UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
Washington,
D.C. 20549
Form
10-K
(Mark
One)
For
the fiscal year ended July 31, 2025
For
the Transition Period from [●] to [●]
Commission
File Number: 001-40101
BRIACELL
THERAPEUTICS CORP.
(Exact
name of registrant as specified in its charter)
(Address of principal executive offices) (Zip Code)
(604)921-1810
(Registrant’s
telephone number, including area code)
Securities
registered pursuant to Section 12(b) of the Act:
Title of each class Trading Symbol Name of each exchange on which registered
Common shares, no par value BCTX The Nasdaq Stock Market LLC
Securities
registered pursuant to Section 12(g) of the Act: None
Indicate
by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☐ No ☒
Indicate
by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Act. Yes ☐ No ☒
Indicate
by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange
Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2)
has been subject to such filing requirements for the past 90 days. Yes ☒ No ☐
Indicate
by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule
405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant
was required to submit such files). Yes ☒ No ☐
Indicate
by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§229.405 of this chapter) is not contained
herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated
by reference in Part III of this Form 10-K or any amendment to this Form 10-K. ☒
If
securities are registered pursuant to Section 12(b) of the Act, indicate by check mark whether the financial statements of the registrant
included in the filing reflect the correction of an error to previously issued financial statements. ☐
Indicate
by check mark whether any of those error corrections are restatements that required a recovery analysis of incentive-based compensation
received by any of the registrant’s executive officers during the relevant recovery period pursuant to §240.10D-1(b). ☐
Indicate
by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, or a smaller reporting
company. See the definitions of “large accelerated filer”, “accelerated filer”, “smaller reporting company”,
and “emerging growth company” in Rule 12b-2 of the Exchange Act.
If
an emerging growth company, indicate by check mark 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. ☐
Indicate
by check mark whether the registrant has filed a report on and attestation to its management’s assessment of the effectiveness
of its internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered
public accounting firm that prepared or issued its audit report. ☐
Indicate
by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Act). Yes ☐ No ☒
The
aggregate market value of the voting and non-voting common equity held by non-affiliates based on a closing sale price of $50.20 per
share, which was the last sale price of the common shares as of January 31, 2025, the last business day of the registrant’s most
recently completed second fiscal quarter, was $94,477,705.
As
of October 15, 2025, 1,883,906 shares of the registrant’s common shares, no par value per share, were issued and outstanding.
TABLE
OF CONTENTS
Page
PART I
Item 1 Business 4
Item 1A Risk Factors 30
Item 1B Unresolved Staff Comments 47
Item 1C Cybersecurity 47
Item 2 Properties 47
Item 3 Legal Proceedings 47
Item 4 Mine Safety Disclosures 47
PART II
Item 6 [Reserved] 48
Item 7A Quantitative and Qualitative Disclosures About Market Risk 53
Item 8 Financial Statements and Supplementary Data 53
Item 9A Controls and Procedures 54
Item 9B Other Information 54
Item 9C Disclosure Regarding Foreign Jurisdictions that Prevent Inspections. 54
PART III
Item 10 Directors, Executive Officers, and Corporate Governance 55
Item 11 Executive Compensation 64
Item 14 Principal Accountant Fees and Services 68
PART IV
SIGNATURES 73
Forward-Looking
Statements
This
Annual Report on Form 10-K contains forward-looking statements which are made pursuant to the safe harbor provisions of Section 27A of
the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as
amended (the “Exchange Act”). These statements may be identified by such forward-looking terminology as “may,”
“should,” “expects,” “intends,” “plans,” “anticipates,” “believes,”
“estimates,” “predicts,” “potential,” “continue” or the negative of these terms or other
comparable terminology. Our forward-looking statements are based on a series of expectations, assumptions, estimates and projections
about our company, are not guarantees of future results or performance and involve substantial risks and uncertainty. We may not actually
achieve the plans, intentions or expectations disclosed in these forward-looking statements. Actual results or events could differ materially
from the plans, intentions and expectations disclosed in these forward-looking statements. Our business and our forward-looking statements
involve substantial known and unknown risks and uncertainties, including the risks in the section titled “Risk Factors”,
that may cause our or our industry’s actual results, levels of activity, performance or achievements to be materially different
from any future results, levels of activity, performance or achievements expressed or implied by these forward-looking statements. In
addition, you are directed to factors discussed in the “Business” section and the “Management’s Discussion
and Analysis of Financial Condition and Results of Operations” section, as well as those discussed elsewhere in this Annual
Report on Form 10-K.
All
of our forward-looking statements are as of the date of this Annual Report on Form 10-K only. In each case, actual results may differ
materially from such forward-looking information. We can give no assurance that such expectations or forward-looking statements will
prove to be correct. An occurrence of, or any material adverse change in, one or more of the risk factors or risks and uncertainties
referred to in this Annual Report on Form 10-K or included in our other public disclosures or our other periodic reports or other documents
or filings filed with or furnished to the U.S. Securities and Exchange Commission (the “SEC”) could materially and adversely
affect our business, prospects, financial condition and results of operations. Except as required by law, we do not undertake or plan
to update or revise any such forward-looking statements to reflect actual results, changes in plans, assumptions, estimates or projections
or other circumstances affecting such forward-looking statements occurring after the date of this Annual Report on Form 10-K, even if
such results, changes or circumstances make it clear that any forward-looking information will not be realized. Any public statements
or disclosures by us following this Annual Report on Form 10-K that modify or impact any of the forward-looking statements contained
in this Annual Report on Form 10-K will be deemed to modify or supersede such statements in this Annual Report on Form 10-K.
