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Clinical Programs: FOG-001

Disease Need

Mutations in the Wnt/β-catenin pathway are responsible for millions of cases of cancer globally every year, but to date there have been no successful therapies targeting this pathway. These mutations are particularly prevalent in colorectal cancer: An estimated 80-90% of cases of colorectal cancer are caused by mutations in the Wnt/β-catenin pathway.[1]

Colorectal cancer is the second-highest cause of global cancer deaths, according to the World Health Organization, with a toll of nearly 1 million deaths annually.[2] It is becoming increasingly common in younger people, with approximately 10% of all new diagnoses of colorectal cancer occurring in people younger than 50.[3]

Mutations in the Wnt/β-catenin pathway are present in the vast majority of  colorectal cancers. Unfortunately, there are no treatments that address this underlying disease biology today.

Metastatic colorectal cancer is an especially devastating malignancy that has seen few meaningful treatment advances in recent decades. There is a huge unmet need for life-extending treatment in this setting. Patients with metastatic disease face a 5-year survival rate of 15.6%.[4]

The life expectancy and prognosis for colorectal cancer patients worsens as they progress through lines of treatment, with those who receive third or later line treatment for metastatic disease facing a dismal outcome. Available agents provide <2% response rates, fewer than 4 months of progression-free survival, and less than 8 months of survival.

Activating mutations in the Wnt/β-catenin pathway are present in a host of other tumor types, including:

  • Desmoid tumors[5]
  • Adamantinomatous craniopharyngioma[6]
  • Endometrial and ovarian (endometrioid) cancer[7]
  • Adrenocortical carcinoma[8]
  • Hepatocellular carcinoma[9]
  • Metastatic castrate-resistant prostate cancer[10]
  • Gastric cancer[11]
  • Non-small cell lung cancer (NSCLC)[12]
  • Pancreatic cancer[13]
  1. Sebio, Expert Opinion on Therapeutic Targets 2014 editorial
  2. World Health Organization, Colorectal cancer fact sheet 2023
  3. Sarkar, Cancers (Basel) 2023 review
  4. Bekaii-Saab, Am J Manag Care 2024
  5. Timbergen, Front Oncol 2019 Review, Tejpar, Oncoene, 1999 b-cat/TCF complex dominant in DT (more TCF3 than TCF4), Braggio, PLoSOne 2022 preclinical BC2059 DT models, Cranmer, ASCO 2022, ph1 abstract 11523; NCT03459469; Soldi, J Pharm Exp Ther 2021
  6. Steward, Wnt Signaling in NSCLC. JNCI 2013 review
  7. McConechy, Mod Pathol 2014; Liu Y, J Natl Cancer Inst 2014
  8. Ghosh et al, Nat Rev Cancer 2023; Doghman, JCEM 2008; Gaujoux, PLoSOne 2013
  9. Holsken et.al, J Pharmaco Neuropath Comm 2016 & Incidence rate 620/y, Momin et. al., Pituitary 2021
  10. cBio/SU2C; Ma, Cancer Res 2022; Velho, Eur Urol 2020; Broderick, ASCO GU 2023/PCPD2024; Robinson, Cell 2015
  11. Harding, Clin Cancer Research 2019; Krutsenko et. al, Cancers 2021 Review
  12. Koushyar 2020 review
  13. Makena, IJMS 2019; Dotan, CCR 2020; Aguilera, MCT 2022; Madan, JCI 2018; Jiang, PNAS 2013