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Elevian Targets Aging to Solve Humanity’s Toughest Diseases – BioSpace

Mark Allen, CEO of Elevian, pictured above. Photo courtesy of Elevian.

Once the domain of mythical fountains of youth and movies like The Curious Case of Benjamin Button, the science of aging prevention and reversal is beginning to enter the mainstream with reputable academic institutions launching companies to accomplish this once improbable feat.

One such company, Elevian, founded by a team of Harvard scientists and physician-turned entrepreneurDr. Mark Allen, is working to restore regenerative capacity with the aim of preventing and treating age-related diseases. A critical factor, they say, is a single protein called Growth differentiation factor 11 (GDF11).

Allen, Elevians chief executive officer, first became interested in the science of aging after taking a course focused on exponential thinking.

All of a sudden, problems that were heretofore unsolvable become solvable, Allen said of the theory that is the opposite of incremental and encourages one to think outside of the box. They talked about examples of problems that weve always thought to be unsolvable, one of them being aging and longevity. So that was it for me. I was like thats perfect for me. Thats what I want to work on.

Searching for clues into the diseases associated with aging, Elevians founders, including Harvard professor of Stem Cell and Regenerative BiologyDr. Amy Wagers, mined the proteome, looking into how proteins change with age. They uncovered several, including one with potentially groundbreaking regenerative capabilities, GDF11.

Elevian believes that this single protein, a key player in the circulatory system, could be a game-changer in regenerative medicine.

GDF11 is one of those proteins that change with age, Allen said. They [the founders] really dug into GDF11 because so little was known about it at the time of their discoveries. They did side-by-side studies with the parabiosis model, injecting just GDF11, to see if it could reproduce some of the effects of parabiosis in the aged animal. And they found, much to everybodys surprise, that replenishing just this one circulating factor was able to reproduce the beneficial effects of parabiosis.

Parabiosis, which means living beside, is performed by joining two living organisms surgically to develop a single, shared physiology. It has been used to study conjoined twins, and more recently, in a 1972 lifespan study attaching old and young rats, scientists Frederic C. Ludwig and Robert M. Elashoff showed evidence of an extended lifespan for the older animals.

As a post-doc at Harvard, Dr. Wagers expanded upon this research using modern histology techniques. When Wagers and her colleagues attached the circulatory systems of young mice to old ones, they found strong evidence of a biological reversal of cardiac hypertrophy, which occurs with aging. They attributed this to GDF11 in a paper published in Science in 2014 and recognized as a runner-up to the publications Breakthrough of the Year.

What they found is that the old animals exposed to young blood experienced a biological reversal of aging by many different measures. Their brains grow younger, their hearts grow younger, their lungs, their bones all over their body. And interestingly, the young animals exposed to old blood have accelerated aging. So this is just really strong proof that circulating factors regulate aging, said Allen.

The mechanism of action appears to be that GDF11 binds directly to the endothelial projectors, the cells that line our blood vessels and improve both the quality and quantity of the vasculature. It does not cross the blood-brain barrier, so we think its mechanism is primarily by improving vasculature, he explained.

Elevian, the recent beneficiary of an initial round of seed financing, is actioning this potent protein to develop a potential regenerative treatment for stroke patients.

English biomedical gerontologist Aubrey de Grey, whom Allen credits with doing a lot to start the medical field of aging reversal, outlined several hallmarks of aging in his 2007 book, Ending Aging. These include stem cell exhaustion, protein aggregate buildup, failed intercellular communicationand senescent cells.

One of the barriers to developing therapeutics based on these factors is the inherent incongruence with the usual regulatory approval systems. Following customary protocol, proving that a drug prevents aging or age-related diseases would quite literally take a lifetime.

Theres no regulatory path for treating aging. Even doing a prevention trial would take years and years and years, because you have to take people and wait until they get disease to see effects. So instead, to get a drug to market, we take the opposite extreme. We look at what is the most devastating possible disease, unmet need, where we could treat for the shortest possible duration and see clinically meaningful effects, Allen explained.

Elevian decided on stroke, which is the number two cause of death worldwide and the third leading cause of disability.

The only existing treatments for a stroke are limited to the acute phase, where an IV injection of a drug such as recombinant tissue plasminogen activator (tPA) (Activase)restores blood flow by dissolving the clot causing the event.

In an ischemic stroke, which makes up 87% of cases, a blood clot forms and prevents blood and oxygen from reaching an area of the brain, impacting breathing and heart function and often leading to paralysis. This is where Elevian believes a drug utilizing GDF11, which acts on the circulatory system, holds such promise for rehabilitation.

Allen revealed that his team has already demonstrated GDF11s impact on stroke-stricken animals.

When we give GDF11 to animals that have had strokes and are paralyzed or have severe motor function debilitation, it returns them almost to normal function. It significantly improves motor function recovery, he said.

On the strength of these preclinical results, Elevian is gearing up to enter human clinical trials with GDF11 for the treatment of stroke.

We really got the green light to go into humans based upon the animal data that we got there, Allen said, adding that there is still a lot of work to be done before they reach this phase. We still have to scale up production of the drug and we have to do extensive safety and toxicology tests IND-enabling studies. The longest pole in the tent is figuring out how to make manufacturing costs effective. The cost of goods is going to be really, really high. So were doing a lot of work in process development right now, and then were going to hand it off to a manufacturing partner to scale up. Were about two years from initiating our human clinical trial in stroke.

Another unmet need where Elevian believes GDF11 can have an impact is Type 2 diabetes, a disorder whose pathology is also intricately connected to the circulatory system and often to aging.

Along with blood clotting factors, glucose resides within the inside lining of blood vessels. In Type 2 diabetics, the lining of an individuals blood vessels begins to become glycosylated, which causes them to narrow, impeding blood flow. Glucose tolerance is known to decrease with age.

In a study published in March 2020, Wagers and her colleagues stated that GDF11 was shown to significantly improve glucose tolerance in aged mice and increase glucose homeostasis, under a variety of dietary conditions.

Allen believes that addressing the aging process is the ultimate exponential strategy to solving a whole host of humanitys biggest killers:

This idea that we could, by targeting the aging progress, potentially promote healthy aging, promote a healthy longevity, and reduce the burden of age-related diseases, and that the same treatment could be used to treat and prevent multiple age-related diseases. That concept was like, why arent we working on that? Why are we spending billions of dollars on Alzheimers and billions of dollars on cancer, billions of dollars on heart disease? We could instead target the aging process and potentially treat them all.

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Elevian Targets Aging to Solve Humanity's Toughest Diseases - BioSpace

Propanc Biopharma Appoints Belen Toledo to Evaluate Impact of Proenzyme Therapy on Tumor Microenvironment – Business Wire

MELBOURNE, Australia--(BUSINESS WIRE)--Propanc Biopharma, Inc. (OTCQB: PPCB) (Propanc or the Company), a biopharmaceutical company developing novel cancer treatments for patients suffering from recurring and metastatic cancer, announced today that the Company appointed Ms. Belen Toledo MSc., a biotechnologist specializing in cell regenerative medicine, to evaluate the impact of proenzyme therapy on the tumor microenvironment. Ms. Toledos work will be part of the Proenzymes Optimization Project 1 (POP1) Joint Research and Drug Discovery Program designed to produce synthetic recombinant, commercial scale quantities of the two proenzymes trypsinogen and chymotrypsinogen.

