NASDAQ: OSRH
OSR Health, Inc.CIK 0001840425 · Health Care · SIC 3841 · Surgical & Medical Instruments
As a global healthcare holding company, with operations in South Korea and Switzerland and an office in the United States, we intend to leverage our existing and expanding network of academic and industry leaders and investor network, including venture capital and private equity, in major… About this business →
Each report below shows a 3-bullet preview. Free accounts read 3 full reports a month — narrative summary, section diffs, and EDGAR-cited quotes.
Sign up freeWant to see a complete report first? Today's free report (WS 10-K) is open in full — no account needed.
Summary not yet generated.
Summary not yet generated.
Partner
Trade OSRH commission-free
Open an account, get a free stock.
Investing involves risk. Free stock terms apply.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Summary not yet generated.
Latest financial statements
From 10-Q filed May 13, 2026 (period ending Mar 31, 2026). SEC XBRL (companyfacts) — not generated by the model.
Consolidated Statements of Operations (Unaudited)
| Description | Q1 ended Mar 31, 2026 | Q3 ended Sep 30, 2025 |
|---|---|---|
| Revenue: | ||
| Total revenue / net sales | 0.5 | 0.6 |
| Cost of revenue / cost of sales | 0.3 | 0.4 |
| Gross profit | 0.2 | 0.3 |
| Operating expenses: | ||
| Research and development | 0.1 | |
| Selling, general and administrative | 3.8 | 4.1 |
| Other operating expenses, net | (0.1) | — |
| Operating income | (3.7) | (3.8) |
| Interest expense | 0.03 | 0.04 |
| Income before income taxes | (3.9) | (4.5) |
| Income tax expense/(benefit) | (0.5) | (1.3) |
| Net income | (3.5) | (3.2) |
| Basic earnings per share | (0.09) | (0.10) |
| Diluted earnings per share | (0.08) | |
Consolidated Balance Sheets (Unaudited)
| Description | Mar 31, 2026 | Dec 31, 2025 |
|---|---|---|
| Current assets: | ||
| Cash and equivalents | 1.6 | 1.7 |
| Accounts receivable, net | 0.3 | 0.3 |
| Other receivables, net | 0.05 | 0.07 |
| Inventories | 0.5 | 0.2 |
| Prepaid expenses and other current assets | 0.3 | 0.3 |
| Other current assets | 0.3 | 0.3 |
| Total current assets | 2.9 | 2.8 |
| Property, plant and equipment, net | 0.2 | 0.2 |
| Operating lease right-of-use assets, net | 0.05 | 0.06 |
| Finite-lived intangible assets, net | 139.0 | 142.5 |
| Goodwill | 29.7 | 24.9 |
| Deferred income taxes and other assets | 0.2 | 0.2 |
| TOTAL ASSETS | 172.2 | 171.2 |
| Current liabilities: | ||
| Current portion of long-term debt | 0.2 | |
| Line of credit | 2.2 | 2.3 |
| Current portion of operating lease liabilities | 0.04 | 0.05 |
| Accrued liabilities | 1.1 | 1.0 |
| Income taxes payable | 0.5 | 0.5 |
| Other current liabilities | 13.8 | 13.4 |
| Total current liabilities | 17.9 | 17.2 |
| Long-term debt | 0.3 | |
| Operating lease liabilities | 0.01 | 0.01 |
| Deferred income taxes and other liabilities | 26.6 | 27.0 |
| Total liabilities | 44.8 | 44.2 |
| Shareholders' equity: | ||
| Common stock | — | — |
| Capital in excess of stated value | 145.6 | 111.0 |
| Accumulated other comprehensive income (loss) | (1.7) | 3.8 |
| Retained earnings (deficit) | (40.1) | (37.2) |
| Total shareholders' equity | 127.4 | 127.0 |
| TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY | 172.2 | 171.2 |
Consolidated Statements of Cash Flows (Unaudited)
| Description | Q1 ended Mar 31, 2026 | Nine months ended Sep 30, 2025 |
|---|---|---|
| Operating Activities: | ||
| Net cash from operating activities | (1.0) | (3.3) |
| Investing Activities: | ||
| Net cash from investing activities | 0.01 | (0.07) |
| Financing Activities: | ||
| Net cash from financing activities | 0.9 | 5.2 |
Amounts in millions USD; EPS as reported. Line labels are presentation-friendly mappings of filer XBRL tags — not a re-audit of the full statements. Use EDGAR for interactive notes and detail. Interactive statements & notes on EDGAR ↗
About OSR Health, Inc.
Source: Item 1 (Business) from the 10-K filed March 31, 2026. Description as filed by the company with the SEC.
Item 1. Business
Company and Business Strategy Overview
As a global healthcare holding company, with operations in South Korea
and Switzerland and an office in the United States, we intend to leverage our existing and expanding network of academic and industry
leaders and investor network, including venture capital and private equity, in major healthcare markets globally to identify, lead and
support the growth of our subsidiaries and subsidiary candidates based on innovative research. Subsidiary candidates are companies that
are either already existing entities or new companies formed in connection with acquiring or licensing existing assets from industry or
academia. We expect to attract industry partners either as co-investors or through technology licensing deals and may raise capital
directly from private, strategic or public investors. We seek to chart a potentially more efficient and optimal route by pairing what
we believe are the right team and pharmaceutical or medical device technologies that have the potential to treat diseases and improve
healthcare outcomes with the necessary financial and other resources. Since our target markets feature large established global businesses
with abundant capital that acquire healthcare companies, we hope to realize additional liquidity through the sale of our subsidiaries
from time to time.
We are a data-driven company. We evaluate our subsidiary candidate
opportunities by better understanding the target indications toward identifying new approaches and technologies to improve treatment outcomes.
We collaborate with academic and industry leaders to promote a seamless integration and partnership between entrepreneurial scientists
and seasoned business development and leadership teams. These technical and scientific experts from academia and industry bring innovative
contributions and a high level of enthusiasm. Our holding company leadership team supports and empowers each subsidiary to transform their
potentially breakthrough discoveries into impactful and viable commercial products.
Read full description ↓
Our company’s collective expertise from industry veterans, seasoned
scientists, capital market and legal professionals provides the core foundation of our global healthcare holding company. The Company
operates as a hub-and-spoke business model with a centralized executive team partnering with subsidiary management teams to ensure
overall program and corporate alignment by and between subsidiaries and holding company. Our overarching goal is to enhance value creation
for our subsidiaries by continuously assessing optimal development options and exploring partnership and fundraising opportunities. We
encourage cooperation and knowledge sharing among our subsidiaries to enhance our synergistic business model. We believe our strong foundational
scientific conviction, entrepreneurial acumen and opportunistic approach positions us as a differentiated global company advancing pharmaceutical
and medical device technologies in an efficient, cost-effective and meaningful manner. Our interdisciplinary team of accomplished
scientists and entrepreneurial business leaders promotes the development and commercialization of a risk diversified portfolio to address
unmet medical needs with resilience and efficiency.
1
Our corporate organization and ownership of subsidiaries is illustrated
by the following chart*:
Portfolio Overview
OSR’s subsidiaries (other than RMC) have diverse scientific and
technological developments, and are engaged in distinct areas of therapeutics research and development, including oral T-cell immunotherapies
and recombinant biologics. This approach not only provides the Company with a broader scope of potential therapeutic solutions but also
reduces the risks associated with a singular-asset approach.
Figure 2 below summarizes our three subsidiaries, two of which have
their own drug development pipelines.
Portfolio Company
Science, Technology and Platform
T-cell immunotherapies based on a live attenuated, safe, orally, available bacterial vaccine strain, genetically modified to develop and elicit patients’ cytotoxic T-cells against specific pre-defined targets
Platform integrating different protein domain sequences linking into a Design-augmented (DA) recombinant biologic with enhanced biological functionality for bone and cartilage regeneration
Neurovascular surgical devices
Figure 2. the Company subsidiary portfolio snapshot.
2
Intellectual Property Overview
We own or have in-licensed numerous patents and intellectual property
underlying patent applications and possess substantial know-how and trade secrets relating to the development and commercialization
of therapeutic product candidates in development by our portfolio companies, including related manufacturing processes and technologies.
As of December 31, 2025, the patent portfolio of our subsidiaries includes 10 patent families of issued patents and pending patent
applications in various stages of prosecution. Generally, the patents issued and patent applications pending are in multiple jurisdictions
including the United States, Europe, Japan, India, and China, with anticipated expiration between 2032 to 2041, without considering
patent term adjustments or patent term extensions. The below table summarizes the seven patent families that have been issued to-date for
our subsidiary companies:
Company
Assignee
Family
Status
Type
Granted
Regions
Expiration
Year
Vaximm
Manufacturing (1)
WO 2013/091898, Method for Producing High Yield Attenuated Salmonella
Strains
Owned
Manufacturing
AU, CA, CN, EP, IN, JP, KR, US, ZA
2032
VXM01 – dosing (2) WO 2014/005683, DNA Vaccine
for Use in Pancreatic Cancer Patients
Owned
Formulation
AU, CN, EP, JP, KR, US, ZA
2033
VXM06 – WT1 (3)
WO 2014/173542, Salmonella-based vectors for cancer immunotherapy
targeting Wilms’ tumor gene
Owned
Composition of Matter
EP, JP, US
2034
VXM04-MSLN (4)
WO 2015/090584, Novel MSLN targeting DNA vaccine for cancer immunotherapy
Owned
Composition of Matter
EP, JP, US
2034
VXM01 – combination (5)
WO 2016/202459, VEGFR-2 targeting DNA vaccine for combination
therapy
Owned
Composition of Matter; Method of Use
AU, CA, CN, EP, IN, US, ZA
2036
VXM01 Tumor expression (7)
WO 2018/149982, Novel VEGFR-2 targeting immunotherapy approach
Owned
Composition of Matter
AU, US
2038
Darnatein
Designer ligands of TGF-ß superfamily (0)
WO 2010/099219
Exclusive License
Composition of Matter
EP, KR, JP
2030
Activin/bmp7 chimeras: super-active sab704 and sab715, and their respective
noggin-sensitized variants, nab704 and nab715; and nab204
WO2020/101366
Owned
Composition of Matter
KR, CN, US
2039
Individual patents are in force for varying periods of time, depending
upon the date of filing of the patent application, the date of patent issuance, and the legal term of patents in the countries in which
they are obtained. Generally, patents issued for applications filed in the United States are in force for 20 years from the
earliest nonprovisional filing date. In addition, in certain instances, a patent term can be adjusted or extended to recapture a portion
of the term effectively lost as a result of the USPTO delay or the FDA regulatory review period (a patent term adjustment or patent term
extension, respectively). The restoration period for FDA delay cannot be longer than five years and the total patent term, including
the restoration period, must not exceed 14 years following FDA approval. The duration of patents outside of the United States
varies in accordance with provisions of applicable local law, but typically is also 20 years from the earliest nonprovisional filing
date. However, the actual protection afforded by a patent varies on a product-by-product basis, from country-to-country, and depends
upon many factors, including the type of patent, the scope of its coverage, the availability of regulatory-related extensions, the
availability of legal remedies in a particular country, and the validity and enforceability of the patent.
3
When appropriate, we seek to protect aspects of our technology and
business not amenable to, or that we do not consider appropriate for, patent protection as trade secrets. We seek to protect this intellectual
property, in part, as trade secrets, by entering into confidentiality agreements with those who have access to our confidential information,
including our employees, contractors, consultants, collaborators, and advisors.
Vaximm
Vaximm Corporate Overview
Vaximm is developing innovative oral T-cell immunotherapies for the
treatment of disorders that require the safe and targeted elimination of specific cell populations. (e.g. neoplasms, other proliferative
diseases, chronic infections). Based on over 20 years of research, Vaximm’s customizable immunotherapy platform has the potential
to be efficiently and effectively adapted to treat various diseases and address specific patient needs. Vaximm currently has three clinical
and pre-clinical drug candidates targeting diseases ranging from glioblastoma to gastrointestinal stromal tumor to ocular diseases.
Vaximm holds the only clinically tested oral cancer vaccine with proven safety and demonstrated efficacy
Vaximm’s flagship asset, VXM01, is a late
clinical-stage (NCT037500701) immuno-oncology candidate for glioblastoma, which early-stage clinical trials
(NCT02718443 and NCT01486329) suggest may be a potentially specific and effective treatment. VXM01 has been granted Orphan Drug
Designation by the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) for both glioblastoma and
pancreatic cancer on August 31, 2017 from FDA and August 23, 2017 from EMA. An Orphan Drug Designation will permit
Vaximm to receive additional years of market exclusivity upon regulatory approval, which provides a significant competitive
advantage. See “Government Regulation — Orphan Drug Designation and Exclusivity.” “
Based on evolving science, Vaximm is developing the VXM01 v 2.0. While meant to improve efficacy, it leverages the proven vector
safety data from VXM01 to move into late-stage development at speed.
While VXM01 (including version 2.0) moves into planned phase 2, phase
2/3 clinical trials, we are continuing to evaluate Vaximm’s other preclinical candidates for further development in investigational
new drug (IND)-enabling studies.
Importantly, the live, attenuated S. typhi strain Ty21a, presents
a proprietary platform for inducing an immune response to other antigens beyond the here chosen VEGFR-2, such as Carcinoembryonic Antigen
(CEA), Fibroblast Activation Protein (FAP) expressed in the tumor stroma, or Multiple Drug Resistance 1 (MDR-1). We have since tested
in preclinical models a variety of other antigens with success.
