Aggressive Fibromatosis

March 04, 2024 -- SpringWorks Therapeutics, Inc. (Nasdaq: SWTX), a commercial-stage biopharmaceutical company focused on severe rare diseases and cancer, announced today that the Company has initiated a rolling submission of a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for mirdametinib, an investigational MEK inhibitor, in pediatric and adult patients with neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PN). “There is tremendous potential for mirdametinib to address the substantial needs that exist for children and adults with NF1-PN, and the initiation of our rolling NDA submission brings us one step closer toward our goal of providing these patients with a best-in-class therapy that could make a significant impact on their lives,” said Saqib Islam, Chief Executive Officer of SpringWorks. “We are excited to advance the regulatory filing for our second product and look forward to working closely with the FDA on their review of our application.” The NDA submission includes data from the Phase 2b ReNeu trial, a multi-center, open-label study that opened across 50 sites in the U.S. and enrolled 114 patients across two cohorts (pediatric and adult). The primary endpoint was confirmed objective response rate (ORR), defined as ≥ 20% reduction in target tumor volume as measured by MRI and assessed by Blinded Independent Central Review (BICR). As of the data cutoff date of September 20, 2023, the BICR-confirmed objective response rate was 52% in pediatric patients and 41% in adult patients. Mirdametinib treatment showed deep and durable responses and demonstrated significant improvements in key secondary patient-reported outcome measures. Pediatric and adult patients in the ReNeu trial experienced statistically significant improvements from baseline in pain, quality of life, and physical function, as assessed across multiple patient-reported outcome tools. Mirdametinib was generally well tolerated in the trial, with the majority of adverse events (AEs) being Grade 1 or Grade 2. The most frequently reported AEs were rash, diarrhea, and vomiting in the pediatric cohort and rash, diarrhea, and nausea in the adult cohort. The FDA and the European Commission have granted Orphan Drug designation for mirdametinib for the treatment of NF1. The FDA has also granted Fast Track designation for the treatment of patients ≥ 2 years of age with NF1-PN that are progressing or causing significant morbidity. In July 2023, the FDA granted mirdametinib Rare Pediatric Disease designation for the treatment of NF1, which provides eligibility for a priority review voucher upon FDA approval. SpringWorks expects to complete the NDA submission in the second quarter of 2024. About the ReNeu Trial ReNeu (NCT03962543) is an ongoing, multi-center, open-label Phase 2b trial evaluating the efficacy, safety, and tolerability of mirdametinib in patients two years of age and older with an inoperable NF1-associated PN causing significant morbidity. The study enrolled 114 patients to receive mirdametinib at a dose of 2 mg/m2 twice daily (maximum dose of 4 mg twice daily) without regard to food. Mirdametinib is administered orally in a 3-week on, 1-week off dosing schedule and has a pediatric formulation (dispersible tablet) for patients who cannot swallow a pill. The primary endpoint of the ReNeu trial is confirmed objective response rate defined as ≥ 20% reduction in target tumor volume as measured by MRI and assessed by BICR. Secondary endpoints include safety and tolerability, duration of response, and changes from baseline in patient reported outcomes. About NF1-PN Neurofibromatosis type 1 (NF1) is a rare genetic disorder that arises from mutations in the NF1 gene, which encodes for neurofibromin, a key suppressor of the MAPK pathway.1,2 NF1 is the most common form of neurofibromatosis, with an estimated global birth incidence of approximately 1 in 2,500 individuals, and approximately 100,000 patients living with NF1 in the United States.3,4 The clinical course of NF1 is heterogeneous and manifests in a variety of symptoms across numerous organ systems, including abnormal pigmentation, skeletal deformities, tumor growth and neurological complications, such as cognitive impairment.5 Patients with NF1 have an eight to 15-year mean reduction in their life expectancy compared to