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Note 1 - Description of Business and Basis of Presentation
3 Months Ended
Mar. 31, 2020
Notes to Financial Statements  
Organization, Consolidation and Presentation of Financial Statements Disclosure [Text Block]
Note
1
- Description of Business and Basis of Presentation
 
Genprex, Inc. ("we" or "the Company") is a clinical stage gene therapy company developing potentially life-changing treatments for cancer and diabetes. Our cancer therapies are based upon our novel proprietary technology platform, including our lead drug candidate, Oncoprex™ immunogene therapy ("Oncoprex"), for non-small cell lung cancer ("NSCLC"). Oncoprex consists of a tumor suppressor gene inserted into a patient’s cells that has immunomodulatory effects and is thereby considered an “immunogene therapy”.   The gene is
one
of a series of genes whose therapeutic use is covered by an exclusive worldwide license from The University of Texas MD Anderson Cancer Center ("MD Anderson"). We also are developing a pre-clinical gene therapy that is covered by an exclusive worldwide license from the University of Pittsburgh of the Commonwealth System of Higher Education that has the potential to cure type
1
and type
2
diabetes. This potential treatment works by transforming alpha cells in the pancreas into functional beta-like cells, which can produce insulin but are distinct enough from beta cells to evade the body’s immune system.
 
Oncology Platform Technologies
 
Our oncology platform technologies are designed to administer cancer fighting genes by encapsulating them into nanoscale hollow spheres called nanovesicles, which are then administered intravenously and taken up by tumor cells where they express proteins that are missing or found in low quantities. Oncoprex has a multimodal mechanism of action whereby it interrupts cell signaling pathways that cause replication and proliferation of cancer cells, re-establishes pathways for apoptosis, or programmed cell death, in cancer cells, and modulates the immune response against cancer cells. Oncoprex has also been shown to block mechanisms that create drug resistance.
 
With Oncoprex, we are initially targeting NSCLC. According to the World Health Organization, in
2018
lung cancer was the leading cause of cancer deaths worldwide, causing more deaths than colorectal, breast, liver or stomach cancers. In
2018,
there were more than
2
million new lung cancer cases and
1.7
million deaths from lung cancer worldwide. In the United States, according to the American Cancer Society, it is estimated that in
2020
there will be more than
228,000
new cases of lung cancer and more than
135,000
deaths from lung cancer.  The American Society of Clinical Oncology reports that NSCLC represents
84
percent of all lung cancers and has a
24
percent
five
-year relative survival rate. However, according to the National Cancer Institute,
57
percent of lung cancer diagnoses are distant, or have metastasized, and the
five
-year relative survival rate for Stage IV (metastatic) NSCLC is approximately
5
percent. We believe that there is a significant unmet medical need for new treatments for NSCLC in the United States and globally, and we believe that Oncoprex
may
be suitable for a majority of NSCLC patients.
 
In
January 2020,
we received a United States Food and Drug Administration ("FDA") Fast Track Designation for use of Oncoprex in combination with epidermal growth factor receptor ("EGFR") inhibitor osimertinib (AstraZeneca’s Tagrisso®) for the treatment of NSCLC patients with EFGR mutations whose tumors progressed after treatment with osimertinib alone. According to the FLAURA study sponsored by AstraZeneca, the median length of time that patients are treated with osimertinib before their tumors progress is approximately
18
 months. Osimertinib is now considered a new standard of care for NSCLC patients with an EGFR mutation. Given this and receipt of FDA’s Fast Track Designation for use of Oncoprex combined with osimertinib in patients whose tumors progress on osimertinib, we are prioritizing this drug combination and patient population and plan to initiate a Phase I/II clinical trial of Oncoprex combined with osimertinib in late
2020
or early
2021.
 
In
2019,
preclinical data was presented by MD Anderson collaborators for the combination of
TUSC2,
the active agent in Oncoprex, with pembrolizumab (Merck’s Keytruda®), showing that
TUSC2
combined with the checkpoint blockade mechanism of action of pembrolizumab was more effective than pembrolizumab alone in increasing the survival of mice with human immune cells (humanized mice) that had metastatic lung cancer. Also presented in
2019
by MD Anderson was pre-clinical data for the combination of
TUSC2,
pembrolizumab and chemotherapy for the treatment of some of the most resistant metastatic lung cancers. This study found that the addition of
TUSC2,
increases the effectiveness of pembrolizumab and chemotherapy, and thus,
may
improve on
first
-line standard of care for lung cancer. In early
May 2020,
we entered into a worldwide, exclusive license agreement with The Board of Regents of the University of Texas System on Behalf of the MD Anderson for the use of
TUSC2
in combination with immunotherapies, including pembrolizumab. 
 
We believe that our platform technologies could allow delivery of a number of cancer fighting genes, alone or in combination with other cancer therapies, to combat multiple types of cancer. We believe that Oncoprex’s combination of pan-kinase inhibition, direct induction of apoptosis, anti-cancer immune modulation and complementary action with targeted drugs and immunotherapies is unique, and positions Oncoprex to provide treatment for patients with NSCLC and possibly other cancers, who are
not
benefitting from currently offered therapies.
 
Diabetes Gene Therapy
 
Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type
2
diabetes, usually in adults, which occurs when the body becomes resistant to insulin or does
not
make enough insulin. In the past
three
decades the prevalence of type
2
diabetes has risen dramatically. Type
1
diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or
no
insulin by itself. According to the  International Diabetes Federation, in
2019
approximately
463
million people worldwide had diabetes and
4.2
million deaths were  attributed to diabetes. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades.
 
Our diabetes gene therapy was developed by lead researcher Dr. George Gittes, at the Rangos Research Center at UPMC Children’s Hospital of Pittsburgh. The therapy utilizes an infusion process in which an endoscope and an adeno-associated virus vector are used to deliver
Pdx1
and MafA genes to the pancreas. The proteins these genes express have been shown to transform alpha cells in the pancreas into functional beta-like cells, which can produce insulin but are distinct enough from beta cells to evade the body’s immune system.
 
The diabetes gene therapy has been tested 
in vivo
 in mice and nonhuman primates. In studies of diabetic mice, the gene therapy approach restored normal blood glucose levels for an extended period of time, typically around
four
months. According to Dr. Gittes, the duration of restored blood glucose levels in mice could translate to decades in humans. If successful, this gene therapy could eliminate the need for insulin replacement therapy for diabetic patients.
 
Capital Requirements, Liquidity and Going Concern Considerations
 
Our condensed financial statements are prepared using the generally accepted accounting principles (“GAAP”) applicable to a going concern, which contemplates the realization of assets and liquidation of liabilities in the normal course of business. However, as shown in the accompanying condensed financial statements, we have sustained substantial losses from operations since inception and have
no
current source of revenue. In addition, we have used, rather than provided, cash in our operations. We expect to continue to incur significant expenditures to further clinical trials for the commercial development of our product candidates.
 
Management recognizes that we must obtain additional capital resources to successfully commercialize our product candidates.  To date, we have received funding in the form of equity and debt, and we plan to seek additional funding in the future. However,
no
assurances can be given that we will be successful in raising additional capital.  If we are
not
able to timely and successfully raise additional capital, the timing of our clinical trials, financial condition and results of operations will continue to be materially and adversely affected. These condensed financial statements do
not
include any adjustments relating to the recoverability and classification of recorded asset amounts and classification of liabilities.