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UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

WASHINGTON, D.C. 20549

 

FORM 8-K

 

CURRENT REPORT

 

Pursuant to Section 13 or 15(d)

of the Securities Exchange Act of 1934

 

Date of Report (Date of earliest event reported): May 7, 2025

 

THERIVA BIOLOGICS, INC.

(Exact name of registrant as specified in its charter)

 

Nevada   001-12584   13-3808303
(State or other jurisdiction of
incorporation)
  (Commission File No.)   (IRS Employer Identification
No.)

 

9605 Medical Center Drive, Suite 270

Rockville, Maryland 20850

(Address of principal executive offices and zip code)

 

(301) 417-4364

Registrant’s telephone number, including area code

 

N/A

(Former name or former address, if changed since last report)

 

Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):

 

  ¨ Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
     
  ¨ Soliciting material pursuant to Rule 14a-12(b) under the Exchange Act (17 CFR 240.14a-12)
     
  ¨ Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
     
  ¨ Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

 

Securities registered pursuant to Section 12(b) of the Act:

 

Title of each class Trading Symbol(s) Name of each exchange on
which registered
Common stock, par value $0.001 per share TOVX NYSE American

 

Indicate by check mark whether the registrant is an emerging growth company as defined in in Rule 405 of the Securities Act of 1933 (17 CFR §230.405 of this chapter) or Rule 12b-2 of the Securities Exchange Act of 1934 (17 CFR §240.12b-2 of this chapter).

 

Emerging growth company ¨

 

If an emerging growth company, indicate by checkmark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨

 

 

 

 

 

Item 7.01. Regulation FD Disclosure.

 

On May 7, 2025, Theriva Biologics, Inc. (the “Company”) issued a press release announcing positive topline outcomes from the VIRAGE Phase 2b clinical trial evaluating the Company’s lead product candidate VCN-01 (zabilugene almadenorepvec) plus standard-of-care (SoC) chemotherapy gemcitabine/nab-paclitaxel as a first line therapy for patients with metastatic pancreatic ductal adenocarcinoma (PDAC) for whom gemcitabine/nab-paclitaxel is the recommended first-line treatment option. VCN-01 is a systemically-administered, tumor selective, stroma-degrading oncolytic adenovirus that has been granted Orphan Drug Designation and Fast Track Designation by the U.S. Food and Drug Administration (FDA) for the treatment of pancreatic cancer.

 

The analysis of the VIRAGE trial (see “About VIRAGE” below) includes data for first-line treatment of 96 newly-diagnosed metastatic PDAC patients:

 

·In the primary endpoint analysis, the 48 patients treated with at least one dose of gemcitabine/nab-paclitaxel SoC had a median overall survival (OS) of 8.6 months, while the 48 patients treated with VCN-01 followed by at least one dose of gemcitabine/nab-paclitaxel SoC had a median OS of 10.8 months [Hazard Ratio (HR) = 0.57, 95% CI 0.34-0.96, p=0.0546].

 

·The improvements in OS in the VCN-01+SoC treatment arm compared to the SoC control arm were reflected in increased progression free survival (PFS) [median PFS 7.0 vs 4.6 months; HR = 0.55, 95% CI 0.34-0.88, p= 0.0105].

 

·The median duration of response (DoR) was 5.4 months (n=15) in the SoC control arm, while the median DoR in the VCN-01+SoC treatment arm was doubled to 11.2 months (n=19, HR = 0.22, 95% CI 0.08-0.62, p=0.0035).

 

The increase in OS was greater for patients who received 2 doses of VCN-01 and 4 or more cycles of gemcitabine/nab-paclitaxel SoC (n=34) compared with patients who received 4 or more cycles of gemcitabine/nab-paclitaxel SoC (n=29) [median OS 14.8 and 11.6 months respectively; HR=0.44, 95% CI: 0.21-0.92, p=0.046], suggesting that the second dose of VCN-01 (administered 3 months after the first dose) provides a meaningful additional benefit in this treatment subgroup.

 

The adverse event (“AE”) VCN-01 profile was consistent with that observed in prior clinical trials. The most common VCN-01 related AEs (pyrexia, flu-like illness, vomiting, nausea, and elevated transaminases) were transient and reversible. These AEs were observed to be less frequent and of reduced CTCAE grade after the second VCN-01 dose (administered on day ~92) compared to the first VCN-01 dose (administered on day 1). A review by an Independent Data Monitoring Committee noted that the overall type and number of AEs in the VCN-01 treatment group was as expected for the pancreatic cancer population, the duration of treatment, and the administration of an oncolytic virus.

 

In addition, the Company will host an event on May 7, 2025 to review and discuss the data from the VIRAGE trial . In connection with the event, the Company intends to discuss the presentation which is furnished as Exhibit 99.2 to this Current Report on Form 8-K.

 

The information in this Item 7.01 and in the press release furnished as Exhibit 99.1 and the presentation furnished as Exhibit 99.2 to this Current Report on Form 8-K shall not be deemed to be “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, or otherwise subject to the liabilities of that section or Sections 11 and 12(a)(2) of the Securities Act of 1933, as amended and shall not be incorporated by reference into any filing with the U.S. Securities and Exchange Commission made by the Company, whether made before or after the date hereof, regardless of any general incorporation language in such filing. The press release furnished as Exhibit 99.1 and the presentation furnished as Exhibit 99.2 to this Current Report on Form 8-K includes “safe harbor” language pursuant to the Private Securities Litigation Reform Act of 1995, as amended, indicating that certain statements contained therein are “forward-looking” rather than historical.

 

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Item 8.01. Other Events. 

 

On May 7, 2025, the Company issued a press release announcing positive topline outcomes from the VIRAGE Phase 2b clinical trial evaluating the Company’s lead product candidate VCN-01 (zabilugene almadenorepvec) plus standard-of-care (SoC) chemotherapy gemcitabine/nab-paclitaxel as a first line therapy for patients with metastatic pancreatic ductal adenocarcinoma (PDAC) for whom gemcitabine/nab-paclitaxel is the recommended first-line treatment option. VCN-01 is a systemically-administered, tumor selective, stroma-degrading oncolytic adenovirus that has been granted Orphan Drug Designation and Fast Track Designation by the U.S. Food and Drug Administration (FDA) for the treatment of pancreatic cancer.

 

The analysis of the VIRAGE trial (see “About VIRAGE” below) includes data for first-line treatment of 96 newly-diagnosed metastatic PDAC patients:

 

·In the primary endpoint analysis, the 48 patients treated with at least one dose of gemcitabine/nab-paclitaxel SoC had a median overall survival (OS) of 8.6 months, while the 48 patients treated with VCN-01 followed by at least one dose of gemcitabine/nab-paclitaxel SoC had a median OS of 10.8 months [Hazard Ratio (HR) = 0.57, 95% CI 0.34-0.96, p=0.0546].

 

·The improvements in OS in the VCN-01+SoC treatment arm compared to the SoC control arm were reflected in increased progression free survival (PFS) [median PFS 7.0 vs 4.6 months; HR = 0.55, 95% CI 0.34-0.88, p= 0.0105].

