EX-99.2 3 simpkins_sgoxdenalixpart.htm EX-99.2 simpkins_sgoxdenalixpart
Exhibit 99.2


 
Cyclin E1 is a Predictive Biomarker of Azenosertib Benefit in Platinum-Resistant Ovarian Cancer (PROC): Outcomes From Part 1b of the DENALI Study (GOG-3066) Fiona Simpkins1,Alexandra Leary2, Lyndsay Willmott3, Bradley J. Monk4, Jean-Sébastien Frenel5, David C. Starks6, Meena Okera7, Angeles Alvarez Secord8, David M. O’Malley9, Lainie Martin1, Kaissa Ouali2, Martin K. Oehler10, Jeffrey C. Goh11, Brian M. Slomovitz12, Peter C. Lim13, Catherine M. Shannon14, Robert Neff15, Doris Kim16, Hailun Li16, Danielle Jandial16, Floor J. Backes9 1Penn Medicine Abramson Cancer Center, Philadelphia, PA, USA; 2Gustave Roussy Cancer Center, Villejuif Cedex, France; 3Arizona Center for Cancer Care, Phoenix, AZ, USA; 4Florida Cancer Specialists & Research Institute, West Palm Beach, FL, USA; 5Institut de Cancérologie de l'Ouest, Saint-Herblain, France; 6Avera Cancer Institute, Sioux Falls, SD, USA; 7Cancer Research SA, Adelaide, SA, Australia; 8Duke Cancer Institute of Duke University Health System, Durham, NC, USA; 9The Ohio State Wexner Medical Center and The James CCC, Columbus, OH, USA; 10Royal Adelaide Hospital, Adelaide, SA, Australia; 11ICON Cancer Centre, Chermside, QLD, Australia; 12Mount Sinai Medical Center, Miami Beach, FL, USA; 13Center of Hope at Renown Regional Medical Center, Reno, NV, USA; 14Mater Cancer Care Centre, South Brisbane, Australia; 15TriHealth Cancer Institute, Cincinnati, OH; 16Zentalis Pharmaceuticals, Inc. San Diego, CA, USA


 
Financial Disclosures for Fiona Simpkins I have the following financial relationships with ACCME defined ineligible companies to report over the past 24 months: • Consulting/Advisory Role: AstraZeneca; GlaxoSmithKline; Zentalis, Repare Therapeutics, FoRx Therapeutics • Research Funding to Institution: AstraZeneca; AstraZeneca/MedImmune; Instil Bio; Repare Therapeutics, Sierra Oncology ACCME, Accreditation Council for Continuing Medical Education


 
I will be discussing the unlabeled or investigational use of Azenosertib, a WEE1 inhibitor, from Zentalis Pharmaceuticals Unlabeled/Investigational Uses


 
Survival according to CCNE1 amplification status1 Ovarian Cancer Patients With Cyclin E1 Overexpression and/or CCNE1 Amplified Ovarian Cancers Have Worse Outcomes aTiming of tissue collection was not disclosed. OS, overall survival; PFS, progression-free survival. 1. Stronach EA, et al. Mol Cancer Res. 2018;16:1103-1111. 2. Pils D, et al. Eur J Cancer. 2014;50:99-110. 3. Peterson S, et al. Gynecol Oncol. 2020;157:405-410. 4. Nakayama N, et al. Cancer. 2010;116:2621-2634. 5. Kang EY, et al. Cancer. 2023;129:697-713. 6. Chan AM, et al. J Pathol Clin Res. 2020;6:252-262. Hazard ratio N=3533 Worse outcome


 
• Cyclin E1 protein overexpression results in cells moving prematurely from G1 to S, there by increasing reliance on the G2-M checkpoint to allow DNA repair1,2 • WEE1 is a master regulator of the cell cycle acting as a brake at G1-S and G2-M to allow DNA repair3 • Targeting WEE1 with azenosertib ultimately leads to mitotic catastrophe4 CDK, cyclin-dependent kinase; G1-S, Gap 1-Synthesis; G2-M, Gap 2-Mitosis; HGSOC, high-grade serous ovarian cancer. 1. Vriend LE, et al. Biochim Biophys Acta. 2013; 1836(2):227-335. 2. Esposito F, et al. Int J Mol Sci. 2021;22(19):10689. 3. Gorski JW, et al. Diagnostics (Basel). 2020;10(5):279. 4. Kim D, et al. NPJ Precis Oncol. 2025;9(3). Targeting WEE1 with Azenosertib Exploits Critical Cell Cycle Checkpoints that Cyclin E1 Overexpressing Cells Require for Survival


