$20B-plus? Mer­ck keeps rack­ing up PhI­II suc­cess­es, scor­ing on triple neg­a­tive breast can­cer chal­lenge as an­a­lysts dri­ve up peak sales es­ti­mates

Just days af­ter Bris­tol-My­ers Squibb man­aged to sur­prise the an­a­lyst brigade with a Phase III flop for its PD-1 check­point Op­di­vo com­bined with chemo in lung can­cer, Mer­ck’s dom­i­nant team is back with an­oth­er sol­id hit for a par­tic­u­lar­ly tough-to-treat sub­group of breast can­cer pa­tients.

Mer­ck’s Phase III KEYNOTE-522 tri­al con­nect­ed on one of two pri­ma­ry end­points, with their Keytru­da/chemo com­bo elim­i­nat­ing all signs of triple-neg­a­tive breast can­cer — what’s called a patho­log­i­cal com­plete re­sponse — at a sig­nif­i­cant­ly high­er rate than chemo alone, re­gard­less of PD-L1 lev­els in the neo-ad­ju­vant set­ting.

That’s an­oth­er first for Mer­ck, which has been steadi­ly rack­ing up new Phase III suc­cess­es for the mar­quee PD-1. In­ves­ti­ga­tors are con­tin­u­ing the tri­al as they wait to see how Keytru­da/chemo did on event-free sur­vival.

As usu­al, we’ll have to wait for a sci­en­tif­ic con­fer­ence to see the hard num­bers. But it’s im­por­tant to note that Mer­ck’s string of suc­cess­es with Keytru­da is al­so a psy­cho­log­i­cal vic­to­ry that can’t be un­der­es­ti­mat­ed. When Bris­tol-My­ers re­leased its lat­est batch of da­ta on Op­di­vo, the com­pa­ny al­so claimed a suc­cess on Part 1a of the Check­mate -227 tri­al, which met the co-pri­ma­ry end­point of OS, “demon­strat­ing a sta­tis­ti­cal­ly sig­nif­i­cant ben­e­fit for Op­di­vo plus low-dose Yer­voy (ip­il­i­mum­ab) ver­sus chemother­a­py in pa­tients whose tu­mors ex­press PD-L1 ≥1%.”

An­a­lysts weren’t hav­ing it, though, skep­ti­cal that the drug would beat Keytru­da af­ter see­ing the Keynote-189 da­ta. At this stage of the PD-1 bat­tle, Bris­tol-My­ers is as­sumed to come in be­hind Mer­ck.

The string of suc­cess­es has an­a­lysts com­pet­ing in peak sales fore­casts for Keytru­da. Mizuho’s Mara Gold­stein re­cent­ly not­ed:

News of the fail­ure of BMY’s Check­mate-227 Part 2, OP­DI­VO + chemother­a­py in front­line NSCLC to demon­strate an OS ben­e­fit vs. chemother­a­py alone, fur­ther so­lid­i­fies KEYTRU­DA’s dom­i­nance in this mul­ti-bil­lion dol­lar mar­ket op­por­tu­ni­ty, in our view, and is sup­port­ive of our in­vest­ment the­sis. We es­ti­mate that KEYTRU­DA sales will sur­pass $20 bil­lion by 2024, and that KEYTRU­DA will re­main the dom­i­nant check­point in­hibitor in the mar­ket.

Gold­stein added this morn­ing that every­thing is still look­ing rosy for Mer­ck as the com­pa­ny looks to add to its lead in triple neg­a­tive breast can­cer. Plus, the Eu­ro­peans are help­ing with an­oth­er pos­i­tive opin­ion for Mer­ck.

In ad­di­tion to TNBC, MRK al­so an­nounced a pos­i­tive CHMP opin­ion for KEYTRU­DA+IN­LY­TA in 1L RCC based on piv­otal Phase III KEYNOTE-426 da­ta – im­proved OS, PFS, and ORR vs SU­TENT. We think this lends sup­port to our view that KEYTRU­DA should pull far­ther ahead of com­peti­tors as the lead­ing check­point in­hibitor, and is sup­port­ive of our in­vest­ment the­sis.

So­cial im­age: Shut­ter­stock

MedTech clinical trials require a unique regulatory and study design approach and so engaging a highly experienced CRO to ensure compliance and accurate data across all stages is critical to development milestones.

In­no­v­a­tive MedTech De­mands Spe­cial­ist Clin­i­cal Tri­al Reg­u­la­to­ry Af­fairs and De­sign

Avance Clinical is the Australian CRO for international biotechs providing world-class clinical research services with FDA-accepted data across all phases. With Avance Clinical, biotech companies can leverage Australia’s supportive clinical trials environment which includes no IND requirement plus a 43.5% Government incentive rebate on clinical spend. The CRO has been delivering clinical drug development services for international biotechs for FDA and EMA regulatory approval for the past 24 years. The company has been recognized for the past two consecutive years with the prestigious Frost & Sullivan CRO Best Practices Award and a finalist in Informa Pharma’s Best CRO award for 2022.