the general population.2 NF1 patients have approximately a 30-50% lifetime risk of developing plexiform neurofibromas, or PN, which are tumors that grow in an infiltrative pattern along the peripheral nerve sheath and that can cause severe disfigurement, pain and functional impairment; in rare cases, NF1-PN may be fatal.6,7 Patients with NF1-PN can also experience additional manifestations, including neurocognitive deficits and developmental delays. NF1-PNs are most often diagnosed in the first two decades of life.9 These tumors can be aggressive and are associated with clinically significant morbidities; typically, they grow more rapidly during childhood.10,11 Surgical removal of these tumors is challenging due to the infiltrative tumor growth pattern along nerves and can lead to permanent nerve damage and disfigurement.12 MEK inhibitors have emerged as a validated class of treatment for NF1-PN.13 Mirdametinib is a potent, oral, allosteric small molecule MEK inhibitor in development as a monotherapy treatment for neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PN) and low-grade glioma (LGG), and as a combination therapy for the treatment of several subsets of biomarker-defined metastatic solid tumors. Mirdametinib is an investigational drug for which safety and efficacy have not been established. Mirdametinib is designed to inhibit MEK1 and MEK2, which occupy pivotal positions in the MAPK pathway. The MAPK pathway is a key signaling network that regulates cell growth and survival and that plays a central role in multiple oncology and rare disease indications when genetically altered. The U.S. Food and Drug Administration (FDA) and the European Commission granted Orphan Drug designation for mirdametinib for the treatment of NF1, and the FDA granted Fast Track designation for the treatment of patients ≥ 2 years of age with NF1-PN that are progressing or causing significant morbidity. SpringWorks is a commercial-stage biopharmaceutical company applying a precision medicine approach to developing and delivering life-changing medicines for people with severe rare diseases and cancer. OGSIVEO™ (nirogacestat), approved in the United States for the treatment of adult patients with progressing desmoid tumors who require systemic treatment, is the Company’s first FDA-approved therapy. SpringWorks also has a diversified targeted therapy pipeline spanning solid tumors and hematological cancers, with programs ranging from preclinical development through advanced clinical trials. In addition to its wholly owned programs, SpringWorks has also entered into multiple collaborations with innovators in industry and academia to unlock the full potential for its portfolio and create more solutions for patients in need. References Yap YS, McPherson JR, Ong CK, et al. The NF1 gene revisited - from bench to bedside. Oncotarget. 2014;5(15):5873-5892. doi:10.18632/oncotarget.2194. Rasmussen S, Friedman J. NF1 Gene and Neurofibromatosis 1. Am J Epidemiol. 2000;151(1):33-40. doi:10.1093/oxfordjournals.aje.a010118. CTF: Children’s Tumor Foundation. New and Improved: The way to talk about NF. Press release. May 9, 2023. Accessed February 2, 2024. Lee: Lee TJ, et al. Incidence and prevalence of neurofibromatosis type 1 and 2: a systematic review and meta-analysis. Orphanet J Rare Dis. 2023;18(1):292. Published 2023 Sep 14. doi:10.1186/s13023-023-02911-2) Weiss BD, Wolters PL, Plotkin SR, et al. NF106: A Neurofibromatosis Clinical Trials Consortium Phase II Trial of the MEK Inhibitor Mirdametinib (PD-0325901) in Adolescents and Adults With NF1-Related Plexiform Neurofibromas. Journal of Clinical Oncology. 2021;JCO.20.02220.doi.org/10. 1200/JCO.20.02220. Prada: Prada CE, Rangwala FA, Martin LJ, et al. Pediatric plexiform neurofibromas: impact on morbidity and mortality in neurofibromatosis type 1. J Pediatr. 2012;160(3):461-467. Miller: Miller DT, et al. Health Supervision for Children With Neurofibromatosis Type 1. Pediatrics. 2019;143(5):e20190660. Ferner R. Neurofibromatosis 1 and neurofibromatosis 2: a twenty first century perspective. The Lancet Neurology. 2007;6(4):340-351. doi:10.1016/s1474-4422(07)70075-3. Prada C, Rangwala F, Martin L, et al. Pediatric Plexiform Neurofibromas: Impact on Morbidity and Mortality in Neurofibromatosis Type 1. J Pediatr. 