Greenleaf Health Expands Services to Support Cell & Gene Therapy – Business Wire

WASHINGTON--(BUSINESS WIRE)--Greenleaf Health, Inc., a leading Food and Drug Administration (FDA) regulatory consulting firm, today announces that the firm has expanded its portfolio of services to guide companies developing cell and gene therapy products. Greenleafs team of regulatory experts will be led by Karen Midthun, M.D., former Director of the FDAs Center for Biologics Evaluation and Research (CBER), and John Taylor, former FDA Counselor to the Commissioner and Principal Deputy Commissioner.

REGULATORY LANDSCAPE: Cell & Gene Therapy

The rapidly evolving fields of cell and gene therapy offer the possibility of novel treatments, and perhaps ultimately cures, for devastating and intractable illnesses. In response to what the FDA has called a "turning point in the development of these technologies and their application to human health, new policies have been introduced to address the development of safe and effective cell and gene therapies.

With innovation often comes uncertainty. In the case of cell and gene therapy products, the FDA has raised concerns about developers operating outside of the existing regulatory paradigm. To prevent this, the FDA has clarified the regulatory framework for regenerative medicine products and announced near-term enforcement actions aimed at ensuring compliance by companies developing and manufacturing cell and gene therapies.

Greenleafs expanded services support companies striving to introduce cell and gene therapy products to patients. The firms team of experts has a robust blend of technical skill and FDA institutional knowledge that spans all therapeutic areas and quality, manufacturing, and compliance systems. By working cross-functionally, Greenleaf ensures that clients have the comprehensive, specialized support needed to understand and navigate the complex regulatory landscape for cell and gene therapies.

FULL-SERVICE SUPPORT

Members of Greenleafs Drug and Biological Products Team work together with the firms Product Quality, Manufacturing, and Compliance Team to deliver guidance on cell and gene therapy products.

Product Development & Review

With the expert direction of Karen Midthun, M.D., Greenleafs team of advisors assists sponsors of cell and gene therapies by optimizing FDA interactions and submissions to support development and regulatory review. Greenleaf also helps sponsors understand and respond to the FDA requirements applicable to various cellular products, and provides guidance to sponsors of cell and gene therapies to treat rare and ultra-rare diseases on ways to maximize trial design using appropriate clinical endpoints and natural history study data to aid efficient product development.

Quality, Manufacturing & Compliance

Greenleafs Product Quality, Manufacturing, and Compliance Team, led by John Taylor and supported by the firms network of independent compliance experts, offers credible, informed guidance to help manufacturers of cell and gene therapies comply with the FDAs multiple current GXP regulations. Greenleaf experts provide strategic and technical support for establishing manufacturing and quality controls; pre- and postapproval inspection readiness; compliance assessments; evaluating and responding to FDA regulatory correspondence; and engaging with CBERs Advanced Technologies Team.

UNMATCHED EXPERTISE

Greenleaf is comprised of experts with a combined total of more than 250 years of FDA experience. The firms team of advisors demonstrates unmatched levels of skill in its specialties of drug and biological products and product quality, manufacturing, and compliance. Greenleafs Cell and Gene Therapy Team, led by Dr. Karen Midthun and John Taylor, is guided by decades of regulatory experience in senior FDA positions, global public health organizations, academia, and industry.

Karen Midthun, M.D.Principal, Drug & Biological Products

Dr. Midthun contributes specialized insight informed by her regulatory, research, and clinical experience to FDA-regulated entities developing cell and gene therapies. Dr. Midthun joined Greenleaf following a distinguished 28-year career in public health, of which 22 years were dedicated to the FDA.

An infectious disease physician by training, Dr. Midthun most recently served as the Director of the FDAs Center for Biologics Evaluation and Research (CBER). During her FDA tenure, Dr. Midthun played a critical role in facilitating policy and technology development in the areas of cell, tissue, and gene therapies, blood products, and vaccines.

John Taylor, J.D.President, Greenleaf Health, and Principal, Compliance & Regulatory Affairs

Taylor has held many high-profile positions at the FDA, as well as senior leadership roles within industry. Taylors wealth of regulatory experience, robust technical skills, and unique strategic perspective are unmatched. Clients working with Greenleafs Product Quality, Manufacturing, and Compliance Team benefit from Taylors vast FDA institutional knowledge.

Taylor joined Greenleaf following a distinguished 20-year career at the FDA, where he served in multiple leadership positions, including as the FDAs Acting Deputy Principal Commissioner, FDA Counselor to the Commissioner, Acting Deputy Commissioner for Global Regulatory Operations and Policy, and Associate Commissioner for Regulatory Affairs.

ABOUT GREENLEAF

Greenleaf Health provides strategic and technical guidance to pharmaceutical, biotechnology, and medical device companies researching, developing, and manufacturing innovative solutions to pressing global public health challenges.

The firm includes former leaders and regulatory professionals from the FDA, Capitol Hill, top global pharmaceutical and medical device companies, leading law firms, and the top U.S. biotechnology trade organization. Greenleafs blend of former FDA officials and industry experts provides a unique set of capabilities when advising entities regulated by the FDA.

For more information on Greenleafs cell and gene therapy services and Greenleaf Health, visit greenleafhealth.com.

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Greenleaf Health Expands Services to Support Cell & Gene Therapy - Business Wire

Emmaus withdraws European application for sickle cell drug that got US approval – MedCity News

A U.S. biotech company has withdrawn its application seeking approval for a drug to treat sickle cell disease in Europe following a negative review by a body of the E.U.s drug regulation authority.

Torrance, California-based Emmaus Life Sciences said Thursday that it was withdrawing its marketing authorization application with the European Medicines Agency for Xyndari (glutamine), which it markets as Endari in the U.S., after a negative opinion by the EMAs Committee for Medicinal Products for Human Use, or CHMP. The CHMP stated that the data in the application did not show the drug was effective at reducing the number of sickle cell disease crises or hospital visits. It had previouslyissueda negative opinion in May.

Shares of Emmaus were down 9 percent Friday morning on the over-the-counter market and were down more than 20 percent when markets closed.

The drug, marketed as Endari in the U.S., has had Food and Drug Administration approval to treat sickle cell disease in patients aged 5 and older since 2017. Earlier his month, the FDA accepted an application for accelerated approval for Global Blood Therapeutics voxelotor, another drug to treat sickle cell disease.

Concerns expressed in the CHMPs opinion in May included a higher discontinuation rate among patients taking the drug than among those taking placebo, and data on how the drug worked for them was not available, with the committee concluding that the way their data were dealt with was not appropriate. Many patients in a supportive study also dropped out early, and the higher number of patients in the Xyndari arm than in the placebo arm who had received another drug, hydroxyurea, may have influenced the results.

According to data from the Phase III study on the ClinicalTrials.gov database, the trial enrolled 230 patients, of whom 152 were randomized to the Endari/Xyndari arm and 78 of whom were randomized to placebo. Of those in the treatment arm, 55 did not complete the study, compared with 19 of those in the placebo arm, yielding respective discontinuation rates of about 36 percent and 24 percent.

One sickle cell disease expert noted that the drug seems to have been approved in the U.S. because of the limited treatment options for sickle cell disease and there being few problems with safety, but it still raised other issues.

There were multiple methodological concerns about the pivotal study of [Endari] to prevent acute complications of sickle cell anemia, wrote Dr. John Strouse, a hematologist and associate professor of medicine at Duke University, in an email.

The FDAs Oncologic Drugs Advisory Committee had expressed similar concerns to those of CHMP about the higher discontinuation rate in the treatment arm. ODAC nevertheless voted to support the drugs overall efficacy and safety profile.

According to the Phase III datathat led to FDA approval, patients in the Endari arm experienced a median three sickle cell crises, two hospitalizations and 6.5 days in the hospital, compared with a respective median four crises, three hospitalizations and 11 days in the hospital among those receiving placebo. The Endari arm also showed an increase in the number of days before a sickle cell crisis occurred and a lower number of patients experiencing acute chest syndrome.