 

·The median duration of response (DoR) was 5.4 months (n=15) in the SoC control arm, while the median DoR in the VCN-01+SoC treatment arm was doubled to 11.2 months (n=19, HR = 0.22, 95% CI 0.08-0.62, p=0.0035).

 

The increase in OS was greater for patients who received 2 doses of VCN-01 and 4 or more cycles of gemcitabine/nab-paclitaxel SoC (n=34) compared with patients who received 4 or more cycles of gemcitabine/nab-paclitaxel SoC (n=29) [median OS 14.8 and 11.6 months respectively; HR=0.44, 95% CI: 0.21-0.92, p=0.046], suggesting that the second dose of VCN-01 (administered 3 months after the first dose) provides a meaningful additional benefit in this treatment subgroup.

 

The adverse event (“AE”) VCN-01 profile was consistent with that observed in prior clinical trials. The most common VCN-01 related AEs (pyrexia, flu-like illness, vomiting, nausea, and elevated transaminases) were transient and reversible. These AEs were observed to be less frequent and of reduced CTCAE grade after the second VCN-01 dose (administered on day ~92) compared to the first VCN-01 dose (administered on day 1). A review by an Independent Data Monitoring Committee noted that the overall type and number of AEs in the VCN-01 treatment group was as expected for the pancreatic cancer population, the duration of treatment, and the administration of an oncolytic virus.

 

-2

 

 

Item 9.01. Financial Statements and Exhibits.

 

 

(d)   Exhibits.

 

Exhibit
Number
  Description
99.1   Press Release issued by Theriva Biologics, Inc., dated May 7, 2025
99.2   Presentation of VIRAGE trial data
104   Cover Page Interactive Data File (embedded within the XBRL document)

 

-3

 

 

SIGNATURES

 

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

 

Dated: May 7, 2025 THERIVA BIOLOGICS, INC.
       
  By: /s/ Steven A. Shallcross
    Name: Steven A. Shallcross
    Title: Chief Executive Officer and Chief Financial Officer

 

-4

 

Exhibit 99.1

 

 

 

Theriva™ Biologics Announces Primary Endpoints for Efficacy and Safety Achieved in VIRAGE Phase 2b Clinical Trial of VCN-01 with Gemcitabine/nab-Paclitaxel in Newly-Diagnosed Metastatic Pancreatic Cancer Patients

 

- Patients treated with VCN-01 (zabilugene almadenorepvec) plus gemcitabine/nab-paclitaxel standard-of-care (SoC) chemotherapy had increased overall survival, progression free survival, and duration of response compared to patients treated with gemcitabine/nab-paclitaxel SoC -

 

- VCN-01 was well-tolerated, with transient and reversible adverse events (AEs), meeting primary safety endpoint -

 

- Greater differences between the treatment arms were observed in patients receiving 2 doses of VCN-01 -

 

- Data to be reviewed during a Key Opinion Leader webinar Featuring Dr. Manuel Hidalgo Medina and Dr. Mike Pishvaian on Wednesday May 7th, 2025 at 0800 US EDT -

 

Rockville, MD, May 07, 2025 – Theriva™ Biologics (NYSE American: TOVX), (“Theriva” or the “Company”), a diversified clinical-stage company developing therapeutics designed to treat cancer and related diseases in areas of high unmet need, today announced positive topline outcomes from the VIRAGE Phase 2b clinical trial evaluating the Company’s lead product candidate VCN-01 (zabilugene almadenorepvec) plus standard-of-care (SoC) chemotherapy gemcitabine/nab-paclitaxel as a first line therapy for patients with metastatic pancreatic ductal adenocarcinoma (PDAC) for whom gemcitabine/nab-paclitaxel is the recommended first-line treatment option. VCN-01 is a systemically-administered, tumor selective, stroma-degrading oncolytic adenovirus that has been granted Orphan Drug Designation and Fast Track Designation by the U.S. Food and Drug Administration (FDA) for the treatment of pancreatic cancer.

 

The analysis of the VIRAGE trial (see “About VIRAGE” below) includes data for first-line treatment of 96 newly-diagnosed metastatic PDAC patients:

 

·In the primary endpoint analysis, the 48 patients treated with at least one dose of gemcitabine/nab-paclitaxel SoC had a median overall survival (OS) of 8.6 months, while the 48 patients treated with VCN-01 followed by at least one dose of gemcitabine/nab-paclitaxel SoC had a median OS of 10.8 months [Hazard Ratio (HR) = 0.57, 95% CI 0.34-0.96, p=0.0546].

 

·The improvements in OS in the VCN-01+SoC treatment arm compared to the SoC control arm were reflected in increased progression free survival (PFS) [median PFS 7.0 vs 4.6 months; HR = 0.55, 95% CI 0.34-0.88, p= 0.0105].

 

·The median duration of response (DoR) was 5.4 months (n=15) in the SoC control arm, while the median DoR in the VCN-01+SoC treatment arm was doubled to 11.2 months (n=19, HR = 0.22, 95% CI 0.08-0.62, p=0.0035).

 

The increase in OS was greater for patients who received 2 doses of VCN-01 and 4 or more cycles of gemcitabine/nab-paclitaxel SoC (n=34) compared with patients who received 4 or more cycles of gemcitabine/nab-paclitaxel SoC (n=29) [median OS 14.8 and 11.6 months respectively; HR=0.44, 95% CI: 0.21-0.92, p=0.046], suggesting that the second dose of VCN-01 (administered 3 months after the first dose) provides a meaningful additional benefit in this treatment subgroup.

 

“The exciting topline data from the VIRAGE Phase 2b trial demonstrate the potential opportunity for VCN-01 to benefit metastatic PDAC patients treated with gemcitabine/nab-paclitaxel SoC chemotherapy.” said Steven A. Shallcross, Chief Executive Officer of Theriva Biologics. “The significantly reduced hazard ratios for survival parameters in the VCN-01 treatment group provide compelling evidence that VCN-01 in combination with gemcitabine/nab-paclitaxel may extend the lives of metastatic PDAC patients. These data, combined with recent advice from the U.S. FDA and the European Medical Agency, are expected to facilitate engagement with industry partners and enable the design of a Phase 3 confirmatory trial that, if successful, may deliver an important new therapeutic option for patients suffering this rapidly fatal disease.”

 

 

 

 

 

 

As previously reported, the VCN-01 adverse event (AE) profile was consistent with that observed in prior clinical trials. The most common VCN-01 related AEs (pyrexia, flu-like illness, vomiting, nausea, and elevated transaminases) were transient and reversible. These AEs were observed to be less frequent and of reduced CTCAE grade after the second VCN-01 dose (administered on day ~92) compared to the first VCN-01 dose (administered on day 1). A review by an Independent Data Monitoring Committee noted that the overall type and number of AEs in the VCN-01 treatment group was as expected for the pancreatic cancer population, the duration of treatment, and the administration of an oncolytic virus.

