MacroGenics Enters Into Agreement With TerSera Therapeutics for the Sale of MARGENZA$(R)$

ROCKVILLE, Md. & DEERFIELD, Ill.--(BUSINESS WIRE)--October 22, 2024-- 

MacroGenics, Inc. $(MGNX)$, a biopharmaceutical company focused on discovering, developing, manufacturing and commercializing innovative antibody-based therapeutics for the treatment of cancer, and TerSera Therapeutics LLC, a privately-held biopharmaceutical company with a focus in oncology and non-opioid pain management, announced today that they have entered into an agreement in which TerSera will acquire global rights to MARGENZA(R) (margetuximab-cmkb).

MARGENZA was approved by the U.S. Food and Drug Administration (FDA) in December 2020 in combination with chemotherapy for the treatment of adult patients with metastatic HER2-positive breast cancer who have received two or more prior anti-HER2 regimens, at least one of which was for metastatic disease. The approval was based on results from the pivotal Phase 3 head-to-head clinical trial (SOPHIA) evaluating the safety and efficacy of MARGENZA vs. Herceptin(R) (trastuzumab), both combined with chemotherapy.

Pursuant to the terms of the agreement, TerSera will pay MacroGenics $40 million at closing. MacroGenics may receive additional sales milestone payments of up to an aggregate of $35 million. The transaction is expected to close in the fourth quarter of 2024, subject to customary closing conditions.

"This transaction will enable us to focus our efforts on advancing our pipeline of novel and differentiated oncology product candidates," said Scott Koenig, M.D., Ph.D., President and Chief Executive Officer of MacroGenics. "We believe TerSera's established and complementary U.S. commercial infrastructure has the potential to broaden patient access to MARGENZA."

"MARGENZA is an important treatment option for patients with metastatic HER2+ breast cancer," said Edward Donovan, Chief Executive Officer of TerSera. "We are very excited to add MARGENZA to our existing oncology portfolio, deepening our commitment to the treatment of patients with breast cancer."

IMPORTANT SAFETY INFORMATION

BOXED WARNING: LEFT VENTRICULAR DYSFUNCTION AND EMBRYO-FETAL TOXICITY

   -- Left Ventricular Dysfunction: MARGENZA may lead to reductions in left 
      ventricular ejection fraction (LVEF). Evaluate cardiac function prior to 
      and during treatment. Discontinue MARGENZA treatment for a confirmed 
      clinically significant decrease in left ventricular function. 
 
   -- Embryo-Fetal Toxicity: Exposure to MARGENZA during pregnancy can cause 
      embryo-fetal harm. Advise patients of the risk and need for effective 
      contraception. 

WARNINGS & PRECAUTIONS:

Left Ventricular Dysfunction

   -- Left ventricular cardiac dysfunction can occur with MARGENZA. 
 
   -- In SOPHIA, left ventricular dysfunction occurred in 1.9% of patients 
      treated with MARGENZA. 
 
   -- MARGENZA has not been studied in patients with a pretreatment LVEF value 
      of <50%, a prior history of myocardial infarction or unstable angina 
      within 6 months, or congestive heart failure NYHA class II-IV. 
 
   -- Withhold MARGENZA for >=16% absolute decrease in LVEF from pretreatment 
      values or LVEF below institutional limits of normal (or 50% if no limits 
      available) and >=10% absolute decrease in LVEF from pretreatment values. 
 
   -- Permanently discontinue MARGENZA if LVEF decline persists greater than 8 
      weeks, or dosing is interrupted more than 3 times due to LVEF decline. 
 
   -- Evaluate cardiac function within 4 weeks prior to and every 3 months 
      during and upon completion of treatment. Conduct thorough cardiac 
      assessment, including history, physical examination, and determination of 
      LVEF by echocardiogram or MUGA scan. 
 
   -- Monitor cardiac function every 4 weeks if MARGENZA is withheld for 
      significant left ventricular cardiac dysfunction. 

Embryo-Fetal Toxicity

   -- Based on findings in animals and mechanism of action, MARGENZA can cause 
      fetal harm when administered to a pregnant woman. Post-marketing studies 
      of other HER2 directed antibodies during pregnancy resulted in cases of 
      oligohydramnios and oligohydramnios sequence manifesting as pulmonary 
      hypoplasia, skeletal abnormalities, and neonatal death. 
 
   -- Verify pregnancy status of women of reproductive potential prior to 
      initiation of MARGENZA. 
 
   -- Advise pregnant women and women of reproductive potential that exposure 
      to MARGENZA during pregnancy or within 4 months prior to conception can 
      result in fetal harm. 
 