2012;160(3):461-467. doi:10.1016/j.jpeds.2011.08.051. Gross A, Singh G, Akshintala S, et al. Association of plexiform neurofibroma volume changes and development of clinical morbidities in neurofibromatosis 1. Neuro Oncol. 2018;20(12):1643-1651. doi:10.1093/neuonc/noy067. Nguyen R, Dombi E, Widemann B, et al. Growth dynamics of plexiform neurofibromas: a retrospective cohort study of 201 patients with neurofibromatosis 1. Orphanet J Rare Dis. 2012;7(1):75. doi:10.1186/1750-1172-7-75. Needle M, Cnaan A, Dattilo J, et al. Prognostic signs in the surgical management of plexiform neurofibroma: The Children’s Hospital of Philadelphia experience, 1974-1994. J Pediatr. 1997;131(5):678-682. doi:10.1016/s0022-3476(97)70092-1. Ferner R. Neurofibromatosis 1 and neurofibromatosis 2: a twenty first century perspective. The Lancet Neurology. 2007;6(4):340-351. doi:10.1016/s1474-4422(07)70075-3. The content above comes from the network. if any infringement, please contact us to modify.

Pictured: A collage of biopharma M&A/ Nicole Bean for BioSpace After a slow 2022 and early part of 2023, the pace of mergers and acquisitions in the pharmaceutical and biotech sectors has accelerated since the middle of last year, highlighted by Pfizer’s $43 billion takeover of Seagen. Since the calendar turned to 2024, we have seen some blockbusters, including Novo Nordisk's $16.5 billion purchase agreement for Catalent and the closing of Bristol Myers Squibb's $4.8 billion acquisition of Mirati Therapeutics. With interest in takeover activity rebounding, BioSpace is pleased to introduce our mergers and acquisitions tracker, which will be updated regularly. Follow along as we keep you up to date on which companies are getting together and which are being absorbed. March March 5 Status: Pending; anticipated closing late Q2 Deal value: Undisclosed Akari Therapeutics and Peak Bio announced an all-stock “merger of equals,” though the combined company will carry the Akari name and continue to be traded on the Nasdaq Capital Market under the AKTX ticker symbol. The new partners plan to focus on business development and licensing across therapeutic areas, including cancer, autoimmune conditions and inflammatory diseases. March 4 Status: Completed Deal value: Undisclosed Eilean Therapeutics said it has purchased privately held startup Ness Therapeutics in an all-equity deal. San Diego–based Ness is developing PTPN2 inhibitors for immuno-oncology. Eilean has been testing small molecule inhibitors that target escape mutations in hematologic and solid tumors. March 4 Status: Pending Deal value: Up to $82 million plus royalties Melbourne, Australia-based Telix Pharmaceuticals will acquire privately held radioisotope production technology company ARTMS, of Burnaby, British Columbia. Telix said that, among other things, ARTMS will be able to support production of Zircaix (TLX250-CDx), its investigational PET imaging agent for identifying clear cell renal cell carcinoma. The deal calls for Telix to pay $42.5 million in stock upfront, $15 million in cash at closing and as much as $24.5 million in contingencies, as well as future royalties. March 1 Status: Pending Deal value: Undisclosed Precisio Biotix Therapeutics announced the purchase of CC Bio, maker of the Zeus bioinformatics platform for antibacterial lysis analysis. Precisio said the Zeus platform is “highly complementary” to its LysiThru lysin screening and engineering system. March 1 Status: Pending Deal value: Up to $31 million Kinnate Biopharma has agreed to sell exarafenib, its investigational pan-RAF inhibitor, to France’s Pierre Fabre Laboratories. Kinnate is in the process of being acquired by Xoma. February Feb. 29 Status: Completed Deal value: Undisclosed JAMP Pharma Group purchased a shuttered drug manufacturing facility in Lévis, Quebec, that belonged to Pharmalab, a company that went out of business in August 2023. Quebec-based JAMP announced plans to rehire a “significant portion” of the 250 former Pharmalab workers at the site to serve the Canadian market. Feb. 28 Status: Pending; anticipated closing early Q2 Deal value: $130 million CoreRx agreed to purchase fellow Florida firm Societal CDMO for $1.10 per share in cash. Societal said the combined company seeks to establish itself as “a preferred CDMO partner in the small molecule space” when the deal closes. Feb. 28 Status: Pending Deal value: Undisclosed Gingko Bioworks announced a trio of acquisitions: Patch Biosciences, Proof Diagnostics and the artificial intelligence and software infrastructure of Reverie Labs. Terms of the sale agreements were not disclosed, but Ginkgo said its board approved stock grants of about $3.5 million to four Reverie employees and nearly $4.3 million to eight Patch Bio employees. Feb. 26 Status: Pending; anticipated closing Q2 Deal value: $135 million NGM Biopharmaceuticals agreed to a buyout by affiliates of venture capital firm The Column Group for $1.55 per share. NGM Bio recently presented data on trials of a dual ILT2/ILT4 antagonist antibody and another compound to treat compensated cirrhosis. Feb. 26 Status: Completed Deal value: $4.1 billion Bristol Myers Squibb closed its previously announced $62.50-per-share takeover of radiopharmaceutical developer RayzeBio. The target company’s portfolio includes RYZ101, an SSTR2-targeting radiotherapeutic that is currently in late-stage testing for gastroenteropancreatic neuroendocrine tumors and is also being trialed for small cell lung cancer. Feb. 22 Status: Pending Deal value: Up to $117.5 million plus royalties Rigel Pharmaceuticals is purchasing the U.S. rights to FDA-approved non-small cell lung cancer drug Gavreto (pralsetinib) from Blueprint Medicines for $15 million. Rigel could be on the hook for an additional $97.5 million in commercial milestone payments and $5 million in regulatory milestone compensation, as well as future tiered royalties. Blueprint regained the global rights to Gavreto from Roche in early 2023. Feb. 22 Status: Completed Deal value: Up to $1.2 billion AstraZeneca closed its acquisition of Chinese cell therapy company Gracell Biotechnologies, giving the British pharma giant ownership of the investigational cell therapy GC012F, a dual-targeting autologous CAR-T therapy, as well as Gracell’s FasTCAR platform for CAR-T development. The deal, announced Dec. 23, is valued at $2 per share. Unspecified regulatory milestone payments could bring the total value to $1.2 billion. Feb. 21 Status: Completed Deal value: $1 million plus contingencies BioVaxys Technology completed the purchase of the discovery, preclinical and clinical assets of bankrupt Canadian immuno-oncology developer Immunovaccine Technologies (IMV). BioVaxys made $750,000 in upfront payments and issued $250,000 in stock to IMV creditors. The company also agreed to make unspecified milestone payments, share licensing revenues and offer royalty payments to the creditors. IMV initiated U.S. bankruptcy proceedings in May 2023, Pharmaceutical Technology reported. Feb. 20 Status: Completed Deal value: $28.2 million Syncona closed its acquisition of Freeline Therapeutics for $6.50 per share in cash, in a deal that had been announced in November. Freeline had been in early-stage trials of FLT201, an adeno-associated virus (AAV) candidate gene therapy for Gaucher disease. Feb. 16 Status: Pending Deal value: $120 million Biotech royalty aggregator Xoma announced an agreement to take over precision oncology firm Kinnate Biopharma for an estimated $120 million in cash. Kinnate's pipeline includes a brain-penetrant MEK inhibitor, a highly selective c-MET inhibitor and exarafenib, a pan-RAF inhibitor in early-stage trials. Feb. 14 Status: Completed Deal value: $180 million Concentra Biosciences completed its acquisition of Theseus Pharmaceuticals, first disclosed Dec. 22. The $4.05-per-share price was at the top end of a previously announced range to purchase Theseus, a clinical-stage company developing pan-variant tyrosine kinase inhibitors and other targeted therapies. Feb. 12 Status: Pending; anticipated closing Q1 Deal value: $4.3 billion Gilead Sciences announced plans to acquire CymaBay Therapeutics for $32.50 per share in cash. The news broke the same day CymaBay announced that the FDA accepted the New Drug Application for its lead candidate seladelpar for the management of primary biliary cholangitis. Feb. 7 Status: Pending Deal value: Up to $123.1 million Telix Pharmaceuticals agreed to purchase QSAM Biosciences in an all-stock transaction. Contingent value rights could be worth as much as $90 million on top of the base price. Telix highlighted QSAM’s lead asset, an investigational radiopharmaceutical treatment for primary and metastatic bone cancer called