Krystal Biotech Announces Positive Interim Clinical Update from KB407 Phase 1 CORAL-1 Study with Confirmation of Wild-Type CFTR Delivery to the Lungs of Patients with Cystic Fibrosis
Confirmed wild-type CFTR delivery and expression in conducting airway cells of patients with class I mutations
KB407 transduction confirmed in all six patients with successful bronchoscopies irrespective of modulator-status; percentage of conducting airway cells transduced in each patient ranged from 29.4% to 42.1%
Registrational repeat dosing CORAL-3 study design submitted to FDA in late December; anticipating enrollment in study to start in 1H 2026 following alignment with the FDA
Investor call to be held
“Molecular confirmation of delivery and expression of unmodified, wild-type CFTR protein in clinically relevant ciliated and secretory cells of the lungs of patients with CF is a tremendous breakthrough and a first for our field,” said
The Company will host an investor conference call and webcast today,
CORAL-1 Highest Dose Cohort Interim Results
KB407 is being evaluated in the Company’s CORAL-1 study, an open label, multi-center Phase 1 study in patients with CF that includes three dose escalation cohorts evaluating either one, two, or four daily administrations of 109 PFU of KB407 via inhalation. Additional details of the CORAL-1 study can be found at www.clinicaltrials.gov under NCT identifier NCT05504837.
Positive interim safety results from the first two dose escalation cohorts, referred to as Cohorts 1 and 2, were reported in 4Q 2024. Today’s update is focused on safety and molecular findings from patients dosed in the highest dose cohort of CORAL-1, Cohort 3.
As of the
KB407 transduction was confirmed in all Cohort 3 patients with successful bronchoscopies irrespective of modulator-status and genetic background, with broad airway distribution and transduction as assessed by CFTR or viral marker immunofluorescence, ranging from 29.4% to 42.1% across these six patients. Key molecular findings are summarized below:
Modulator Ineligible Patients (n = 4)
| Patient Number | 1 | 2 | 3 | 4 |
| CFTR Variants | 2184delA/W1282X Class I Patient |
R553X/M1V Class I Patient |
C1210-12T/1408A>G | R334W/R1162X |
| Baseline ppFEV1 | 64 | 45 | 45 | 69 |
| Total Number of Biopsies Suitable for Analysis | 7 | 5 | 5 | 6 |
| Protein Marker Assessed* | CFTR | CFTR | ||
| Percentage of Conducting Airway Cells Positive for CFTR or |
Overall: 42.1% Range: 33.1%-62.0% |
Overall: 29.4% Range: 24.6%-32.3% |
Overall: 36.5% Range: 29.1%-44.8% |
Overall: 33.8% Range: 29.0%-36.3% |
* Positive cell counts for patients 3 and 4 based on viral marker expression given potential for background endogenous CFTR
** Overall values are based on the combined cell counts across all analyzable biopsies from a given patient while range values reflect cell counts from individual biopsies; conducting airway cells defined as airway-exposed epithelial cells lining the bronchi of the lung
All biopsies suitable for analysis from the four modulator ineligible patients (combined n = 23 biopsies) were positive for CFTR or viral marker expression, indicative of widespread dissemination of KB407 throughout the conducting airways of the lung.
Modulator Eligible Patients (n = 2)
| Patient Number | 5 | 6 |
| CFTR Variants | F508del/F508del | F508del/F508del |
| Baseline ppFEV1 | 54 | 59 |
| Total Number of Biopsies Suitable for Analysis | 4 | 4 |
| Percentage of Conducting Airway Cells Positive for |
Overall: 36.8% Range: 28.3%-46.4% |
Overall: 31.4% Range: 27.3%-38.0% |
* Overall values are based on the combined cell counts across all analyzable biopsies from a given patient while range values reflect cell counts from individual biopsies; conducting airway cells defined as airway-exposed epithelial cells lining the bronchi of the lung
All biopsies suitable for analysis from the two modulator eligible patients (combined n = 8 biopsies) were positive for viral marker expression.
Consistent with the safety profile previously reported from Cohorts 1 and 2, inhaled KB407 continued to be well tolerated by patients treated with the highest dose in Cohort 3. All but one KB407-related adverse event were mild to moderate in severity and transient in nature. One serious adverse event (SAE) of asthma exacerbation was reported 24 hours after completion of the bronchoscopy. The SAE was deemed procedure related, and not related to KB407, by the independent data monitoring committee. The SAE resolved in 5 days.
“Today’s update has profound implications for Krystal and for the many CF patients unable to benefit from modulator therapy ,” said Suma Krishnan, President,
The Company submitted the CORAL-3 study design to the
About CF
CF is an inherited disease caused by genetic mutations that result in dysfunctional or absent CFTR protein. Lack of functional CFTR causes dehydrated mucus buildup in the lungs, pancreas, and other organs. This mucus buildup in the lungs leads to loss of lung function, and eventually, respiratory failure. According to the
About KB407
KB407 is a redosable gene therapy designed to deliver two copies of the full-length CFTR transgene to the lung via inhalation for the treatment of CF. By enabling expression of full-length, wild-type CFTR protein in the lung, treatment with KB407 has potential to restore CFTR-mediated ion transport, mucus clearance, and lung function in patients with CF regardless of their underlying genetic mutation. KB407 has been shown to successfully transduce patient-derived epithelial cells and deliver functional CFTR in 2D and 3D in vitro organotypic systems and, as demonstrated in the CORAL-1 Phase 1 study, is amendable to inhaled administration via nebulization, with successful lung delivery and broad airway distribution confirmed in multiple patients with cystic fibrosis.
About
Forward-Looking Statements
This press release contains “forward looking” statements within the meaning of the Private Securities Litigation Reform Act of 1995 based on the Company’s current expectations and beliefs regarding its product candidate, KB407 for the treatment of patients with cystic fibrosis. These forward-looking statements include, without limitation, statements relating to the potentially transformative potential of KB407 as a mutation-agnostic therapy; and the Company’s planned study, CORAL-3, that is designed to evaluate the safety and efficacy of repeat KB407 administration, including expected alignment on the CORAL-3 study design with the FDA in 1Q 2026 and initiation of enrollment in CORAL-3 in 2Q 2026. All statements other than historical facts are or may be deemed to be forward‑looking statements and involve known and unknown risks, uncertainties, and assumptions that could cause actual results to differ materially from those indicated by such forward-looking statements as a result of various important factors, including uncertainties inherent in the initiation and conduct of clinical trials, regulatory review of clinical trials, and applications for marketing approvals; whether results of early clinical trials will be indicative of the results of later-stage studies; and such other important factors as are set forth under the caption “Risk Factors” in the Company’s annual and quarterly reports on file with the U.S. Securities and Exchange Commission. The Company provides this information as of the date of this press release and assumes no obligation to update any forward-looking statements.
CONTACT
Investors and Media:
spaquette@krystalbio.com
Source: Krystal Biotech, Inc.