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Advancing candidates designed to address resistance mechanisms in multiple cancers

The pipeline

Our portfolio of novel agents targets multiple resistance mechanisms by leveraging our specialized expertise in the following areas:

Precision Oncology
Using biomarkers and targeted therapeutics to identify the right drugs for the right patients
Key Tumor Dependencies
Using our resistance platform to target cancer-specific vulnerabilities
Hormone-Dependent Cancers
Using our expertise in hormonally dependent cancers to prevent relapse or reverse resistance

BRAIN PENETRANT EGFR/HER2 INHIBITOR PROGRAM: ORIC-114

The ErbB receptor tyrosine kinase family is involved in key cellular functions, including cell growth and survival. EGFR and HER2 exon 20 insertion mutations are observed across multiple solid tumors, including NSCLC, breast, gastrointestinal, bladder and other cancers. EGFR exon 20 insertion mutations are observed in approximately 2.1% of all patients with NSCLC and these patients have a worse prognosis than patients with NSCLC driven by other EGFR mutations. HER2 exon 20 insertion mutations are observed in approximately 1.5% of all patients with NSCLC and atypical EGFR mutations are observed in approximately 2.9% of all patients with NSCLC. Approximately one-third of patients with exon 20 insertion mutations develop brain metastases, which contributes to poor prognosis.

ORIC-114 is a brain penetrant, orally bioavailable, irreversible inhibitor designed to selectively target EGFR and HER2 with high potency against exon 20 insertion mutations. ORIC-114 has demonstrated greater brain exposure in preclinical studies compared to certain other compounds being developed against exon 20 mutations and has shown strong anti-tumor activity in an EGFR-driven intracranial lung cancer model. ORIC-114 has also demonstrated strong anti-tumor activity in both a subcutaneous and intracranial HER2-positive breast cancer model. In the fourth quarter of 2021, we filed a CTA for ORIC-114 in South Korea, which was cleared in the first quarter of 2022. We also filed and cleared an IND with the FDA for ORIC-114 in the third quarter of 2022. We are enrolling a Phase 1b trial of ORIC-114 as a single-agent, in patients with advanced solid tumors with EGFR and HER2 exon 20 alterations, atypical EGFR mutations or HER2 amplifications, and that trial allows patients with CNS metastases that are either treated or untreated but asymptomatic. We reported initial Phase 1b data from this trial at the ESMO Congress in October 2023, which demonstrated both systemic and intracranial activity in a heavily pre-treated patient population across multiple dose levels.

EGFR/HER2 exon20 Cancer with Brain Metastases
CEGFR/HER2 exon20 cancer with brain metastases
 
 
 
 
CEGFR/HER2 exon20 cancer with brain metastases
HER2+ Breast Cancer with Brain Metastases
 HER2+ Breast Cancer with Brain Metastases
ORIC-114 is a clinical candidate with the potential for treatment
of EGFR/HER2 driven cancers, including in patients with active brain metastases

PRC2 INHIBITOR PROGRAM: ORIC-944

The dysregulation of PRC2 methyltransferase activity can lead to tumorigenesis in a wide range of cancers including prostate cancer, breast cancer, and hematological malignancies. PRC2 is composed of two druggable subunits: EED and EZH2. Several companies are developing EZH2 inhibitors; however, the pharmacologic properties of these compounds result in high doses that achieve only partial target inhibition in the clinic. Additionally, preclinical studies suggest drug resistance to EZH2 inhibitors may develop via EZH1 bypass compensation or acquired mutations in EZH2. Allosteric inhibition of EED impacts the assembly, stabilization, and activation of PRC2, and may have benefits over EZH2-mediated inhibition of PRC2. ORIC-944 is a potent and selective allosteric inhibitor of PRC2 via the EED subunit that was designed to have superior drug properties over EZH2 inhibitors and is efficacious in androgen-insensitive and enzalutamide-resistant prostate cancer models in preclinical studies. We filed and cleared an IND with the FDA for ORIC-944 in the fourth quarter of 2021. We are enrolling a Phase 1b trial of ORIC-944 as a single-agent, in patients with advanced prostate cancer and reported initial Phase 1b data from this trial in January 2024, demonstrating potential best-in-class drug properties, including clinical half-life consistent with a preclinical prediction of greater than 10 hours, robust target engagement and a favorable safety profile.