 

Theriva will host a live virtual event to review and discuss the data from the VIRAGE trial of VCN-01 on Wednesday, May 7th 2025, 8:00 AM EDT. The virtual event will feature eminent pancreatic cancer clinician/researchers Dr. Manuel Hidalgo Medina MD PhD (Chief, Division of Hematology and Medical Oncology, Weill Cornell Medical College and Attending Physician, New York-Presbyterian Hospital) and Dr. Mike Pishvaian MD PhD (Director of Gastrointestinal, Developmental Therapeutics and Clinical Research Programs for the Johns Hopkins Kimmel Cancer Center and Associate Professor at the School of Medicine). To register for the event, click HERE.

 

About Pancreatic Ductal Adenocarcinoma

 

Cancer of the pancreas consists of two main histological types: cancer that arises from the ductal (exocrine) cells of the pancreas or, much less often, cancers may arise from the endocrine compartment of the pancreas. Pancreatic ductal adenocarcinoma (“PDAC”) accounts for more than 90% of all pancreatic tumors. It can be located either in the head of the pancreas or in the body/tail. Pancreatic cancer usually metastasizes to the liver and peritoneum. Other less common metastatic sites are the lungs, brain, kidney and bone. In its early stages, pancreatic cancer does not typically result in any characteristic symptoms, so in most cases it is diagnosed in its late stages (locally advanced non-metastatic or metastatic disease) when surgical resection and possibly curative treatment is not possible. It is generally assumed that only 10% of cases are resectable at presentation, whereas 30-40% of patients are diagnosed at local advanced/unresectable stage and 50-60% present with distant metastases.

 

About VIRAGE

 

VIRAGE is a two-arm, Phase 2b open-label, randomized, controlled, multicenter clinical trial in patients with histologically confirmed, newly-diagnosed metastatic PDAC. Patients were enrolled at 5 sites in the U.S. and 9 sites in Spain. In both the control and VCN-01 (zabilugene almadenorepvec) treatment arms, patients received gemcitabine/nab-paclitaxel standard-of-care chemotherapy in repeated 28-day cycles until disease progression. In the VCN-01 treatment arm only, patients were also administered intravenous VCN-01 seven-days prior to starting the first and fourth cycles of gemcitabine/nab-paclitaxel treatment (study days 1 and ~92 respectively). Primary endpoints for the trial include overall survival and VCN-01 safety/tolerability. Additional endpoints include progression free survival, duration of response, and measures of VCN-01 biodistribution, replication, and immune response. The study was designed with 80% power to detect a HR of 0.65 for overall survival with a 1-sided alpha of 0.05 (2-sided alpha 0.1). Reported p-values are for 2-sided statistical analysis using the log rank test. More information about the trial is available on Clinicaltrials.gov (NCT05673811), through the Spanish Clinical Trials Registry and European Union Drug Regulating Authorities Clinical Trials Database (EudraCT Number: 2022-000897-24).

 

About VCN-01

 

VCN-01 (zabilugene almadenorepvec) is a systemically administered oncolytic adenovirus designed to selectively and aggressively replicate within tumor cells and degrade the tumor stroma that serves as a significant physical and immunosuppressive barrier to cancer treatment. This unique mode-of-action enables VCN-01 to exert multiple antitumor effects by (i) selectively infecting and lysing tumor cells; (ii) enhancing the access and perfusion of co-administered chemotherapy products; and (iii) increasing tumor immunogenicity and exposing the tumor to the patient’s immune system and co-administered immunotherapy products. Systemic administration enables VCN-01 to exert its actions on both the primary tumor and metastases. VCN-01 has been administered to over 140 patients to date in clinical trials of different cancers, including PDAC (in combination with chemotherapy), head and neck squamous cell carcinoma (with an immune checkpoint inhibitor), ovarian cancer (with CAR-T cell therapy), colorectal cancer, and retinoblastoma (by intravitreal injection). More information on these clinical trials is available at Clinicaltrials.gov.

 

 

 

 

 

 

About Theriva™ Biologics, Inc.

 

Theriva™ Biologics (NYSE American: TOVX), is a diversified clinical-stage company developing therapeutics designed to treat cancer and related diseases in areas of high unmet need. The Company’s subsidiary Theriva Biologics, S.L., has been developing a new oncolytic adenovirus platform designed for intravenous (IV), intravitreal and antitumoral delivery to trigger tumor cell death, improve access of co-administered cancer therapies to the tumor, and promote a robust and sustained anti-tumor response by the patient’s immune system. The Company’s lead clinical-stage product candidate is VCN-01 (zabilugene almadenorepvec), an oncolytic adenovirus designed to replicate selectively and aggressively within tumor cells, and to degrade the tumor stroma barrier that serves as a significant physical and immunosuppressive barrier to cancer treatment. Additional clinical stage assets include (1) SYN-004 (ribaxamase) which is designed to degrade certain commonly used IV beta-lactam antibiotics within the gastrointestinal (GI) tract to prevent microbiome damage, thereby limiting overgrowth of pathogenic organisms such as VRE (vancomycin resistant Enterococci) and reducing the incidence and severity of acute graft-versus-host-disease (aGVHD) in allogeneic hematopoietic cell transplant (HCT) recipients); and (2) SYN-020, a recombinant oral formulation of the enzyme intestinal alkaline phosphatase (IAP) produced under cGMP conditions and intended to treat both local GI and systemic diseases. For more information, please visit Theriva Biologics’ website at www.therivabio.com.

 

Forward-Looking Statement

 

This release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. In some cases forward-looking statements can be identified by terminology such as “may,” “should,” “potential,” “continue,” “expects,” “anticipates,” “intends,” “plans,” “believes,” “estimates,” and similar expressions, and include statements regarding the exciting topline data from the VIRAGE Phase 2b trial demonstrating the potential opportunity for VCN-01 to benefit metastatic PDAC patients treated with gemcitabine/nab-paclitaxel SoC chemotherapy; the significantly reduced hazard ratios for survival parameters in the VCN-01 treatment group providing compelling evidence that VCN-01 in combination with gemcitabine/nab-paclitaxel may extend the lives of metastatic PDAC patients; and the data, combined with recent advice from the U.S. FDA and the European Medical Agency, being expected to facilitate engagement with industry partners and enable the design of a Phase 3 confirmatory trial that, if successful, may deliver an important new therapeutic option for patients suffering this rapidly fatal disease. These forward-looking statements are based on management’s expectations and assumptions as of the date of this press release and are subject to a number of risks and uncertainties, many of which are difficult to predict that could cause actual results to differ materially from current expectations and assumptions from those set forth or implied by any forward-looking statements. Important factors that could cause actual results to differ materially from current expectations include, among others, the ability of VCN-01 to benefit metastatic PDAC patients treated with gemcitabine/nab-paclitaxel; the ability of VCN-01 in combination with gemcitabine/nab-paclitaxel to extend the lives of metastatic PDAC patients; the data facilitating engagement with industry partners; the ability to confirm the potential therapeutic benefits of VCN-01 in a Phase 3 clinical trial and delivering an important new therapeutic option for metastatic PDAC patients; the Company’s ability to reach clinical milestones when anticipated including enrolling the expected number of patients in each trial; the Company’s product candidates, including VCN-01, demonstrating safety and effectiveness, as well as results that are consistent with prior results; the ability to complete clinical trials on time and achieve the desired results and benefits, continuing clinical trial enrollment as expected; the ability to obtain regulatory approval for commercialization of product candidates or to comply with ongoing regulatory requirements, regulatory limitations relating to the Company’s ability to promote or commercialize their product candidates for the specific indications, acceptance of product candidates in the marketplace and the successful development, marketing or sale of the Company’s products, developments by competitors that render such products obsolete or non-competitive, the Company’s ability to maintain license agreements, the continued maintenance and growth of the Company’s and VCN’s patent estate, the ability to continue to remain well financed, and other factors described in the Company’s Annual Report on Form 10-K for the year ended December 31, 2024 and its other filings with the SEC, including subsequent periodic reports on Forms 10-Q and current reports on Form 8-K. The information in this release is provided only as of the date of this release, and Theriva Biologics undertakes no obligation to update any forward-looking statements contained in this release on account of new information, future events, or otherwise, except as required by law.