●
VXM04: A preclinical-stage oral T-cell vaccine targeting mesothelin (MSLN)
●
VXM06: A preclinical-stage oral T-cell vaccine targeting Wilms Tumor Protein (WT1)
●
VXM08: A preclinical-stage oral T-cell vaccine targeting CEA(Carcinoembryonic antigen)
●
VXM10 : A preclinical-stage oral T-cell vaccine targeting PD-L1 (Programmed death-ligand 1)
These products are currently undergoing preclinical studies to evaluate
their safety, immunogenicity, and anti-tumor efficacy. Vaximm will need to complete these preclinical studies and submit Investigational
New Drug (IND) applications to the relevant regulatory authorities before initiating clinical trials for each of these product candidates.
While Vaximm has direct experience advancing a therapeutic candidate
from preclinical to late-stage clinical trials and developed a pipeline of other preclinical therapeutic candidates, other than receiving
Orphan Drug Designation for VXMO1, Vaximm has limited experience in applying for regulatory or marketing approval for any of its product
candidates specifically. That said, this experience exists within the team. As Vaximm continues to advance its line of oral immunotherapies,
it will remain flexible and opportunistic to explore partnering options.
4
Opportunity
Current approaches to targeted immunotherapies have various limitations,
such as drug biodistribution, off-target effects, immunotolerance, and evasion. The complex and diverse makeup of tumor microenvironments
creates further difficulties. Production of targeted immunotherapies is expensive and time-intensive, making tailor-made therapies
challenging to produce and manufacture at scale and, thus, not readily accessible. Optimally, the development of innovative new strategies
can overcome drug resistance, enhance druggability, and improve drug biodistribution to maximize treatment efficacy.
Vaximm seeks to overcome these limitations by leveraging our foundational
science and innovative platform of attenuated bacterial strains to produce effective, customizable, oral vaccines efficiently and cost-effectively.
Vaximm’s lead product candidate, VXM01, targets the tumor vasculature and specific tumor antigens. It differs decidedly from other
vaccine approaches, since VXM01 does not have to overcome local immune suppression/encapsulation. The target, further, does not allow
for mutations and immune escape. VXM01 and the underlying proprietary platform, further, has the potential to target multiple indications,
even beyond oncology.
VXM01 has recently completed a Phase 2 clinical trial in Europe
for the treatment of recurrent glioblastoma, where activity has been observed to date. Vaximm also plans to initiate a new clinical trial
of VXM01 in recurrent glioblastoma patients in the United States.
If VXM01 demonstrates efficacy in the treatment of recurrent glioblastoma,
Vaximm intends to expand by developing oral cancer vaccines targeting other solid tumor indications. The company’s strategy generally
involves the following key steps:
1.
Identify novel tumor-specific antigens: Vaximm will leverage its
expertise in antigen discovery to identify new tumor-specific antigens that can be targeted by Vaximm’s platform. This will
include, as per precedent, targets which are expressed by cancer supporting tissue.
The safety profile and the mode of action of the platform make it a
prime candidate for combination with standard of care treatments. Thus, currently envisioned clinical development will initially focus
on add-on trials, avoiding initially combinations of non-approved assets. This presents a straight forward way to approval.
2.
Conduct preclinical studies with the FDA’s good laboratory practice (“GLP” regulations): Before testing any drug or biological product candidate in humans, the product candidate must undergo rigorous pre-clinical testing. The pre-clinical developmental stage generally involves laboratory evaluations of drug chemistry, formulation, and stability, as well as studies to evaluate toxicity in animals, to assess the potential for adverse events and, in some cases, to establish a rationale for therapeutic use. The conduct of pre-clinical studies is subject to federal regulations and requirements, including GLP regulations for safety/toxicology studies. Vaximm will perform preclinical studies to evaluate the safety, immunogenicity, and anti-tumor efficacy of its oral cancer vaccine candidates in line with the GLP regulations that the FDA requires.
3.
File an Investigational New Drug (IND) application: Upon the successful completion of preclinical studies, Vaximm will submit an IND application to regulatory authorities such as the FDA. IND is a request for authorization from the FDA to ship an investigation product and then administer it to humans and must be allowed to proceed by the FDA before human clinical trials may begin. This submission includes all relevant data from preclinical studies and outlines the proposed clinical trial protocols. The IND review period typically takes 30 days, during which the regulatory agency evaluates the submission to ensure the safety of proceeding to human trials.
4.
Initiate clinical trials: Based on the preclinical data and IND approval, the company will design and conduct additional Phase 2 clinical trials to assess the safety, tolerability, and preliminary efficacy of its oral cancer vaccines in other cancer indications.
5
5.
Conduct Phase 3 clinical trials: Phase 3 trials are large-scale, randomized, controlled studies designed to provide additional supporting evidence of the efficacy and safety of therapeutic candidates. These trials typically involve hundreds of patients and are conducted at multiple sites worldwide. Vaximm will work closely with clinical investigators, regulatory authorities, partners and patient advocacy groups to design and execute Phase 3 clinical trials for its oral cancer vaccine candidates.
6.
Seek regulatory approval: Following the successful completion of Phase 3 clinical trials, the result of the pre-clinical studies and clinical trials, together with detailed information relating to the product’s chemistry, manufacture, controls, and proposed labeling, among other things, are submitted to authorities, such as the FDA or EMA. This stage is known as the New Drug Application (NDA) review.
Regulatory Steps
New Drug Application
A New Drug Application (NDA) tells the full story of a drug. Its purpose
is to demonstrate that a drug is safe and effective for its intended use in the population studied.
A drug developer must include everything about a drug — from
preclinical data to Phase 3 trial data — in an NDA. Developers must include reports on all studies, data, and
analyses. Along with clinical results, developers must include proposed labeling, safety updates, drug abuse information, patent information,
any data from studies that may have been conducted in other countries, institutional review board compliance information and directions
for use. Vaximm has that information largely readily available due to past work. Especially, there seems no need for expensive and long-lasting
animal safety studies.
NDA Review
Once each authority such as FDA or EMA receives an NDA, the review
team decides if it is complete. If it is not complete, the review team can refuse to file the NDA. If it is complete, the review
team has 6 to 10 months to make a decision on whether to approve the drug. The process includes the following:
●
Each member of the review team conducts a full review of his or her section of the application. For example, the medical officer and the statistician review clinical data, while a pharmacologist reviews the data from animal studies. Within each technical discipline represented on the team, there is also a supervisory review. All expertise needed with a proven track record are available within the team
●
FDA or EMA inspectors travel to clinical study sites to conduct a routine inspection. The Agency looks for evidence of fabrication, manipulation, or withholding of data.
●
The project manager assembles all individual reviews and other documents, such as the inspection report, into an “action package.” This document becomes the record for NDA review. The review team issues a recommendation, and a senior official makes a decision.
NDA Approval
In cases where FDA or EMA determines that a drug has been shown to
be safe and effective for its intended use, it is then necessary to work with the applicant to develop and refine prescribing information.
This is referred to as “labeling.” Labeling accurately and objectively describes the basis for approval and how best to use
the drug.
6
FDA Advisory Committees
Often, the NDA contains sufficient data for FDA or EMA to determine
the safety and effectiveness of a drug. Sometimes, though, questions arise that require additional consideration. In these cases, FDA
or EMA may organize a meeting of one of its Advisory Committees to get independent, expert advice and to permit the public to make comments.
These Advisory Committees include a Patient Representative that provides input from the patient perspective.
The estimated timeframe for this process is as follows:
●
If
applicable: Antigen discovery and vaccine formulation: About 1year.
(This step is not necessary for VXM01
including 2.0, but may have to in part be executed for new targets)
● Preclinical
studies: About 1 year
● IND
filing and review: 1 month
● Phase 1/2
clinical trials: 2-3 years
● Phase 3
clinical trials: 2-3 years
● Regulatory
approval (including NDA review): 1 year
Based on this timeline, Vaximm anticipates that its next oral cancer
vaccine candidate beyond VXM01 could enter clinical trials within the next 3-5 years, with potential regulatory approval in
less than 7 years.
In case of the improved version of VXM01, these timelines are expected
to be significantly shorter (about 4years).
Clinical Trials
Overview of VXM01 clinical trial
VXM01 was clinically tested in two trials in advanced pancreatic cancer
and in Glioblastoma:
● VXM01
Phase I Dose Escalation Study in Patients With Locally Advanced, Inoperable and Stage IV Pancreatic Cancer (NCT01486329)
● VXM01
Phase I Pilot Study in Patients With Operable Recurrence of a Glioblastoma (NCT02718443)
In both studies, VXM01 was found to be extremely safe and found to
consistently elicit the expected immune response including biomarkers and indication of efficacy.
7
1. A randomized, double blinded, placebo phase 1/2 trial in pancreatic carcinoma (NCT01486329):
VXM01 Phase I Dose Escalation Study in Patients With Locally Advanced,
Inoperable and Stage IV Pancreatic Cancer.
NCT01486329 was a randomized, placebo-controlled, double-blinded
dose-escalation study included a total of 72 treated patients with locally advanced and stage IV pancreatic cancer. The patients
received in this trial VXM01 or placebo (S. typhi carrying a non-coding DNA plasmid) in addition to gemcitabine as standard of care.
In addition to safety as primary endpoint, the VXM01-specific immune reaction, as well as clinical response parameters were
evaluated. After the initial doses, patients received up to six monthly boost vaccinations, or placebo treatment. Vaccinations were
applied orally, and concomitant treatment with standard-of-care gem-citabine during the priming phase (first 4 weekly doses):
● Part 1 (n=45, 5 dose levels) initiation treatment only in
the first week on days 1, 3, 5, and 7 at doses ranging from 106 colony forming units (CFU) up to 1010 CFU of VXM01 or placebo (2:1 randomization).
● Part 2 (n=27, 2 dose levels) at two alternative doses of
either 106 colony-forming units (CFU)or 107 CFU with up to 6 monthly boosts after initiation treatment. Immune monitoring involved interferon-gamma
(IFN-𝛾) ELIspot analysis with long overlapping peptides spanning the entire VEGFR-2 sequence. (Designation: VXM01 has received
orphan drug designation from the U.S. Food and Drug Administration (FDA) and the European Commission.
8
This trial was completed at the University of Heidelberg and the German
Cancer Research Center (DKFZ).
Overall survival (all comers):
Importantly, target specific T cell activation over placebo was noted
in both, periphery and tumor tissue.
Part 1, T cell response over placebo: “Prime”
9
Activation was noted in both, subjects with and without pre-dosing
existing immune response
Boosting after 40 days sustained and increased the immune response:
“Boost”
There was encouraging survival in subjects boosted in part 2 with bad
prognosis based on CA-19-9, status, extend of disease.
Subgroup analysis “bad prognosis”:
10
The effect gets more pronounced when looking at patients with successful
immune induction at prime:
Observed pharmacodynamic effects in VXM01 treatment group vs. placebo
included
● a decrease in tumor perfusion,
● increase in serum collagen,
● mild elevation in blood pressure,
● mild drop in thrombo-cyte, leukocyte and lymphocyte counts.
All of which are indictive of successful vessel targeting and ratification.
For example, increased blood pressure in patients treated with VXM01 over placebo indicates blood vessel rarefication.
Increase of VEGF-A and collagen IV (indicator of vessel destruction)
after vaccination further supported the observed vaccination effects on tumor perfusion, particularly since we observed a significant
inverse correlation between collagen IV serum levels and alterations of tumor perfusion after the vaccination.
DCE-MRI was employed to assess tumor perfusion. After 38 days, tumor
perfusion as 18% reduced in the VXM01 subjects while unchanged in placebo treated patients
In conclusion, VXM01 elicits a productive, complex
VEGFR-2-specific effector T-cell response in patients with pancreatic cancer that correlates with anti- angiogenic activity and has
a favorable safety profile. Changes indicative of anti-angiogenic efficacy in tumor perfusion, serum biomarkers, and blood pressure
in VXM01 treated patients but not in the control arm were recorded.
Importantly, no safety concerns were noted
Trial design end results are published in:
● Niethammer
AG, Lubenau H, Mikus G, Knebel P, Hohmann N, Leowardi C, Beckhove P, Akhisaroglu M, Ge Y, Springer M, Grenacher L, Buchler MW, Koch M,
Weitz J, Haefeli WE, Schmitz-Winnenthal FH. Double-blind, placebo-controlled first in human study to investigate an oral vaccine aimed
to elicit an immune reaction against the VEGF-Receptor 2 in patients with stage IV and locally advanced pancreatic cancer. BMC Cancer.
2012 Aug 20;12:361.
11
● Schmitz-Winnenthal
FH, Hohmann N, Niethammer AG, Friedrich T, Lubenau H, Springer M, Breiner KM, Mikus G, Weitz J, Ulrich A, Buechler MW, Pianka F, Klaiber
U, Diener M, Leowardi C, Schimmack S, Sisic L, Keller AV, Koc R, Springfeld C, Knebel P, Schmidt T, Ge Y, Bucur M, Stamova S, Podola
L, Haefeli WE, Grenacher L, Beckhove P. Anti-angiogenic activity of VXM01, an oral T-cell vaccine against VEGF receptor 2, in patients
with advanced pancreatic cancer: A randomized, placebo-controlled, phase 1 trial. Oncoimmunology. 2015 Mar 16;4(4):
2. A phase1 clinical trial of VXM01 in Glioblastoma was initiated in May 2016 (ClinicalTrials.gov ID: NCT02718443). The
trial was conducted at the Neurology Clinic and National Center for Tumor Diseases in Heidelberg, Germany, and the principal investigator
is Dr. Wolfgang Wick, MD, who is a professor at the Neurology Clinic and National Center for Tumor Diseases.
The phase I clinical trial was evaluated for 14 patients with
recurrent glioblastoma who had progressed after standard treatment and were candidates for reoperation. The primary objective of the study
was to examine the safety and tolerability of the investigational VEGFR2 DNA vaccine VXM01 after four vaccinations in glioblastoma patients.