Because we have demonstrated the efficacy of Xyndari, as supported by the data from the trials conducted, we are disappointed by the CHMPs position, Emmaus CEO Yutaka Niihara said in a statement Thursday. We remain committed to the patients who suffer from sickle cell disease and will continue to endeavor to broaden our global patient base while identifying new clinical uses for L-glutamine, obtaining additional patients and distribution partners, and through ongoing community and physician outreach.

Niihara said the company was seriously considering a decentralized approval procedure on a country-by-country basis, though he was not available to elaborate further.

Photo: virusowy, Getty Images

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Emmaus withdraws European application for sickle cell drug that got US approval - MedCity News

Disabling one protein might one day lead to a cure for the common cold – Science News

An uncommon way of thinkingmay be bringing scientists one step closer to a cure for the common cold.

Researchers have identifieda key protein in humans that some viruses use to multiply inside of human cells.Disabling that protein, instead of attacking the virus itself, may prevent infections from spreading. In mice and human cells engineered to lack thisprotein, the viruses couldnt replicate, Jan Carette, a microbiologist at Stanford University School of Medicine,and colleagues report September 16 in Nature Microbiology.

Its not quite a cure forthe common cold, but its an interesting step forward, says Ellen Foxman, animmunologist at Yale School of Medicine who was not involved in the study.

Colds are the most common infectious disease in humans. On average, adults catch a cold two or three times each year, while children get the sniffles even more often (SN: 2/12/09). Any one of a few hundred viruses, including rhinoviruses, can cause these infections. That fact and because these viruses can mutate quickly to become resistant to drugs makes it difficult to find a cure.

Headlines and summaries of the latest Science News articles, delivered Tuesdays and Thursdays

So researchers at Stanford and the University of California, SanFrancisco focused on the human host rather than the virus. Viruses hijack cells and rely on humans own cellularmachinery to make more virus and sicken their host. The team wanted to see if itcould identify human genes that make the proteins that many viruses hijack inorder to replicate.

Using the gene-editing tool CRISPR,Carette and colleagues systematically deleted chunks of DNA to build a libraryof human cells, each missing one gene and therefore unable to make that genescorresponding protein. The researchers then infected the cells with two typesof viruses, one that causes colds and another that has been linked toneurological diseases.

Using different viralproteins like hooks, the scientists pulled out human proteins that werephysically attached to a viral protein. That let the team identify which humanproteins were interacting with viral ones an indication that the virus was using that proteinto hijack the cell.

One human protein wasrepeatedly fished out of the cells: SETD3. And experiments indicated that theviruses needed SETD3 to take over the cell. Scientists knew this protein couldaffect actin proteins, which help muscles contract. But its role in viralinfections came as a surprise.

When the researchersinjected viruses into mice engineered to lack a working version of the SETD3 gene, the mice didnt get sick. Humanlung cells that also lacked the gene remained healthy. (Lung cells are oftenused in these types of studies because they are especially susceptible to manyrhinoviruses that cause colds.)

Repeating those experimentswith similar but potentially more serious viruses suggested the approach may beeffective against more than just the common cold. Engineered human cells didntbecome infected when they were exposed to viruses that cause hand, foot and mouthdisease and a polio-like spinal cord disease called acute flaccid myelitis. Andwhen mice were exposed to these viruses, the rodents that didnt have a functioningversion of SETD3 were much morelikely to survive than those that had the working gene.

We have identified an excellent target, says Carette, of SETD3. But its unclear whetherdisabling that gene and its protein could cause other problems. While theengineered mice survived and were healthy and fertile, they werent able to push their pups out of the wombduring birth, he says, which might be related to the proteins role in musclecontractions.

Scientists dont fully understand what this gene does in the human body, and getting rid of it completely could have unknown effects, says Vincent Racaniello, a virologist at Columbia University who wasnt involved in the work. The authors show that mice lacking the gene for SETD3 are viable and resistant to infection. However, this observation does not mean that SETD3 in humans is dispensable, he wrote in an e-mail.

Instead, the researchers think their best bet is to search for a drug that blocks the human protein and its viral counterparts from interacting, or one that destroys the human protein only when it is interacting with viral ones. But those types of drugs are still a long way off. The question is always When can I buy it over the counter? Carette says. Drug development takes time.

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Disabling one protein might one day lead to a cure for the common cold - Science News

‘Provocative’ Results With Stem Cells in Progressive MS – Medscape

STOCKHOLM A new trial of autologous mesenchymal stem cells in progressive multiple sclerosis (MS) has shown encouraging results, with significant benefits vs placebo in several measures of disability.

The double-blind placebo-controlled phase 2 study described as "very pioneering" and "provocative" by outside commentators was presented at the recent 35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2019.

Both intravenous and intrathecal administration of the stem cells showed beneficial clinical effects compared with placebo in terms of Expanded Disability Status Scale (EDSS) changes and several other functional outcomes, but the intrathecal route appeared superior to intravenous administration, reported Dimitrios Karussis, Hadassah University Hospital, Jerusalem, Israel.

Benefits were also noted mainly in the intrathecal group in relapse rates and several other secondary endpoints vs placebo, including timed 25-foot walk test, 9-hole peg test, several measures of cognitive function, and the rate of change of T2 lesion load on magnetic resonance imaging (MRI), as well as newer biomarkers including optimal coherence tomography, retinal nerve fiber layer thickness, and functional MRI motor network.

The study showed both intravenous and intrathecal administration of the cells appeared safe with no serious adverse events observed vs placebo.

"A phase 3 trial is warranted to confirm these findings," Karussis concluded.

Commenting for Medscape Medical News, Robert Fox, MD, Cleveland Clinic, co-chair of the session at which the study was presented, said the study was "provocative" as it showed "quite a robust change in disability trajectory and inflammatory markers despite only including a small number of patients."

"The data suggested a marked impact on these patients with progressive MS," Fox noted. "We've seen other stem cell trials but this is the one with the most provocative results which need to be understood further," he added.

Karussis explained that two small open-label clinical trials of mesenchymal stem cells have previously shown some indications of clinical benefits in MS and amyotrophic lateral sclerosis (ALS) patients in terms of stabilization of disability and some functional improvements.

"This third study is a double-blind, placebo-controlled trial to try and establish safety and the optimal route of administration intrathecal or intravenous injection in progressive MS," he said.

The study included 48 progressive MS patients with activity who had failed on at least one MS therapy and had an EDSS score of 3.0 to 6.5.

Mesenchymal stem cells were aspirated from the bone marrow of each patient, expanded in vivo, and then transplanted back into the patient intrathecally or intravenously at a dose of 1 million stem cells per kg body weight.

Each patient received two injections. For the first injection, 16 patients received stem cells by intrathecal injection, 16 received stem cells by intravenous injection, and 16 received placebo.

After 6 months the patients were crossed over and all patients who first got placebo were given stem cells (half by intrathecal and half by intravenous injection); those who first received stem cells were divided into two subgroups half received a second injection with the same route of administration as the first injection and the other half received placebo.

There was no major difference in baseline demographics in the three groups. Most patients had secondary progressive MS, with about 20% having primary progressive MS. The average EDSS at baseline was about 5.8 with an average progression over the previous year of around +0.7.

Efficacy results showed statistically significant benefits in patients receiving intrathecal stem cell injections vs placebo, with EDSS scores reducing by 0.2 vs an increase of 0.3 in the placebo group. The ambulation score improved by 0.8 points in the intrathecal stem cell group vs an increase of 1.3 with placebo.

The sum of functional scores improved by 3 points in the intrathecal stem cell group vs a worsening by 1 point in the placebo group. The mean number of relapses per patient were 0.06 in the intrathecal stem cell group vs 0.56 in the placebo group, and 94% of the intrathecal stem cell group was relapse free at the end of the study vs 53% of the placebo group.

