Ubamatamab

关注并星标CPHI制药在线 在今年ASCO年会前，再生元公布了 EGFR /CD28双特异性抗体正在进行的临床 I/II 期研究早期数据，结果显示该药物对晚期实体瘤患者的治疗反应不尽如人意。 截至2023年10月13日，共有94名患者参与了研究。其中，仅有1名患者实现了完全缓解，2名患者表现出部分缓解，而9名患者病情保持稳定。值得注意的是，一名肝转移患者在研究截止日期之后达到了部分缓解。综合来看，总体缓解率为20%，而疾病控制率为80%。 在安全性方面，几乎所有患者都出现了治疗引起的不良事件，35%的参与者出现了3级或4级不良事件。90%的患者出现了被认为与研究药物相关的毒性，但这些副作用中只有7%为3级或4级。5%的患者因副作用退出研究。尚未出现与治疗相关的死亡病例。 除了EGFR/CD28，再生元还在研究多种 CD28 共刺激双特异性抗体，包括 PSMA/CD28、MUC16/CD28与 Libtayo 的组合或与相应的 CD3 双特异性抗体组合，在各种肿瘤中进行正在进行的 1 期试。 无独有偶，再生元此前曾被广泛看好的PSMA/CD28（REGN5678）双抗也在去年遭遇滑铁卢。REGN5678联合Libayo治疗研究组发生了两起免疫介导的患者死亡事件，因此暂停了该研究联合治疗组的患者招募。此前REGN5678正在开展单药或联合PD-1抑制剂Libayo治疗前列腺癌的I期临床试验。 作为CD28双抗的领跑者，再生元也在探索不同的治疗模式，包括与PD-1、CD3双抗的联用，然而目前两款CD28双抗进展均不顺利，似乎也预示着再生元的双抗之路并不平坦。 再生元双抗平台 所有再生元公司的双特异性抗体均设计为与天然性的人类抗体极为相似，并与两个不同的靶标结合。它们源自再生元公司专有的新一代技术--VelocImmune，并使用该公司的Veloci-Bi平台创建。这就可以创建没有接头或人工序列的双特异性抗体。此外，使用与人类抗体药物相似的方法，具有相似的药代动力学来制造再生元双特异性抗体。 目前，在正在进行的针对多种血液癌症和实体瘤的临床试验中，有多种Regeneron研究性双特异性抗体。这些双特征分为三类： 1. CD3双特异性抗体被设计为桥接T细胞和肿瘤细胞。在肿瘤部位，它们通过其CD3受体激活T细胞并促进T细胞杀死癌细胞。研究对象包括： ● CD20/CD3（Odronextamab）用于非霍奇金B细胞淋巴瘤； ● 用于多发性骨髓瘤的BCMA/CD3（Linvoseltamab）； ● MUC16/CD3（REGN4018）用于卵巢癌。 2. CD28共刺激双特异性抗体也被设计为桥接T细胞和肿瘤细胞。在肿瘤部位，它们通过其CD28受体共同刺激T细胞，并可能与PD-1抑制剂和/或CD3双特异性药物协同作用。研究对象包括： ● PSMA/CD28（REGN5678）与Libtayo联合治疗前列腺癌。 ● EGFR/CD28(REGN7075)与Libtayo联合治疗实体瘤。 3. 靶向肿瘤的双特异性抗体旨在仅靶向癌细胞上的蛋白质。这样，它们可能会影响各种信号通路，从而阻碍癌细胞生存和增殖的能力。研究对象包括： ● METxMET（REGN5093）用于由MET突变和/或扩增驱动的非小细胞肺癌。REGN5093靶向癌细胞上MET受体的两个不同部分，以降解该受体并阻断其触发细胞增殖的能力。        Regeneron抗体药物研发策略        图片来源：Regeneron Pharmaceuticals官网 CD3双抗：有喜又有忧 Linvoseltamab是一款BCMA/CD3双特异性抗体，采用了再生元独有的全人源抗体技术VelocImmune和全长双抗技术平台VelociBi，与人体天然的抗体非常接近。该产品能够将表达CD3的T细胞与多发性骨髓瘤细胞上的B细胞成熟抗原（BCMA）桥接，以促进T细胞活化和对癌细胞的杀伤。 今年2月21日，再生元宣布，FDA已经同意优先审查linvoseltamab的生物制品许可申请（BLA），用于治疗既往至少接受过三次治疗的复发或难治性（R/R）多发性骨髓瘤（MM）患者。PDUFA日期为2024年8月22日。 该 BLA 主要基于一项linvoseltamab 治疗 R/R MM I/II期关键性试验（LINKER-MM1）数据。据2023年12月披露的试验数据显示，中位随访时间为11个月时，在1/2期临床试验（n=117）中接受剂量为200 mg的linvoseltamab治疗的患者中观察到客观缓解率（ORR）为71%，46%达到完全缓解或更佳。2月初，欧洲药品管理局受理了 linvoseltamab 在同一适应症中的上市许可申请。 在针对BCMA靶点的研发中， BCMA/CD3双特异性抗体是近年来的一个研发热点。近三年已有2个双抗获批上市，分别为辉瑞的Elrexfio®（Elranatamab，2023年在美国获批）和强生的Tecvayli®（Teclistamab，2022年在法国、2023年在美国获批）。 FDA不仅对Elrexfio®和Tecvayli®给予了突破性疗法和加速批准的特别通道，对于Linvoseltamab也是批准了快速通道和优先审评，可见FDA对于BCMA-CD3双抗治疗多发性骨髓瘤寄予了厚望。 BCMA-CD3双抗也不负众望，R/R MM接受双抗治疗的ORR为58%，Tecvayli®将这一数据提高到了62%。而在Linvoseltamab最新发布的数据中，ORR为71%，显示出良好的治疗效果。 与现有的BCMA双抗产品相比，Linvoseltamab有更高的ORR和CR[3]，CRS比例接近或略低，给药频率低于其他上市产品。随着进一步的临床研究，Linvoseltamab有机会在多发性骨髓瘤的一线治疗中为患者带来更多的获益，有望成为具有best-in-class潜力的R/R MM双抗治疗药物。 BCMA/CD3双抗Linvoseltamab即将撞线，无疑给再生元注入了一针及时的强心剂，然而CD20/CD3双抗Odronextamab被FDA拒批，又给再生元当头浇了一盆冷水。 CD20/CD3双特异性抗体已迎来爆发期。不足半年时间，FDA批准了三款双抗的上市，分别是罗氏的Lunsumio（Mosunetuzumab）和Columvi（Glofitamab），以及艾伯维/Genmab的Epkinly（Epcoritamab）。但是近日FDA却踩了"刹车"，拒绝批准第四款CD20/CD3双抗Odronextamab的上市。 拒绝的理由是验证性临床试验未启动，这是自2022年加速审批新政策推出后首次出现在FDA的CRL信函中的理由。通常药企在获得加速批准的情况下会采取拖延战略，不按时完成验证性临床试验。以前FDA也会采取灵活策略，不会强制要求企业完成。但是这次FDA向企业拖延说"NO"，拒绝批准上市。 Odronextamab是再生元基于专有的Veloci-Bi双抗平台构建开发的一款CD3/CD20双特异性抗体，它可同时结合癌细胞上的CD20和T细胞上的CD3，从而促进局部T细胞活化和癌细胞杀伤。 Odronextamab的监管之路充满荆棘。除了此次上市被拒，早在2020年12月，Odronextamab部分临床试验就被FDA叫停，FDA要求再生元进一步降低3级细胞因子释放综合征（CRS）的发生率。此后，该公司不得不在临床前修改试验方案，该项禁令部分已于2021年5月解除。 目前CD3双抗在血液瘤治疗方面已经取得了令人欣喜的突破，但在实体瘤方面仍待探索。卵巢癌组织相比其它实体瘤相对更加松散，是一种介于血液瘤和实体瘤之间的瘤种；此外，这类癌症的一个重要特点是肿瘤浸润T细胞相对较多。因此，广泛认为卵巢癌这类特殊的"中间态"肿瘤可能是探索CD3双抗实体瘤应用的一个优先选择。 再生元的Ubamatamab就是一款MUC16/CD3双抗，MUC16大约在80%~90%的卵巢癌患者中都有表达，Ubamatamab对卵巢癌患者显示出优秀的疗效和良好的安全性。一项1期试验数据显示，在既往接受过大量治疗的卵巢癌患者中，Ubamatamab单药治疗带来了很有前景的疗效，并且安全性良好。