This
Annual Report on Form 10-K may include market data and certain industry data and forecasts, which we may obtain from internal company
surveys, market research, consultant surveys, publicly available information, reports of governmental agencies and industry publications,
articles and surveys. Industry surveys, publications, consultant surveys and forecasts generally state that the information contained
therein has been obtained from sources believed to be reliable, but the accuracy and completeness of such information is not guaranteed.
While we believe that such studies, clinical trials and publications are reliable, we have not independently verified market and industry
data from third-party sources.
Risk
Factor Summary
Our
business is subject to significant risks and uncertainties that make an investment in us speculative and risky. Below we summarize what
we believe are the principal risk factors but these risks are not the only ones we face, and you should carefully review and consider
the full discussion of our risk factors in the section titled “Risk Factors”, together with the other information
in this Annual Report on Form 10-K. If any of the following risks actually occurs (or if any of those listed elsewhere in this Annual
Report on Form 10-K occur), our business, reputation, financial condition, results of operations, revenue, and future prospects could
be seriously harmed. Additional risks and uncertainties that we are unaware of, or that we currently believe are not material, may also
become important factors that adversely affect our business.
● We are developing novel technologies which may not be effective or safe;
● There is substantial doubt about our ability to continue as a going concern
● We are highly dependent on our key personnel;
● We have an unproven market for our product candidates;
● We are a pre-revenue clinical stage company;
PART
I
ITEM
BUSINESS
BUSINESS
Overview
of the Company
BriaCell
Therapeutics Corp. (“Briacell” or the “Company”) is a clinical-stage biotechnology company that is developing
novel immunotherapies to transform cancer care. Immunotherapies have come to the forefront in the fight against cancer as they harness
the body’s own immune system to recognize and destroy cancer cells. The Company is currently advancing its Bria-IMTTM targeted
immunotherapy in combination with an immune check point inhibitor (Retifanlimab) in a pivotal1 Phase 3 study in metastatic
breast cancer (listed on ClinicalTrials.gov as NCT06072612). Bria-IMTTM is currently under Fast Track Designation
by the U.S. Food and Drug Administration (the “FDA”) intended to accelerate the review process of novel treatments that address
unmet medical needs. Positive completion of the pivotal study, following review by FDA, could lead to full approval of the Bria-IMTTM
immune checkpoint inhibitor combination in metastatic breast cancer. BriaCell has reported benchmark-beating patient survival and clinical
benefit in metastatic breast cancer with median overall survival of 13.4 months in BriaCell’s metastatic breast cancer patients
vs. 6.7-9.8 months2 for similar patients reported in the literature in its Phase 2 study of Bria-IMTTM combination study
with retifanlimab. Additionally, BriaCell reported median overall survival of 16.5 months in Phase 2 Bria-IMTTM study patients treated
in combination with immune checkpoint inhibitor in patients treated with the Phase 3 formulation since 2022 (post-COVID). A completed
Bria-IMTTM Phase 1/2 combination study with retifanlimab (an anti-PD1 antibody manufactured by Incyte) confirmed tolerability and
early-stage efficacy (listed on ClinicalTrials.gov as NCT03328026).
BriaCell Phase 1/2 Study of Bria-OTSTM, BriaCell’s personalized off-the-shelf immunotherapy, also known
as Bria-BRESTM, in metastatic breast cancer is ongoing (listed on ClinicalTrials.gov as NCT06471673). The first
patient treated with 4 inoculations of cells (single agent) demonstrated complete resolution of a lung metastasis. BriaCell is currently
developing Bria-OTSTM and its advanced form, Bria-OTS+TM, as a platform technology for personalized off-the-shelf immunotherapies
for numerous types of cancer. In September 2024, the Company announced BriaCell had received positive feedback from its Pre-Investigational
New Drug Application (Pre-IND) meeting with FDA for Bria-PROS+TM for prostate cancer.
Market
It
is estimated by the National Cancer Institute Cancer Facts and Figures that in 2025, approximately 319,750 people (316,950 women and
2,800 men) will be diagnosed with breast cancer in the United States. That means that every two minutes an American woman is
diagnosed with breast cancer and more than 42,170 are projected to die in 2025. Although about 100 times less common than in women,
breast cancer also affects men. It is estimated that the lifetime risk of men getting breast cancer is about 1 in 1,000, and the
American Cancer Society estimates that approximately 2,800 new cases of invasive male breast cancer will be diagnosed and
approximately 510 men will die from breast cancer in 2025.
According
to the May 2025 “Global Oncology Trends 2025” report by the IQVIA Institute, the global market for cancer drugs (including
immunotherapy drugs) is expected to reach nearly $441 billion by the end of 2029.
1
“Pivotal” is an industry term referring to a Phase 3 clinical study intended to show and confirm the safety and efficacy
of a treatment.
2
Cortes J, et al. Annals of Oncology 2018; Kazmi S, et al. Breast Cancer Res Treat. 2020 Aug 17; O’Shaughnessy J et al. Breast
Cancer Res Treat. 2022; Tripathy D, et al. JAMA Oncol. 2022
About
13% percent of women will be diagnosed with breast cancer at some point during their lifetime. In 2025, over 4 million women were
living with female breast cancer in the United States. Approximately 83% of cases present as invasive breast cancer.
