# PureTech Health pipeline of new medicines poised for tremendous growth

- Link: https://www.directorstalkinterviews.com/puretech-health-pipeline-of-new-medicines-poised-for-tremendous-growth/4121136640
- Published: 2023-12-20T07:40:48+00:00
- Author: Amilia Stone

**PureTech Health plc** (Nasdaq: PRTC, LON:PRTC), a clinical-stage biotherapeutics
company dedicated to changing the lives of patients with devastating diseases, has
reported on the key progress made across its Wholly Owned Programs^(2) and Founded
Entities^(3) in 2023, announces two new Founded Entities and provides an update 
on cash and operational runway guidance.

**Key Highlights:**

·    Strong progress in 2023 included the successful LYT-300 clinical trial of acute
anxiety in healthy adults and initial data from ongoing clinical trials of LYT-200
in solid tumors and acute myeloid leukemia, along with Royalty Pharma deal of up
to $500M, as well as clinical and regulatory advances across multiple Wholly Owned
Programs and Founded Entities.

·    PureTech continues to build and will further expand its Wholly Owned Pipeline
focus in pulmonary and rare diseases. Certain Glyph^(TM) intellectual property will
remain at PureTech. Key catalysts expected in 2024 include results from idiopathic
pulmonary fibrosis (IPF) late-stage trial of LYT-100 in Q4 2024.

·    New clinical-stage neuroscience Founded Entity: Seaport Therapeutics will advance
certain central nervous system (CNS) programs and relevant Glyph intellectual property.
Rapid growth of neuroscience pipeline, powered by Glyph platform, including new 
therapeutic candidate announced today (LYT-320), and initiations of two clinical
trials in 2024 (LYT-300 and LYT-310).

·    New clinical-stage oncology Founded Entity: Gallop Oncology to advance LYT-
200 and other galectin-9 intellectual property; additional results from clinical
trials in leukemia and solid tumors expected in 2024.

·    Robust balance sheet position with estimated Consolidated Cash, Cash Equivalents
and Short-Term Investments at year end of approximately $320 million^(1), extends
operational runway guidance into 2027 based on the Company’s strategic operating
plan.

·    The PureTech Board may declare special dividends and/or share buybacks as part
of an overall returns strategy.

> **Daphne Zohar, Founder and Chief Executive Officer of PureTech, commented**: “
> PureTech has had a particularly productive year. One of the advantages of the 
> hub-and-spoke model we pioneered is that it has enabled us to build an exciting
> pipeline of new medicines poised for tremendous growth, without diluting our shareholders
> in almost seven years. Our Founded Entities are a significant source of value 
> to us, and we have generated over $800 million in non-dilutive proceeds to advance
> our pipeline and growth since 2020.
> “A good example of how our successful model has funded our pipeline and operations
> is our strategic deal with Royalty Pharma acquiring an interest in our royalty
> in KarXT for up to $500 million, which provided us with upfront non-dilutive capital
> and significant upside based on Karuna’s future regulatory and commercial successes.
> “I’m also proud of our track record which includes 80 percent^(4) success across
> clinical trials, with a probability of clinical success that is six times better
> than the industry average^(5).
> “Advancing programs to a key value inflection point before determining the most
> expedient and cost-effective path forward is a hallmark of our hub-and-spoke business
> model, and we’ve seen the success of it realized in the U.S. FDA clearance of 
> two medicines, a third that has recently filed for approval, and several additional
> therapeutic candidates being advanced through late-stage clinical trials. This
> model allows us to create and advance new medicines in a capital efficient manner.
> Importantly, the strategic decision announced today to advance certain programs
> through two new Founded Entities will make it easier for the true value of these
> programs to be recognized and, as they continue to advance, deliver the greatest
> value back to our shareholders.
> “We are extremely proud of the numerous accomplishments made by our team in 2023
> and look forward to a productive and exciting 2024, where we expect to deliver
> multiple milestones to improve the lives of patients and drive benefit to our 
> shareholders.”