研究结果显示，在接受至少1剂20mg或更高剂量Ubamatamab治疗的42名患者中，有14.3%的患者肿瘤大幅度缩小，57.1%的患者疾病得到控制，没有进一步恶化。疗效平均持续12.2个月。此外，23.8%的患者CA-125水平有所好转。 MET双抗和ADC：未来可期 再生元开创性的开发了靶向MET的双特异抗体，该抗体可以同时结合两个不同的表位，并和MET抗原形成2+2型的复合物，较大的分子量促进了复合物的内吞，并且较大的分子量也促进了溶酶体对复合物的降解，进一步的防止了MET抗原再生回到细胞表面，从而展现了良好的抑制肿瘤的效果。在临床前的研究中，无论是细胞水平还是动物水平，MET双抗REGN5093多优于目前临床中的抗体，目前该双抗已经进入临床。在REGN5093的剂量爬坡试验中，在36位接受最高剂量药物、带有MET变异的晚期NSCLC患者中，有6位出现部分缓解。在这些出现部分缓解的病患中，有5位曾经接受过抗PD-1抗体的治疗。 在双抗的基础上，再生元还开发了METxMET双抗ADC METxMET-M114（REGN5093-M114），该双抗ADC采用了可以裂解的linker，可以在一定程度上避免因为溶酶体降解能力降低导致的耐药性；另外一方面，该双抗ADC采用了不具有旁观者效应的M24毒素，这主要是因为MET在部分正常组织低表达，不具有旁观者效应可以进一步提高双抗ADC的安全性。临床前研究表明，该抗体不仅对常规的MET高表达的肿瘤有效，而且对多种具有天然或者获得性耐药的肿瘤也具有良好的药效，并且优于已经进入临床3期的Telisotuzumab vedotin抗体；在安全性方面，该双抗在大动物实验中展现了良好的安全性及耐受性。目前，METxMET-M114（REGN5093-M114）针对非小细胞肺癌的临床试验已经进入2期。 结语 在双抗药物开发方面，再生元虽然不如罗氏和强生那么强势，但是依靠Veloci-Bi双抗平台正在走自己独特的道路，相比于罗氏和强生在血液瘤中的深耕，再生元更多的关注实体瘤，目前再生元已经有多种双抗疗法在探索实体瘤的治疗。虽然在前期的探索上遭遇到一些挫折，但再生元仍有多款颇具潜力的双抗和多项组合疗法进入临床，而这些疗法也许可以给实体瘤的治疗带来革命性的变化。 参考来源        1. Dimitris Skokos et al. A class of costimulatoryCD28-bispecific antibodies that enhance the antitumor activity ofCD3-bispecific antibodies. Sci. Transl. Med. 2020        2. Alice O. Kamphorst et al. Rescue of exhausted CD8 Tcells by PD-1 targeted therapies is CD28-dependent. Science.        3. John O. DaSilva, Katie Yang, Oliver Surriga et al. A Biparatopic Antibody-Drug Conjugate to Treat MET-Expressing Cancers, Including Those that Are Unresponsive to MET Pathway Blockade.AACR 2021 【企业推荐】 【智药研习社直播预告】 来源：CPHI制药在线 声明：本文仅代表作者观点，并不代表制药在线立场。本网站内容仅出于传递更多信息之目的。如需转载，请务必注明文章来源和作者。 投稿邮箱：Kelly.Xiao@imsinoexpo.com ▼更多制药资讯，请关注CPHI制药在线▼ 点击阅读原文，进入智药研习社~

First dose-escalation results for REGN5668 (MUC16xCD28), a costimulatory bispecific, in combination with Libtayo® (cemiplimab) showed encouraging initial activity in patients with recurrent ovarian cancer Additional data include a late-breaking oral presentation of first results for neoadjuvant Libtayo in combination with low-dose stereotactic body radiotherapy in early-stage hepatocellular carcinoma TARRYTOWN, N.Y., Dec. 07, 2023 (GLOBE NEWSWIRE) -- Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN) today announced the presentation of new and updated data on multiple combination therapies from its oncology pipeline at the European Society for Medical Oncology Immuno-Oncology (ESMO IO) Congress 2023 from December 6 to 8 in Geneva, Switzerland. Highlights include first Phase 1 dose-escalation data for the investigational costimulatory bispecific antibody REGN5668 (MUC16xCD28) in combination with PD-1 inhibitor Libtayo® (cemiplimab) showing encouraging initial activity in patients with recurrent ovarian cancer. Additionally, a late-breaking oral presentation will detail the first results from a Phase 2 trial investigating neoadjuvant Libtayo in combination with low-dose stereotactic body radiotherapy (SBRT) in patients with early-stage hepatocellular carcinoma (HCC). “Our ESMO IO presentations highlight the continued progress of Regeneron’s oncology pipeline, which was strategically curated to have the potential to offer novel and differentiated combinations targeting several types of difficult-to-treat cancers. We look forward to sharing first clinical data from our costimulatory bispecific program in patients with recurrent ovarian cancer, which is investigating a MUC16xCD28 bispecific antibody in combination with our PD-1 inhibitor Libtayo,” said Israel Lowy, Senior Vice