The secondary objective was to examine the immune and biomarker response to the vaccine. During the course of this clinical trial, 7 patients
were alive and survived for more than 12 months after initiation of treatment. No adverse effects related to VXM01 were observed.
source: Wick, W et al. “P01.031 VXM01 phase I study in
patients with progressive glioblastoma — final results.” Neuro-Oncology vol. 20, Suppl 3 (2018): iii235.
doi:10.1093/neuonc/noy139.073
As the Phase 1 trial progressed, VXM01 was granted orphan drug
status by the FDA and EMA in 2017 for the treatment of glioma.
Authority
Orphan
Designation
Designation date
Source
FDA
Treatment of Malignant glioma
08/31/2017
https://www.accessdata.fda.gov/scripts/opdlisting/oopd/detailedIndex.cfm?cfgridkey=596117
EMA
Treatment of glioma
23/08/2017
https://ec.europa.eu/health/documents/community-register/html/o1909.htm
As a next step, on November 21, 2018, a combination study of VXM01
and anti-PD-L1 checkpoint inhibitor avelumab in 28 patients with relapsed glioblastoma began (ClinicalTrials.gov ID NCT03750071 ).
The trial included 25 patients with non-resectable tumors and 3 with resectable tumors. The main objective of the study is to evaluate
the safety and tolerability of VXM01 vaccine treatment in combination with avelumab.
Dr. Wolfgang Wick, the principal investigator for the Phase I
clinical trial and also a key opinion leader in the field of brain malignancies, also conducted this combination study. He will remain
principal investigator for future trials.
This Phase I/II clinical trial was not sized or designed to yield
advanced comparative statistical results. Larger patient cohorts and additional design features typical of Phase 2/PoC studies (including
randomization, Blinding, control groups) are required to obtain data yielding advanced statistics and guide the design of registrational
(Ph3) studies. Initiation of such trials is planned for 2026. That said, the data to date shows promising responses, including as single
agent, having generated considerable interest in the field at the time.
VXM01 Phase 1/2 clinical trial — Patient selection
criteria
Patients were selected by a third-party clinical trial provider, each
of whom met the following criteria:
●
Diagnosis: anaplastic astrocytoma (WHO Grade III) or glioblastoma (WHO Grade IV) located above the tentorium cerebelli in the brain.
12
●
Age: 18 years or older.
●
Sex: men or women who were post-menopausal for at least 2 years or surgically sterile.
●
Disease progression: evidence of tumor growth after at least one treatment regimen containing radiation and temozolomide chemotherapy.
●
Resectable tumor: eligible for a repeat surgery to remove the tumor, with the surgery able to be delayed for 30 days.
●
General health: good bone marrow, liver, and kidney function (as determined by blood and urine tests); able to undergo MRI scans; no active infection at the time of vaccination; Karnofsky performance status greater than 70; and adequate blood counts.
●
No recent clinical trials: no participation in another clinical trial within 30 days before screening.
●
No specific infections: negative test results for Hepatitis B, Hepatitis C, and HIV.
●
No interfering conditions: no other medical or social conditions that might interfere with the study or make it unsafe for the patient to participate.
The study included 14 white patients with a mean age of 56.8 years.
The majority of participants (64.3%) were male.
VXM01 phase I clinical trial — Tumor response
The tumor response was assessed by objective response rate (ORR) according
to immunotherapy Response Assessment for Neuro-Oncology (iRANO; 2015).
Overall, the tumor response to VXM01 was mixed, with some patients
showing signs of stable disease or even tumor shrinkage, while others experienced disease progression. These findings highlight the variability
in treatment response and the challenges of managing glioblastoma. The extension study results provide further insights into the potential
for long-term disease control in some patients, but also underscore the need for further research to optimize treatment strategies
and identify those most likely to benefit.
Best Overall Response
106 CFU (N=7) n (%)
107 CFU (N=6) n (%)
Total (N=13) n (%)
CR
1 (14.3)
—
1 (7.1)
PR
1 (14.3)
—
1 (7.1)
SD
5 (71.4)
5 (83.3)
10 (76.9)
PD
—
1 (16.7)
1 (7.1)
ORR (%) [95% CI]
28.6 [3.7 – 71.0]
0.0 [0.0 – 45.9]
15.4 [1.9 – 45.4]
DCRR (%) [95% CI]
100.0 [59.0 – 100.0]
83.3 [35.9 – 99.6]
92.3 [64.0 – 99.8]
Note: A hyphen (-) indicates no events were reported. n = number
of patients with an event; N = number of patients; NR = non-resectable. Percentages are based on the number of patients. CR = complete
response; PR = partial remission; SD = stable disease; PD = progressive disease; ORR = objective response rate (CR and PR);
DCR = disease control rate (CR, PR, and SD).
13
In this study, we assessed clinical response using several measures,
including progression-free survival (PFS) and overall survival (OS). PFS ranged from 9 to 366 days, with a median PFS of 0.8 months
in the 107 CFU dose group and 2.6 months in the 106 CFU dose group. OS ranged from 67 to 416 days,
with a median OS of greater than 14 months in the 106 CFU group and 7.6 months in the 107 CFU
group.
For the 3 patients who entered the prolongation phase, PFS ranged between
30 and 960 days, and overall survival ranged between 776 and 1147 days. These findings suggest a potential advantage in terms
of PFS and OS for the lower dose group, although they may be influenced by the slightly better baseline status of the patients in the
106 CFU dose group.
VXM01 phase 1/2 clinical trial — Immune response
The effect of VXM01 was explored by evaluating the VEGFR-2 specific
T cell response and frequency of immune cells in peripheral blood, and by staining of immune- and biomarkers in tumor tissue obtained
during resection.
Peripheral T-cell response:
All 9 tested patients showed a VEGFR2-specific T-cell and
IFN-γ immune response, with a clear increase observed after the initial vaccination and further increases after the first booster
dose. This indicates that VXM01 effectively stimulated an immune response against VEGFR2, a protein involved in tumor growth.
ELISpot assay was used to measure the number of these T cells that
produced interferon gamma (IFN-γ) when stimulated with different fragments of the VEGFR-2 protein.
Mean difference count pool-all minus negative control
106 CFU; mean ± SD (N)
107 CFU; mean ± SD (N)
Total; mean ± SD (N)
Day 0
4.5 ± 6.22 (3)
18.1 ± 17.64 (5)
13.0 ± 15.46 (8)
Day 21
14.5 ± 10.35 (3)
10.4 ± 17.13 (4)
12.2 ± 13.68 (7)
Day 35
8.4 ± 7.06 (3)
13.4 ± 15.36 (5)
11.6 ± 12.48 (8)
Week 12 + 10 days
-17.5 (2)
30.6 ± 20.96 (5)
16.9 ± 30.39 (7)
Week 24 + 10 days
-2.0 (1)
-4.5 ± 9.57 (4)
-4.0 ± 8.36 (5)
Week 36 + 10 days
20.4 (1)
27.0 (2)
24.8 ± 4.45 (3)
Week 48 + 10 days
29.6 (1)
28.7 (1)
29.2 (2)
Brain Tumor Immunohistochemistry:
An analysis of tumor tissue from 8 re-operated patients showed
a statistically significant increase in CD8 T-cells (immune cells that kill cancer cells) after vaccination with VXM01. Specifically,
the mean number of CD8 T-cells increased from 159 cells/mm² in the primary tumor to 296 cells/mm² in the recurrent tumor,
with a P-value of 0.0239 (paired t-test). Additionally, there was a decrease in regulatory T-cells (Treg), which are immune
cells that suppress immune responses. The median number of Treg cells dropped from 32 cells/mm² in the primary tumor to 12 cells/mm²
in the recurrent tumor. This resulted in a higher CD8:Treg ratio, which has been associated with better clinical outcomes in other studies.
VXM01 phase I clinical trial — Safety result
In this trial, there were no notable differences observed between the
two dose groups (106 CFU and 107 CFU).
All patients experienced at least one treatment-emergent adverse
event (TEAE), but most were mild or moderate in severity and considered unrelated to VXM01. The most common TEAEs were consistent with
the underlying disease or progression of disease, and included aphasia, hemiparesis, fatigue, headache, and lymphopenia.
14
No treatment-limiting toxicities (TLTs) were observed. Four TEAEs
(flatulence, dizziness, fatigue, and nausea) were considered related to VXM01, but all were mild and resolved without intervention. All
serious adverse events (SAEs) and deaths were attributed to the underlying disease or disease progression.
Adverse after prime and boosting doses
106 CFU (N=7) n (%) E
107 CFU (N=6) n (%) E
Drug related TEAEs
1 (14.3) 2
2 (33.3) 2
Drug related SAEs
—
—
Drug related Treatment-Emergent SAEs
—
—
TLTs Related to VXM01
—
—
Treatment Discontinuations Due to AEs
—
—
Study Discontinuations Due to AEs
—
—
Note: A hyphen (-) indicates no events were reported. E = number
of events; n = number of patients with an event; N = number of patients. Percentages are based on the number of patients. CFU: colony
forming units.
VXM01 phase I/II clinical trial — Patient selection
criteria
Patients were selected by a third party clinical trial provider, each
of whom met the following criteria:
●
Diagnosis: confirmed glioblastoma (WHO Grade IV) located above the tentorium cerebelli in the brain.
●
Disease progression: evidence of tumor growth after receiving standard treatment with radiation and temozolomide chemotherapy.
●
Prior treatment: completion of radiotherapy at least 3 months before entering the trial.
●
Resectable tumors (subset of patients): eligible for a repeat surgery to remove the tumor, with the surgery able to be delayed for 30 days.
●
General health: good bone marrow, liver, and kidney function; able to undergo MRI scans; no active serious infections; and a Karnofsky performance status of 70 or higher (meaning they could mostly care for themselves).
●
Tumor samples: availability of tumor tissue for analysis.
●
Sex: men were eligible. Women had to be post-menopausal or surgically sterile due to a lack of safety data on the vaccine’s potential impact on reproduction.
With these criteria, the trial recruited 25 patients with non-resectable tumors
and 3 with resectable tumors. Overall, the mean age of participants was 58 years, with the majority (78.6%) being male.
VXM01 phase I/II clinical trial — Tumor response
The tumor response was assessed by Objective Response Rate (ORR) and
Duration of Response (DoR) according to immunotherapy Response Assessment for Neuro-Oncology (iRANO; 2015)
Overall, in the non-resectable patients the ORR was 12.0% (95%
CI: 2.5 – 31.2), with 3 responders out of 25 patients (12.0%) who had a partial remission. Of the patients with a
partial remission, 1 patient in the 106 CFU/mL group had a DoR of 5.6 months, while the patients in the 107 CFU/mL
group had a DoR of 2.7 and 11.1 months. All patients who had stable disease (n=3) received 107 CFU/mL VXM01.
15
Best Overall Response
106 CFU/mL (N=3) n (%)
107 CFU/mL (N=25) n (%)
Total NR (N=25) n (%)
PR
1 (33.3)
2 (8.0)
3 (12.0)
SD
—
3 (12.0)
1 (4.0)
PD
2 (66.7)
20 (80.0)
21 (84.0)
ORR (%) [95% CI]
33.3 [0.8 – 90.6]
8.0 [1.0 – 26.0]
12.0 [2.5 – 31.2]
DCRR (%) [95% CI]
33.3 [0.8 – 90.6]
20.0 [6.8 – 40.7]
16.0 [4.5 – 36.1]
Note: A hyphen (-) indicates no events were reported. n = number
of patients with an event; N = number of patients; NR = non-resectable. Percentages are based on the number of patients. CR = complete
response; PR = partial remission; SD = stable disease; PD = progressive disease; ORR = objective response rate (CR and PR); DCR = disease
control rate (CR, PR, and SD).
The clinical response was assessed by recurrence-free survival
after re-operation (RFS) (in the 107 CFU/mL resectable group), time-to-progression (TTP), progression free survival
(PFS), and overall survival (OS). In the patients who underwent tumor resection (107 CFU/mL resectable group), disease
progression occurred only in Patient 01-17 with an RFS of 1.8. Patient 01-14 was censored with an RFS of 20.9 months.
The results for TTP and PFS were identical, with an overall median of 2.7 months and range of 1.2 to 13.8 months in the non-resected patients
(Total NR group). The median OS in the Total NR group was 11.1 months (95% CI: 8.5 – 15.1) with a range of 3.8 to
38.2 months. At the time of database lock, 1 patient in the 107 CFU/mL resectable group was alive and had stable
disease without post-resection recurrence, while 3 patients in the 107 CFU/mL non-resectable group were alive
with progressive disease in longterm follow-up.
VXM01 phase I/II clinical trial — Immune response
The effect of VXM01 plus avelumab was explored by evaluating the VEGFR-2 specific
T cell response and frequency of immune cells in peripheral blood, and by staining of immune- and biomarkers in tumor tissue obtained
during resection.
ELISpot assay was used to measure the number of these T cells that
produced interferon gamma (IFN-γ) when stimulated with different fragments of the VEGFR-2 protein.
VEGFR-2 specific ELISpot counts were calculated as the ELISpot
count per peptide pool minus the negative control. The VEGFR-2 specific T cell response was defined positive when the test peptide
pool had at least two-fold higher spot counts compared to the negative control and the difference of the triplicates was significant
in an unpaired two-tailed student’s t-test.
Overall, 12 of 28 patients (42.9%, all in the 107 CFU/mL
non-resectable group) had a VEGFR-2 specific T cell response classified as negative for all peptides at all time points tested.
The VEGFR-2 specific T cell response was decreased on Day 21 compared with baseline in 6 patients, was increased in 4 patients (all
107 CFU/mL non-resectable group), and remained at the same level compared with baseline in 5 patients. At Week 16,
the VEGFR-2 specific T cell response was increased compared with baseline in 7 patients (1 patient in 106 CFU/mL
group, 6 patients in 107 CFU/mL group), decreased in 5 patients (all 107 CFU/mL group), and remained the
same in 3 patients.
