Cantargia: Clinical stage antibody-based cancer therapy
Cantargia's focus is on antibody-based cancer treatments that attacks cancer cells as well as targeting tumour inflammation. The company was founded in 2009 around research from Lund University. Cantargia's lead drug, CAN04, is in clinical development.
The importance of the role of inflammation in cancer is becoming increasingly recognised by researchers. Cantargia has a focus is on the interleukin-1 system and the molecule IL1RAP. IL1RAP is found on a number of different cancer including leukaemia, lung cancer and pancreatic cancer, and is involved in both tumour growth and inflammation. The company is developing antibodies with a dual mechanism of action that activate the immune system and block the signals that lead to tumour growth.
Moving through the clinic
Cantargia's lead antibody, CAN04 (nidanilimab), blocks signals from the target molecule IL1RAP, limiting tumour growth, and stimulates the immune system's natural killer cells to attack cells that overexpress IL1RAP. This is known as antibody-dependent cell-mediated cytotoxicity (ADCC). CAN04 may also be able to counteract metastasis by modulating myeloid cells in the tumour microenvironment, according to results showing reduced lung metastases in an in vivo model of triple-negative breast cancer.
Preclinical trials of CAN04 in mouse cancer models have shown signs of efficacy as a monotherapy and in combination with cancer chemotherapy. The strongest effect was with cisplatin, with a significantly improved therapeutic effect and a CAN04-related reduction of cisplatin side effects.
"We believe that treatment with our lead molecule, CAN04, has the potential to play an important role in immuno-oncology," said Göran Forsberg, CEO.
CAN04 is in a clinical trial in non-small cell lung cancer (NSCLC) and pancreatic cancer. The phase I/IIa study, known as CANFOUR, began with an evaluation of the safety and tolerability of CAN04 at escalating dose levels in five clinics in Belgium, the Netherlands, Denmark and Norway. This is ongoing, and the drug is generally well tolerated. A maximum tolerated dose and recommended phase IIa dose are expected by the end of 2018.
The second part, which aims to get an initial indication of anti-tumour activity, will involve more patients at around 20 centres in six or seven countries. This is expected to begin before the end of 2018, and will involve both monotherapy and combination therapy. Patients with NSCLC may receive cisplatin/gemcitabine in addition to CAN04, and patients with pancreatic cancer could also be dosed with the combination gemcitabine/nab-paclitaxel. Recruitment should be complete during 2019, and results expected in early 2020. CAN04 may also have potential in breast cancer, various forms of leukaemia, liver cancer, oesophageal cancer and head and neck cancer.
CAN04 is manufactured in a cell line licensed from BioWa, in an industrial manufacturing process developed by Glycotope Biotechnology (now Celonic). The antibody has patent coverage in Europe, the US and China.
”China is one of the most rapidly growing markets for pharmaceuticals. The granted patent further strengthens our position as well as the market potential for CAN04,” said Forsberg.
The next steps for the company
Cantargia's technology also has potential for applications in autoimmune disease. The company is developing a second antibody against IL1RAP, CANxx, for the treatment of autoimmune and inflammatory diseases, and aims to select a product candidate during 2019.
"In our biological platform, it is a small step from cancer to autoimmune disease. We are also aware that expanding the areas we focus on also reduces risk for us and for our investors," said Forsberg.
Cantargia has seven full-time people, along with a handful of consultants. The team has extensive experience from development of novel compounds in both biotech as well as big pharma environment.
"We started with a virtual model, as the company began as a university spinout, and the founders wanted to remain as University scientists rather than a company employees. To allow this we outsourced the research to their labs, as well as to specialists, and retained a core team. We see this as an effective and long-term business model; we do plan to expand, but only by a few more people. We have gone from a discovery in university environment to a public clinical stage company in just seven to eight years."
As part of this model, once CAN04 has reached phase 2a, Cantargia will seek a partner.
"We are flexible – there are a number of attractive business models from a co-development agreement to a trade sale of the company. The partner will then finance CAN04, while Cantargia can further advance the other program."