MedicuRx Corporation is developing MR-01, a novel third-generation Camptothecin analogue under an exclusive license from Arno Therapeutics, for the treatment of Glioblastoma Multiforme (GBM). MR-01 has completed two phase 1 studies and a phase 2 study in GBM patients, demonstrating proof of concept. The phase 2 study achieved its primary endpoint of 6 month progression free survival in 6 of 32 patients. MedicuRx aims to advance MR-01 into phase 2b/3 studies based on these promising results for the treatment of GBM, an area of high unmet medical need.
2. Executive Summary
MedicuRx Corporation (MedicuRx) is a party to an
exclusive letter of intent (“LOI”) with Arno Therapeutics Inc.
(“Arno”) related to the license of MR-01, a novel third-
generation Camptothecin analogue, under development for
the treatment of Glioblastoma Multiforme (GBM)
MR-01 has completed two phase 1 studies and has
demonstrated proof of concept in a XX patient Phase II
study
Dr. Joseph Rubinfeld, Ph.D, founder of MedicuRx,
recognized the unique ability of MR01 to ….. And has
assembled a team complete any necessary … to reach
Phase 3 and ultimate approval of the drug by the FDA
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3. Overview of Camptothecins
Camptothecins are Topoisomerase-I inhibitors that cause
single strand DNA breaks
First generation: clinically unsuccessful
Demonstrated excellent preclinical efficacy, but poor in vivo stability and
significant toxicity
Second-generation analogues: clinically successful
Third-generation analogues: focused on improving lactone
stability and regulating plasma protein binding
The two approved Camptothecin analogues on the market
recorded $900 million in aggregate revenue in 2008
Hycamtin® (topotecan), Camptosar® (irinotecan)
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4. MR-01
MR-01 is a small molecule, rationally designed to improve
lactone stability by increasing lipophilicity
Increased lipophilicity may increase central nervous system
penetration
Potential for more predictable metabolism/toxicity
May cross blood brain barrier
Phase I study demonstrated that ~ 85% remains in active
“lactone” form
Phase I data, presented at ASCO 2009, demonstrated anti-
tumor activity, safety and desired PK profile
Phase II trial enrollment completed with patients with GBM
and Gliosarcoma (GSC)
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5. Silatecans Provide Enhanced Stability
Enhanced lipophilicity promotes drug partitioning into lipid
bilayers, which prevents hydrolysis in the aqueous milieu of
blood, favoring the lactone form
Interference with the binding of the drug carboxylate to
human serum albumin (10-OH functionality)
Best candidate, MR-01, received NIH’s Rapid Access to
Intervention Development (RAID) program support in three
funding cycles
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7. Glioblastoma Multiforme (GBM)
Most common & deadliest of malignant primary brain
tumors
Classified as a grade iv (most serious) astrocytoma
Develops primarily in the cerebral hemispheres
Develops from the lineage of star-shaped glial cells called
astrocytes that support nerve cells; may also develop in
other parts of the brain, brainstem, or spinal cord
Incidence - approximately 23,000 patients diagnosed per
year; survival rate - approximately 12-15 months from
diagnosis, only 3-5% survive 3+ years
Limited treatment options, with limited success
Aggressive surgery; radiation therapy; chemotherapy
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8. Phase II Study: Glioblastoma
Multiforme/Gliosarcoma
A Phase II Study of MR-01 in Adult Patients with Recurrence of
Glioblastoma Multiforme (GBM) or Gliosarcoma (GSM)
Study Design: Phase II single agent 7.5 mg/m2 i.v. (1 hour
infusion) once daily for 5 days on an every 21-day cycle
Cohort : Avastin® naïve and Avastin® Relapse (>90 days
after last dose)
Primary Endpoint: 6 month Progression Free Survival
(PFS)
Results: 6 patients have achieved the 6 month PFS
Premise on “Futility Analysis” : If ≥ 4/32 patients achieve the PFS
endpoint then MR-01 would be worthy of further evaluation
Statistically Significant Results at 6 patients/32
achieving Primary Endpoint AND 2 more patients
responded beyond Futility Analysis
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9. Phase II Study in GBM/GSM
Study design: Single agent MR-01 given 7.5 mg/m2,
IV QDx5/21 days to patients with recurrent
Avastin® naïve and Avastin® responders
If received Avastin relapsed >90 days (N=32)
Study Endpoint:
6 month PFS in 20% of patients on trial or total of
6 patients, which is considered statistically significant
Unmet medical need due to limited treatment options
PI: James Vrendenburgh, M.D., was at Duke University, now
