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Atossa Therapeutics Releases Promising Preliminary Analysis Demonstrating (Z)-Endoxifen’s Potential to Rapidly Reduce Ki-67 and Tumor Volume in ER+/HER2- Breast Cancer

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Atossa Therapeutics (ATOS) announced promising preliminary results from a phase 2 trial of (Z)-endoxifen in the I-SPY 2 Endocrine Optimization Pilot study. The trial, involving 20 women with ER+/HER2- breast cancer, met its primary endpoint with 95% of patients receiving >75% of planned treatment at 10mg daily dose. Key findings showed a 69% reduction in Ki-67 (cancer cell division marker) and a 30.4% decrease in functional tumor volume after 3 weeks. The treatment was well-tolerated with only mild side effects reported, including hot flushes, insomnia, and fatigue, with no dose reductions or discontinuations required.

Atossa Therapeutics (ATOS) ha annunciato risultati preliminari promettenti da uno studio di fase 2 riguardante (Z)-endoxifene nell'ambito dello studio pilota I-SPY 2 per l'ottimizzazione endocrina. Lo studio, che ha coinvolto 20 donne con cancro al seno ER+/HER2-, ha raggiunto il suo obiettivo primario, con il 95% delle pazienti che ha ricevuto oltre il 75% del trattamento pianificato alla dose giornaliera di 10 mg. Risultati chiave hanno mostrato una riduzione del 69% del Ki-67 (marcatore della divisione cellulare cancerosa) e una diminuzione del 30,4% del volume tumorale funzionale dopo 3 settimane. Il trattamento è stato ben tollerato, con solo lievi effetti collaterali segnalati, tra cui vampate di calore, insonnia e affaticamento, senza necessità di riduzioni di dosaggio o interruzioni.

Atossa Therapeutics (ATOS) anunció resultados preliminares prometedores de un ensayo de fase 2 del (Z)-endoxifeno en el estudio piloto de optimización endocrina I-SPY 2. El ensayo, que involucró a 20 mujeres con cáncer de mama ER+/HER2-, cumplió con su objetivo primario, con el 95% de las pacientes recibiendo más del 75% del tratamiento planeado a una dosis diaria de 10 mg. Hallazgos clave mostraron una reducción del 69% en Ki-67 (marcador de división celular cancerosa) y una disminución del 30,4% en el volumen tumoral funcional después de 3 semanas. El tratamiento fue bien tolerado, con solo efectos secundarios leves informados, incluidos sofocos, insomnio y fatiga, sin necesidad de reducciones de dosis o interrupciones.

아토사 테라퓨틱스 (ATOS)는 I-SPY 2 내분비 최적화 파일럿 연구에서 (Z)-엔독시펜의 2상 시험에서 유망한 초기 결과를 발표했습니다. 이 시험은 ER+/HER2- 유방암 환자 20명을 포함하며, 환자의 95%가 일일 10mg의 계획된 치료량을 75% 이상 받는 주요 목표를 달성했습니다. 주요 결과는 Ki-67 (암세포 분열 마커)의 69% 감소와 3주 후 기능적 종양 볼륨의 30.4% 감소를 보여주었습니다. 치료는 부작용이 경미하여 잘 견뎌졌으며, 단지 열감, 불면증, 피로 등의 미미한 부작용이 보고되었을 뿐, 복용량 감소나 치료 중단은 필요하지 않았습니다.

Atossa Therapeutics (ATOS) a annoncé des résultats préliminaires prometteurs d'un essai de phase 2 sur le (Z)-endoxifène dans le cadre de l'étude pilote d'optimisation endocrinienne I-SPY 2. L'essai, qui a impliqué 20 femmes atteintes de cancer du sein ER+/HER2-, a atteint son objectif principal, 95% des patientes ayant reçu plus de 75% du traitement prévu à une dose quotidienne de 10 mg. Résultats clés ont montré une réduction de 69% du Ki-67 (marqueur de division cellulaire cancéreuse) et une diminution de 30,4% du volume tumoral fonctionnel après 3 semaines. Le traitement a été bien toléré avec seulement des effets secondaires légers rapportés, notamment des bouffées de chaleur, de l'insomnie et de la fatigue, sans nécessité de réductions de dose ni d'interruptions.

