Full Press Release Details
Interleukin-12 (IL-12) KOL Roundtable NASDAQ: PDSB | April 21, 2023
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Disclaimer PDS Biotech is hosting this roundtable Each panelist is speaking at
the request of PDS Biotech Information presented is consistent with FDA guidelines
Introducing our Panel Dr. James Gulley Co-Director of the Center for
Immuno-Oncology National Cancer Institute Dr. Jeffrey Schlom Co-Director of the Center for Immuno-Oncology National Cancer Institute
Today's Agenda 5 Welcome and Introductions Dr. Lauren V. Wood History of IL-12
and NHS-IL12/PDS0301 Dr. James Gulley Preclinical and Mechanistic Studies of NHS-IL12/PDS0301 Dr. Jeffrey Schlom Clinical Studies of NHS-IL12/PDS0301 Dr. James Gulley Panel Discussion Moderated by Dr. Lauren V. Wood Closing
Remarks Dr. Lauren V. Wood
History of IL-12 and NHS-IL12 / PDS0301 Dr. James Gulley
Investigations elucidate the mechanisms of IL-12 anti-tumor activity Modified
from Trinchieri G, Nature Reviews Immunology 2003 DC IL-12 Antigen processing & presentation
1994: Early clinical development of IL-12 Day 1 Test dose 15 Cycle
1 19 35 Cycle 2 40 Tumor measurement 50 Schema of Phase 1: Day 1 Cycle 1 (dosed at MTD) 5 Schema of Phase 2: 500 ng/kg defined as the MTD Explanation: Mouse and monkey data show that the test dose' in the phase one trial reduced
the toxicity of subsequent daily administrations - clinical trials allowed to resume Severe toxicity in all patients; two patient deaths; trial stopped - Source: Leonard J et al, Blood 1997, Atkins M et al, Clin Ca Res 1997
IL-12 de-sensitization in patients is associated with counter-induction of
IL-10 The first dose of IL-12 increases production of Th1 cytokines such as IFN- and TNF- Frequent, repeated dosing was associated with declining IFN- and TNF- levels, and a persistent elevation of the Th2 cytokine, IL-10 IL-10 is a
negative regulator of IL-12 activity Repeated administration also increased serum levels of soluble IFN- receptor IL-10 1st dose 7th dose IFN- Source: Portielje J, Clin Can Res 2003
After well over a decade in the clinic, recombinant IL-12 has failed due to
limited efficacy and toxicity Phase 2 Selected Phase I Limited efficacy observed in RCC and melanoma Promising activity against lymphomas Immunomodulatory effects clearly demonstrated Toxicities problematic, tolerability improved with
s.c. delivery Frequent, repeated dosing causes a de-sensitization effect that limits efficacy
Re-thinking IL-12 immunotherapy A strategy for success with NHS-IL12
(PDS0301): NHS-IL12 targets IL-12 delivery to the tumor, increasing exposure at the tumor site while reducing systemic exposure Further improved tolerability due to the reduced potency of NHS-IL12 NHS-IL12 is a large macromolecule (~250 kDa)
with a longer PK than rIL-12, providing efficacious exposure with a single s.c. dose, eliminating the need for frequent dosing Administration by s.c. route will promote lymphatic absorption of the large NHS-IL12 molecule, promoting IL-12
effects at draining lymph nodes prior to systemic distribution Monitor the IL-10/IFN- axis to guide the establishment of optimal dose schedules in the clinic
NHS-IL12 - Molecule Overview Molecule Composition M9241 (NHS-IL12) is an
immuno-cytokine comprised of two IL-12 heterodimers each fused to one of the H-chains of the IgG NHS76 (fully human) antibody It is a complex molecule with several glycosylation sites IL-12 has been genetically modified to eliminate a
