Regulatory & Policy

Chengdu Origen and Vanotech receive FDA clearance for KHN921 gene therapy in hypertrophic cardiomyopathy

Chengdu Origen Biotechnology and Vanotech have received US FDA clearance to proceed with a Phase I/II clinical trial of KHN921, an AAV9-based gene therapy...

China-based Chengdu Origen Biotechnology and Vanotech - a US subsidiary of Chengdu Kanghong Pharmaceutical Group - have received US FDA clearance to proceed with a Phase I/II clinical trial of KHN921, an AAV9-based gene therapy targeting MYBPC3 mutation-associated hypertrophic cardiomyopathy (HCM). As per the firms' press release, the US FDA clearance means KHN921 will enter first-in-human testing in adults with symptomatic disease caused by pathogenic MYBPC3 variants.

The proposed Phase I/II study is a multicenter, open-label, dose-escalation and expansion trial evaluating the safety, tolerability, and efficacy of a single intracoronary administration of KHN921 in adults with symptomatic MYBPC3 mutation-associated HCM. No trial registry identifier has been publicly disclosed at the time of the announcement.

KHN921 and HCM

Hypertrophic cardiomyopathy (HCM) is the most common monogenic cardiovascular disorder, affecting approximately 1 in 500 individuals worldwide. The condition is characterized by unexplained left ventricular hypertrophy and carries risks of heart failure, arrhythmias, and sudden cardiac death, particularly in younger patients. Mutations in MYBPC3, which encodes cardiac myosin-binding protein C, a regulator of sarcomere structure and cardiac contraction, represent one of the most prevalent genetic causes of HCM. Pathogenic MYBPC3 variants typically lead to haploinsufficiency, disrupting normal cardiac function and driving the pathological remodeling that defines the disease.

KHN921 is a recombinant, replication-deficient adeno-associated virus vector of serotype AAV9 encoding a functional copy of the MYBPC3 gene. The intended mechanism is restoration of myosin-binding protein C expression in cardiomyocytes, directly addressing the protein deficit that results from pathogenic MYBPC3 variants. The construct is administered via a single intracoronary infusion, a route selected to promote cardiac tissue retention.

The current approved treatment landscape for HCM addresses symptoms and hemodynamics but does not modify the underlying genetic defect. Bristol Myers Squibb's mavacamten (Camzyos), a selective cardiac myosin ATPase inhibitor approved by the US FDA in 2022, and Cytokinetics' aficamten (Myqorzo), a next-generation myosin inhibitor approved in December 2025, both reduce left ventricular outflow tract obstruction in symptomatic obstructive HCM. Neither is approved for the non-obstructive phenotype, which accounts for roughly 30%–40% of HCM cases, and neither addresses the genetic root cause of disease in MYBPC3 carriers. Older agents including beta-blockers, verapamil, and disopyramide remain guideline-directed options for symptomatic control across phenotypes, but similarly offer no disease-modifying effect. No approved therapy corrects or compensates for MYBPC3 haploinsufficiency.

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Competitive position in AAV gene therapy for cardiovascular disease

KHN921 enters a nascent but active field of AAV gene therapy cardiovascular programs targeting MYBPC3. The most directly comparable program in clinical development is Tenaya Therapeutics' TN-201, also an AAV9-based construct delivering a functional MYBPC3 gene via intravenous infusion. Tenaya presented first-in-human data from the MyPeak-1 Phase Ib/II trial at the American Heart Association Scientific Sessions in November 2025, placing TN-201 ahead of KHN921 in clinical development. The two programs share the same genetic target and patient population, and their differentiation will ultimately depend on safety profiles, durability of transgene expression, variant coverage, and delivery approach — intracoronary for KHN921 versus intravenous for TN-201.

The intracoronary route used by KHN921 is intended to maximize cardiac tissue exposure while potentially limiting systemic vector distribution, though this delivery method introduces procedural complexity compared to peripheral intravenous infusion.

The broader competitive and regulatory context will also shape KHN921's development trajectory. Bristol Myers Squibb and Cytokinetics are each running Phase III trials to expand mavacamten and aficamten, respectively, into non-obstructive HCM — a population that overlaps with MYBPC3 carriers. If approved in that setting, these agents would offer an established oral treatment option for the same patients KHN921 aims to serve, raising the bar for what a gene therapy program would need to demonstrate in terms of durability, convenience, and safety to justify its use.


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