VXM01 phase I/II clinical trial — Safety result
The majority of reported events in this trial being mild to moderate
severity in nature but would need to be assessed in a larger patient population. Notably, while SAEs were observed during the study period,
all of them were target disease-related rather than treatment-related. The observed SAEs included brain edema, epilepsy, stroke,
hyponatremia, gait disturbance, and pulmonary embolism, which are commonly reported symptoms in patients with brain tumors or severe illnesses
as their disease progresses and were not attributable to VXM01 administration. A safety evaluation will be determined following review
of all safety data by relevant regulatory agencies.
16
All patients (n=28; 100%) experienced multiple AEs, but no treatment-limiting toxicities
(TLT) related to VXM01 or avelumab, or infusion-related adverse events (AEs) were recorded for any group. No treatment-related SAEs
were recorded for the 106 CFU/mL and 107 CFU/mL resectable groups. No VXM01- or avelumab-related SAEs
or treatment-emergent SAEs were recorded for any group. One patient discontinued study treatment due to rheumatoid arthritis which
occurred after the first 5 weeks of treatment. This adverse event was assessed as unrelated to VXM01 administration and occurred
independently of the patient’s underlying condition, thus it was not reported as TLT. Four patients experienced a total of
5 (five) immune-related AEs (irAEs). These immune-related AEs included hypothyroidism, autoimmune thyroiditis, fatigue,
and the aforementioned rheumatoid arthritis. As with other reported events, these immune-related AEs were assessed and determined
to be unrelated to VXM01 administration.
Adverse Event Category
106 CFU/mL (N=3) n (%) E
107 CFU/mL (N=25) n (%) E
Drug related SAEs
—
—
Drug related Treatment-Emergent SAEs
—
—
TLT Related to VXM01
—
—
TLT Related to avelumab
—
—
Infusion-related Adverse Events
—
—
Immune-related Adverse Events
—
4 (16.0) 5
Treatment Discontinuations Due to AEs
—
1 (4.0) 1
Study Discontinuations Due to AEs
—
—
Note: A hyphen (-) indicates no events were reported. E = number
of events; n = number of patients with an event; N = number of patients. Percentages are based on the number of patients.
Intellectual Property
Vaximm actively maintains 8 patent families relating to Vaximm’s
portfolio of assets, in the United States and in other major markets as described shown in the tables below of specific patents within
each patent family that have been issued or are under examination. All patents within each of the active patent families have been issued
or are currently under various stages of nationalization and are owned or in-licensed patent families by Vaximm and cover composition
of matter, formulation and/or methods of use, are shown in the table below.
Manufacturing (1)
WO 2013/091898, Method for Producing High Yield Attenuated Salmonella Strains
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
21/12/2012
PCT/EP2012/005364
2013/091898
—
AU
PCT
21/12/2012
2012359166
23/11/2017
2012359166
2012359166
21/12/2032
granted
CA
PCT
21/12/2012
2,853,656
29/12/2020
2,853,656
2,853,656
21/12/2032
granted
CN
PCT
21/12/2012
201280064144.2
19/04/2017
104066834
104066834
21/12/2032
granted
EP*
PCT
21/12/2012
12 808 264.1
30/08/2017
2 794 849
2 794 849
21/12/2032
granted
IN
PCT
21/12/2012
5386/DELNP/2014
10/06/2019
313960
IN05386DN2014
21/12/2032
granted
JP
PCT
21/12/2012
2014-547768
01/12/2017
6251179
2015-502162
21/12/2032
granted
KR
PCT
21/12/2012
10-2014-7020387
23/08/2019
10-2015932
10-2014-0105028
21/12/2032
granted
US
PCT
21/12/2012
14/366,186
15/11/2016
9,493,738
2014-0349274
21/12/2032
granted
ZA
PCT
21/12/2012
2014/04501
24/02/2016
2014/04501
2014/04501
21/12/2032
granted
17
VXM01 — dosing (2)
WO 2014/005683, DNA Vaccine for Use in Pancreatic Cancer Patients
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
26/06/2013
PCT/EP2013/001882
2014/005683
—
AU
PCT
26/06/2013
2013286335
07/12/2017
2013286335
2013286335
26/06/2033
granted
AU
DIV
26/06/2013
2017258877
14/03/2019
201725887
2631924
26/06/2033
granted
CA
PCT
26/06/2013
2,877,938
2,877,938
26/06/2033
under examination
CN
PCT
26/06/2013
201380035905.6
30/10/2020
CN201380035905.6A
104519908
26/06/2033
granted
EP*
PCT
26/06/2013
13 732 833.2
25/09/2019
2 869 836
2 869 836
26/06/2033
granted
IN
PCT
26/06/2013
180/DELNP/2015
IN00180DN2015
26/06/2033
under examination
JP
PCT
26/06/2013
2015-518890
20/04/2018
6325534
2015-522263
26/06/2033
granted
KR
PCT
26/06/2013
10-2015-7002939
12/03/2020
10-2090612
10-2015-0036361
26/06/2033
granted
US
PCT
26/06/2013
14/409,434
16/08/2016
9,415,098
2015-0165011
26/06/2033
granted
US
CON2
31/05/2018
15/994,766
21/05/2019
10,293,037
2019-0008936
26/06/2033
granted
ZA
PCT
26/06/2013
2014/09156
27/07/2016
2014/09156
2014/09156
26/06/2033
granted
VXM06 — WT1 (3)
WO 2014/173542, Salmonella-based vectors for cancer immunotherapy targeting Wilms’ tumor gene
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
24/04/2014
PCT/EP2014/001099
2014/173542
—
EP*
PCT
24/04/2014
14 721 208.8
06/06/2018
2 988 762
2 988 762
24/04/2034
granted
JP
PCT
24/04/2014
2016-509326
12/10/2018
6416877
2016-518835
24/04/2034
granted
US
PCT
24/04/2014
14/786,652
20/03/2018
9,920,297
14/786,652
24/04/2034
granted
US
CON
24/04/2014
15/872,750
27/10/2020
10,815,455
2018/0163169
24/04/2034
granted
VXM04-MSLN (4)
WO 2015/090584, Novel MSLN targeting DNA vaccine for cancer immunotherapy
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
17/12/2014
PCT/EP2014/003403
2015/090584
—
EP*
PCT
17/12/2014
14 821 508.0
28/08/2019
3 082 850
3 082 850
17/12/2034
granted
JP
PCT
17/12/2014
2016-559513
14/01/2020
6662787
2017-502692
17/12/2034
granted
US
CON
17/12/2014
15/785,743
15/10/2019
10,441,645
2018/0064794
17/12/2034
granted
18
VXM01 — combination (5)
WO 2016/202459, VEGFR-2 targeting DNA vaccine for combination therapy
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
16/06/2016
PCT/EP2016/001004
2016/202459
—
AU
PCT
16/06/2016
2016278588
31/03/2022
AU2016278588A
2016278588
16/06/2036
granted
CA
PCT
16/06/2016
2989247
17/10/2023
CA2989247A
2989247
16/06/2036
granted
CN
PCT
16/06/2016
201680035593.2
13/07/2021
CN201680035593.2A
107995868
16/06/2036
granted
EP
PCT
16/06/2016
16736381.1
06/11/2019
3 310 379
3 310 379
16/06/2036
granted
EPHK
PCT
118111736.6
11/12/2020
HK1252435
HK1252435
16/06/2036
granted
EP(T1)
DIV
19205420.3
3626262
16/06/2036
under examination
IN
PCT
16/06/2016
201717043556
08.11.2023
467201
201717043556 A
16/06/2036
granted
JP
PCT
16/06/2016
2017-565248
21.09.2021
JP2017565248A
2018517419
16/06/2036
under examination
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
US
PCT
16/06/2016
15/737,659
02/02/2021
10,905,752
US 2018/0250345
16/06/2036
granted
US
CON
16/06/2016
17/107,203
US20210077605A1
16/06/2036
pending
ZA
PCT
16/06/2016
2017/08439
26/05/2021
2017/08439
16/06/2036
granted
VXM01 Tumor expression (7)
WO 2018/149982, Novel VEGFR-2 targeting immunotherapy approach
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
16/02/2018
PCT/EP2018/053918
WO 2018/149982
—
AU
PCT
16/02/2018
2018222777
01/02/2024
2018222777B9
2018222777 A
16/02/2038
granted
CA
PCT
16/02/2018
305833
305833 A
16/02/2038
under examination
CN
PCT
16/02/2018
201880012318.8
110291187 A
16/02/2038
under examination
EP
PCT
16/02/2018
18 704 568.7
3 583 200 A
16/02/2038
under examination
IN
PCT
16/02/2018
201917030262
201917030262 a
16/02/2038
under examination
JP
PCT
16/02/2018
2019-544614
16/02/2038
under examination
US
PCT
16/02/2018
16/486,425
20/04/2021
10980868B2
2020038496 A
16/02/2038
granted
VXM10 — PD-L1 (8)
WO 2018/167290, Novel PD-L1 targeting DNA vaccine for cancer immunotherapy
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
16/02/2018
PCT/EP2018/056721
WO 2018/167290
—
CN
PCT
16/02/2018
201880018761.6
110430893
16/02/2038
under examination
EP
PCT
16/02/2018
18710879
3 595 704
16/02/2038
under examination
JP
PCT
16/02/2018
2019-550795
2020-511139
16/02/2038
under examination
19
VXM01 in combination with an antibiotic (9)
WO 2021/144254, Salmonella-based DNA vaccines in combination with an antibiotic
Country Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
12/01/2021
PCT/EP2021/050470
WO 2021/144254
—
AU
PCT
12/01/2021
2021208400
2121208400
12/01/2041
under examination
CA
PCT
12/01/2021
3162994
3162994
12/01/2041
under examination
CN
PCT
12/01/2021
202180008543.6
114980871
12/01/2041
under examination
EP
PCT
12/01/2021
21700697
4090321
12/01/2041
under examination
IN
PCT
12/01/2021
202217033481
202217033481
12/01/2041
under examination
JP
PCT
12/01/2021
2022542046
2023510770
12/01/2041
under examination
KR
PCT
12/01/2021
1020227027291
1020220128638
12/01/2041
under examination
US
PCT
12/01/2021
17791282
20230121528
12/01/2041
under examination
Darnatein
Corporate Overview
Darnatein is developing design-augmented (DA) biologics for age-related and
other degenerative diseases, such as osteoarthritis and spine and joint disorders. Darnatein’s lead DA biologics are intended to
be injected directly into pathological tissues to promote regeneration of target tissues such as bone or cartilage cells. Leveraging these
innovative DA biologics to regenerate bone and cartilage has the potential to restore functionality and reduce pain across several degenerative
conditions.
Darnatein has identified and advanced two therapeutic candidates, DRT-102,
a clinical-stage asset for spinal fusion, and DRT-101, a pre-clinical stage asset for osteoarthritis. A small exploratory, clinical
trial of 15 patients with DRT-102 indicated potential efficacy compared to a placebo, with no serious adverse events reported. Safety
and efficacy evaluation will be determined following review of all safety data by relevant regulatory agencies. Larger clinical trials
will be required to provide more extensive and accurate data on the safety and effectiveness of DRT102. A pre-clinical (non-human)
trial of DRT-101 demonstrated cartilage regeneration and joint healing in animals, with no serious adverse events reported. Based
on these preliminary results, Darnatein intends to continue the development and testing of DRT-101 and, when additional resources
are available, DRT-102. Darnatein has not previously advanced any therapeutic candidates into late-stage clinical trials nor received
regulatory and marketing approvals for any commercial sales of its products.
Opportunity
Age-related degeneration, such as osteoarthritis and spine disorders,
is a naturally occurring process that may be accelerated due to chronic and cumulative impact over time. Limited therapeutic options exist
and only offer limited and temporary symptomatic relief with no cure currently available.
Beyond therapeutic options, invasive surgical procedures may be available
for spine and joint disorders but are not readily accessible and may not be a curative, pain-free, long-term solution. Additionally,
neither symptomatic therapies nor invasive and costly surgical procedures address the underlying cause of chronic and age-related degenerative
diseases. Darnatein’s novel Design Augmented (DA) approach has the potential to overcome these limitations of spine and joint disorders
and osteoarthritis with a regenerative therapy to overcome degeneration in bone and cartilage.
20
Design-Augmented Biologics Program
In recent years, scientists have studied the role of bone morphogenetic
proteins (BMPs) in healing bone and cartilage. BMPs have been used clinically in orthopedic procedures but they are typically administered
at high, supra-physiological concentrations that have been linked to undesirable local and systemic side effects. BMPs engineered
to have enhanced therapeutic potency may circumvent this problem and provide the desired effects of healing bone and cartilage while minimizing
the likelihood of adverse events.
DRT-101 for Cartilage and Joint Recovery
DRT-101 is a synthetic bio-signaling molecule that replaces
BMPRII-binding segments of BMP-7, one of the bone-forming proteins, with high affinity ActRII binding segments of Activin A,
a member of the transforming growth factor ß (TGF-ß). In nature, endogenous BMP7 promotes chondrogenesis in damaged cartilage
tissue by signaling primarily via the type II receptor BMPRII and to a lesser extent via the activin type II receptor ActRII,
which it binds with lower affinity. DRT-101 amplifies intracellular regeneration signaling capacity compared to natural BMP-7 and
allows for regeneration and restoration of mechanically depleted cartilage cells to normal levels.
DRT-101 pre-clinical study in animals
DRT-101 was evaluated in Sprague Dawley rats by ChemOn Inc. in
2021 for toxicity measurement. This study was conducted to assess the approximate lethal dose (ALD) and the dose-range finding(DRF)
of the test substance DRT-101, when administered intravenously.
