing a service for or on behalf of a covered entity.
−Removed: increased the civil and criminal penalties that may be imposed against covered entities, business associates and possibly other
−Removed: persons, and gave state attorneys general new authority to file civil actions for damages or injunctions in federal courts to
−Removed: enforce HIPAA and seek attorney’s fees and costs associated with pursuing federal civil actions.
−Removed: In addition, certain states
−Removed: have their own laws that govern the privacy and security of health information in certain circumstances, many of which differ
−Removed: from each other and/or HIPAA in significant ways and may not have the same effect, thus complicating compliance efforts.
−Removed: and Reimbursement
−Removed: of pharmaceutical products depend significantly on the extent to which coverage and adequate reimbursement are provided by third-party
−Removed: Third-party payors include state and federal government health care programs, managed care providers, private health insurers
−Removed: and other organizations.
−Removed: Although we currently believe that third-party payors will provide coverage and reimbursement for our
−Removed: product candidates, if approved, we cannot be certain of this.
−Removed: Third-party payors are increasingly challenging the price, examining
−Removed: the cost-effectiveness, and reducing reimbursement for medical products and services.
−Removed: In addition, significant uncertainty exists
−Removed: as to the reimbursement status of newly approved healthcare products.
−Removed: government, state legislatures and foreign governments
−Removed: have continued implementing cost containment programs, including price controls, restrictions on coverage and reimbursement and
−Removed: requirements for substitution of generic products.
−Removed: Adoption of price controls and cost containment measures, and adoption of more
−Removed: restrictive policies in jurisdictions with existing controls and measures, could further limit our net revenue and results.
−Removed: may need to conduct expensive clinical studies to demonstrate the comparative cost-effectiveness of our products.
−Removed: candidates that we develop may not be considered cost-effective and thus may not be covered or sufficiently reimbursed.
−Removed: time consuming and expensive for us to seek coverage and reimbursement from third-party payors, as each payor will make its own
−Removed: determination as to whether to cover a product and at what level of reimbursement.
−Removed: Thus, one payor’s decision to provide
−Removed: coverage and adequate reimbursement for a product does not assure that another payor will provide coverage or that the reimbursement
−Removed: levels will be adequate.
−Removed: Moreover, a payor’s decision to provide coverage for a drug product does not imply that an adequate
−Removed: reimbursement rate will be approved.
−Removed: Reimbursement may not be available or sufficient to allow us to sell our products on a competitive
−Removed: and profitable basis.
−Removed: United States and some foreign jurisdictions are considering or have enacted a number of legislative and regulatory proposals
−Removed: to change the healthcare system in ways that could affect our ability to sell our products profitably.
−Removed: Among policy makers and
−Removed: payors in the United States and elsewhere, there is significant interest in promoting changes in healthcare systems with the stated
−Removed: goals of containing healthcare costs, improving quality and/or expanding access.
−Removed: In the United States, the pharmaceutical industry
−Removed: has been a particular focus of these efforts and has been significantly affected by major legislative initiatives.
−Removed: way of example, in March 2010, the Affordable Care Act was signed into law, intended to broaden access to health insurance, reduce
−Removed: or constrain the growth of healthcare spending, enhance remedies against fraud and abuse, add new transparency requirements for
−Removed: the healthcare and health insurance industries, impose new taxes and fees on the health industry and impose additional health
−Removed: policy reforms.
