Mirna Therapeutics Brings First MicroRNA Replacement Therapy into Clinic

It has been a long wait, but 5 years following the initiation of anti-miR122 development for the treatment of HCV infection by Santaris, a second microRNA Therapeutics has now entered clinical development.  MRX34 by Mirna Therapeutics is a miR-34a replacement therapy for the treatment of liver cancer or cancers with liver involvement.  

MicroRNA replacement therapy is technically very similar to RNAi Therapeutics.  It involves adding to cells naturally occurring microRNAs to orchestrate typically a range of processes deemed to be therapeutic.  It is added to cells in the form of double-stranded RNA triggers very much alike RNAi triggers and can therefore largely utilize the same types of delivery approaches.  The delivery technology for MRX34 is the NOV340 SMARTICLE technology owned by Marina Biotech.  This liposomal delivery technology is distinct from SNALP, most notably by employing ionizable ‘amphoteric’ lipids, lipids that can take on both positive and negative charge depending on pH, and not ionizable cationic lipids, lipids that merely become positively charged at acidic pH, as in the case of SNALPs. 

An extensive literature supports miR-34a as an exciting microRNA for replacement therapy in cancer rivaling the most famous let-7.  Accordingly, miR-34 emerged as Mirna Therapeutics’ top priority based on extensive screening conducted at Ambion (now Life Technologies) from which Mirna Therapeutics was spun out.  Under transcriptional control by the guardian of the genome, p53, its pleiotropic effects range from cell cycle inhibition, to counter-acting anti-apoptotic mechanisms and to sensitizing towards chemotherapy.  The choice of liver-related cancers was thus not based on cancer biology (many cancers cancers would apply), but largely a function of where the company thinks NOV340 can deliver to.

This to me raises again the question of whether liver cancer is closer to normal liver or whether it is closer to solid tumors in general in terms of delivery.  MRX34 thus follows Alnylam’s reasonings as manifested by ALN-VSP02, but goes against what is known about blood supply differences between normal liver and liver cancer and what is practiced by the likes of Tekmira and Dicerna.

The phase I study will be a typical dose-escalation study seeking to determine the maximally tolerated dose.  Given the importance of delivery, close attention should be paid to the pharmacokinetic and biodistribution data from this trial.  These should start to become available in the first half of 2014.

The development is positive for at least two other companies.  As the provider of the delivery technology, Marina Biotech obviously stands to gain financially and otherwise from such clinical milestones.  Whether it will be sufficient to pay off its debts that have come due and consequently avert bankruptcy is an open question.  Due to the financial distress, Marina Biotech struggled to enter into deals giving it fair compensation for its technology.

Although the most direct competitor to Mirna Therapeutics, InteRNA as the other major microRNA replacement company in oncology should also benefit from the initiation of the phase I study as it helps to validate its approach.  The question will be whether among its stable of microRNA replacement candidates, there are some with as robust activities as miR-34a.   

BMS Partners with Santaris

In other recent news related to microRNA Therapeutics, Big Pharma Bristol-Myers Squibb partnered with LNA antisense company Santaris under which the Danish company collected $10M upfront.  Although the press release did not specify much the aims of the the alliance, referring to RNA Therapeutics broadly, a few factors speak in favor of microRNAs being involved.  

Most notably, BMS had terminated an phosphorothioate RNaseH antisense collaboration with ISIS Pharmaceuticals.  As Santaris in turn had terminated their PCSK9 phosphorothioate RNaseH antisense program as well, most likely due to kidney toxicity (--> phosphorothioate chemistry as also in Prosensa; van Poelgeest et al. 2013), the first suspicion that BMS sought out Santaris as a more potent PCSK9 alternative becomes less compelling.  Moreover, ISIS Pharmaceuticals is suing Santaris over US patent infringement of RNaseH technology which should hinder the ability of Santaris to enter into relationships with US companies for RNaseH antisense purposes.  Of course, the deal could also indicate that a settlement is in the making...

Gradalis Swiftly Moves ddRNAi-Enhanced Cancer Vaccine Candidate through Clinic

I’ve been reminded a number of times by the staunch Benitec-supporters here that Texas-based biotech company Gradalis has been moving a ddRNAi-enhanced cancer vaccine candidate (‘FANG’) aggressively through clinical development. Virtually out of nowhere, Gradalis initiated clinical trials two years ago and there are now two active phase II trials, one in ovarian cancer and one for advanced melanoma. A peer-reviewed publication on the phase I trial was also just published (Senzer et al.) arguably making FANG the lead RNAi candidate in oncology.

The phase I study involved over 40 patients with advanced solid tumors and demonstrated the safety and logistic feasibility of the approach. Although evidence of suggestive of efficacy was presented such as a clear correlation between an immune response and survival, it would be premature to conclude anything with regard to efficacy. Having now followed a number of cancer vaccines, most of which have eventually failed, it seems to me that correlations such as this could be just as well as a reflection of the fact that those with more responsive immune systems will do better anyway.

‘FANG’ comprises of plasmid DNA from which a single RNA polymerase II promoter drives the expression of an upstream GM-CSF open-reading-frame followed by a pair of downstream RNAi hairpins. This plasmid is introduced by electroporation in a petri dish into the patients’ own cancer cells which have been obtained from a tumor resection. After allowing some time for the expression of the transgenes, the cells are irradiated so as to kill off their proliferative potential and are then re-introduced like many other vaccines by intradermal injection.