Additional highlights and progress include the following:

**Outlook for 2024****, new Founded Entities and execution of corporate strategy**

o  Building on the success of early studies for LYT-100, and with the important 
upcoming catalyst for IPF in 2024, PureTech will continue to build on its internal
expertise in pulmonary and rare diseases and expanding its portfolio in those therapeutic
areas. Certain Glyph intellectual property will remain at PureTech.

o  PureTech is reinforcing the proven success of its model by adding two new “spokes”
to the PureTech “hub.” PureTech will be advancing its programs in two important 
therapeutic areas (neuroscience and oncology respectively) in two new clinical-stage
Founded Entities, Seaport Therapeutics and Gallop Oncology.

o  The launch of Seaport Therapeutics will accelerate the development of new neuroscience
medicines in areas of high unmet need with the addition of capital partners to bring
nearer-term patient benefit. It also builds on the success PureTech has achieved
in the neuroscience arena with the same strategy and team at PureTech that invented
KarXT. If approved, KarXT will be the third therapeutic candidate to be taken from
inception at PureTech to FDA regulatory approval and will represent the first new
mechanism of action for patients with schizophrenia in over 50 years.

o  The launch of Gallop Oncology builds on the promising clinical and preclinical
data from PureTech’s LYT-200 program in solid tumors and hematological malignancies.
The development of a novel oncology medicine requires a dedicated effort that is
best enabled through a separate Founded Entity and external capital.

**Wholly Owned Programs**

o  **LYT-100 (deupirfenidone)** is currently in development for the treatment of
IPF, which is a rare, progressive, and fatal disease. While existing standard-of-
care treatments are effective, they cause significant side effects, and as a result,
three out of four people living with IPF in the U.S. forego treatment. LYT-100, 
which has shown 50 percent reduction of the GI and overall adverse events compared
to pirfenidone in a head-to-head study, has the potential to both supplant the current
standard-of-care treatments and to serve a larger population of patients who are
unable to tolerate current therapies.

o  Progressed a Phase 2b dose-ranging trial of LYT-100 in patients with IPF. Topline
results are expected in Q4 2024. PureTech plans to pursue a streamlined development
program for LYT-100 in IPF and is using the same validated endpoints that have supported
past approvals. PureTech believes the results of the ongoing trial, together with
an additional registration study in Phase 3, could serve as the basis for registration
in the U.S. and other geographies.

o  Presented expanded data at the CHEST Annual Meeting 2023 from a completed trial
of LYT-100 in healthy older adults, which informed the two doses selected for the
ongoing Phase 2b trial (ELEVATE IPF). In addition to supporting the improved tolerability
of LYT-100 versus the FDA-approved dose of pirfenidone, the new data presented supported
the selection of a higher dose of LYT-100 with the potential for improved efficacy
that is now being evaluated in ELEVATE IPF.

**Newly Announced Founded Entities:**

o  **Seaport Therapeutics:**

o  **LYT-300 (oral Glyph-allopregnanolone)** is an oral prodrug of allopregnanolone,
enabled by the Glyph platform, that is currently in development for the treatment
of both neuropsychiatric and rare CNS conditions. Allopregnanolone has demonstrated
benefit in a range of CNS conditions, but it can only be administered via IV, which
has hindered its broad therapeutic use. Using the Glyph platform, LYT-300 retains
the activity and potency of endogenous allopregnanolone in an oral form.

§ Successful topline results from a Phase 2a proof-of-concept trial of LYT-300 using
a validated clinical model of anxiety in healthy volunteers were reported recently.
Oral administration of LYT-300 achieved the trial’s primary endpoint of a statistically
significant reduction versus placebo in the increase from baseline to peak levels
of the stress hormone salivary cortisol (p=0.0001) with a treatment effect size 
versus placebo of 0.72, measured by the Cohen’s D.

