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Scandion Oncology
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== Scandion Oncology: The cancer resistance company == === Two shots on goal for SCO-101 === Scandion Oncology’s clinical development strategy for SCO-101 revolves around two clinical studies: CORIST (NCT04247256) and PANTAX (NCT04652206) (Exhibit 1). Of these, the Phase II CORIST trial is the most advanced and aims to demonstrate proof-of-concept for SOC-101 in patients with mCRC in combination with FOLFIRI (folinic acid + fluorouracil + irinotecan). Colorectal cancer represents the third leading cause of cancer-related deaths in the United States. Colorectal cancer has an estimated incidence rate of 0.0039% in the United States. In 2020 915,880 people worldwide died from the disease and it is expected that a further 52,580 people in the United States will die from the disease in 2022. At diagnosis, c 20% of patients will have mCRC and five-year survival of patients with mCRC is only 20%, representing a clear unmet medical need. '''Exhibit 1: SCO-101 development strategy'''<ref>Source: Scandion Oncology interim report Q122.</ref> [[File:Image3-f037ec1ee2495554a573c0cdde896311.png|600px]] The market for CRC treatment is estimated to reach $8.7bn by 2028 (EvaluatePharma) and, since Avastin (bevacizumab, Roche) went off-patent in 2019, has become more fragmented (see Exhibit 2). This market represents an attractive opportunity for SCO-101, in Edison Investment Research's view, as Edison believes Scandion could potentially establish market share for its product candidates more easily compared to indications that are dominated by one or two therapies. Additionally, many treatments for CRC (including mCRC) are already off-patent, for example irinotecan and 5-fluorouracil (the active ingredients of FOLFIRI). Edison Investment Research believes this will motivate Scandion to pursue premium pricing for SCO-101 as it would generally be used in combination with relatively inexpensive drugs. '''Exhibit 2: Estimated CRC market to 2028'''<ref name=":0">Source: EvaluatePharma, Edison Investment Research.</ref> [[File:Image4-6ff227f569067ae2b29573f4aa4f3314.png|600px]] '''Exhibit 3: Estimated PC market to 2028<ref name=":0" />''' [[File:Image5-ca177f6ef17ee0c8dfa1ecbf0e399de9.png|600px]] The second trial, PANTAX, is a Phase Ib study investigating the safety and tolerability of SCO-101 in patients with unresectable or metastatic PC as an add-on to treatment with nab-paclitaxel and gemcitabine. PC accounts for only 3% of all cancers but 7% of cancer-related deaths, due to the disease’s invasive and often incurable nature. Accordingly, the five-year survival rate for patients with PC is only 11%, dropping to 3% for patients who are diagnosed after the disease has metastasised. The PC treatment market is estimated to reach $5.3bn by 2028 (source: EvaluatePharma). However, Merck’s Keytruda (pembrolizumab) is expected to dominate the market in this period (consensus worldwide sales in 2028 of $2.7bn). Edison Investment Research notes that, as in CRC, many standard PC treatments are off-patent (eg nab-paclitaxel) and if SCO-101 can restore clinical response to these (eg nab-paclitaxel), Edison Investment Research sees an sizable opportunity for Scandion Oncology in this market. === Partnership deal will be key for development === The company awaits an important proof-of-concept readout from part 2 of the Phase II CORIST clinical trial in mCRC, which is expected in mid-2022. Success in CORIST will be key in establishing proof-of-concept and advancing it to subsequent trials. Edison Investment Research notes that CORIST is an open-label study and Edison Investment Research believes potential global big pharma partners will prefer randomised data before considering in-licensing, meaning further clinical studies will likely be necessary, in its view, to maximise the value of SCO-101. Assuming positive data from CORIST part 2, Edison Investment Research anticipates management will raise additional capital to fund randomised trial (likely Phase II) thus building the data package needed to engage global big pharma partners. ==== IP position encouraging ==== Around 20 years ago, SCO-101 (then known as endovion) was a clinical compound under investigation for the treatment of sickle cell anaemia and was owned by Danish biotechnology company NeuroSearch. The drug was discontinued after Phase I trials. Subsequently, Scandion Oncology was formed in 2017 after initial investigations indicated the compound as a potential add-on therapy to overcome cancer resistance. Scandion now possesses a large intellectual property estate on SCO-101, which it is continuously expanding. Importantly, the company has market protection for the treatment of cancers with SCO-101 in combination with other anti-cancer agents until 2037 in Europe (EP3458052B and EP3622953B) and 2038 in the US (US11,103,481). Edison Investment Research sees this as a positive position for Scandion as it will (assuming the potential launch of SCO-101 in CRC in 2026) allow for over 10 years of market protection in Europe and the United States.
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