RE: My Thoughts on a takeover !21 Nov 2025 11:36
In patients with soft tissue sarcomas (n=17 evaluable), multiple tumor responses are observed, even at lower doses including one responder at the 160 mg/m2 Q3W dose level. The stabilization of disease despite the removal of the drug is observed in this indication as well, suggesting a highly-effective and durable treatment in this cancer indication. The key difference between the biology of many subsets of soft tissue sarcoma and other epithelial malignancies is that many sarcoma subsets demonstrate direct tumor cell expression of FAP, which could enhance efficacy. The vast majority of epithelial malignancies do not demonstrate expression of FAP on tumor cells, only on the cancer associated fibroblasts.
Cardiac safety data demonstrate that despite dosing of faridoxorubicin with a cumulative exposure up to 550 mg/m2 of conventional doxorubicin, no severe cardiac events were reported, either during the dosing timing or in the follow-up period. Echocardiogram (ECHO) data were analyzed similar to the liposomal doxorubicin label in the full cohort of patients and these data presented based on the cumulative dose received of released doxorubicin. These data reveal that only two patients demonstrated ECHO changes consistent with adverse findings, one patient treated below the maximum of 450mg/m2 and one patient treated to 500 mg/m2. This includes a patient reported previously experiencing the early dose limiting toxicity due to ECHO changes in the 120 mg/m2 Q3W cohort (grade 2 cardiac failure). None of the patients treated to the cumulative dose of 550 mg/m2 demonstrated observed ECHO changes. The cardiac safety data compare favorably to that reported with both the doxorubicin and liposomal doxorubicin respective drug labels.
Clinical pharmacology data with faridoxorubicin
Despite dosing up to approximately 4x the dose of conventional doxorubicin, the data demonstrate exposure of released doxorubicin in plasma and normal tissues is generally lower than that observed with conventional dose doxorubicin (75 mg/m2 Q3W) and the median tumor to plasma ratio is 100:1. The lack of toxicity is explained by the limited tissue distribution as well as limited first pass effect exposure of released doxorubicin (reported in Lahu et al. AACR 2025).
Biopsy and plasma data collected during the trial at 24 hours after the first dose demonstrate two key factors relevant to the pre|CISION® platform: (1) intratumoral concentration of the active payload is dose-dependent, indicating that the higher doses lead to higher absolute values of released doxorubicin in the tumor and (2) efficient cleavage of the PDC is observed in all tumors, even those with limited 1+ expression, suggesting the lower level of expression required for cleavage of the peptide is quite low, demonstrating the potential of pre|CISION® medicines in a number of other malignancies with lower expression of FAP.