§ LYT-300 is advancing into a Phase 2 clinical trial for the treatment of Fragile
X-associated Tremor/ Ataxia Syndrome (FXTAS), which is a rare neurological disease.
A Phase 2 trial is expected to initiate in 2024. PureTech was chosen to receive 
up to $11.4 million from the U.S. Department of Defense through a highly competitive
grant process to advance LYT-300 in FXTAS.

o  **LYT-310 (oral Glyph-cannabidiol [CBD]),** is currently in development for the
treatment of epilepsies and other neurological indications. A different CBD-based
product purified from plant sources, has received regulatory approval in the U.S.
and Europe to treat seizures resulting from certain rare conditions, but it requires
a large volume of a sesame oil-based formulation, which limits its use in broader
indications and age groups.

§ **New today:** Preclinical data demonstrated LYT-310 was effective in preventing
seizures in the Maximal Electroshock Model (MES), a validated and highly translatable
preclinical model considered a gold standard for the assessment of anti-seizure 
drugs. LYT-310 was tested against various formulations of CBD, including an oral
CBD formulation in sesame oil. LYT-310 showed strong anti-seizure protection activity
and was shown to be more effective at preventing seizures at a dose three times 
lower than an oral CBD formulation. Based on the data, LYT-310 has the potential
to expand the use of CBD to broader patient populations, particularly in populations
and conditions where higher doses are required to achieve a therapeutic effect.

§ Initiation of a Phase 1 clinical trial of LYT-310 is expected in the first half
of 2024.

o  **New today: LYT-320 (oral Glyph-agomelatine),** was nominated as a new therapeutic
candidate powered by PureTech’s Glyph platform. A novel prodrug of agomelatine, 
LYT-320 is in development for the treatment of anxiety and mood disorders. Anxiety
disorders affect nearly 30 percent of U.S. adults^(6) and are an area of significant
unmet need.

§ LYT-320 uses the Glyph platform to bypass first-pass metabolism by the liver and
thus has the potential to reduce liver exposure, hepatotoxicity, and the need for
liver function monitoring.

§ Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine
reuptake inhibitors (SNRIs) are first-line treatments for generalized anxiety disorder(
GAD) and depressive disorders but have side effects and efficacy limitations. A 
major limitation of SSRIs and SNRIs are adverse events such as sexual dysfunction
and emotional blunting.

§ Agomelatine acts through a completely different mechanism of action and offers
superior overall tolerability for patients compared to standard-of-care. The drug
has demonstrated clear human efficacy in multiple studies of GAD where the gold-
standard Hamilton Anxiety Rating Scale (HAM-A) was used as the primary endpoint.
Agomelatine is approved for major depressive disorder (MDD) in the European Union
and for MDD and GAD in Australia. Agomelatine has not been approved in the U.S.,
offering LYT-320 first-in-class potential for the U.S. market and best-in-class 
potential in the rest of the world. However, agomelatine is associated with hepatoxicity
necessitating extensive liver function monitoring that has held back its use. Agomelatine
has very low oral bioavailability (approximately one percent) due to extensive hepatic
first-pass metabolism, potentially contributing to hepatoxicity.

§ In multiple _in vivo_ studies, LYT-320 showed oral bioavailability and plasma 
exposures greater than 10-fold higher than orally dosed agomelatine. Exposures comparable
to approved therapeutic agomelatine doses could thus be enabled by LYT-320 comprising
a reduced dose of agomelatine, which _in silico_ modeling using the FDA-licensed
DILIsym platform, has projected will greatly reduce the risk of causing clinically
significant liver enzyme elevations.

§ Initiation of first-in-human enabling studies is expected in 2024 and LYT-320 
is expected to advance into clinical studies in the first half of 2025.

o  **Gallop Oncology:**

o  **LYT-200 (anti-galectin-9 mAb)** is in development for the treatment of metastatic/
locally advanced solid tumors, including head and neck and urothelial cancers, and
hematological malignancies, such as acute myeloid leukemia (AML) and high-risk myelodysplastic
syndromes (MDS). A wide variety of preclinical data support the potential clinical
efficacy of LYT-200 and the importance of galectin-9 as a target and suggests a 
potential opportunity for biomarker development.