There were also some smaller but significant improvements in some of the endpoints in the intravenous stem cell group vs placebo but not in the relapse rates, Karussis reported.

For the secondary endpoints patients receiving intrathecal stem cells had significant benefits in the 25-foot walk test, an improvement of 6% to 10% in walking speed vs a deterioration in the placebo group. The 9-hole peg test also showed positive results in the intrathecal stem cell group.

When comparing two treatments vs one treatment, only intrathecally treated patients showed superiority in each of the primary efficacy parameters compared with one treatment.

When asked how much of the effect was thought to be anti-inflammatory, Karussis replied that there appeared to be some dissociation between anti-inflammatory and other effects. "Gadolinium enhancing lesions were much less affected than some other disability parameters, including walking and functional MRI, which may indicate that the main effect was not immunomodulatory," he said.

Fox commented: "It will take a bit of diving into the data to understand how much might have been from an anti-inflammatory effect and how much was truly addressing the progressive facet of the disease."

"One concern was that the second 6 months of treatment patients who then went on placebo seemed to decline quite dramatically," Fox added. "So this begs the question of whether this is just a short-lived benefit and how often will these stem cells treatments need to be given."

Karussis and Fox have disclosed no relevant financial relationships.

35th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2019: Abstract 157. Presented September 12, 2039.

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'Provocative' Results With Stem Cells in Progressive MS - Medscape

‘I’ve Been Duped’: Disabled Veteran Says He Spent Thousands at Health Center With No Improvement – NBC Bay Area

Stephanie Burnette reached out to us after our first I-Team report about an expensive nerve treatment marketed to seniors. She says she and her husband still owe thousands of dollars for treatment they say didn't work for them.

While she and her husband both have neuropathy, Carlos Dominguez does not. This was confirmed by his neurologist in June and again in August.

But after his visit to Superior Health Centers in Aug. 2019, Dominguez says he didn't know what to think.

"They tell me they're going to put me through treatment to cure me," he said.

The disabled veteran says he was drawn to Superior Health Centers by an invitation offering a free dinner and the promise of stem cell treatments.

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"That's what I keep hearing is going to help people who have arthritis, which is what I have in my knee," Dominguez said of stem cells.

To his surprise, he says they also told him he had the debilitating nerve condition called neuropathy and Superior Health warned of dire consequences.

"He told me that later on you could basically have an amputation whether it be your toes or your feet ... so how are you feeling? Of course I'm scared," he said.

Dominguez said Superior Health bombarded him with paperwork he showed us the documents and pointed out more than a dozen places he had to initial and sign.

"They keep shoving one after another after another. They don't even give you a chance to stop and you know, get your thoughts straight."

When it was all said and done, Dominguez had signed up for 2 1/2 months treatment at a cost of $15,602.

The financing was arranged by Superior Health and none of the treatment costs were covered by insurance. Dominguez's neurologist confirmed after his visit with Superior that he does not have neuropathy.

And what about the promise of stem cells? Dominguez showed us a document which says Superior Health uses "human umbilical cord tissue."

"The tissuehas no stem cells or anything that could play any role in regenerating damaged organs or tissues or anything," Kevin McCormack, a spokesman for California Institute for Regenerative Medicine said.

CIRM is the state agency that funds stem cell research. McCormack warns many clinics are making big promises with no scientific proof.

"Long term it doesn't work, it doesn't repair the damage, it doesn't restore functions. It doesn't do anything. The only thing it improves is the bank account of these clinics," he said.

Chiropractor Philip Straw first came to the NBCLA I-Team's attention when viewers reached out to our investigative unit with complaints about the neuropathy treatment they received from Optimal Health/Straw Chiropractic. The I-Team started asking questions late last year. We were told in January that the business was closing its doors, but they appear to have reopened as Superior Health Centers where Carlos went.

For example, Straw is seen in television commercials advertising neuropathy treatment. When we've called the number displayed on the commercial, it connects to Superior Health Centers.

NBCLA has tried unsuccessfully to reach Straw and an attorney for Superior Health for comment.

But in a previously issued statement, the attorney wrote:

"Philip Straw is neither practicing at the facility nor is he a professional tenant of Superior Health Centers ... While patients acknowledge that there is no guaranty that they will improve from the treatment, many patients report significant improvement."

When Dominguez heard patient Michele Botts in our first I-Team report, he said her words resonated with him.

"I go, oh boy. I've been duped. That's the first thing I thought ... I've been taken," he said.

Taken for thousands of dollars and left, he says, with no improvement and no hope.

Dominguez never received any stem cell treatments. Instead, he says he told Superior Health he wanted out of his contract and cleared of his financial obligation. He says Superior has not agreed to that.

Consumers can contact the California Chiropractic Examiners Board online here or call 916-263-5355 to speak with someone.

This story is from our sister station, NBC Los Angeles. Click here for more investigative stories from NBC stations across the county.

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'I've Been Duped': Disabled Veteran Says He Spent Thousands at Health Center With No Improvement - NBC Bay Area

Finding alternatives to animal testing – University of California

Researchers at the University of California, Riverside, are part ofan ambitious planat the U.S. Environmental Protection Agency, or EPA, to eliminate animal testing by 2035. Their contribution: developing a way to test whether chemicals cause musculoskeletal birth defects using lab-grown human tissue, not live animals.

Nicole zur Nieden, an associate professor of molecular, cell, and systems biology, andDavid Volz, an associate professor of environmental toxicology, are both experts on alternatives to regulatory toxicity testing and chemicals policy and regulation. They received $849,811 to grow human stem cells into bone-like tissue to test industrial and environmental chemicals that might interfere with fetal growth.

Birth defects that affect musculoskeletal tissues can be caused by chemical ingredients in pesticides, fungicides, paints, and food additives. Harmful chemicals must be identified through testing in order to be regulated. Currently, this testing is done on live animals, usually rodents such as mice.

The UC Riverside project, led by zur Nieden, will stimulate human pluripotent stem cells, which have the capacity to develop into any sort of cell, with agents that direct them to form bone cells. The cells will pass through the same developmental stages and be subject to the same molecular cues as in a human embryo. The researchers will expose the cells to selected chemicals at critical junctures, then assess them using advanced imaging and next-generation sequencing techniques.

Bone cells can develop through three different pathways. zur Nieden will use chemicals known to affect specific routes of bone development to look for patterns in how the chemicals affect these origins. The patterns will serve as blueprints for testing unknown chemicals. Next, the researchers will test unknown chemicals and compare them to previously compiled libraries of compounds that have already been tested in animals to see how accurate the petri dish, or in vitro, tests are for assessing risk.

A hallmark feature of bone-forming cells is that they make a bony matrix out of little crystals called hydroxyapatite, which eventually form calcium phosphate, the white stuff on the surface of all bones. Cost-saving visual analysis can help identify defects in calcium.

Calcium crystals appear white when viewed with your eyes, said zur Nieden. But when you view the cultures using phase contrast microscopy, it inverts the light so the normal crystals appear black. Abnormal crystals will have more white and shades of gray. You can use an image analysis algorithm to measure the blackness in images to determine if the calcium has formed correctly or not.

Scientists have known for a long time that animals differ from humans in important developmental and physiological ways, and that animal test results are not always reliable for people. Moreover, animal research is expensive and time-consuming, as well as increasingly untenable for ethical reasons. Non-animal alternatives have been in development for nearly 25 years, and some are already standard.

To the general public, the EPAs announcement seemed to come out of nowhere, said Volz, whose lab will sequence messenger RNA in chemical-exposed bone cells from zur Niedens lab to look for changes in gene expression. It didnt happen overnight. That train has already left the station.

Volz said the EPAs Science to Achieve Results Program, through which UC Riverside received the new grant, has been funding research on animal alternatives for more than 10 years.