The table below lists the type, species, purpose and results of our
completed pre-clinical toxicology studies from 2021-2022. These studies were conducted with the assistance of Chemon Inc., a
GLP-licensed third-party vendor.
Type of Study
Species
Purpose
Results
Period
Single Dose Intravenous Toxicity Test of DRT-101 in Sprague-Dawley Rats
Sprague Dawley Rats
Assess the toxicity of the test substance DRT-101 when administered intravenously to Sprague-Dawley Rats
The approximate lethal dose (ALD) was determined to exceed 10mg/kg for both males and females.
2021.03.05-
2021.05.11
Single Dose Intravenous Toxicity Test of DRT-101 in Sprague-Dawley Rats
Sprague Dawley Rats
Investigate the toxicity and histopathological changes at the administration route
The approximate lethal dose exceeded 0.625 mg/kg for both males and females, and toxicologically adverse changes including dysplasia and hypertrophy of cartilage at the injection area were observed.
2021.04.29-
2021.11.01
Two-Week Repeated Dose Intravenous Toxicity Test of DRT-101 in Sprague-Dawley Rats
Sprague Dawley Rats
Investigate the toxicity of DRT-101 when administered intravenously to Sprague-Dawley rats repeatedly for two weeks, with the aim of determining dosage for subsequent intravenous toxicity tests
DRT-101 was injected at dose of 0.069, 0.208, and 0.625 mg/kg/day. Swelling at the administration area (tail) was observed in male and female rats in dose groups above 0.208 mg/kg/day. Induration at the administration area was observed in all test substance groups of both sexes. The induration is speculated to be dysplasia and hypertrophy of cartilage in the tail. Accordingly, it is recommended to set 0.069 mg/kg/day as the high-dose group for the next repeated intravenous toxicity studies.
2021.12.07-
2022.02.10
Currently, the toxicity test of DRT-101 is ongoing with BiotoxTech.
The purpose of this study is to evaluate the potential toxicity and determine the dose levels for a repeated toxicity study of DRT-101,
when given Intra-articular injection to rats and Beagles(non-rodents)
The table below outlines the type, species, purpose and results of
the pre-clinical toxicology studies so far conducted with the assistance of BiotoxTech
Type of study
Species
Purpose
Results
Date of
Completion
30-Day Repeated Intraarticular Injection (total 2 times) Dose Range Finding Study
Sprague-
Dawley Rats
To evaluate the potential toxicity and determine the dose levels for a repeated toxicity study of DRT-101, when given Intra-articular injection to the Sprague-Dawley rats.
There were no DRT-101-related effects on body weight, food consumption,
clinical pathology, or organ weight.
In external and macroscopic evaluations, thickening in the injection
site was observed in both sexes of the 3, 9 and 30 µg/animal groups in a dose-dependent manner.
p-values < 0.05 (Anova&Dunnett)
2024.09.13
21
Type of study
Species
Purpose
Results
Date of
Completion
30-Day Repeated Intraarticular Injection (total 2 times) Dose Range Finding Study
Beagle dogs
To evaluate the potential toxicity of DRT-101 when administered via intra-articular injection to Beagle dogs 2 times with an interval of 4 weeks, and to determine the dose levels for a 6-week repeated toxicity study.
No deaths occurred during the course of the study. In clinical observations, all animals in DRT-101 dosing groups exhibited edemas at injection sites and abnormal gait after dosing. Edemas were exhibited in a broad area around the injection site, the right stifle joint, gradually recovering in 10 days for the 0.05 and 0.15 mg/animal dose groups, and in 24 days for the 0.5 mg/animal dose group.
2024.09.03
DRT-102 for Bone Regeneration
DRT-102 is an investigational product classified as a medical
device product by the Ministry of Food and Drug Safety of the Republic of Korea (“MFDS”). DRT-102 is composed of freeze-dried AB204
protein, that promotes bone formation, and a synthetic bone graft in granular form.
The AB protein (AB204) is a synthetic protein, created by fusing Activin
and BMP-2, both members of the BMP (Bone Morphogenetic Protein) family, growth factors by Darnatein’s segmental reassembly technology.
AB204 combines BMP’s type II receptor binding with activin A’s high-affinity type II receptor binding. It induces
significantly greater and longer-lasting Smad 1/5/8 phosphorylation in osteoblastic cells compared to BMP2, promoting mineral calcium
nodule formation crucial for bone apatite formation. Unlike BMP2, AB204 is unaffected by noggin by design and also inhibits activin signaling,
which further enhances its bone formation and is noteworthy since activin antagonism itself can promote bone formation. When used in conjunction
with existing synthetic bone grafts, it facilitates the generation of new bone and can aid in fracture healing.
The synthetic bone graft uses approved products and is composed of
hydroxyapatite and beta-tricalcium phosphate, with internal pores connected in a three-dimensional structure. By coating a highly
bioactive and absorbable ß -TCP on an HA scaffold that can support structurally for a long period with excellent biocompatibility
and slow biodegradation, it enables rapid initial bone bonding and long-term support dynamics.
DRT-102 pre-clinical study for toxicity measurement in
animal models
The toxicity test of DRT-102 was conducted with multiple institutions
including KTR (Korea Chemical Corporation), KIT (Korea Institute of Toxicology), and ChemOn. The purpose of this study is to evaluate
the potential toxicity and determine the dose levels for a repeated toxicity study of DRT-102, when intravenously administered to rats
and Beagles(non-rodents)
The table below outlines the type, species, purpose and results of
the pre-clinical toxicology studies so far.
Type of study
Species
Purpose
Results
Date
Institution
Dose Range Finding Study: 2-Week Repeated Intravenous Injection
Sprague-
Dawley Rats
To evaluate the potential toxicity and determine the dose levels for a repeated toxicity study of DRT-102, when intravenously injected to the Sprague-Dawley rats.
No deaths were observed. A slight dose-dependent increase in the absolute and relative weights of the spleen and liver was noted in female rats administered 0.25 and 0.5 mg/kg/day. Therefore, it was determined to set the high dose for the 4-week repeated intravenous toxicity study at 0.5 mg/kg/day
2013.11.11
~
2014.05.07
ChemOn
22
Type of study
Species
Purpose
Results
Date
Institution
Single Intravenous Injection
Sprague-
Dawley Rats
To evaluate the potential toxicity of DRT-102 when administered intravenously single time
The approximate lethal dose (ALD) of AB204 was determined to exceed 10 mg/kg (400 times the clinically intended dose) for both males and females.
2012.02.02
~
2012.04.09
ChemOn
4-Week Repeated Intravenous Injection with 2-Week Recovery Period for Rodents
Sprague-
Dawley Rats
To evaluate the characteristics of DRT-102 when administered intravenously to Sprague-Dawley rats repeatedly for 4 weeks and to assess its recovery potential through a 2-week recovery period.
No deaths were observed, and no toxicologically adverse changes were detected. Under the conditions of this study, the No Observed Adverse Effect Level (NOAEL) of the test substance DRT-102 in rats was determined to be 0.32 mg/kg/day.
2014.01.02
~
2014.06.16
ChemOn
Dose Range Finding Study: 2-Week Repeated Intravenous Injection for Non-Rodents
Beagle dog
To evaluate the characteristics of DRT-102 when administered intravenously to Beagle dog repeatedly for 2 weeks.
No changes attributable to the test substance were observed. Therefore, in the upcoming 4-week repeated intravenous toxicity study, the high dose will be set at 0.5 mg/kg/day
2013.11.25
~
2014.02.13
ChemOn
4-Week Repeated Intravenous Injection with 2-Week Recovery Period for Non-Rodents Following PK Sampling
Beagle dog
To examine the characteristics of DRT-102 when administered intravenously to Beagle dogs repeatedly for 4 weeks, and to assess its recovery potential through a 2-week recovery period
No toxicological changes were observed. Therefore, under the conditions of this study, the No Observed Adverse Effect Level (NOAEL) was determined to be 0.32 mg/kg/day for both males and females.
2014.02.11
~
2014.07.18
ChemOn
Safety Test – Cardiovascular System
Beagle Dog
To evaluate the effects of a single intravenous administration of DRT-102 to male Beagle dogs on cardiovascular function, including blood pressure, heart rate, and electrocardiogram (ECG), using a telemetry device for remote monitoring.
No adverse effect on cardiovascular function, including blood pressure, heart rate, and electrocardiogram (ECG) was observed.
2014.07.17
~
2014.08.07
KIT (Korea Institute of Toxicology)
Safety Test – Respiratory System
Sprague-
Dawley Rats
To evaluate the effects of a single intravenous administration of the test substance AB204 on the respiratory system by measuring the respiratory rate and volume in Sprague-Dawley rats.
When DRT-102 is administered as a single intravenous dose of 0.8 mg/kg or lower, the test substance does not affect the respiratory system.
2014.07.17
~
2014.08.07
ChemOn
23
Type of study
Species
Purpose
Results
Date
Institution
Safety Test – Central Nervous System
ICR Mouse
To evaluate the effects of a single intravenous administration of DRT-102 on the central nervous system by observing the animals’ body temperature and systemic behaviors in ICR mice.
When DRT-102 was administered as a single intravenous dose of 0.8 mg/kg or lower to ICR mice, no changes in body temperature or systemic behaviors were observed.
2014.03.25
~
2014.04.29
ChemOn
Biological Safety Tests
—
Cytotoxicity test (Elution method)
Grade 2 (mildly cytotoxic)
2014.0924
~
2014.10.28
KTR (Korea Chemical Corporation)
NZW rabbits
Intracutaneous reactivity
No signs of erythema or edema.
Dunkin Hartley guinea pigs
Skin Irritation test
No skin reactions after sensitization, indicating weak skin sensitization.
ICR mice
Acute toxicity test
No systemic toxicity changes observed within 72 hours after administration
NZW rabbits
Fever test
No body temperature increase of 0.5°C or higher.
—
Genotoxicity Test
(Microbial Reversion Mutation)
Negative
—
Genotoxicity Test (Mammalian Chromosome)
Negative
Pre-clinical study of DRT-102 for efficacy measurement
in animal models
Efficacy test of DRT-102 was conducted with multiple institution
including Joint Center for Bioscience, Inha University Hospital, Seoul Borame Medical Center, and Pharmalegacy (China). The purpose of
this study is to evaluate the potential efficacy of DRT-102, when intravenously administered.
The table below outlines the type, species, purpose and results of
the pre-clinical efficacy studies so far.
Type of study
Species
Purpose
Results
Date
Institution
Beagle dog spinal fusion
Beagle dog
To evaluate the efficacy of DRT-102 by tibial bone Fusion
– Test group implanted with DRT-102 showed a significantly
higher fusion rate compared to the rhBMP-2 control group
– Histological examination revealed that the AB204 group exhibited
superior new bone formation and bone trabecular formation compared to both the rhBMP-2 and Osteon groups.
2013.07.01
~
2014.06.30
Seoul Boramae Medical Center
Rat spinal fusion
CD Rats
To evaluate the efficacy of DRT-102 by spinal bone Fusion
– 3 µg Implantation: In the group implanted with AB204,
fusion rates were 50% at week 4 and 75% at week 8. In contrast, the rhBMP-2 group showed fusion rates of 25% at both week 4 and week
8.
– 6 µg Implantation: In the AB204 group, fusion rates reached
100% at both week 4 and week 8. For the rhBMP-2 group, fusion rates were 25% at week 4 and 50% at week 8.
– 10 µg Implantation: The AB204 group showed a 100% fusion
rate at week 4, whereas the rhBMP-2 group showed only 75% fusion at week 4.
2012.10.01
~
2014.03.31
Inha University Hospital
– DRT-102 showed a concentration-dependent increase in new bone formation, with no pathological abnormalities observed.
24
Type of study
Species
Purpose
Results
Date
Institution
Rabbit tibial defect fusion
NZW Rabbit
To evaluate the efficacy of DRT-102 by tibial bone Fusion
– Histopathological evaluation of non-decalcified bone sections from the 8-week necropsy group, using Goldner’s Trichrome staining, revealed that the bone area surrounding the test substance was greatest in the rhBMP-2 (positive control) group. The DRT-102 (100µg) group exhibited a slightly higher bone area around the test substance compared to the negative control group. Additionally, when measuring the length of osteoid relative to the area of new bone, the AB204 (100µg) group showed the highest ratio.
2014.06.
05 ~ 2014.
12.31
Korea Animal
Medical Institute
Mouse calvaria & Tibial defect fusion
C3H Rats
to evaluate the bone healing property of DRT-102 on Calvaria and Tibia osteotomy compared to rhBMP-2 in mouse.
– DRT-102 facilitates the healing of the CSD (critical-sized defect)
in the tibia of rats.
– CT scans and histological analyses showed that only DRT-102 was
effective in healing the segment.
2011.10.
01 ~ 2014.
9.31
JCB (joint center for biosciences)
– Bone generated by BMP2 did not integrate well with the existing bone, with visible boundaries, whereas bone newly formed by DRT-102 completely fused with the existing bone without visible differences.
– The fidelity of the newly formed bone was particularly observed in Villanueva-stained tissue slides, which showed osteoblasts and mineralized bone.
In Vitro – Efficacy Test
MC3T3-E1 cell
To evaluate osteoinductivity of DRT-102 in MC3T3-E1 preosteblastic cells
– DRT-102 was not toxic to the cells.
– DRT-102 promoted calcium nodule formation three times
more than BMP2
– DRT-102 also increased ALP activity, another measure of
osteogenic potential, by over 135% compared to BMP2
2011.10.
01 ~ 2014.
09.31
JCB (joint center for biosciences)
Monkey fibular defect fusion
Cynomolgus Monkey
To evaluate the efficacy of DRT-102 on primates’ tibial bone defect
– When 5 mg of AB204/DBM was administered, it produced more than twice the amount of mineralized tissue compared to the 5 mg BMP-2/DBM treatment.
