VG161: Addressing high unmet need in HCC & ICC

VG161

VG161, Virogin’s pioneering oncolytic virus built on the company’s proprietary SynerlyticTM Platform, is an attenuated herpes simplex virus type 1 (HSV-1) armed with multiple payloads of IL12 & IL15/IL15Ra and a unique PD-L1 blocking peptide. The neurovirulence of wild-type HSV-1 is mitigated by the deletion of ICP 34.5 gene. These payloads can synergistically stimulate both innate and adaptive anti-tumor immunity in the tumor microenvironment. VG161 has been confirmed to be safe and effective in many tumor xenograft mouse models and in GLP toxicity studies preclinically.

VG161 is being investigated as image guided, intratumoral injections (IT) in multiple Phase I & II clinical trials in US, Australia & China. Currently, there are 10 ongoing clinical trials (mono & combination therapy) across multiple geographies, with 2 of them conducted in Developed Markets.

VG161 has successfully completed a Phase I clinical trial in Australia and has entered a Phase 2 trial in the US. Our Phase 2 trial evaluates VG161 both as a mono and combination therapy at Mayo Clinic, with a focus on target indications Hepatocellular Carcinoma (HCC) & Intrahepatic Cholangiocarcinoma (ICC).

Modality & Product Snapshot

Oncolytic Virus (First-generation attenuated HSV-1)
Oncolysis, immune cell activation

Target Indications

HCC

(Hepatocellular Carcinoma)

ICC

(Intrahepatic cholangiocarcinoma)

Regulatory Designations

Fast Track Designation

HCC

Orphan Drug Designation

ICC

Focus on Hepatocellular Carcinoma

Disease Overview

  • HCC accounts for 75% to 90% of all primary liver cancers and the incidence of liver cancers is rising globally (~800,000 / 661,000 new cases of liver cancer / HCC are diagnosed annually worldwide)
  • With over 700,000 estimated annual deaths, liver cancer is the 4th major cancer in terms of all mortality
  • ~70-80% relapse/refractory to current drugs (low ORR/OS/PFS after 2nd line)

Unmet Need

  • Difficult to treat with poor prognosis & very low survival rates ( 5-year survival rates at 21%)
  • According to SEER statistics, the 5-year survival rates for patients who have distant disease after second-line therapies was only 3.5%. This very low survival rates highlight very big unmet medical need in HCC
  • IO has a particularly poor outcome in patients with liver cancer

Treatment Landscape

  • While Immunotherapy has progressed well in earlier line settings, opportunities exist for improvement as efficacy from IO has reached a saturation in 1L setting
  • Despite CPI is cornerstone in frontline & second line settings, unmet need exists in post 1L/2L CPI (lack of data / treatment options)

Our Approach & Differentiation

Our oncolytic HSV-1 VG161 not only does direct tumor directed killing (oncolysis) & but also activates innate & adaptive immune systems to boost the anti-tumor response. Hence, we believe IT (Intratumoral administration) of oncolytic virus has the potential to improve IO effectiveness & overcome resistance in earlier line settings.

Clinical Proof of Concept

  • VG161 has demonstrated monotherapy activity as confirmed responses per RECISTv1.1 in advanced solid tumors (HCC, ICC) and prolonged PFS (various solid tumors such as sarcoma) in IO refractory tumors

  • Partial responses & reductions in tumor burden after VG161 monotherapy in injected & non-injected tumors in HCC
  • VG161 was administered in numerous patients with NO reported DLTs or significant safety issue demonstrating a very good safety profile and for the OV and for the IT route of administration

  • VG161 program validated the IL12, IL15 cytokine profile and de-risked the next generation platform
Regulatory
Validation

In the response letter for Fast Track Designation for VG161, the FDA determined that VG161’s effect of PFS and OS in patients with advanced HCC (who progressed following or were intolerant to 1L & 2L available therapies) met the agency’s criteria for fast-track designation

Looking Forward

Based on the single-agent antitumor activity demonstrated in hepatocellular carcinoma (HCC) in the latest line settings and the FDA’s Fast Track Designation, we believe that VG161 is well-positioned to address the high unmet medical need in HCC. As part of our Phase 2 plan in the US, we aim to recruit and dose a monotherapy safety run-in cohort for HCC and ICC at the Mayo Clinic before the year’s end. Additionally, we plan to initiate recruitment for the combination cohort of VG161 plus Nivolumab early next year.

Combo/Mono

Region

Protocol

Indications

Registration Number

PHASE

IND Approval

Phase I

Phase II

Australia

VG161-A101

Solid Tumors

US

VG161-A201

HCC & ICC

VG161-C101

Solid Tumors

Monotherapy

VG161-C102

Primary Liver Cancers

China

VG161-C201

ICC

VG161-C206

Sarcoma

US

VG161-A201

(VG161+ Nivolumab)

HCC & ICC

Combo

China

VG161-A202

(VG161+ Nivolumab)

Metastatic Gastric Cancer

China

VG161-A203

(VG161+Camrelizumab)

HCC