CycloSam (Samarium-153-DOTMP). QSAM had signed a term sheet for the planned acquisition in November that included a $2 million pre-closing collaboration fee from Australia-based Telix to continue its development work. Feb. 7 Status: Pending Deal value: Up to $880 million Jazz Pharmaceuticals signed a definitive agreement to purchase the proprietary Kirsten rat sarcoma virus (KRAS) inhibitor program of Redx Pharma for $10 million upfront and as much as $870 million in development, regulatory and commercial milestone payments, as well as potential royalties. The next milestone is FDA Investigational New Drug clearance, the companies said. Feb. 6 Status: Pending Deal value: Up to $87.5 million Immunome said it would acquire the AL102 investigational small molecule gamma secretase inhibitor and a related drug candidate from Ayala Pharmaceuticals for $50 million in cash and stock, with contingencies for an additional $37.5 million in milestone payments. Ayala subsequently announced that it had completed enrollment in a Phase III study to evaluate AL102 in desmoid tumors. Feb. 5 Status: Pending; anticipated closing in first half of 2024 Deal value: $2.9 billion Novartis reached an agreement with MorphoSys to acquire the German biotech for more than $73 per share in cash. At the center of the merger is pelabresib, an investigational small molecule inhibitor of the BET protein which suppresses the expression of abnormal genes involved in cancer development. The companies expect the acquisition to close in the first half of the year. Feb. 5 Status: Pending; anticipated closing late 2024 Deal value: $16.5 billion Novo Nordisk made a splash with a $16.5 billion offer—the largest new M&A announcement in the biotech sector so far this year—to take over troubled CDMO Catalent. Novo Holdings, the investment arm of the Novo Nordisk Foundation, will purchase all outstanding Catalent shares for $63.50 each and flip three manufacturing plants to Novo Nordisk for $11 million as the latter seeks to ramp up production of its blockbuster diabetes drug Ozempic and weight-loss medication Wegovy. Neil Versel is the business editor at BioSpace. You can reach him at neil.versel@biospace.com. Follow him on LinkedIn or X.

STAMFORD, Conn., Feb. 29, 2024 (GLOBE NEWSWIRE) -- SpringWorks Therapeutics, Inc. (Nasdaq: SWTX), a commercial-stage biopharmaceutical company focused on severe rare diseases and cancer, announced today that the European Medicines Agency (EMA) has validated the Marketing Authorization Application (MAA) for nirogacestat, an oral gamma secretase inhibitor, for the treatment of adults with desmoid tumors. If approved, nirogacestat will be the first therapy to receive marketing authorization in the European Union (EU) for the treatment of desmoid tumors. Nirogacestat previously received Orphan Drug designation from the European Commission for the treatment of soft tissue sarcoma. “The validation of our marketing authorization application is an important step towards bringing nirogacestat to patients with desmoid tumors in the European Union who currently do not have an approved therapy,” said Saqib Islam, Chief Executive Officer of SpringWorks. “We look forward to working with the EMA on this important submission.” The MAA submission is based on results from the Phase 3 DeFi trial. In DeFi, nirogacestat met the primary endpoint of improving progression-free survival (PFS), demonstrating a statistically significant improvement over placebo with a 71% reduction in the risk of disease progression (hazard ratio (HR) = 0.29 (95% CI: 0.15, 0.55); p< 0.001). Median PFS was not reached in the nirogacestat arm and was 15.1 months in the placebo arm. Confirmed objective response rate (ORR) based on blinded independent central review of Response Evaluation Criteria in Solid Tumors v1.1 was 41% with nirogacestat versus 8% with placebo (p<0.001); the complete response rate was 7% in the nirogacestat arm and 0% in the placebo arm. Nirogacestat also demonstrated early and sustained improvements in patient-reported outcomes (PROs) measured as of the cycle 10 assessment, including pain (p<0.001), desmoid tumor-specific symptoms (p<0.001), physical/role functioning (p<0.001), and overall health-related quality of life (p≤0.01). Nirogacestat exhibited a manageable safety and tolerability profile. The most