Ms. Toledo, will elucidate molecular pathways involved in the proenzymes anti-tumor efficacy and study how they interact with the pre-metastatic tumor niche, focusing on the interaction and suppression of tumor associated cells, like cancer-associated fibroblasts and macrophages. A pre-metastatic tumor niche is an environment in a secondary organ conducive to the metastasis (spreading) of a primary tumor. Such a niche provides favorable conditions for growth, and eventually metastasis, in an otherwise foreign and hostile environment for the primary tumor cells. Metastasis remains the main cause of patient death from solid tumors for cancer sufferers. To achieve this, Ms. Toledo will use integrated tumor models in a microfluidics chip by obtaining 3-dimensional bio-impressions of tumor cells from patients with advanced solid tumors, developed at the Centre for Biomedical Research, University of Granada, Granada, Spain, led by Prof. Juan Marchal M.D.

Belen Toledo is a very capable biotechnologist who is excited about the project and its potential as a novel approach for the prevention and treatment of metastatic cancer. We look forward to exploring the potential of proenzyme therapy, which is groundbreaking research, said Prof. Macarena Pern, Ph.D., Lecturer and Joint Research Supervisor from Jan University.

The application of 3D tumor models on-a-chip will allow us to faithfully recreate tumor heterogeneity and stroma-tumor interactions. We aim to evaluate the effect of proenzyme therapy on effective personalized therapy models, generated from a small biopsy of patients, said Prof. Juan Antonio Marchal M.D., Joint Research Supervisor from Granada University.

Evaluating the effects of proenzyme therapy in the tumor microenvironment is critically important, as it tells us the drug is able to penetrate into this target area and exert its effects. At the same time, it confirms the selectivity of the drug on solid tumors, by targeting cancer cells and leaving healthy cells alone. The scientific implications provide us with confidence that our drug is effective and less toxic compared to standard treatment approaches, said Dr. Julian Kenyon M.D., Propancs Chief Scientific Officer and Joint Research Supervisor.

The POP1 program is designed to produce a backup clinical compound to the Companys lead product candidate, PRP. The objective is to produce large quantities of trypsinogen and chymotrypsinogen for commercial use that exhibits minimal variation between lots and without sourcing the proenzymes from animals. Propanc is undertaking the challenging research project in collaboration with the Universities of Jan and Granada, led by research scientists Mr. Aitor Gonzlez MSc. and Ms. Toledo, supported by Profs. Pern and Marchal, representing the Universities and Dr. Kenyon.

About Propanc Biopharma, Inc.

Propanc Biopharma, Inc. (the Company) is developing a novel approach to prevent recurrence and metastasis of solid tumors by using pancreatic proenzymes that target and eradicate cancer stem cells in patients suffering from pancreatic, ovarian and colorectal cancers. For more information, please visit http://www.propanc.com.

The Companys novel proenzyme therapy is based on the science that enzymes stimulate biological reactions in the body, especially enzymes secreted by the pancreas. These pancreatic enzymes could represent the bodys primary defense against cancer.

To view the Companys Mechanism of Action video on its anti-cancer lead product candidate, PRP, please click on the following link: http://www.propanc.com/news-media/video

Forward-Looking Statements

All statements other than statements of historical facts contained in this press release are forward-looking statements, which may often, but not always, be identified by the use of such words as may, might, will, will likely result, would, should, estimate, plan, project, forecast, intend, expect, anticipate, believe, seek, continue, target or the negative of such terms or other similar expressions. These statements involve known and unknown risks, uncertainties and other factors, which may cause actual results, performance or achievements to differ materially from those expressed or implied by such statements. These factors include uncertainties as to the Companys ability to continue as a going concern absent new debt or equity financings; the Companys current reliance on substantial debt financing that it is unable to repay in cash; the Companys ability to successfully remediate material weaknesses in its internal controls; the Companys ability to reach research and development milestones as planned and within proposed budgets; the Companys ability to control costs; the Companys ability to obtain adequate new financing on reasonable terms; the Companys ability to successfully initiate and complete clinical trials and its ability to successful develop PRP, its lead product candidate; the Companys ability to obtain and maintain patent protection; the Companys ability to recruit employees and directors with accounting and finance expertise; the Companys dependence on third parties for services; the Companys dependence on key executives; the impact of government regulations, including FDA regulations; the impact of any future litigation; the availability of capital; changes in economic conditions, competition; and other risks, including, but not limited to, those described in the Companys Registration Statement on Form S-1, Amendment No. 5, filed with the U.S. Securities and Exchange Commission (the SEC) on November 3, 2020, and in the Companys other filings and submissions with the SEC. These forward-looking statements speak only as of the date hereof and the Company disclaims any obligations to update these statements except as may be required by law.

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Propanc Biopharma Appoints Belen Toledo to Evaluate Impact of Proenzyme Therapy on Tumor Microenvironment - Business Wire

ProgenCell – Stem Cell Therapies offers an updated Stem Cell Therapy for Anti Aging Protocol – PR Web

SAN DIEGO (PRWEB) January 29, 2021

ProgenCell Stem Cell Therapies announced an updated stem cell therapy for anti aging or healthy aging protocol. A Comprehensive protocol developed by the more than 12 years of experience in the field of Regenerative Medicine and the most rigorous scientific protocols, and overseen by an Independent Review Board (IRB) composed by prominent figures in medicine and scientific research.

The Anti Aging Stem Cell Treatment Protocol is performed administering stem cells intravenously with a previous and strict regimen of multivitamins, minerals and hormones and a subsequent nutritional and vitamin support.

This updated protocol has been developed thanks to the information we have been able to compile, analyze and research, allowing us to determine the dosage of the vitamins. Hormones and nutrients administered according to each patients context, added Dr. Jorge Luis Gavio ProgenCells Medical Director. ProgenCells stem cell research center has an in-house laboratory and adjacent medical facility, which not only sets us apart as an institution, it also gives us the scientific platform to upgrade our protocols, he continued.

To date, ProgenCell Stem Cell Therapies has been offering stem cell therapy in Mexico successfully with a wide range of protocolos designed specifically for many conditions including Parkinsons Disease, Multiple Sclerosis, Retinitis Pigmentosa, and arthritis just to name a few.

Stem cell therapy for anti aging at ProgenCell Stem Cell Therapies is offered by board certified and fully licensed doctors, and every case is overseed by an Independent Review Board, with a scientific and Ethics Committee.

The treatments at ProgenCell Stem Cells comply with quality assurance standards that exceed those recommended by the FDA (Federal Drug Administration), and all protocols are registered and audited by COFEPRIS (the mexican government agency with jurisdiction).

The process of becoming a ProgenCell Patient for Anti Aging Stem Cell Therapy Protocol starts with a free virtual consultation with a Regenerative Medicine Scientific Liaison who will guide you through the process and establish a health route map. After the treatment is booked, a patient concierge works with each international patient on travel logistics, to live the full ProgenCel Experience.

For more information on stem cell therapy for anti aging and to obtain a free consultation, call (888) 443-6235 or visit http://www.progencell.com to learn more.

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Doctors urge immunocompromised to get COVID vaccine when it becomes available – KMTV – 3 News Now

OMAHA, Neb. (KMTV) According to the Centers for Disease Control and Prevention, 61 million Americans live with some form of disability including those that are immunocompromised.

Many of these people are at increased risk for severe illness from COVID-19, but vaccine research within these groups are limited.