−Removed: Among the provisions of the Affordable Care Act of importance to our potential drug candidates are:
−Removed: annual, nondeductible fee on any entity that manufactures or imports specified branded prescription drugs and biologic agents,
−Removed: apportioned among these entities according to their market share in certain government healthcare programs;
−Removed: increase in the statutory minimum rebates a manufacturer must pay under the Medicaid Drug Rebate Program to 23.1% and 13.0%
−Removed: of the average manufacturer price for branded and generic drugs, respectively;
−Removed: new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that
−Removed: are inhaled, infused, instilled, implanted or injected;
−Removed: new Medicare Part D coverage gap discount program, in which manufacturers must agree to offer 50% point-of-sale discounts
−Removed: off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition
−Removed: for a manufacturer’s outpatient drugs to be covered under Medicare Part D;
−Removed: of a manufacturer’s Medicaid rebate liability to covered drugs dispensed to individuals who are enrolled in Medicaid
−Removed: managed care organizations;
−Removed: of eligibility criteria for Medicaid programs by, among other things, allowing states to offer Medicaid coverage to additional
−Removed: individuals and by adding new mandatory eligibility categories for certain individuals with income at or below 133% of the
−Removed: federal poverty level, thereby potentially increasing a manufacturer’s Medicaid rebate liability;
−Removed: of the entities eligible for discounts under the Public Health Service pharmaceutical pricing program;
−Removed: new Patient-Centered Outcomes Research Institute to oversee, identify priorities in, and conduct comparative clinical effectiveness
−Removed: research, along with funding for such research.
−Removed: addition, other legislative changes have been proposed and adopted since the Affordable Care Act was enacted.
−Removed: These changes include,
−Removed: among others, the Budget Control Act of 2011, which mandates aggregate reductions to Medicare payments to providers of up to 2%
−Removed: per fiscal year effective April 1, 2013, and, due to subsequent legislative amendments, will remain in effect through 2024 unless
−Removed: additional Congressional action is taken.
−Removed: In January 2013, President Obama signed into law the American Taxpayer Relief Act of
−Removed: 2012, which, among other things, further reduced Medicare payments to several providers, including hospitals and cancer treatment
−Removed: centers, increased the statute of limitations period for the government to recover overpayments to providers from three to five
−Removed: These new laws may result in additional reductions in Medicare and other healthcare funding, which could have a material
−Removed: adverse effect on customers for our product candidates, if approved, and, accordingly, our financial operations.
−Removed: expect that the Affordable Care Act, as well as other healthcare reform measures that may be adopted in the future, may result
−Removed: in more rigorous coverage criteria and lower reimbursement, and in additional downward pressure on the price that we receive for
−Removed: any approved product.
−Removed: Any reduction in reimbursement from Medicare or other government-funded programs may result in a similar
−Removed: reduction in payments from private payors.
−Removed: The implementation of cost containment measures or other healthcare reforms may prevent
−Removed: us from being able to generate revenue, attain profitability or commercialize our drugs.
−Removed: Capital Resources
−Removed: of December 31, 2020, we had 5 full-time employees.
−Removed: We consider the intellectual capital of our employees to be an important driver
−Removed: of our business and key to our future prospects.
−Removed: Since the Company’s inception the Company has experienced no employee turnover.
−Removed: We monitor our compensation programs closely and provide what we consider to be a very competitive mix of compensation and insurance
−Removed: benefits for all our employees, as well as participation in our equity programs.
+Added: these requirements, the FDA may, among other things, halt our clinical trials, require us to recall a product from distribution, or withdraw
+Added: approval of the product.
+Added: The FDA may withdraw approval
+Added: if compliance with regulatory requirements and standards is not maintained or if problems occur after the product reaches the market.
+Added: Later discovery of previously unknown problems with a product, including adverse events of unanticipated severity or frequency, or with
+Added: manufacturing processes, or failure to comply with regulatory requirements, may result in revisions to the approved labeling to add new
+Added: safety information;
+Added: imposition of post-market studies or clinical studies to assess new safety risks;
+Added: or imposition of distribution restrictions
+Added: or other restrictions under a REMS program.
+Added: The FDA closely regulates
+Added: the marketing, labeling, advertising and promotion of pharmaceutical products.
+Added: A company can make only those claims relating to safety
+Added: and efficacy, purity and potency that are approved by the FDA and in accordance with the provisions of the approved label.
+Added: other agencies actively enforce the laws and regulations prohibiting the promotion of off-label uses.