at Saint Francis Hospital and Medical Center in Hartford, CT
(Seven sites in the US and Canada)
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10. Phase II Glioblastoma
Multiforme/Gliosarcoma Summary
Phase II Study Overview
32 patients enrolled @ 7 US sites
32 Avastin® naïve/relapse patients
First patient first dose 15DEC 09
Last patient first dose 21FEB12
Primary efficacy endpoint for the Avastin®
Naïve/relapse cohort is 6-month PFS
6 patients have reached the primary endpoint
The highest number of cycles of treatment received:
39 cycles or approximately 27 months on treatment
with high Quality of Life (QOL)
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12. Summary MR-01
A Novel Third-Generation Camptothecin Analogue
Topoisomerase-1 Inhibitor, which cause Single Strand DNA Breaks
Improved Bioavailability due to Increased Stability in Blood
No Evidence of Significant Toxicity (severe diarrhea), in Contrast to
other Camptothecins
In Late Phase II Clinical Trial with Evidence of Reaching Primary
Efficacy Endpoint of Progression Free Survival (PFS) of Greater
than 6 months
In Late Phase II Clinical Trial in GBM patients with evidence of
Disease and Tumor Regression
Other Potential Indications are in Small-Cell Lung Cancer,
Colorectal Cancer, Pancreatic Cancer, and MDS
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13. CMC Summary
API
GMP I “ Standard route “ using 10- hydroxy- camptothecin as
starting material
Process developed at US based CRO
Stability: Stable for at least 60 months @ 25C°/60%RH
Exploratory route (fully synthetic)
Avoids the use of cytotoxic starting material
Only final step will required cytotoxic suite
Likely potential for various patents ranging from
composition of matter, process, intermediates, etc.
Avoids high cost ‘camptothecin backbone’ starting
materials
Route developed at China based CRO
Will require process development/optimization
and scale-up
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14. CMC Summary
Drug Product
cGMP I – III:
Simple solution 10mg/vial ( 5mg/ml)
cGMP I, II manufactured by NCI
cGMP III manufactured by Arno Therapeutics
No major foreseeable scale-up challenges
Very stable DP: Current retest date: > 60 months at
25°C/60% RH
Lyophilized cyclodextrin formulation ( IP with U of Kentucky
until 2022 - under discussions with Arno on development)
Prototype demo batch ( 5L scale)
Stable for at least 24 months at 25°C/65% RH
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15. Patent Summary
Global
Composition of matter expired in June 2013 (Univ. of
Pittsburg-Licensor)
Positive Outcome: 1) 20% licensor’s fee-no longer
applicable, 2) 5% sales royalty fees-no longer
applicable
Cyclodextrin formulation patent valid until 2022
No practical relevance
Analog patents still valid
No practical relevance
Intermediate patent still valid
Relevance depends on synthesis route
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16. Patent Summary
Global Patent review and patent strategy:
10- hydroxy- camptothecin starting material derived from natural
product, a native Chinese desiduous tree, Camptotheca acuminata
Camptotheca acuminata has seasonal, variable and availability
challenges
New Synthetic route developed:
Higher Reference Standards (No Further Toxicology Studies
needed)
Far Less Contaminants
No Variability
No Seasonal and Availability of 10- hydroxy- camptothecin
starting material challenges
No Cytotoxic Starting Material needed
Developing Scale-up and Optimization process
Patent Strategy Filings: 1) Composition of Matter/Active
Pharmaceutical Product (API), 2) Intermediates, 3) Synthetic Route
4) Active Drug Product
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17. Temodar®- Temozolomide, Orally Active Alkylating Agent
(Schering-Plough now Merck)
oApproved in 2005 for Newly Diagnosed Adult Patients
oPatent expired August 2013 (Teva and Perrigo now have
approved Generics)
oAnnual sales-Estimated $882 Million Globally, Year
2012
Avastin®- Bevacizumab, Antiangiogenic VEGF Inhibitor
(Genentech/Roche)
o Approved in 2009 for Patients with Recurrent GBM
and Prior Treatment
o Annual sales-Estimated $170 Million Globally for this
Indication, Year 2012
GBM Approved Drugs
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18. MR-01 Potential Market Revenue
Two Approved Camptothecin Analogues:
Hycamtin®-Topotecan, Semi-Synthetic Derivative
(GlaxoSmithKline)
o Approved in 2007 for Small Cell Lung Cancer & Ovarian
o Annual Sales World Wide Approximately $500Million
Camptosar®-Irinotecan, Semi-Synthetic Derivative
(Pfizer)
o Approved in 1996 for Metastatic Colorectal Cancer
o Annual Sales World Wide Approximately $1Billion
o Generics available through ACCORD Healthcare, Actavis, etc.