PRC2 Function
PRC2 Function illustration
PRC2 Background
  • Two druggable subunits:
    – EED: responsible for histone binding; target of ORIC-944
    – EZH2: responsible for histone methylation; target of first-generation inhibitors
  • Dysregulation of PRC2 linked to several cancers – Decreased expression of target genes associated with poor prognosis in prostate cancer
  • First-generation inhibitors, designed to inhibit EZH2, have demonstrated promising clinical activity and chemoresistance via – Approved for epithelioid sarcoma and follicular lymphoma – Limited progress made for treatment of prostate cancer
PRC2 is a validated oncogenic target across several cancers with promising
therapeutic potential in prostate cancer, among other indications

CD73 INHIBITOR PROGRAM: ORIC-533

Many cancers usurp the anti-inflammatory adenosine pathway to avoid detection by the immune system, thereby reducing the effectiveness of certain chemotherapy- and immunotherapy-based treatments. Accumulation of adenosine in the tumor microenvironment is implicated in local immune suppression that leads to tumor growth. CD73 is an enzyme that controls the rate at which extracellular adenosine is produced and its overexpression is associated with poor prognosis in several cancers, including TNBC, NSCLC, prostate cancer and multiple myeloma among others. Preclinical data using ex vivo autologous models from relapsed/refractory multiple myeloma patients revealed that single agent inhibition of CD73 could restore anti-cancer immunity, triggering significant lysis of multiple myeloma cells. Our product candidate, ORIC-533, is an orally bioavailable small molecule inhibitor of CD73 that has demonstrated more potent adenosine inhibition in vitro compared to an antibody-based approach, and single agent activity in myeloma model systems.

CD73 Mediates Immunosuppression in Multiple Myeloma
CD73 Mediates Immunosuppression in Multiple Myeloma
Rationale for ORIC-533 in Multiple Myeloma
  • Immunosuppressive adenosine generation from adenosine monophosphate (AMP) requires the activity of the cell surface ecto-5’-nucleotidase, CD73
  • Patient data demonstrate relapsed/refractory (r/r) multiple myeloma is adenosine rich
    – High CD73 and adenosine are associated with poor prognosis and therapeutic resistance in multiple myeloma
  • Patient-derived ex vivo models from r/r multiple myeloma patients revealed single agent activity with ORIC CD73 inhibitor
    – Preclinical activity favorable to standard of care therapies in cross literature comparisons

DISCOVERY RESEARCH PROGRAMS

In addition to our product candidates, we are leveraging our resistance platform in pursuit of multiple discovery research programs that focus on our expertise within hormone-dependent cancers, precision oncology and key tumor dependencies. These programs highlight our medicinal chemistry and structure-based design expertise, thus for the most part utilize a small molecule therapeutic approach to target oncogenic drivers in solid tumors like prostate, breast and lung cancer that relapse with innate, acquired or bypass resistance. Our most advanced discovery research programs are currently in lead optimization.

PLK4 Inhibitor Program

Polo family of serine/threonine protein kinase 4, PLK4, is a cell cycle protein that regulates centriole duplication. Recent research identified a synthetic lethal relationship between PLK4 inhibition and TRIM37 amplification/overexpression commonly found in breast cancer and neuroblastoma.

ORIC discovered novel, potent, orally bioavailable small molecule inhibitors of PLK4 that are highly selective, in contrast to the candidate in clinical development. Preclinical data demonstrates that the highly selective ORIC PLK4 inhibitors showed greater potency in TRIM37 high cancer cell lines as compared to TRIM37 low cell lines and demonstrates strong antitumor activity in TRIM37 high xenograft models.

PLK4 Inhibition Is Synthetically Lethal to
Tumor Cells with TRIM37 Amplifications
PLK4 Inhibition Is Synthetically Lethal to Tumor Cells with TRIM37 Amplifications
ORIC Small Molecule Inhibitor of PLK4
Discovery and Development Rationale
  • Polo-like kinase 4 (PLK4) is a serine/threonine protein kinase that controls centrosome duplication during cell division
  • Cells with TRIM37 amplifications require PLK4 function for growth and survival
    – provides an opportunity for synthetic lethal targeting
  • TRIM37 amplifications occur in breast cancer (~20%) and neuroblastoma (~55%), and have been associated with early relapse and poor prognosis
Targeting TRIM37 amplified cancers with a potent and selective PLK4 inhibitor is a potential first-in-class opportunity