Prosecution Insights
Last updated: July 17, 2026
Application No. 18/745,091

TREATMENT OF POST-BARIATRIC HYPOGLYCEMIA WITH EXENDIN (9-39)

Non-Final OA §103
Filed
Jun 17, 2024
Priority
May 22, 2015 — provisional 62/165,743 +7 more
Examiner
HELLMAN, KRISTINA M
Art Unit
1654
Tech Center
1600 — Biotechnology & Organic Chemistry
Assignee
The Board of Trustees of the Leland Stanford Junior University
OA Round
3 (Non-Final)
66%
Grant Probability
Favorable
3-4
OA Rounds
4m
Est. Remaining
99%
With Interview

Examiner Intelligence

Grants 66% — above average
66%
Career Allowance Rate
464 granted / 706 resolved
+5.7% vs TC avg
Strong +55% interview lift
Without
With
+54.8%
Interview Lift
resolved cases with interview
Typical timeline
2y 5m
Avg Prosecution
51 currently pending
Career history
749
Total Applications
across all art units

Statute-Specific Performance

§101
2.9%
-37.1% vs TC avg
§103
37.0%
-3.0% vs TC avg
§102
7.3%
-32.7% vs TC avg
§112
17.2%
-22.8% vs TC avg
Black line = Tech Center average estimate • Based on career data from 706 resolved cases

