Nadunolimab will be investigated in myelodysplastic syndrome and relapsed myeloid leukaemia by MD Anderson (n=40). The main endpoint will be safety, as a single-agent and in combination with other therapies; efficacy and biomarker endpoints are included as secondary endpoints. The costs for Cantargia should be moderate. The disadvantage of the setup is the lack of control by Cantargia and that speed may not be a priority. The US Department of Defense funds the trial with USD1.1m. AML is often caused by exposure to radiation or chemicals, which likely explains the interest.

Nadunolimab has demonstrated promise in leukaemia in preclinical experiments, but Cantargia chose to go ahead with solid cancers as the market potential is much bigger. We believe nadunolimab could work just as well (or even better) in blood-based cancers.  

According to Datamonitor Healthcare, the AML market is worth around USD1.5bn today and is expected to grow to USD3bn by 2032 (in the USD, Japan and EU5). There were around 160,000 incident cases worldwide in 2022.

We will update our sum-of-the-parts valuation with AML and return with a comment later. This will likely have a minor impact on the base case.