Atossa Therapeutics (ATOS) gab vielversprechende vorläufige Ergebnisse aus einer Phase-2-Studie zu (Z)-Endoxifen im Rahmen der I-SPY 2 Endokrinen Optimierungs-Pilotstudie bekannt. In der Studie, die 20 Frauen mit ER+/HER2- Brustkrebs umfasste, wurde das primäre Ziel erreicht, wobei 95% der Patientinnen mehr als 75% der geplanten Behandlung in einer täglichen Dosis von 10 mg erhielten. Wichtige Ergebnisse zeigten eine 69%ige Reduktion von Ki-67 (Marker für die Zellteilung bei Krebs) und eine 30,4%ige Verringerung des funktionalen Tumorvolumens nach 3 Wochen. Die Behandlung wurde gut vertragen, mit nur milden Nebenwirkungen wie Hitzewallungen, Schlaflosigkeit und Müdigkeit, ohne dass Dosen reduziert oder Behandlungen abgebrochen werden mussten.

Positive
  • Met primary endpoint with 95% patient compliance rate
  • Significant 69% reduction in Ki-67 biomarker from baseline
  • 30.4% reduction in functional tumor volume after 3 weeks
  • Well-tolerated treatment with only mild side effects
  • No dose reductions or treatment discontinuations required
Negative
  • None.

Insights

The preliminary Phase 2 trial results for (Z)-endoxifen show compelling efficacy in treating ER+/HER2- breast cancer. The key findings demonstrate 95% of patients completing the treatment protocol, a significant 69% reduction in Ki-67 (a critical tumor proliferation marker) and a 30.4% decrease in functional tumor volume after just 3 weeks. These results are particularly noteworthy for several reasons:

  • The high completion rate indicates excellent tolerability, with no dose reductions or discontinuations due to adverse events
  • The rapid biomarker response suggests potent anti-tumor activity
  • The patient population represents an underserved group with current treatment options

The dual targeting of ERα and PKCβ through higher doses combined with abemaciclib could potentially enhance these already promising results. This positions (Z)-endoxifen as a potentially significant advancement in neoadjuvant breast cancer treatment.

These positive trial results significantly strengthen Atossa's market position in the breast cancer therapeutics space. The data supports (Z)-endoxifen's commercial potential in several ways:

  • The strong safety profile and high treatment completion rate suggest lower regulatory hurdles
  • Rapid efficacy in reducing key biomarkers could lead to faster market adoption
  • The focus on ER+/HER2- breast cancer targets a large market segment with unmet needs

For a company with a market cap of $179M, successful development of (Z)-endoxifen represents substantial upside potential. The positive data could attract partnership opportunities or additional institutional investment, particularly as the company advances toward later-stage trials.

(Z)-endoxifen at 10 mg once daily met the primary endpoint with 19/20 (95%) receiving > 75 % of planned treatment in I-SPY-2 Phase 2 Trial

Low dose (Z)-endoxifen was well tolerated and demonstrated promising rapid activity in reducing 3-wk Ki-67 and FTV Biomarkers

SEATTLE, Oct. 31, 2024 (GLOBE NEWSWIRE) -- Atossa Therapeutics, Inc. (Nasdaq: ATOS) ("Atossa" or the "Company"), today released a preliminary analysis from a phase 2 trial of (Z)-endoxifen as part of the I-SPY 2 Endocrine Optimization Pilot (EOP) will be the subject of a poster presentation at the inaugural RISE UP (Revolutionizing Investigations to StEp Up Prevention) Breast Cancer Conference in San Francisco, November 1-3, 2024. Atossa Therapeutics is a clinical-stage biopharmaceutical company developing innovative medicines for breast cancer. An explainer video of this announcement can be found here.