The EPAs plan to end animal testing by 2035 follows up on earlier changes to the Toxic Substances Control Act, or TSCA, enacted in 1976. TSCA authorizes the EPA to regulate chemicals found in consumer products such as cleaning agents, furniture, paint, carpeting, clothing, and other consumer goods. Regulation under TSCA does not apply to chemicals in food, drugs, cosmetics, and pesticides, which are regulated under different laws.

Even after TSCA, thousands of common chemicals used in everything from plastic to sunscreen have never been tested for safety in humans. In 2016, Congress passed the Lautenberg Chemical Safety Act, amending TSCA to close the loophole for industrial chemicals. The law mandated the EPA to evaluate existing chemicals with clear and enforceable deadlines, and to develop risk-based chemical assessments. It promoted the use of non-animal testing methods, a move sought by both industry and animal rights groups.

The new EPA plan introduces an aggressive timeline for ramping up development of non-animal tests that can accurately predict toxicity in humans. Volz said the United States lags behind some other countries around the world, which have already greatly reduced animal testing. He said he interacts with fewer and fewer students interested in research involving animal experiments, and that our culture is shifting toward a desire to reduce animal suffering.

But neither Volz nor zur Nieden are sure animal testing can ever be replaced completely, a position echoed by the EPA memo, which states that after 2035, animal tests will be approved on a case-by-case basis. Some chemicals, for example, are not directly toxic to cells but become toxic after they are metabolized in the body.

If your result is that the chemical does not interfere with a human stem cell developing in a dish, how sure can you be thats not really happening in humans? The best way we have to assess that is an animal experiment, zur Nieden said. At the same time, we want to do this in an appropriate way. We need to think about, is this really necessary? Can we look at the question some other way?

zur Nieden thinks we need a tiered system, with in vitro tests weeding out the most toxic chemicals first, and animal tests used where in vitro tests dont reveal toxicity.

If you cannot fully replace an animal test with an in vitro method, you can at least decrease suffering of the animal. If you think about a highly toxic chemical that has effects on the mom as she is exposed during pregnancy as well as on the developing embryos, if you can use an in vitro test system to find all these strong toxic chemicals, you will not need to test them in an animal, she said.

Previous versions of the test system zur Nieden will use for the new musculoskeletal research have been able to identify embryotoxic chemicals for other tissues, such as heart tissue, with almost 100 percent accuracy.

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Finding alternatives to animal testing - University of California

Gene therapy shows promise repairing brain tissue damaged by stroke – National Institute on Aging

From the NIH Directors Blog by Dr. Francis Collins

Its a race against time when someone suffers a stroke caused by a blockage of a blood vessel supplying the brain. Unless clot-busting treatment is given within a few hours after symptoms appear, vast numbers of the brains neurons die, often leading to paralysis or other disabilities. It would be great to have a way to replace those lost neurons. Thanks to gene therapy, some encouraging strides are now being made.

In a recent study in Molecular Therapy, researchers reported that, in their mouse and rat models of ischemic stroke, gene therapy could actually convert the brains support cells into new, fully functional neurons.1 Even better, after gaining the new neurons, the animals had improved motor and memory skills.

For the team led by Gong Chen, Penn State, University Park, the quest to replace lost neurons in the brain began about a decade ago. While searching for the right approach, Chen noticed other groups had learned to reprogram fibroblasts into stem cells and make replacement neural cells.

As innovative as this work was at the time, it was performed mostly in lab Petri dishes. Chen and his colleagues thought, why not reprogram cells already in the brain?

They turned their attention to the brains billions of supportive glial cells. Unlike neurons, glial cells divide and replicate. They also are known to survive and activate following a brain injury, remaining at the wound and ultimately forming a scar. This same process had also been observed in the brain following many types of injury, including stroke and neurodegenerative conditions such as Alzheimers disease.

To Chens NIH-supported team, it looked like glial cells might be a perfect target for gene therapies to replace lost neurons. As reported about five years ago, the researchers were on the right track.2

The Chen team showed it was possible to reprogram glial cells in the brain into functional neurons. They succeeded using a genetically engineered retrovirus that delivered a single protein called NeuroD1. Its a neural transcription factor that switches genes on and off in neural cells and helps to determine their cell fate. The newly generated neurons were also capable of integrating into brain circuits to repair damaged tissue.

There was one major hitch: the NeuroD1 retroviral vector only reprogrammed actively dividing glial cells. That suggested their strategy likely couldnt generate the large numbers of new cells needed to repair damaged brain tissue following a stroke.

Fast-forward a couple of years, and improved adeno-associated viral vectors (AAV) have emerged as a major alternative to retroviruses for gene therapy applications. This was exactly the breakthrough that the Chen team needed. The AAVs can reprogram glial cells whether they are dividing or not.

In the new study, Chens team, led by post-doc Yu-Chen Chen, put this new gene therapy system to work, and the results are quite remarkable. In a mouse model of ischemic stroke, the researchers showed the treatment could regenerate about a third of the total lost neurons by preferentially targeting reactive, scar-forming glial cells. The conversion of those reactive glial cells into neurons also protected another third of the neurons from injury.

Studies in brain slices showed that the replacement neurons were fully functional and appeared to have made the needed neural connections in the brain. Importantly, their studies also showed that the NeuroD1 gene therapy led to marked improvements in the functional recovery of the mice after a stroke.

In fact, several tests of their ability to make fine movements with their forelimbs showed about a 60% improvement within 20 to 60 days of receiving the NeuroD1 therapy. Together with study collaborator and NIH grantee Gregory Quirk, University of Puerto Rico, San Juan, they went on to show similar improvements in the ability of rats to recover from stroke-related deficits in memory.

While further study is needed, the findings in rodents offer encouraging evidence that treatments to repair the brain after a stroke or other injury may be on the horizon. In the meantime, the best strategy for limiting the number of neurons lost due to stroke is to recognize the signs and get to a well-equipped hospital or call 911 right away if you or a loved one experience them. Those signs include: sudden numbness or weakness of one side of the body; confusion; difficulty speaking, seeing, or walking; and a sudden, severe headache with unknown causes. Getting treatment for this kind of brain attack within fourhours of the onset of symptoms can make all the difference in recovery.

This research was supported in part by NIA grant AG045656.

References:

[1] Chen Y-C, et al. A NeuroD1 AAV-based gene therapy for functional brain repair after ischemic injury through in vivo astrocyte-to-neuron conversion. Molecular Therapy. 2019. Epub Sept. 6.

[2] Guo Z, et al. In vivo direct reprogramming of reactive glial cells into functional neurons after brain injury and in an Alzheimers disease model. Cell Stem Cell. 2014;14(2):188-202. doi: 10.1016/j.stem.2013.12.001.

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Gene therapy shows promise repairing brain tissue damaged by stroke - National Institute on Aging

Vitro Biopharma 3rd Quarter ended July 31st 2019 Financial Results of Operations – Yahoo Finance

GOLDEN, CO / ACCESSWIRE / September 26, 2019 / Vitro Diagnostics, Inc. (VODG), dba Vitro Biopharma, announced its 3rd quarter ended September 24th 2019 financial results of operations.

Vitro Diagnostics Inc. ("Vitro Biopharma") is pleased to announce a record 3rd quarter in Stem Cell Revenues. Vitro Biopharma recorded 3rd quarter revenues of $225,191 vs $141,783 an increase of 59% over the same comparative quarter last year. Current quarter stem cell revenues increased 60% from the prior comparative quarter, consisting of $175,533 for the 3rd quarter ended July 31st, 2019 vs $109,717 for the third quarter ended July 31st, 2018. In the nine months ended July 31st, 2019, revenues were 78% higher than the comparable period in 2018, $629,986 in 2019 versus $354,854 in 2018.

The company's gross profit margins decreased from 76% in the comparative prior year's quarter to 66% in the current quarter. Current COGS is charged with higher cryogenic shipping costs (affecting 5% of COGS) which the company is acting to reduce by stocking inventory at its partners clinic in the Cayman Islands. Subsequent to the quarter its partner in the Cayman Islands established a cryogenic dewar storage facility to support therapies on demand and substantially reducing shipping costs. In addition the current quarter better represents the growth of all the revenue streams represented by AlloRx, InfiniVive, NutraVivo (STEMulize) and Research and Development products. Nine months ended July 31st 2019 margins held up at 71% versus 74% in the prior comparative 9 month period ended July 31st 2018.