Office Action

§103
DETAILED ACTION Examiner acknowledges receipt of the reply filed 2/02/2026, in response to the final office action mailed 12/03/2025. Claims 1, 10, 13, 14, and 32-40 are pending and being examined on the merits in this office action. Notice of Pre-AIA or AIA Status The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA . Continued Examination Under 37 CFR 1.114 A request for continued examination under 37 CFR 1.114, including the fee set forth in 37 CFR 1.17(e), was filed in this application after final rejection. Since this application is eligible for continued examination under 37 CFR 1.114, and the fee set forth in 37 CFR 1.17(e) has been timely paid, the finality of the previous Office action has been withdrawn pursuant to 37 CFR 1.114. Applicant's submission filed on 2/02/2026 has been entered. Claim Rejections - 35 USC § 103- withdrawn The rejection of claims 1, 10, 13, 14, 32, and 35-40 under 35 U.S.C. 103 as being unpatentable over Stoffers et al. (U.S. 2008/0269130 - previously cited), in view of Gurman et al (Expert Rev Med Devices 11:205-223 (Jan 2014)- previously cited) and Makwana et al (Int’l J Pharma Invest 1: 200-206 (2011)- previously cited) is withdrawn. The rejection of claims 1, 10, 13, 14, and 32-40 remain/are rejected under 35 U.S.C. 103 as being unpatentable over Stoffers et al. (U.S. 2008/0269130 - previously cited), Gurman et al (Expert Rev Med Devices 11:205-223 (Jan 2014)- previously cited) and Makwana et al (Int’l J Pharma Invest 1: 200-206 (2011)- previously cited), as applied to claims 1, 10, 13, 14, 32, and 35-40 above, and further in view Franco et al. (Obes. Surg. 21:1458–1468 (2011)- previously cited) is withdrawn. A new §103 rejection is set forth herein with additional rationale and reference. Response to Arguments Upon further considerations of the claims, a new § 103 rejection is set forth herein. An action on the merits is presented below. Specification Please note, the specification has not been checked to the extent necessary to determine the presence of all possible error. Applicant's cooperation is required in correcting any errors of which applicant may become aware in the specification. MPEP § 608.01. New Rejections Claim Rejections - 35 USC § 103 The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action: A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made. The factual inquiries for establishing a background for determining obviousness under 35 U.S.C. 103 are summarized as follows: 1. Determining the scope and contents of the prior art. 2. Ascertaining the differences between the prior art and the claims at issue. 3. Resolving the level of ordinary skill in the pertinent art. 4. Considering objective evidence present in the application indicating obviousness or nonobviousness. Claims 1, 10, 13, 14, 32, and 35-40 remain/are rejected under 35 U.S.C. 103 as being unpatentable over Stoffers et al. (U.S. 2008/0269130 - previously cited), as evidenced by Green et al (J Endocrinol 185:307-317 (2005)), in view of Gurman et al (Expert Rev Med Devices 11:205-223 (Jan 2014)- previously cited) and Makwana et al (Int’l J Pharma Invest 1: 200-206 (2011)- previously cited). This is a new rejection. Stoffers et al. teach methods of treating and ameliorating post-prandial hypoglycemia [hyperinsulinemic hypoglycemia], comprising administering antagonist of the GLP-1 receptor (abstract, paras. [0005], [0027], [0044]-[0054], [0115]-[0123], [0137]). GLP-1 receptor antagonist include exendin (9-39) (e.g., paras. [0035]-[0037], [0050], [0064]-[0081]). Stoffers et al. teach that the GLP-1 receptor antagonist can be administered via subcutaneous administration (e.g., claim 13, paras. [0100]-[0108], [0141]). Stoffers et al. further teach that post-prandial hypoglycemia can also be caused by gastric-bypass surgery or Nissen fundoplication (paras. [0005], [0050]-[0055]). Stoffers et al. teach compositions comprising the GLP-1R antagonist (e.g., paras. [0100]-[0116]). Stoffers et al. do not expressly teach that the composition is administered in a volume of 0.25-2 mL. Gurman et al is a review article discussing the advantages of prefilled devices for parenteral applications (abstract). Parenteral delivery represents one of the most important administration routes because many conditions requiring this route are acute and often times life-threatening. Parenteral delivery involves the administration through subcutaneous (sc.) route, often providing high bioavailability and rapid onset of action, a prerequisite for emergency situations where the parenteral route is the preferred (and sometimes the only alternative) route of rapid administration. The sc. route refers to the introduction of the drug into the tissue lying underneath the dermis and epidermis that constitutes the skin. The sc. route is the preferred route for at home injection, is adapted for short- and long-term therapies and compared with other parenteral routes, improves the quality of life (p. 205). Prefilled devices allow for accuracy of treatment, sterility, convenience, improved