Redx Pharma

‘004 mono insufficient in BTC; H223 combo is key

Lighthouse | 8 March 2023

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  • Top-line RXC004 monotherapy data from the advanced biliary tract cancer (BTC) arm of the Phase II PORCUPINE2 study confirm that RXC004’s safety profile is consistent with prior Phase I safety data. Of the 16 treated BTC patients, who had not been genetically selected, some experienced a durable clinical benefit, albeit this is not sufficient to support further development of RX004 as monotherapy in this indication. According to published data, very few monotherapy agents are effective or have been approved in advanced second-line BTC (the patients included in this trial). Analysis of results from this cohort, including efficacy and biomarker data, will be used to characterise and understand RXC004 monotherapy and combination activity.
  • Evidence of a durable clinical benefit is consistent with RXC004’s dual mechanism of action. RXC004 is an innovative porcupine inhibitor for Wnt-ligand dependent cancers and, as we have previously highlighted, RXC004 on its own is cytostatic (slows cell growth) rather than cytotoxic (kills tumours). RXC004 also has an immune-enhancing effect, and the primary efficacy hypothesis in BTC is that RXC004 could reverse Wnt-driven immune evasion and act synergistically with anti-PD-1 checkpoint inhibitors (CPIs). Given this potential to overcome anti-PD-1 resistance, RXC004 combination data (+ CPIs) due in H223 will be key.
  • RXC004 is currently being investigated in two Phase II trials, both of which are ongoing: (1) PORCUPINE in genetically selected microsatellite stable metastatic colorectal cancer (MSS mCRC); and (2) PORCUPINE2 in genetically selected pancreatic and unselected BTC.
  • Combination data from both PORCUPINE2 in BTC (+ Keytruda, Merck) and from PORCUPINE (+ Opdivo, Bristol Myers Squibb) are expected during H223. In addition, further RXC004 monotherapy data from the genetically selected pancreatic cancer arm of PORCUPINE2 and from PORCUPINE are also expected during H223.

Trinity Delta view: The first data from the ongoing RXC004 Phase II programme suggest that RXC004 monotherapy treatment alone is not sufficiently effective to warrant further development in BTC. However, a better indication of RXC004’s potential efficacy should arise from combination studies with CPIs Keytruda and Opdivo during H223. Some tumours do not respond to Keytruda and Opdivo and it is RXC004’s immune-enhancing mechanism that could overcome this resistance.

Our Redx Pharma valuation and forecasts remain suspended following the recommended all share business combination with Jounce Therapeutics.

Redx Pharma is a research client of Trinity Delta Research Limited and for the purposes of the Takeover Code, Trinity Delta is deemed to be connected with Redx Pharma.


8 March 2023

Market Cap£139.0m
Primary exchangeAIM London
Company CodeREDX
Corporate clientYes

Company description

Redx Pharma specialises in the discovery and development of small molecule therapeutics, with an emphasis on oncology and fibrotic diseases. It aims to initially progress them through proof-of-concept studies, before evaluating options for further development and value creation.


Lala Gregorek
+44 (0) 20 3637 5043

Philippa Gardner
+44 (0) 20 3637 5042


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