Overall operating expenses increased in the quarter by $93,769 to $194,682 from $100,913 in the prior year's comparative quarter. The increase in expenses primarily reflects the increased costs of sales and marketing $27,919, Laboratory certifications (ISO 9001, ISO 13485, CLIA) accounting, regulatory, business development $30,048 and notes interest expenses $20,392. This represents the company's investment in its executive team and outside consultants to support the company's increased business development activities in the Cayman Islands, Bahamas and it's US and international Cosmetic partnership with Infinivive MD, operated by Jack Zamora, MD. For the 9 months ended July 31st 2019 the company grew revenues by 78% while only growing operating expenses by 16%. These investments also provide for further business development opportunities.

During the quarter the company achieved and pursed the following objectives:

The company moved forward increasing its manufacturing capacity at its current laboratory facility to support expanded operations and pre-positioning for the expanded manufacturing facilities due to go online in mid-fiscal 2020. During the quarter the company expanded its cell culture incubator capacity, cell analysis equipment and automated cryogenic equipment for expanded and automated production of its AlloRx Stem Cells and its stem cell serum product now branded as InfiniVive MD. The manufacturing equipment added in the 3rd quarter costs were $115,868 and was financed with a 5-year finance facility.

The current expansion has increased our capacity to process 15 Billion AlloRx Stem Cells a month. This represents approximately $ 4 Million of capacity per year. Furthermore, the doubling of manufacturing facility at the beginning of the 2020 year will expand our capacity to approximately 100 Billion AlloRx Stem Cells a month or approximately $1.7 Million of revenue capacity per month. This would give Vitro Biopharma a revenue run rate capacity of $20M a year. This will become our new processing capacity which will be initially 10% utilized and provide for future exponential growth.

Our increased capacity is rigorously controlled by our Quality Management System, now certified to the ISO9001 Quality Standard and the ISO13485 Medical Device Standard as well. This provides cGMP-compliant manufacturing of the highest quality stem cells/medical devices for clinical trial testing to provide further evidence of safety and efficacy for treatment for a wide variety of indications. Highly regulated cGMP biologics manufacturing within an FDA-compliant facility provides numerous opportunities to the Company to drive strong revenue growth. We are presently focused on our partnerships in the Caribbean with DVC Stem in Grand Cayman Island, InfiniVive MD in the US and emerging opportunities in the Commonwealth of the Bahamas. Recent destruction of the Bahamas due to hurricane Dorian have deferred our revenue expectations into the latter part of 2020 versus the beginning of 2020. We are actively pursuing other partnership opportunities as well; including pursuing an FDA-based IND ("Investigational New Drug") with an IRB for musculoskeletal conditions utilizing the business & manufacturing infrastructure that supported the Bahamas IRB approval. We are presently developing opportunities for diagnostic support of clinical trials of TBI and Alzheimer's disease based on our CLIA certified clinical laboratory utilizing multiplexed biomarker profiling.

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We have recently reformulated our stem cell activation product, NutraVivo, into a single capsule soft-gel format (STEMulize) that is now undergoing testing prior to commercial release. The company also entered into a memorandum of understanding with New York-based partner Magnus Ventures to develop a Nutraceutical subsidiary for Vitro Biopharma that will focus on nutraceutical therapy of stem cell activation and cellular wellness. The company and its partner are looking to launch the on-line and social media platform for STEMulize in the first half of 2020. The product is currently recommended to our partners' stem cell and cosmetic customers where it is being beta tested for enhancing and supporting cellular wellness in conjunction with the stem cell treatments. The company has scientific data supporting the natural product's capabilities of anti-inflammation, stem cell activation and other cellular effects. The structure of the new company is not finalized but Magnus Ventures is looking to raise between $500,000 to $1,000,000 for the STEMulize subsidiary to support a direct to consumer on-line marketing launch. It is anticipated that Vitro Biopharma will retain over 60% majority control of the new nutraceutical subsidiary.

STEMulize contains natural substances that activate the body's own stem cells to enhance recovery from injury such as TBI, stroke, MS, PD and other autoimmune and neurological diseases. The revised NutraVivo product will be offered as a private label product to InfiniVive clinics and is being implemented as supplemental support to clinical treatments now ongoing in the Cayman Islands. Patients report positive benefits from NutraVivo therapy following stem cell transplants including increased overall energy and improved motor function in MS patients. We are currently testing the new formulation for its commercial release and implementing a name change to STEMulize to reflect its use as a nutraceutical stem cell activator.

The Company's cosmetic stem cell serum private labelled as InfiniVive MD Stem Cell Serum is applied as a topical cosmetic beautification product that is used in conjunction with various skin resurfacing devices. InfiniVive MD continues to expand its base of authorized cosmetic partner clinics and revenues grew 98% in the quarter to approximately $105,000 vs $53,000 in the prior comparative quarter. The cosmetic surgery industry is cyclically slow in the summer months as a result the current quarter cosmetic revenues of $105,000 were lower from the previous second quarter revenues of $130,000. These developments have been in process for the last year and the Joint Development and Supply Agreement dated May 15th 2018 between Vitro Biopharma and Jack Zamora is now producing material results. The agreement requires a minimum level of performance of $1,000,000 annualized by the six-month ended period of June 30th 2020 in order to retain exclusivity in the cosmetic distribution channel.

InfiniVive MD Stem Cell Serum is revolutionizing cosmetic care. The results are delivering reduced down time and an improved beautification experience. The InfiniVive MD product offers many benefits including increased beautification, hydration and improved results compared to alternative cosmetic products. We work with a variety of regulatory consultants to assist us in the appropriate regulatory pathway. The company and its consultants considers InfiniVive MD as a cosmetic beautification product for topical use only.

http://www.jackzamoramd.com http://www.InfiniVivemd.com

Vitro Biopharma's OEM cosmetic topical serum is being distributed by InfiniVive MD into cosmetic clinics that are providing the topical treatment as a beautification product used in conjunction with various skin resurfacing devices. To date the company's product is being offered in 10 cosmetic clinics.

Our clinical trial entitled "Vitro Biopharma Allogeneic MSC Therapy of Musculoskeletal Conditions" was approved by the National Stem Cell Ethics Committee of the Bahama's on February 26, 2019. Subsequent to its 3rd quarter, the executive team of Vitro Biopharma visited Dr. Conville Brown and toured his facilities at the Medical Pavilion of the Bahamas. Subsequent to our trip and plans, hurricane Dorian wiped out the Islands of Abaca and Grand Bahamas but significantly spared Nassau where our partner clinic is located. However the government and hospital facilities are being taxed by devastation to property and the people. The company expects these developments to set back its revenue plans into the later half of 2020.

About the Medical Pavilion of the Bahamas: TMPB operates within a 40,000 square foot building as a partnered care specialty medical facility with 10 different centers in various areas including cardiology, cancer, clinical research and kidney disease. One of the centers is the Partners Stem Cell Centre, where the present trial will be conducted. The Partners Stem Cell Centre provides an environment to conduct stem cell research and clinical trials under the model of ''FDA rigor in a Non-FDA Jurisdiction'' TMPB employs 20 medical specialists in various fields. See http://www.tmp-bahamas.com for additional information.

While our plans in the Bahamas have been set back there is currently no revenue contribution loss, only a delay in expanding our revenue diversification.