2014.06.
01 ~ 2014.
10.31
Pharmalegacy (China)
25
Type of study
Species
Purpose
Results
Date
Institution
Mouse Calvaria Defect
C3H mouse
To evaluate the bone healing property of DRT-102 on Calvaria and Tibia osteotomy compared to rhBMP-2 in mouse.
– No animals died due to surgery
– No individuals showed abnormal changes in body weight.
– Bone remodeling was observed in X-ray images after
2 months post-surgery
– The volume of new bone and the area of osteoid forming the
new bone were more prominent than control group
2014.08 ~
2014.10.15
JCB (joint center for biosciences)
Clinical trial of DRT-102
Darnatein is conducting a single-blind, active-controlled, randomized,
multicenter confirmatory trial to evaluate the efficacy of DRT-102 for the treatment of Lumbar Spinal Fusion. The trial is being
conducted at Boramae Medical Center of Seoul National University, Inha University Hospital, and Soonchunhyang University Seoul Hospital.
The clinical trial of DRT-102 includes both exploratory and confirmatory
phases. The patient selection criteria for both studies are as follows:
Inclusion Criteria:
(1) Age between 30-80 years old.
(2) Patients requiring one-level posterior decompression
and fusion between L1 and S1 due to severe spinal stenosis, spondylolisthesis, spondylosis, or retrolisthesis.
Exclusion Criteria:
(1) Average spine T-score< -2.5 on dual-energy X-ray absorptiometry
(DEXA),
(2) History of cancer,
(3) Patient unable to discontinue anticoagulation therapy,
(4) Female patients of childbearing potential,
(5) Patients testing positive for DRT-102 antibody,
(6) Specific conditions, including psychological problems.
Patients were regularly followed up at 2, 12, 24 and 48 weeks
postoperatively. Patients were divided into two groups: TLIF (Transforaminal Lumbar Interbody Fusion) performed with or without the use
of DRT-102.
2 mg of DRT-102 was reconstituted using sterile water and
the resulting solution was used to soak 6cc of Osteon II (Genoss, #OT7G2030600) were inserted into PEEK (polyetheretherketone) cages
before placement into the prepared disc space. No autogenous grafts were used in the investigational group, while the control group received
autograft in cages.
Exploratory clinical trial of DRT-102
DRT-102 was evaluated in a exploratory clinical trial with 4 patients
(excluding two dropouts) conducted at Inha University Hospital managed by DT&R CRO in 2016 ~ 2019.
The primary objective of this study was to evaluate the bone fusion
rate of DRT-102 for patients with severe spinal stenosis, spondylolisthesis, spondylosis, or retrolisthesis, all of whom required
posterior decompression and fusion.
Source: Choi, Seung-hyun, et al. “Evaluation of Posterolateral
Lumbar Fusion with Composite Bone Graft AB204-sp: A Preliminary Comparative Study and Therapeutic Exploratory Trial.” Korea Health
Industry Development Institute, Mar. 2019. National R&D Research Report, TRKO202000003168, scienceon.kisti.re.kr/srch/selectPORSrchReport.do?cn=TRKO202000003168.
Accessed 21 Oct. 2024.
To assess the bone fusion rate, a CT scan was conducted for 6 months
postoperatively to measure the fusion status.
26
The criteria for determining bone fusion were as follows:
a. Formation of continuous trabeculation between the
adjacent vertebral body and the graft bone.
b. Evidence of remodeling between the adjacent vertebral
body and the graft bone.
c. Absence of radiolucent areas between the adjacent
vertebral body and the graft bone.
Fusion was determined successful if at least two of the criteria (a,
b, or c) were met. In cases where only one criterion was met or none were satisfied, non-fusion was diagnosed.
The secondary evaluation parameters included the bone fusion rate observed
on X-rays 6 months postoperatively, the rate of bone degeneration assessed on MRI 6 months postoperatively, the
improvement in Visual Analog Scale (VAS) scores, and the improvement in the Oswestry Disability Index (ODI).
SN003
SN004
SN005
SN006
Visit 1
(Screwening)
Visit 2
(6 month)
Visit 1
(Screening)
Visit 2
(6 month)
Visit 1
(Screening)
Visit 2
(6 month)
Visit 1
(Screening)
Visit 2
(6 month)
Procedure Site
L4 – L5
L4 – L5
L4 – L5
L4 – L5
X-ray
Y
Y
Y
Y
Y
Y
Y
Y
CT-scan
—
Y
a, c
—
Y
a, c
—
Y
100%
fusion
on rt.
side &
—
Y
a, c
satisfied
satisfied
50%
fusion
on lt.
side
satisfied
MRI
—
Y
—
Y
—
Y
—
Y
VAS(mm)
Lumbar
100
45
95
94
32
17
93
74
Lt. leg
100
41
94
9
0
18
91
74
Rt. leg
0
0
64
68
0
16
40
50
ODI
44
17
34
26
12
13
19
15
NOTE: a: Formation of continuous trabeculation between the adjacent
vertebral body and the graft bone, b: Evidence of remodeling between the adjacent vertebral body and the graft bone, c: Absence of
radiolucent areas between the adjacent vertebral body and the graft bone.
This study has indicated that all patients exhibited strong spine fusion
through X-ray, CT and MRI. Three patients (SN003, SN004, SN005) exhibited 100% spinal fusion at the procedure site. For patient
SN005, 100% fusion was observed on the right side, while 50% fusion was observed on the left side.
27
Significant improvements were also observed in VAS and ODI scores.
In the case of VAS, pain levels decreased from severe to worst pain levels to mild to moderate pain levels. For ODI, which measures discomfort
in daily activities, scores improved from moderate to severe disability to minimal to moderate disability, indicating an enhancement in
quality of life.
During the course of this clinical trial, no drug-related adverse
effects or toxicity were observed.
Confirmatory clinical trial of DRT-102
DRT-102 was further evaluated in a confirmatory clinical trial
from 2020 to 2022. This study involved 15 total patients and was conducted at Inha University, SNU Medical School Boramae Hospital,
and SoonChunHyang Medical School Hospital. This trial was managed by DT&R CRO.
The primary objective of this study was to evaluate the bone fusion
rate of DRT-102 in a larger patient population.
Primary efficacy endpoint was evaluated with bone fusion rate (%) as
observed on CT scans at 24-weeks post-surgery.
Bone fusion is determined when at least two out of the following three
criteria are satisfied:
a. Continuous trabeculation formation
b. Evidence of bone remodeling
c. Absence of radiolucent areas
[Bone Fusion Rate Based on CT Scans
at 24 Weeks Post-Surgery]
Control
CT Scan
Test
CT Scan
Fufilled
Critera
Bone Fusion
Fufilled
Critera
Bone Fusion
1
—
F
1
a, b, c
S
2
—
F
2
b
F
3
—
F
3
a, b, c
S
4
—
F
4
a, b
S
5
a, b
S
5
a, b, c
S
6
a, b
S
6
a, b, c
S
7
b
F
7
b
F
8
a, b, c
S
Success
Fail
Total
Control
2 (25%)
5 (71.4%)
7 (46.7%)
Test
6 (75%)
2 (28.6%)
8 (53.3%)
Note: S = Bone Fusion Success; F = Bone Fusion Failure; a = Continuous
trabeculation formation; b = Evidence of bone remodeling; c = Absence of radiolucent areas
The bone fusion rate in the test group was 75%, while it was 28.57%
in the control group, resulting in a difference of 46.43% between the two groups.
Secondary efficacy endpoints included Bone fusion rate (%) based on X-rays at
24 weeks post-surgery.
28
Bone fusion rate (%) based on X-rays at 24 weeks post-surgery
The number of successful and failed bone fusions was observed on X-rays post-surgery in
the experimental and control groups, along with the bone fusion success rates. The difference in bone fusion rates between the two groups
was evaluated using the chi-square test.
Evaluation Criteria
a. Formation of bridging callus
b. Absence of bone spurs connecting the two vertebrae
at the surgical site.
Control Group
X-ray
X-ray
Fulfilled
Criteria
Bone
Fusion
Test Group
Fulfilled
Criteria
Bone
Fusion
1
F
1
a, b
S
2
F
2
F
3
F
3
a, b
S
4
F
4
a, b
S
5
a, b
S
5
a, b
S
6
a
S
6
a, b
S
7
F
7
F
8
a, b
S
Success
Fail
Total
Control
2 (25
%)
5 (71.4
%)
7 (46.7
%)
Test
6 (75
%)
2 (28.6
%)
8 (53.3
%)
Total
8 (100
%)
7 (100
%)
5 (100
%)
Note: S = Bone Fusion Success; F = Bone Fusion Failure; a = Continuous
trabeculation formation; b = Evidence of bone remodeling; c = Absence of radiolucent areas
[Changes in p-value according to the number of subjects]
Success
Fail
# of
patients
p-value
Success
Fail
# of
patients
p-value
Control
2
5
7
Control
3
8
11
Test
6
2
8
0.132
Test
9
3
2
0.039
15
23
Success
Fail
# of
patients
p-value
Success
Fail
# of
patients
p-value
Control
4
0
4
Control
9
9
28
Test
2
4
6
0.026
Test
24
8
32
0.002
30
60
Note: S = Bone Fusion Success; F = Bone Fusion Failure; a = Continuous
trabeculation formation; b = Evidence of bone remodeling; c = Absence of radiolucent areas
29
The clinical trial results indicate that the success rate in the test
group was significantly higher at 75%, compared to only 25% in the control group. Additionally, the failure rate in the control group
was 71.4%, which was markedly higher than the 28.6% observed in the test group. These findings demonstrate that the test group, which
received DRT-102, exhibited a substantially better outcome in terms of bone fusion compared to the control group. Overall, the data strongly
suggest that DRT-102 is more effective than the control treatment in promoting bone fusion.
The chi-square test of the study demonstrates how the p-value changes
with varying sample sizes in the clinical trial, comparing the control and test groups. Initially, with a smaller sample size of 15 patients,
the p-value is 0.132, indicating no statistically significant difference between the two groups. However, as the sample size increases
to 23 patients, the p-value drops to 0.039, suggesting a statistically significant difference favoring the test group.
With a moderate sample size of 30 patients, the p-value further
decreases to 0.026, indicating stronger statistical evidence of the difference in success rates between the control and test groups. Finally,
in the largest sample size of 60 patients, the p-value reaches 0.002, demonstrating a statistically significant difference. Throughout
the analysis, the test group outperformed the control group in success rates.
Development plans for DRT-101 and DRT-102
Based on preliminary tests of DRT-101 and DRT-102, Darnatein intends
to expand the potential application of DRT-101 to other cartilage regeneration targets, including spinal cartilage in the treatment
of lower back pain. Darnatein may, depending upon securing additional financial resources and other opportunities requiring investment,
expand the potential application of DRT-102 to other bone regeneration targets, including non-fusion bone fracture in the treatment
of deformed bone tissue. Darnatein’s strategy generally involves the following key steps:
1. Identify novel drug candidate for cartilage- and bone-degenerative disorders:
Darnatein will leverage its expert knowledge and experience in tissue regenerative medicine to identify new cartilage- and bone-degenerative disorders
that can be targeted by Darnatein’s DRT-101 and DRT-102 platforms.
2. Conduct preclinical studies with the FDA’s good
laboratory practice (“GLP”) regulations: Before testing any drug or biological product candidate in humans, the product candidate
must undergo rigorous pre-clinical testing. The pre-clinical developmental stage generally involves laboratory evaluations of
drug chemistry, formulation, and stability, as well as studies to evaluate toxicity in animals, to assess the potential for adverse events
and, in some cases, to establish a rationale for therapeutic use. The conduct of pre-clinical studies is subject to federal regulations
and requirements, including GLP regulations for safety/toxicology studies. Darnatein will first perform preclinical studies to evaluate
the safety, immunogenicity, and efficacy of regenerating the new target tissue candidates.
3. File an Investigational New Drug (IND) application:
Upon the successful completion of preclinical studies, Darnatein will submit an IND application to regulatory authorities such as the
FDA. IND is a request for authorization from the FDA to ship an investigation product and then administer it to humans and must be
allowed to proceed by the FDA before human clinical trials may begin. This submission includes all relevant data from preclinical studies
and outlines the proposed clinical trial protocols. The IND review period typically takes 30 days, during which the regulatory agency
evaluates the submission to ensure the safety of proceeding to human trials.
4. Initiate clinical trials: Based on the preclinical
data, Darnatein will design and conduct additional Phase 1 clinical trials to assess the safety, tolerability, and preliminary efficacy
of its regeneration of those new tissue candidates.
5. Conduct Phase 2 and Phase 3 clinical trials:
Phase 2 trials are designed to determine if the new treatment has sufficiently promising efficacy to warrant further investigation
in a large-scale randomized phase 3 trial, as well as to further assess safety. These studies usually involve a few hundred
patients. Phase 2 trials also generate insights on adverse events and their management, the diseases in which the treatment is effective,
and the best regimen for future use in a later phase, depending on the trial design.
30
Phase 3 trials are large-scale, randomized, controlled
studies designed to provide additional supporting evidence of the efficacy and safety of therapeutic candidates. These trials typically
involve hundreds to thousands of patients and are typically conducted at multiple hospital sites worldwide.
Darnatein will work closely with clinical investigators, regulatory
authorities, and patient advocacy groups to design and execute initially Phase 2 and seek to continue with Phase 3 clinical
trials based on evaluation of Phase 2 studies for its tissue targets.
6. Seek regulatory approval: Following the successful
completion of Phase 3 clinical trials, the result of the pre-clinical studies and clinical trials, together with detailed information
relating to the product’s chemistry, manufacture, controls, and proposed labeling, among other things, are submitted to authorities,
such as the FDA or EMA. This stage is known as the New Drug Application (NDA) review.