common adverse events (>15%) reported in patients receiving nirogacestat were diarrhea, ovarian toxicity, rash, nausea, fatigue, stomatitis, headache, abdominal pain, cough, alopecia, upper respiratory tract infection, and dyspnea. The DeFi trial results were published in the March 9, 2023 edition of the New England Journal of Medicine and presented during a Presidential Symposium at the European Society for Medical Oncology Congress 2022.1, 2 “Desmoid tumors can have a significant impact on patients’ lives and there is a pressing need for a new treatment for patients in Europe,” said Bernd Kasper, M.D., Ph.D., University of Heidelberg, Mannheim Cancer Center, Mannheim, Germany and Principal Investigator of the DeFi trial. “In the DeFi trial, nirogacestat demonstrated significant improvements across progression-free survival, objective response rate, and patient-reported outcomes, and had a safety pro supports long-term dosing. These results support that nirogacestat will be a practice-changing therapy if approved by the EMA.” In November 2023, the U.S. Food and Drug Administration approved OGSIVEO™ (nirogacestat) for the treatment of adults with progressing desmoid tumors who require systemic treatment. The U.S. prescribing information includes the following Warnings & Precautions: diarrhea, ovarian toxicity, hepatotoxicity, non-melanoma skin cancers, electrolyte abnormalities, and embryo-fetal toxicity. Please see below for additional Important Safety Information. About Desmoid Tumors Desmoid tumors (sometimes referred to as aggressive fibromatosis, or desmoid fibromatosis) are rare, aggressive, locally invasive tumors of the soft tissues that can be serious, debilitating, and, in rare cases when vital structures are impacted, life-threatening.3,4 Desmoid tumors are most commonly diagnosed in patients between the ages of 20 and 44 years, with a two-to-three times higher prevalence in females. 5,6 In the European Union, the incidence of desmoid tumors is estimated to be approximately 3-5 cases per million per year.7 Although they do not metastasize, desmoid tumors are associated with recurrence rates of up to 77% after surgical resection.5,8,9 Desmoid tumor experts and treatment guidelines now recommend systemic therapies as first-line intervention instead of surgery for most tumor locations requiring treatment.9 About OGSIVEO™ (nirogacestat) OGSIVEO (nirogacestat) is an oral, selective, small molecule gamma secretase inhibitor approved in the United States for the treatment of adult patients with progressing desmoid tumors who require systemic treatment. OGSIVEO is not approved for the treatment of any other indication in the United States, or for any indication in any other jurisdiction by any other health authority. SpringWorks is also evaluating nirogacestat as a potential treatment for patients with ovarian granulosa cell tumors and for patients with multiple myeloma as part of several B-cell maturation agent (BCMA) combination therapy regimens in collaboration with leaders in industry and academia. IMPORTANT SAFETY INFORMATION WARNINGS AND PRECAUTIONS Diarrhea: Diarrhea occurred in 84% of patients treated with OGSIVEO. Grade 3 events occurred in 16% of patients. Monitor patients and manage using antidiarrheal medications. Modify dose as recommended. Ovarian Toxicity: Female reproductive function and fertility may be impaired in patients treated with OGSIVEO. Impact on fertility may depend on factors like duration of therapy and state of gonadal function at time of treatment. Long-term effects on fertility have not been established. Advise patients on the potential risks for ovarian toxicity before initiating treatment. Monitor patients for changes in menstrual cycle regularity or the development of symptoms of estrogen deficiency, including hot flashes, night sweats, and vaginal dryness. Hepatotoxicity: ALT or AST elevations occurred in 30% and 33% of patients, respectively. Grade 3 ALT or AST elevations (>5 × ULN) occurred in 6% and 2.9% of patients. Monitor liver function tests regularly and modify dose as recommended. Non-Melanoma Skin Cancers: New cutaneous squamous cell carcinoma and basal cell carcinoma occurred in 2.9% and 1.4% of patients, respectively. Perform dermatologic evaluations prior to initiation of OGSIVEO and routinely during treatment. Electrolyte