Approximately 6% of new breast cancer diagnoses are Stage IV (metastatic breast cancer (“MBC”), which has already spread
to other organs). Twenty to thirty percent of all women diagnosed with breast cancer will develop MBC. Breast cancer can be
subdivided based on receptor status - the hormone receptors for estrogen (ER) and progesterone (PR), collectively referred to as
hormone receptors (HR), and the Her2/neu growth factor receptor (HER2). Based on the latest SEER statistics, 68% were found to be
HR+/HER2−, 10% were triple-negative (HR−/HER2−), 10% were HR+/HER2+, and 4% were
HR−/HER2+.1
It
is estimated that over 150,000 women in the US were living with MBC in 20152 and this is projected to increase to over 240,000
by 2030. For those with metastatic disease at diagnosis, their 5-year survival rate is 30%.1 For patients who develop MBC
after initially having localized disease, if they had a good response to treatment (i.e. a disease-free interval of more than 24 months),
their survival rate is similar to that of patients with MBC at initial diagnosis, but if their disease-free interval is less than 24
months, their prognosis is worse.4 We currently propose that Bria-IMT’sTM indication will be for the treatment
of patients with MBC who have no approved alternative therapies available. Similarly, another study showed that the median overall survival
among patients with de novo stage IV MBC was 39.2 months, while for patients with relapsed disease it was 27.2 months.5 Median
progression free survival after first-line therapy is only 9 months and the survival benefit decreases with subsequent lines of therapy.6
One study showed that of 386 patients with MBC, 374 (97%) received first-line therapy, 254 (66%) received second-line therapy,
175 (45%) received third-line therapy, and 105 (27%) received therapy beyond third-line.7 More recent data indicates that
for patients with MBC who have received 2 or more prior lines of therapy, median survival is 5.9-9.8 months.
1
See https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/2022-2024-breast-cancer-fact-figures-acs.pdf
2
Mariotto AB, Etzioni R, Hurlbert M, Penberthy L, Mayer M. Estimation of the Number of Women Living with Metastatic Breast Cancer
in the United States. Cancer Epidemiol Biomarkers Prev. 2017 Jun;26(6):809-815.
3
Breast Cancer Facts & Figures 2017-2018. Atlanta: American Cancer Society, Inc. 2017.
4
Lobbezoo, D. J. A. et al. Prognosis of metastatic breast cancer subtypes: the hormone receptor/HER2-positive subtype is associated
with the most favorable outcome. Breast Cancer Res. Treat. 141, 507-514 (2013).
5
Dawood S, Broglio K, Ensor J, Hortobagyi GN, Giordano SH. Survival differences among women with de novo stage IV and relapsed breast
cancer. Ann Oncol. 2010 Nov; 21(11):2169-74.
6
Bonotto M, Gerratana L, Iacono D, Minisini AM, Rihawi K, Fasola G, Puglisi F. Treatment of Metastatic Breast Cancer in a Real-World
Scenario: Is Progression-Free Survival With First Line Predictive of Benefit From Second and Later Lines? Oncologist.
7
Kotsakis A, Ardavanis A, Koumakis G, Samantas E, Psyrri A, Papadimitriou C. Epidemiological characteristics, clinical outcomes
and management patterns of metastatic breast cancer patients in routine clinical care settings of Greece: Results from the EMERGE multicenter
retrospective chart review study. BMC Cancer. 2019 Jan 18;19(1):88.
For
further information on our lead candidate Bria-IMTTM clinical development, see “Bria-IMTTM” in the “Production
/Pipeline” section.
Competition
Currently
available therapeutic options for breast cancer offer some hope for patients, but there is much room for improvement. Evaluating
response rates (partial and complete responses = ORR), progression free survival (“PFS”) and overall survival
(“OS”) from recent clinical trials in similar late-stage subjects with metastatic or recurrent breast cancer indicate
that response rates range from 3-5% with PFS from 1.6 to 2.3 months1, and OS from ~7 to 14 months2.
MBC
treated with second or higher lines of therapy has a very poor prognosis and few effective therapies that consistently induce long-term
remission, which indicates the market demand and clinical need for new and improved therapeutic drugs and treatment options in order
to improve these response outcomes and patient survival rates. Thus, Bria-IMTTM has the potential to induce long-term remission,
especially in combination with immunotherapies.
There
are a number of cancer vaccines in development for breast cancer, including but not limited to TPIV200 (Marker Therapeutics, Inc.), AE-37
(Antigen Express), and Stimuvax (Merck KgA). While these development candidates are aimed at a number of different targets, and AE-37
has published data in the HER2 breast cancer patient population, there is no guarantee that any of these compounds will not in the future
be indicated for treatment of low-to-intermediate HER2 breast cancer patients and become directly competitive with Bria-IMT.
1Bardia
A, et al. J Clin Oncol. 2024 May 20;42(15):1738-1744; Tripathy D, et al. JAMA Oncol. 2022 Nov 1;8(11):1700-1701; O’Shaughnessy J, et
al. Breast Cancer Res Treat. 2022 Sep;195(2):127-139.