President, Translational and Clinical Oncology at Regeneron. “This is our second costimulatory bispecific program to report clinical data, with a total of four such agents currently in the clinic, and adds to the evidence showing that our novel CD28 costimulatory bispecifics can potentially enhance the anti-tumor activity of anti-PD-1 therapies in a synergistic fashion. Studies are also underway exploring the combination of CD28 costimulatory bispecifics with CD3 bispecifics, including REGN5668 with ubamatamab, our MUC16xCD3 bispecific.” Per initial results to be shared at ESMO IO, a combination of REGN5668 with Libtayo showed early clinical activity in patients with recurrent ovarian cancer. The trial enrolled 28 platinum-experienced patients with recurrent ovarian cancer, who received infusions of REGN5668 once-weekly at a dose range of 0.3-300 mg, with the addition of Libtayo infusions every three weeks beginning between day 21 and 28. At the time of initial data cut off (July 14, 2023), 6 patients (21%) had stable disease, while 1 patient (in the 300 mg REGN5668 cohort) had an ongoing confirmed partial response with a 59% target lesion reduction from baseline. Dose escalation is ongoing and has included administration of REGN5668 doses beyond 300 mg in combination with Libtayo. The combination of REGN5668 and Libtayo demonstrated an acceptable safety pro 28 patients with fatigue (32%), nausea (29%) and pain (18%) as the most common treatment-related adverse events (TRAEs). Infusion-related reactions occurred in 7% of patients and cytokine release syndrome occurred in 11% of patients and were all grade 1 or 2. There was one instance of a TRAE that was grade 3, which was fatigue. As of data cut off, there were no dose-limiting toxicities or adverse events resulting in death or treatment discontinuation. Dose escalation is continuing in order to define an optimal dose for expansion cohorts. Regeneron presentations at ESMO IO: Medicine(s) Abstract Title Abstract Lead Author Presentation date/time (all CET) Libtayo, REGN5668 REGN5668 (MUC16xCD28 bispecific antibody) with cemiplimab (anti-PD-1 antibody) in recurrent ovarian cancer: Phase 1 dose-escalation study #127P John L. Hayes, M.D., Ph.D. Thursday, December 7, 2023; 12PM–1PM CET Libtayo, chemotherapy Patient-reported outcomes (PROs) of cemiplimab + chemotherapy in advanced non-small cell lung cancer (NSCLC): EMPOWER-lung 3 liver metastases subpopulation #783P Ana Baramidze, M.D., Ph.D. Thursday, December 7, 2023; 12PM–1PM CET Libtayo, SBRT Low-dose stereotactic body radiotherapy prior to pre-operative cemiplimab for patients with resectable hepatocellular carcinoma #LBA4 Thomas Marron, M.D., Ph.D. Thursday, December 7, 9:25AM–9:30AM CET The potential uses of Libtayo and REGN5668 described above are investigational, and their safety and efficacy in these uses have not been fully evaluated by any regulatory authority. REGN5668 is not currently approved for use in any indication. About Regeneron in Cancer We aspire to turn revolutionary discoveries into medicines that can transform the lives of those impacted by cancer. Our team around the world is driven to solve the needs and challenges of those affected by one of the most serious diseases of our time. Backed by our legacy of scientific innovation and a deep understanding of biology, genetics and the immune system, we’re pursuing potential therapies across more than 30 types of