+Added: Failure to comply with these requirements
+Added: can result in, among other things, adverse publicity, warning letters, corrective advertising and potential civil and criminal penalties.
+Added: Physicians may prescribe legally available products for uses that are not described in the product’s labeling and that differ from
+Added: those tested by us and approved by the FDA.
+Added: Such off-label uses are common across medical specialties.
+Added: Physicians may believe that such
+Added: off-label uses are the best treatment for many patients in varied circumstances.
+Added: The FDA does not regulate the behavior of physicians
+Added: in their choice of treatments.
+Added: The FDA does, however, restrict manufacturer’s communications on the subject of off-label use of
+Added: their products.
+Added: Other Healthcare Laws and Compliance Requirements
+Added: Our sales, promotion, medical
+Added: education, clinical research and other activities following product approval will be subject to regulation by numerous regulatory and
+Added: law enforcement authorities in the United States in addition to FDA, including potentially the Federal Trade Commission, the Department
+Added: of Justice, the Centers for Medicare and Medicaid Services, or CMS, other divisions of the U.S.
+Added: Department of Health and Human Services
+Added: and state and local governments.
+Added: Our promotional and scientific/educational programs must comply with the federal Anti-Kickback Statute,
+Added: the civil False Claims Act, physician payment transparency laws, privacy laws, security laws, and additional federal and state laws similar
+Added: to the foregoing.
+Added: The federal Anti-Kickback
+Added: Statute prohibits, among other things, the knowing and willing, direct or indirect offer, receipt, solicitation or payment of remuneration
+Added: in exchange for or to induce the referral of patients, including the purchase, order or lease of any good, facility, item or service that
+Added: would be paid for in whole or part by Medicare, Medicaid or other federal health care programs.
+Added: Remuneration has been broadly defined
+Added: to include anything of value, including cash, improper discounts, and free or reduced price items and services.
+Added: The federal Anti-Kickback
+Added: Statute has been interpreted to apply to arrangements between pharmaceutical manufacturers on one hand and prescribers, purchasers, formulary
+Added: managers, and beneficiaries on the other.
+Added: Although there are a number of statutory exceptions and regulatory safe harbors protecting some
+Added: common activities from prosecution, the exceptions and safe harbors are drawn narrowly.
+Added: Practices that involve remuneration that may be
+Added: alleged to be intended to induce prescribing, purchases or recommendations may be subject to scrutiny if they do not qualify for an exception
+Added: or safe harbor.
+Added: Failure to meet all of the requirements of a particular applicable statutory exception or regulatory safe harbor does
+Added: not make the conduct per se illegal under the federal Anti-Kickback Statute.
+Added: Instead, the legality of the arrangement will be evaluated
+Added: on a case-by-case basis based on a cumulative review of all its facts and circumstances.
+Added: Several courts have interpreted the statute’s
+Added: intent requirement to mean that if any one purpose of an arrangement involving remuneration is to induce referrals of federal healthcare
+Added: covered business, the federal Anti-Kickback Statute has been violated.
+Added: The government has enforced the federal Anti-Kickback Statute to
+Added: reach large settlements with healthcare companies based on sham research or consulting and other financial arrangements with physicians.
+Added: Further, a person or entity does not need to have actual knowledge of the statute or specific intent to violate it to have committed a
+Added: In addition, the government may assert that a claim including items or services resulting from a violation of the federal Anti-Kickback
+Added: Statute constitutes a false or fraudulent claim for purposes of the False Claims Act.
+Added: Many states have similar laws that apply to their
+Added: state health care programs as well as private payors.
+Added: Federal false claims and false
+Added: statement laws, including the federal civil False Claims Act, or FCA, imposes liability on persons or entities that, among other things,
+Added: knowingly present or cause to be presented claims that are false or fraudulent or not provided as claimed for payment or approval by a
+Added: federal health care program.
