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Revolution sees a new pan-KRAS challenger

Pfizer moves to take PF-07934040 into its first clinical trial.

Revolution Medicines, which until now has had a relatively unopposed path in pan-KRAS inhibition, will soon face a formidable competitor: Pfizer’s challenger, PF-07934040, is to enter its first-in-human study next month, according to a just revealed listing on the clinicaltrials.gov registry.Pfizer is also moving fast with a tetravalent LTβR agonistic antibody, PF-07329640, which it only unveiled at a February R&D event, but which is already in phase 1. Here, however, there is virtually no industry competition, according to OncologyPipeline, whereas pan-KRAS inhibition could soon see Lilly and BeiGene join Pfizer in challenging Revolution.Revolution has moved fast with its multi-KRAS inhibitor, RMC-6236, backed by its nearly $2bn cash balance. However, while the company has mooted the start this year of two phase 3 trials with this project, specifically in lung and pancreatic cancers, neither has yet begun.Pfizer appears to be taking a broad approach to initial testing of PF-07934040, whose phase 1 trial will include a range of cancers with almost any KRAS mutation. The only restriction is G12C-mutant NSCLC that’s already been treated, most likely with either of the two marketed drugs – Amgen’s Lumakras or Bristol Myers Squibb’s Krazati.Last year Lilly and BeiGene unveiled preclinical pan-KRAS assets that they expect to take into the clinic in 2024. Boehringer Ingelheim has been active here too, currently with the “KRAS-multi” project BI 3706674, after discontinuing earlier work on pan-KRAS:SOS1 inhibition. Recently disclosed first-in-human studies*ProjectMechanismCompanyTrialScheduled startBY101921PARP7 inhibitorChengdu Baiyu PharmaceuticalSolid tumours11 Mar 2024ISM8207QPCTL inhibitorInsilico/ FosunVarious25 Apr 2024PF-07329640Anti-LTβR tetravalent MAbPfizerSolid tumours, +/- Avastin or sasanlimab9 May 2024PF-07934040Pan-KRAS inhibitorPfizerKRAS-mutated cancers**28 Jul 2024OPN-6602CBP/p300 inhibitorOpna Bio4L+ multiple myelomaJun 2024SHR-4849UndisclosedJiangsu HengRuiSolid tumoursJul 2024VET3-TGIOncolytic virusKaliVir ImmunotherapeuticsStealth-001, solid tumours, +/- Keytruda1 Aug 2024Notes: *projects newly listed on the clinicaltrials.gov database between 30 May and 7 Jun 2024; **excludes previously treated NSCLC patients with KRAS G12C. Other recently disclosed first-in-human trial initiations include that of KaliVir’s oncolytic virus VET3-TGI. This modality is in focus since the flotation of CG Oncology and promising data presented last week by Replimune, and KaliVir claims that VET3-TGI is differentiated by additionally encoding IL-12 and a TGF-β inhibitor.The private Swiss biotech Opna Bio is taking OPN-6602, a dual inhibitor of p300 and CBP, into the clinic in multiple myeloma. This becomes its third clinical asset, after the CSF1R/TRK inhibitor OPN-7486 and the BET inhibitor OPN-2853, for which Opna is now seeking development and commercialisation partners.Meanwhile, Chengdu Baiyu’s PARP7 inhibitor BY101921 and Insilico/Fosun’s QPCTL inhibitor ISM8207 have just appeared on clinicaltrials.gov, though they have been listed on Chinese clinical study registries, and in the OncologyPipeline database, since January and March respectively.Such mechanisms show a variety of novel approaches being taken into the clinic, and among these Pfizer’s PF-07329640 should be of interest. This molecule was highlighted at Pfizer’s oncology innovation day in February as a possible combo partner for checkpoint blockade, and its mechanism involves binding to and having an agonistic effect on LTβR, the lymphotoxin β receptor.The idea is that activating LTβR induces the formation of tertiary lymphoid structures, which have been reported to enhance response to anti-PD-1 therapy. The only other related project is M300, which conditionally agonises LTβR by co-engaging FAP, and is in preclinical development at the private UK biotech Mestag Therapeutics.
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