Abnormalities: Decreased phosphate (65%) and potassium (22%) occurred in OGSIVEO-treated patients. Phosphate <2 mg/dL occurred in 20% of patients. Grade 3 decreased potassium occurred in 1.4% of patients. Monitor phosphate and potassium levels regularly and supplement as necessary. Modify dose as recommended. Embryo-Fetal Toxicity: Oral administration of nirogacestat to pregnant rats during the period of organogenesis resulted in embryo-fetal toxicity at maternal exposures below human exposure at the recommended dose of 150 mg twice daily. Advise pregnant women of the potential risk to a fetus. Advise females and males of reproductive potential to use effective contraception during treatment with OGSIVEO and for 1 week after the last dose. ADVERSE REACTIONS The most common (≥15%) adverse reactions were diarrhea, ovarian toxicity, rash, nausea, fatigue, stomatitis, headache, abdominal pain, cough, alopecia, upper respiratory tract infection, and dyspnea. Serious adverse reactions occurring in ≥2% of patients were ovarian toxicity (4%). The most common laboratory abnormalities (≥15%) were decreased phosphate, increased urine glucose, increased urine protein, increased AST, increased ALT, and decreased potassium. DRUG INTERACTIONS CYP3A Inhibitors and Inducers: Avoid concomitant use with strong or moderate CYP3A inhibitors (including grapefruit products, Seville oranges, and starfruit) and strong or moderate CYP3A inducers. Gastric Acid Reducing Agents: Avoid concomitant use with proton pump inhibitors and H2 blockers. If concomitant use cannot be avoided, OGSIVEO can be staggered with antacids (e.g., administer OGSIVEO 2 hours before or 2 hours after antacid use). Consult the full Prescribing Information prior to and during treatment for important drug interactions. To report suspected adverse reactions, contact SpringWorks Therapeutics at 1-888-400-SWTX (1-888-400-7989) or FDA at 1-800-FDA-1088 or Please see full U.S. Prescribing Information for OGSIVEO for more information. About SpringWorks Therapeutics SpringWorks is a commercial-stage biopharmaceutical company applying a precision medicine approach to developing and delivering life-changing medicines for people with severe rare diseases and cancer. OGSIVEO™ (nirogacestat), approved in the United States for the treatment of adult patients with progressing desmoid tumors who require systemic treatment, is the Company’s first FDA-approved therapy. SpringWorks also has a diversified targeted therapy pipeline spanning solid tumors and hematological cancers, with programs ranging from preclinical development through advanced clinical trials. In addition to its wholly owned programs, SpringWorks has also entered into multiple collaborations with innovators in industry and academia to unlock the full potential for its portfolio and create more solutions for patients in need. For more information, visit and follow @SpringWorksTx on X (formerly Twitter), LinkedIn, and YouTube. SpringWorks Forward-Looking Statements This press release contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, relating to our business, operations, and financial conditions, including but not limited to current beliefs, expectations and assumptions regarding the future of our business, future plans and strategies, our development and commercialization plans, our preclinical and clinical results, the market potential of OGSIVEO for adult patients with desmoid tumors, expectations regarding timing and results of the EMA’s review of the MAA for nirogacestat, including the adequacy of the data contained in the MAA to serve as the basis for marketing approval of nirogacestat for the treatment of desmoid tumors in the European Union, as well as relating to other future conditions. Words such as, but not limited to, “look forward to,” “believe,” “expect,” “anticipate,” “estimate,” “intend,” “plan,” “would,” “should” and “could,” and similar expressions or words, identify forward-looking statements. New risks and uncertainties may emerge from time to time, and it is not possible to predict all risks and uncertainties. Any forward-looking statements in this presentation are based on management’s current expectations and beliefs and are subject to a number of risks, uncertainties and important factors that may cause actual events or results to differ materially from