This is why Omaha resident, Jordan Palmer double checked with her team of doctors to make sure the vaccine was right for her.

Palmer was diagnosed with Multiple Sclerosis in 2017. She tried a variety of different procedures, and eventually underwent a stem cell transplant in December of 2019. The procedure significantly helped control her symptoms, but she is still immunocompromised.

The tricky thing about Multiple Sclerosis is that people don't understand that you might be disabled one day, but then the next day you could get up and walk, talk and look normal, Palmer said. It's a very invisible condition."

Just as Palmer was healing from her stem cell transplant, the world broke out in a different invisible disease: COVID-19. The deadly virus has forced everyone, especially those who are immune-compromised, to think twice about their health. Its even raised questions about the vaccine and whether it would impact them differently.

University of Nebraska Medical Center infectious disease doctor, James Lawler said there is limited data on how the COVID-19 vaccine impacts those who have underlying health conditions. Yet, he has not found many circumstances where he would recommend against the shot.

For most of these folks that have underlying health conditions, they are more prone to more serious disease with COVID-19, Lawler said.

Lawler said he has seen no evidence that the vaccine is dangerous for immunocompromised individuals.

As for Palmer, she also had conversations with doctors and is planning on getting the vaccine as soon as possible. She said she is relying on it to feel safe cutting hair and seeing her friends, some of whom she hasnt seen since before the pandemic when she received her stem cell transplant.

I just need science to prevail in this situation because it's saved my life once and I know it will again, Palmer said. We just need to vaccinate, pleaseso that it's over.

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Doctors urge immunocompromised to get COVID vaccine when it becomes available - KMTV - 3 News Now

Autologous Stem Cell and Non Stem Based therapies Market Share, Size 2021 Global Industry Future Trends, Growth, Strategies,, Segmentation, In-depth…

Autologous Stem Cell and Non Stem Based therapies Market delivers a succinct analysis of industry size, regional growth and revenue forecasts for the upcoming years. The report further sheds light on significant challenges and the latest growth strategies adopted by manufacturers who are a part of the competitive spectrum of this business domain.

Autologous Stem Cell and Non Stem Based therapies Market: Global Size, Trends, Competitive, Historical & Forecast Analysis, 2021-2027. Rise in the prevalence of Cancer and Diabetes in all age groups population. Furthermore, the growing geriatric population is another key factor which drives the Autologous Stem Cell and Non Stem Based therapies Market.

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Scope Of Market Reports

Autologous Stem Cell transplantation is a process in which cells from which all blood cells develop are removed, preserved and later given to the same person after severe treatment. In autologous stem cell transplantation, the patient itself acts as stem cell donor. These cells are collected in advance while they are in remission and returned to the patient at a later stage i.e., after two months. They are used to replace stem cells which have been impaired by high doses of chemotherapy.It is important to realize that the processes required in a stem cell transplant are lengthy and complicated. A transplant involves a lot of preparation and a lot of care after procedure. Many people have a single autologous stem cell transplant while others mainly having myeloma or tumors; have two or more continuous transplants.

The initial step in an autologous stem cell transplant is gathering the stem cells. Physicians usually collect stem cells from the bloodstream (peripheral blood stem cells) in advance. A mobilization treatment is used. When the stem cells are in the bloodstream, then collection process starts.The blood is separated using an Apheresis machine. This procedure requires a few hours, and is repeated until the appropriate amount of stem cells is collected. Once the stem cells are harvested, they are frozen in our Stem Cell Processing and Cryopreservation Laboratory until its time to transplant.

Autologous Stem Cell and Non Stem Based therapies Market is segmented on the basis of Application, product, End user and Geography. Based upon ApplicationAutologous Stem Cell and Non Stem Based therapies Market is classified as Neurodegenerative Disorders,Autoimmune Diseases, cancer &Tumors, Cardiovascular Diseases and Others. Based on the ProductAutologous Stem Cell and Non Stem Based therapies Market is classified into Blood Pressure Monitoring Devices, Pulmonary Pressure Monitoring Devices and Intracranial Pressure Monitoring Devices. On the basis of End users Autologous Stem Cell and Non Stem Based therapies Market is classified into Hospitals, Ambulatory Surgical Centers and Others.

The regions covered in Autologous Stem Cell and Non Stem Based therapies Market report are North America, Europe, Asia-Pacific and Rest of the World. On the basis of country level, Global Melanoma Drug Market sub divided in to U.S., Mexico, Canada, U.K., France, Germany, Italy, China, Japan, India, South East Asia, GCC, Africa, etc.

Rising prevalence of cancer and diabetes among people across all age groups, growing geriatric population, increasing demand for autologous stem cell and non-stem cell based therapies is another factor, which is likely to create a heightened demand. Moreover, Favorable reimbursement policies across several nations are also boosting market. Risks and complications associated with the Autologous Stem Cell and Non Stem Based therapy such as diarrhea, hair loss, nausea, severe infections, vomiting, heart complications, and infertility and thehigh cost of autologous cellular therapies ranging from $500,000 to $1,000,000 restraint the market. Innovation of some newtherapies with improved efficacy, fewer side effects are expected to offer good opportunity for growth of Autologous Stem Cell and Non Stem Based therapies Market in the future.

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North America is probable to attain the largest share of the Autologous Stem Cell and Non Stem Based therapies Market in terms of revenue and expected to hold the position followed by Europe region. This is due to less risk related with the treatment. Also, the demand for these treatments is high due to their ability to cure a significant number of infectious diseases. Autologous stem cell and non-stem cell based therapies do not require an outside donor hence the treatment is less infectious and cheap. However, Asia Pacific is expected to show the high growth in the forecast period. The demand in this region will be led by countries such as China, India, Malaysia, and Vietnam. The demand is likely to grow as autologous stem cell and non-stem cell based therapies aid in the efficient management of cardiovascular diseases as well. Rising healthcare facilities as well as increasing tax and reimbursement procedures is also estimated to help in the growth of the autologous stem cell and non-stem cell based therapies market in the Asia Pacific.

Furthermore, increase in awareness of disease and government initiatives for improving health care facilities are expected to boost the regional market to a certain extent.

By Application Analysis Neurodegenerative Disorders, Autoimmune Diseases, Cancer & Tumors, Cardiovascular Diseases, Others

By Product Analysis Blood Pressure Monitoring Devices, Pulmonary Pressure Monitoring Devices, Intracranial Pressure Monitoring Devices, Others

By End User Analysis Hospitals, Ambulatory Surgical centers, Others

North America, US, Mexico, Chily, Canada, Europe, UK, France, Germany, Italy, Asia Pacific, China, South Korea, Japan, India, Southeast Asia, Latin America, Brazil, The Middle East and Africa, GCC, Africa, Rest of Middle East and Africa

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Researchers use patients’ cells to test gene therapy for rare eye disease – National Institutes of Health

News Release

Thursday, January 28, 2021

Approach could provide new path for difficult-to-treat forms of Leber congenital amaurosis.

Scientists at the National Eye Institute (NEI) have developed a promising gene therapy strategy for a rare disease that causes severe vision loss in childhood. A form of Leber congenital amaurosis, the disease is caused by autosomal-dominant mutations in the CRX gene, which are challenging to treat with gene therapy. The scientists tested their approach using lab-made retinal tissues built from patient cells, called retinal organoids. This approach, which involved adding copies of the normal gene under its native control mechanism, partially restored CRX function. The study report appears today in Stem Cell Reports. NEI is part of the National Institutes of Health.

