Plerixafor

CHICAGO--( BUSINESS WIRE )--Please replace the release dated January 22, 2025 with the following corrected version due to multiple revisions. The updated release reads: EXICURE, INC. ANNOUNCES PURCHASE AGREEMENT WITH GPCR THERAPEUTICS INC. Exicure, Inc. (Nasdaq: XCUR, “the Company”, “Exicure”), today announced that on January 19, 2025, Exicure Inc. (“the Company”) entered into a Share Purchase Agreement with GPCR Therapeutics Inc., a Korean corporation (“GPCR”), pursuant to which the Company acquired from GPCR all of the issued and outstanding equity securities of GPCR Therapeutics USA Inc., a California corporation (“GPCR USA”). The transactions completed under the Share Purchase Agreement closed concurrently with execution. GPCR USA was, until immediately prior to closing under the Share Purchase Agreement, a wholly owned subsidiary of GPCR. In connection with the closing of the Share Purchase Agreement, the Company and GPCR entered into a License and Collaboration Agreement (“L&C Agreement”) to further develop and commercialize GPCR’s technologies related to certain intellectual properties and patents. The L&C Agreement requires the Company to make milestone payments to GPCR upon the achievement of specific milestone events relating to clinical trials, marketing authorizations, and net sales, as well as for the Company to pay a recurring royalty payment based on at least 10% of net sales, as set forth in the L&C Agreement. About GPCR USA, Inc. GPCR USA is a biotech company that is currently led by Dr. Pina Cardarelli, the CSO and president of GPCR USA. The company has an ongoing Phase 2 clinical trial focused on blood cancer patients, particularly those eligible for hematopoietic stem cell transplantation (HSCT). The trial involves the combined administration of G-CSF, GPC-100 (Burixafor) and propranolol. Per Dr. Cardarelli, "Two additional patients will receive treatment in January 2025. GPCR USA plans to complete the administration of GPC-100 to 20 patients by the end of April and aim to announce the clinical trial results by September." In December of last year, GPCR USA presented results at the American Society of Hematology conference evaluating the impact of inhibiting CXCR4 and ADRB2 (beta-2 adrenergic receptor) on stem cell mobilization. Interim data from 10 patients for burixafor in combination with propranolol and G-CSF is promising. Results suggest that the treatment regimen can mobilize CD34 + stem cells sufficiently for autologous stem cell transplant. Notably, burixafor allowed for same day administration of both mobilizing agent and leukapheresis. This fast kinetics of mobilization is differentiated from the FDA approved plerixafor or motixafortide, which require overnight pre-treatment prior to leukapheresis. The median times to neutrophil and platelet engraftment, 11 and 14 days respectively, are slightly less than what has been observed for standard of care. Importantly, 100% of the patients met the primary objective and the combination regimen exhibited excellent safety profiles in patients receiving the new front line blood cancer drug, Daratumumab. Dr. Cardarelli stated, "After completing patient treatment, we will conduct follow-up observations until July and then start data analysis," adding that positive results from the GPC-100 trial could have a beneficial impact on attracting additional investment and enhancing corporate value. Currently, the ongoing clinical trials have met all primary end points and are at the stage of deciding whether to proceed to Phase 3. A proposed double-blind clinical trial comparing the mobilization agent Plerixafor with GPC-100 is under discussion. Additionally, research has shown that the combination of GPC-100 and propranolol increases the number of specific T cells, which are favorable for enhancing CAR-T (Chimeric Antigen Receptor T-cell) response rates, and relevant papers are being published. Thus, this could assist Exicure in expanding its additional pipeline for cell and gene therapies. Dr. Cardarelli suggested that in the future, it will be essential to prioritize discussions with various partners based on the likelihood of success and high return on investment. She concluded, "If the hypotheses presented to GPCR USA are validated, there may be potential G-Protein Coupled Receptor targets that could be applicable to various diseases. We are considering steps such as establishing collaborations with companies