2Rugo,
H. S., et al. The Lancet, 402(10411), 1423–1433; Bardia A, et al. J Clin Oncol. 2024 May 20;42(15):1738-1744.
While
there are many biotech companies working to create an effective breast cancer therapeutic vaccine, a significant gap remains in the
effectiveness and safety of second or higher lines of therapy. The most studied targeted immunotherapy, Neuvax (Galena), a HER2
peptide vaccine, failed a Phase III trial, but there is encouraging data to support at least three ongoing clinical trials combining
trastuzumab with HER2 epitope immunogens.1 The National Cancer Institute (“NCI”) randomized trial adding
PANVAC (a poxviral-based immunogen) to docetaxel increased the median PFS from 3.9 months to 7.9 months and is to be used as a basis
for larger, more sophisticated clinical trials.2 An immunogen targeting a carbohydrate antigen, globo-H, was associated
with improved PFS, but only in the subset able to mount antibody responses.3 A Johns Hopkins breast cancer trial using a
breast cancer cell line transfected with the gene for GM-CSF has not been positive but, using the same cell line with trastuzumab,
40% of patients enjoyed clinical benefit (CR+PR+stable) at one year.4 Finally, the study of targeted cancer
immunotherapies in combination with other therapies is receiving much attention, particularly combination with checkpoint
inhibitors.5
There
are several other approaches to developing targeted breast cancer immunotherapies. These include using peptide cocktails, a triple peptide
regimen, recombinant HER2, antigen-pulsed dendritic cells, DNA immunogens, whole cell allogeneic GM-CSF secreting SKBR3 or T47D cells,
an (HLA)-A2/A3-restricted immunogenic peptide derived from the HER2 protein, oxidized mannan-MUC1, and personalized peptide immunogens.
Among
the most promising results in patients with advanced disease have been using whole-cell preparations, particularly if the cells are engineered
to express GM-CSF. We are taking this approach and capitalizing on positive initial results with Bria-IMTTM monotherapy in difficult
to treat patients using a regimen that both limits regulatory T cell activity (using low dose cyclophosphamide pre-treatment) and boosts
the immune response (using post-dose alpha interferon in the inoculation sites). The combination with PD-1 inhibitors is a logical extension
of our findings where 21 of 23 MBC patients had demonstrable PD-L1 expression on the circulating tumor cells (“CTCs”) and/or
circulating cancer-associated macrophage-like cells (“CAMLs”). The overall strategy, once the initial milestones have been
met, to enroll additional patients for product registration, will allow rapid progression of the best therapeutic option to a Biologics
License Application (“BLA”).
Cancer
immunotherapy has become a significant growth area for the biopharmaceutical industry, attracting large pharmaceutical companies as well
as small niche players. Generally, our principal competitors in the cancer immunotherapy market comprise both companies with currently
approved products for various indications, such as manufacturers of approved bispecific antibodies, CAR-T cells, and checkpoint inhibitors,
as well as companies currently engaged in cancer immunotherapy clinical development. The large and medium-size players who have successfully
obtained approval for cancer immunotherapy products include Bristol-Myers Squib Company, Merck & Co., Inc., Genentech, Inc. (a subsidiary
of Roche Holding AG), AstraZeneca PLC, Celgene Corporation, Johnson & Johnson/Janssen Pharmaceuticals, Amgen, Novartis, Acerta Pharmaceuticals
(a subsidiary of AstraZeneca), Juno Therapeutics, Inc. (a subsidiary of Celgene), Kite Pharma, Inc., a wholly-owned subsidiary of Gilead
Sciences, Inc. and Pfizer, Inc./EMD Serono, Inc. Most of these companies, either alone or together with their collaborative partners,
have substantially greater financial resources than does BriaCell.
Companies
developing novel products with similar indications to those we are pursuing are expected to influence our ability to penetrate and maintain
market share. For patients with early-stage breast cancer, adjuvant therapy is often given to prevent recurrence and increase the chance
of long-term disease-free survival. Adjuvant therapy for breast cancer can include chemotherapy, hormonal therapy, radiation therapy,
or combinations thereof. In addition, the HER2 targeted drug trastuzumab (HERCEPTIN), alone or in combination with pertuzumab (PERJETA),
both manufactured and marketed by Roche/Genentech, may be given to patients with tumors with high expression of HER2 (IHC 3+), as well
as other novel targets such as MUC1, which may be useful in treating breast cancer. In addition, the FDA approved the first ever immunotherapy
regimen for breast cancer to the Roche/Genentech PD-L1 checkpoint inhibitor atezolizumab (TECENTRIQ), combined with Celgene’s nab-paclitaxel
(ABRAXANE) for TNBC that cannot be removed with surgery and is locally advanced or metastatic.
Many
of our competitors, either alone or with their strategic partners, have substantially greater financial, technical and human resources
than we do, and also have greater experience in obtaining FDA and other regulatory approvals of treatments and commercializing those
treatments. Accordingly, our competitors may be more successful than us in obtaining approval for cancer immunotherapy products and achieving
widespread market acceptance. Our competitors’ treatments may be more effectively marketed and sold than any products we may commercialize,
thus causing limited market share before we can recover the expenses of developing and commercializing of our cancer immunotherapy product
candidate.
1
Mittendorf, E. A.; Peoples, G. E., Injecting Hope-A Review of Breast Cancer Vaccines. Oncology (Williston Park) 2016, 30 (5), 475-81,
485.
2
Heery, C. R.; Ibrahim, N. K.; Arlen, P. M.; Mohebtash, M.; Murray, J. L.; Koenig, K.; Madan, R. A.; McMahon, S.; Marte, J. L.;
Steinberg, S. M.; Donahue, R. N.; Grenga, I.; Jochems, C.; Farsaci, B.; Folio, L. R.; Schlom, J.; Gulley, J. L., Docetaxel Alone or in
Combination With a Therapeutic Cancer Vaccine (PANVAC) in Patients With Metastatic Breast Cancer: A Randomized Clinical Trial. JAMA Oncol
2015, 1 (8), 1087-95.
