Aptose Biosciences(APTO) - 2024 Q4 - Annual Report

Clinical Trials and Drug Development - Aptose is conducting a Phase 1/2 clinical trial for Tuspetinib (TUS) in combination with Venetoclax (VEN) and a hypomethylating agent (HMA) for newly diagnosed acute myeloid leukemia (AML) patients[258]. - In a completed trial, Tuspetinib as a single agent achieved a complete response (CR) rate of 36% among all patients and 50% among those with mutated FLT3[259]. - The TUS+VEN doublet combination maintained a favorable safety profile with no new safety signals and significant clinical responses in heavily pretreated relapsed/refractory AML patients[260]. - The TUS+VEN+HMA triplet therapy is expected to establish a new standard of care for newly diagnosed AML patients, particularly those who are VEN-naïve and FLT3i-naïve[261]. - The myeloMATCH precision medicine trials, launched in May 2024, aim to expedite tailored drug combination treatments for newly diagnosed AML and myelodysplastic syndromes (MDS) patients[266]. - The APTIVATE clinical trial demonstrated that TUS+VEN is active across diverse R/R AML populations, including those with adverse genetic mutations[272]. - At the 66th Annual ASH Meeting, Aptose presented findings supporting the advancement of TUS as a third agent in combination therapies for newly diagnosed AML[269]. - Aptose plans to initiate the TUS+VEN+AZA triplet study with a starting dose of 40 mg of Tuspetinib, escalating to 80 mg based on safety and activity[268]. - The ongoing APTIVATE Phase 1/2 trial has treated over 170 patients with TUS alone or in combination with VEN, showing a favorable safety profile and significant response rates[277]. - The APTIVATE trial aims to identify patient populations sensitive to TUS monotherapy and the TUS+VEN doublet, with brisk enrollment and early signs of antileukemic activity reported[287]. - Tuspetinib targets known VEN resistance mechanisms, potentially re-sensitizing prior-VEN failure patients to treatment[282][283]. Financial Performance and Compliance - Nasdaq notified the company of a deficiency regarding a private placement that violated shareholder approval rules[301]. - The company received a deficiency letter for not meeting the minimum bid price requirement, with a deadline to regain compliance by January 13, 2025[303]. - A reverse stock split of 1-for-30 was approved to regain compliance with Nasdaq listing requirements[305]. - As of December 31, 2024, the Company reported negative shareholders' equity of $4.5 million, compared to negative shareholders' equity of$2.9 million as of December 31, 2023[313]. - The Company has not regained compliance with Nasdaq's minimum equity requirement of $2.5 million as of March 28, 2025[308]. - The Company had cash, cash equivalents, and restricted cash of$6.7 million as of December 31, 2024, down from $9.3 million as of December 31, 2023[311]. - The Company has sufficient liquidity to support operations until April 2025, relying on equity financing and strategic partner payments[309]. - The Company raised approximately$9.7 million from a public offering on January 30, 2024, with cash transaction costs of $1.6 million[323]. - The Company completed a public offering on November 25, 2024, raising gross proceeds of$8.0 million before deducting placement agent fees and other expenses[332]. - The Company plans to raise additional funds through equity financing or other financing activities to meet capital requirements[313]. - The Company submitted a compliance plan to Nasdaq on May 17, 2024, and received an extension until September 30, 2024, to regain compliance[307]. - The company filed a short form base shelf prospectus allowing the distribution of up to $200 million of Common Shares, warrants, or units, effective until October 7, 2025[333]. Research and Development Expenses - Cash used in operating activities decreased from$44.6 million in 2023 to $36.0 million in 2024, a reduction of$8.6 million[336]. - The net loss for the year ended December 31, 2024, was $25.4 million, a decrease of approximately$25.8 million compared to a net loss of $51.2 million in 2023[346]. - Research and development expenses decreased by$21.7 million to $15.1 million in 2024 from$36.8 million in 2023, primarily due to reduced program costs for tuspetinib[350]. - General and administrative expenses decreased to $11.2 million in 2024 from$15.6 million in 2023, a reduction of $4.4 million[352]. - The company expects research and development expenses to be lower in 2025 than in 2024, contingent on successful financing activities[347]. Drug Formulation and Market Potential - The G3 formulation of Luxeptinib (LUX) achieved approximately 10-fold better absorption compared to the original formulation, but development has been paused in favor of prioritizing Tuspetinib[262]. - The G3 formulation of luxeptinib demonstrated an 18-fold improvement in plasma steady-state exposure compared to the original G1 formulation[295]. - Continuous dosing of the 50 mg G3 formulation showed plasma exposure levels equivalent to the 900 mg G1 formulation[296]. - The G3 formulation achieved 2-3 µM steady-state plasma levels at 200 mg BID, with approximately 10-fold better absorption than G1[300]. - The potential market for luxeptinib in R/R CLL patients with FLT3 mutations is estimated at$200 million by 2039[291].