solid tumors and blood cancers. Our cancer strategy is powered by cutting-edge technologies and therapies that can be flexibly combined to investigate potentially transformative treatments for patients. Oncology assets in clinical development comprise nearly half of Regeneron’s pipeline, and include checkpoint inhibitors, bispecific antibodies and costimulatory bispecific antibodies. Our approved PD-1 inhibitor Libtayo serves as the backbone of many of our investigational combinations. To complement our extensive in-house capabilities, we collaborate with patients, healthcare providers, governments, biopharma companies and each other to further our shared goals. Together, we are united in the mission to serve as a beacon of transformation in cancer care. About Libtayo Libtayo is a fully human monoclonal antibody targeting the immune checkpoint receptor PD-1 on T cells and was invented using Regeneron's proprietary VelocImmune® technology. By binding to PD-1, Libtayo has been shown to block cancer cells from using the PD-1 pathway to suppress T-cell activation. In the U.S. and other countries Libtayo is indicated in certain patients with advanced basal cell carcinoma (BCC), advanced cutaneous squamous cell carcinoma (CSCC) and advanced non-small cell lung cancer (NSCLC), as well as in advanced cervical cancer in the European Union, Canada and Brazil. As of July 1, 2022, Libtayo is developed and marketed globally by Regeneron. In the U.S., the generic name for Libtayo in its approved indications is cemiplimab-rwlc, with rwlc as the suffix designated in accordance with Nonproprietary Naming of Biological Products Guidance for Industry issued by the U.S. Food and Drug Administration (FDA). Outside of the U.S., the generic name of Libtayo in its approved indication is cemiplimab. The extensive clinical program for Libtayo is focused on difficult-to-treat cancers. Libtayo is currently being investigated in trials as a monotherapy, as well as in combination with either conventional or novel therapeutic approaches for other solid tumors and blood cancers. These potential uses are investigational, and their safety and efficacy have not been evaluated by any regulatory authority. U.S. FDA-approved Indications Libtayo is a prescription medicine used to treat: People with a type of skin cancer called cutaneous squamous cell carcinoma (CSCC) that has spread or cannot be cured by surgery or radiation. People with a type of skin cancer called basal cell carcinoma (BCC) when your BCC cannot be removed by surgery (locally advanced BCC) or when it has spread (metastatic BCC) and have received treatment with a hedgehog pathway inhibitor (HHI), or cannot receive treatment with a HHI. Adults with a type of lung cancer called non-small cell lung cancer (NSCLC). LIBTAYO may be used in combination with chemotherapy that contains a platinum medicine as your first treatment when your lung cancer has not spread outside your chest (locally advanced lung cancer) and you cannot have surgery or chemotherapy with radiation, or your lung cancer has spread to other areas of your body (metastatic lung cancer), and your tumor does not have an abnormal “EGFR,” “ALK,” or “ROS1” gene. LIBTAYO may be used alone as your first treatment when your lung cancer has not spread outside your chest (locally advanced lung cancer) and you cannot have surgery or chemotherapy with radiation, or your lung cancer has spread to other