§ Presented data from the ongoing Phase 1 clinical trial of LYT-200 at the ESMO 
Immuno-Oncology Congress 2023. In the initial results, LYT-200 demonstrated a favorable
safety profile in all cohorts, including the monotherapy and combination arms with
BeiGene’s tislelizumab, and showed disease control and suggestions of initial anti-
tumor activity. In the combination arm, 11 patients have been dosed, and all evaluable
patients treated so far include four patients with head and neck cancers and two
patients with urothelial cancer. In the evaluable patients with head and neck cancers,
disease control was observed in three of the four patients, with one patient experiencing
a complete response after nine months, one patient with a deepening partial response
after eight months, and one patient with disease stabilization at four months so
far, with treatment in these patients remains ongoing. The two evaluable patients
with urothelial cancer experienced disease stabilization for seven months and three
months, so far, and both remain on treatment. The combination arm continues to enroll
patients with head and neck and urothelial cancers. Completion of the trial and 
results are expected by the end of 2024.

o  **New today:** In the ongoing Phase 1b trial evaluating LYT-200 as a single agent
in relapsed/refractory AML and MDS patients, three dose escalation cohorts have 
completed to date at weekly doses of 2 mg/kg (cohort 1), 4 mg/kg (cohort 2) and 
7.5 mg/kg (cohort 3). In a heavily pre-treated patient population, the early data
demonstrates a favorable safety and tolerability profile of LYT-200 with no dose
limiting toxicities. In the first cohort, disease stabilization was observed in 
two of the five patients treated, with one patient achieving red blood cell transfusion
independence. In the second cohort, disease stabilization was observed in two of
the four patients treated. In the third cohort, disease stabilization was observed
in all four of the patients treated, with a reduction in bone marrow blasts observed
in two of the four patients and the clearance of peripheral blasts observed in one
patient. Two patients achieved more than 50 percent bone marrow blast reduction,
with one of these patients observing an increase in platelet count without transfusions.
The fourth cohort, evaluating a weekly regimen of LYT-200 at the 12 mg/kg dose, 
is still ongoing. The part 2 portion of the Phase 1b trial evaluating LYT-200 in
combination with venetoclax and hypomethylating agents is also ongoing. PureTech
plans to present additional data from the trial in a scientific forum in 2024.

**Founded Entities:**

o  **Karuna Therapeutics (Nasdaq: KRTX) (Karuna)**

o  Announced the U.S. Food and Drug Administration has accepted its New Drug Application(
NDA) for KarXT (xanomeline-trospium) for the treatment of schizophrenia in adults.
The application has been granted a Prescription Drug User Fee Act (PDUFA) date of
September 26, 2024.

o  Announced positive results from its Phase 1b open-label, eight-week inpatient
trial evaluating the effect of KarXT on 24-hour ambulatory blood pressure in adults
with schizophrenia demonstrating that KarXT was not associated with increases in
blood pressure.

o  The transaction of Karuna shares as described in this paragraph constitutes a
class 2 transaction for the purposes of the UK Financial Conduct Authority’s Listing
Rules. Since October 12, 2023, PureTech has raised aggregate proceeds of approximately
$31.9 million, net of transaction fees, through the sale of shares of Karuna in 
on-market transactions and the completion of call options (collectively, the “Transaction”).
PureTech also notes that it may, but is not committing to, undertake sales of Karuna
shares to generate additional proceeds consistent with prior transactions at its
discretion. The proceeds of the Transaction are held by PureTech as Cash and Cash
Equivalents, and PureTech intends to use the proceeds from the Transaction to further
the advancement and growth of the Company. Following the Transaction, PureTech holds
892,852 shares of Karuna common stock, which is equal to approximately 2.4 percent
of Karuna’s outstanding shares as of October 31, 2023, with a market value of approximately
$195.6 million as of December 19, 2023. Any future changes in our holdings will 
be reflected through standard updates of our corporate presentation and our other
reporting. PureTech is also eligible to receive up to $400 million in potential 
future milestone payments from its deal with Royalty Pharma and retains the right
to certain royalty payments based on the sales of KarXT, as well as 20 percent sublicense
income covered by PureTech’s license agreement with Karuna.