A preliminary data analysis from this study, which included 20 women with ER+/HER2- breast cancer who received 10mg of (Z)-endoxifen orally once daily for six cycles (each cycle = 28 days), showed that (Z)-endoxifen met the primary endpoint with 95 percent (19/20 patients) receiving > 75 % of planned treatment.

The data also demonstrated (Z)-endoxifen activity in rapidly reducing key biomarkers such as Ki-67 by 69 percent from baseline and a 30.4 percent reduction in functional tumor volume (FTV) from baseline after 3 weeks of treatment. Ki-67 is a protein that helps measure how quickly cancer cells in a tumor are dividing, and FTV is a quantitative measurement of tumor burden that can be used to assess treatment response for breast cancer.

(Z)-endoxifen was well tolerated in this study with the most common side effects being mild, including hot flushes, insomnia, and fatigue. No dose reductions or discontinuations due to treatment related adverse events were observed in this study. Surgical Ki-67 values and 24-wk imaging will be analyzed in the future.

“We are very encouraged by these results and thrilled by the signs of rapid reduction in Ki-67 and FTV as it demonstrates progress in our effort to develop (Z)-endoxifen as an effective and tolerant neoadjuvant treatment for ER+/HER2- breast cancer patients. This data provides further evidence that (Z)-endoxifen may be able to slow the progression of ER+ breast cancer in the neoadjuvant setting,” said Dr. Steven Quay, Chief Executive Officer of Atossa Therapeutics. “We are honored to have these findings from the I-SPY 2 EOP study of (Z)-endoxifen presented at the inaugural RISE UP conference and commend Dr. Laura Esserman and other members of the Organizing Committee for their focus on reimagining breast cancer prevention and treatment.”

The I-SPY 2 EOP trial focuses on patients with newly diagnosed estrogen receptor-positive (ER+) invasive breast cancer whose tumors are predicted to be sensitive to endocrine therapy but for whom chemotherapy is expected to provide little or no benefit. These patients have substantial risk for recurrence, often after five years, and need novel treatments that are more effective and tolerable than the current standard of care.

The ongoing study arm enrolled 20 women between March 2023 and May 2024. Participants received 10 mg of (Z)-endoxifen daily for six cycles, with ovarian function suppression introduced in premenopausal patients starting on cycle two. Primary endpoints included the feasibility of treatment, with >75 percent of patients completing the therapy. Secondary endpoints include changes in Ki-67 and FTV, both of which have demonstrated early reduction in response to (Z)-endoxifen. Higher doses of (Z)-endoxifen in combination with abemaciclib are currently being explored in ongoing studies to further enhance the dual targeting of ERα and PKCβ activity.

About (Z)-Endoxifen
(Z)-endoxifen is one of the most potent Selective Estrogen Receptor Modulator (SERM) for estrogen receptor inhibition and may cause estrogen receptor degradation. It has also been shown to have efficacy in the setting of patients with tumor resistance to other hormonal treatments. In addition to its potent anti-estrogen effects, (Z)-endoxifen has been shown to target PKCβ1, a known oncogenic protein, at clinically attainable blood concentrations. Finally, (Z)-endoxifen appears to deliver similar or even greater bone agonistic effects while resulting in little or no endometrial proliferative effects compared with standard treatments, like tamoxifen.

Atossa is developing a proprietary oral formulation of (Z)-endoxifen that is encapsulated to bypass the stomach, as acidic conditions in the stomach convert a significant proportion of (Z)-endoxifen to the inactive (E)-endoxifen. Atossa’s (Z)-endoxifen has been shown to be well tolerated in Phase 1 studies and in a small Phase 2 study of women with breast cancer. (Z)-endoxifen is currently being studied in five phase 2 trials: one in healthy women with measurable breast density, one in women diagnosed with ductal carcinoma in situ, and three other studies including the EVANGELINE study and two I-SPY studies in women with ER+/HER2- breast cancer. Atossa’s (Z)-endoxifen is protected by four issued U.S. patents and numerous pending patent applications.