+Added: The FCA has been used to prosecute persons or entities that “cause” the submission of claims
+Added: for payment that are inaccurate or fraudulent, by, for example, providing inaccurate billing or coding information to customers, promoting
+Added: a product off-label, submitting claims for services not provided as claimed, or submitting claims for services that were provided but
+Added: not medically necessary.
+Added: Actions under the FCA may be brought by the Attorney General or as a qui tam action by a private individual in
+Added: the name of the government.
+Added: Violations of the FCA can result in significant monetary penalties and treble damages.
+Added: The federal government
+Added: is using the FCA, and the accompanying threat of significant liability, in its investigation and prosecution of pharmaceutical and biotechnology
+Added: companies throughout the country, for example, in connection with the promotion of products for unapproved uses and other illegal sales
+Added: and marketing practices.
+Added: The government has obtained multi-million and multibillion dollar settlements under the FCA in addition to individual
+Added: criminal convictions under applicable criminal statutes.
+Added: In addition, certain companies that were found to be in violation of the FCA
+Added: have been forced to implement extensive corrective action plans, and have often become subject to consent decrees or corporate integrity
+Added: agreements, restricting the manner in which they conduct their business.
+Added: The federal Health Insurance
+Added: Portability and Accountability Act of 1996, or HIPAA, created additional federal criminal statutes that prohibit, among other things,
+Added: knowingly and willfully executing, or attempting to execute, a scheme to defraud any healthcare benefit program, including private third-party
+Added: knowingly and willfully falsifying, concealing or covering up a material fact or making any materially false, fictitious or fraudulent
+Added: statement in connection with the delivery of or payment for healthcare benefits, items or services;
+Added: and willfully obstructing a criminal
+Added: investigation of a healthcare offense.
+Added: Like the federal Anti-Kickback Statute, the Affordable Care Act amended the intent standard for
+Added: certain healthcare fraud statutes under HIPAA such that a person or entity no longer needs to have actual knowledge of the statute or
+Added: specific intent to violate it in order to have committed a violation.
+Added: Given the significant size
+Added: of actual and potential settlements, we expect that the government will continue to devote substantial resources to investigating healthcare
+Added: providers’ and manufacturers’ compliance with applicable fraud and abuse laws.
+Added: Also, many states have similar fraud and abuse
+Added: statutes or regulations that may be broader in scope and may apply regardless of payor, in addition to items and services reimbursed under
+Added: Medicaid and other state programs.
+Added: Additionally, to the extent that our products, once commercialized, are sold in a foreign country,
+Added: we may be subject to similar foreign laws.
+Added: In addition, there has been
+Added: a recent trend of increased federal and state regulation of payments made to physicians and other healthcare providers.
+Added: The Patient Protection
+Added: and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act, or collectively, the Affordable Care Act, among
+Added: other things, imposed new reporting requirements on certain manufacturers of drugs, devices, biologics and medical supplies for which
+Added: payment is available under Medicare, Medicaid or the Children’s Health Insurance Program, with specific exceptions, for payments
+Added: or other transfers of value made by them to physicians and teaching hospitals, as well as ownership and investment interests held by physicians
+Added: and their immediate family members.
+Added: Covered manufacturers are required to collect and report detailed payment data and submit legal attestation
+Added: to the accuracy of such data to the government each year.
+Added: Failure to submit required information may result in civil monetary penalties
+Added: of up to an aggregate of $150,000 per year (or up to an aggregate of $1 million per year for “knowing failures”), for all
+Added: payments, transfers of value or ownership or investment interests that are not timely, accurately and completely reported in an annual
+Added: Additionally, entities that do not comply with mandatory reporting requirements may be subject to a corporate integrity agreement.
+Added: Certain states also mandate implementation of commercial compliance programs, impose restrictions on covered manufacturers’ marketing
+Added: practices and/or require the tracking and reporting of gifts, compensation and other remuneration to physicians and other healthcare professionals.
+Added: We may also be subject to
+Added: data privacy and security regulation by both the federal government and the states in which we conduct our business.