Our treatment approach, which adds more copies of the normal gene, could potentially treat autosomal-dominant LCA caused by a variety of mutations, said Anand Swaroop, Ph.D., chief of the NEI Neurobiology, Neurodegeneration and Repair Laboratory and senior author of the report.

The U.S. Food and Drug Administration approved Luxturna in 2017 for the treatment of LCA patients with mutations in a gene called RPE65. Although hailed as a major advance in gene therapy, Luxturna is ineffective against other forms of LCA, including those caused by autosomal-dominant mutations in CRX.

The CRX gene encodes a protein (also called CRX) that binds to DNA and instructs the retinas photoreceptors to make light-sensitive pigments called opsins. Without functional CRX protein, photoreceptors lose their ability to detect light and eventually die.

Disorders like autosomal-dominant LCA are tricky to treat with gene therapy, because adding more of the normal gene does not always restore function. People with autosomal-dominant mutations still have one normal copy of the gene, but the mutant version of the protein interferes with the normal protein. Sometimes, instead of restoring normal function, simply adding more of the normal protein can enhance the disease in unpredictable ways.

To explore how gene augmentation adding copies of the normal gene would affect autosomal-dominant LCA, Swaroops team, developed retinal organoids from two volunteers with LCA and from their unaffected family members. Led by Kamil Kruczek, Ph.D., a postdoctoral fellow in Swaroops lab, they built the complex retina-like tissues in several stages, starting with skin cells, inducing the production of mature photoreceptors and other retinal cells with the genetic profile of each volunteer. As expected, patient organoids made far less light-sensing opsin than the organoids made from unaffected family members.

To carefully control how much CRX gene would be expressed by the recipient photoreceptors, the team re-engineered the CRX promoter so it could be delivered with the CRX gene as part of the gene therapy. A promoter is a neighboring sequence of DNA that controls when and how genes are expressed. The researchers packed the gene and their engineered promoter inside a virus that shuttled them into the organoid photoreceptors.

The teams gene augmentation strategy restored some CRX protein function for organoids from both patients, driving expression of opsins in both types of photoreceptors: rods and cones.

The fact that this strategy worked for both CRX mutations was pretty exciting, said Swaroop. Gene augmentation may be a viable therapy for LCA caused by other autosomal-dominant mutations.

This proof-of-concept gene therapy study is the first step toward a potential treatment for a rare form of LCA, said Brian Brooks, M.D., NEI clinical director and co-author on the study. Its a great example of bench-to-bedside science, when researchers in basic and clinical science collaborate.

The current study was funded through the intramural programs of the NEI and the National Institute of Allergy and Infectious Diseases, both part of NIH. Patient samples were collected at the NIH Clinical Center, clinical trial number NCT01432847.

NEI has protected intellectual property around this technology which is available for licensing and or co-development. Details can be found on the NIH OTT Licensing website: Gene Therapy for Treatment of CRX-Autosomal Dominant Retinopathies | Office of Technology Transfer, NIH or by contacting NEI Office of Translational Research mala.dutta@nih.gov

Additional authors include: Zepeng Qu, James Gentry, Benjamin Fadl, Linn Gieser, Suja Hiriyanna, Zacahry Batz, Mugdha Samant, Ananya Samanta, Colin Chu, Laura Campello, and Zhijian Wu.

NEI leads the federal governments research on the visual system and eye diseases. NEI supports basic and clinical science programs to develop sight-saving treatments and address special needs of people with vision loss. For more information, visit https://www.nei.nih.gov.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

Kruczek K. Qu Z, Gentry J, Fadl BR, Gieser L, Hiriyanna S, Batz Z, Samant M, Samanta A, Chu CJ, Campello L, Brooks BP, Wu Z, and Swaroop A. Gene therapy of dominantCRX-Leber congenital amaurosis using patient stem cell-derived retinal organoids.Stem Cell Reports, January 28, 2020.https://doi.org/10.1016/j.stemcr.2020.12.018

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Researchers use patients' cells to test gene therapy for rare eye disease - National Institutes of Health

Studies Indicating T-Cells May Be Needed For Long-Term Protection From The SARS-Cov-2 Virus – PRNewswire

PALM BEACH, Fla., Jan. 28, 2021 /PRNewswire/ -- According to the National Institutes of Health (NIH), the tide in the global fight against COVID-19, the disease caused by the SARS-CoV-2 virus, may soon begin to turn. Last month, three pharmaceutical companies announced promising results from vaccine trials. Countries around the world are now poised to begin the largest mass vaccination campaigns since the 1950s. Researchers led by Dr. Dan Barouch of Beth Israel Deaconess Medical Center used monkeys to look at levels of antibodies and immune cells required to prevent reinfection with the virus. NIH said some questions remainabout what types and amounts of immune system components are needed to produce long-term immunity against SARS-CoV-2. This information would be valuable both for tracking the effectiveness of vaccines and designing new ones in the future. It said that This finding suggests that T cells are needed for long-term protection from the virus. "Antibodies alone can protect, including at relatively low levels, but T cells are also helpful if antibody levels are insufficient," Barouch says. "Such knowledge will be important in the development of next generation vaccines, antibody-based therapeutics, and public health strategies for COVID-19."Active biotech companies in the Covid-19 developments this week include Sorrento Therapeutics, Inc. (NASDAQ: SRNE), BioVaxys Technology Corp. (OTCPK: LMNGF) (CSE: BIOV), INOVIO (NASDAQ: INO), CytoDyn Inc. (OTCQB: CYDY), Novavax, Inc. (NASDAQ: NVAX).

BMJ. Com reportedon a similar test but humans were the patients here, to find out how long the T Cells last after an infection. The results were that Robust cellular immunity persists for at least for six months after even mild or asymptomatic SARS-CoV-2 infection, research has shown. The study of 100 people showed that all had a cellular immune response against SARS-CoV-2 six months after infection although the size of response was 50% higher in those who had experienced symptomatic disease. There has been concern that the cellular immune response following covid-19 infection may not be sustained. "This data is reassuring," lead study author Paul Moss, from the University of Birmingham, told a Science Media Centre briefing on 2 November. "However, it does not mean that people cannot be re-infected. We need to have much larger population studies to show that." Moss also added that the findings "can't be taken as confirmation that an 'immunity passport' would be feasible."

BioVaxys Technology Corp. (OTCPK: LMNGF) (CSE: BIOV.CNQ) BREAKING NEWS: COVID-T CLINICAL DEVELOPMENT PROGRAM INITIATED REGULATORY ADVISORY GROUP ENGAGED - BioVaxys Technology Corp. ("BioVaxys") is pleased to announce that it has initiated the clinical development program for Covid-T, the Company's novel diagnostic platform for detecting T-cell activity. The US Food and Drug Administration ("FDA") has tentatively agreed to permit that BioVaxys can file for a pre-Emergency Use Authorization ("EUA") for Covid-T. Under an EUA, FDA may allow the use of unapproved medical products, or unapproved uses of approved medical products in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions when certain statutory criteria have been met, including that there are no adequate, approved, and available alternatives.

Covid-T addresses an unmet need for a low-cost, easy-to-administer, and accurate tool to test for the presence of T-cells which may offer lasting protection against SARS-CoV-2.

It is believed that detection of T-cells can potentially identify safe and/or at-risk populations. Covid-T also provides an ability to evaluate the effectiveness of any SARS-CoV-2 vaccine candidate in stimulating T-cell immunity. Mass availability of Covid-T would complement antibody testing and various public health risk mitigation strategies.