safety, and patient compliance (pp. 205-206 and 219-222. Gurman et al discusses commercially available prefilled devices (Table 1), and various dose volumes. Gurman et al further teach that prefilled device designs allow for dose adjustments (pp. 209 and 222). Makwana et al is another review article teaching the advantages of prefilled devices – including convenience, affordability, accuracy, sterility, and safety (pp. 200-205). Prefilled devices can accommodate volumes typically ranging from 0.25 to 5 ml (p. 200). It would have been obvious to one of ordinary skill in the art to subcutaneously administer a composition comprising exendin (9-39) to a patient for treating hyperinsulinemic hypoglycemia, wherein the composition was administered in a volume of 0.25 mL to 2 mL. Stoffers et al. explicitly taught methods of treating and ameliorating hyperinsulinemic hypoglycemia, as well as routes of administration (subcutaneous) (paras. [0106]-[0109], claim 13). Gurman and Makwana taught prefilled devices that allow for drug delivery via subcutaneous administration (volume range of 0.25 to 5 ml). The skilled artisan would have had a reasonable expectation of success because prefilled devices are increasingly being adopted due to their increasingly safe and easy utilization by patients, portability, accuracy of dose and quick delivery, which leads to increased patient compliance. Gurman further taught that prefilled device designs allow for dose/volume adjustments (pp. 209 and 222). The U.S. Federal Circuit has explicitly stated that in order to make a prima facie case of obviousness, the suggestion and motivation to combine the references need not be explicitly stated in the text of the references. In DyStar Textilfarben GmbH & Co. Deutschland KG v. C.H. Patrick Co., 80 USPQ2d 1641 (Fed. Cir. 2006), the Court writes, “the suggestion test is not a rigid categorical rule. The motivation need not be found in the references sought to be combined, but may be found in any number of sources, including common knowledge, the prior art as a whole, or the nature of the problem itself. In re Dembiczak, 175 F.3d 994, 999 [50 USPQ2d 1614] (Fed. Cir. 1999). As we explained in Motorola, Inc. v. Interdigital Tech. Corp., 121 F.3d 1461, 1472 [43 USPQ2d 1481] (Fed. Cir. 1997), ‘there is no requirement that the prior art contain an express suggestion to combine known elements to achieve the claimed invention. Rather, the suggestion to combine may come from the prior art, as filtered through the knowledge of one skilled in the art.’” See Dystar at 1645. “Our suggestion test is in actuality quite flexible and not only permits, but requires, consideration of common knowledge and common sense.” See Dystar at 1650. In this case, Stoffers et al taught a method for treating hyperinsulinemic hypoglycemia in a subject comprising subcutaneous administration of a composition comprising a therapeutically effective amount of exendin(9-39). Gurman and Makwana taught devices for subcutaneous delivery of therapeutic agents, e.g., a composition comprising exendin(9-39), as well as the claimed volumes. Furthermore, it would have been obvious to try subcutaneous as a route of administration of exendin(9-39). It has been held that under KSR that “obvious to try” may be an appropriate test under 103. The Supreme Court stated in KSR, When there is motivation “to solve a problem and there are a finite number of identified, predictable solutions, a person of ordinary skill has good reason to pursue the known options within his or her technical grasp. If this leads to anticipated success, it is likely the product not of innovation but of ordinary skill and common sense. In that instance the fact that a combination was obvious to try might show that it was obvious under § 103.” KSR Int’l Co. v. Teleflex Inc., 127 S. Ct. 1727,_,82 USPQ2d 1385, 1397 (2007). Stoffers et al. explicitly taught methods of treating and ameliorating hyperinsulinemic hypoglycemia, as well as routes of administration (subcutaneous) (paras. [0104]-[0109], claim 13). Specifically, claim 13 recites a finite number of six (6) routes of administration: intravenous, parenteral, oral, inhalant, intraperitoneal, and subcutaneous. The skilled artisan would have had reason to try subcutaneous administration with the reasonable expectation that at least one would be successful especially in light of the fact that the art teaches subcutaneous administration of exendin(9-39) for the same purpose as instantly claimed, treating hyperinsulinemic hypoglycemia. Thus, use of subcutaneous administration of exendin(9-39) for treating hyperinsulinemic hypoglycemia is “the product not of innovation but of ordinary skill and common sense,” leading to the conclusion that invention is not patentable as it would have been obvious. Furthermore, there would be a reasonable expectation of success because the prior art is presumed fully enabled (see, e.g., MPEP § 2121(I)) for all that it discloses (see, e.g., MPEP §§ 2123(I)-(II)). It is well-within the ordinary skill in the art to combine known components in