Faron to advance bexmarilimab into a registrational Phase 2/3 study in treatment-naïve (frontline) HR-MDS after positive meeting with the FDA

TURKU, FINLAND – Faron Pharmaceuticals Ltd. (AIM: FARN, First North: FARON), a clinical-stage biopharmaceutical company focused on tackling cancers through novel immunotherapies, today announces it has received positive and valuable feedback from the U.S. Food and Drug Administration (FDA) regarding the proposed clinical development plan leading to approval for bexmarilimab, its wholly-owned, novel precision cancer immunotherapy.

The feedback was received as part of the Company’s recent BEXMAB study’s end-of-phase 2 (EOP2) meeting with the FDA. The FDA advised Faron to focus on frontline development since possible frontline approval enables use across the entire HR MDS indication.

The meeting was requested to gain alignment on the design of a planned registrational phase 2/3 trial evaluating bexmarilimab in combination with azacitidine for patients with treatment-naïve (frontline) higher-risk myelodysplastic syndrome (HR-MDS). Key objectives included obtaining the FDA’s input on the proposed trial design, dosing strategy and clinical endpoints intended to support regulatory approval.

Following the FDA’s guidance, the trial will begin with a dose optimisation run-in period comparing 1 mg/kg and 3 mg/kg regimens with placebo, all in combination with azacitidine. Once the optimal dose has been determined, the trial will seamlessly transition into the registrational stage, which includes an interim analysis to support accelerated approval based on IWG 2023 response criteria in frontline patients.

“We are extremely encouraged by the collaborative and highly productive dialogue with the FDA, which provided a clear and actionable path for the clinical development of bexmarilimab in frontline HR-MDS, an area of profound unmet medical need,” said Dr. Juho Jalkanen, Chief Executive Officer of Faron. “The agency’s guidance has endorsed a direct route towards accelerated approval using Complete Response (CR) + CR equivalent (CReq) per International Working Group (IWG) 2023 criteria as a co-primary endpoint with Overall Survival (OS). This is a significant step forward in our mission to provide a potentially transformative new treatment option to patients and represents a major regulatory de-risking milestone, as we are now only one study away from getting bexmarilimab approved for the benefit of HR MDS patients.”

The FDA confirmed IWG 2023-defined CR + CReq as an acceptable primary endpoint to support an application for accelerated approval in frontline patients. In line with this guidance, Faron will include CR + CReq as a co-primary efficacy endpoint along with Overall Survival (OS) in the phase 2/3 trial. The Company will seek accelerated approval based on an interim readout on the CR + CReq data in frontline patients. Composite complete remission (cCR) will be evaluated as the key secondary endpoint. In addition to the clinical discussion, the FDA was satisfied with Faron’s approach to non-clinical and CMC activities for phase 2/3 and subsequent steps to approval.

“Improving outcomes of patients with HR-MDS continues to be a top priority for our field. Bexmarilimab is an antibody with a novel mechanism of action that has demonstrated promising safety and activity in combination with azacitidine in phase 1/2 clinical trials in the first- and second-line settings for HR-MDS,” added Dr. Amer Zeidan, MBBS, MHS, Professor of Medicine at Yale School of Medicine and Chief of the Division of Hematologic Malignancies at Yale Cancer Center and Smilow Cancer Hospital.

“I am thrilled that we have agreed with the regulators on a pathway to explore the full potential of bexmarilimab in the frontline setting for patients with HR-MDS. I also would like to highlight the FDA accepting the use of CR+CReq IWG 2023 criteria as part of the primary endpoint, making this the first registrational clinical trial to do so. Many experts, including myself, strongly believe the IWG 2023 criteria to be more patient centric and reflect clinically meaningful benefits to patients in a more robust fashion than the old IWG 2006 criteria, which have been used for all past (and failed) phase 3 clinical trials for HR-MDS,” concluded Dr. Zeidan.

Disclosure: Dr Amer Zeidan has consulted and received honoraria from Faron. The views expressed as his personal views and not necessarily those of his employer.