3
Huang, C.; Yu, A.; Tseng, L., Randomized phase II/III trial of active immunotherapy with OPT-822/OPT-821 in patients with metastatic
breast cancer. J Clin Oncol 2016, 34 (15).
4
Chen, G.; Gupta, R.; Petrik, S.; Laiko, M.; Leatherman, J. M.; Asquith, J. M.; Daphtary, M. M.; Garrett-Mayer, E.; Davidson, N.
E.; Hirt, K.; Berg, M.; Uram, J. N.; Dauses, T.; Fetting, J.; Duus, E. M.; Atay-Rosenthal, S.; Ye, X.; Wolff, A. C.; Stearns, V.; Jaffee,
E. M.; Emens, L. A., A feasibility study of cyclophosphamide, trastuzumab, and an allogeneic GM-CSF-secreting breast tumor vaccine for
HER2+ metastatic breast cancer. Cancer Immunol Res 2014, 2 (10), 949-61.
5
McArthur, H. L.; Page, D. B., Immunotherapy for the treatment of breast cancer: checkpoint blockade, cancer vaccines, and future
directions in combination immunotherapy. Clin Adv Hematol Oncol 2016, 14 (11), 922-933.
Mergers
and acquisitions in the biotechnology and pharmaceutical industries may result in even more resources being concentrated among a smaller
number of our competitors. Smaller or early-stage companies may also prove to be significant competitors, particularly through collaborative
arrangements with large and established companies. These activities may lead to consolidated efforts that allow for more rapid development
of cancer immunotherapy product candidates.
These
competitors also compete with us in recruiting and retaining qualified scientific and management personnel, the ability to work with
specific clinical contract organizations due to conflicts of interest, and the conduct of trials in the ability to recruit clinical trial
sites and subjects for our clinical trials.
We
expect any products that we develop and commercialize to compete on the basis of, among other things, efficacy, safety, price and the
availability of reimbursement from government and other third-party payors. Our commercial opportunity could be reduced or eliminated
if our competitors develop and commercialize products that are viewed as safer, more convenient or less expensive than any products that
we may develop. Our competitors also may obtain FDA or other regulatory approval for their products more rapidly than we may obtain approval
for our current product candidates or any other future product candidate, which could result in our competitors establishing a strong
market position before we are able to enter the market.
Products/Pipeline
Bria-IMTTM
About
Bria-IMT TM
Bria-IMTTM,
BriaCell’s lead candidate, is a whole-cell immunotherapy for metastatic breast cancer. Bria-IMTTM in combination with an immune
check point inhibitor is undergoing pivotal Phase 3 clinical testing in patients with advanced MBC patients who have failed prior lines
of therapy. The pivotal Phase 3 combination study is listed on ClinicalTrials.gov as NCT06072612.
Mechanism
of Action of Bria-IMTTM
Bria-IMTTM (SV-BR-1-GM) is
a targeted immunotherapy for the treatment of breast cancer. Bria-IMTTM is a genetically engineered human breast cancer cell line
with features of immune cells and clinically applied as a targeted immunotherapy. Bria-IMTTM immunotherapy is derived from a grade
II (moderately differentiated) tumor which activates the immune system to attack and destroy breast cancer tumors.
Bria-IMTTM
is designed to secrete GM-CSF, a factor that stimulates components of the immune system. Specifically, GM-CSF activates dendritic
cells, the cells that start immune responses. These activated dendritic cells then activate T cells, a key component of the immune
system, to recognize the tumor cells as foreign, and eliminate them. To amplify this action, we have combined Bria-IMTTM with
other immune system activators including cyclophosphamide (used in low doses to reduce immune suppression), and low-dose local
interferon-α, a cytokine that further activates the immune system. This is termed the Bria-IMTTM regimen. We believe this
approach of simultaneous activation of the immune system via different pathways will improve the immune system response to attack
and destroy cancer cells.
Phase
1/2 Clinical Trial of the Bria-IMTTM regimen in Advanced Metastatic Breast Cancer
BriaCell
conducted Phase 1/2a clinical trials (SVMC #01-026 and WRI-GEV-007) of the Bria-IMTTM regimen in patients with advanced breast cancer.
In the 2 studies a total of 27 patients were treated. They had failed on the average (median) 5 prior lines of therapy. The treatment
was generally well tolerated with local irritation at the inoculation sites the main adverse event judged at least possibly related to
study medication. In total, 18 patients were evaluable (had measurable disease and both baseline and on treatment imaging studies). The
efficacy data is shown here.
● Tolerability was excellent with no dose-limiting toxicities.
In
this study it was also noted that in 21 of 23 patients with circulating tumor cells or cancer-associated macrophage-like cells expressed
PD-L1, and immune checkpoint that blocks the activity of activated T cells to kill tumor cells. This led to the design of a combination
study where the Bria-IMTTM regimen is given in combination with an immune checkpoint inhibitor (CPI).
Phase
1/2 Clinical Trial of Bria-IMTTM in Combination with Immune Check Point Inhibitors in Advanced Metastatic Breast Cancer
BriaCell
has been conducting a Phase 1/2a clinical trial (BRI-ROL-001) of Bria-IMTTM, in combination with immune checkpoint inhibitors such
as pembrolizumab (KEYTRUDA®; manufactured by Merck & Co., Inc.) and retifanlimab, an immune checkpoint inhibitor manufactured
by Incyte. The combination study is listed in ClinicalTrials.gov as NCT03328026 under FDA-approved BB-IND 10312 under protocol
BRI-ROL-001 at ten clinical sites throughout the United States. The study is now closed to enrollment.