   -- Advise women of reproductive potential to use effective contraception 
      during treatment and for 4 months following the last dose of MARGENZA. 

Infusion-Related Reactions (IRRs)

   -- MARGENZA can cause IRRs. Symptoms may include fever, chills, arthralgia, 
      cough, dizziness, fatigue, nausea, vomiting, headache, diaphoresis, 
      tachycardia, hypotension, pruritus, rash, urticaria, and dyspnea. 
 
   -- In SOPHIA, IRRs were reported by 13% of patients on MARGENZA plus 
      chemotherapy. Most of the IRRs occur during Cycle 1. Grade 3 IRRs were 
      reported in 1.5% of MARGENZA-treated patients. 
 
   -- Monitor patients during and after MARGENZA infusion. Have medications and 
      emergency equipment to treat IRRs available for immediate use. 
 
   -- In patients experiencing mild or moderate IRRs, decrease rate of infusion 
      and consider premedications, including antihistamines, corticosteroids, 
      and antipyretics. Monitor patients until symptoms completely resolve. 
 
   -- Interrupt MARGENZA infusion in patients experiencing dyspnea or 
      clinically significant hypotension and intervene with supportive medical 
      therapy as needed. Permanently discontinue MARGENZA in all patients with 
      severe or life-threatening IRRs. 

MOST COMMON ADVERSE REACTIONS:

The most common adverse drug reactions (>10%) with MARGENZA in combination with chemotherapy are fatigue/asthenia (57%), nausea (33%), diarrhea (25%), vomiting (21%), constipation (19%), headache (19%), pyrexia (19%), alopecia (18%), abdominal pain (17%), peripheral neuropathy (16%), arthralgia/myalgia (14%), cough (14%), decreased appetite (14%), dyspnea (13%), infusion-related reactions (13%), palmar-plantar erythrodysesthesia (13%), and extremity pain (11%).

You may report side effects to the FDA at (800) FDA-1088 or www.fda.gov/medwatch or to MacroGenics at (844)-MED-MGNX (844-633-6469).

INDICATION

MARGENZA is a HER2/neu receptor antagonist indicated, in combination with chemotherapy, for the treatment of adult patients with metastatic HER2-positive breast cancer who have received two or more prior anti-HER2 regimens, at least one of which was for metastatic disease.

Please see full Prescribing Information, including Boxed Warning.

About HER2-positive Breast Cancer

Human epidermal growth factor receptor 2 (HER2) is a protein found on the surface of some cancer cells that promotes growth and is associated with aggressive disease and poor prognosis. Approximately 15-20% of breast cancer cases are HER2-positive. Monoclonal antibodies targeting HER2 have greatly improved outcomes; however, a significant number of patients progress to later lines of therapy. Effective treatments for metastatic HER2-positive breast cancer continue to remain an unmet need.

About MARGENZA

MARGENZA (margetuximab-cmkb) is an Fc-engineered, monoclonal antibody that targets the HER2 oncoprotein. HER2 is expressed by tumor cells in breast, gastroesophageal and other solid tumors. Similar to trastuzumab, margetuximab-cmkb inhibits tumor cell proliferation, reduces shedding of the HER2 extracellular domain and mediates antibody-dependent cellular cytotoxicity (ADCC). However, through MacroGenics' Fc Optimization technology, margetuximab-cmkb has been engineered to enhance the engagement of the immune system. In vitro, the modified Fc region of margetuximab-cmkb increases binding to the activating Fc receptor FCGR3A (CD16A) and decreases binding to inhibitor Fc receptor FCGR2B (CD32B). These changes lead to greater in vitro ADCC and NK cell activation. The clinical significance of in vitro data is unknown.

About MacroGenics, Inc.

MacroGenics is a biopharmaceutical company focused on discovering, developing, manufacturing and commercializing innovative monoclonal antibody-based therapeutics for the treatment of cancer. The Company generates its pipeline of product candidates primarily from its proprietary suite of next-generation antibody-based technology platforms, which have applicability across broad therapeutic domains. The combination of MacroGenics' technology platforms and protein engineering expertise has allowed the Company to generate promising product candidates and enter into several strategic collaborations with global pharmaceutical and biotechnology companies. For more information, please see the Company's website at www.macrogenics.com.

About TerSera Therapeutics

TerSera Therapeutics is a biopharmaceutical company with a focus in oncology and non-opioid pain management. Founded in 2016, TerSera is building new cornerstones of care through its portfolio of unique therapeutics, amplifying their ability to deliver meaningful outcomes for patients. TerSera has been recognized as a 2024 Healthcare Top Workplace. For additional information, please visit tersera.com and follow us on LinkedIn.

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