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A combined diagnostic and targeted gene therapy platform for brain tumor relapse

Periodic Reporting for period 1 - Soxradicate Relapse (A combined diagnostic and targeted gene therapy platform for brain tumor relapse)

Periodo di rendicontazione: 2022-09-01 al 2024-02-29

Tumor relapse is often fatal and leads to death of malignant cancer types, including aggressive brain tumors in both adults and children. Improving prognosis and to identify increased risk of recurrence in patients diagnosed with a malignant brain tumor is lacking. The treating physician/oncologist cannot always inform to a patient if or when his/her tumor can or will recur. We have developed a combined diagnostic and therapeutic kit to help doctors and brain cancer patients with this information.

Overall objectives are to develop and commercialize a diagnostic tool (LCC Diagnostics) and a gene therapy (LCC Therapeutics) to target latent (slow-dividing) cancer cells (LCCs). We will focus on malignant brain cancer in where a therapy-resistant relapse promoted by LCCs that we previously showed often escape standard therapy is likely leading to death of the patient.

Expected results includes improving and certifying the relevance and efficacy of the LCC Diagnostics, as well as defining regulatory needs and preclinical testing, safety and efficacy of LCC Therapeutics to prepare for future clinical trials. A detailed and improved business plan will also be developed during this project.
The diagnostic kit (LCC Diagnostics) has been tested in a broader set of brain tumor patients. Patient specific categories with tumor-specific entities that would benefit from diagnosis have been identified. In detail, both pediatric and adult brain tumor cells have been identified that are specifically vulnerable to our therapeutic invention for LCC Therapeutics. Preliminary data from using LCC Diagnostics show that our target is upregulated after standard treatment (standard irradiation or standard cytostatic drugs for both pediatric and adult brain tumors). Cell culture experiments has identified detailed ratios and more precise magnitudes of increased levels from our reporters (in the LCC Diagnostics kit). An estimation of the increased risk for brain tumor relapse has been clarified from using the diagnostic kit in careful experimental settings. We have started to set up standard routines and defined criteria for the collection of patient samples from operation.

The therapeutic kit (LCC Therapeutics) has been developed with different promoters. Proof of concept studies have been performed to evaluate the pros and cons of various promoters. A minimal promoter has been selected to drive herpes simplex virus HSV-TK expression in LCC Therapeutics. This promoter is optimal to use for selective killing of cancer cells as expected. LCC Therapeutics has been tested for efficacy in vitro and in animals in vivo. In mice it was found to have great efficacy in both pediatric and adult brain tumor cells after infecting cells with the gene therapy. Following 10 days of ganciclovir treatment that turn on LCC Therapeutics (that acts like a Trojan Horse) will significantly eradicate SOX9-positive tumor cells. Here, tumor growth is suppressed (inducing cell death of tumor cells) and mice consequently survive significantly longer. We further tested 20 days of ganciclovir treatment, experienced even better survival differences and still found no side effects (no weigh loss or apparent sickness) from treatment. The scientific discoveries were summarized in a manuscript that will be submitted for publication before the summer of 2024.

An international patent application was submitted in August 2021 and was published in March 2022, before this project started. Patenting applications for national approval were initiated in late 2022, which was fully supported by this ERC PoC project. Here, we have according to our project proposal consulted a European patent attorney in Stockholm, Sweden, and during 2023 we sent in revised national patent applications to EPO, USPTO, Canada and as well a PCT National Phase entry in Australia and Canada.

A business model has been written together with a business advisor, with a first target product profile (TPP) attachment for the invention with details on intended use, target populations (relapsing malignant brain tumors with a focus on relapsed glioblastoma patients) including safety and efficacy-related characteristics of our gene therapy. Estimated costs future clinical trials have been proposed after meetings with companies (SMEs) experienced with similar gene therapy projects. We have had meetings with manufacturing companies that can perform GMP-production of our gene therapy LCC Therapeutics. Estimated costs for the full manufacturing to first clinical trials has been clarified. A rough but pragmatic estimate of further investments needed has been made and included in our business plan.

Finally, we ordered and tested a number of AAV serotypes that can facilitate LCC Therapeutics delivery in the brain. Therefore, high grade viral titers of the most promising AAVs were cloned and ordered. Before the project was completed, an AAV2 version of LCC Therapeutics was tested in vitro. It was found to work well and could specifically eradicate latent brain tumor cells. We presented the data to a local investor coupled to our university. The investor company was convinced by our results and has now supported this project where AAV2 LCC Therapeutics will now be tested in vivo and a regulatory strategy for the therapy towards future clinical trials for glioblastoma patients will now be initiated.

In summary, the ERC PoC project has been carried out as expected.
Access to market and finance is underway. An investor has been approached and has co-financed the proof of concept of the project with approx. 100,000 Euro during 2024. Several applications to further raise money to the project has been submitted or is ongoing. A business advisor has worked with the project but a novel potential CEO will be contacted that can help promote our project further.

Further demonstration of efficacy of the AAV LCC Therapeutics is ongoing and has shown great efficacy after tumor injection and infection using AAV2 viruses targeting therapy-resistant LCCs. We will next test the efficacy of cells injected into immunocompetent mice. This is to understand how the animals tolerate LCC Therapeutics in a working immunocompetent environment (similarly found in patients).

We have finally identified a regulatory advisor that can guide us with a strategy to pursue a future clinical trial of LCC Therapeutics (see image attached) for this project.
Proposed simplified clinical trial for LCC Therapeutics for use in relapsed GBM patients
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