areas of your body (metastatic lung cancer), and your tumor tests positive for high “PD-L1,” and your tumor does not have an abnormal “EGFR,” “ALK,” or “ROS1” gene. It is not known if Libtayo is safe and effective in children. IMPORTANT SAFETY INFORMATION FOR U.S. PATIENTS What is the most important information I should know about LIBTAYO? LIBTAYO is a medicine that may treat certain cancers by working with your immune system. LIBTAYO can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen anytime during treatment or even after your treatment has ended. Call or see your healthcare provider right away if you develop any new or worsening signs or symptoms, including: Lung problems: cough, shortness of breath, or chest pain Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual, stools that are black, tarry, sticky or have blood or mucus, or severe stomach-area (abdomen) pain or tenderness Liver problems: yellowing of your skin or the whites of your eyes, severe nausea or vomiting, pain on the right side of your stomach-area (abdomen), dark urine (tea colored), or bleeding or bruising more easily than normal Hormone gland problems: headache that will not go away or unusual headaches, eye sensitivity to light, eye problems, rapid heartbeat, increased sweating, extreme tiredness, weight gain or weight loss, feeling more hungry or thirsty than usual, urinating more often than usual, hair loss, feeling cold, constipation, your voice gets deeper, dizziness or fainting, or changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness Kidney problems: decrease in your amount of urine, blood in your urine, swelling of your ankles, or loss of appetite Skin problems: rash, itching, skin blistering or peeling, painful sores or ulcers in mouth or nose, throat, or genital area, fever or flu-like symptoms, or swollen lymph nodes Problems can also happen in other organs and tissues. These are not all of the signs and symptoms of immune system problems that can happen with LIBTAYO. Call or see your healthcare provider right away for any new or worsening signs or symptoms, which may include: chest pain, irregular heartbeat, shortness of breath or swelling of ankles, confusion, sleepiness, memory problems, changes in mood or behavior, stiff neck, balance problems, tingling or numbness of the arms or legs, double vision, blurry vision, sensitivity to light, eye pain, changes in eyesight, persistent or severe muscle pain or weakness, muscle cramps, low red blood cells, or bruising Infusion reactions that can sometimes be severe or life-threatening. Signs and symptoms of infusion reactions may include: nausea, vomiting, chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, feel like passing out, fever, back or neck pain, or facial swelling Rejection of a transplanted organ. Your healthcare provider should tell you what signs and symptoms you should report and monitor you, depending on the type of organ transplant that you have had Complications, including graft-versus-host disease (GVHD), in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with LIBTAYO. Your healthcare provider will monitor you for these complications Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with LIBTAYO. