Core Viewpoint - Annamycin, a next-generation anthracycline, shows no evidence of cardiotoxicity in 90 subjects across five clinical trials, indicating its potential as a safer treatment option for various cancers [1][3]. Group 1: Clinical Trial Results - An independent assessment confirmed the absence of cardiotoxicity in subjects treated with Annamycin, with data reviewed from 90 subjects [1]. - The trials involved treating acute myeloid leukemia (AML) and soft tissue sarcoma (STS) with Annamycin as a monotherapy and in combination with cytarabine [1]. - Notably, 65 out of 90 subjects received doses exceeding the FDA's lifetime maximum of 550 mg/m², with one subject receiving over 6500 mg/m² [3]. Group 2: Safety and Efficacy Data - The assessment included data from serial 12-lead ECGs, echocardiography, and cardiac biomarker measurements, which are critical for evaluating potential heart damage [2]. - Annamycin is designed to avoid multidrug resistance mechanisms and lacks the cardiotoxicity associated with current anthracyclines [4]. Group 3: Future Development and Market Potential - The company has initiated the MIRACLE trial, a pivotal Phase 3 study evaluating Annamycin in combination with cytarabine for relapsed or refractory AML [5][6]. - The company believes that Annamycin could become the first non-cardiotoxic anthracycline, addressing a significant unmet medical need in cancer treatment [3]. - The potential market opportunity for Annamycin is substantial, given the high incidence of cardiotoxicity in existing cancer treatments [3].

Core Insights - Moleculin Biotech, Inc. is advancing its drug candidates Annamycin and WP1066, targeting hard-to-treat tumors and viruses, with significant milestones expected in 2026 [2][3][11] Annamycin Development - Annamycin is set for pivotal Phase 2B/3 MIRACLE trial data readouts in Q1 2026, focusing on second line acute myeloid leukemia (AML) and initiating a trial for pancreatic cancer [3][4] - The MIRACLE trial has expanded to nine countries, with over 46 sites selected and 20 contracted, aiming to treat 45 subjects in Part A by Q1 2026 [3][4] - Annamycin is anticipated to be the first non-cardiotoxic anthracycline, addressing a significant market opportunity as current treatments often lead to heart damage [3][4] Expected Milestones for Annamycin - Q1 2026: Update on non-cardiotoxicity review and unblinding of data for the first 45 subjects [4] - 1H 2026: Recruitment of the 90th subject for the MIRACLE trial [4] - 2027: Begin recruitment for third line AML subjects and pediatric AML clinical study [4] WP1066 Development - WP1066 is designed to stimulate immune response against tumors by inhibiting regulatory T cells and oncogenic transcription factors [5][14] - Ongoing Phase 2 trial for WP1066 in combination with radiation for glioblastoma (GBM) is being conducted at Northwestern University [6][8] - Emory University is conducting a Phase 1 trial with positive results, leading to plans for a follow-on trial [7][8] Expected Milestones for WP1066 - Q1 2026: Continuation of Phase 2 GBM trial at Northwestern [11] - 2H 2026: Initiation of Phase 2 pediatric trial for brain tumors at Emory [11] - 2H 2026: Preclinical data on WP1066 intravenous formulation [11]