James Passin, CEO of BioVaxys, stated, "We believe that our low cost, scalable, easy-to-administer test for T cell immunity to SARS-CoV-2 may help solve the urgent global public health crisis of prioritizing the distribution of Covid-19 vaccines; we look forward to rapidly advancing Covid-T towards commercialization."Current methods of measuring T-cell immunity require drawing blood from the test subject, followed by a time-consuming and expensive analysis of the blood sample at laboratories possessing specialized equipment.

Covid-T is based on the well-established concept of Delayed Type Hypersensitivity ("DTH"), the oldest and most reliable test of human T lymphocyte function. The process involves an intradermal "skin prick" of an immunogenic composition of the SARS-CoV-2 S-protein, where an inflammatory response develops 24-72 hours after skin exposure to the s-spike antigen.

BioVaxys anticipates that once clinical testing is complete, Covid-T would have the potential for detecting differences in T-cell responses between the original SARS-CoVC-2 virus and the two new strains of SARS-Cov-2 the had originally been identified in the UK and South Africa---B.1.1.7 and 501Y.V2, respectively--- but which are spreading worldwide.

"Although our vaccine programs are of major importance to us, Covid-T is a priority for BioVaxys, especially given the unmet need for such a simple, disposable, and accurate tool to test for the presence of T-cells against SARS-CoV-2," says BioVaxys President and Chief Operating Officer Ken Kovan.BioVaxys has prepared the clinical development plan for Covid-T, and engaged global regulatory advisory group Rio Pharmaceutical Services ("RPS") of Bridgewater, NJ, to provide strategic regulatory guidance, prepare an FDA pre-submission guidance package, recommend regulatory pathway, and support BioVaxys on the registration filing.

RPS has provided pharmaceutical and medical-device advisory services across the entire drug, biologic and device development and approval spectrum of the pharmaceutical industry since 2000.Collectively, the RPS team of pharmaceutical industry executives offers nearly 150 years of experience in providing advice and support services for medical, scientific, clinical-trial and regulatory issues to clients including a majority of Fortune 500 pharmaceutical companies. Read this full release and more news for BioVaxys Technology at: https://www.financialnewsmedia.com/news-biov/

Other recent developments in the biotech industry include:

Sorrento Therapeutics, Inc. (NASDAQ: SRNE) recently announced positive preliminary results from its Phase 1b study of human allogeneic adipose-derived mesenchymal stem cells (COVI-MSC) for patients suffering from COVID-19-induced acute respiratory distress (ARD) or acute respiratory distress syndrome (ARDS). This ongoing study (PSC-CP-004) is a single arm, non-randomized Phase 1b study of the safety and preliminary efficacy of COVI-MSCs administered every other day for three infusions for a total of 1 x 106cells/kg. The primary objective is to evaluate the safety of intravenous infusion of allogeneic adipose MSC cells in patients with COVID-19-induced ARD or ARDS. The secondary objective is to evaluate efficacy outcome variables to give guidance regarding the risk/benefit ratio in patients with COVID-19 respiratory distress.

The first three patients enrolled tolerated treatment well and improved rapidly. Each of the three patients was discharged from the hospital within a week of starting the patient's COVI-MSC infusions and two patients were discharged on the day of their last infusion. One of the patients had been in the hospital for three weeks, unable to be weaned from significant oxygen support, and another patient with uncontrolled diabetes had been discharged previously but had to be readmitted due to recurrent ARD. Each of the infusions were well-tolerated and no patient reported any infusion-related adverse events. A fourth patient is currently at the beginning of a course of treatment, with no safety issues following the patient's first infusion. Additional enrollment continues.

INOVIO (NASDAQ: INO), a biotechnology company focused on bringing to market precisely designed DNA medicines to treat and protect people from infectious diseases and cancer, and Advaccine Biopharmaceuticals Suzhou Co., Ltd. ("Advaccine"), an emerging biotech company with next-generation technology in vaccines, both preventive and therapeutic, recently announced that they have entered into a collaboration and license agreement for COVID-19 DNA vaccine candidate INO-4800.

Under the collaboration and license agreement, Advaccine will have the exclusive right to develop, manufacture and commercialize INO-4800 withinGreater China, inclusive of Mainland China,Hong Kong,Macao, andTaiwan. Advaccine will license its plasmid manufacturing process for use with INO-4800 and other INOVIO pipeline product candidates to INOVIO with the right to sublicense to INOVIO's manufacturing partners. Additionally, Advaccine will provide its clinical data to INOVIO in support of INOVIO's global INO-4800 regulatory filings and INOVIO will provide its INO-4800 clinical data for Advaccine to incorporate into its marketing applications inGreater China. Advaccine will make to INOVIO an upfront payment of$3.0 millionas well as pay an aggregate of$108.0 millionupon the achievement of specified development and sales-based milestones for INO-4800 inGreater China. INOVIO will be entitled to receive a royalty equal to a high single-digit percentage of annual net sales in each region withinGreater China.

CytoDyn Inc. (OTCQB: CYDY), a late-stage biotechnology company developing Vyrologix (leronlimab-PRO 140), a CCR5 antagonist with the potential for multiple therapeutic indications, announced this month a research manuscript submitted by Nicholas J. Agresti, M.D. has been accepted for publication in the Journal of Translational Autoimmunity. Dr. Agresti's research findings were based on four critically ill COVID-19 patients treated with leronlimab under eIND.

The manuscript Ms. No. JTAUTO-D-20-00043R1 is entitled "Disruption of CCR5 Signaling to Treat COVID-19-Associated Cytokine Storm: Case Series of Four Critically Ill Patients Treated with Leronlimab."

Nicholas J. Agresti, M.D., stated, "We are very thankful with the clinical outcomes for these patients and are honored by the acceptance of our research for publication. We hope this work will continue to advance research to understand how to effectively mitigate the effects of COVID-19."

Novavax, Inc. (NASDAQ: NVAX), a late-stage biotechnology company developing next-generation vaccines for serious infectious diseases, recently announced that it has finalized an agreement with the Government of Canada to supply up to 76 million doses of NVX-CoV2373, the company's recombinant protein-based COVID-19 vaccine. Canada has committed to purchase 52 million doses of the vaccine with the option for up to an additional 24 million doses. NVX-CoV2373 is currently in Phase 3 clinical development for the prevention of COVID-19.

"We thank the Government of Canada for their confidence in our program and ongoing partnership in the regulatory review and delivery of a safe, effective COVID-19 vaccine for the citizens of Canada," said John J. Trizzino, Chief Commercial Officer and Chief Business Officer, Novavax. "Novavax is proud to play our part in working tirelessly together with governments, scientists, regulators and others in the global effort to put an end to the pandemic."

The company expects to supply NVX-CoV2373 to Canada beginning as early as the second quarter of 2021, following authorization by Canada's regulatory agency.