 
Part 1b: Study design ✓ PROC ✓ 1-5 prior lines of therapy ✓ Prior bevacizumab ✓ All comers (irrespective Cyclin E1 status) Key eligibility criteria Endpoints PFSb Safety and tolerability ORR, DORa Enrollment (N=102) Azenosertib 400 mg QD 5:2 NCT05128825 Enrollment complete P re s c re e n in g / T is s u e C o n s e n t In te ri m A n a ly s is Patients with Cyclin E1+ tumors Azenosertib 400 mg 5:2 Azenosertib 300 mg 5:2 1:1 randomization Azenosertib (Dose TBD) Endpoints PFS Safety and tolerability ORR, DOR Part 2a Part 2bc DENALI (GOG-3066): Phase 2, Open-Label, Multicenter Study of Azenosertib in PROC (Part 1 and 2) aPer RECIST v1.1 by ICR and investigator every 6 weeks until disease progression, death from any cause (ORR: up to 12 months; DOR: up to 60 months). bPer RECIST v1.1 by ICR and investigator every 6 weeks until disease progression, death from any cause up to 12 months. cSubject to FDA feedback. 5:2, 5 days on, 2 days off; DOR, duration of response; ICR, independent committee review; ORR, objective response rate; PFS, progression-free survival; PROC, platinum-resistant ovarian cancer; QD, once daily; RECIST, Response Evaluation Criteria in Solid Tumors; TBD, to be determined. ClinicalTrials.gov: https://clinicaltrials.gov/study/NCT05128825


 
Characteristicsa (N=102) Median age (range), years 66 (34-82) Race, n (%) White 70 (69) Black/African American 6 (6) Asian 3 (3) Otherb 1 (1) Not reported 22 (22) ECOG PS, n (%) 0 53 (52) 1 49 (48) Prior lines of treatment Median (range) 3 (1-5) 1-2, n (%) 35 (34) 3-4, n (%) 57 (56) 5, n (%) 10 (10) Characteristicsa (N=102) Prior therapy, n (%) Bevacizumab 93 (91) PARPi 57 (56) Mirvetuximab 15 (15) CCNE1 amplification,c Evaluable, n 88 Amplified, n (%) 27 (31) Cyclin E1 status by IHC Evaluable, n 94 IHC+, n (%) 48 (51) DENALI (GOG-3066) Part 1b: Patient Baseline Characteristics Data cutoff date: January 13, 2025. aFull analysis set: all treated patients. Biomarker dataset: all treated patients with evaluable tissue and Cyclin E1 IHC status. bHispanic. c85% (23/27) of patients with CCNE1-amplified tumors were also Cyclin E1+ by IHC. Amp, amplified; CCNE1 amplification defined as Copy Number ratio ≥3 with genomic ploidy correction as per Foundation Medicine. ECOG PS, Eastern Cooperative Oncology Group performance status; IHC, immunohistochemistry; PARPi, poly(ADP-ribose) polymerase inhibitor.


 
All treated patients (N=102) ORR in response-evaluablec patients, % (n/N; 95% CI) 20.4 (19/93; 12.8-30.1) ORR, ITTa % (n/N; 95% CI) 18.6 (19/102; 11.6-27.6) Cyclin E1 IHC+ (n=48) ORR in response-evaluablec patients, % (n/N; 95% CI) 34.9 (15/43; 21.0-50.9) ORR, ITTa % (n/N; 95% CI) 31.3 (15/48; 18.7-46.3) DENALI (GOG-3066) Part 1b: Cyclin E1+ by IHC is a Biomarker Predicting Response to Azenosertib Data cutoff date: Jan 13, 2025. aIntent to treat/Full analysis set: all treated patients. bBiomarker dataset: all treated patients with evaluable tissue and Cyclin E1 IHC status. cIncludes patients who received at least one post-treatment scan. Amp, amplified; IHC, immunohistochemistry; ITT, Intent to treat population; ORR, objective response rate; PD, progressive disease; PR, partial response. All treated patientsa (N=102) C y c li n E 1 I H C + Biomarker positive: Cyclin E1 IHCb (n=48) ORR in response-evaluable patients 20.4% ORR in response-evaluable patients 34.9% + Treatment ongoing CCNE1 Status: Amplified Non-amplified Not evaluable B e s t % C h a n g e f ro m B a s e li n e


 
17 180 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 P a ti e n ts amDOR is subject to change, there are 4 ongoing responders as of the January 13, 2025 data cutoff. IHC, immunohistochemistry; cPR, confirmed partial response; SD, stable disease; PD, progressive disease; mDOR, median duration of response; mPFS, median progression free survival; NE, not evaluable Treatment Duration (Months) mDOR 6.3 monthsa (95% CI, 2.7 - NE) mPFS 4.1 months (95% CI, 2.8 - 6.8) 4 ongoing responders Cyclin E1+ (N=48) PDSDcPRBest Overall Response First Partial Response CCNE1 Amplified NE DENALI (GOG-3066) Part 1b: Duration of Response in Cyclin E1 IHC+ Ovarian Cancer