 

For further information, please contact:

 

Investor Relations:
Kevin Gardner
LifeSci Advisors, LLC
kgardner@lifesciadvisors.com
617-283-2856

 

Source: Theriva Biologics, Inc.

 

 

 

 

Exhibit 99.2

 

VIRAGE Phase 2b Clinical Trial of VCN - 01 in Pancreatic Cancer 07 May 2025

 

 

2 FORWARD LOOKING STATEMENTS This presentation contains forward - looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 . In some cases forward - looking statements can be identified by terminology such as “may,” “should,” “potential,” “continue,” “expects,” “anticipates ,” “intends,” “plans,” “believes,” “estimates,” and similar expressions, and include statements regarding oncolytic viruses (OVs) being promising cancer therapeutics; the multiple potential value opportunities for VCN - 01; the regulatory status expected to facilitate VCN - 01 development; potential access to a priority review voucher; the therapeutic potential of VCN - 01 and other Theriva OVs; the ability of VCN - 01 and other Theriva OVs to overcome key OV challenges ; the potential of VCN - 01 to enable immuno - oncology therapies in refractory tumors; the clinical advancement of VCN - 01 and other Theriva OVs in div erse cancer indications (including pancreatic ductal adenocarcinoma, head and neck cancer, ovarian cancer, colorectal cancer, and retinob las toma) and the projected milestones . Important factors that could cause actual results to differ materially from current expectations include, among others, the Co mpany’s ability to enroll patients as planned and reach clinical trial milestones when anticipated ; the Company’s ability to complete clinical trials on time and achieve the desired results and benefits ; the Company’s product candidates demonstrating safety and effectiveness, including positive clinical data that demonstrates VCN - 01 may lead to improved clinical outcomes for patients; the Company’s ability to obtain regulatory approval for commercializ ation of product candidates or to comply with ongoing regulatory requirements; regulatory limitations relating to the Company’s ability to pro mot e or commercialize their product candidates for the specific indications; acceptance of product candidates in the marketplace and the successful devel opm ent, marketing or sale of the Company’s products; developments by competitors that render such products obsolete or non - competitive; the Company’s ability to maintain license agreements; the continued maintenance and growth of the Company’s patent estate; the ability to continue to remain well finan ced ; and other factors described in the Company’s Annual Report on Form 10 - K for the year ended December 31, 2024 and its other filings with the SEC, i ncluding subsequent periodic reports on Forms 10 - Q and current reports on Form 8 - K. The information in this release is provided only as of the date of this release, and Theriva Biologics undertakes no obligation to update any forward - looking statements contained in this release on account of new information, future events, or otherwise, except as required by law.

 

 

3 VIRAGE PHASE 2 DATA UPDATE – AGENDA AND SPEAKERS Introduction to Theriva and VCN - 01 Steven Shallcross - CEO, CFO, Theriva Biologics, Inc. Pancreatic cancer treatment landscape Manuel Hidalgo Medina, MD, PhD – Chief of Hematology and Medical Oncology, Weill Cornell Medicine/New York - Presbyterian Hospital Mike Pishvaian , MD, PhD - Associate Professor of Oncology and Director of Gastrointestinal, Developmental Therapeutics and Clinical Research Programs, Johns Hopkins Kimmel Cancer Center VIRAGE Phase 2b clinical data review Manel Cascallo, PhD – General Director, Theriva Biologics S.L. Questions and answers All speakers Steven Shallcross Manel Cascallo Mike Pishvaian Manuel Hidalgo

 

 

4 Theriva Biologics develops unique oncolytic virus therapeutics targeting solid tumors VCN - 01 (zabilugene almadenorepvec)

 

 

5 OVERVIEW Financial Snapshot NYSE American Exchange TOVX Ticker $11.6M Cash (12/31/2024) Q3 2025 Projected cash runway 55.8k¹ Average Daily Volume (3M) Rockville, MD / Barcelona, Spain Locations CRC colorectal cancer. HNSCC head and neck squamous cell carcinoma. Rb retinoblastoma. SoC standard of care. ICI Immune checkpoint inhibitors. ¹At 28Apr2025 Yahoo! Finance VCN - 01 Completed Phase 2b clinical trial in first - line metastatic pancreatic cancer in combination with SoC chemotherapy VCN - 01 Phase 1 clinical trials support multiple additional indications (CRC, HNSCC, Rb) and combinations (ICI & CAR - T cells) VCN - X innovative oncolytic virus discovery engine enabling development of a distinct product pipeline

 

 

6 THERIVA PIPELINE *Based on Management’s current beliefs and expectations. aGVHD acute graft - vs - host disease; allo - HCT allogeneic hematopoietic ce ll transplant. CSR clinical study report. HNSCC head and neck squamous cell carcinoma. IV intravenous. IVit intravitreal. ¹Final Phase 1b/2a study cohort contingen t on grant funding or partnership. ² Seeking partnership or out - licensing for further development. Status* Sites Phase 3 Phase 2 Phase 1 Pre - IND Target Candidate Phase 2b enrollment complete Orphan Drug Designation US, EU Fast Track Designation US Multicenter Spain, USA Pancreatic Cancer (IV) with gemcitabine/nab - paclitaxel VCN - 01 Selective, Stroma Degrading OV Phase 1 Complete, CSR in preparation Orphan Drug Designation US, EU Rare Pediatric Disease Designation US Retinoblastoma (IVit) Phase 1 Complete, CSR in preparation HNSCC (IV) + durvalumab Phase 1 Study On - going Brain tumors (IV) Preclinical Studies On - going Solid tumors (IV) VCN - X and Albumin Shield OVs Phase 1b/2a On - going Prevention of aGVHD in allo - HCT SYN - 004 [1] Oral β - lactamase Phase 1 Studies Complete Potential indications include NAFLD/NASH, celiac, radiation enteritis SYN - 020 [2] Oral IAP

