Our current portfolio of investigational product candidates, AL101 and AL102, targets aberrant activation of the Notch-pathway with gamma secretase inhibitors.
When gamma secretase, the enzyme responsible for Notch activation, is inhibited, it turns off the Notch-pathway activation. Aberrant activation of the Notch-pathway has long been implicated in multiple solid tumor and hematological cancers and has often been associated with more aggressive cancers. Notch serves as a critical facilitator in processes, such as cellular proliferation, survival, migration, invasion, drug resistance and metastatic spread--all of which contribute to poorer patient prognosis.
AL101 and AL102 are designed to address the underlying key drivers of tumor growth by targeting Notch-pathway activation directly.
We’re working on therapies that, if approved by regulatory authorities, could transform today’s treatment options for rare and aggressive cancers.
Desmoid tumors, also called aggressive fibromatosis or desmoid-type fibromatosis, are rare connective tissue tumors that typically arise in the upper and lower extremities, abdominal wall, head and neck area, mesenteric root and chest wall with the potential to arise in additional parts of the body. Desmoid tumors do not metastasize but often aggressively infiltrate neurovascular structures and vital organs. People living with desmoid tumors are often limited in their daily life due to chronic pain, functional deficits, general decrease in their quality of life and organ dysfunction.
Desmoid tumors have an annual incidence of approximately 1,700 patients in the United States and typically occur in patients between the ages of 15 and 60 years. They are most commonly diagnosed in young adults 30-40 years of age and are more prevalent in females.
Today, surgery is no longer regarded as the cornerstone treatment of desmoid tumors due to a high rate of recurrence post-surgery and there are currently no FDA-approved systemic therapies for the treatment of unresectable, recurrent or progressive desmoid tumors.
Ayala is currently conducting a Phase 2/3 clinical trial of AL102 for the treatment of progressing desmoid tumors.
ACC is a rare malignancy of the secretory glands, most commonly of the salivary glands. ACC has an annual incidence of approximately 3,400 patients in the United States, approximately 1,700 of which are recurrent/metastatic (R/M) ACC patients. There are currently no FDA-approved therapies for this indication.
Based on scientific literature and our bioinformatics research, we estimate that 18% to 22% of R/M ACC patients have Notch-activating mutations. As the understanding of the biology of cancer and ACC specifically evolved, the importance of the Notch-pathway and Notch-activating mutations was established. ACC patients with Notch-activating mutations are more likely to present advanced-stage disease, and develop a distinctly different pattern of metastatic disease compared to those without.
For Notch patients, overall median survival rates can be significantly worse—roughly four times shorter than patients without Notch-activating mutations.
Ayala is currently in Phase 2 (ACCURACY) Clinical Trial for AL101 in patients with ACC bearing activated Notch mutations.
TNBC is one of the most aggressive types of breast cancer. It has an annual incidence of approximately 270,000 patients in the United States and is the leading cause of cancer death in women worldwide. In the United States, TNBC is the second leading cause of cancer death in women.
Triple negative breast cancer is characterized by negative tests for three of the common receptors found in breast cancer: estrogen, progesterone, and HER2 protein. As a result, this means TNBC does not respond to hormonal therapy medicines or medicines to target the HER2 protein receptors.
TNBC is associated with a younger age at diagnosis, advanced stage at diagnosis, increased risk of visceral metastasis and decreased survival. Approximately 37% of TNBC patients have recurrent/metastatic (R/M) TNBC, resulting in an annual incidence of approximately 10,000 R/M TNBC patients in the United States. Based on primary literature and our bioinformatics research, we estimate that approximately 9% to 16% of TNBC patients have Notch-activating gene alterations including mutations and fusions.
Ayala is currently conducting Phase 2 clinical trial of AL101 for treatment of R/M TNBC in patients with Notch-activating mutations.
T-ALL is an aggressive, rare form of T-cell specific leukemia. T-ALL has an annual incidence of approximately 1,200 patients in the United States, of which an estimated 400 patients, including pediatric patients, present for the treatment of relapsed/refractory (R/R) T-ALL. Approximately 65% of all T-ALL patients have Notch-activating mutations. In addition, there is an incremental subset of patients with Notch-pathway activation who do not bare Notch-activating mutations.
T-ALL is characterized by chemotherapy resistance, induction failure and tendency for early relapse.
Ayala will soon commence Phase 2 clinical trial of AL101 for the treatment of R/R T-ALL.
We are collaborating with Novartis to develop AL102 for the treatment of multiple myeloma (MM), in combination with Novartis’ B-cell maturation antigen (BCMA) targeting therapies.
The Novartis BCMA program is in Phase 1 clinical trial.