Blueprint
UNITED
STATES
SECURITIES
AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM
8-K
CURRENT
REPORT
Pursuant to Section
13 or 15(d) of the
Securities Exchange
Act of 1934
Date of Report
(date of earliest event reported): December 16, 2016
CEL-SCI
CORPORATION
(Exact name of
Registrant as specified in its charter)
Colorado
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01-11889
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84-0916344
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(State or other
jurisdiction
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(Commission File
No.)
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(IRS
Employer
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of
incorporation)
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Identification
No.)
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8229 Boone
Boulevard, Suite 802
Vienna,
Virginia 22182
(Address of
principal executive offices, including Zip Code)
Registrant’s
telephone number, including area
code: (703) 506-9460
N/A
(Former name or
former address if changed since last report)
Check the
appropriate box below if the Form 8-K filing is intended to
simultaneously satisfy the filing obligations of the registrant
under any of the following provisions:
☐
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Written
communications pursuant to Rule 425 under the Securities Act (17CFR
230.425)
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☐
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Soliciting material
pursuant to Rule 14a-12 under the Exchange Act (17 CFR
240.14a-12)
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☐
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Pre-commencement
communications pursuant to Rule 14d-2(b) under the Exchange Act (17
CFR 240.14d-2(b)
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☐
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Pre-commencement
communications pursuant to Rule 13e-4(c) under the Exchange Act (17
CFR 240.13e-14c))
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Item
8.01
Other Events
In
August 2016, we announced that the currently available data from
the Phase 3 clinical study reflected that the accumulation of
deaths in the study was lower than that which was anticipated based
on reported literature at the Phase 3 study’s inception. If
the number of deaths continued to be accumulated at the current
rate, it had been determined that it would take longer than
originally planned to complete the study. To minimize this
eventuality, we decided it would be necessary to enroll up to 1,273
patients to have 1,146 evaluable patients. There were also other
changes in the protocol, such as the required number of deaths
(392) and a required overall survival of 6.5% in favor of the
Multikine comparator arm. With this increased patient enrollment,
we expected a corresponding increase in the number of deaths, and,
if this plan were implemented, the study could be completed in a
more timely manner. As required by law and in order to be able to
implement the plan, we submitted an amendment to the existing Phase
3 protocol for our head and neck cancer study to multiple
regulatory agencies in the countries abroad where the Phase 3 study
is being conducted as well as to the FDA to allow for this
expansion in patient enrollment.
On
September 26, 2016, we received verbal notice from FDA that the
Phase 3 clinical trial in advanced primary head and neck cancer has
been placed on clinical hold. At such time, enrollment in the Phase
3 study was 926 patients.
On
October 21, 2016, we received a partial clinical hold letter from
FDA and, on November 18, 2016, we submitted a response to
FDA’s partial clinical hold letter.
In its
partial clinical hold letter, FDA identified the following specific
deficiencies: a) FDA stated that there is an unreasonable and
significant risk of illness or injury to human subjects and cited
among other things the absence of prompt reports by us to the FDA
of IDMC recommendations to close the study entirely (made in spring
of 2014) or at least to close it to accrual of new patients (made
in spring of 2016); b) FDA stated that the investigator brochure is
misleading, erroneous, and materially incomplete; and c) FDA stated
that the plan or protocol is deficient in design to meet its stated
objectives. In its partial clinical hold letter, FDA also
identified the information needed to resolve these deficiencies. In
addition, FDA’s partial clinical hold letter included two
requests relating to quality information regarding our
investigational final drug product, which were noted by FDA as
non-hold issues. We believe that our response submitted to FDA on
November 18, 2016, addressed each of the deficiencies identified by
FDA including detailing our belief that, under the applicable FDA
guidance, there was no obligation to report the cited IDMC
recommendations to the FDA at the time they were issued, and it
also requested a face-to-face meeting with FDA, and outlined our
commitment to diligently work with FDA in an effort to have the
partial clinical hold for the study lifted.
On
December 8, 2016, FDA advised us that the Agency was denying our
request for a meeting at that time because FDA’s review of
our November 18, 2016 response was ongoing. We also were advised
that we would be receiving a letter addressing our November 18,
2016 response by December 18, 2016.
On
December 16, 2016, FDA issued an Incomplete Response To Hold letter
to us indicating that based on the Agency’s preliminary
review of our November 18, 2016 submission, FDA has determined that
it is not a complete response to all of the issues listed in
FDA’s clinical hold letter. FDA identified the following
specific deficiencies: a) FDA stated that we did not provide the
information identified as necessary to address FDA’s
statement that patients enrolled in the study are exposed to
unreasonable and significant risk of illness or injury to human
subjects; b) FDA stated that we did not provide the information
identified as necessary to address FDA’s statement that
continued enrollment of patients in the study exposes the patients
to unreasonable risks and FDA furthermore stated that the study is
unlikely to demonstrate that the addition of our investigational
drug Multikine to the standard of care is superior to standard of
care and thus should be terminated for futility; (c) FDA stated
that we did not provide the information identified as necessary to
address FDA’s statement that the investigator brochure is
misleading, erroneous, and materially incomplete; (d) FDA stated
that we did not provide the information identified as necessary to
address FDA’s statement that the proposed revised clinical
protocol is inadequate in design to meet its stated objectives and
FDA furthermore stated that this deficiency cannot be addressed by
further revisions to the protocol. In its incomplete response to
hold letter, FDA also identified the steps we must take to address
these deficiencies. In addition, FDA’s incomplete response to
hold letter noted with respect to FDA’s two requests relating
to quality information regarding our investigational final drug
product, which we had been instructed by FDA to submit separately
from the response to the partial clinical hold, which again were
noted by FDA as non-hold issues, that our November 18, 2016,
submission had not included the information addressing these two
requests.