Based on these steps and the timeline for regulatory approvals, Darnatein
anticipates that its first therapeutic regimen to enter clinical trials within the next 2 – 3 years, with potential
regulatory approval in the next 8 – 11 years.
For a description of the regulatory steps for the implementation of
Darnatein’s strategy described above, see “Business of the Company and Certain Information About the
Company — Vaximm — Regulatory Steps”.
Intellectual Property
Darnatein owns exclusive intellectual property rights covered under
2 patent families relating to DRT-101, DRT-102 and other associated candidates filed in the United States and across major markets,
including Europe, China, India, and Japan. This patent family covers composition of matter, with a priority date of 2019 and estimated
expiry in 2039, not including potential patent term adjustments or patent term extensions.
Designer ligands of TGF-ß superfamily
(Licensed Patent Rights) (0)
WO 2010/099219, Exclusive License Agreement between Joint Center for Biosciences and Darnatein
Country
Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
24/02/2010
PCT/US2010/025260
2010/099219
EP
PCT
24/02/2010
10746779
10/02/2016
2401293B1
2401293
24/02/2030
granted
KR
PCT
24/02/2010
1020117021911
12/10/2015
1015586420000
1020110121642
24/02/2030
granted
CA
PCT
24/02/2010
2752647A1
2752647
24/02/2030
Under Examination
JP
PCT
24/02/2010
2011551315
20/11/2015
5841845
2012518420
24/02/2030
granted
DRT-101 (SAB-704) (1)
WO 2020/101366, Activin/bmp7 chimeras: super-active sab704 and sab715, and their respective noggin-sensitized variants,
nab704 and nab715; and nab204
Country
Code
Type
Filing date
Filing no.
Grant Date
Grant no.
Publ. No.
Expiry
Status
WO
PCT
13/11/2019
PCT/KR2019/015478
2020/101366
—
US
PCT
13/11/2019
20210395322
20210395322
13/11/2039
granted
EP
PCT
13/11/2019
19885240
3880695
13/11/2039
Under Examination
KR
PCT
13/11/2019
1020217018273
30/10/2025
10-2725896
1020210077790
13/11/2039
granted
CN
PCT
13/11/2019
201980075594.3
14/7/2025
7795027
113039199
13/11/2039
granted
31
RMC
Corporate Overview
RMC is a Korea-based neurovascular intervention medical device
and systems distribution company exclusively serving the Korea market currently. RMC distributes, but does not design or manufacture,
commercial medical products, including cerebral surgical devices.
Opportunity
RMC distributes cerebrovascular surgery equipment in South Korea and
seeks growth opportunities in South Korea for other medical device products and systems.
As a rapidly aging country, demand for medical equipment is expected
to accompany the rise in cerebrovascular diseases such as strokes. RMC has established close relationships with leading university hospitals
and general hospitals in Korea to supply cerebrovascular surgery equipment. These relationships provide opportunities for continued sales
of products distributed by RMC as well as assisting RMC in identifying demand for other medical devices that RMC may add to enhance its
product portfolio. This is expected to enhance RMC’s competitiveness in South Korea.
RMC has established a nationwide sales network and logistics system,
enabling it to swiftly and efficiently supply products to any region in the country. This serves as a significant strength compared to
competitors and is expected to contribute to building long-term trust with medical institutions.
Products and Related Systems
The table below shows the products and related systems currently distributed
by RMC.
Company
Product and System
Function of Product/System
Asahi Intecc
Chikai Guide Wire
This product is designed to facilitate the placement and exchange of therapeutic devices such as cerebral catheters during endovascular therapy and is intended for use in the neurovascular field. It is used as a guidewire for stent delivery catheters, coil delivery microcatheters, carotid stent delivery catheters and balloon catheters used in cerebral aneurysm coil embolization.
Fubuki Guide Catheter
This catheter is used to guide neurovascular interventional devices to sites for percutaneous endovascular procedures in neurovascular vessels; also used for contrast injection. This catheter is designed to guide therapeutic cerebrovascular catheters to lesions or sites for percutaneous endovascular procedures in the cerebral vasculature.
Microport Neurotech
Numen coil system
This product is a single-use device for endovascular embolization of intracranial aneurysms and other neurovascular malformations such as arteriovenous fistulas. It is used to dye blood vessels in the neurovascular system to permanently block blood flow to aneurysms or other vascular malformations, or for arterial and venous embolization in peripheral vessels.
32
Since 2015, RMC has also distributed neuro-intervention medical
device equipment manufactured by Penumbra Inc. RMC’s distribution agreement with Penumbra Inc. for the resale of its reperfusion
catheter, neuron delivery catheter and related tubing and canister, expired on June 30, 2024. The parties’ negotiations for
a new (or extended) agreement terminated on November 20, 2024. RMC will not purchase additional Penumbra products. Certain issues,
such as whether RMC may continue to sell its existing inventory of Penumbra products or whether Penumbra will repurchase RMC’s inventory,
have not as yet been resolved. To replace sales of Penumbra products, RMC intends to seek to become the sales representative of other
neuro-intervention medical device equipment manufacturers, as well as expand sales of products offered by companies it currently
represents.
Strategic Evolution into a Healthcare 4PL Platform
As described above, RMC has historically operated as a medical device
importer and distributor in Korea with a primary focus on the neuro-intervention field. However, following a comprehensive strategic review,
the management has determined to transform RMC into a fourth-party logistics (“4PL”) platform for the Korean healthcare supply
chain — a strategic evolution that we view as a significant new growth engine for the consolidated group and a material driver of
revenue growth through 2030.
Industry Context and Market Opportunity
The Korean medical device import and distribution sector is under material
structural stress, driven by two converging dynamics:
● Foreign exchange pressure: Import purchase obligations are predominantly USD-denominated, while distributor revenues are generated
in KRW. Sustained KRW depreciation has materially increased the local currency cost of Minimum Purchase Guarantee (“MPG”) commitments
to global manufacturers, compressing margins and straining liquidity across the independent distributor base.
● Working capital mismatch: Large university hospitals — the dominant demand-side buyers — typically remit payment up to
six months after device delivery, while receiving National Health Insurance Service (“NHIS”) reimbursement within approximately
two weeks of claim filing. Independent distributors are required to finance this five-to-six month A/R gap without adequate access to
institutional capital.
These dynamics have produced a class of financially constrained distributors
actively seeking to exit their Korea agency mandates, import licenses, and MPG obligations — a dislocation management believes presents
RMC with a compelling and time-sensitive consolidation opportunity.
RMC’s targeted 4PL product categories span eleven identified product
lines with a combined total addressable market (“TAM”) estimated at approximately KRW 159.9 billion (~$110.7 million).
Management notes that this estimate reflects a conservative, narrowly scoped assumption based on RMC’s historical neurointervention focus,
representing approximately 2.3% of total Korean medical device imports of ~USD 4.88 billion (Korean Medical Device Association, 2022).
The Company intends to revisit and update this TAM as RMC establishes a presence in product categories beyond its current core market.
33
RMC 4PL Business Model
RMC’s 4PL model addresses the structural pain points above by positioning
the Company as a financially capable consolidator and central platform across the Korean medical device supply chain, built on three core
capabilities:
● Mandate Acquisition: RMC assumes Korea agency mandates, import licenses, and MPG obligations from financially distressed independent
distributors, consolidating a historically fragmented and undercapitalized segment of the supply chain.
● Working Capital Intermediation: Leveraging OSR Holdings’ NASDAQ-listed parent credibility and financial resources, RMC bridges the
structural A/R gap inherent in the distributor-to-hospital payment cycle — a capability most independent distributors cannot replicate.
● Scope Expansion and ICC Services: The 4PL platform aggregates mandates across medical device categories beyond neurointervention,
enhancing scale economics and reducing concentration risk. In-Country Care (“ICC”) services represent an additional, complementary
revenue stream as the platform matures.
A number of Korean distributors have already approached RMC proactively,
viewing its NASDAQ-listed parent as a credible and well-capitalized consolidator. Management believes RMC is positioned to execute its
roll-up strategy promptly upon capital allocation by OSR Holdings.
4PL Product Pipeline
The table below sets forth the eleven identified 4PL product categories,
each with estimated Korean market TAM, target MFDS approval year, and projected market share for 2027–2030 (KRW millions).
Product Category
TAM (KRW mil)
MFDS Target
2027E
2028E
2029E
2030E
Category A
12,600
2026
10 %
15 %
20 %
20 %
Category B
12,600
2026
5 %
10 %
10 %
10 %
Category C
10,410
2026
5 %
20 %
25 %
25 %
Category D
9,364
2026
20 %
25 %
30 %
30 %
Category E
1,314
2027
—
5 %
5 %
5 %
Category F
66,647
2027
10 %
15 %
20 %
25 %
Category G
6,800
2026
15 %
20 %
30 %
30 %
Category H
6,726
2026
5 %
5 %
5 %
5 %
Category I
6,497
2027
20 %
25 %
25 %
25 %
Category J
9,311
2028
—
10 %
20 %
30 %
Category K
17,634
2028
—
10 %
20 %
30 %
Total TAM
159,903 (~$110 mil)
Market share projections reflect management estimates based on identified
pipeline opportunities and distributor consolidation targets. Actual results may differ materially.
34
Financial Projections
The table below summarizes RMC’s projected revenue and profitability
across its three segments for fiscal years 2026–2030 (KRW millions).
KRW mil
2026E
2027E
2028E
2029E
2030E
4PL Revenue
—
13,604
23,651
31,976
38,003
ICC Revenue
500
800
1,000
1,200
1,200
Current Business
3,600
4,400
4,600
5,000
5,600
Total Revenue
4,100
18,804
29,251
38,176
44,803
Net Income
615
1,880
2,340
3,054
3,584
Net Margin
15 %
10 %
8 %
8 %
8 %
Forward-looking estimates prepared by management. Subject to risks
and uncertainties. See “Forward-Looking Statements” and “Risk Factors” elsewhere in this Annual Report.
Key observations: (i) 4PL revenue is not projected to commence until
2027, reflecting the time required for mandate acquisition and MFDS approvals following 2026 capital deployment; (ii) total RMC revenue
is projected to grow from KRW 4.1 billion in 2026 to KRW 44.8 billion in 2030 (~82% CAGR), driven primarily by the 4PL ramp; and (iii)
net margin is expected to stabilize at approximately 8% from 2028, with the current business providing a stable organic base throughout.
Key Execution Considerations
Investors should be aware of the following principal risks specific
to RMC’s 4PL initiative:
● Capital Deployment: Execution pace is contingent upon OSR Holdings allocating sufficient capital; delays could materially impact the
projected revenue ramp.
● Regulatory Timelines: MFDS oversight of import license and mandate transfers may defer revenue commencement beyond projected periods.
● Foreign Exchange: RMC will assume USD-denominated MPG obligations; continued KRW depreciation could increase local currency costs
materially.
● Working Capital: Scaling the platform will require disciplined management of an expanding A/R base given the structural hospital payment
cycle.
● Pipeline Conversion: No assurance exists that identified distributor candidates will transfer mandates on commercially acceptable
terms or within projected timeframes.
Outlook
Management views RMC’s 4PL transformation as one of the most significant
value creation opportunities within the OSR Holdings portfolio. The Company will provide updates on mandate acquisitions, capital deployed,
and MFDS milestones in its periodic filings and through other public disclosures as material developments warrant.
Intellectual Property
Except for trade secrets related to operating a medical product distribution
business, there is no significant intellectual property owned or licensed by RMC.
35
Competition in our Industry
Competition for Product Candidates
We face competition with respect to our current product candidates
and will face competition with respect to future product candidates, from pharmaceutical and biotechnology companies to public and private
research institutions, among others.
If our current and/or our future product candidates do not offer sustainable
advantages over competing products, we may otherwise not be able to successfully compete against current and future competitors.
Our competitors may obtain regulatory approval of their products more
rapidly than we may or may obtain patent protection or other intellectual property rights that limit our ability to develop or commercialize
our product candidates. Our competitors may also develop drugs that are more effective, more convenient, more widely used and less costly
or have a better safety profile than our products and these competitors may also be more successful than us in manufacturing and marketing
their products.
The most common methods of treating patients with cancer are surgery,
radiation and drug therapy, including chemotherapy, hormone therapy and targeted drug therapy or a combination of such methods. There
are a variety of available drug therapies marketed for cancer. In many cases, these drugs are administered in combination to enhance efficacy.
Our product candidates, if any are approved, may compete with these existing drug and other therapies.
The table below summarizes the main competitors we have identified
for Vaximm’s VXM01. Each of these identified competitors are developing therapies for glioblastoma and have active clinical trials
ongoing assessing the safety and efficacy of their product candidates.
Drug Name
Company
Mechanism
Indication
Clinical
Phase
NCT
Number(s)
Depatuxizumab mafodotin (ABT-414)
AbbVie
Antibody-drug conjugate targeting EGFR
Newly diagnosed glioblastoma
Phase 2/3
NCT02573324
Durvalumab (MEDI4736)
AstraZeneca
PD-L1 checkpoint inhibitor
Newly diagnosed and recurrent glioblastoma
Phase 2
NCT02336165
Regorafenib
Bayer
Multi-kinase inhibitor
Recurrent glioblastoma
Phase 2
NCT02926222
Tasadenoturev( DNX-2401)
DNAtrix
Oncolytic adenovirus
Recurrent glioblastoma
Phase 2
NCT03178032
Ofranergene obadenovec (VB-111)
VBL Therapeutics
Dual-targeted gene therapy
Recurrent glioblastoma
Phase 3
NCT02511405
AV-GBM-1
Aivita Biomedical
Personalized dendritic cell vaccine
Newly diagnosed glioblastoma
Phase 2
NCT03400917
VAL-083
Kintara Therapeutics
DNA-targeting agent
Recurrent and newly diagnosed glioblastoma
Phase 2/3
NCT02717962, NCT03050736
36
With respect to Darnatein, competition takes two forms: pharmaceutical
products (drugs) that address the underlying causes of osteoarthritis, and orthopedic solutions involving bone graft and other products.