During the quarter Vitro Biopharma continued to expand its clinical trial business in the Cayman Islands with its partner http://www.DVCStem.com under the joint IRB covering inflammatory conditions. Treatments to date have covered MS (Multiple Sclerosis), OA(Osteoarthritis), PD (Parkinson's disease) and other inflammatory conditions. DVC Stem specializes in clinical stem cell regenerative medicine utilizing Vitro Biopharma's AlloRx Stem Cells under approval of the Ministry of Health of the Cayman Islands. Subsequent to the quarter, our executive team visited DVC Stem to train personal in stem cell deployment & cryogenics based on their new onsite cryogenic storage facility.

Our overall objectives are to support high quality offshore medical stem cell tourism with clinical trial partners worldwide.

The Company has several patent applications (11) pending in the US and foreign jurisdictions. These patents cover our AlloRx Stem Cell line and various aspects of our NutraVivo stem cell activation products & processes as well as specific diagnostic tests of stem cell activity and therapeutic effectiveness. During the quarter, the Company has responded to office actions and continues to vigorously prosecute & expand its patent filings.

Dr. Jim Musick, CEO of Vitro Biopharma, said, "We are very pleased to report the results of operations through our 3rd fiscal quarter in 2019. We experienced strong revenue growth over the comparative prior year quarter. Our 3rd quarter is typically a cyclical low quarter as the Research products are not in demand during the summer period as well as it is a cyclically low quarter for the cosmetic revenue stream. The company expects with continued increases from all revenue categories that it will be cash flow positive in mid. 2020 and report its first net quarterly profit in the later 2020 timeframe.

We have added several regulatory certifications and outside oversight of our biomanufacturing operations. We are now ISO9001, ISO13485 and CLIA certified and cGMP compliant. Our regulatory certifications allow us to gain offshore IRB approvals, e.g., in the Commonwealth of the Bahamas and other countries since the ISO Standards are internationally recognized. Certification to these rigorous standards are often required to perform manufacturing operations supporting IRB-approved clinical trials, especially in foreign jurisdictions.

Our stem cell products are distinctly superior to stem cell transplants in the USA. The latter usually involve use of impure products lacking validation as stem cells and containing insufficient numbers of stem cells to achieve therapeutic benefits. These are produced without regulatory oversight and have been known to cause serious adverse effects. Hence the use of highly purified and well characterized stem cells (AlloRx Stem Cells) is needed to provide safety and efficacy in regenerative medicine therapies. Results from our clinical studies show safe administration of AlloRx Stem Cells and evidence of efficacy in OA ("Osteoarthritis"), MS ("Multiple Sclerosis") and PD ("Parkinson's Disease")

Our Research and Development team is developing a novel product for clinical applications, called AlloEx Exosomes. Exosomes are secreted from stem cells and may mediate therapeutic benefits without the use of stem cells. The mechanism of stem cell effects on the body is complex, but exosomes offer an important line extension to AlloRx that represents further revenue diversification opportunities for Vitro Biopharma.

In summary, Vitro Biopharma is advancing as a key player in regenerative medicine with 10+ years experience in the development and commercialization of stem cell products for research, recognized by a Best in Practice Technology Innovation Leadership award for Stem Cell Tools and Technology and a growing track record of successful translation to therapies. We continue to leverage our proprietary technology platform to the establishment of international Stem Cell Centers of Excellence and regulatory approvals in the US and worldwide."

Sincerely yours,

James R. Musick, PhD.President, CEO & Chairman of the Boardwww.vitrobiopharma.com

Forward-Looking Statements

Statements herein regarding financial performance have not yet been reported to the SEC nor reviewed by the Company's auditors. Certain statements contained herein and subsequent statements made by and on behalf of the Company, whether oral or written may contain "forward-looking statements". Such forward looking statements are identified by words such as "intends," "anticipates," "believes," "expects" and "hopes" and include, without limitation, statements regarding the Company's plan of business operations, product research and development activities, potential contractual arrangements, receipt of working capital, anticipated revenues and related expenditures. Factors that could cause actual results to differ materially include, among others, acceptability of the Company's products in the market place, general economic conditions, receipt of additional working capital, the overall state of the biotechnology industry and other factors set forth in the Company's filings with the Securities and Exchange Commission. Most of these factors are outside the control of the Company. Investors are cautioned not to put undue reliance on forward-looking statements. Except as otherwise required by applicable securities statutes or regulations, the Company disclaims any intent or obligation to update publicly these forward-looking statements, whether as a result of new information, future events or otherwise.

CONTACT:

Dr. James MusickChief Executive OfficerVitro Biopharma(303) 999-2130 Ext. 1E-mail: jim@vitrobiopharma.com

SOURCE: Vitro Diagnostics, Inc.www.vitrobiopharma.com

Vitro Diagnostics, Inc.3rd Quarter ended July 31st;Income Statement

Stem Cell Therapies and Treatments

Stem Cell Products

Other Services

Total Revenues

COGS

Gross Profit

SGA Expenses

Office Expenses

Consulting,Accounting,Legal and Banking Fees

Laboratory R&D & Quality Control

Total Operating Expenses

Net Operating Profit (Loss)

Non Cash Depreciation and Amortization

Non Cash Stock for Services

Non Cash Interest on Secured Notes Payable

Non Cash Interest on Shareholder Debt

Net Income (Loss)

Vitro Diagnositics Inc.3rd Quarter Ended July 31st;Balance Sheet

ASSETS

Cash

Accounts Receivable

Inventory

Notes Receivable and Prepaids

Current Assets

Fixed Assets

Intangible and other Assets

Total Assets

LIABILITIES

Trade Accounts Payable

Bank Credit Cards

Capital Lease Obligaitons

Current Liabilities

Secured Convertible Notes

Capital Lease Obligations

Shareholder Accrued Comp. Payable

Shareholder Debts Payable

Long Term Liabilities

Total Liabilities

SHAREHOLDERS EQUITY

Common Stock

Paid in Capital

Retained Earnings

Net Income

Total Equity

TOTAL LIABILITIES AND EQUITY

Vitro Diagnostics, Inc.QIII ended July 31st; Statement of Cashflows

Net Loss QIII ended July 31st;

Non Cash Depreciation and Amortization

Decrease in current and other Assets

Increase in Current and other current Liabilities

Net cash used in operations Quarter ended July 31st 2019

Cashflows from Investing Activities during the Quarter

Equipment and Patent Expenditures

Equipmment Financing

Increase in Notes Payable

Non Cash Secured Note Interest

Non Cash Shareholder Note Interest

Net Cash provided by Financing Activities during the Quarter

Net Increase (Decrease) in Cash Quarter ended July 31st 2019

Cash Beginning of the Quarter May 1st 2019

Cash Quarter ended July 31st 2019

Vitro Diagnostics Inc.3rd Quarter ended July 31st 2019Statement of Changes in Shareholders Equity

Balance April 30th 2019

Balance July 31st 2019

The fully diluted Shares outstanding consists of;

Currently issued shares

Excerpt from:
Vitro Biopharma 3rd Quarter ended July 31st 2019 Financial Results of Operations - Yahoo Finance

Science Talk – Celebrating Professor Sir Mel Greaves and his legacy in leukaemia research – The Institute of Cancer Research

I joined a group of leading figures from around the world in leukaemia research recently as they gathered at the Royal Society to celebrate Professor Sir Mel Greavesoutstanding contributions to the field, and his recent knighthood.

Throughout the day, speakers gave talks on some of the giants of leukaemia research Sidney Farber, John Goldmanand Donald Metcalfto name a few.

Each scientist who spoke emphasised Sir Mels impact on the field and told touching personal stories about how he inspired their own scientific careers.

Professor Mel Greaves was knighted in 2018, for his groundbreaking work to understand the hidden natural historyand causes of childhood leukaemia during a 35-year career at The Institute of Cancer Research, London.

Find out more

Dr Elli Papaemmanuil, who is currently at The Memorial Sloan Kettering Cancer Centerin New York, spoke about how fortunate she felt to have crossed paths with Professor Greaves during her time at the ICR. I would not be a scientist if it were not for Mel, she said, with clear enthusiasm for both Mels mentorship and the scientific findings she presented.