Tony Coles, Cerevel CEO

Cerev­el takes the pub­lic of­fer­ing route, with a twist — rais­ing big mon­ey thanks to ri­val da­ta

As public biotechs seek to climb out of the bear market, a popular strategy to raise cash has been through public offerings on the heels of positive data. But one proposed raise Wednesday appeared to take advantage not of a company’s own data, but those from a competitor.

Cerevel Therapeutics plans to raise $250 million in a public offering and another $250 million in debt, the biotech announced Wednesday afternoon, even though it did not report any news on its pipeline. However, the move comes days after rival Karuna Therapeutics touted positive Phase III data in schizophrenia, a field where Cerevel is pursuing a similar program.

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Who are the women blaz­ing trails in bio­phar­ma R&D? Nom­i­nate them for End­points' 2022 spe­cial re­port

Over the past three years, Endpoints News has spotlighted 60 women who have blazed trails and supercharged R&D across the biopharma world. And judging from the response we’ve received, to both our special reports and live events, telling their stories — including any obstacles they may have had to overcome — has inspired our readers in many different ways.

But change takes time, and the fact remains that women are still underrepresented at the upper ranks of the drug-making world.

Bernat Olle, Vedanta Biosciences CEO

Cit­ing 'chal­leng­ing eco­nom­ic en­vi­ron­ment,' PhI­II-ready mi­cro­bio­me biotech lays off 20% of staffers

The market downturn isn’t just sweeping up public biotechs.

Vedanta Biosciences, a developer of oral drugs derived from the human microbiome, is laying off about 20% of its staff — an unfortunately common occurrence these days. But CEO Bernat Olle took the unusual step of sharing the decision on LinkedIn and offering to connect the employees being let go with any company that’s hiring in their areas.

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Hervé Affagard, MaaT Pharma CEO

One year in­to clin­i­cal hold, FDA has more ques­tions about 'pooled' mi­cro­bio­me ther­a­py

The FDA is still wary about a trial testing a microbiome therapy in patients with steroid-resistant acute graft-versus-host disease (aGVHD).

A year after MaaT Pharma’s IND application in the US was first met with a clinical hold, the French biotech said the agency is maintaining the hold. The crux of the matter, MaaT suggested, has to do with the way it puts together its drug candidate, which is administered as an enema (i.e. an injection of fluid into the bowel).

Up­dat­ed: Amid mas­sive re­struc­tur­ing, Bio­gen looks to re­duce phys­i­cal pres­ence in Boston

Biogen is putting a sizable chunk of office and research space in Kendall Square and Weston, MA up for sublease, marking another big change as the biotech grapples with the aftershock of a disastrous and controversial rollout for its Alzheimer’s drug.

The subbleases are “part of Biogen’s overall implementation of the ‘Future of Work,’ which is allowing us to optimize our footprint and reduce the amount of space we occupy, taking into consideration new elements such as the hybrid work model,” Biogen spokesperson Ashleigh Koss wrote in a statement to Endpoints News, adding that the company has had subleases across several buildings for years.

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Saurabh Saha, Centessa CEO (BIO19)

One of 2021's star biotech play­ers flags an­oth­er big set­back for the pipeline

Two months after scuttling their lead drug, Centessa’s executive team is back with the latest in a series of setbacks that have tanked its stock and blown holes in its strategic lineup of biotech subs.

The company reported in its Q2 post today that it has decided to scrap ZF874 after a patient demonstrated elevated liver enzymes — a classic red safety flag — in a Phase I study for alpha-1-antitrypsin (A1AT).

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Illustration: Kim Ryu for Endpoints News

Why non-opi­oid pain drugs keep fail­ing — and what's next for the field

In 1938, Rita Levi-Montalcini was forced to move her lab into her bedroom in Turin, as Mussolini’s facist government expelled Jewish people from studying or working in schools in Italy. Levi-Montalcini, then just a few years out of medical school and using sewing needles as scalpels in her makeshift lab, would soon discover nerve growth factor, or NGF, in chicken embryos.

Her discoveries formed the basis of our understanding of the peripheral nervous system and how cells talk to each other, and Levi-Montalcini went on to win the Nobel Prize in 1986. Much later, NGF was hailed as a promising target for new pain therapies, with some analysts quoting an $11 billion market. However, the latest anti-NGF candidate, Pfizer and Eli Lilly’s tanezumab, was rejected by the FDA last year because of a side effect that dissolved bone in some of its patients.

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Pfiz­er launch­es re­bate pro­gram for rare dis­ease pa­tients who have to stop tak­ing Panzy­ga

Pfizer is launching its second-ever rebate program, this time for Panzyga, its treatment for a rare neurological disease of the peripheral nerves.

The program began last month, according to STAT which first reported the news, and offers a refund of out-of-pocket costs for patients who must discontinue their course before the fifth treatment for “clinical reasons.”

Panzyga was approved back in 2018 to treat primary immunodeficiency (PI) in patients two years and older and chronic immune thrombocytopenia (cITP) in adults. It has since picked up an indication in chronic inflammatory demyelinating polyneuropathy (CIDP), a condition that’s characterized by weakness of the arms or legs, tingling or numbness, and a loss of deep tendon reflexes, according to the NIH.