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Theriva™ Biologics Announces U.S. FDA Guidance on Design of Phase 3 Study of VCN-01 for the Treatment of Metastatic Pancreatic Cancer

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Theriva Biologics (NYSE American: TOVX) announced outcomes from a Type D meeting with the FDA regarding the Phase 3 study design of VCN-01 for metastatic pancreatic cancer treatment. The FDA advised against expanding the ongoing VIRAGE Phase 2b study into Phase 3, recommending instead a standalone Phase 3 study of VCN-01 with gemcitabine/nab-paclitaxel.

The FDA agreed with Theriva's proposed Phase 3 design and indicated that including additional standard-of-care chemotherapy was unnecessary. The meeting also addressed statistical elements for confirmatory clinical studies. The company recently completed target enrollment for the VIRAGE Phase 2b study and plans to request another FDA meeting after its completion to discuss Phase 3 protocol details.

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Positive

  • FDA provided general agreement with proposed Phase 3 study design
  • Successfully completed target enrollment in VIRAGE Phase 2b clinical study
  • Clear regulatory pathway established for Phase 3 trial

Negative

  • FDA rejected expansion of current Phase 2b into Phase 3, requiring new standalone study
  • Additional regulatory meetings needed before Phase 3 can begin

Insights

The FDA's guidance on Theriva's Phase 3 study design for VCN-01 represents a significant milestone in their pancreatic cancer program. The regulator's preference for a standalone Phase 3 trial, rather than expanding the current VIRAGE Phase 2b study, provides clear direction for the development pathway. The FDA's endorsement of combining VCN-01 with gemcitabine/nab-paclitaxel without additional chemotherapy agents streamlines the trial design and potentially reduces complexity in data interpretation.

The completion of target enrollment in the VIRAGE study positions Theriva to gather important efficacy data that will inform the Phase 3 protocol. For a micro-cap company with a market cap of just $3.7M, securing this regulatory clarity is particularly valuable as it helps optimize resource allocation and increases the probability of successful trial execution.

The FDA's recommendation for a standalone Phase 3 trial, while potentially extending the development timeline, actually strengthens the program's scientific rigor. The guidance on statistical considerations, including sample size estimation and population analysis, will be important for generating robust, registration-worthy data. The regulator's support for the simpler combination with just gemcitabine/nab-paclitaxel, rather than multiple standard-of-care options, should result in cleaner data and more straightforward statistical analysis.

The planned follow-up meeting after VIRAGE study completion indicates a well-structured regulatory strategy. This stepwise approach allows for incorporation of Phase 2b results into the Phase 3 design, potentially optimizing trial parameters and increasing chances of success in this challenging indication.

ROCKVILLE, Md., Dec. 05, 2024 (GLOBE NEWSWIRE) -- Theriva™ Biologics (NYSE American: TOVX), a diversified clinical-stage company developing therapeutics designed to treat cancer and related diseases in areas of high unmet need, today announced the outcomes of a recent Type D meeting with the U.S. Food and Drug Administration (FDA) to obtain guidance on the design of a Phase 3 clinical study of lead clinical candidate VCN-01 in combination with standard-of-care chemotherapy for the treatment of metastatic pancreatic adenocarcinoma (PDAC). The Company recently announced the completion of target enrollment into the multinational VIRAGE Phase 2b clinical study evaluating intravenous VCN-01 in combination with gemcitabine/nab-paclitaxel as a first line therapy for PDAC patients.

Type D meetings are focused on a narrow set of issues that are used to discuss issues at key decision points to provide timely feedback critical to moving a drug development program forward. The FDA advised that the on-going VIRAGE Phase 2b study should not be expanded into a Phase 3 study; rather, the optimal path forward for the VCN-01 PDAC program is to conduct a stand-alone Phase 3 study of VCN-01 with gemcitabine/nab-paclitaxel. The FDA provided general agreement with Theriva’s proposed design for a Phase 3 clinical study and indicated that inclusion of additional standard-of-care chemotherapy for PDAC was not necessary as it would complicate the study design and analysis. The FDA meeting also highlighted the FDA’s preferences regarding certain statistical elements of confirmatory clinical studies, including methods for sample size estimation and the study population(s) used for data analysis.

“The FDA’s advice on key elements of a potential confirmatory Phase 3 study evaluating VCN-01 plus gemcitabine/nab-paclitaxel as a first-line treatment for metastatic PDAC patients is critical as the VIRAGE study has entered final patient follow-up and we are actively planning the next steps in VCN-01 development,” said Steven A. Shallcross, Chief Executive Officer of Theriva Biologics. “The feedback from the FDA and European regulatory agencies will facilitate the design of a Phase 3 study protocol that is expected to maximize our ability to provide a new therapeutic option to patients suffering this terrible disease.”

An additional meeting with the FDA will be requested after the completion of the VIRAGE study to discuss the details of the proposed confirmatory Phase 3 study protocol.

About Pancreatic Ductal Adenocarcinoma

Cancer of the pancreas consists of two main histological types: cancer that arises from the ductal (exocrine) cells of the pancreas or, much less often, cancers may arise from the endocrine compartment of the pancreas. Pancreatic ductal adenocarcinoma (“PDAC”) accounts for more than 90% of all pancreatic tumors. It can be located either in the head of the pancreas or in the body/tail. Pancreatic cancer usually metastasizes to the liver and peritoneum. Other less common metastatic sites are the lungs, brain, kidney, and bone. In its early stages, pancreatic cancer does not typically result in any characteristic symptoms. In many instances, progressive abdominal pain is the first symptom. Therefore, in most cases, pancreatic cancer is diagnosed in its late stages (locally advanced non-metastatic or metastatic stage of the disease) when surgical resection and possibly curative treatment is not possible. It is generally assumed that only 10% of cases are resectable at presentation, whereas 30-40% of patients are diagnosed at local advanced/unresectable stage and 50-60% present with distant metastases.