Dr Papaemmanuil recalled that on a recent visit to her lab, Mel spent an hour with each of the scientists she supervises, taking the time to work through problems with them and sharing his expertise generously.

Describing her work, she explained the causes of leukaemia, with complex interplay between genetic mutations and chromosomal translocations a change in which large chunks of two chromosomes get swapped over which can cause disease.

She recounted how she emailed Mel one Christmas, excited by her findings and asking for some input, and he politely told her that as it was the holiday season, she should go home and be with her family. This commitment to balancing a scientific career with family was echoed throughout the day, with Mel hailed as a mentor who encouraged a good work-life balance in combination to a devotion to his work.

She finished up by thanking Mel for the phenomenal impact he has had in the field and on individual scientists, and it was clear from the rapturous applause in the room that her words struck a chord with many in attendance.

Running through all of the talks was a thread of scientific dedication from these researchers the word obsession was used by numerous speakers to describe the fervent nature of the devotion these scientists give to the cause of leukaemia.

Why do children get leukaemia? Why does one child of a set of identical twins develop the disease while the other twin an exact genetic copy escape unscathed?

Delving into these questions is what led these international researchers to the top, and their achievements over the last 60 years have been truly remarkable.

Acute lymphocytic leukaemia (ALL) was once 100 per cent lethal, and now has a 90 per cent cure rate. More is understood about the genetics of leukaemia than ever before, and many of the scientists spoke about standing on the shoulders of giants.

Our research into childhood leukaemia has had an enormous impact on the lives of children with cancer all across the world. With your support today, we can make ALL a disease of the past.

Support our appeal

John E Dick, who is based at the Princess Margaret Cancer Centrein Toronto, spoke of a sabbatical he took in Mels lab early on his career, and how working there set him off down a path of scientific questions he had not previously considered.

Thinking about the nature of stem cells he wondered why the fate of some of these cells is to become endlessly proliferating cancer cells, and why some remain healthy.

This led him to discover that while some people have genetic changes which are precursors to leukaemia, they dont go on to develop the disease more changes are necessary to kick off the reactions that cause leukaemia.

He concluded with the strong statement that we cannot divorce stem cell biology from evolution, and thats a legacy Mel has given us all.

Mel began his own talk at the end of the day with a reference to Charles Darwin, who he argued came up with the best idea in science, ever with his theory of evolution by natural selection. Mels enthusiasm for science was palpable by all in the room and is positively infectious.

His lecture, entitled the Li Chong Chan lecture, was named in honour of a former researcher who worked with Mel. Li Chong Chan was a Clinical Fellow and PhD student in Mels laboratory at the ICR (198487).

Mel praised the young PhD students, post-docs, and junior scientists who he emphasised are of equal importance as the prestigious scientists who might have come before them.

He emphasised a point made by many researchers throughout the day: little advancement in science comes from a truly original eureka moment of totally original thought. We are always building on the work of the scientists who came before is.

Professor Greaves then led the audience through some of the highlights of his career, touching on the importance of identical twins in his research and explaining that many cancers arise as a result of a mismatch between modern lifestyles and the way human beings have evolved.

The body has been crafted by the process of evolution to withstand all sorts of stresses, but the modern world presents a unique set of challenges, many of which let cancerous cells flourish and develop into disease.

Throughout September, The Institute of Cancer Research is recognising Childhood Cancer Awareness Month with news stories, videos and blog posts that highlight our latest efforts to improve the lives of children with cancer.

Find out more

One of the most promising avenues of research Professor Greaves feels will make an impact on cancer prevention in future is a set of treatments targeting the microbiome the mix of good bacteria which live in and on the human body, mostly in the gut.

The development of a healthy gut microbiome starts early in life. This microbiome helps protect us against infections, aid in proper digestion, and also helps to prime the immune system, which in turn affects the likelihood of developing leukaemia.

Professor Greaves'excitement about this avenue of research is clear, and hes showing no signs of slowing down his research. Recognising that his ideas are audacious, he said Im an optimist. Unless you couple being audacious with being an optimist, theres no point.

After Mels lecture, the day finished up with some closing remarks from the ICRs Chief Executive Professor Paul Workman, who thanked everyone for attending and summed up the day by saying of Mel, Not only is he a great scientist, hes just a great human being.

Read more:
Science Talk - Celebrating Professor Sir Mel Greaves and his legacy in leukaemia research - The Institute of Cancer Research

Genmab Announces U.S. FDA Approval of DARZALEX (daratumumab) in Combination with Bortezomib, Thalidomide and Dexamethasone for Frontline Multiple…

Company Announcement

Copenhagen, Denmark; September 26, 2019 Genmab A/S (Nasdaq:GMAB) announced today that the U.S. Food and Drug Administration (U.S. FDA) has approved the use of DARZALEX (daratumumab) in combination with bortezomib, thalidomide and dexamethasone (VTd) as treatment for patients newly diagnosed with multiple myeloma who are eligible for autologous stem cell transplant (ASCT). The supplemental Biologics License Application (sBLA) for this indication was submitted by Genmabs licensing partner, Janssen Biotech, Inc. (Janssen) in March 2019. The U.S. FDA subsequently granted priority review to the sBLA, with a Prescription Drug User Fee Act (PDUFA) target date of September 26, 2019. In August 2012, Genmab granted Janssen Biotech, Inc. an exclusive worldwide license to develop, manufacture and commercialize daratumumab.

The approval was based on data from part one of the Phase III CASSIOPEIA study of daratumumab in combination with VTd as treatment for patients newly diagnosed with multiple myeloma who are candidates for ASCT. The study is sponsored by the French Intergroupe Francophone du Myelome (IFM) in collaboration with the Dutch-Belgian Cooperative Trial Group for Hematology Oncology (HOVON) and Janssen.

Todays approval is an important step forward for patients with multiple myeloma. There are now three different treatment combinations that include DARZALEX for patients newly diagnosed with multiple myeloma, whether they are eligible for ASCT or not. We are grateful for the efforts of the IMF, HOVON and Janssen that led to the strong data from the CASSIOPEIA trial, which formed the basis of this new approval, said Jan van de Winkel, Ph.D., Chief Executive Officer of Genmab.

About the CASSIOPEIA (MMY3006) studyThis Phase III study is a randomized, open-label, multicenter study, run by the French Intergroupe Francophone du Myelome (IFM) in collaboration with the Dutch-Belgian Cooperative Trial Group for Hematology Oncology (HOVON) and Janssen, including 1,085 newly diagnosed patients with previously untreated symptomatic multiple myeloma who are eligible for high dose chemotherapy and stem cell transplant. In the first part of the study, patients were randomized to receive induction and consolidation treatment with daratumumab combined with bortezomib, thalidomide (an immunomodulatory agent) and dexamethasone (a corticosteroid) or bortezomib, thalidomide and dexamethasone alone. The primary endpoint is the proportion of patients that achieve a stringent Complete Response (sCR). In the second part of the study (currently ongoing), patients that achieved a response will undergo a second randomization to either receive maintenance treatment of daratumumab 16 mg/kg every 8 weeks for up to 2 years versus no further treatment (observation). The primary endpoint of this part of the study is progression free survival (PFS).