 

 

7 VCN - 01 IS A UNIQUELY ENGINEERED HUMAN ADENOVIRUS 5 High dose, highly replicating virus designed to destroys cancer cells Replication enhanced by significantly increased E2F binding. E1a - δ24 gene deletion means replication only in cells with a defective Rb - E2F pathway. Fiber shaft RGDK modification. PH20 soluble human testicular hyaluronidase enzyme expression is under control of the virus major la te promoter (MLP). Systemic Selective Stroma Degrading E2F binding +++  E1a - Δ24  MLP  PH20 -- RGDK VCN - 01 targets both primary and metastatic lesions Replicating virus expresses PH20 hyaluronidase Exposes solid tumors to the immune system and co - administered therapies Virus replicates only in tumor cells Liver detargeted

 

 

8 VCN - 01 IS A UNIQUELY ENGINEERED HUMAN ADENOVIRUS 5 Cancer Associated Fibroblast Stroma Tumor Surrounded by STROMA VCN - 01 1 SYSTEMIC delivers VCN - 01 to the primary tumor and metastases and detargets the liver SELECTIVE replication at very high levels lyses tumor cells directly without harming healthy tissues 2

 

 

9 VCN - 01 DESIGNED TO HAVE MULTIPLE ANTI - TUMOR ACTIONS PH20 PH20 PH20 PH20 PH20 PH20 PH20 PH20 Neoantigen Cancer Associated Fibroblast Stroma STROMA degradation by PH20 facilitates solid tumor access and destruction by coadministered cancer therapies 3 4 IMMUNOGENIC actions of VCN - 01 turn “cold” tumors “hot” and elicit an anti - tumor immune response VCN - 01 nab - paclitaxel gemcitabine T - Cells Tumor Stroma Degraded

 

 

10 VCN - 01 EXTENSIVE CLINICAL PROGRAM 142 patients treated with VCN - 01 to date in multiple indications and combinations HEAD & NECK – IV + Durvalumab (20) PANCREATIC - IV + Gemcitabine / Abraxane ® Phase 1 (26) and Phase 2b (53)* COLORECTAL – IV Alone (15) PANCREATIC - IT + Gemcitabine / Abraxane ® (8) PANCREATIC, OVARIAN - IV + huCART - meso cells (9)* BRAIN TUMORS – IV (1)* HEAD & NECK – IV alone (1) *On - going study. Abraxane® - nab - paclitaxel. Durvalumab (IMFINZI ® , AstraZeneca) is an anti - PD - L1 mAb immune checkpoint inhibitor. huCART - meso are autologous T cells engineered to express an extracellular single chain variable fragment (scFv) with mesothelin specificity. IT - intratumoral. IV - intravenous. IVit - intravitreal. Rb - retinoblastoma. See Appendix for study registry numbers and publications. Rb – IVit alone (9) (Number of VCN - 01 Patients Treated in Parentheses) Lead Indication for Phase 3

 

 

PANCREATIC CANCER TREATMENT LANDSCAP E

 

 

12 (m)FOLFIRINOX, NALIRIFOX (ECOG 0 - 1) Gemcitabine + nab - Paclitaxel (ECOG 0 - 2) S ingle agent gemcitabine, capecitabine, 5 - FU (ECOG 3 - 4) PANCREATIC CANCER CURRENT TREATMENTS ¹Bengtsson (2020) Sci Rep 10: 16425. ²Used in <20% of PDAC cases. ³Identical to first - line chemotherapy. CPI checkpoint inhibitor for cancers with microsatellite instability or deficient mismatch repair. ECOG Eastern Cooperative Oncology Group Performance Status. (m)FOLFI RIN OX (modified) leucovorin+5 - FU+irinotecan+oxaliplatin. nab - Paclitaxel nanoparticle albumin - bound paclitaxel. NALIRIFOX leucovorin+ 5 - FU+liposom al irinotecan+oxaliplatin . Adapted from Tempero (2021) J Natl Compr Canc Netw 19: 439. Resectable Borderline Resectable Metastatic / Recurrent (unresectable) Locally Advanced (unresectable) FOLFIRINOX Gemcitabine + nab - Paclitaxel 5 - FU + leucovorin + liposomal i rinotecan Radiotherapy if increases resection margins² Neoadjuvant³ Gemcitabine ± erlotinib , single agent capecitabine or 5 - FU; ± CPI Stage I (5%) Stage II (28%) Stage III (11%) Stage IV (56%) Progression or Recurrence after 1 st Line First - Line Treatments Additional treatment s are available for small subsets of patients with gene mutations such as gBRCAm , NRG1 fusion Status Staging¹

 

 

VCN - 01 IN METASTATIC PANCREATIC CANCER

 

 

14 VCN - 01 LEAD INDICATION PANCREATIC CANCER Highly fatal cancer protected by dense tumor stroma • Orphan disease, highest mortality of all solid tum ors • Median survival 8 - 11 months for metastatic disease 1,2 • USA est. 6 6,440 new cases and 51,750 deaths in 2024 3 • Hyaluronic acid in stroma is associated with reduced treatment efficacy and poor prognosis 4 • VCN - 01 designed to degrade hyaluronic acid • Incidence is growing worldwide • Est. treatment market ~$2.9B (2024) ~$6.0B (2030) 5 ¹ Michael (2019) BMC Palliat Care 18:13, Bengtsson (2020) Sci Rep 10:16425, Carioli (2021) Ann Oncol 32:478, ASCO Pancreatic Cancer Statistics . ² SEER Cancer Stat Facts: Pancreatic Cancer website . ³ American Cancer Society. Cancer Facts & Figures 2024. Atlanta: American Cancer Society; 2024. ⁴ Tahkola (2021) Sci Rep 11:12216, Placencio - Hickok (2022) Pancreatology 22:92. ⁵Grand View Research website . Pancreatic adenocarcinoma resected from the pancreas body and tail

 

 

15 PREFERRED VCN - 01 DOSING REGIMEN ESTABLISHED IN PHASE 1 Dose escalation in patients with metastatic pancreatic cancer ¹Single dose of VCN - 01 administered by 10 min IV infusion. ²nab - Paclitaxel (Abraxane®; 30 min infusion) administered at least 4 hours after VCN - 01. ³Gemcitabine (30 min infusion) administered immediately after Abraxane® infusion. Garcia - Carbonero (2022) J Immunother Cancer 10:e003255. [NCT02045602] SoC standard of care. SEQUENTIAL | 36 | 29 | 22 | 15 | 8 | 1 Cycle 1 Day VCN - 01 (1x10 13 vp) ¹ nab - Paclitaxel ² Gemcitabine ³ Repeat SoC chemotherapy 28 - day cycles starting Day 36 Encouraging clinical profile Primary AEs fever, flu - like illness, reversible increase in liver enzymes Survival and response rates better than published results for gemcitabine/nab - paclitaxel SoC Clinical evidence of proposed MOA VCN - 01 viral genomes and increased immune markers detected in tumor biopsies VCN - 01 tumor penetration and replication indicated by persistent systemic PH20

 

 

16 V IR AGE PANCREATIC CANCER PHASE 2B CLINICAL TRIAL Multicenter, open - label, randomized, controlled trial (NCT05673811) • Patients with newly - diagnosed metastatic pancreatic ductal adenocarcinoma ( first line ) • Direct comparison of up to two doses of VCN - 01 with gemcitabine/nab - paclitaxel standard of care (SoC) chemotherapy to SoC chemotherapy alone (randomized 1:1) • Primary endpoints overall survival , VCN - 01 AE profile and tolerability • Secondary endpoints include progression free survival , duration of response Study designed with 80% power to detect a hazard ratio (HR) of 0.65 for OS with a 1 - sided alpha of 0.05 (2 - sided alpha 0.1). P - values are for 2 - sided statistical analysis using the log rank test .

