Focus on cardiovascular disease and cancer

Based on their mechanisms of action, Kancera sees significant opportunities for its fractalkine blockers in cardiovascular diseases and oncology. Currently, Kancera is focusing its development activities on two specific fields: prevention of heart injuries caused by excessive inflammation and certain forms of hard-to-treat solid tumors.

Myocardial infarction is the most serious acute manifestation of cardiovascular disease leading to heart failure. Despite the advanced treatments available today, such as the life-saving percutaneous coronary intervention (PCI), major complications are common following a myocardial infarction and these can be life threatening.

High medical need

More than 1.2 million PCIs are conducted annually in the seven largest markets alone (US, EU-big 5 and Japan). Approximately 35% of these, or about 450,000, constitute high risk patients (STEMI).

The objective with PCI is to open narrowed or blocked sections of the artery, restoring blood flow to the heart. The intervention is lifesaving but associated with an increased risk of excessive inflammation that may cause heart injuries.

Significant market opportunities

KAND567 represents a new class of drug with potential to address a significant medical need. As myocardial infarction may lead to heart failure, Kancera foresees a high willingness from payors to finance more effective treatments and sees correspondingly significant market opportunities. The treatment of heart failure is a significant burden to healthcare systems globally and the costs of pharmaceutical drugs are estimated to grow 15% annually and reach 16 billion USD in 2026.

Today, there are no pharmaceutical products approved for treatment of the excessive inflammatory response that may occur in connection with PCI in STEMI. Ongoing clinical developments in the field of cardiovascular diseases focus to a large extent on treatment of heart failure and chronic disease.

As a consequence, Kancera sees an opportunity for KAND567 to become first-in-class and a totally new option for treatment of acute hyperinflammation in connection with myocardial infarction.

With more than 65,000 incidences annually in the seven largest markets alone (USA, EU-big 5 and Japan), ovarian cancer is one of the most lethal forms of cancer among women. As symptoms are difficult to discover, the disease is often diagnosed at a late stage when the disease has progressed. About 65% of diagnosed cases are in stage III-IV and at this stage, probability of five years survival is about 30%.

High medical need

First line standard of care is to conduct surgery, followed by chemotherapy with carboplatin and paclitaxel. Chemotherapy aims to cause damage to the cancer cell’s DNA and thereby inhibit tumor growth and disease progression. However, a major challenge is that cancer cells develop the ability to repair the DNA damage caused by chemotherapy and thereby develop resistance. Approximately 70% of all patients experience relapse from chemotherapy within three years.

In the event of a relapse, the continued treatment is decided based on perceived platinum-resistance. Patients judged to be platinum-sensitive are usually re-challenged with platinum, often in combination with other drugs. If the patient is believed to be platinum resistant, other therapies are introduced. For every relapse, the probability of treatment effect is reduced. As a consequence, there is a large medical need to increase the sensitivity for platinum-chemotherapy, which is the objective for treatment with KAND145.

Since their introduction, PARP inhibitors have established themselves as a core component of standard of care – in first-line maintenance as well as in second to fourth lines, following platinum relapse. The main mechanism of action of PARP inhibitors is to block cancer cells’ DNA repair. However, PARP inhibitors are only effective on certain tumor gene types, representing approximately 30% of diagnosed cases. In addition, cancer cells eventually develop resistance towards treatment with PARP inhibitors. At this stage, the tumor has also developed resistance to platinum-chemotherapy, leaving patients with poor prognosis and few treatment options remaining.

Significant market opportunities

The market for pharmaceutical drugs for treatment of ovarian cancer is forecast to increase from 1.8 billion USD in 2018 to 6.7 billion USD in 2028. In light of the price levels of other marketed products, such as PARP inhibitors, Kancera estimates that payors’ willingness to finance new drugs that prolong survival and improve quality of life is high. Even though ovarian cancer is a highly competitive field, with many agents in the pipeline, Kancera believes that there is a clear position for KAND145 in second-third line for treatment of patients with carboplatin relapse.