DISCLAIMER:FN Media Group LLC (FNM), which owns and operates FinancialNewsMedia.com and MarketNewsUpdates.com, is a third party publisher and news dissemination service provider, which disseminates electronic information through multiple online media channels. FNM is NOT affiliated in any manner with any company mentioned herein. FNM and its affiliated companies are a news dissemination solutions provider and are NOT a registered broker/dealer/analyst/adviser, holds no investment licenses and may NOT sell, offer to sell or offer to buy any security.FNM's market updates, news alerts and corporate profiles are NOT a solicitation or recommendation to buy, sell or hold securities.The material in this release is intended to be strictly informational and is NEVER to be construed or interpreted as research material.All readers are strongly urged to perform research and due diligence on their own and consult a licensed financial professional before considering any level of investing in stocks.All material included herein is republished content and details which were previously disseminated by the companies mentioned in this release.FNM is not liable for any investment decisions by its readers or subscribers.Investors are cautioned that they may lose all or a portion of their investment when investing in stocks.For current services performed FNM has been compensated forty nine hundred dollars for news coverage of the current press releases issued by BioVaxys Technology Corp. by a non-affiliated third party.FNM HOLDS NO SHARES OF ANY COMPANY NAMED IN THIS RELEASE.

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Studies Indicating T-Cells May Be Needed For Long-Term Protection From The SARS-Cov-2 Virus - PRNewswire

Two Gene Therapies Fix Fault in Sickle Cell Disease and -thalassemia – MD Magazine

Two different gene therapies have been used to mitigate a mechanism underlying development of sickle cell disease (SCD) and transfusion-dependent -thalassemia (TDT), and both have demonstrated clinical success in separate, concurrently published trials.

The hemoglobinopathies manifest after fetal hemoglobin synthesis is replaced by adult hemoglobin in individuals who have inherited a mutation in the hemoglobin subunit gene (HBB).Identifying factors in the conversion from fetal to adult hemoglobin synthesis, however, has provided potential targets for therapeutic intervention.

Gene therapy that can safely arrest or reduce the conversion offers the potential for a one-time treatment to obviate the need for lifetime transfusions and iron chelation for patients with TDT, and the pain management, transfusions and hydroxyurea administration for those with SCD.

Two groups of investigators have now reported in The New England Journal of Medicine that, using different gene therapy techniques that target the transcription factor, BCL11a, involved in the globin switching, they have improved clinical outcomes in patients with TDT and with SCD.

In an editorial in the issue featuring the 2 studies, Mark Walters, MD, Blood and Marrow Transplant Program, University of California, San Francisco-Benioff Children's Hospital, welcomed the breakthroughs.

"These trials herald a new generation of broadly applicable curative treatments for hemoglobinopathies," Walters wrote.

In one clinical trial with 2 patients, one with TDT and the other with SCD, Haydar Frangoul, MD, MS, Medical Director, Pediatric Hematology/Oncology, Sarah Cannon Center for Blood Cancer at the Children's Hospital at Tristar Centennial, and colleagues administered CRISPR-Cas9 gene edited hematopoietic stem and progenitor cells (HSPCs) with reduced BCL11A expression in the erythroid lineage.

The product, CTX001, had been shown in preclinical study to restore -globulin synthesis and reactivate production of fetal hemoglobin. Both patients underwent busulfan-induced myeloablation prior to receiving the treatment.

The investigators suggested that the CRISPR-Cas9-based gene-edited product could change the paradigm for patients with these conditions, if it was found to successfully and durably graft, produce no "off-target" editing products, and, importantly, improve clinical course.

"Recently approved therapies, including luspatercept and crizanlizumab, have reduced transfusion requirements in patients with TDT and the incidence of vaso-occlusive episodes in those with SCD, respectively, but neither treatment addressed the underlying cause of the disease nor fully ameliorates disease manifestations," Frangoul and colleagues wrote.

The investigators reported that both patients had "early, substantial, and sustained increases" in pancellularly distributed fetal hemoglobin levels during the 12-month study period. Further, the patients no longer required transfusions, and the patient with SCD no longer experienced vaso-occlusive episodes after the treatment.

In commentary accompanying the report, Harry Malech, MD, Genetic Immunotherapy Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Disease (NIAID), National Institutes of Health (NIH), Bethesda, MD, described the investigators' application of the gene-editing technology as a "remarkable level of functional correction of the disease phenotype."

"With tangible results for their patients, Frangoul et al have provided a proof of principle of the emerging clinical potential for gene-editing treatments to ameliorate the burden of human disease," Malech pronounced.

In the other published trial, with 6 patients with SCD, Erica Esrick MD, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, and colleagues described results with infusion of gene-modified cells derived from lentivirus insertion of a gene that knocks down BCL11a by encoding an erythroid-specific, inhibitory short-hairpin RNA (shRNA).

The severity of SCD that qualified patients for enrollment included history of stroke (n = 3), frequent vaso-occlusive events (n = 2) and frequent episodes of priapism (1).Patients were followed for 2 years, and offered enrollment in a 13-year long-term follow-up study.The infusion of the experimental drug BCH-BB694, from the short hairpin RNA embedded within an endogeonous micro RNA scaffold (termed a shmiR vector), was initiated after myeloablation with busulfan.

Esrick and colleagues reported that, at median follow-up of 18 months (range, 7-29), all patients had engraftment and a robust and stable HbF induction broadly distributed in red cells.Clinical manifestations of SCD were reduced or absent during the follow-up period; with no patient having a vaso-occlusive crisis, acute chest syndrome, or stoke subsequent to the gene therapy infusion.Adverse events were consistent with effects of the preparative chemotherapy.

"The field of autologous gene therapies for hemoglobinopathies is advancing rapidly," Esrick and colleagues reported, "including lentiviral trials of gene addition in which the nonsickling hemoglobin is formed from an exogenous -globin or modified -globin gene."

Walters agreed that gene therapy is rapidly progressing, but expressed concern about the large gap that looms between laboratory bench and clinical bedside, particularly for this affected population.

"Access to and delivery of these highly technical therapies in patients with sickle cell disease will be challenging and probably limited to resource-rich nations, at least in the short term," Walters commented.

The studies, CRISPR-Cas9 Gene Editing for Sickle Cell Disease and -Thalassemia, as well as, Post-Transcriptional Genetic Silencing of BCL11A to Treat Sickle Cell Disease, were published online in The New England Journal of Medicine.

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Two Gene Therapies Fix Fault in Sickle Cell Disease and -thalassemia - MD Magazine

If I Have Cancer, Dementia or MS, Should I Get the Covid Vaccine? – Kaiser Health News

By Judith Graham January 27, 2021

This story also ran on CNN. It can be republished for free.

As public demand grows for limited supplies of covid-19 vaccines, questions remain about the vaccines appropriateness for older adults with various illnesses. Among them are cancer patients receiving active treatment, dementia patients near the end of their lives and people with autoimmune conditions.

Recently, a number of readers have asked me whether older relatives with these conditions should be immunized. This is a matter for medical experts, and I solicited advice from several. All strongly suggested that people with questions contact their doctors and discuss their individual medical circumstances.

Experts advice may be helpful since states are beginning to offer vaccines to adults over age 65, 70 or 75, including those with serious underlying medical conditions. Twenty-eight states are doing so, according to the latest survey by The New York Times.

Q: My 80-year-old mother has chronic lymphocytic leukemia. For weeks, her oncologist would not tell her yes or no about the vaccine. After much pressure, he finally responded: It wont work for you, your immune system is too compromised to make antibodies. She asked if she can take the vaccine anyway, just in case it might offer a little protection, and he told her he was done discussing it with her.

First, some basics. Older adults, in general, responded extremely well to the two covid-19 vaccines that have received special authorization from the Food and Drug Administration. In large clinical trials sponsored by drugmakers Pfizer and Moderna, the vaccines achieved substantial protection against significant illness, with efficacy for older adults ranging from 87% to 94%.

