Syros gets a "win" at last

Syros has been plugging away with its retinoic acid receptor alpha (RARα) agonist tamibarotene for years, and finally has something to celebrate today, with positive initial data from the Select-AML-1 trial. However, even when the group went public in 2016 tamibarotene was off-patent, its composition-of-matter patent having expired; little wonder Syros is worth just $93m, even after its stock climbed 57% today. Select-AML-1 has a target enrolment of 80 newly diagnosed, unfit AML patients with RARA gene overexpression, thought to account for 30% of AML. Patients are then randomised, on an open-label basis, to either tamibarotene, Velclexta and azacitidine, or a Venclexta/azacitidine doublet. Today’s results, in 19 evaluable patients, detailed a 100% CR/CRi rate among nine patients receiving the triplet; only seven of 10 patients on the doublet achieved this. Adding tamibarotene didn't appear to increase myelosuppressive side effects like neutropenia, with the caveat that patient numbers are small. But a 64% rate of constipation with the triplet will be something to watch when Syros reports more data next year. Results from the pivotal Select-MDS-1 study are also due in 2024.