possessing antibody manufacturing technologies, testing those technologies, and conducting joint research on multiple G-Protein Coupled Receptors.” Dr. Cardarelli was an inventor of the CXCR4 antibody, Ulocuplumab developed by BMS, and in 2019 she joined GPCR Therapeutics evaluating the combination of CXCR4 and ADRB2. She later served as the Chief Scientific Officer (CSO) of GPCR USA, contributing to the establishment of GPCR USA, talent acquisition, formation of a scientific advisory board, and the introduction of cell analysis and high-throughput screening technologies. She also successfully designed clinical trials for GPC-100 and secured FDA orphan drug designation. About Exicure, Inc. Exicure, Inc. is an early-stage biotechnology company focused on developing nucleic acid therapies targeting ribonucleic acid against validated targets. Following its recent restructuring and suspension of clinical and development activities, the Company is exploring strategic alternatives to maximize stockholder value, both with respect to its historical biotechnology assets and more broadly. For further information, see www.exicuretx.com . Forward-Looking Statements This press release includes “forward-looking statements” within the meaning of the safe harbor provisions of the United States Private Securities Litigation Reform Act of 1995. Forward looking statements are those which are not historical in nature. They are often identified by their inclusion of words such as “will,” “anticipate,” “estimate,” “plan,” “should,” “expect,” “believe,” “intend” and similar expressions. Forward-looking statements involve known and unknown risks, uncertainties and other factors that may cause actual outcomes to differ materially from the outcomes expressed or implied by this report. Such risks include, among others, the accuracy of projections, targets, or plans, the possibility of listing deficiencies, and the risk that Nasdaq will ultimately delist the Company’s common stock. All such factors are difficult to predict and may be beyond the Company’s control. The Company undertakes no obligation and does not intend to update or revise any forward-looking statements contained herein, except as required by law or regulation. You are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this report.

Currently, only three CXCR4 (C-X-C motif chemokine receptor 4) antagonists have been approved globally: Plerixafor, Motixafortide, and Mavorixafor, indicating significant market potential. With a deeper understanding of the role of CXCR4 in tumor progression, the demand for CXCR4 antagonists continues to grow. In 2024, the global CXCR4 antagonist market is valued at several billion RMB, with steady growth projected in the coming years. Key players in the global market include Sanofi, BioLineRx, X4 Pharmaceuticals, Eli Lilly, and Roche. The increasing global aging population and the rising incidence of chronic diseases such as cancer create a vast market opportunity for anti-tumor drugs like CXCR4 antagonists. Advances in drug development further inject vitality into the CXCR4 antagonist market. Global Transactions of CXCR4 Antagonists in Patsnap SynapseMechanism of Action of CXCR4 AntagonistsSchematic diagram of CXCR4[1]CXCR4 is a seven-transmembrane G-protein-coupled receptor (GPCR) widely expressed across various cell types, particularly immune cells, hematopoietic stem cells, endothelial cells, and numerous tumor cells. Its primary ligand is the chemokine CXCL12 (also known as SDF-1, stromal cell-derived factor 1). Binding of CXCL12 to CXCR4 induces conformational changes in CXCR4, activating the G-protein complex. The G-protein complex dissociates into Gα and Gβγ subunits, with Gβγ activating the PI3K and RAS-MAPK pathways. CXCL12-CXCR4/CXCR7 signaling pathway[2]Subsequently, the Gβγ subunit activates guanine nucleotide exchange factors (GEFs), such as SOS. These GEFs facilitate the exchange of GDP for GTP on RAS proteins, activating them. Activated RAS proteins, in turn, stimulate the MAPK (mitogen-activated protein kinase) and MEK1/2 (mitogen-activated protein kinase kinase 1/2) pathways. Activated MEK1/2 phosphorylates and activates ERK1/2 (extracellular signal-regulated kinases 1/2). ERK1/2 activation promotes cell proliferation and survival. Additionally, ERK1/2 can activate transcription factors such as c-Fos and c-Jun, further regulating gene expression. Once activated, ERK1/2 enters the nucleus and phosphorylates