But people 65 and older undergoing cancer treatment were not included in these studies. As a result, its not known what degree of protection they might derive.

Dr. Tobias Hohl, chief of the infectious diseases service at Memorial Sloan Kettering Cancer Center in New York City, suggested that three factors should influence patients decisions: Are vaccines safe, will they be effective, and what is my risk of becoming severely ill from covid-19? Regarding risk, he noted that older adults are the people most likely to become severely ill and perish from covid, accounting for about 80% of deaths to date a compelling argument for vaccination.

Regarding safety, there is no evidence at this time that cancer patients are more likely to experience side effects from the Pfizer-BioNTech and Moderna vaccines than other people. Generally, we are confident that these vaccines are safe for [cancer] patients, including older patients, said Dr. Armin Shahrokni, a Memorial Sloan Kettering geriatrician and oncologist.

The exception, which applies to everyone, not just cancer patients: people who are allergic to covid-19 vaccine components or who experience severe allergic responses after getting a first shot shouldnt get covid-19 vaccines.

Efficacy is a consideration for patients whose underlying cancer or treatment suppresses their immune systems. Notably, patients with blood and lymph node cancers may experience a blunted response to vaccines, along with patients undergoing chemotherapy or radiation therapy.

Even in this case, we have every reason to believe that if their immune system is functioning at all, they will respond to the vaccine to some extent, and thats likely to be beneficial, said Dr. William Dale, chair of supportive care medicine and director of the Center for Cancer Aging Research at City of Hope, a comprehensive cancer center in Los Angeles County.

Balancing the timing of cancer treatment and immunization may be a consideration in some cases. For those with serious disease who need therapy as quickly as possible, we should not delay [cancer] treatment because we want to preserve immune function and vaccinate them against covid, said Hohl of Memorial Sloan Kettering.

One approach might be trying to time covid vaccination in between cycles of chemotherapy, if possible, said Dr. Catherine Liu, a professor in the vaccine and infectious disease division at Fred Hutchinson Cancer Research Center in Seattle.

In new guidelines published late last week, the National Comprehensive Cancer Network, an alliance of cancer centers, urged that patients undergoing active treatment be prioritized for vaccines as soon as possible. A notable exception: Patients whove received stem cell transplants or bone marrow transplants should wait at least three months before getting vaccines, the group recommended.

The American Cancer Societys chief medical and scientific officer, Dr. William Cance, said his organization is strongly in favor of cancer patients and cancer survivors getting vaccinated, particularly older adults. Given vaccine shortages, he also recommended that cancer patients who contract covid-19 get antibody therapies as soon as possible, if their oncologists believe theyre good candidates. These infusion therapies, from Eli Lilly and Co. and Regeneron Pharmaceuticals, rely on synthetic immune cells to help fight infections.

Q: Should my 97-year-old mom, in a nursing home with dementia, even get the covid vaccine?

The federal government and all 50 states recommend covid vaccines for long-term care residents, most of whom have Alzheimers disease or other types of cognitive impairment. This is an effort to stem the tide of covid-related illness and death that has swept through nursing homes and assisted living facilities 37% of all covid deaths as of mid-January.

The Alzheimers Association also strongly encourages immunization against covid-19, both for people [with dementia] living in long-term care and those living in the community, said Beth Kallmyer, vice president of care and support.

What I think this question is trying to ask is Will my loved one live long enough to see the benefit of being vaccinated? said Dr. Joshua Uy, medical director at a Philadelphia nursing home and geriatric fellowship director at the University of Pennsylvanias Perelman School of Medicine.

Potential benefits include not becoming ill or dying from covid-19, having visits from family or friends, engaging with other residents and taking part in activities, Uy suggested. (This is a partial list.) Since these benefits could start accruing a few weeks after residents in a facility are fully immunized, I would recommend the vaccine for a 97-year-old with significant dementia, Uy said.

Minimizing suffering is a key consideration, said Dr. Michael Rafii, associate professor of clinical neurology at the University of Southern Californias Keck School of Medicine. Even if a person has end-stage dementia, you want to do anything you can to reduce the risk of suffering. And this vaccine provides individuals with a good deal of protection from suffering severe covid, he said.

My advice is that everyone should get vaccinated, regardless of what stage of dementia theyre in, Rafii said. That includes dementia patients at the end of their lives in hospice care, he noted.

If possible, a loved one should be at hand for reassurance since being approached by someone wearing a mask and carrying a needle can evoke anxiety in dementia patients. Have the person administering the vaccine explain who they are, what theyre doing and why theyre wearing a mask in clear, simple language, Rafii suggested.

Q: Im 80 and I have Type 2 diabetes and an autoimmune disease. Should I get the vaccine?

There are two parts to this question. The first has to do with comorbidities having more than one medical condition. Should older adults with comorbidities get covid vaccines?

Absolutely, because theyre at higher risk of becoming seriously ill from covid, said Dr. Abinash Virk, an infectious diseases specialist and co-chair of the Mayo Clinics covid-19 vaccine rollout.

Pfizers and Modernas studies specifically looked at people who were older and had comorbidities, and they showed that vaccine response was similar to [that of] people who were younger, she noted.

The second part has to do with autoimmune illnesses such as lupus or rheumatoid arthritis, which also put people at higher risk. The concern here is that a vaccine might trigger inflammatory responses that could exacerbate these conditions.

Philippa Marrack, chair of the department of immunology and genomic medicine at National Jewish Health in Denver, said theres no scientifically rigorous data on how patients with autoimmune conditions respond to the Pfizer and Moderna vaccines.

So far, reasons for concern havent surfaced. More than 100,000 people have gotten these vaccines now, including some who probably had autoimmune disease, and theres been no systematic reporting of problems, Marrack said. If patients with autoimmune disorders are really worried, they should talk with their physicians about delaying immunization until other covid vaccines with different formulations become available, she suggested.

Last week, the National Multiple Sclerosis Society recommended that most patients with multiple sclerosis another serious autoimmune condition get the Pfizer or Moderna covid vaccines.

The vaccines are not likely to trigger an MS relapse or to worsen your chronic MS symptoms. The risk of getting COVID-19 far outweighs any risk of having an MS relapse from the vaccine, it said in a statement.

Were eager to hear from readers about questions youd like answered, problems youve been having with your care and advice you need in dealing with the health care system. Visitkhn.org/columniststo submit your requests or tips.

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If I Have Cancer, Dementia or MS, Should I Get the Covid Vaccine? - Kaiser Health News

L-MIND Trial Results Show CD19 Antibody Is Reasonable in R/R DLBCL – Targeted Oncology

During a Targeted Oncology Case Based Peer Perspectives Roundtable event, Loretta J. Nastoupil, MD, associate professor, director, Lymphoma Outcomes Database, section chief, New Drug Development, in the Department of Lymphoma/Myeloma, Division Cancer Medicine, at The University of Texas MD Anderson Cancer Center, discussed the case of a 74-year-old patients with diffuse large B-cell lymphoma.

Targeted OncologyTM: What are the potential second- and third-line therapy options for this patient at this point in their treatment?

NASTOUPIL: The current NCCN [National Comprehensive Cancer Network] guidelines...look like a laundry list of a number of different therapeutic options and [do] not necessarily provide an algorithm for what might be the preferred choice based [on] certain patient characteristics.1 It just signifies that there may be several different chemoimmuno-therapy approaches and then even some potential targeted therapy approaches.