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19. MR-01 Milestones & Timelines
Milestones:
Phase IIb/III ready Compound in GBM
Statistically Significant Results with 6 Patients out of 32 who Achieved Primary
End-Point: 6 Month Progression Free Survival
Significantly Improved QoL for Patients on MR-01 and Tumor Shrinkage
Selection of Manufacturing Process and Contract Manufacturing Facilities
Estimated Timelines to Completion based on Assumptions
(For Phase IIb through End of Phase III):
Acquisition of MR-01: Target date no later than November 2014
Phase IIb/III Meeting with FDA: February 2014
KOL Meeting: March 2015
Final Design and Approval of Protocol: May 2015
First Patient Screened and Enrolled: August 2015
Last Patient Responder on 6-Month PFS (Assumption based 12
Patients in PIIb and 150 Patients in PIII): May 2019
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20. Executive Management
Joseph Rubinfeld, Ph.D.: Co-Founder & CEO
Dr. Rubinfeld co-founded SuperGen, Inc. (NASDAQ:ASTX) in 1991, and served as Chief
Executive Officer, President and Director until 2005. During his tenure, Dr. Rubinfeld
guided and established SuperGen into an internationally recognized pharmaceutical
company with successful oncology products including Nipent® (which surpassed $20
million), Mitozytrex, Mitomycin, Daunorubicin, and the Surface Safe® disposable cleaning
system. He attained FDA approval for Dacogen® (Decitabine) in May 2006 for
myelodysplastic syndrome (MDS).
In 2005, Dr. Rubinfeld founded a new company, JJ Pharma, Inc., of which he was
Chairman and Chief Executive Officer – JJ Pharma’s primary interest is cardiovascular
research. Dr. Rubinfeld was one of the four initial founders (1980) of Amgen, Inc.
(AMGN:NASDAQ), and served as Vice President and Chief of Operations until 1983.
Dr. Rubinfeld received a Ph.D. in chemistry from Columbia University and holds nearly
100 patents. He is credited with inventing amoxicillin, biodegradable detergents and
shortening the Polaroid film development process to 10 seconds. He was also a founding
father of the Industrial Biotechnology Association (IBA), which was the parent of BIO.
From 1987 to 1990, he was a Senior Director at Cletus Corporation. From 1968 to 1980, Dr.
Rubinfeld was employed by Bristol-Myers Company International Division in a variety of
positions, including Vice President and Director of Research and Development. At Bristol-
Myers, Dr. Rubinfeld was instrumental in developing and licensing its initial oncologic
product lines, Mitomycin, Etoposide, Cisplatin, and Bleomycin. He was also responsible
for the development of two major antibiotics, amoxicillin and Cephadroxil.
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21. Executive Management
Mark J. Gustavson – Co-Founder, Chairman & CFO
Mark J. Gustavson, based in our San Francisco office, is a seasoned and accomplished banker with a depth of
experience in institutional backed plays and international business. Mark has held many simultaneous roles
including Angel Investor, early stage fund raiser, reorganization specialist and company founder, acquiring
experience on “‘both sides of the street.”
Mr. Gustavson 's general management and operations background in banking complements his focus on strategic
investment banking work at Colmen Group, tailoring solutions to each client’s unique needs. Sell Side Private
Equity Representation yielded significant results, from seed round funding, Series A and bridge financing to
successful exits through the IPO stage and beyond. Sector specialties include BioPharma, fiber optics, IP-based
banking, mobile device systems, IP-based payment technologies, and social media.
Prior to Colmen, Mark was a Private Banker at Hong Kong and Shanghai Banking Corporation (HSBC) in Saipan,
Commonwealth of the Northern Mariana Islands. While at HSBC, Mr. Gustavson performed Portfolio and Global
Investment Management, employing his extensive knowledge of early stage technology companies to domestic
investors. Mr. Gustavson has also testified as an expert witness on banking laws and federal statutory and
regulatory guidelines regarding current and ongoing litigation within the CNMI, and consulted with U.S. Senate
legal counsel on pending CNMI banking legislation.
Mr. Gustavson holds a BS degree in Political Science from the University of Oregon.
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