In
the Phase 1 part of the study, the Bria-IMTTM regimen was dosed in combination with Keytruda ® in 11 patients and in 11 patients
with retifanlimab, with one patient starting on the combination with Keytruda® and crossing-over to the combination with retifanlimab.
In the Phase 2 part of the study an additional 32 patients were dosed (54 patients total). In Phase 2 part of the study, the Bria-IMTTM
regimen is being dosed in combination with retifanlimab with patients randomized to either receive the Bria-IMTTM regimen first
(16 patients) or retifanlimab first (16 patients).
BriaCell
also evaluated 2 formulations of Bria-IMT, one treated with interferon gamma and one untreated.
The design of the study is shown here.
The
patients had advanced breast cancer as shown here.
N (%)
Age, Median (Range) 61 (38-81) years
Race/Ethnicity
● Asian 3 (6%)
● Other 3 (6%)
ECOG
Tumor Grade
● Unknown 3 (5%)
Prior systemic therapy, Median (Range) 6 (2-13)
Previous therapies
● Antibody Drug Conjugate 23 (44%)
● Checkpoint Inhibitror 11 (20%)
Metastatic or Recurrent Target Lesion sites
● Brain 4 (7%)
Metastatic Breast Cancer Subtype
● HER2low/HR+ 4 (7%)
Treatment
with the combination regimen was generally well tolerated as shown here.
There was no statistically significant
difference in Progression Free Survival (PFS) based on order of administration (CPI in cycle 1 or delayed to cycle 2). There was a significant
effect of PFS of formulation as shown here.
Data presented at ASCO 2024
see Calfa et al. Journal of Clinical Oncology 42, 6_suppl
https://doi.org/10.1200/JCO.2024.42.16_suppl.1022
The
overall survival of the patients for all patients on this study has been evaluated in an ongoing fashion. Since the study was largely
on hold during COVID (2020 and 2021), patients dosed in 2019 and 2020 have been followed for a longer time. Therefore survival data has
been evaluated for patients dosed before 2022 and since 2022. This should be considered in the context of clinical studies in patients
with metastatic breast cancer who have failed at least 2 prior regimens1.
The
Bria-IMTTM regimen, using the Phase 3 formulation, with a CPI has shown a median overall survival (OS) of 13.4 months for all patients
by the Kaplan Meier method, as shown in the Figure below. For patients treated since 2022, the median OS was estimated at 16.5 months.
Figure
B. Overall Survival of Patients with Metastatic Breast Cancer treated with the Bria-IMTTM regimen using the Phase 3 formulation
with a CPI.
Update of data presented at the 2024 San Antonio
Breast Cancer Symposium
ClinicalTrials.gov ID NCT03328026
1 Cortes J, et al. Annals of Oncology 2018;
Kazmi S, et al. Breast Cancer Res Treat. 2020 Aug 17; O’Shaughnessy J et al. Breast Cancer Res Treat. 2022; Tripathy D, et al. JAMA
Oncol. 2022
In
its Phase 2 study of Bria-IMT plus check point inhibitors (CPI), outperformed ADC drugs in hormone receptor positive (HR+) metastatic
breast cancer (MBC) patients. In BriaCell’s Phase 2 clinical study in late-stage MBC, 25 of 37 patients treated with the ongoing
pivotal Phase 3 Bria-IMT formulation were identified as having HR+ breast cancer. As shown in Table 1, the survival data of these 25
patients (17.3 months) exceeds those of the current ADC standard of care TRODELVY® (14.4 months) and those treated with
chemotherapy (11.3 months). The survival data for the Bria-IMT regimen + immune check point inhibitor in the triple negative breast cancer
(TNBC), characterized by the absence of estrogen (ER), progesterone (PR) and human epidermal growth factor (HER2) receptors, was also
better than TRODELVY® and markedly higher than those of chemotherapy.
Table
1: Comparable Analysis of median overall survival (estimated using the Kaplan-Meier method) for the BriaCell Phase 2 study of BriaCell’s
Bria-IMTTM plus CPI versus other drugs in MBC patient subsets.
Bria-IMTTM plus CPI* HR+ 6 17.3
TRODELVY®1 (sacituzumab govitecan-hziy) HR+ 4 14.4
Single agent chemotherapy HR+ 4 11.3
Bria-IMTTM plus CPI* TNBC 6 13.9
TRODELVY®1 (sacituzumab govitecan-hziy) TNBC 3** 11.8
Single agent chemotherapy TNBC 3** 6.9
*
Patients treated with the Phase 3 formulation
**
Number of prior chemotherapy-containing regimens
HR+:
hormone receptor-positive
TNBC:
Triple-negative breast cancer (lacks the estrogen receptor, progesterone receptor, and lacks or has low levels of human epidermal growth
factor receptor 2 (HER2))
BriaCell
has also analyzed the data from the Phase 1/2 study in patients who have failed prior ADC therapy. The results are shown here in comparison
to studies of comparable patients in the literature.
During
the course of this study, BriaCell has had several remarkable responders. The data for 2 of them is shown here.
Patient
06-005 had failed 13 prior regimens. She had baseline breast cancer metastases behind the left eye (orbit), in the outside lining of
the brain (dura mater) and the adrenal gland. Following 6 months of treatment the orbital tumor completely resolved and the others improved.
