Noxopharm (ASX:NOX) and the rising interest in radiopharmaceuticals and nuclear medicine


by Rachael Jones

Noxopharm Limited (ASX:NOX) Managing Director and CEO, Dr Graham Kelly and Associate Professor Louise Emmett, Clinical Director of Theranostics and Nuclear Medicine at St Vincent's Hospital, Sydney talk about the growing interest in radiopharmaceuticals.

Rachael Jones: Hello I’m Rachael Jones for the Finance News Network. Joining me today from Noxopharm (ASX:NOX) is CEO and Managing Director, Dr Graham Kelly. Also joining me today is Associate Professor, Louise Emmett, Clinical Director of Theranostics and Nuclear Medicine at St Vincent’s Hospital in Sydney. 

Louise and Graham, welcome to FNN.

Louise Emmett: Thank you.

Dr Graham Kelly: Thank you Rachael.

Rachael Jones: First of all, starting with you Louise. Could you describe for us what theranostics is and how it ties in with nuclear medicine?

Louise Emmett: So theranostics is two words, therapy plus diagnostics. And it really describes this new technology that’s been developed, where we use very small proteins to target cancers, and we can use that in two ways. We target them with imaging, using PET tracer agents and then we also use the same peptide to target them with therapy. The advantage of theranostics is we can identify where the cancer is. And we can then identify the type of cancer and exactly the cancer characteristics, which we can then use to better target treatment.

Rachael Jones: Thank you Louise, now turning to you Graham. Noxopharm is working very closely with St Vincent’s Hospital in Sydney. Can you tell us more about that?

Dr Graham Kelly: As Louise has just explained, the field of theranostics is an emerging and exciting area in the whole field of cancer therapy. It’s a form of therapy that involves the use of radioactive drugs, or radiopharmaceuticals. And the evidence of this becoming a major area is shown in the fact that Novartis (SWX:NOVN) last year in 2018, spent $6 billion on acquiring two smaller companies. Now our hope is that Veyonda (formally known as NOX66) will become a companion drug, to be used in this field of theranostics. 

And the reason we believe that’s possible is that Veyonda is designed to make radiotherapy more effective. And it’s a drug that helps existing radiation kill cancer cells more effectively and more specifically. So that we are only targeting the tumour cell, not the non-tumour cell. So we see theranostics like Louise does, as a looming area of cancer therapy and we’d like to be part of it.

Rachael Jones: Louise, could you tell us about the therapeutic approach with Lutetium PSMA therapy, in prostate cancer?

Louise Emmett: Lutetium PSMA as Graham alluded to; it’s a radiation therapy. The really interesting thing about these new radiation therapies is they’re targeted directly to the cancer cell. And the Lutetium PSMA, there’s a receptor on the prostate cancer cell surface, PSMA. Lutetium PSMA is this very clever new protein, or peptide that’s been developed by some German ready chemists. And it actually binds very tightly to the receptor on the prostate cancer cell surface, and enters directly into the cancer itself. And it then it delivers its nuclear payload, it damages the DNA of that cell and that cell dies. 

So we’ve been doing trials in Lutetium PSMA since 2015 at St Vincent’s. And there are also trials that are going at Peter MacCallum Cancer Institute that have shown good efficacy of Lutetium PSMA, in men who have metastatic castrate resistant prostate cancer. We’re getting some very good results and are very excited.

Rachael Jones: Louise can you tell us about the LuPIN study?

Louise Emmett: The LuPIN trial is a collaboration between Noxopharm and St Vincent’s Hospital, in Sydney. And it’s a phase one-dose escalation trial, where we’re looking at safety and efficacy, using Lutetium PSMA as a therapy agent, in combination with NOX66 (known as Veyonda). And we’re doing it in men who have end-stage metastatic castrate resistant prostate cancer. So these are men who have already failed hormone treatment, they’ve already failed two lines of chemotherapy and they’re very symptomatic with their disease. They don’t have a lot of other options. And we’re giving Lutetium PSMA and NOX66 (known as Veyonda) in combination, every six weeks for up to six doses. 

The background to the LuPIN trial is that at St Vincent’s Hospital, Sydney, we did an initial pilot trial with Lutetium PSMA therapy, in men with metastatic prostate cancer. And we got some very good responses, but not everyone responded to the treatment the way we would have liked. So the concept of using combination treatments that specifically target the cancer cells is very appealing. And that’s where we came up with the concept of the LuPIN trial, combining a radiation sensitiser with Lutetium PSMA therapy. 

Rachael Jones: How are the results so far for that trial?

Louise Emmett: So the trial’s going really well. It’s a phase one trial, dose escalation trial with an expansion phase two, at the higher dose level. And currently we’ve enrolled three quarters of the patients, for the phase two-expansion. Looking at the results, we’ve had safety and efficacy that we’ve been looking at with this trial. From a safety point of view, we find that the treatment has been very well tolerated and we have had very few issues with safety. 

So we have submitted an interim abstract with results on both safety and efficacy, to the Society of Nuclear Medicine meeting, which will be presented in June of this year (in America).

Rachael Jones: Thanks Louise and moving to you now Graham for the last question. What are the company’s plans for Veyonda (formally known as NOX66) and for theranostic therapy?

Dr Graham Kelly: We hope to see Veyonda become a companion drug that would be used, in any form of radiotherapy. And that covers both theranostics, which tends to involve administering the radiation intravenously, as well as the very standard use of radiotherapy, where a machine delivers it externally to the body. So both of those are delivering radiation to the body. And we aim to see Veyonda, or NOX66 as it used to be known, become a standard companion drug wherever radiotherapy is used. 

Rachael Jones: Louise and Graham, thanks for the update and best of luck with the trial. 

Dr Graham Kelly: Thank you very much.

Louise Emmett: Thank you.