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may also need to delay or completely stop treatment with LIBTAYO if you have severe side effects. Before you receive LIBTAYO, tell your healthcare provider about all your medical conditions, including if you: have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus have received an organ transplant have received or plan to receive a stem cell transplant that uses donor stem cells (allogeneic) have received radiation treatment to your chest area have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome are pregnant or plan to become pregnant. LIBTAYO can harm your unborn baby Females who are able to become pregnant: Your healthcare provider will give you a pregnancy test before you start treatment You should use an effective method of birth control during your treatment and for at least 4 months after your last dose of LIBTAYO. Talk to your healthcare provider about birth control methods that you can use during this time Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with LIBTAYO are breastfeeding or plan to breastfeed. It is not known if LIBTAYO passes into your breast milk. Do not breastfeed during treatment and for at least 4 months after the last dose of LIBTAYO Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. The most common side effects of LIBTAYO when used alone include tiredness, muscle or bone pain, rash, diarrhea, and low levels of red blood cells (anemia). The most common side effects of LIBTAYO when used in combination with platinum-containing chemotherapy include hair loss, muscle or bone pain, nausea, tiredness, numbness, pain, tingling, or burning in your hands or feet, and decreased appetite. These are not all the possible side effects of LIBTAYO. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Regeneron Pharmaceuticals at 1-877-542-8296. Please see full Prescribing Information, including Medication Guide. About Regeneron's VelocImmune Technology Regeneron's VelocImmune technology utilizes a proprietary genetically engineered mouse platform endowed with a genetically humanized immune system to produce optimized fully human antibodies. When Regeneron's co-Founder, President and Chief Scientific Officer George D. Yancopoulos was a graduate student with his mentor Frederick W. Alt in 1985, they were the first to envision making such a genetically humanized mouse, and Regeneron has spent decades inventing and developing VelocImmune and related VelociSuite® technologies. Dr. Yancopoulos and his team have used VelocImmune technology to create a substantial proportion of all original, FDA-approved or authorized fully human monoclonal antibodies. This includes REGEN-COV® (casirivimab and imdevimab), Dupixent® (dupilumab), Libtayo®, Praluent® (alirocumab), Kevzara® (sarilumab), Evkeeza® (evinacumab-dgnb), Inmazeb® (atoltivimab, maftivimab and odesivimab-ebgn) and Veopoz™ (pozelimab-bbfg). About Regeneron Regeneron is a leading biotechnology company that invents, develops, and commercializes life-transforming medicines for people with serious diseases. Founded and led for 35 years by physician-scientists, Regeneron's unique ability to repeatedly and consistently translate science into medicine has led to numerous FDA-approved treatments and product candidates in development, almost all of which were homegrown in Regeneron's laboratories. Regeneron's medicines and pipeline are designed to help patients with eye diseases, allergic and inflammatory diseases, cancer, cardiovascular and metabolic diseases, hematologic conditions, infectious diseases, and rare diseases. Regeneron is accelerating and improving