various transcription factors, including c-Fos and c-Jun, which bind to specific DNA sequences to regulate gene expression, ultimately affecting cell proliferation, differentiation, and survival. When CXCR4 interacts with CXCL12, it activates signaling pathways including RAS-MAPK, PI3K-AKT-mTOR, JAK-STAT, and PLC. These pathways play crucial roles in cell migration, proliferation, and survival. Under normal physiological conditions, CXCR4 is critical for regulating cell migration and localization during development, homeostasis, and inflammation, aiding immune system activation and facilitating cell movement. High CXCR4 expression is associated with poor prognosis and chemotherapy resistance in various cancer subtypes, partly due to enhanced interactions between cancer cells and the stroma. The CXCR4/CXCL12 signaling axis plays a central role in tumor progression through autocrine and paracrine mechanisms. Similar to other GPCRs, CXCR4 undergoes homo- or heterodimerization in its functional signaling regions on the cell surface. Receptor aggregation in dimers or oligomers significantly enhances the sensitivity and intensity of chemokine responses. Schematic representation of the signaling pathways activated by CXCR4[3]CXCR4 antagonists block the binding of CXCL12 to CXCR4, inhibiting tumor cell migration and invasion, reducing HIV infection and transmission, regulating immune cell migration, and promoting hematopoietic stem cell mobilization, showcasing significant applications across multiple fields. In oncology, CXCR4 antagonists like Motixafortide, combined with Keytruda and chemotherapy, have significantly improved objective response rates (ORR) and progression-free survival (PFS) in patients with advanced pancreatic ductal adenocarcinoma and demonstrated antitumor effects in breast and lung cancers. For HIV treatment, CXCR4 antagonists like Plerixafor and AMD3100 reduce viral infection and spread by blocking HIV-CXCR4 interactions while enhancing the host immune response. In autoimmune diseases, CXCR4 antagonists mitigate inflammatory responses by reducing immune cell migration, alleviating symptoms in conditions like systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). In hematopoietic stem cell mobilization, CXCR4 antagonists such as Plerixafor and Motixafortide facilitate the release of hematopoietic stem cells from bone marrow into peripheral blood for autologous transplantation in diseases like non-Hodgkin lymphoma (NHL) and multiple myeloma (MM). Market Drivers for CXCR4 Antagonist DevelopmentWith advancements in precision medicine, targeted therapeutics are increasingly prioritized. As a critical target in various diseases, CXCR4 antagonist development aligns with the precision medicine trend. CXCR4 antagonists hold significant value in treating hematological disorders such as multiple myeloma. Furthermore, these antagonists are being explored for new indications like breast cancer, WHIM syndrome, and Waldenström’s macroglobulinemia, all of which represent substantial patient populations and offer vast market potential. The combination of CXCR4 antagonists with other therapies, such as chemotherapeutics and immune checkpoint inhibitors, markedly enhances therapeutic efficacy and addresses clinical needs. Additionally, governmental and regional policy and financial support for innovative drug development have attracted extensive attention to and support for CXCR4 antagonists as promising innovative drugs. Top 10 Indications of CXCR4 Antagonists in Patsnap SynapseTechnological advancements and innovation have significantly driven the development of CXCR4 antagonists. Novel small-molecule antagonists such as Plerixafor and Mavorixafor, as well as peptide-based antagonists like Motixafortide, have demonstrated high affinity and favorable pharmacological efficacy. The application of antibody-based therapies and nanotechnology has further enhanced drug specificity and effectiveness. Multiple clinical trials have highlighted the substantial efficacy and safety of CXCR4 antagonists across various diseases. Some of these drugs have received FDA designations as Breakthrough Therapies or Fast Track therapies, expediting their development and approval. Targets of CXCR4 Antagonists in Patsnap SynapseRegional Development Analysis of CXCR4 AntagonistsNorth America leads in the development and market adoption of CXCR4 antagonists due to its advanced medical technology and robust