 
12 11 11 4 7 3 2 3 16 7 3 5 1 0 25 50 75 100 Grade ≥3 Grades 1-2 66 51 15 14 60 15 13 13 12 11 11 12 Total 15 23 % Patients Hematological Thrombocytopenia Anemia Neutropenia Gastrointestinal Nausea Diarrhea Decreased appetite Constipation Dysgeusia Abdominal pain Other Fatigue ALT increased Asthenia Dizziness Headache Hypomagnesemia AST increased Dehydration TRAEs, n (%) Leading to dose reduction 44 (43.1) Leading to dose interruption 59 (57.8) Leading to discontinuation 22 (21.6) Leading to death 2 (2.0)b Serious TRAEs 22 (21.6) 35 29 16 DENALI (GOG-3066) Part 1b: Safety and Tolerability Summary Data cutoff date: January 13, 2025 aIf a patient had multiple grades of the same adverse event, The worse grade was reported bOne patient had sepsis, and 1 patient had pancytopenia. ALT, alanine aminotransferase; AST, aspartate aminotransferase; TRAE, treatment-related adverse event. TRAEs occurring in ≥10% of patientsa


 
Part 2 Key eligibility criteria ✓ PROC ✓ Cyclin E1+ IHC ✓ 1-3 prior lines of therapy ✓ 4 if prior mirvetuximab P re s c re e n in g / T is s u e C o n s e n t In te ri m A n a ly s is b Patients with Cyclin E1+ tumors Azenosertib 400 mg 5:2 Azenosertib 300 mg 5:2 1:1 randomization Azenosertib (dose TBD) PFS Safety and tolerability ORR, DOR NCT05128825 Part 2a Part 2ba Endpoints aSubject to FDA feedback. bEnrollment will continue through the interim analysis 5:2, 5 days on, 2 days off; DOR, duration of response; FRa, folate receptor alpha; ORR, objective response rate; PFS, progression-free survival; PROC, platinum-resistant ovarian cancer; TBD, to be determined. ClinicalTrials.gov: https://clinicaltrials.gov/study/NCT05128825. DENALI (GOG-3066): Phase 2, Open-Label, Multicenter Study Investigating Azenosertib in Cyclin E1+ PROC


 
Azenosertib warrants further development in Cyclin E1+ PROC in Part 2 of the ongoing DENALI study • Cyclin E1+ / overexpression by IHC represents ~ 50% of PROC • Cyclin E1+ IHC more than doubles the eligible patient population beyond CCNE1 amp • Azenosertib demonstrates ORR of ~35% in evaluablea patients with Cyclin E1+ HGSOC • Median duration of response is 6.3 months • Cyclin E1 by IHC is a predictive biomarker for response to azenosertib • GI toxicity (nausea, diarrhea) and fatigue are the most common TRAEs; although less common, hematological toxicities require close monitoring during treatment with azenosertib Conclusions aIncludes patients who received at least one post treatment scan bmDOR is subject to change, there are 4 ongoing responders as of the January 13, 2025 data cut off GI, gastrointestinal; HGSOC, high-grade serous ovarian cancer; mDOR, median duration of response; PROC, platinum-resistant ovarian cancer; TRAE, treatment-related adverse event.


 
This study was sponsored by Zentalis Pharmaceuticals, Inc. Enrolling sites • Alliance Cancer Specialists, PC − USOR – Wynnewood • Arizona Oncology Associates, PC – HAL • Avera Cancer Institute • Baystate Medical Center • Burnside War Memorial Hospital − The Brian Fricker Oncology Centre • Cancer Research South Australia • Carle Cancer Center • Center of Hope • Centre Antoine Lacassagne Centre Régional de Lutte Contre Le Cancer • Centre Oscar Lambret • Centrum Badań Klinicznych JCI • Community Cancer Center North • Cox Medical Centers • Dana-Farber Cancer Institute • Duke Cancer Institute • EDOG Institut de Cancérologie de l’Ouest – PPDS • Florida Cancer Specialists − EAST − SCRI – PPDS • Icon Cancer Care Chermside • Institut Gustave Roussy • Lancaster General Hospital • Mark H Zangmeister Center − SCRI – PPDS • Maryland Oncology Hematology, P.A. (Rockville) • Mater Hospital Brisbane • Memorial Health University Medical Center • Mercy Hospital St Louis • Minnesota Oncology Hematology, PA – Maplewood • Mitchell Cancer Institute • Monument Health Rapid City Hospital • Mount Sinai Medical Center • Nebraska Methodist Hospital • NorthShore University Health System • Northwell Health Cancer Institute • Norton Cancer Institute, Downtown • Ohio State University Comprehensive Cancer Center • Oncology Associates of Oregon • Ridley Tree Cancer Center • Rocky Mountain Cancer Centers • Sarasota Memorial Healthcare System • St. Louis Cancer Care LLP • Texas Oncology (Tyler) • Texas Oncology, PA – Austin • TriHealth Cancer Institute • UC San Diego Moores Cancer Center • University Hospitals Case Medical Center • University of Pennsylvania • Utah Cancer Specialists (Salt Lake City) • Virginia Oncology Associates (Norfolk) − USOR Acknowledgements