We are
reviewing all of our options in response to FDA’s incomplete
response to hold letter. As an initial matter, the Company plans to
send FDA a request accompanied by the required complete meeting
package for an in person meeting with the Agency to discuss all
matters relating to the partial clinical hold, because, among other
things, we believe that there may be some misunderstanding
regarding our conduct of the Phase 3 clinical trial as well as some
misinterpretation of some of the information contained in the
response we submitted on November 18, 2016 to the partial clinical
hold letter. Pending the scheduling of that FDA meeting and
resolution of the partial clinical hold issues, we expect to
prepare a comprehensive submission to FDA detailing our belief,
accompanied by what we believe to be appropriate supporting data,
records, and information reflecting that we have taken the steps
necessary to address the specific deficiencies identified by FDA,
including: a) demonstrating that patients enrolled in the study are
not exposed to unreasonable and significant risk of illness or
injury; b) demonstrating that continued enrollment of patients in
the study does not expose the patients to unreasonable risks and
that the study should not be terminated for futility; (c)
demonstrating that a supplemented investigator brochure is not
misleading, erroneous, or materially incomplete; (d) demonstrating
that the proposed revised clinical protocol is adequate in design
to meet its stated objectives and that this deficiency can be
addressed by the proposed revisions to the protocol.
Subject
to the partial clinical hold, we estimate that the total remaining
cash cost of the Phase 3 clinical trial, excluding any costs that
will be paid by our partners, would be approximately $12.1 million.
Should FDA lift the partial clinical hold and allow the amended
protocol submitted to them to proceed, which requires an enrollment
of up to 1,273 subjects, the remaining cost of the Phase 3 clinical
trial will be higher than currently estimated. This is in addition
to the approximately $34.5 million that CEL-SCI already had spent
on the trial as of September 30, 2016. This number may be affected
by the rate of any future patient enrollment, rate of death
accumulation in the study, foreign currency exchange rates, and
many other factors, some of which cannot be foreseen today. It is
therefore possible that the cost of the Phase 3 clinical trial will
be higher than currently estimated. If FDA will only lift the
partial clinical hold with termination of the current study and
initiation of a new clinical trial, any such new trial can only be
initiated if permitted by FDA and as appropriate other regulatory
authorities around the world after the requisite submissions are
made to them, and the additional duration and costs of the Phase 3
clinical program would likely exceed those already incurred in
connection with the Phase 3 clinical trial. If there is a need to
conduct an additional Phase 3 pivotal study, any such requirement
would have significant and severe material consequences for us and
could impact our ability to continue as a going
concern.
We will
not be able to enroll any additional patients in the Phase 3 study
unless FDA lifts the partial clinical hold. In addition, in the
spring of 2016, the IDMC recommended to us that new patient
enrollment should stop in the Phase 3 study, but patients already
on study should continue to be treated and followed. Although we
had expected to work through the concerns raised by the IDMC while
we worked through the partial clinical hold with FDA, the IDMC
informed us on December 13, 2016, that because the study is on
partial clinical hold imposed by FDA, the IDMC has no formal
recommendation regarding continuation of the trial at this time. If
the partial clinical hold is not lifted by FDA or if it is
determined by FDA that the study has been compromised, the study
may be terminated, or if the partial clinical hold is lifted by FDA
but the IDMC continues to recommend that enrollment not be allowed
to continue, the study may be terminated by us.
If the
partial clinical hold is not lifted, the Phase 3 study will not be
able to be completed to its prespecified endpoints in a timely
manner, if at all, and, if the Phase 3 study cannot be completed to
its prespecified endpoints, the study would not be able to be used
as the pivotal study supporting a marketing application in the
United States, and at least one entirely new Phase 3 pivotal study
would need to be conducted to provide the pivotal study supporting
a marketing application in the United States. Even if the partial
clinical hold is lifted, if it is not lifted in a timely fashion,
the nature and duration of the partial clinical hold could
irreparably harm the data from the Phase 3 study such that it may
no longer be able to be used as the pivotal study supporting a
marketing application in the United States. Even if the partial
clinical hold is lifted in a timely fashion, it remains possible
that the regulatory authorities could determine that the Phase 3
study is not sufficient to be used as a single pivotal study
supporting a marketing application in the United
States.
SIGNATURES
Pursuant to the
requirements of the Securities Exchange Act of 1934, the registrant
has duly caused this report to be signed on its behalf by the
undersigned hereunto duly authorized.
Date: December 22,
2016
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CEL-SCI
CORPORATION
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By:
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/s/
Patricia B.
Prichep
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Patricia B.
Prichep
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Senior Vice
President of Operations
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