Candel Therapeutics (NASDAQ: CADL) Reports Positive Data From Phase 2 Trial Of CAN-2409 In Borderline Resectable Pancreatic Cancer

Clinical-stage biopharmaceutical company Candel Therapeutics, Inc. CADL reported updated survival data from its randomized phase 2 clinical trial of CAN-2409 in borderline resectable pancreatic cancer. Pancreatic cancer is the fourth leading cause of cancer-related death in the U.S. The disease accounts for approximately 3% of all cancers, with an estimated 64,050 patients diagnosed in 2023.

The randomized, controlled clinical trial is specifically looking into the safety and efficacy of CAN-2409 plus valacyclovir (prodrug), together with standard of care (SoC) chemoradiation, followed by resection – if possible – in borderline resectable pancreatic ductal adenocarcinoma (PDAC). 

Very encouraging results were recently reported by the Needham, Massachusetts-based company. 

Patients reached an estimated median overall survival of 28.8 months after experimental treatment with CAN-2409 versus only 12.5 months in the control group in PDAC. At 24 months, the survival rate was 71.4% in CAN-2409 treated patients compared to only 16.7% in the control group after chemoradiation. Thus, prolonged and sustained survival was observed after experimental treatment with CAN-2409 in patients with borderline resectable PDAC. Importantly, 4 out of 7 patients who received CAN-2409 were still alive at the time of data cut-off, with 2 patients surviving more than 50.0 months from enrollment. Only 1 out of 6 patients in the randomized control SoC chemotherapy group remained alive at the data cut-off (50.6 months).

No new safety signals were observed, providing further support that multiple injections of CAN-2409 are generally well tolerated. Additionally, there were no dose-limiting toxicities or cases of pancreatitis reported. 

Previous analysis of resected tumors showed dense aggregates of immune cells – including CD8+, cytotoxic tumor-infiltrating lymphocytes and dendritic cells – in PDAC tissue after CAN-2409 administration. This reinforces the potential of CAN-2409 to activate a robust antitumoral immune response in patients with cancer also in ‘cold', immunosuppressive tumors like PDAC. 

"Given the frequent recurrence and short survival with SoC chemotherapy for non-metastatic PDAC, effective new treatment options are urgently needed," said Garrett Nichols, MD, MS, Chief Medical Officer of Candel. "We are very encouraged by the improved survival associated with CAN-2409, which has been shown to be durable after prolonged follow-up based on the updated data in this randomized clinical trial. CAN-2409 was generally well tolerated without significant additional local or systemic toxicity when added to SoC chemoradiation."

Candel's most advanced viral immunotherapy candidate, CAN-2409, is an investigational off-the-shelf, replication-defective adenovirus designed to induce an individualized, systemic immune response against the tumor. Because of its versatility, CAN-2409 has the potential to treat a broad range of solid tumors. More than 1,000 patients have been dosed with CAN-2409 to date, with a favorable reported tolerability profile and proof of concept in each indication that the company is currently pursuing.

CAN-2409 is injected directly into the tumor or target tissue using a localized injection method that is akin to the standard approach for in situ vaccination to elicit an immune response against the injected tumor and uninjected metastases. 

Long-term survival data in PDAC was recently updated with eight months of further follow-up since the first analysis was presented at the 2023 Society for Immunotherapy (SITC) Annual Meeting. Based on the data presented at SITC, the U.S. Food and Drug Administration (FDA) granted Fast Track Designation to Candel Therapeutics for CAN-2409 in combination with valacyclovir for the treatment of patients with PDAC in December 2023. More recently, the FDA also granted Orphan Drug Designation.

"The failure of conventional immunotherapy to improve outcomes in pancreatic cancer is attributed to the highly immunosuppressive tumor microenvironment, which is largely devoid of immune cells," said Paul Peter Tak, MD, PhD, FMedSci, President and Chief Executive Officer of Candel. "The immunological changes induced by CAN-2409, evident in the pancreatic tissue and the peripheral blood after administration, suggest that CAN-2409 is able to change the balance between the tumor and the patient's anti-tumor immune response, which can convert progressive cancer into a chronic disease associated with improved survival."

Featured photo by National Cancer Institute on Unsplash.

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