 

 

17 V IR AGE ENROLLMENT Total USA Spain Parameter 17 7 10 Sites Open 171 40 131 Screened 59 (35%) 17 (43%) 42 (32%) Screen Failure 112 23 89 Randomized 55 11 44 SoC 57 12 45 VCN - 01 + SoC Treated* 48 7 41 SoC 48 9 39 VCN - 01 + SoC Standard of care (SoC) is gemcitabine / nab - paclitaxel chemotherapy in repeated 28 - day cycles *Patients received at least one dose of SoC in each arm and comprise the Full Analysis Set Five (5) additional patients received one dose of VCN - 01 but no doses of SoC and are included in the Safety P opulation

 

 

18 V IR AGE BASELINE DEMOGRAPHICS Patients who received at least one dose of SoC in each Arm (FAS) Full analysis set (FAS) for ARM I includes patients who received at least one dose of gemcitabine/nab paclitaxel SoC chemotherapy; FAS for ARM II includes patients who received VCN - 01 followed 1 week later by at least one dose of gemcitabine/nab paclitaxel SoC chemotherapy. 70.8% of patients in the VCN - 01+SoC arm received 2 doses of VCN - 01. Combined (n=96) VCN - 01 + SoC (n=48) SoC (n=48) Statistics 96 48 48 n Age (years) 67.8 (8.75) 66.0 (8.97) 69.5 (8.25) Mean (SD) 67.5 66.0 68.5 Median Gender 45 (46.9) 23 (47.9) 22 (45.8) n (%) Male 51 (53.1) 25 (52.1) 26 (54.2) n (%) Female ECOG at randomization 36 (37.5) 19 (39.6) 17 (35.4) n (%) 0 60 (62.5) 29 (60.4) 31 (64.6) n (%) 1 Body Mass Index (kg/m 2 ) 24.76 (3.992) 23.84 (3.502) 25.69 (4.265) Mean (SD) 24.05 23.70 25.65 Median

 

 

19 Grade 3 - 4 All Grades Preferred Term – No. Patients (%) a,b Second Dose (n=36) First Dose (n=53) Second Dose (n=36) First Dose (n=53) - 1 (1.9%) 19 (52.7%) 31 (58.5%) Pyrexia - - 6 (16.6%) 16 (30.2%) Nausea 1 (2.8%) 1 (1.9%) 4 (11.1%) 15 (28.3%) Asthenia - - 9 (25.0%) 14 (26.4%) Vomiting - 5 (9.4%) 1 (2.7%) 10 (18.9%) Aspartate aminotransferase increased - 4 (7.5%) 1 (2.7%) 9 (16.9%) Alanine aminotransferase increased - 7 (13.2%) 1 (2.7%) 9 (16.9%) Influenza like illness - 4 (7.5%) 2 (5.5%) 8 (15.1%) Transaminases increased - 1 (1.9%) 1 (2.7%) 7 (13.2%) Platelet count decreased/Thrombocytopenia - - 1 (2.7%) 7 (13.2%) Decreased appetite - - 3 (5.5%) 7 (13.2%) Diarrhea - - - 5 (9.4%) Fatigue - - 7 (19.4%) 5 (9.4%) Chills - 3 (5.7%) 1 (2.7%) 4 (7.5%) Lymphocyte count decreased - 3 (5.7%) - 4 (5.7%) Gamma - glutamyl transferase increased - 1 (1.9%) - 3 (5.7%) Anemia - - 2 (5.5%) 3 (5.7%) Cytokine release syndrome a Number of patients and b percentage of patients dosed presenting the treatment related adverse event ( TEAE ) . Note: events with a temporal continuity are accounte d as only one with the highest grade V IR AGE TREATMENT EMERGENT ADVERSE EVENTS VCN - 01 related events occurring in ≥5% of patients Additional Grade 3/4 AEs occurring <5% Treatment - induced liver injury 2 (3.8%) Neutrophil count decreased 1 (1.9%) Lipase increased 1 (1.9%) Alkaline phosphatase increased 1 (1.9%) Neutropenia 1 (1.9%) Hypotension 1 (1.9%)

 

 

20 • VIRAGE clinical data was reviewed on two occasions by an independent Data Monitoring Committee (DMC) who noted the following: • Intravenous VCN - 01 was well tolerated in patients treated in this study • The most common VCN - 01 related AEs (pyrexia, flu - like illness, vomiting, nausea, and elevated transaminases) were transient and reversible. • AEs were observed to be less frequent and of reduced CTCAE grade after the second VCN - 01 dose compared to the first VCN - 01 dose • The overall type and number of AEs in the VCN - 01+SoC treatment group was as expected for the pancreatic cancer population, the duration of treatment, and the administration of an oncolytic virus V IR AGE SAFETY REVIEW BY INDEPENDENT DMC

 

 

21 INCREASED PROGRESSION - FREE SURVIVAL IN VCN - 01+SOC ARM Adj HR (95% CI) Median (95% CI) Events / Total Treatment Arm Ref. 4.6 (3.5 - 6.5) 41 / 48 SoC 0.55 (0.34 - 0.88) 7.0 (4.8 - 11.2) 33 / 48 VCN - 01 + SoC Logrank P - value: 0.0105 + Censor Based on CT scan evaluation by sites. Data are for the Full Analysis Set (FAS) which comprises patients who received at least 1 dose of gemcitabine/nab - paclitaxel (SoC) chemotherapy in each arm. 70.8% of patients in the VCN - 01+SoC arm received 2 doses of VCN - 01. SoC VCN - 01 + SoC

 

 

22 INCREASED OVERALL SURVIVAL IN VCN - 01+SOC ARM Data are for the Full Analysis Set (FAS) which comprises patients who received at least 1 dose of gemcitabine/nab - paclitaxel (SoC) chemotherapy in each arm. 70.8% of patients in the VCN - 01+SoC arm received 2 doses of VCN - 01. SoC VCN - 01 + SoC Adj HR (95% CI) Median (95% CI) Events / Total Treatment Arm Ref. 8.6 (6.9 - 11.6) 35 / 48 SoC 0.57 (0.34 - 0.96) 10.8 (7.4 - 15.8) 27 / 48 VCN - 01 + SoC Logrank P - value: 0.0546 + Censor