regulatory framework. Significant investments from both the U.S. government and private sector have spurred research by major pharmaceutical companies and biotech startups. With a substantial patient population suffering from cancers, HIV infections, immune disorders, and requiring hematopoietic stem cell transplants, demand for CXCR4 antagonists remains strong. Key drugs, including Plerixafor and Mavorixafor, have achieved notable progress in this region. Regional Distribution of CXCR4 Antagonist Research and Development in Patsnap SynapseIn Europe, biopharmaceutical R&D is highly active, with many institutions and companies advancing work on CXCR4 antagonists. While the European Medicines Agency (EMA) maintains stringent drug approval processes, it is continuously optimizing these procedures to accelerate the market entry of innovative medicines. Europe's comprehensive healthcare systems and high patient receptivity to novel therapies drive demand for CXCR4 antagonists in oncology, HIV, immune disorders, and stem cell transplantation. Prominent drugs such as Motixafortide and Balixafortide are undergoing extensive clinical trials in the region. In Asia, particularly in countries like China, Japan, and South Korea, the biopharmaceutical market is expanding rapidly, with increasing demand for innovative drugs. Rich clinical trial resources and a large patient base create favorable conditions for CXCR4 antagonist research. The region exhibits significant potential due to its high prevalence of cancers, HIV infections, immune disorders, and stem cell transplant requirements. Representative drugs, such as Balixafortide, introduced by Fosun Pharma, are undergoing clinical trials for breast cancer. Numerous Asian pharmaceutical companies and research institutions are actively developing various CXCR4 antagonists. Market Competition Landscape for CXCR4 AntagonistsDevelopment Stage Distribution of CXCR4 Antagonists in Patsnap SynapsePlerixafor was the first FDA-approved CXCR4 antagonist, primarily used in autologous hematopoietic stem cell transplantation. Sanofi holds a first-mover advantage in the CXCR4 antagonist market, with a significant market share. The successful application of Plerixafor in stem cell transplantation has provided Sanofi with valuable data and experience, enabling further exploration of additional indications. For instance, Sanofi is investigating the potential of Plerixafor in oncology, particularly in enhancing immune cell infiltration within the tumor microenvironment and improving the efficacy of immunotherapies. Moreover, Sanofi is exploring Plerixafor's application in HIV treatment, aiming to reduce viral infection and transmission by blocking the interaction between HIV and CXCR4. Major Research Institutions for CXCR4 Antagonists in Patsnap SynapseThe CXCR4 antagonist Mavorixafor, the flagship product of X4 Pharmaceuticals, has received FDA priority review designation for the treatment of WHIM syndrome. WHIM syndrome is a rare primary immunodeficiency characterized by recurrent infections, hypogammaglobulinemia, and bone marrow abnormalities. The approval of Mavorixafor represents the first targeted therapy for WHIM syndrome, addressing an unmet medical need. In Phase 3 clinical trials for WHIM syndrome, Mavorixafor demonstrated positive outcomes, including favorable safety and efficacy profiles. These clinical results not only supported its regulatory submission but also bolstered X4 Pharmaceuticals’ market presence and investor confidence. Additionally, X4 Pharmaceuticals is actively exploring the use of Mavorixafor in other conditions, such as HIV infection and certain forms of chronic neutropenia. CXCR4 Antagonist Portfolio of X4 Pharmaceuticals in Patsnap SynapseBioLineRx's Motixafortide has shown remarkable efficacy in the treatment of pancreatic cancer and other malignancies. In collaboration with major pharmaceutical companies such as Merck and Roche, BioLineRx is advancing the development and commercialization of Motixafortide. Clinical trial data indicate that the combination of Motixafortide with Keytruda and chemotherapy significantly improves objective response rates (ORR) and progression-free survival (PFS) in patients. Motixafortide has also demonstrated promising results in autologous hematopoietic stem cell transplantation (ASCT). When combined with granulocyte colony-stimulating factor (G-CSF), Motixafortide substantially enhances the efficiency