Several pharmaceutical companies and research institutions are actively working on developing Disease-Modifying Osteoarthritis Drugs
(DMOADs) to address the underlying causes of osteoarthritis (current treatments primarily focus on symptom management). There are currently
no approved DMOAD treatments for osteoarthritis but the table below identifies drugs under development:
The table below summarizes the main competitors we have identified
for Darnatein’s DRT-101. Each of these identified competitors are developing therapies for osteoarthritis and have active clinical
trials ongoing assessing the safety and efficacy of their product candidates.
Drug Name
Company
Mechanism
Indication
Clinical
Phase
NCT
Number(s)
Invossa
Kolon TissueGene
Cell and gene therapy (TGF-ß1 expressing chondrocytes)
Osteoarthritis
Phase 3
NCT03383471
Lorecivivint
Biosplice Therapeutics
CLK/DYRK1A inhibitor
Osteoarthritis
Phase 3
NCT03928184
Sprifermin
Merck KGaA/EMD serono
Recombinant human fibroblast growth factor 18
Osteoarthritis
Phase 2
NCT01919164
NCT01033994
The table below summarizes the main competitors we have identified
for Darnatein’s DRT-102. Each of these identified competitors are commercialized orthopedic solutions.
Drug Name
Company
Mechanism
Indication
Infuse Bone Graft
Medtronic
rhBMP-2 and collagen sponge
Spinal fusion, long bone fractures, orthopedic surgery
Osteocel Plus
NuVasive
Demineralized bone matrix (DBM) and mesenchymal stem cells (MSC)
Spinal fusion, bone defects
Bio4
Stryker
A viable bone matrix containing endogenous bone forming cells
Bone repair and regeneration
i-Factor
Cerapedics
P-15 peptide and anorganic bone matrix
Spinal fusion, bone defects
Novabone IRM
Novabone
Composed of bioactive glass, chemically bonds with bone and promotes new bone formation
Bone defects, dental grafting
With aging populations comes a higher number of cerebrovascular disease
patients. There are a number of potential treatments such as drug therapy and open surgery. Minimally invasive procedures, such as neurovascular
intervention, have been growing. Various international medical device brands are competing for market share.
The table below summarizes the main competitors we have identified
for RMC:
Device Name
Company
Mechanism
Indication
React catheter
Medtronic
Reperfusion catheter
Treatment of acute ischemic stroke
AXS infinity catheter
Stryker
Neurovascular Delivery catheter
Delivery of therapeutic devices in neurovascular procedures
AXS catalyst 7 distal access catheter
Stryker
Distal access support canister
Neurovascular access and support for device delivery
Synchro wire
Stryker
Neurovascular guide wire
Navigation through neurovascular anatomy
Traxcess wire
Microvention
Neurovascular guide wire
Navigation through neurovascular anatomy
Envoy guide catheter
Cerenovous
Neurovascular guide catheter
Support and delivery of neurointerventional devices
Guider soft tip guide catheter
Boston scientific
Soft tip neurovascular Guide catheter
Support and delivery of neurointerventional devices
Microplex coil system
Microvention
Detachable embolization coil system
Embolization of intracranial aneurysms
GDC coil system
Stryker
Detachable Coil system
Embolization of intracranial aneurysms
Axium prime coil system
Medtronic
Detachable Coil system
Embolization of intracranial aneurysms
37
Manufacturing
We do not have any manufacturing facilities or personnel at this time,
except that Darnatein maintains and uses manufacturing facilities owned by Joint Center for Biosciences, Darnatein’s affiliate and
the Company’s shareholder, for purposes of R&D and clinical and preclinical materials for its sole use. We currently rely on
CMOs for the manufacture of our product candidates for preclinical and clinical testing in non-commercial quantities.
Our product candidates include small molecules, vaccines, and monoclonal
and bispecific antibodies. Several contract manufacturing facilities exist that have expertise in each product type and we anticipate
that our product candidates can be produced by them at scale and in a cost-effective manner. As needed, we also expect to rely on
CMOs for the manufacturing of companion diagnostics, which are assays or tests to identify an appropriate patient population. Depending
on the technology solutions we choose, we may rely on multiple third parties to manufacture and sell a single test.
Vaximm has a master service agreement with Richter-Helm BioLogics
GmbH & Co. KG (“RHB”), a CMO located in Germany, for the manufacture of Vaximm’s product candidates. RHB will
provide cell line development, process development, manufacturing, and related services for Vaximm’s product candidates. The agreement
became effective April 10, 2012, and will remain in effect until terminated by either party. Vaximm pays RHB for services rendered
based on agreed-upon rates specified in individual work orders. Vaximm retains ownership of all intellectual property related to
its product candidates, while RHB owns IP related to manufacturing processes developed under the agreement.
Commercialization
We will objectively assess and choose each program’s commercialization
option that maximizes potential value for patients and for our stockholders. We anticipate optimizing commercial value through various
options, including internal advancement, strategic partnerships, and spin-outs or public offerings. If we opt to commercialize a
particular candidate ourselves, we anticipate assembling a commercialization team inclusive of sales and marketing operations to promote
and sell our products. Our focus will be the community of relevant medical practitioners who are the key specialists in treating the patient
populations for which our product candidates are being developed. We may also enter into distribution and other marketing arrangements
with third parties for any of our product candidates that obtain marketing approval.
We currently do not have marketing and sales management operations
for any of our pharmaceutical products and will rely, at least initially, on third parties for support. The responsibilities of marketing
operations would include developing educational initiatives with respect to approved products and establishing relationships with researchers
and practitioners in relevant fields of medicine. We will reevaluate the sales operations from time to time and may eventually build an
in-house marketing and sales management organization.
Our Management Team
Members of our management team are not obligated to devote any specific
number of hours to our matters, but they intend to devote as much of their time as they, in the exercise of their respective business
judgment, deem necessary to our affairs until we have completed our initial business combination. The amount of time that any member of
our management team will devote in any time period will vary based on whether a target business has been selected for our initial business
combination and the current stage of the business combination process. We do not have an employment agreement with any member of our management
team.
We believe our management team’s operating and transaction experience
and relationships with companies will provide us with a substantial number of potential business combination targets. Over the course
of their careers, the members of our management team have developed a broad network of contacts and corporate relationships in the healthcare
and biotechnology industry. This network has grown through the activities of our management team sourcing, acquiring and financing businesses,
our management team’s relationships with sellers, financing sources and target management teams and the experience of our management
team in executing transactions under varying economic and financial market conditions. See “Item 10. Directors, Executive Officers
and Corporate Governance” for a more complete description of our management team’s experience.
38
Status as a Public Company
We are an “emerging growth company,” as defined in Section 2(a)
of the Securities Act of 1933, as amended (the “Securities Act”), as modified by the JOBS Act. As such, we are eligible to
take advantage of certain exemptions from various reporting requirements that are applicable to other public companies that are not “emerging
growth companies” including, but not limited to, not being required to comply with the independent registered public accounting
firm attestation requirements of Section 404 of the Sarbanes-Oxley Act, reduced disclosure obligations regarding executive compensation
in our periodic reports and proxy statements, and exemptions from the requirements of holding a non-binding advisory vote on executive
compensation and stockholder approval of any golden parachute payments not previously approved. If some investors find our securities
less attractive as a result, there may be a less active trading market for our securities and the prices of our securities may be more
volatile.
In addition, Section 107 of the JOBS Act also provides that an
“emerging growth company” can take advantage of the extended transition period provided in Section 7(a)(2)(B) of the
Securities Act for complying with new or revised accounting standards. In other words, an “emerging growth company” can delay
the adoption of certain accounting standards until those standards would otherwise apply to private companies. We intend to take advantage
of the benefits of this extended transition period.
We will remain an emerging growth company until the earlier of (1) the
last day of the fiscal year (a) following the fifth anniversary of the completion of our IPO, (b) in which we have total annual
gross revenue of at least $1.235 billion, or (c) in which we are deemed to be a large accelerated filer, which means the market
value of our common stock that is held by non-affiliates exceeds $700 million as of the prior June 30th, and (2) the date on
which we have issued more than $1.0 billion in non-convertible debt securities during the prior three-year period.
Additionally, we are a “smaller reporting company” as defined
in Item 10(f)(1) of Regulation S-K. Smaller reporting companies may take advantage of certain reduced disclosure obligations, including,
among other things, providing only two years of audited financial statements. We will remain a smaller reporting company until the last
day of the fiscal year in which (1) the aggregate worldwide market value of our common stock held by non-affiliates equaled or exceeded
$250 million as of the prior June 30th and (2) our annual revenues equaled or exceeded $100 million during such completed
fiscal year or the aggregate worldwide market value of our common stock held by non-affiliates equaled or exceeded $700 million as
of the prior June 30th.
Facilities
Our executive offices are located at 10900 NE 4th Street, Suite 2300,
Bellevue, WA 98004 and Hoedong-gil, 37-36, 3F, Paju, Gyeonggi-do, 10881 Korea, and our telephone number is (425) 635-7700 and +82 31 948
9419, respectively. Our executive offices are provided to us by an affiliate of our Sponsor. Commencing on March 1, 2023, we agreed
to pay an affiliate of our Sponsor a total of $7,500 per month for office space, utilities and secretarial and administrative support.
We consider our current office space adequate for our current operations.
Website
We maintain a corporate website at www.osr-holdings.com. Our website
and information contained on, or that can be accessed through, our website is not deemed to be incorporated by reference in, and is not
considered part of, this report. You should not rely on any such information in making your decision whether to invest in our securities.
Employees
We currently have four officers. These individuals are not obligated
to devote any specific number of hours to our matters, but they intend to devote as much of their time as they deem necessary, in the
exercise of their respective business judgement, to our affairs until we have completed our initial business combination. The amount of
time they will devote in any time period will vary based on whether a target business has been selected for our initial business combination
and the stage of the initial business combination process we are in. We do not have an employment agreement with any member of our management
team.
39
Periodic Reporting and Financial Information
We have registered our common stock and warrants under the Exchange
Act and have reporting obligations, including the requirement that we file annual, quarterly and current reports with the SEC. In accordance
with the requirements of the Exchange Act, our annual reports will contain financial statements audited and reported on by our independent
registered public accountants. These filings are available to the public via the Internet at the SEC’s website located at http://www.sec.gov.
You may request a copy of our filings with the SEC (excluding exhibits) at no cost by writing or telephoning us at the following address
or telephone number:
OSR Holdings, Inc.
10900 NE 4th Street, Suite 2300
Bellevue, WA 98004
Telephone: (425) 635-7700
We will provide stockholders with audited financial statements of the
prospective target business as part of the tender offer materials or proxy solicitation materials sent to stockholders to assist them
in assessing the target business. In all likelihood, these financial statements will need to be prepared in accordance with, or reconciled
to, GAAP, or IFRS, depending on the circumstances, and the historical financial statements may be required to be audited in accordance
with the standards of the PCAOB. These financial statement requirements may limit the pool of potential targets we may conduct an initial
business combination with because some targets may be unable to provide such statements in time for us to disclose such statements in
accordance with federal proxy rules and complete our initial business combination within the prescribed time frame. We cannot assure you
that any particular target business identified by us as a potential business combination candidate will have financial statements prepared
in accordance with GAAP or that the potential target business will be able to prepare its financial statements in accordance with the
requirements outlined above. To the extent that these requirements cannot be met, we may not be able to acquire the proposed target business.
While this may limit the pool of potential business combination candidates, we do not believe that this limitation will be material.
We will be required to evaluate our internal control procedures for
the fiscal year ending December 31, 2025 as required by the Sarbanes-Oxley Act. Only in the event we are deemed to be a large accelerated
filer or an accelerated filer will we be required to have our internal control procedures audited. A target company may not be in compliance
with the provisions of the Sarbanes-Oxley Act regarding adequacy of their internal controls.
The development of the internal controls of any such entity to achieve
compliance with the Sarbanes-Oxley Act may increase the time and costs necessary to complete any such business combination. Prior to the
date of our prospectus in connection with our IPO, we filed a registration statement on Form 8-A with the SEC to voluntarily register
our securities under Section 12 of the Exchange Act. As a result, we are subject to the rules and regulations promulgated under the
Exchange Act. We have no current intention of filing a Form 15 to suspend our reporting or other obligations under the Exchange Act prior
or subsequent to the consummation of our initial business combination.
We will remain an emerging growth company until the earlier of (1) the
last day of the fiscal year (a) following the fifth anniversary of the completion of our IPO, (b) in which we have total annual
gross revenue of at least $1.235 billion, or (c) in which we are deemed to be a large accelerated filer, which means the market
value of our shares of common stock that are held by non-affiliates exceeds $700 million as of the prior June 30th, and (2) the
date on which we have issued more than $1.0 billion in non-convertible debt during the prior three-year period.
Additionally, we are a “smaller reporting company” as defined
in Item 10(f)(1) of Regulation S-K. Smaller reporting companies may take advantage of certain reduced disclosure obligations, including,
among other things, providing only two years of audited financial statements. We will remain a smaller reporting company until the last
day of the fiscal year in which (1) the aggregate worldwide market value of our common stock held by non-affiliates equaled or exceeded
$250 million as of the prior June 30th and (2) our annual revenues equaled or exceeded $100 million during such completed
fiscal year or the aggregate worldwide market value of our common stock held by non-affiliates equaled or exceeded $700 million as
of the prior June 30th.
40