the traditional drug development process through its proprietary VelociSuite® technologies, such as VelocImmune®, which uses unique genetically humanized mice to produce optimized fully human antibodies and bispecific antibodies, and through ambitious research initiatives such as the Regeneron Genetics Center®, which is conducting one of the largest genetics sequencing efforts in the world. For additional information about Regeneron, please visit or follow Regeneron on LinkedIn. Forward-Looking Statements and Use of Digital Media This press release includes forward-looking statements that involve risks and uncertainties relating to future events and the future performance of Regeneron Pharmaceuticals, Inc. (“Regeneron” or the “Company”), and actual events or results may differ materially from these forward-looking statements. Words such as “anticipate,” “expect,” “intend,” “plan,” “believe,” “seek,” “estimate,” variations of such words, and similar expressions are intended to identify such forward-looking statements, although not all forward-looking statements contain these identifying words. These statements concern, and these risks and uncertainties include, among others, the nature, timing, and possible success and therapeutic applications of products marketed or otherwise commercialized by Regeneron and/or its collaborators or licensees (collectively, “Regeneron’s Products”) and product candidates being developed by Regeneron and/or its collaborators or licensees (collectively, “Regeneron’s Product Candidates”) and research and clinical programs now underway or planned, including without limitation Libtayo® (cemiplimab) in combination with REGN5668 (MUC16xCD28 costimulatory bispecific antibody), Libtayo in combination with stereotactic body radiotherapy (“SBRT”), and other of Regeneron’s Product Candidates discussed or referenced in this press release; the likelihood, timing, and scope of possible regulatory approval and commercial launch of Regeneron’s Product Candidates and new indications for Regeneron’s Products, including Libtayo in combination with REGN5668 for the treatment of recurrent ovarian cancer and Libtayo in combination with SBRT for the treatment of early-stage hepatocellular carcinoma; uncertainty of the utilization, market acceptance, and commercial success of Regeneron’s Products and Regeneron’s Product Candidates and the impact of studies (whether conducted by Regeneron or others and whether mandated or voluntary), including the studies discussed or referenced in this press release, on any of the foregoingor any potential regulatory approval of Regeneron’s Products and Regeneron’s Product Candidates (such as Libtayo in combination with REGN5668 and Libtayo in combination with SBRT); the ability of Regeneron’s collaborators, licensees, suppliers, or other third parties (as applicable) to perform manufacturing, filling, finishing, packaging, labeling, distribution, and other steps related to Regeneron’s Products and Regeneron’s Product Candidates; the ability of Regeneron to manage supply chains for multiple products and product candidates; safety issues resulting from the administration of Regeneron’s Products and Regeneron’s Product Candidates (such as Libtayo in combination with REGN5668 and Libtayo in combination with SBRT) in patients, including serious complications or side effects in connection with the use of Regeneron’s Products and Regeneron’s