Company Overview - ESSA Pharma is focused on developing novel therapies for prostate and other androgen-driven cancers[7] - The company's lead candidate, EPI-7386, is a first-in-class oral, small molecule androgen receptor N-terminal domain inhibitor ("Aniten")[9, 28] - As of March 31, 2023, ESSA had $157 million in cash and short-term deposits, providing a runway through 2025[9, 69] EPI-7386 Monotherapy Development - Phase 1a study showed EPI-7386 was safe and well-tolerated, with tumor volume decreases observed in some patients[38] - ctDNA declines were observed in patients with AR mutations, amplifications, and truncations, suggesting activity against these tumors[38] - Phase 1b expansion study is underway to verify the recommended Phase 2 dose and gain further insight into EPI-7386's biological activity[40, 41] EPI-7386 Combination Therapy Development - ESSA is collaborating with multiple companies to evaluate EPI-7386 in combination with second-generation antiandrogens like enzalutamide, apalutamide, and darolutamide[49] - Initial data from the Phase 1/2 EPI-7386 + enzalutamide combination study showed rapid, deep, and durable PSA reductions[58] - In the combination study, 5 out of 6 patients achieved a PSA90, and 4 out of 6 patients achieved a PSA90 in 90 days and ultimately achieved a PSA < 02 ng/mL[58] Market and Opportunity - Prostate cancer is the 2nd most common cause of male cancer deaths, with an estimated 268,000 new cases and 34,500 deaths in 2022 in America[19] - Global sales of leading antiandrogens generated over $86 billion in 2021[19]

Core Insights - The U.S. FDA has approved darolutamide in combination with androgen deprivation therapy (ADT) for patients with metastatic castration-sensitive prostate cancer (mCSPC), marking the third indication for this drug [2][9] - The approval is based on the Phase III ARANOTE trial, which demonstrated a 46% reduction in the risk of radiological progression or death compared to placebo plus ADT [2][10] - Darolutamide is already approved in over 85 markets globally for various indications related to prostate cancer, including mHSPC and non-metastatic castration-resistant prostate cancer (nmCRPC) [5][6] Company Overview - Darolutamide, marketed as Nubeqa®, achieved blockbuster status with annual sales of EUR 1.52 billion reported by Bayer for the full year of 2024 [6] - The drug is developed jointly by Orion and Bayer, indicating a strong collaboration in the oncology sector [6][11] - Orion Corporation has a robust clinical development program for darolutamide, exploring its efficacy across various stages of prostate cancer [13] Industry Context - Prostate cancer is the second most common cancer in men, with an estimated 1.5 million diagnoses and approximately 397,000 deaths worldwide in 2022 [4] - The incidence of prostate cancer is projected to rise to 2.9 million by 2040, highlighting the growing need for effective treatment options [4] - The ARANOTE trial involved 669 patients and assessed the efficacy and safety of darolutamide plus ADT, reinforcing the drug's established safety profile [7][8]