those expressed or implied by any forward-looking statements contained in this presentation, including, without limitation, risks relating to: (i) our expectations regarding the potential clinical benefit of nirogacestat for patients with desmoid tumors, (ii) estimates regarding the number of adult patients who are diagnosed with desmoid tumors annually per year in Europe and the potential market for nirogacestat, (iii) the fact that topline or interim data from clinical studies may not be predictive of the final or more detailed results of such study or the results of other ongoing or future studies, (iv) the timing of our planned regulatory submissions and interactions, including the timing and outcome of decisions made by the U.S. Food and Drug Administration (FDA), European Medicines Agency (EMA), and other regulatory authorities, investigational review boards at clinical trial sites and publication review bodies, (v) whether FDA, EMA, or other regulatory authorities will require additional information or further studies, or may fail or refuse to approve or may delay approval of our product candidates, including nirogacestat and mirdametinib, (vi) our ability to obtain regulatory approval of any of our product candidates or maintain regulatory approvals granted for our products, (vii) our ability to maintain adequate patent protection and successfully enforce patent claims against third parties, and (viii) our ability to meet any specific milestones set forth herein. Except as required by applicable law, we do not plan to publicly update or revise any forward-looking statements contained herein, whether as a result of any new information, future events, changed circumstances or otherwise. Although we believe the expectations reflected in such forward-looking statements are reasonable, we can give no assurance that such expectations will prove to be correct. Accordingly, readers are cautioned not to place undue reliance on these forward-looking statements. For further information regarding the risks, uncertainties and other factors that may cause differences between SpringWorks’ expectations and actual results, you should review the “Risk Factors” in Item 1A of Part I of SpringWorks’ Annual Report on Form 10-K for the year ended December 31, 2023, as well as discussions of potential risks, uncertainties and other important factors in SpringWorks’ subsequent filings. Contacts Kim Diamond Vice President, Communications and Investor Relations Phone: 203-561-1646 Email: kdiamond@springworkstx.com Samantha Hilson Sandler Senior Director, Investor Relations Phone: 203-461-5501 Email: samantha.sandler@springworkstx.com References 1 Gounder M, Ratan R, Alcindor T, et al. Nirogacestat, a Gamma-Secretase Inhibitor for Desmoid Tumors. N Engl J Med. 2023;388:898-912. doi:10.1056/NEJMoa2210140. 2 Kasper B, Ratan R, Alcindor T, et al. DeFi: A phase III, randomized controlled trial of nirogacestat versus placebo for progressing desmoid tumors (DT). Ann Oncol. 2022;33(suppl_7): S808-S869. 3 Sbaraglia M, Bellan E, Dei Tos AP. The 2020 WHO Classification of Soft Tissue Tumours: news and perspectives. Pathologica. 2021;113(2):70-84. doi:10.32074/1591-951X-213. 4 Penel N, Chibon F, Salas S. Adult desmoid tumors: biology, management and ongoing trials. Curr Opin Oncol. 2017;29(4):268-274. doi:10.1097/CCO.0000000000000374. 5 Skubitz KM. Biology and treatment of aggressive fibromatosis or desmoid tumor. Mayo Clin Proc. 2017;92(6):947-964. doi:10.1016/j.mayocp.2017.02.012. 6 van Broekhoven DLM, Grünhagen DJ, den Bakker MA, van Dalen T, Verhoef C. Time trends in the incidence and treatment of extra-abdominal and abdominal aggressive fibromatosis: a population-based study. Ann Surg Oncol. 2015;22(9):2817-2823. doi:10.1245/s10434-015-4632-y. 7 Orphanet Report Series: Rare Diseases collection. Prevalence and incidence of rare diseases: bibliographic data. January 2019. . 8 Easter DW, Halasz NA. Recent trends in the management of desmoid tumors. Summary of 19 cases and review of the literature. Ann Surg. 1989;210(6):765-769. doi:10.1097/00000658-198912000-00012. 9 Gronchi A, Kasper B, et al. Desmoid Tumor Working Group. The management of desmoid tumours: a joint global consensus-based guideline approach for adult and paediatric patients. Eur J Cancer. 2020;127:96-107. doi:10.1016/j.ejca.2019.11.013.