+Added: HIPAA, as amended
+Added: by the Health Information Technology and Clinical Health Act, or HITECH, and their respective implementing regulations, imposes specified
+Added: requirements on certain health care providers, plans and clearinghouses (collectively, “covered entities”) and their “business
+Added: associates,” relating to the privacy, security and transmission of individually identifiable health information.
+Added: Among other things,
+Added: HITECH makes HIPAA’s security standards directly applicable to “business associates,” defined as independent contractors
+Added: or agents of covered entities that create, receive, maintain or transmit protected health information in connection with providing a service
+Added: for or on behalf of a covered entity.
+Added: HITECH also increased the civil and criminal penalties that may be imposed against covered entities,
+Added: business associates and possibly other persons, and gave state attorneys general new authority to file civil actions for damages or injunctions
+Added: in federal courts to enforce HIPAA and seek attorney’s fees and costs associated with pursuing federal civil actions.
+Added: certain states have their own laws that govern the privacy and security of health information in certain circumstances, many of which
+Added: differ from each other and/or HIPAA in significant ways and may not have the same effect, thus complicating compliance efforts.
+Added: Coverage and Reimbursement
+Added: Sales of pharmaceutical products
+Added: depend significantly on the extent to which coverage and adequate reimbursement are provided by third-party payors.
+Added: Third-party payors
+Added: include state and federal government health care programs, managed care providers, private health insurers and other organizations.
+Added: we currently believe that third-party payors will provide coverage and reimbursement for our product candidates, if approved, we cannot
+Added: be certain of this.
+Added: Third-party payors are increasingly challenging the price, examining the cost-effectiveness, and reducing reimbursement
+Added: for medical products and services.
+Added: In addition, significant uncertainty exists as to the reimbursement status of newly approved healthcare
+Added: government, state legislatures and foreign governments have continued implementing cost containment programs, including
+Added: price controls, restrictions on coverage and reimbursement and requirements for substitution of generic products.
+Added: Adoption of price controls
+Added: and cost containment measures, and adoption of more restrictive policies in jurisdictions with existing controls and measures, could further
+Added: limit our net revenue and results.
+Added: We may need to conduct expensive clinical studies to demonstrate the comparative cost-effectiveness
+Added: of our products.
+Added: The product candidates that we develop may not be considered cost-effective and thus may not be covered or sufficiently
+Added: It is time consuming and expensive for us to seek coverage and reimbursement from third-party payors, as each payor will make
+Added: its own determination as to whether to cover a product and at what level of reimbursement.
+Added: Thus, one payor’s decision to provide
+Added: coverage and adequate reimbursement for a product does not assure that another payor will provide coverage or that the reimbursement levels
+Added: will be adequate.
+Added: Moreover, a payor’s decision to provide coverage for a drug product does not imply that an adequate reimbursement
+Added: rate will be approved.
+Added: Reimbursement may not be available or sufficient to allow us to sell our products on a competitive and profitable
+Added: Healthcare Reform
+Added: The United States and some
+Added: foreign jurisdictions are considering or have enacted a number of legislative and regulatory proposals to change the healthcare system
+Added: in ways that could affect our ability to sell our products profitably.
+Added: Among policy makers and payors in the United States and elsewhere,
+Added: there is significant interest in promoting changes in healthcare systems with the stated goals of containing healthcare costs, improving
+Added: quality and/or expanding access.
+Added: In the United States, the pharmaceutical industry has been a particular focus of these efforts and has
+Added: been significantly affected by major legislative initiatives.
+Added: By way of example, in March
+Added: 2010, the Affordable Care Act was signed into law, intended to broaden access to health insurance, reduce or constrain the growth of healthcare
+Added: spending, enhance remedies against fraud and abuse, add new transparency requirements for the healthcare and health insurance industries,
+Added: impose new taxes and fees on the health industry and impose additional health policy reforms.