known arrangements to obtain a known and expected result having a known and art-recognized utility. In addition, as evidenced by Green et al, subcutaneous administration of Ex(9–39) was known in the prior art, and Ex(9–39) was known to retain functional activity. Green et al disclose once daily subcutaneous injections (1700 h) of Ex(9–39) (25 nmol/kg in saline) over an 11-day period (p. 310). Green et al teach that subcutaneous administration of Ex(9–39) effectively blocked GLP-1 activity (e.g., Fig 1, pp. 310-315, Fig 1). Thus, it was well-within the ordinary skill in the art to administer exendin(9-39) by subcutaneous administration, with the expectation that exendin(9-39) would function in the manner as expected, e.g., treating hyperinsulinemic hypoglycemia. Gurman and Makwana taught devices for subcutaneous delivery of therapeutic agents, e.g., a composition comprising exendin(9-39), as well as the claimed volumes. Accordingly, claim 1 is rendered obvious. Regarding claims 10, 13, 14, and 32, the optimization of result effect parameters (dosage amounts, steady state plasma levels, and dosing regimen) is obvious as being within the skill of the artisan. The optimization of known effective amounts of known active agents to be administered, is considered well in the competence level of an ordinary skilled artisan in pharmaceutical science, involving merely routine skill in the art. It has been held that it is within the skill in the art to select optimal parameters, such as amounts of ingredients, in a composition in order to achieve a beneficial effect. See In re Boesch, 205 USPQ 215 (CCPA 1980). It is also noted that “[W]here the general conditions of a claim are disclosed in the prior art, it is not inventive to discover the optimum or workable ranges by routine experimentation.” In re Aller, 220 F.2d 454, 456, 105 USPQ 233, 235 (CCPA 1955). Regarding claims 35 and 36, Stoffers et al. teach that hyperinsulinemic hypoglycemia can be congenital, or acquired by gastric bypass surgery or Nissen fundoplication [gastrointestinal surgery] (abstract, paras. [0004]-[0010], [0027]-[0032], [0050]-[0054]). Regarding claim 37, Stoffers et al teach that the compositions can include saline [reads on isotonic solution] (paras. [0107]-[0108], [0158]). Regarding claim 38, Gurman et al discusses pen injectors for subcutaneous administration (e.g., pp. 206-215, 219-221, Table 1). Regarding claim 39, Stoffers et al teach that the compositions can include a buffer or preservative (paras. [0107]-[0109)). Regarding claim 40, Gurman et al discusses dual chamber devices that allow for drug and a lyophilized form and reconstitution of the powder drug prior to administration (pp. 207, 210, 219-222). Claims 1, 10, 13, 14, 32, and 35-40 are obvious in view of the teachings of the cited references. Pursuant to MPEP 2121(I), when the reference relied on expressly anticipates or makes obvious all the elements of the claimed invention, the reference is presumed to be operable. Once such a reference is found, the burden is on applicant to rebut the presumption of operability. In re Sasse, 629 F.2d 675, 207 USPQ 107 (CCPA 1980). Moreover, MPEP 2121(III) states that a prior art reference provides an enabling disclosure and thus anticipates a claimed invention if the reference describes the claimed invention in sufficient detail to enable a person of ordinary skill in the art to carry out the claimed invention; "proof of efficacy is not required for a prior art reference to be enabling for purposes of anticipation." Impax Labs. Inc. v. Aventis Pharm. Inc., 468 F.3d 1366, 1383, 81 USPQ2d 1001, 1013 (Fed. Cir. 2006). MPEP 716.07 states that since in a patent it is presumed that a process if used by one skilled in the art will produce the product or result described therein, such presumption is not overcome by a mere showing that it is possible to operate within the disclosure without obtaining the alleged product. In re Weber, 405 F.2d 1403, 160 USPQ 549 (CCPA 1969). Response to Arguments- as relating to § 103 rejection over Stoffers, Gurman and Makwana – withdrawn herein Examiner notes the instant 103 rejection has a new reference and additional rationale. Applicant traversed the rejection at pp. 4-7 of the reply filed 2/02/2026. Applicant asserts that despite Stoffers teaching subcutaneous administration, “[t]his position is legally and factually insufficient” and that obviousness requires more than a showing that individual components of the claimed method were disclosed in the prior art, and the skilled artisan would have been motivated to select the specific components of the claimed method as a whole with a reasonable expectation of success (reply at p. 5). Applicant asserts that the cited references do not disclose or suggest the presently claimed methods, and that Stoffers only mentions subcutaneous administration in passing. Applicant asserts improper hindsight reconstruction by the Office and that Stoffers does not direct the skilled artisan to specifically select the specific route of administration required by the present