proteolytic cleavage site (p40 clipping resistant) The junction region between the IL-12 and NHS76 has been de-immunized. Molecule Characteristics NHS76 targets regions of tumor necrosis where cell membrane integrity has been lost and DNA
has become exposed. It has affinity for both single- and double-stranded DNA Tolerability is further increased by administering NHS-IL12 by the s.c. route of administration to achieve a slow, sustained release into the bloodstream and
enhance lymphatic absorption No ADCC or CDC activity in vitro
MOA: Innate & Adaptive Immunity Driving Force Distinct Mechanisms for IL-12
as a Tumor Targeting Therapy Induces differentiation of na ve CD4+ T-cells to the Th1 phenotype Increases the proliferation and lytic capacity of CD8+ cytotoxic T cells and NK cells Promotes IFN- production via NK & T-cells Increases
the production of IP-10 (interferon-inducible protein 10) and MIG (monokine induced by interferon gamma) which then mediates an anti-angiogenic effect Enhances antigen-presentation through paracrine upregulation of MHC class I and II
expression Source: Lasek et al 2014
Effector programing of CD8+ T-cells dependent on APC in TME CD8+ T cells in
tumor-draining lymph nodes maintain a TCF1+ stem-like program Tumor-specific CD8+ T cells migrate to the tumor in the stem-like state CD8+ T cells only acquire the canonical effector program within the tumor Effector program acquisition
requires co-stimulation in the tumor microenvironment Source: Prokhnevska Kissick et al. CD8+ T cell activation in cancer comprises an initial activation phase in lymph nodes followed by effector differentiation within the tumor. Immunity Dec
Kinetic Analysis of Tumor Localization Following s.c. Administration of
AF750-labeled NHS-muIL12 and BC1-muIL12 15 chTNT is a mouse/human chimeric Ab 131I-chTNT is a targeted radiotherapeutic Image at right shows biodistribution of 131I-chTNT in a patient with lung cancer. 131I-chTNT is licensed in China for
advanced lung cancer treatment NHS-76 is a fully human 2nd generation TNT antibody 131I-chTNT targeting to lung tumor
Preclinical and Mechanistic Studies of NHS-IL12/PDS0301 Dr. Jeffrey Schlom
Components of Effective Cancer Immunotherapy Source: Schlom and Gulley. JAMA,
Potential of IL-12 as an anti-cancer therapy: Bridges host innate and adaptive
immunity Produced by activated APCs (macrophages, DCS, neutrophils, B cells) Drives Th1 differentiation of helper T cells Promotes IFN- production via NK & T cells Increases proliferation and lytic capacity of NK, NKT, and CD8+ T
cells Stimulates further IL-12 production in DCs & enhances antigen presentation Upregulates IP-10/CXCL10 & MIG/CXCL9 - mediate an anti-angiogenic effect - drive infiltration of CD8+ T cells Clinically, recombinant human IL-12
has a narrow therapeutic index and its systemic administration can result in significant toxicity Image: Del Vecchio, et al. Cancer Res, 2020 Exploiting Immunotherapy Combinations With NHS-IL12/PDS0301
Tumor Localization Kinetics of AF750-labeledNHS-muIL12 and BC1-muIL12 (sc)
MC38 LLC Antitumor Effect of NHS-muIL12 vs. muIL12 (sc) Fallon Schlom, Greiner. Oncotarget, 2014; Greiner Schlom. Immunotargets Ther., 2021
The Combination of PDS0101, NHS-IL12 and Bintrafusp alfa Reduced Tumor Volume and
Increased T-cell Clonality in TC-1-bearing Mice Source: Smalley Rumfield Schlom, Jochems. J Immunother Cancer. 2020
PDS0301 (NHS-IL12) Accumulates in Tumors and Promotes PDS0101 Induced CD8 and CD4