and quality of CD34+ stem cell collection. In the GENESIS global Phase 3 trial, the combination achieved significantly higher success rates compared to the placebo group, with 88.8% of patients achieving an optimal CD34+ cell dose in a single apheresis session and 92.5% in up to two sessions. Beyond pancreatic cancer and ASCT, BioLineRx is investigating Motixafortide in other oncology applications, including breast cancer, gastric cancer, and prostate cancer. Preliminary findings suggest that Motixafortide enhances antitumor immune responses by blocking CXCR4 receptors, reducing immunosuppressive cells in the tumor microenvironment, and increasing the infiltration of effector T cells and other antitumor immune cells. BioLineRx is also exploring combination therapies involving Motixafortide and other immunotherapies, such as PD-1 inhibitors and chemotherapeutic agents, which have demonstrated synergistic effects in early studies. CXCR4 Antagonist Portfolio of BioLineRx in Patsnap SynapseBioLineRx has established strategic partnerships with major pharmaceutical companies such as Merck and Roche to jointly develop and promote Motixafortide. These collaborations have accelerated the clinical research and market entry of Motixafortide, enhancing its global market presence. For example, BioLineRx partnered with Merck to conduct clinical trials of Motixafortide in combination with Keytruda for the treatment of pancreatic cancer. Additionally, BioLineRx collaborated with China-based Genfleet Therapeutics to develop Motixafortide for the Chinese market. Genfleet is independently responsible for designing and developing first-line combination therapies targeting advanced pancreatic ductal adenocarcinoma in mainland China. This partnership expedites Motixafortide's entry into the Chinese market, addressing the treatment needs of local patients. Fosun Pharma, through its collaboration with Polyphor, introduced Balixafortide for the treatment of breast cancer and other potential cancers. Balixafortide has demonstrated notable efficacy in breast cancer treatment. Clinical trial data from Fosun Pharma showed that Balixafortide, combined with eribulin mesylate injection, exhibited good efficacy and safety in HER2-negative metastatic breast cancer patients. In a global Phase 3 clinical trial, this combination achieved an objective response rate (ORR) of 40%, a median progression-free survival (mPFS) of 8.5 months, and a disease control rate (DCR) of 75%. Fosun Pharma is also exploring the application of Balixafortide in other cancers, such as pancreatic ductal adenocarcinoma (PDAC). According to an announcement by Spexis AG, Balixafortide demonstrated good safety and efficacy in PDAC patients, inhibiting tumor growth and metastasis. Additionally, Fosun Pharma is investigating combination therapies involving Balixafortide and other chemotherapeutic agents. For instance, the combination of Balixafortide with eribulin not only enhanced therapeutic efficacy but also reduced side effects, improving patients' quality of life. This combined therapy strategy offers new approaches to cancer treatment. ConclusionCXCR4 antagonists demonstrate immense potential across various medical fields, particularly in oncology, HIV infection, immune disorders, and hematopoietic stem cell transplantation. Advances in technology and supportive policies have provided robust backing for the development of CXCR4 antagonists, which hold promising market prospects. As more clinical trials are conducted and new drugs are approved, CXCR4 antagonists are poised to become vital tools for treating diverse diseases, offering hope and new options for patients. How to obtain the latest research advancements in the field of biopharmaceuticals? In the Synapse database, you can keep abreast of the latest research and development advances in drugs, targets, indications, organizations, etc., anywhere and anytime, on a daily or weekly basis. Click on the image below to embark on a brand new journey of drug discovery! Refrence  1.Yu, J., X. Zhou, and L. Shen, CXCR4-Targeted Radiopharmaceuticals for the Imaging and Therapy of Malignant Tumors. Molecules, 2023. 28(12).2.Yang, Y., et al., CXCL12-CXCR4/CXCR7 Axis in Cancer: from Mechanisms to Clinical Applications. Int J Biol Sci, 2023. 19(11): p. 3341-3359.3.Bianchi, M.E. and R. Mezzapelle, The Chemokine Receptor CXCR4 in Cell Proliferation and Tissue Regeneration. Front Immunol, 2020. 11: p. 2109.