About multiple myelomaMultiple myeloma is an incurable blood cancer that starts in the bone marrow and is characterized by an excess proliferation of plasma cells.1 Multiple myeloma is the third most common blood cancer in the U.S., after leukemia and lymphoma.2 Approximately 26,000 new patients were expected to be diagnosed with multiple myeloma and approximately 13,650 people were expected to die from the disease in the U.S. in 2018.3 Globally, it was estimated that 160,000 people were diagnosed and 106,000 died from the disease in 2018.4 While some patients with multiple myeloma have no symptoms at all, most patients are diagnosed due to symptoms which can include bone problems, low blood counts, calcium elevation, kidney problems or infections.5

About DARZALEX (daratumumab)DARZALEX (daratumumab) intravenous infusion is indicated for the treatment of adult patients in the United States: in combination with bortezomib, thalidomide and dexamethasone as treatment for patients newly diagnosed with multiple myeloma who are eligible for autologous stem cell transplant; in combination with lenalidomide and dexamethasone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant; in combination with bortezomib, melphalan and prednisone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant; in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of patients with multiple myeloma who have received at least one prior therapy; in combination with pomalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least two prior therapies, including lenalidomide and a proteasome inhibitor (PI); and as a monotherapy for the treatment of patients with multiple myeloma who have received at least three prior lines of therapy, including a PI and an immunomodulatory agent, or who are double-refractory to a PI and an immunomodulatory agent.6 DARZALEX is the first monoclonal antibody (mAb) to receive U.S. Food and Drug Administration (U.S. FDA) approval to treat multiple myeloma. DARZALEX is indicated in Europe in combination with bortezomib, melphalan and prednisone for the treatment of adult patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant; for use in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of adult patients with multiple myeloma who have received at least one prior therapy; and as monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma, whose prior therapy included a PI and an immunomodulatory agent and who have demonstrated disease progression on the last therapy. The option to split the first infusion of DARZALEX over two consecutive days has been approved in both Europe and the U.S. In Japan, DARZALEX is approved in combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of adults with relapsed or refractory multiple myeloma and in combination with bortezomib, melphalan and prednisone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant. DARZALEX is the first human CD38 monoclonal antibody to reach the market in the United Stated, Europe and Japan. For more information, visit http://www.DARZALEX.com.

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Daratumumab is a human IgG1k monoclonal antibody (mAb) that binds with high affinity to the CD38 molecule, which is highly expressed on the surface of multiple myeloma cells. Daratumumab triggers a persons own immune system to attack the cancer cells, resulting in rapid tumor cell death through multiple immune-mediated mechanisms of action and through immunomodulatory effects, in addition to direct tumor cell death, via apoptosis (programmed cell death).6,7,8,9,10

Daratumumab is being developed by Janssen Biotech, Inc. under an exclusive worldwide license to develop, manufacture and commercialize daratumumab from Genmab. A comprehensive clinical development program for daratumumab is ongoing, including multiple Phase III studies in smoldering, relapsed and refractory and frontline multiple myeloma settings. Additional studies are ongoing or planned to assess the potential of daratumumab in other malignant and pre-malignant diseases in which CD38 is expressed, such as amyloidosis, NKT-cell lymphoma and B-cell and T-cell ALL. Daratumumab has received two Breakthrough Therapy Designations from the U.S. FDA for certain indications of multiple myeloma, including as a monotherapy for heavily pretreated multiple myeloma and in combination with certain other therapies for second-line treatment of multiple myeloma.

About Genmab Genmab is a publicly traded, international biotechnology company specializing in the creation and development of differentiated antibody therapeutics for the treatment of cancer. Founded in 1999, the company has two approved antibodies, DARZALEX (daratumumab) for the treatment of certain multiple myeloma indications, and Arzerra (ofatumumab) for the treatment of certain chronic lymphocytic leukemia indications. Daratumumab is in clinical development for additional multiple myeloma indications, other blood cancers and amyloidosis. A subcutaneous formulation of ofatumumab is in development for relapsing multiple sclerosis. Genmab also has a broad clinical and pre-clinical product pipeline. Genmab's technology base consists of validated and proprietary next generation antibody technologies - the DuoBody platform for generation of bispecific antibodies, the HexaBody platform, which creates effector function enhanced antibodies, the HexElect platform, which combines two co-dependently acting HexaBody molecules to introduce selectivity while maximizing therapeutic potency and the DuoHexaBody platform, which enhances the potential potency of bispecific antibodies through hexamerization. The company intends to leverage these technologies to create opportunities for full or co-ownership of future products. Genmab has alliances with top tier pharmaceutical and biotechnology companies. Genmab is headquartered in Copenhagen, Denmark with core sites in Utrecht, the Netherlands and Princeton, New Jersey, U.S.

Contact: Marisol Peron, Corporate Vice President, Communications & Investor Relations T: +1 609 524 0065; E: mmp@genmab.com

For Investor Relations: Andrew Carlsen, Senior Director, Investor RelationsT: +45 3377 9558; E: acn@genmab.com

This Company Announcement contains forward looking statements. The words believe, expect, anticipate, intend and plan and similar expressions identify forward looking statements. Actual results or performance may differ materially from any future results or performance expressed or implied by such statements. The important factors that could cause our actual results or performance to differ materially include, among others, risks associated with pre-clinical and clinical development of products, uncertainties related to the outcome and conduct of clinical trials including unforeseen safety issues, uncertainties related to product manufacturing, the lack of market acceptance of our products, our inability to manage growth, the competitive environment in relation to our business area and markets, our inability to attract and retain suitably qualified personnel, the unenforceability or lack of protection of our patents and proprietary rights, our relationships with affiliated entities, changes and developments in technology which may render our products or technologies obsolete, and other factors. For a further discussion of these risks, please refer to the risk management sections in Genmabs most recent financial reports, which are available on http://www.genmab.com and the risk factors included in Genmabs final prospectus for our U.S. public offering and listing and other filings with the U.S. Securities and Exchange Commission (SEC), which are available at http://www.sec.gov. Genmab does not undertake any obligation to update or revise forward looking statements in this Company Announcement nor to confirm such statements to reflect subsequent events or circumstances after the date made or in relation to actual results, unless required by law.

Genmab A/S and/or its subsidiaries own the following trademarks: Genmab; the Y-shaped Genmab logo; Genmab in combination with the Y-shaped Genmab logo; HuMax; DuoBody; DuoBody in combination with the DuoBody logo; HexaBody; HexaBody in combination with the HexaBody logo; DuoHexaBody; HexElect; and UniBody. Arzerra is a trademark of Novartis AG or its affiliates. DARZALEX is a trademark of Janssen Pharmaceutica NV.

1 American Cancer Society. "Multiple Myeloma Overview." Available at http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-what-is-multiple-myeloma.Accessed June 2016.2 National Cancer Institute. "A Snapshot of Myeloma." Available at http://www.cancer.gov/research/progress/snapshots/myeloma. Accessed June 2016. 3 Globocan 2018. United States of America Fact Sheet. Available at http://gco.iarc.fr/today/data/factsheets/840-united-states-of-america-fact-sheets.pdf.4 Globocan 2018. World Fact Sheet. Available at http://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf. Accessed December 2018.5 American Cancer Society. "How is Multiple Myeloma Diagnosed?" http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-diagnosis. Accessed June 2016.6 DARZALEX Prescribing information, July 2019. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/761036s019lbl.pdf Last accessed July 20197 De Weers, M et al. Daratumumab, a Novel Therapeutic Human CD38 Monoclonal Antibody, Induces Killing of Multiple Myeloma and Other Hematological Tumors. The Journal of Immunology. 2011; 186: 1840-1848.8 Overdijk, MB, et al. Antibody-mediated phagocytosis contributes to the anti-tumor activity of the therapeutic antibody daratumumab in lymphoma and multiple myeloma. MAbs. 2015; 7: 311-21.9 Krejcik, MD et al. Daratumumab Depletes CD38+ Immune-regulatory Cells, Promotes T-cell Expansion, and Skews T-cell Repertoire in Multiple Myeloma. Blood. 2016; 128: 384-94.10 Jansen, JH et al. Daratumumab, a human CD38 antibody induces apoptosis of myeloma tumor cells via Fc receptor-mediated crosslinking.Blood. 2012; 120(21): abstract 2974.

Company Announcement no. 46CVR no. 2102 3884LEI Code 529900MTJPDPE4MHJ122

Genmab A/SKalvebod Brygge 431560 Copenhagen VDenmark

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Genmab Announces U.S. FDA Approval of DARZALEX (daratumumab) in Combination with Bortezomib, Thalidomide and Dexamethasone for Frontline Multiple...