 

 

23 DURATION OF RESPONSE DOUBLED IN VCN - 01+SOC ARM Based on CT scan evaluation by sites. Data are for the Full Analysis Set (FAS) which comprises patients who received at least 1 dose of gemcitabine/nab - paclitaxel (SoC) chemotherapy in each arm. SoC VCN - 01 + SoC Adj HR (95% CI) Median (95% CI) Events / Total Treatment Arm Ref. 5.4 (2.0 - 6.8) 11 / 15 SoC 0.22 (0.08 - 0.62) 11.2 (7.4 - NE) 7 / 19 VCN - 01 + SoC Logrank P - value: 0.0035 + Censor

 

 

24 V IR AGE ANALYSIS OF PTS RECEVING TWO VCN - 01 DOSES Evaluate the impact of the second VCN - 01 dose • Measure OS and PFS in patients who initiate the 4 th treatment cycle • ARM I: Cycle 4 of gemcitabine/nab - paclitaxel SoC • ARM II: Second dose of VCN - 01 followed by Cycle 4 of gemcitabine/nab - paclitaxel SoC OS overall survival. PFS progression free survival VCN - 01 2 Doses Analysis

 

 

25 V IR AGE DEMOGRAPHICS PTS RECEIVING TWO VCN - 01 DOSES Comparison of patients who started the 4 th treatment cycle Analysis compares patients in ARM II who received a second dose of VCN - 01 followed 1 - week later by the 4 th treatment cycle of gemcitabine/nab - paclitaxel SoC to patients in ARM I who started the 4 th treatment cycle of gemcitabine/nab - paclitaxel SoC. Combined VCN - 01 + SoC SoC Statistics 63 (65.6) 34 (70.8) 29 (60.4) n (%) No. Patients (% of cohort) 66.9 (9.09) 65.8 (9.71) 68.1 (8.31) Mean (SD) Age (years) 66.0 66.0 66.0 Median Gender 30 (47.6) 17 (50.0) 13 (44.8) n (%) Male 33 (52.4) 17 (50.0) 16 (55.2) n (%) Female ECOG at randomization 29 (46.0) 15 (44.1) 14 (48.3) n (%) 0 34 (54.0) 19 (55.9) 15 (51.7) n (%) 1 Body Mass Index (kg/m 2 ) 24.31 (3.547) 23.78 (3.707) 24.94 (3.304) Mean (SD) 23.70 23.65 25.60 Median

 

 

26 IMPROVED PFS IN PTS RECEIVING TWO VCN - 01 DOSES PFS progression free survival. Based on CT scan evaluation by sites. Analysis compares patients in ARM II who received a second dose of VCN - 01 followed 1 - week later by the 4 th treatment cycle of gemcitabine/nab - paclitaxel SoC to patients in ARM I who started the 4 th treatment cycle of gemcitabine/nab - paclitaxel SoC. SoC VCN - 01 2 doses + SoC Adj HR (95% CI) Median (95% CI) Events / Total Treatment Arm Ref. 7.4 (5.7 - 8.4) 22 / 29 SoC 0.48 (0.25 - 0.91) 11.2 (7.3 - 16.6) 19 / 34 VCN - 01 x 2 + SoC Logrank P - value: 0.0173 + Censor

 

 

27 IMPROVED OS IN PTS RECEIVING TWO VCN - 01 DOSES OS overall survival. Analysis compares patients in ARM II who received a second dose of VCN - 01 followed 1 - week later by the 4 th treatment cycle of gemcitabine/nab - paclitaxel SoC to patients in ARM I who started the 4 th treatment cycle of gemcitabine/nab - paclitaxel SoC. SoC VCN - 01 2 doses + SoC Adj HR (95% CI) Median (95% CI) Events / Total Treatment Arm Ref. 11.6 (8.6 - 12.8) 19 / 29 SoC 0.44 (0.21 - 0.92) 14.8 (10.6 - NE) 15 / 34 VCN - 01 x 2 + SoC Logrank P - value: 0.0460 + Censor

 

 

28 • Enrolled a “real world” population of older and more fragile patients • Acceptable AE profile consistent with prior VCN - 01 clinical trials • Increased OS, PFS, and DoR in VCN - 01 plus gemcitabine/nab - paclitaxel SoC treatment group compared to SoC alone • Hazard ratios for OS (0.57), PFS (0.55), and DoR (0.22) compare favorably to values reported for Phase 3 trial comparing NALIRIFOX with gemcitabine/nab - paclitaxel (0.83, 0.69, and 0.67 respectively)¹ • Second VCN - 01 dose appears to confer additional survival benefit • Regulatory advice received (FDA, EMA) on potential pivotal trial design • Orphan Drug Designation (FDA, EMA) and Fast Track Designation (FDA) V IR AGE RESULTS SUPPORT VCN - 01 PHASE 3 TRIAL IN PDAC DoR duration of response. OS overall survival. PFS progression free survival. NALIRIFOX leucovorin+ 5 - FU+liposomal irinotecan+oxaliplatin . ¹Wainberg (2023) Lancet 402:1272; median age 65 years, ECOG 1 57% in NALIRIFOX group.

 

 

29 QUESTIONS AND ANSWERS Steven Shallcross CEO, CFO, Theriva Biologics, Inc. Manuel Hidalgo Medina, MD, PhD Chief of Hematology and Medical Oncology, Weill Cornell Medicine/New York - Presbyterian Hospital Mike Pishvaian , MD, PhD Associate Professor of Oncology and Director of Gastrointestinal, Developmental Therapeutics and Clinical Research Programs, Johns Hopkins Kimmel Cancer Center Manel Cascallo, PhD General Director, Theriva Biologics S.L.

 

 

APPENDIX

 

 