She was judged an overall partial responder.
Imaging
for Patient 06-005
Patient
11-018 had failed 8 prior regimens including the ADC Enhertu®. She had a right orbital tumor causing extensive proptosis (eye bulging)
& brain (temporal lobe) metastasis. There was a complete resolution of the temporal lobe metastasis and a marked reduction in the
orbital lesion with resolution of proptosis and improvement in eye pain. She has been on the study for >21 months.
Imaging
for Patient 11-018
Overall
BriaCell has treated 7 patients with intracranial (inside the skull) metastatic disease who had measurable disease. The intracranial
overall response rate (iORR) is 71%, which compares very favorably with the data for comparable patients in the literature. Some of this
data is shown here.
Intracranial
responses for patients treated with Bria-IMTTM
Note
that the iORR in comparable patients typically <20%. (see Niwinska A, Pogoda K, Jagiello-Gruszfeld A, Duchnowska R. Intracranial Response
Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy. Cancers (Basel). 2022 Feb 15;14(4):965 and Tripathy D, Tolaney
SM, Seidman AD, Anders CK, Ibrahim N, Rugo HS, Twelves C, Diéras V, Müller V, Du Y, Currie SL, Hoch U, Tagliaferri M, Hannah
AL, Cortés J; ATTAIN Investigators. Treatment With Etirinotecan Pegol for Patients With Metastatic Breast Cancer and Brain Metastases:
Final Results From the Phase III ATTAIN Randomized Clinical Trial. JAMA Oncol. 2022 Jul 1;8(7):1047-1052.)
Phase
3 Clinical Trial of Bria-IMTTM in Combination with Immune Check Point Inhibitors in Advanced Metastatic Breast Cancer compared with
Treatment of Physician’s Choice (Bria-ABC)
BriaCell
has been conducting a Phase 3 clinical trial (Bria-ABC) of Bria-IMTTM, in combination with immune checkpoint inhibitor retifanlimab,
an immune checkpoint inhibitor manufactured by Incyte. The combination study is listed in ClinicalTrials.gov as NCT06072612 under
FDA-approved BB-IND 10312. The primary endpoint is overall survival.
Bria-IMTTM is currently under
Fast Track Designation by the FDA intended to accelerate the review process of novel treatments that address unmet medical needs. Positive
completion of the pivotal study, following review by the FDA, could lead to full approval of the Bria-IMTTM immune checkpoint inhibitor
combination in advanced metastatic breast cancer.
The FDA has agreed that improvement
in overall survival in the Bria-IMTTM combination arm as compared to the physician’s choice of treatment arm will be the primary
endpoint of the study. The study is expected to enroll 177 patients in the Bria-IMTTM combination therapy arm and 177 patients in
the treatment of physician’s choice arm. To gather additional information on the Bria-IMTTM regimen alone, 50 patients are
expected to be enrolled in this regimen and will be eligible for combination therapy following their initial post treatment evaluation.
These patients will not be included in the primary analysis. The study will have an interim evaluation for efficacy which could result
in early completion of the study. We expect frequent and responsive FDA communication under our Fast Track status during our pivotal Phase
3 study. The overall design of the study is shown here.
The
first interim analysis will be at 144 events (mortalities). If the hazard ratio (HR) is ≤ 0.6, BriaCell will submit a Biologics Licensing
Application (BLA). If the HR is > 0.6, the study will continue to completion with HR target of 0.7. Either of these could result in
full approval of the Bria-IMTTM CPI combination regimen in advanced metastatic breast cancer.
The
successful completion of the pivotal study would allow BriaCell to subsequently submit a Biologics License Application and accelerate
the path to commercialization. The Phase 3 study has multiple locations throughout the USA as noted in the ClinicalTrials.gov listing
https://clinicaltrials.gov/study/NCT06072612.
On
December 2, 2024, March 20, 2025, and June 24, 2025, BriaCell announced that the Data Safety Monitoring Board (DSMB), an independent
group of experts who review and monitor safety data of a clinical study to determine if a study should continue, be modified, or be halted
early, had completed its first, second, and third reviews of safety events in patients enrolled in BriaCell’s pivotal randomized
Phase 3 study of Bria-IMTTM plus an immune checkpoint inhibitor (CPI) combination regimen (ClinicalTrials.gov NCT06072612)
in metastatic breast cancer. The Data Safety Monitoring Board (DSMB) stated no safety concerns, and recommended continuation of BriaCell’s
pivotal Phase 3 study of Bria-IMTTM plus a CPI in MBC.
On
April 22, 2025, the Company announced its ongoing pivotal Phase 3 clinical study (listed on ClinicalTrials.gov as NCT06072612)
has consented over 100 and has enrolled over 75 patients. BriaCell anticipates reporting top line data as early as H1-2026.
On
April 30, 2025, BriaCell reported “Late-Breaker” Phase 3 data at AACR 2025. Positive tolerability profile and potential response
biomarkers were identified. Phase 3 clinical data showed potential predictive biomarkers for treatment response, first identified in
the Phase 2 study. Biomarkers could be utilized to predict and provide better patient outcomes, including response rates and survival
benefits. Positive delayed-type hypersensitivity (DTH) (p = 0.001) and a favorable Neutrophil-to-Lymphocyte Ratio (NLR) (p = 0.02) were
linked to longer progression-free survival (PFS) in Phase 3 patients. Presence of Circulating Tumor Cells (CTC) after patients’
initial Phase 3 treatment supports their role as negative prognostic marker (p = 0.04). The Bria-IMT Phase 3 regimen was well-tolerated
with a preferred tolerability profile.