claims. Id. Applicant alleges that even if the prior art discloses the elements of the present claims, the Office did not establish that the skilled artisan would have had a reasonable expectation of success in achieving the claimed results. Applicant asserts that therapeutic dosing regimens, including therapeutic administration routes is an unpredictable art and mere disclosure of an administration route does not render its clinical performance predictable (pp. 5-6). Applicant asserts skilled practitioner would not have recognized that different routes of administration are affected by bioavailability, absorption, and patient specific physiological factors (p. 6). Applicant asserts unexpected results and that the application “demonstrates a subcutaneous administration of exendin(9-39) and effectively prevent hypoglycemia in patients having hyperinsulinemic hypoglycemia (referring to Ex 3). Applicant further states that subcutaneous administration allows for more flexibility to the patient and alternative approaches (referencing the as-filed specification- reply at p. 6). Applicant asserts that the ”surprising results” achieved by the claimed methods are not suggested by the cited references. Id. Applicant asserts that the cited references do not recognize, predict, or suggest that the claimed method would produce the observed results as demonstrated by applicant. Applicant asserts that Stoffers focuses on administration of exendin(9-39) by continuous intravenous infusion and asserts that the reference would not lead a skilled practitioner to subcutaneous administration of the peptide (pp. 6-7). Applicant asserts that Gurman and Makwana “failed to teach or suggest that subcutaneous administration of exendin(9-39) would effectively treat hyperinsulinemic hypoglycemia” (p. 7). Applicant asserts that a skilled practitioner would not have had a reasonable expectation of success in arriving at the present claims in view of the cited references alone or in any combination. Id. Examiner has reviewed and considered applicants arguments, but is not persuaded. Examiner first notes that Applicant’s arguments and the excerpt cited from the office action mailed 12/03/2025, provided in the reply filed 2/02/2026 at pp. 4-5 is from the response to arguments section/ examiner’s rebuttal. The §103 rejection stands on its own merits. In response to applicant's arguments against the references individually, one cannot show nonobviousness by attacking references individually where the rejections are based on combinations of references. See In re Keller, 642 F.2d 413, 208 USPQ 871 (CCPA 1981); In re Merck & Co., 800 F.2d 1091, 231 USPQ 375 (Fed. Cir. 1986). In response to applicant's argument that the examiner's conclusion of obviousness is based upon improper hindsight reasoning, it must be recognized that any judgment on obviousness is in a sense necessarily a reconstruction based upon hindsight reasoning. But so long as it takes into account only knowledge which was within the level of ordinary skill at the time the claimed invention was made, and does not include knowledge gleaned only from the applicant's disclosure, such a reconstruction is proper. See In re McLaughlin, 443 F.2d 1392, 170 USPQ 209 (CCPA 1971). Examiner reminds applicant that patents and applications are relevant as prior art for all they contain. "The use of patents as references is not limited to what the patentees describe as their own inventions or to the problems with which they are concerned. They are part of the literature of the art, relevant for all they contain." In re Heck, 699 F.2d 1331, 1332-33, 216 USPQ 1038, 1039 (Fed. Cir. 1983). A reference may be relied upon for all that it would have reasonably suggested to one having ordinary skill the art. Merck & Co. v. Biocraft Laboratories, 874 F.2d 804, 10 USPQ2d 1843 (Fed. Cir.), cert. denied, 493 U.S. 975 (1989). Nonpreferred embodiments constitute prior art. Disclosed examples and preferred embodiments do not constitute a teaching away from a broader disclosure or nonpreferred embodiments. In re Susi, 440 F.2d 442, 169 USPQ 423 (CCPA 1971). "A known or obvious composition does not become patentable simply because it has been described as somewhat inferior to some other product for the same use." In re Gurley, 27 F.3d 551, 554, 31 USPQ2d 1130, 1132 (Fed. Cir. 1994). See M.P.E.P. §2123. Contrary to applicant’s arguments, subcutaneous administration of exendin(9-39) is expressly taught by Stoffers (e.g., claim 13, paras. [0100]-[0106], [0141]). Stoffers et al. teach methods of treating and ameliorating post-prandial hypoglycemia [hyperinsulinemic hypoglycemia], comprising administering antagonist of the GLP-1 receptor (abstract, paras. [0005], [0027], [0044]-[0054], [0115]-[0123], [0137]). GLP-1 receptor antagonist include exendin (9-39) (e.g., paras. [0035]-[0037], [0050], [0064]-[0081]). Thus, Stoffers is not limited to continuous intravenous infusion. It is the Examiner’s understanding that Applicant is alleging that the prior art does not provide a reasonable expectation of success and is “unpredictable”. MPEP § 2143.02(I)-(III) discusses the level of predictability and guidance required to establish a “reasonable expectation of success” sufficient to establish obviousness. As explained at MPEP § 2143.02(II), “Obviousness does not require absolute predictability”, but rather only “at least some degree of predictability”. Here, the predicted and expected result of subcutaneous administration of exendin(9-39) to treat hyperinsulinemic hypoglycemia is expressly taught by Stoffers et al. This is pertinent because the prior art is presumed fully enabled (see, e.g., MPEP § 2121(I)) for all that it discloses (see, e.g., MPEP §§ 2123(I)-(II)), and the burden is on the Applicant to rebut operability and enablement (see, e.g., MPEP § 2121(I)) commensurate in scope with the requirements of MPEP §§ 716.05 or 716.07. To date, zero evidence of inoperability (MPEP § 716.07) or skepticism of experts (MPEP § 716.05) has been placed on record. As evidenced by Green, subcutaneous administration of exendin(9-39) of was known in the prior art. Green further established that exendin(9-39) retained function. Accordingly, because the prior art is presumed fully enabled and no evidence to the contrary exists, then there is a reasonable expectation that exendin(9-39) can be subcutaneously administered to treat hyperinsulinemic hypoglycemia as instantly claimed, and disclosed by the prior art. Examiner further refers Applicant to Xuan et al (Peptides 46:172-179 (2013)) and Grieve et al (Br J Pharamacol 157:1340-1351 (2009))- disclosed below in the section entitled “Relevant Art Not Relied Upon”. Xuan et al disclose in vitro bioactivity and in vivo pharmacokinetic profiles following subcutaneous administration of exenatide in rats (abstract, pp. 174-178). Xuan et al further disclose that exenatide is currently available in the market (Byetta) as twice-daily subcutaneous injection (5 or 10 µg/day) (p. 172)- e.g., before 2013. Exenatide is 39 amino acids in length. Id. Grieve et al et al disclose that exendin-4(1–39), shares 50% structural homology with GLP-1, has also been found to be a potent GLP-1R agonist, binding with comparable affinity to GLP-1 (p. 1342). Table 1 discloses that exenatide and exenatide-LAR are administered by subcutaneous administration. Examiner acknowledges that exenatide is longer than the claimed Ex(9-39), which is a truncated version of exenatide. However, Xuan and Grieve establish that subcutaneous administration of a functional peptide with overlapping sequence identity (amino acid positions 9-39) was known in the prior art. Thus, subcutaneous administration of the claimed Ex(9-39) would have had a reasonable expectation of success in treating hyperinsulinemic hypoglycemia. Even if applicant did properly establish unexpected results, caselaw reiterated the principle from Newell Cos. v. Kenny Mfg. Co., 9 USPQ2d 1417, 1426 (Fed. Cir. 1988) that the mere presence of secondary considerations does not necessarily overcome a strong case of obviousness. See Pfizer Inc. v. Apotex Inc., 82 U.S.P.Q.2d 1321, 1338-39 (Fed. Cir. 2007) (quoting In re Chupp, 816 F.2d 643, 646 (Fed. Cir. 1987)). Secondary considerations are only one factor in determining obviousness. Gurman et al taught parenteral delivery involves the administration through subcutaneous (sc.) route, often providing high bioavailability and rapid onset of action, a prerequisite for emergency situations where the parenteral route is the preferred (and sometimes the only alternative) route of rapid administration. The sc. route refers to the introduction of the drug into the tissue lying underneath the dermis and epidermis that constitutes the skin. The sc. route is the preferred route for at home injection, is adapted for short- and long-term therapies and compared with other parenteral routes, improves the quality of life (p. 205). Gurman and Makwana taught devices for subcutaneous delivery of therapeutic agents, e.g., a composition comprising exendin(9-39), as well as the claimed volumes. Examiner refers applicant to the above 103 rejection for specific details. Claim(s) 1, 10, 13, 14, and 32-40 remain/are rejected under 35 U.S.C. 103 as being unpatentable over Stoffers et al. (U.S. 2008/0269130 - previously cited), as evidenced by Green et al (J Endocrinol 185:307-317 (2005)), Gurman et al (Expert Rev Med Devices 11:205-223 (Jan 2014)- previously cited) and Makwana et al (Int’l J Pharma Invest 1: 200-206 (2011)- previously cited), as applied to claims 1, 10, 13, 14, 32, and 35-40 above, and further in view Franco et al. (Obes. Surg. 21:1458–1468 (2011)- previously cited). This is a new rejection. The teachings of Stoffers et al., Green et al, Gurman and Makwana are set forth above. Stoffers et al. taught that post-prandial hypoglycemia can also be caused by gastric-bypass surgery or Nissen fundoplication (paras. [0005], [0050]-[0055]). However, the references do not explicitly teach treatment of patients that have had other forms of bariatric or gastrointestinal surgeries. Franco et al. is a review article discussing the advantages