About VCN-01

VCN-01 is a systemically administered oncolytic adenovirus designed to selectively and aggressively replicate within tumor cells and degrade the tumor stroma that serves as a significant physical and immunosuppressive barrier to cancer treatment. This unique mode-of-action enables VCN-01 to exert multiple antitumor effects by (i) selectively infecting and lysing tumor cells; (ii) enhancing the access and perfusion of co-administered chemotherapy products; and (iii) increasing tumor immunogenicity and exposing the tumor to the patient’s immune system and co-administered immunotherapy products. Systemic administration enables VCN-01 to exert its actions on both the primary tumor and metastases. VCN-01 has been administered to 142 patients to date in Company- and investigator-sponsored clinical trials of different cancers, including PDAC (in combination with chemotherapy), head and neck squamous cell carcinoma (with an immune checkpoint inhibitor), ovarian cancer (with CAR-T cell therapy), colorectal cancer, and retinoblastoma (by intravitreal injection). More information on these clinical trials is available at Clinicaltrials.gov.

About Theriva™ Biologics, Inc.

Theriva™ Biologics (NYSE American: TOVX), is a diversified clinical-stage company developing therapeutics designed to treat cancer and related diseases in areas of high unmet need. The Company is advancing a new oncolytic adenovirus platform designed for intravenous (IV), intravitreal and antitumoral delivery to trigger tumor cell death, improve access of co-administered cancer therapies to the tumor, and promote a robust and sustained anti-tumor response by the patient’s immune system. The Company’s lead candidates are: (1) VCN-01, an oncolytic adenovirus designed to replicate selectively and aggressively within tumor cells, and to degrade the tumor stroma barrier that serves as a significant physical and immunosuppressive barrier to cancer treatment; (2) SYN-004 (ribaxamase) which is designed to degrade certain commonly used IV beta-lactam antibiotics within the gastrointestinal (GI) tract to prevent microbiome damage, thereby limiting overgrowth of pathogenic organisms such as VRE (vancomycin resistant Enterococci) and reducing the incidence and severity of acute graft-versus-host-disease (aGVHD) in allogeneic hematopoietic cell transplant (HCT) recipients; and (3) SYN-020, a recombinant oral formulation of the enzyme intestinal alkaline phosphatase (IAP) produced under cGMP conditions and intended to treat both local GI and systemic diseases. For more information, please visit Theriva Biologics’ website at www.therivabio.com.

Forward-Looking Statement

This release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. In some cases forward-looking statements can be identified by terminology such as “may,” “should,” “potential,” “continue,” “expects,” “anticipates,” “intends,” “plans,” “believes,” “estimates,” and similar expressions, and include statements regarding the feedback from the FDA and European regulatory agencies facilitating the design of a Phase 3 study protocol; the protocol maximizing the Company’s ability to provide a new therapeutic option to patients suffering pancreatic cancer. Important factors that could cause actual results to differ materially from current expectations include, among others, the Company’s ability to effectively design the Phase 3 study protocol; the Company’s and VCN’s ability to reach clinical milestones when anticipated, including the ability to continue to enroll patients as planned, generating positive clinical data that establishes VCN-01 may lead to improved clinical outcomes for patients with PDAC and other solid cancers; the Company’s and VCN’s product candidates demonstrating safety and effectiveness, as well as results that are consistent with prior results; the ability to complete clinical trials on time and achieve the desired results and benefits; the ability to obtain regulatory approval for commercialization of product candidates or to comply with ongoing regulatory requirements, regulatory limitations relating to the Company’s and VCN’s ability to promote or commercialize their product candidates for the specific indications, acceptance of product candidates in the marketplace and the successful development, marketing or sale of the Company’s and VCN’s products, developments by competitors that render such products obsolete or non-competitive, the Company’s and VCN’s ability to maintain license agreements, the continued maintenance and growth of the Company’s and VCN’s patent estate, the ability to continue to remain well financed, and other factors described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 and its other filings with the SEC, including subsequent periodic reports on Forms 10-Q and current reports on Form 8-K. The information in this release is provided only as of the date of this release, and Theriva Biologics undertakes no obligation to update any forward-looking statements contained in this release on account of new information, future events, or otherwise, except as required by law.

For further information, please contact:
Investor Relations:
Chris Calabrese
LifeSci Advisors, LLC
ccalabrese@lifesciadvisors.com
917-680-5608
Source: Theriva Biologics, Inc.


FAQ

What did the FDA recommend for Theriva's (TOVX) VCN-01 Phase 3 study?

The FDA recommended conducting a standalone Phase 3 study of VCN-01 with gemcitabine/nab-paclitaxel, rather than expanding the current VIRAGE Phase 2b study.

What is the current status of Theriva's (TOVX) VIRAGE Phase 2b study?

Theriva has completed target enrollment in the VIRAGE Phase 2b study, which is evaluating VCN-01 in combination with gemcitabine/nab-paclitaxel for first-line therapy in PDAC patients.

What is the treatment combination being tested in Theriva's (TOVX) VCN-01 clinical trials?

VCN-01 is being tested in combination with standard-of-care chemotherapy (gemcitabine/nab-paclitaxel) for the treatment of metastatic pancreatic adenocarcinoma (PDAC).
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