Collaboration with Prevail InfoWorks, Inc.
In
collaboration with Prevail InfoWorks, Inc. (“InfoWorks”), a Philadelphia, PA based contract research organization, BriaCell
continues to recruit additional sites to speed up the patient recruitment process. BriaCell has signed a Master Service and Technology
Agreement (“MSTA”) agreement with InfoWorks to provide clinical services and technologies for BriaCell’s upcoming pivotal
study in advanced metastatic breast cancer. Services include clinical site coordination, project management, clinical monitoring and
pharmacovigilance (safety management) services, and the use of InfoWork’s integrated real-time data analytics platform, The Single
Interface ®, for clinical support and real-time data analysis.
In
May 2023, Prevail Partners, LLC (“Prevail Partners”), an investment fund and affiliate of InfoWorks invested $4 million
in the company at a 20% premium to the trailing thirty (30) trading day volume-weighted average price of the common shares of the
Company on the Nasdaq Stock Exchange.
Manufacturing
We
do not own or operate manufacturing facilities for the production of our product candidates, nor do we have plans to develop our own
manufacturing operations in the foreseeable future. We currently depend on third-party contract manufacturers for all of our required
raw materials, active pharmaceutical ingredients, and finished product candidate for our clinical trials. We currently employ internal
resources and third-party consultants to manage our manufacturing contractors.
Bria-IMTTM
is currently manufactured under current Good Manufacturing Practices (“cGMP”) pursuant to agreements with UC Davis and with
FujiFilm Diosynth Biotechnology (“Fuji”), which is located in Thousand Oaks, California.
On
June 11, 2015, the Company entered into an Agreement for Services with The Regents of the University of California, acting for and on
behalf of UC Davis, pursuant to which UC Davis manufactures Bria-IMTTM (previously known as BriaVax) at its GMP facility. The Company
pays UC Davis certain hourly rates depending on the specific services provided by UC Davis in connection with its manufacturing of Bria-IMTTM.
On
July 5, 2022, BriaCell announced that it had entered into a manufacturing service agreement with Waisman Biomanufacturing at the University
of Wisconsin-Madison (“Waisman”), to manufacture Bria-ProsTM, BriaCell’s off-the-shelf personalized immunotherapy
for prostate cancer, for anticipated use in clinical studies. Waisman is a leading contract manufacturing organization with experience
in the manufacturing of cellular therapies for clinical trials. Under the terms of the agreement, Waisman will be responsible for GMP
manufacturing of Bria-ProsTM for anticipated use in clinical studies. Waisman’s expert team will be working closely with BriaCell’s
scientific and product development teams to ensure timely production of Bria-ProsTM in compliance with applicable regulatory requirements
by the FDA.
Pursuant to the Company’s
master services agreement with Fuji, dated May 29, 2023, to manufacture Bria-IMTTM, for anticipated use in clinical studies including
the Phase 3 study. Fuji is a leading contract manufacturing organization with experience in the manufacturing of cellular therapies for
clinical trials. Under the terms of the agreement, Fuji will be responsible for GMP manufacturing of Bria-IMTTM for anticipated
use in clinical studies. Fuji’s expert team will be working closely with BriaCell’s scientific and product development teams
to ensure timely production of Bria-IMTTM in compliance with applicable regulatory requirements by the FDA.
Production and Marketing Plan
Bria-IMTTM cells grow in
simple tissue culture media and are irradiated prior to inoculation. Bria-IMTTM manufacturing will be performed by Contract Manufacturing
Organizations. We have been working with FUJIFILM Diosynth Biotechnologies (“Fuji”) and the University of California, Davis
Health System (“UC Davis”) GMP facility, who have developed a frozen formulation where the cells are grown, harvested and
irradiated, followed by cryopreservation in a viable state. The cells are stockpiled and shipped directly to clinical sites for inoculation.
Each lot of Bria-IMTTM is tested for potency (i.e. GM-CSF production), identity (i.e. HER2+ and ER/PR-) and adventitious agents to
rule out contamination with infectious agents. To date, there have been no issues with these tests. Additional manufacturing facilities
have been evaluated and may be enlisted as demand grows.
Marketing will target oncologists
who are well-versed in the use of immunotherapy and especially breast cancer treatment centers. The initial target will be patients with
metastatic or recurrent breast cancer who have failed at least two prior treatment regimens. We plan to develop the clinical data for
Bria-IMTTM and to use this information to reach out to oncologists seeking additional therapeutic options for their patients. We
will include in this effort a physician education campaign targeting the oncologists most likely to treat metastatic breast cancer. As
these physicians become more aware of the data regarding Bria-IMTTM in breast cancer, we will make sure they also understand how
best to use Bria-IMTTM in combination with other therapies that have complementary synergistic mechanisms of action. This will also
come from the clinical studies described above focusing on combination therapy. Partnering with other pharmaceutical companies in order
to market a number of drugs is also an option that we intend to pursue. Our eventual goal is to reach all oncologists who treat late stage
breast cancer, either by direct outreach or by partnering with another company that has an established presence in the oncology space.
Bria-OTSTM
Bria-OTSTM: Personalized Off-the-Shelf Immunotherapy
BriaCell
Phase 1/2 Study of Bria-OTSTM, also known as Bria-BRESTM, in metastatic breast cancer is open. The Phase 1/2 clinical study
is listed on ClinicalTrials.gov as NCT06471673.