+Added: Among the provisions of the Affordable Care
+Added: Act of importance to our potential drug candidates are:
+Added: an annual, nondeductible fee on any entity that manufactures or imports specified branded prescription drugs and biologic agents, apportioned among these entities according to their market share in certain government healthcare programs;
+Added: an increase in the statutory minimum rebates a manufacturer must pay under the Medicaid Drug Rebate Program to 23.1% and 13.0% of the average manufacturer price for branded and generic drugs, respectively;
+Added: a new methodology by which rebates owed by manufacturers under the Medicaid Drug Rebate Program are calculated for drugs that are inhaled, infused, instilled, implanted or injected;
+Added: a new Medicare Part D coverage gap discount program, in which manufacturers must agree to offer 50% point-of-sale discounts off negotiated prices of applicable brand drugs to eligible beneficiaries during their coverage gap period, as a condition for a manufacturer’s outpatient drugs to be covered under Medicare Part D;
+Added: extension of a manufacturer’s Medicaid rebate liability to covered drugs dispensed to individuals who are enrolled in Medicaid managed care organizations;
+Added: expansion of eligibility criteria for Medicaid programs by, among other things, allowing states to offer Medicaid coverage to additional individuals and by adding new mandatory eligibility categories for certain individuals with income at or below 133% of the federal poverty level, thereby potentially increasing a manufacturer’s Medicaid rebate liability;
+Added: expansion of the entities eligible for discounts under the Public Health Service pharmaceutical pricing program;
+Added: a new Patient-Centered Outcomes Research Institute to oversee, identify priorities in, and conduct comparative clinical effectiveness research, along with funding for such research.
+Added: In addition, other legislative
+Added: changes have been proposed and adopted since the Affordable Care Act was enacted.
+Added: These changes include, among others, the Budget Control
+Added: Act of 2011, which mandates aggregate reductions to Medicare payments to providers of up to 2% per fiscal year effective April 1, 2013,
+Added: and, due to subsequent legislative amendments, will remain in effect through 2024 unless additional Congressional action is taken.
+Added: January 2013, President Obama signed into law the American Taxpayer Relief Act of 2012, which, among other things, further reduced Medicare
+Added: payments to several providers, including hospitals and cancer treatment centers, increased the statute of limitations period for the government
+Added: to recover overpayments to providers from three to five years.
+Added: These new laws may result in additional reductions in Medicare and other
+Added: healthcare funding, which could have a material adverse effect on customers for our product candidates, if approved, and, accordingly,
+Added: our financial operations.
+Added: We expect that the Affordable
+Added: Care Act, as well as other healthcare reform measures that may be adopted in the future, may result in more rigorous coverage criteria
+Added: and lower reimbursement, and in additional downward pressure on the price that we receive for any approved product.
+Added: Any reduction in reimbursement
+Added: from Medicare or other government-funded programs may result in a similar reduction in payments from private payors.
+Added: The implementation
+Added: of cost containment measures or other healthcare reforms may prevent us from being able to generate revenue, attain profitability or commercialize
+Added: Human Capital Resources
+Added: As of December 31, 2021, we
+Added: had 10 full-time employees.
+Added: We consider the intellectual capital of our employees to be an important driver of our business and key to
+Added: our future prospects.
+Added: We monitor our compensation programs closely and provide what we consider to be a very competitive mix of compensation
+Added: and insurance benefits for all our employees, as well as participation in our equity programs.
None of our employees is subject to a collective
1 unchanged sentence
We consider our relations with our employees to be good.
−Removed: were incorporated under the laws of the State of Nevada on September 25, 2015.
−Removed: Our principal executive office is located at 1200
−Removed: Prospect Street, Suite 525, La Jolla, CA 92037 and our telephone number is (858) 964-3720.
+Added: Corporate Information
+Added: We were incorporated under the laws of the State
+Added: of Nevada on September 25, 2015.
+Added: Our principal executive office is located at 225 NE Mizner Blvd, Suite 640, Boca Raton FL 33432 and our
+Added: telephone number is (858) 964-3720.
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.