In the first study, treatment with oral SCY-078 in patients with vulvovaginal candidiasis (VVC), resulted in significantly better clinical cure rates and fewer recurrences of VVC at the four-month follow-up when compared to the standard of care (oral fluconazole). In the second study, which evaluated oral SCY-078 as a step down therapy in patients with invasive candidiasis, oral SCY-078 achieved the target exposure for efficacy and was well-tolerated.
"We are delighted with these positive results that support the concept that a fungicidal product with high tissue penetration like SCY-078 could yield superior clinical outcomes," said David Angulo, M.D., Chief Medical Officer of SCYNEXIS. “We identified a well-tolerated oral dose that achieves our target exposure in invasive candidiasis patients, and further confirmed the antifungal activity of oral SCY-078 in two independent human models of Candida infections. These results support our planned development of SCY-078 as the first drug in a novel antifungal class for the treatment of a broad range of fungal infections with growing unmet medical needs.”
Phase 2 Proof-of-Concept Study of Oral SCY-078 in Patients with VVCThe first study evaluated the effect of two dose regimens of SCY-078 in patients with moderate to severe VVC as a proof-of-concept study to support the development of SCY-078 in invasive candidiasis and other Candidainfections. Clinical cure rate, defined as a resolution of signs and symptoms of infection without further antifungal treatment, is now the recommended primary endpoint per the latest FDA guidelines for VVC. As previously reported, clinical cure rate was higher for patients receiving oral SCY-078 compared to oral fluconazole at the test of cure visit (Day 24). Additionally, follow-up data now available showed a high clinical cure rate at the four-month visit (end of observation period) of 88% in patients who received SCY-078 compared to 65% in patients who received fluconazole (p=0.04). Moreover, during the four-month observation period, patients who received SCY-078 had a lower recurrence rate (4%) versus fluconazole (15%).
Phase 2 Study of Oral SCY-078 in Patients with Invasive Candidiasis
The second study evaluated the pharmacokinetics (PK), safety, and tolerability of SCY-078 as an oral step-down treatment in patients initially treated with intravenous (IV) echinocandin therapy for invasiveCandida infections. Twenty-two patients were randomized to receive study drug or standard of care (one of the patients randomized to standard of care could not receive oral fluconazole due to aCandida glabrata with decreased fluconazole-susceptibility and received micafungin for the entire duration of antifungal therapy). As previously reported, the study met its primary objective by confirming the once daily oral dose of SCY-078 750mg as a dose that is both overall safe and tolerated and achieves the target exposure in these patients. During the study period, there were no reports of mycological failures in the SCY-078 750mg group (n=7) versus two infection-related failures (one fungemia and one abdominal sepsis) in the fluconazole group (n=7). No relapses were observed in these two groups during the six-week follow-up period.
As previously reported, SCY-078 was overall safe and tolerated in both studies. There were no discontinuations due to adverse events (AEs) and no related serious AEs. Consistent with previous findings, the most common AEs were mild to moderate gastrointestinal (GI) events such as diarrhea nausea, vomiting, abdominal pain or discomfort. In patients with invasive candidiasis, the number of GI events were comparable in both the SCY-078 and fluconazole treatment arms.
"We achieved our stated goals and further de-risked the development of our lead product candidate, SCY-078," said Marco Taglietti, M.D., President and Chief Executive Officer of SCYNEXIS. “With these positive Phase 2 data in hand, we believe SCY-078 is now the most advanced novel agent in a new antifungal class that can address the growing issue of resistance. We are also pleased to announce the infusion of additional funds from Solar Capital, providing us with the financial strength and flexibility to accelerate and expand the development of SCY-078 and to leverage our internal antifungal platform.”
Additional Capital Raised
SCYNEXIS closed a $15 million term loan with Solar Capital, fully funded at close. This transaction complements the company’s recent equity raise, and results in minimal dilution to shareholders. Please refer to the Form 8-K filing with the Securities and Exchange Commission for additional information about the facility.
"Solar Capital is pleased to start a financing partnership with SCYNEXIS that should enable the company to expand its pipeline of indications for SCY-078, as well as accelerate its other development programs," said Anthony Storino, head of life science lending at Solar Capital. “We believe SCYNEXIS offers a unique value proposition in an area with significant unmet medical needs, and we are excited to contribute to the company’s growth and future successes.”
As of September 30, 2016, SCYNEXIS’ preliminary estimate of its cash, cash equivalents and marketable securities totaled $58.4 million, including the $15 million from the loan facility.
Armentum Partners acted as financial advisor to SCYNEXIS on the loan facility.
About the Studies
Phase 2 Proof-of-Concept Study of Oral SCY-078 in Patients with Vulvovaginal Candidiasis (VVC)Multicenter, randomized, active controlled, evaluator-blinded study (clinicaltrials.gov identifier:NCT02679456) of oral SCY-078 compared to oral fluconazole in adult female patients with acute vulvovaginal candidiasis (VVC). A total of 96 patients with an acute moderate to severe, symptomatic episode of VVC were randomized in a 1:1:1 ratio to receive either three daily doses or five daily doses of oral SCY-078 750mg QD with a 1,250mg loading dose or oral fluconazole, at the labeled approved dose regimen of 150mg single dose. This was a pilot investigation and not powered to demonstrate a statistical significant difference in the parameters tested (p values for the comparisons mentioned were >0.05 unless otherwise indicated). Efficacy was evaluated based on the proportion of patients achieving clinical cure, mycological eradication and therapeutic cure (combination of both clinical cure and mycological eradication) at day 24 (+/-3) after initiation of treatment. The 3-day and the 5-day SCY-078 regimens performed similarly, allowing a pooled analysis. Intent-to-treat (ITT) population is defined as all subjects randomized (n=96 subjects). Per-Protocol (PP) population is defined as subjects with culture confirmed Candida infection at baseline (n=70 subjects). Subjects in the PP population were followed for four months. Recurrence was defined as a symptomatic VVC episode requiring additional antifungal therapy, per investigators’ decision.
Phase 2 Study of Oral SCY-078 in Patients with Invasive CandidiasisMulticenter, multinational, randomized, open-label study (clinicaltrials.govidentifier: NCT02244606) following three to ten days of IV echinocandin therapy. A total of 27 patients with invasive candidiasis were enrolled and 22 were randomized to receive either SCY-078 500mg QD with a 1,000mg loading dose (7 patients), SCY-078 750mg QD with a 1,250mg loading dose (7 patients) or standard of care (7 patients receiving fluconazole 400mg QD with a 800mg loading dose and 1 patient receiving micafungin IV 100mg QD due to a Candida glabrata with decreased fluconazole-susceptibility for up to 28 days). Efficacy was assessed based on achievement of favorable global response defined as the resolution of signs and symptoms attributable to the Candida infection and mycological eradication without the use of any other antifungal agent. Patients were followed for six weeks after the end of treatment.