Then in the third line, CAR [chimeric antigen receptor] T-cell therapy becomes an option for patients.

Why is the tafasitamab and lenalidomide regimen listed in this poll? What is the rationale for combining these agents?

For those who may not be familiar, tafasitamab is a naked CD19 antibody, not a CAR T therapy. Its not an antibody-drug conjugate but a naked antibody engineered for enhanced ADCC [anti- body-dependent cellular cytotoxicity].

Tafasitamab and lenalidomide were approved in July 2020 for the treatment of DLBCL.2 Its an interesting label in that it is approved for patients who are not transplant candidates, and so that raises the question of how you define a nontransplant candidate. Its approved in combination withlenalidomide, 25 mg dosed 1 through 21 of a 28-day cycle; the lenalidomide is continued for a maximum of 12 cycles, but the tafasitamab is continued as monotherapy until disease progression or intolerance.

Tafasitamab was engineered for enhanced ADCC and direct cell death. Investigators saw encouraging activity in a phase 1 trial as a single agent. Then the rationale for combination with lenalidomide is because of the enhanced ADCC and because of activity seen with rituximab [Rituxan] and lenalidomide across a number of B-cell lymphoma subtypes. It was felt that this might be an interesting synergistic combination, and then [investigators] set out to explore it further in this phase 2 study in relapsed/refractory DLBCL.

Which trial looked at this combination, and what was the design?

The L-MIND study [NCT02399085] was an open-label, multi-center study.3 [Investigators] evaluated patients with relapsed/ refractory DLBCL. Now some important eligibility criteria are worth noting. They restricted eligibility to patients who had had 1 to 3 prior lines of therapy, so this is not a heavily pretreated patient population.

Patients who were ineligible for high-dose chemotherapy or autologous stem cell transplant were evaluated. There are not agreed-upon criteria for whos not a transplant candidate, other than failing to have chemotherapy-sensitive disease. But because this [trial] would enroll patients whod only had 1 prior line of therapy, that opens the discussion to how you would define a nontransplant candidate. This was done in a number of European sites where age alone is a factor, so generally patients over the age of 70 are deemed not appropriate candidates for stem cell transplant; its one of the more common criteria that were applied for defining this patient population.

The study schema outlined the dosing of lenalidomide at 25 mg [daily], which is standard in multiple myeloma studies. Its a bit higher than the standard dosing done in most Hodgkin or non-Hodgkin lymphoma studies and speaks to the evolution of treatment over time, particularly when weve combined [lenalidomide] with other agents. Most of the time were starting at 20 mg, but for the purposes of this study, in the schema it was 25 mg of lenalidomide.

Its also important to note that there was an induction phase with the combination, and particularly during cycle 1, tafasitamab was dosed weekly with an additional loading dose on day 4 of cycle 1 and then continued weekly up to all 3 cycles so 12 weeks of treatment. Beyond cycle 3, it was dosed every other week or every 2 weeks until disease progression or intolerance. The primary end point of the study was objective response rate [ORR] as assessed by independent central review, and then key secondary end points included progression-free survival [PFS], duration of response [DOR], and overall survival [OS], in addition to safety.

There were 81 patients enrolled on the single-arm phase 2 study, and that speaks to the fact that lymphoma is a rare tumor type. The median age was 72, again [considering] that age over 70 was one of the most common criteria utilized to define a nontransplant candidate. About 51% of the patient population had an IPI risk score of 3 or higher, 75% had advanced-stage disease, median number of prior lines of therapy was 2, and primary refractory [disease] comprised only about 19% of the patient population. These patients generally were not primary refractory, though [the trial] did include some. Prior stem cell transplant patients might be a poor transplant candidate because theyve already had transplant; [these patients comprised] about 11% of the patient population.

What were the efficacy data seen in the L-MIND study?

The ORR determined by the independent central review was quite notable. The ORR in patients with relapsed/refractory DLBCL was 60%, and the complete response rate was 43%. Probably even more important is that it appeared to be durable. The median DOR was 21.7 months. It was not reached among those patients who achieved a complete response, which was almost half the study population....DOR for patients who had a partial response [was markedly lower at] only 4.4 months, and 72% of [all] patients had an ongoing response beyond 12 months.

Importantly, there was a PFS in this patient population of 12.1 months, and median OS had not been reached. At 18 months, 64% of the patient population was still alive. I think this is important because if you put this into context, prior to the introduction of CAR T, if we look at the SCHOLAR-1 datawhich were of a retrospective analysis of patients treated at MD Anderson Cancer Center, at Mayo Clinic, and in the Lysa group, which is a large French group the median OS...was 6 months for patients with relapsed/ refractory DLBCL in second line or later.4 Again, this is a marked improvement over that.

The median PFS is also quite notable at 12 months [at 50%] because the median PFS for the CAR T population was only about 6 months. Now this probably reflects a specific patient population in that most of these patients were not as heavily pretreated as the CAR T population. A small percent- age were primary refractory.

Are other studies in the DLBCL setting looking at this regimen?

There were data reported at the 2020 American Society of Clinical Oncology Annual Meeting [from] the RE-MIND study [NCT04150328]....They essentially compared [the L-MIND] results with a synthetic control where they captured retrospective data of single-use lenalidomide in relapsed/refractory DLBCL and then tried to match that in terms of baseline characteristics.5

It looks like [the combination] was at least a significant improvement over lenalidomide monotherapy. Then the question is really: Is it better than the other options currently available in the relapsed DLBCL space? And that hasnt been answered. Its moving into front line. The phase 1b data were reported. Theres a randomized study that is launching, so that will then raise the question of how we sequence treatment in DLBCL.

What was the toxicity profile of tafasitamab and lenalidomide for these patients?

The most common adverse events [AEs] were neutropenia, anemia, and thrombocytopenianot surprising to me because again this is an antibody in combination with lenalidomide.3 Grade 3 or higher neutropenia occurred in 48% of patients and grade 3 or higher thrombocytopenia in 17% of patients. Fortunately, febrile neutropenia was not high. There was 10% with grade 3 and 2% with grade 4. Growth factor use was at the discretion of the treating physician. It was not built into the protocol in terms of prophylactic use.

For the most common AEs that were nonhematologic, [what was noticeable was] the vast majority were grade 1/2, though about 9% of patients had a grade 3 rash, which is not unusual for lenalidomide in lymphoma. One percent had grade 3 diarrhea, and about 5% had hypokalemia. Some of that might be related to diarrhea and some nausea. Cough was about 1% at grade 3 or higher, and bronchitis was 1% at grade 4. Fatigue was another common AE, with 15% at grade 1 or 2.

Serious AEs occurred in 51% of the study population, although 19% were attributed to the study drug; 12% discontinued therapy as a result of toxicity, and then 9% had an AE of special interest. The AEs of special interest included tumor flare in 3 patients, and 1 patient with grade 2 basal cell carcinoma. Grade 3 [allergic dermatitis] occurred in 3 patients. There were 13% who had a treatment-emergent AE that led to death; however, according to the [investigators], none [of the deaths] were thought to be related to study treatment. The severity and incidence of the toxicities after lenalidomide was discontinued decreased, suggesting that a lot of the toxicity was due to the combination and not the CD19 monotherapy.

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L-MIND Trial Results Show CD19 Antibody Is Reasonable in R/R DLBCL - Targeted Oncology