o  **Vedanta**

o  Dosed the first patient in the Phase 2 COLLECTiVE202 clinical study of VE202 
for the treatment of ulcerative colitis. The FDA also granted Fast Track designation
to VE202.

o  Expects to initiate the Phase 3 RestoratiVE303 pivotal study of VE303, designed
for the prevention of recurrent _Clostridioides difficile_ infection, in the coming
months.

o  **Vor (Nasdaq: VOR)**

o  Presented updated clinical data from patients treated in VBP101, its Phase 1/
2a multicenter, open-label, first-in-[human study](https://www.directorstalkinterviews.com/company/open-orphan-plc/orph.l)
of trem-cel (VOR33) in patients with acute myeloid leukemia (AML) at the ASTCT/EBMT
6^(th) International Conference on Relapse After Transplant and Cellular Therapy(
HSCT²). The additional data demonstrated successful engraftment of trem-cel in all
seven patients treated to date with trem-cel. All three patients treated with Mylotarg
experienced hematologic protection and CD33-negative donor cell enrichment with 
multiple cycles.

o  **Entrega**

o  Advanced its platform for the oral administration of biologics, vaccines and 
other drugs that are otherwise not efficiently absorbed when taken orally. Entrega’s
technology platform uses a proprietary, customizable hydrogel dosage form to control
local fluid microenvironments in the GI tract to both enhance absorption and reduce
the variability of drug exposure. Peptide therapeutics (e.g., the emerging GLP-1
agonist class) are ideally suited to benefit from Entrega’s approach.

o  Demonstrated increased oral peptide bioavailability of two- to three-fold over
standard permeation enhancer formulations.

o  **Akili, Inc. (Nasdaq: AKLI) (Akili)**

o  Announced it received authorization from the U.S. FDA to expand the label for
EndeavorRx^(Ⓡ7) from 8 to 12 year-old patients with primarily inattentive or combined-
type attention-deficit/hyperactivity disorder (ADHD) who have a demonstrated attention
issue to include older children aged 13-17. This increased age range is expected
to more than double the number of pediatric patients with ADHD who are now eligible
for EndeavorRx.

o  Announced its strategic plan to transition from a prescription to a non-prescription
business model. Akili also submitted a 510(k) application to the FDA for EndeavorOTC
^(8) as an over-the-counter treatment for adults with ADHD.

o  Announced it plans to submit data to the FDA to convert its pediatric prescription
product, EndeavorRx, to OTC in 2024.

o  Announced topline results of the STARS-ADHD-Adult clinical trial evaluating the
efficacy and safety of EndeavorRx (AKL-T01) in adults with ADHD. The results demonstrated
attention improved in more than 80 percent of adults with ADHD, and over one-third
of participants no longer exhibited an attention deficit following treatment. Improvements
in attention were nearly seven times larger than those seen in the pivotal trial
that supported EndeavorRx’s FDA authorization for 8 to 12 year-olds with ADHD. Additionally,
nearly half of adults treated with EndeavorRx met a prespecified threshold for clinically
meaningful improvement in their quality of life. EndeavorRx treatment was well-tolerated,
with minimal side effects and no serious device-related adverse events reported.

o  **Sonde Health**

o  Continued to scale its sales and revenue growth through partnerships with several
top health companies, providers, pharma and device original equipment manufacturers.
Sonde’s voice-based artificial intelligence platform has now generated over 1.2 
million voice samples from more than 85,000 individuals on four continents.

As part of PureTech Health’s distinctive approach to drug development, which includes
efficient de-risking and deprioritizing of programs that don’t reach pre-specific
thresholds for advancement, the Company is no longer advancing its Alivio™ platform,
including therapeutic candidates LYT-500 and LYT-510, to pivot resources towards
the programs with the highest probability of success. Additionally, PureTech announced
in October that it would not be moving forward with the previously contemplated 
plan of merger with Gelesis.

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