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01/04/11 9:23 AM

#111863 RE: DewDiligence #111858

Santaris joins several others with recent RNAi news.

The companies I follow in the field of RNAi therapeutics were pummeled in the latter half of 2010. Negative pipeline and partnership news from Tekmira and Alnylam was perhaps the largest contributor to the sector downturn.

Count me as skeptical of the Santaris claims regarding drug delivery, the sine qua non of RNAi therapeutics.

The unique combination of small size and very high affinity allows this new class of drugs candidates to potently and specifically inhibit RNA targets in many different tissues without the need for complex delivery vehicles. The most important features of LNA-based drugs include excellent specificity providing optimal targeting; increased affinity to targets providing improved potency; and favorable pharmacokinetic and tissue-penetrating properties that allow systemic delivery of these drugs without complex and potentially troublesome delivery vehicles.

However, the other arguable leader in RNAi delivery, Tekmira has a lot of work to prove its technology as well.

In somewhat related news, ISIS also reported today initiation of phase 2 studies involving a drug that I think is based on antisense:
Isis Pharmaceuticals, Inc. announced the initiation of two Phase 2 studies of ISIS-EIF4ERx in patients with non-small cell lung cancer and prostate cancer.

Finally, this news from Alnylam today is worth posting here:
http://finance.yahoo.com/news/Alnylam-Demonstrates-RNAi-in-bw-625516518.html?x=0&.v=1

To me, the science and the results look strong as evidence of successfully demonstrating delivery of potentially therapeutic drug to an organ (liver).

Press Release Source: Alnylam Pharmaceuticals, Inc. On Tuesday January 4, 2011, 7:30 am EST
CAMBRIDGE, Mass.--(BUSINESS WIRE)-- Alnylam Pharmaceuticals, Inc. (Nasdaq:ALNY - News), a leading RNAi therapeutics company,
today presented new clinical data from its ALN-VSP Phase I liver cancer trial in a presentation at the Dana-Farber Cancer Institute in Boston.
Results from molecular analysis of human biopsy samples showed achievement of pharmacologically relevant siRNA drug levels in tissues. In
addition, using a highly precise polymerase chain reaction (PCR)-based technique known as 5’- rapid ampli?cation of cDNA ends (5’-RACE),
analysis of human tissue samples showed proof of RNAi-mediated target mRNA cleavage, and thus RNAi in man with the systemically
delivered RNAi therapeutic. These results provide signi?cant human proof of concept for Alnylam’s efforts in advancing RNAi therapeutics to
patients.
“These data provide conclusive evidence that RNAi can be harnessed in man and, as such, represent a notable and important milestone in the
advancement of RNAi therapeutics as a potential new class of medicines,” said Phillip Sharp, Ph.D., Institute Professor, The Koch Institute for
Integrative Cancer Research, MIT, and Chairman of Alnylam Scienti?c Advisory Board and Alnylam Director. “I applaud Alnylam scientists,
clinicians, and their collaborators for reaching this important achievement and I look forward to the results of their continued efforts.”
Post-treatment tumor biopsies from eight patients were analyzed for ALN-VSP drug levels. All biopsy samples were obtained on a voluntary
basis using a CT-guided procedure. Five of these biopsy samples were obtained from tumor in the liver and three were taken from tumor
located outside the liver in patients receiving doses of ALN-VSP ranging from 0.4 to 1.25 mg/kg. The two siRNAs targeting VEGF and KSP
that comprise ALN-VSP were detected in almost all of these biopsy samples at concentrations ranging from 0.3 to 142 ng/g tissue. These levels
of siRNA are pharmacologically relevant since in pre-clinical studies with systemically delivered siRNAs, a tissue level of 1 ng/g has been
shown to be associated with 50% target gene silencing (Landesman et al., Silence, 1:16, 2010).
RNAi is an endogenous cellular enzymatic process whereby siRNAs mediate sequence-dependent cleavage of target mRNAs; cleavage of the
target mRNA is highly precise, occurring exactly 10 nucleotide positions from the 5’-end of the siRNA antisense strand. In order to establish
RNAi-mediated effects in vivo, 5’RACE has been established as a robust method for detecting the speci?c cleavage products of siRNA
pharmacology in pre-clinical animal models (Soutschek et al., Nature, 432: 173-8, 2004; Zimmermann et al., Nature, 441: 111-4, 2006). As a
PCR-based technique, 5’RACE is not a quantitative measurement; a positive result simply con?rms that there is evidence of RNAi-mediated
target mRNA cleavage.
As currently analyzed, three patients had biopsies that were of suf?cient quality to permit blinded 5’ RACE analysis for the VEGF target
mRNA following the ?rst dose of ALN-VSP; additional analyses are ongoing. All three biopsy samples were from the 0.4 mg/kg dose group,
and post-treatment biopsy samples were comprised of 80% to 100% normal liver. In two patients whose post-treatment biopsies were
performed two days after dosing, the 5’ RACE assay combined with deep sequencing showed that approximately 27% and 29% of all
VEGF-derived mRNA fragments corresponded exactly to the predicted RNAi-mediated cleavage product based on the VEGF siRNA sequence.
By contrast, a pre-dose biopsy available for one of those patients contained only approximately 1% predicted VEGF cleavage product, and
analysis of banked normal liver and tumor samples from untreated patients showed a background level of only 0.1% to 0.7%. Compared to
these low background levels, the amount of predicted VEGF cleavage product in the two post-treatment biopsies was highly statistically
signi?cant (p<0.0001). In the third patient at 0.4 mg/kg whose post-treatment biopsy was obtained 7 days post-dose, there was no detectable
increase in the predicted VEGF cleavage product compared to the pre-dose biopsy. These positive 5’ RACE data from human biopsies provide
clear evidence for RNAi in man following systemic administration of lipid nanoparticle (LNP)-formulated siRNA.
“Achievement of these results is very important for Alnylam’s overall RNAi therapeutics efforts, and has many implications. First, we have
been able to quantify signi?cant human tissue levels of siRNAs at concentrations that exceed our 1 ng/g target level that is associated with
effective target gene silencing in pre-clinical animal models. More importantly, we have demonstrated proof of RNAi mechanism in man with
LNP delivery of siRNAs, an important milestone in overall human translation of RNAi therapeutics,” said John Maraganore, Ph.D., Chief
Executive Of?cer of Alnylam. “As this systemic delivery platform is employed in our pipeline of clinical and development-stage programs, we
believe that we have now made a major leap forward in advancing RNAi therapeutics to patients.”
About ALN-VSP Clinical Program
ALN-VSP is Alnylam’s ?rst systemic RNAi program and represents the company’s ?rst clinical program in oncology. ALN-VSP is a
systemically delivered RNAi therapeutic comprising two siRNAs designed to target two genes critical for the growth and survival of cancer
cells....