31 Bayo - Puxan N et al. (2006) Role of the putative heparan sulfate glycosaminoglycan - binding site of the adenovirus type 5 fiber sh aft on liver detargeting and knob - mediated retargeting. J Gen Virol 87:2487 – 2495 Bazan - Peregrino M et al. (2021) VCN - 01 disrupts pancreatic cancer stroma and exerts antitumor effects. J ImmunoTher Cancer 9:e00 3254. Garcia - Carbonero R et al. (2019) Poster 5185: Systemic administration of the hyaluronidase - expressing oncolytic adenovirus VCN - 01 in patients with advanced or metastatic pancreatic cancer: first - in - human clinical trial. European Society for Molecular Oncology conference ESMO, 29 Septemb er 2019. Garcia - Carbonero R et al. (2022) A phase I, multicenter, open - label study of intravenous VCN - 01 oncolytic adenovirus with or without nab - paclitaxel plus gemcita bine in patients with advanced solid tumors J ImmunoTher Cancer 10:e003255 Garcia - Carbonero R et al. (2024) VIRAGE: A phase IIb, open - label, randomized study of nab - paclitaxel and gemcitabine plus/minus VCN - 01 in patients with metastatic pancreatic cancer. J Clin Oncol 42S:TPS4210. Guedan S et al. (2010) Hyaluronidase expression by an oncolytic adenovirus enhances its intratumoral spread and suppresses tumor gro wt h. Mol Ther 18:1275 – 1283 Hidalgo M et al. (2019) Poster 5465: Proof of concept clinical study by EUS - guided intratumor injection of VCN - 01, an oncolytic adenovirus expressing hyaluronidase i n patients with pancreatic cancer. European Society for Molecular Oncology conference ESMO, 28 September 2019. Jove M et al. (2022) Poster 1231P: Phase I study to evaluate the safety, tolerability, and efficacy of VCN - 01 in combination wit h durvalumab (MEDI4736) in subjects with recurrent/metastatic squamous cell carcinoma of the head and neck (R/M HNSCC) Ann Oncol. 33:S1112. European Society for Mol ecular Oncology conference ESMO 2022, 10 September 2022 Kiyokawa M et al. (2021) Modification of extracellular matrix enhances oncolytic adenovirus Immunotherapy in glioblastoma . Clin Cancer Res 27:889 - 902 Martínez - Vélez N et al. (2019) The oncolytic adenovirus VCN - 01 as therapeutic approach against pediatric osteosarcoma. Clin Canc er Res 22:2217 - 25 Mato - Berciano A et al. (2021) Oncolytic adenovirus with hyaluronidase activity that evades neutralizing antibodies: VCN - 11. J C ontrol Rel 332:517 - 528 Pascual Pasto G et al. (2019) Therapeutic targeting of the RB1 pathway in retinoblastoma with the oncolytic adenovirus VCN - 01. S ci Transl Med 11:eaat9321 Pascual - Pasto G et al. (2021) Presentation: VCN - 01 is an encouraging therapy against retinoblastoma. International Oncolytic Virus Conference IOVC2021, 07 November 2021, Sedona, AZ. Rodríguez - García A et al. (2015) Safety and efficacy of VCN - 01, an oncolytic adenovirus combining fiber HSG - binding domain repla cement with RGD and hyaluronidase expression. Clin Cancer Res 21:1406 - 18 Rojas J et al. (2012) Improved systemic antitumor therapy with oncolytic adenoviruses by replacing the fiber shaft HSG - binding d omain with RGD. Gene Ther 19:453 – 457 Rojas J et al. (2010) Minimal RB - responsive E1A promoter modification to attain potency, selectivity, and transgene - arming capac ity in oncolytic adenoviruses. 2010) Mol Ther 18:1960 – 1971 Rojas L et al. (2016) Albumin - binding adenoviruses circumvent pre - existing neutralizing antibodies upon systemic delivery. J Con trol Rel 237:78 – 88 THERIVA ONCOLYTIC VIRUSES KEY PUBLICATIONS

 

 

32 DESCRIPTION, CLASSIFICATION, STAGING, STROMA Balachandran VP et al. (2019) Broadening the impact of immunotherapy to pancreatic cancer: challenges and opportunities. Gast roe nterology 156:2056 - 72 Christenson ES et al. (2020) Current and emerging therapies for patients with advanced pancreatic ductal adenocarcinoma: a br igh t future. Lancet Oncol 21:e135 - e145 Orth M et al. (2019) Pancreatic ductal adenocarcinoma: biological hallmarks, current status, and future perspectives of combi ned modality treatment approaches. Radiation Oncol 14:141 Placencio - Hickok VR et al. (2022) Hyaluronan heterogeneity in pancreatic ductal adenocarcinoma: primary tumors compared to sites of met as tasis. Pancreatology 22:92 - 97 Sarantis P et al. (2020) Pancreatic ductal adenocarcinoma: treatment hurdles, tumor microenvironment and immunotherapy. World J Gastrointest Oncol 12:173 - 181 Tahkola K et al. (2021) Stromal hyaluronan accumulation is associated with low immune response and poor prognosis in pancreat ic cancer. Sci Rep 11:12216 Yu J et al. (2015) Time to progression of pancreatic ductal adenocarcinoma from low - to - high tumour stages. Gut 64:1783 - 9 INCIDENCE Bengtsson A et al. (2020) The actual 5 - year survivors of pancreatic ductal adenocarcinoma based on real - world data. Sci Rep 10:1 6425. Carioli G et al. (2021) European cancer mortality predictions for the year 2021 with focus on pancreatic and female lung cancer. Ann Oncol 32:478. da Costa WL et al. (2020) Trends in the incidence of pancreatic adenocarcinoma in all 50 United States examined through an ag e - p eriod - cohort analysis. JNCI Cancer Spectrum 4:pkaa033 GLOBOCAN International 2020 survey of persons 0 - 74 years. https://gco.iarc.fr/today/data/factsheets/cancers/13 - Pancreas - fact - sheet.pdf Michael N et al. (2019) Timing of palliative care referral and aggressive cancer care toward the end - of - life in pancreatic cance r: a retrospective, single - center observational study. BMC Palliat Care 18 :1 3. Sung H et al. (2021) Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 18 5 Countries. CA Cancer J Clin 71:209 – 249 Ushio J et al. (2021) Pancreatic ductal adenocarcinoma: epidemiology and risk factors. Diagnostics 11:562 TREATMENT Dotan E et al. (2025) Effect of baseline geriatric and quality of life assessments on treatment outcomes in ECOG - ACRIN EA2186 (G IANT): A randomized phase II study of gemcitabine and nab - paclitaxel compared with 5 - fluorouracil, leucovorin, and liposomal irinotecan in older patients with treatment - naïve met astatic pancreatic cancer. J Clin Oncol 43S:676 Conroy T et al. (2011) FOLFIRINOX versus Gemcitabine for Metastatic Pancreatic Cancer. N Engl J Med 364:1817 - 25. Elsayed M et al. (2021) The latest advancement in pancreatic ductal adenocarcinoma therapy: a review article for the latest guideline s and novel therapies. Biomedicines 9:389 Tempero MA et al. (2021) NCCN Clinical Practice Guidelines in Oncology. Pancreatic Adenocarcinoma, V2.2021. J Natl Compr Canc Netw 19:439 - 457 Toesca DAS et al. (2018) Management of borderline resectable pancreatic cancer. Int J Radiation Oncol Biol Phys 100:1155 - 74 Vogel A et al. (2016) Efficacy and safety profile of nab - paclitaxel plus gemcitabine in patients with metastatic pancreatic canc er treated to disease progression: a subanalysis from a phase 3 trial (MPACT). BMC Cancer16:817 Von Hoff DD et al. (2013) Increased survival in pancreatic cancer with nab - paclitaxel plus gemcitabine. N Engl J Med 369:1691 - 70 3 Wainberg ZA et al. (2023) NALIRIFOX versus nab - paclitaxel and gemcitabine in treatment - naive patients with metastatic pancreatic ductal adenocarcinoma (NAPOLI 3): a randomised, open - label, phase 3 trial. Lancet 402:1272 PANCREATIC CANCER REFERENCES