The GM-CSF component, wildly popular in the cancer vaccine field and also part of Dendreon’s famous prostate cancer vaccine PROVENGE, is supposed to serve as an attractant, proliferation and maturation factor for dendritic cells which are supposed to ingest, present and thereby stimulate an immune response against the antigens unique to a tumor; the pair of ‘bifunctional’ hairpins meanwhile both target furin which is thought to be an important protease for the maturation of the various isoforms of TGF-beta, a well-known immunosuppressant often overexpressed in cancer.

‘Bifunctional’ here means that one hairpin is perfectly matched and therefore mostly relies on the so-called Ago2/cleavage-dependent mode of RISC activation, whereas the other hairpin contains a central bulge due to mismatching changes introduced in the passenger strand arm of the hairpin thus relying on the non-cleavage pathway of RISC activation which can be facilitated by all four human Argonautes (both predicted to yield the identical guide strand). This strategy of distributing the RNAi between the various Argonaute proteins is certainly an interesting idea, but I’m not sure whether even Gradalis knows what consequences of this is both in terms of efficacy and safety.

A general lack of detailed molecular mechanistic studies is probably my biggest concern with this candidate and when thinking about Gradalis in general. It also at least partly explains why FANG has been moving so rapidly through the clinic. I find it particularly troubling that I have seen no detailed studies by Gradalis looking at the relationship between furin knockdown and TGFbeta inhibition which is key for Gradalis' strategy. This already has caused difficulties in interpreting some of the phase I data where possible assay problems complicated reconciling apparently only modest reductions in furin with much more pronounced down-regulations of TGFbeta. This not only makes it more difficult to make the right development decisions, but also when it comes to finding a partner for the program. On the other hand, you could argue that a cancer vaccine candidate involving both GM-CSF expression and TGFbeta inhibition already has a good chance at succeeding, and sweating out the technical details would only cause delays without making us much the wiser.

As I had mentioned, the Benitec supporters are following Gradalis’ development with much interest as such an advanced ddRNAi candidate may be a prime licensing opportunity for Benitec which controls an important part of the ddRNAi patent landscape. I’ve certainly looked at the hairpin structures involved in light of Benitec’s patent claims (esp. the ‘099 Graham patents) and there is a good chance that Gradalis ought to take a license as it further monetizes this candidate, although their structures may give them a bit of wiggle room.

Mirna Therapeutics selects Marina Biotech’s SMARTICLE delivery tech

In another notable development last week, cancer microRNA Therapeutics company Mirna Therapeutics said that it would use Marina Bio’s SMARTICLE liposomal delivery technology for the development of microRNA replacement therapy for cancer. Based on conference presentations, the two companies had been collaborating on the delivery of microRNA mimics before announcing the deal. An attraction of the SMARTICLE delivery technology, which Marina had acquired from Novosom, is certainly the fact that there is already clinical experience after SMARTICLE-enabled ‘DNAi’ compound by ProNAi has begun dosing a year ago. Similar to related agreements between Mirna and Silence, and InteRNA and Silence, insightful details about the financials were not disclosed. For Marina, which have diluted shareholders by what seems like a 100-fold over the last 3 years (unreal, really), it is good news as its extensive technology offering is finally getting takers.

Silence Therapeutics Finds another Cancer MicroRNA Therapeutics Partner

It’s actually very simple, and apparently it is small biotechnology companies that are first to realize and act on it: Develop a technology that can deliver small silencing RNAs to a given cell/tissue type, and only our exploding insights into the genetics of disease set the limit for the number of potential indications. This benefits both the delivery company that can re-coup some of their investments through licensing out its technology for a few of the many possible targets, and also the licensee which does not need to exhaust and risk its capital to develop its own delivery technology, but can focus on their targets and pick something already fairly de-risked off the shelf for what should be reasonable financial terms at this juncture.

This must have been the reason why Mirna Therapeutics, after apparently having given up on neutral lipid emulsion technology it had developed with BIOO Scientific (LANCEr), has now chosen to partner with Silence to evaluate that company’s endothelial cell-directed AtuPLEX delivery system, which has already shown some promising results in the clinic (see ASCO 2011 presentation), and Silence’s more novel DBTC delivery system for hepatic nucleic acid delivery, for use with its MicroRNA Therapeutic payloads (most likely mimics) to treat cancer. This follows similar deals last month with Dutch cancer MicroRNA Therapeutics company InteRNA, and a collaboration with a mysterious ‘Top Ten Pharma’ (most likely Takeda) concerning the AtuPLEX-related DACC delivery system for lung endothelial cell-directed siRNA delivery.

Whether all these deals will pay off for Silence and their partners now depend on their progress in the lab. It is likely that the work with Mirna Therapeutics will involve miR-34 which is a well validated tumor suppressor microRNA, and has also been implicated in angiogenesis, making it an interesting microRNA mimic to be evaluated with Silence’s lipid-based delivery systems.

As I’m writing this, Arrowhead just announced that it has acquired Roche’s RNAi assets…deal activity in RNAi Therapeutics is clearly heating up again!