Product Candidates in clinical trials; determinations by regulatory and administrative governmental authorities which may delay or restrict Regeneron’s ability to continue to develop or commercialize Regeneron’s Products and Regeneron’s Product Candidates; ongoing regulatory obligations and oversight impacting Regeneron’s Products, research and clinical programs, and business, including those relating to patient privacy; the availability and extent of reimbursement of Regeneron’s Products from third-party payers, including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted by such payers; competing drugs and product candidates that may be superior to, or more cost effective than, Regeneron’s Products and Regeneron’s Product Candidates; the extent to which the results from the research and development programs conducted by Regeneron and/or its collaborators or licensees may be replicated in other studies and/or lead to advancement of product candidates to clinical trials, therapeutic applications, or regulatory approval; unanticipated expenses; the costs of developing, producing, and selling products; the ability of Regeneron to meet any of its financial projections or guidance and changes to the assumptions underlying those projections or guidance; the potential for any license, collaboration, or supply agreement, including Regeneron’s agreements with Sanofi and Bayer (or their respective affiliated companies, as applicable), to be cancelled or terminated; the impact of public health outbreaks, epidemics, or pandemics (such as the COVID-19 pandemic) on Regeneron's business; and risks associated with intellectual property of other parties and pending or future litigation relating thereto (including without limitation the patent litigation and other related proceedings relating to EYLEA® (aflibercept) Injection and REGEN-COV® (casirivimab and imdevimab)), other litigation and other proceedings and government investigations relating to the Company and/or its operations, the ultimate outcome of any such proceedings and investigations, and the impact any of the foregoing may have on Regeneron’s business, prospects, operating results, and financial condition. A more complete description of these and other material risks can be found in Regeneron’s filings with the U.S. Securities and Exchange Commission, including its Form 10-K for the year ended December 31, 2022 and its Form 10-Q for the quarterly period ended September 30, 2023. Any forward-looking statements are made based on management’s current beliefs and judgment, and the reader is cautioned not to rely on any forward-looking statements made by Regeneron. Regeneron does not undertake any obligation to update (publicly or otherwise) any forward-looking statement, including without limitation any financial projection or guidance, whether as a result of new information, future events, or otherwise. Regeneron uses its media and investor relations website and social media outlets to publish important information about the Company, including information that may be deemed material to investors. Financial and other information about Regeneron is routinely posted and is accessible on Regeneron's media and investor relations website ( ) and its LinkedIn page ( ). Contacts: Media Relations Taylor Ramsey Tel: +1 914-409-2381 taylor.ramsey@regeneron.com Investor Relations Vesna Tosic Tel: +1 914-847-5443 vesna.tosic@regeneron.com