and disadvantages of three gastrointestinal surgeries: gastrectomy, Roux-en-Y gastric bypass and adjustable gastric banding (abstract; p. 159-146). Laparoscopic Roux-en-Y gastric bypass is one of the most commonly performed procedures for obese patients. Id. It would have been obvious to the skilled artisan that a patient who has undergone a bariatric surgery or gastrointestinal surgery and developed hyperinsulinemic hypoglycemia would be a suitable candidate for treatment with exendin(9-39), as taught by Stoffers et al. The skilled artisan would have recognized that patients that have undergone bariatric and gastrointestinal procedures of sleeve Roux-en-Y gastric bypass, gastrectomy, and adjustable gastric banding could also be candidates for treatment with exendin(9-39). Claims 33 and 34 are deemed to be obvious. Claims 1, 10, 13, 14, and 32-40 are obvious in view of the teachings of the cited references. Response to Arguments- as relating to § 103 rejection over Stoffers, Gurman, Makwana, and Franco – withdrawn herein Applicant traversed the rejection at pp. 7-8 of the reply filed 2/02/2026. Applicant asserts that the cited references do not teach or suggest the claimed method, and “do not demonstrate the effectiveness of subcutaneously administered exendin(9-39) in treating hyperinsulinemic hypoglycemia” and the claimed methods achieved surprising results (reply at p. 8). Applicant asserts that the cited reference Franco et al does not mention hyperinsulinemic hypoglycemia or treatment thereof by exendin(9-39). Examiner has reviewed and considered applicants arguments, but is not persuaded. Examiner refers applicant to the above rebuttal arguments which also apply to the instant rejection and are incorporated herein. Relevant Art Not Relied Upon Xuan et al (Peptides 46:172-179 (2013)) disclose in vitro bioactivity and in vivo pharmacokinetic profiles following subcutaneous administration of exenatide in rats (abstract, pp. 174-178). Xuan et al further disclose that exenatide is currently available in the market (Byetta) as twice-daily subcutaneous injection (5 or 10 µg/day) (p. 172)- e.g., before 2013. Exenatide is 39 amino acids in length. Id. Examiner acknowledges that exenatide is longer than the claimed Ex(9-39), which is a truncated version of exenatide. However, Xuan et al established that subcutaneous administration of a functional peptide with overlapping sequence identity (amino acid positions 9-39) was known in the prior art. Thus, subcutaneous administration of the claimed Ex(9-39) would have had a reasonable expectation of success. Grieve et al (Br J Pharamacol 157:1340-1351 (2009)) disclose that exendin-4(1–39), shares 50% structural homology with GLP-1, has also been found to be a potent GLP-1R agonist, binding with comparable affinity to GLP-1 (p. 1342). Table 1 discloses that exenatide and exenatide-LAR are administered by subcutaneous administration. Grieve et al teach that Exendin(9-39) is an antagonist of GLP-1R (p. 1344). Examiner acknowledges that exenatide is longer than the claimed Ex(9-39), which is a truncated version of exenatide/exendin-4(1-39). However, Grieve et al established that subcutaneous administration of a functional peptide with overlapping sequence identity (amino acid positions 9-39) was known in the prior art. Thus, subcutaneous administration of the claimed Ex(9-39) would have had a reasonable expectation of success. Berteau et al (Patient Preference and Adherence 4:379-388 (2010)- previously cited) is an article discussing disposable auto injector pens for subcutaneous self-injection by patients. The autoinjector administered either 0.2 mL or 1 mL volume fluid (abstract). This study indicated that the autoinjector used by the subject was similar to a syringe used by a nurse in terms of performance and safety in administering the injections, and better in terms of pain, overall acceptance, and preference. Id. Conclusion No claims are allowed. Claims 1, 10, 13, 14, and 32-40 are pending and are rejected. Any inquiry concerning this communication or earlier communications from the examiner should be directed to KRISTINA M HELLMAN whose telephone number is (571)272-2836. The examiner can normally be reached M-F 9:00 am-5:30 pm. Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice. If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, LIANKO GARYU can be reached at 571-270-7367. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300. Information regarding the status of published or unpublished applications may be obtained from Patent Center. Unpublished application information in Patent Center is available to registered users. To file and manage patent submissions in Patent Center, visit: https://patentcenter.uspto.gov. Visit https://www.uspto.gov/patents/apply/patent-center for more information about Patent Center and https://www.uspto.gov/patents/docx for information about filing in DOCX format. For additional questions, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000. /KRISTINA M HELLMAN/Examiner, Art Unit 1654
Read full office action