T Cell Infiltration and Expansion in Tumors - Maximum T Cell Accumulation in Tumor with All Three Agents 21 PBS Control PDS0301 (NHS-IL12) PDS0101 vaccine PDS0101 + PDS0301 PDS0101 + PDS0301 + checkpoint inhibitor
Hypothesis: Necrosis-inducing Agents Will Increase NHS-IL12 Targeting to the Tumor
and Increase Immune Activation Day 17 Docetaxel causes necrosis in a dose-specific manner Tumoral NHS-IL12
Anti-tumor Activity of Docetaxel + NHS-IL12
Docetaxel and NHS-IL-12 Combination Therapy Independent of PD-L1 Tumor
Expression MC38-PD-L1 KO: MC38 cells were co-transfected recombinant Cas9 and a RNA targeting murine PD-L1 PD-L1 negative cells were cloned and used in subsequent studies Model of Primary Checkpoint Resistance Cells made and characterized
by Dr. Duane Hamilton
FDA-approved HDACi Indication Vorinostat Cutaneous T cell
lymphoma Romidepsin Cutaneous & peripheral T cell lymphoma Belinostat Peripheral T cell lymphoma Tucidinostat Cutaneous T cell lymphoma Panobinostat Multiple myeloma HDACi in solid tumors Exploiting Immunotherapy Combinations
With HDAC Inhibition Source: Hontecillas-Prieto,et al. Front Genet., 2020
Exploiting Immunotherapy Combinations with NHS-IL12 ABSTRACT
Days Post-Tumor Implant Tumor Volume (mm3) EMT6 (BrCa) NHS-IL12 PBS ENT CR:
0/5 1/7 0/7 3/7 7/7 0/7 Days Post-Tumor Implant Tumor Rechallenge Survival Kristin Hicks ENT+NHS-rmIL12 rmIL-12 ENT+rmIL-12 Entinostat plus NHS-IL12 Source: Hicks Schlom, Gameiro. Nat Commun, 2021 Exploiting Immunotherapy
Combinations with NHS-IL12
79% TGI: 100% 63% Cures: 40% 100% 20% Can NHS-IL12 Plus Entinostat Overcome
PD-1/-L1 Refractory Tumors Due to Defects in APM/IFN Signaling? Source: Minnar...Schlom, Gameiro. J Immunother Cancer, 2022
M2 to M1 shift Activated CD8+
TILs Increased CD8/Tregs TC-1/a9 CMT.64 RVP3 TC-1/a9 TME NHS-IL12 Synergizes with Entinostat to Suppress PD1/ PDL1 Refractory Tumors
Components of Effective Cancer Immunotherapy Source: Schlom and Gulley. JAMA,
Clinical Studies of NHS-IL12 / PDS0301 Dr. James Gulley
Source: Clinical Cancer Research, 2019 Tumor targeted cytokine (binds DNA in
areas of necrosis) Demonstrated safety and biologic activity MTD 16.8 mg/kg s.c. every 28 days NCI Phase 1: First in Human (FIH) Study NCT01417546
NCI Phase 1: FIH Study Phase I Study Design (Open Label) Assess the safety, PK
and immune impact 3+3 dose-escalation in solid tumors (SAD & MAD portions) Dosing Schedule: Q4W s.c. administration 6 week DLT period Primary Objective MTD Secondary Objectives PK of subcutaneously administered
NHS-IL12 Immunogenicity To determine immune response, including frequency of immune cell subtypes infiltrating tumor tissue (CD8 memory/effector cells, CD4 memory/effector cells, Tregs, NK cells, DCs), and activation of T lymphocytes against
relevant tumor-associated antigens as measured by tetramer and/or ELISPOT analysis Dose Level* (mcg/kg) # of pts Tumor Types # of pts Treatment duration (MD), # of cycles Tumor Types 0.1 3 Kaposi, Breast, Transitional 0.5 3 CRC
(n=2), Mesothelioma 1.0 4 CRC (n=4) 2.0 4 CRC (n=2), Rectal, Pancreatic 4 1, 1, 4, 5 NSCLC (n=3), Renal 4.0 3 CRC, Gallbladder, Lung 4 2, 2, 2, 9 Rectal, Pancreatic, Gallbladder, Prostate 8.0 3 Pancreatic, NEC lung, Esoph
(sq) 3 3, 5, 6 CRC (n=2), Pancreatic 12.0 2 Adeno Ca (tongue), Breast 4 1, 3, 3, 14 Prostate (n=2), Thymoma, Anal 16.8 (MTD) 17 1, 1, 2, 2, 2, 2, 2, 2, 3, 4, 6 PDAC, Ovarian (n=3), Breast, Adeno Ca intestinal, Prostate (n=3),