About Atossa Therapeutics        
Atossa Therapeutics, Inc. is a clinical-stage biopharmaceutical company developing innovative medicines in areas of significant unmet medical need in oncology with a focus on using (Z)-endoxifen to prevent and treat breast cancer. For more information, please visit www.atossatherapeutics.com.

Contact
Michael Parks, VP Investor and Public Relations
484-356-7105
michael.parks@atossainc.com

FORWARD LOOKING STATEMENTS        
This press release contains certain information that may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. We may identify these forward-looking statements by the use of words such as “expect,” “potential,” “continue,” “may,” “will,” “should,” “could,” “would,” “seek,” “intend,” “plan,” “estimate,” “anticipate,” “believe,” “future,” or other comparable words. Forward-looking statements in this press release are subject to risks and uncertainties that may cause actual results, outcomes, or the timing of actual results or outcomes, such as data related to the (Z)-endoxifen program, the potential of (Z)-endoxifen as a breast cancer prevention and treatment agent, and potential milestones and growth opportunities for the Company, to differ materially from those projected or anticipated, including risks and uncertainties associated with: macroeconomic conditions and increasing geopolitical instability; the expected timing of releasing data; any variation between interim and final clinical results; actions and inactions by the FDA and foreign regulatory bodies; the outcome or timing of regulatory approvals needed by Atossa, including those needed to continue our planned (Z)-endoxifen trials; our ability to satisfy regulatory requirements; our ability to remain compliant with the continued listing requirements of the Nasdaq Stock Market; our ability to successfully develop and commercialize new therapeutics; the success, costs and timing of our development activities, including our ability to successfully initiate or complete our clinical trials, including our (Z)-endoxifen trials; our anticipated rate of patient enrollment; our ability to contract with third-parties and their ability to perform adequately; our estimates on the size and characteristics of our potential markets; our ability to successfully defend litigation and other similar complaints and to establish and maintain intellectual property rights covering our products; whether we can successfully complete our clinical trial of oral (Z)-endoxifen in women with mammographic breast density and our trials of (Z)-endoxifen in women with breast cancer, and whether the studies will meet their objectives; our expectations as to future financial performance, expense levels and capital sources, including our ability to raise capital; our ability to attract and retain key personnel; our anticipated working capital needs and expectations around the sufficiency of our cash reserves; and other risks and uncertainties detailed from time to time in Atossa’s filings with the Securities and Exchange Commission, including without limitation its Annual Reports on Form 10-K and Quarterly Reports on 10-Q. Forward-looking statements are presented as of the date of this press release. Except as required by law, we do not intend to update any forward-looking statements, whether as a result of new information, future events or circumstances or otherwise.


FAQ

What were the key results of Atossa Therapeutics (ATOS) Phase 2 trial for (Z)-endoxifen?

The trial showed 95% of patients received >75% of planned treatment, with a 69% reduction in Ki-67 and 30.4% reduction in tumor volume after 3 weeks.

What side effects were reported in ATOS's (Z)-endoxifen trial?

The treatment was well-tolerated with only mild side effects including hot flushes, insomnia, and fatigue, with no dose reductions or discontinuations required.

How many patients were enrolled in Atossa's (ATOS) I-SPY 2 EOP trial?

The study enrolled 20 women with ER+/HER2- breast cancer between March 2023 and May 2024.

What was the dosage of (Z)-endoxifen used in ATOS's Phase 2 trial?

Patients received 10mg of (Z)-endoxifen orally once daily for six cycles, with each cycle lasting 28 days.

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