Prosecution Timeline

Jun 17, 2024
Application Filed
Jul 18, 2025
Non-Final Rejection mailed — §103
Oct 17, 2025
Response Filed
Dec 03, 2025
Final Rejection mailed — §103
Feb 02, 2026
Request for Continued Examination
Feb 04, 2026
Response after Non-Final Action
Apr 14, 2026
Non-Final Rejection mailed — §103 (current)

Precedent Cases

Applications granted by this same examiner with similar technology

Patent 12678487
TARGETING LUNG-RESIDENT TNFR2+ cDC2 (R2D2) SUBPOPULATION TO TREAT ASTHMA
4y 11m to grant Granted Jul 14, 2026
Patent 12661388
ASSESSING AND TREATING ACUTE DECOMPENSATED HEART FAILURE
3y 9m to grant Granted Jun 23, 2026
Patent 12653859
PEPTIDES AND MEDICAL USES THEREOF
5y 3m to grant Granted Jun 16, 2026
Patent 12653868
USES OF A2 DOMAIN OF VON WILLEBRAND FACTOR
4y 7m to grant Granted Jun 16, 2026
Patent 12648907
MEMBRANE PROTEIN SCAFFOLDS FOR EXOSOME ENGINEERING
4y 10m to grant Granted Jun 09, 2026
Study what changed to get past this examiner. Based on 5 most recent grants.

Strategy Recommendation AI-generated — please review before filing

Get a prosecution strategy drawn from examiner precedents, rejection analysis, and claim mapping.
Typically takes 5-10 seconds — AI-generated, attorney review required before filing

Prosecution Projections

3-4
Expected OA Rounds
66%
Grant Probability
99%
With Interview (+54.8%)
2y 5m (~4m remaining)
Median Time to Grant
High
PTA Risk
Based on 706 resolved cases by this examiner. Grant probability derived from career allowance rate.

Sign in with your work email

Enter your email to receive a magic link. No password needed.

Personal email addresses (Gmail, Yahoo, etc.) are not accepted.

Free tier: 3 strategy analyses per month