Af­ter a run of CT­LA-4 com­bo fail­ures, sci­en­tists spot­light a way to make it work — in se­lect pa­tients

CT­LA-4/PD-(L)1 com­bi­na­tions have been one of the El Do­ra­dos of on­col­o­gy, its promise for­ev­er be­hind that next hill but ap­par­ent­ly un­at­tain­able af­ter a se­ries of piv­otal clin­i­cal fail­ures. But re­searchers at New York’s Memo­r­i­al Sloan Ket­ter­ing Can­cer Cen­ter and the Tech­ni­cal Uni­ver­si­ty of Mu­nich think they may know how to fix what’s wrong and boost the dri­ve to next-gen can­cer com­bos.

In a pre­clin­i­cal an­i­mal re­search pro­gram, re­searchers found that with­in a cell, check­points re­ly on a spe­cif­ic mol­e­cule — RNA-sens­ing mol­e­cule RIG-I — to work. If that sounds fa­mil­iar, it’s be­cause it has al­ready been iden­ti­fied as a tar­get for boost­ing im­mune re­spons­es and was sub­ject to at least one Phase I/II tri­al. Pfiz­er in De­cem­ber al­lied it­self with Kine­ta with $15 mil­lion up­front and $505 mil­lion in po­ten­tial mile­stones to de­vel­op RIG-I im­munother­a­pies, and three years ago Mer­ck pur­chased Ger­man up­start Rigontec for $137 mil­lion up­front and over $400 mil­lion in po­ten­tial mile­stones for the same pur­pose.

The sci­ence team’s work helps spot­light what they’re af­ter.

Pub­lish­ing in Sci­ence Im­munol­o­gy, the re­searchers found that high ex­pres­sion of the gene for RIG-I (gene DDX58) her­ald­ed re­spon­sive­ness to CT­LA-4 ther­a­py and sug­gest­ed doc­tors might test for RIG-I ex­pres­sion in tu­mors to pre­dict who will re­spond to the ther­a­py. They could then tai­lor treat­ments to that pop­u­la­tion. The study al­so sug­gests that com­bin­ing  PD-1/CT­LA-4 with a RIG-I ag­o­nist might boost the ef­fec­tive­ness of the hereto­fore of­ten dis­ap­point­ing ther­a­py.

CT­LA-4 and PD-1 ther­a­pies, which won their prin­ci­pal founders 2018’s No­bel Prize in med­i­cine, work by tar­get­ing a re­cep­tor on T cells that stop the cell’s “check­point,” if you will – by block­ing the re­cep­tor, it es­sen­tial­ly re­leas­es the brakes on the im­mune sys­tem and al­lows the body’s T cells to start a full high-speed chase on the tu­mor(s). Sev­er­al such im­munother­a­pies have been ap­proved in the past few years, be­gin­ning with ip­il­i­mum­ab for melanoma in 2011, but the ec­sta­t­ic promise has turned up a lot of dry wa­ter beds of late. Tri­als from the ma­jor play­ers, in­clud­ing Bris­tol-My­ers Squibb, As­traZeneca, and Sanofi,  at­tack­ing small cell lung can­cer, head and neck car­ci­no­ma, and non-small cell lung can­cer with a mix of PD-1 and CT­LA-4 in­hibitors have all failed.

This is not the first study look­ing at how to im­prove and tai­lor CT­LA-4 ther­a­pies. Last year, re­searchers work­ing on mice found that they could “im­age” the re­sponse with a ra­dioac­tive trac­er that latch­es to OX40, a mol­e­cule on­ly found in ac­ti­vat­ed T cells, and thus the­o­ret­i­cal­ly learn ear­ly on if a pa­tient is re­spond­ing to the ther­a­py.

So­cial im­age: Memo­r­i­al Sloan Ket­ter­ing Can­cer Cen­ter

Pi­o­neer­ing Click Chem­istry in Hu­mans

Reimagining cancer treatments

Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020, which is nearly one in six deaths. Recently, we have seen incredible advances in novel cancer therapies such as immune checkpoint inhibitors, cell therapies, and antibody-drug conjugates that have revamped cancer care and improved survival rates for patients.

Despite this significant progress in therapeutic targeting, why are we still seeing such a high mortality rate? The reason is that promising therapies are often limited by their therapeutic index, which is a measure of the effective dose of a drug, relative to its safety. If we could broaden the therapeutic indices of currently available medicines, it would revolutionize cancer treatments. We are still on the quest to find the ultimate cancer medicine – highly effective in several cancer types, safe, and precisely targeted to the tumor site.

Ivan Cheung, Eisai US chairman and CEO

Bio­gen, Ei­sai re­fresh amy­loid hy­poth­e­sis with PhI­II show­ing Alzheimer's med slows cog­ni­tive de­cline

In the first look at Phase III data for lecanemab, Eisai and Biogen’s follow-up Alzheimer’s drug to the embattled Aduhelm launch, results show the drug passed with flying colors on a test looking at memory, problem solving and other dementia metrics.

One of the most-watched Alzheimer’s therapies in the clinic, lecanemab met the study’s primary goal on the CDR-SB — Clinical Dementia Rating-Sum of Boxes — giving the biotech the confidence to ask for full approval in the US, EU and Japan by next March 31. The experimental drug reduced clinical decline on the scale by 27% compared to placebo at 18 months, the companies said Tuesday night Eastern time and Wednesday morning in Japan.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,200+ biopharma pros reading Endpoints daily — and it's free.

Vlad Coric, Biohaven CEO (Photo Credit: Andrew Venditti)

As Amy­lyx de­ci­sion waits in the wings, Bio­haven’s ALS drug sinks (again) in plat­form tri­al

The FDA’s decision on Amylyx’s ALS drug is set to come out sometime Thursday. In a space with few drugs, any approval would be a major landmark.

But elsewhere in the ALS field, things are a bit more tepid.

Thursday morning, Biohaven announced that its drug verdiperstat failed its arm of an ALS platform trial led by Massachusetts General Hospital. According to a press release, the drug did not meet its primary endpoint — improvement on an ALS functional status test — or any key secondary endpoints at 24 weeks. The trial had enrolled 167 patients, giving them either verdiperstat or placebo twice a day.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,200+ biopharma pros reading Endpoints daily — and it's free.

Gilead names 'k­ing­pin­s' in coun­ter­feit HIV med law­suit

Gilead is mounting its counterfeit drug lawsuit, naming two “kingpins” and a complex network of conspirators who allegedly sold imitation bottles of its HIV meds, some of which ended up in US pharmacies.

The pharma giant on Wednesday provided an update on what it called a “large-scale, sophisticated counterfeiting conspiracy,” accusing two new defendants of “leading and orchestrating” a scheme to sell hundreds of millions of dollars in illegitimate drugs posing as meds such as Biktarvy and Descovy.

Nooman Haque, head of life sciences and healthcare at Silicon Valley Bank, and John Carroll

I’m head­ed to Lon­don soon for #EU­BIO22. Care to join me?

It was great getting back to a live ESMO conference/webinar in Paris followed by a live pop-up event for the Endpoints 11 in Boston. We’re staying on the road in October with our return for a live/streaming EUBIO22 in London.

Silicon Valley Bank’s Nooman Haque and I are once again jumping back into the thick of it with a slate of virtual and live events on October 12. I’ll get the ball rolling with a virtual fireside chat with Novo Nordisk R&D chief Marcus Schindler, covering their pipeline plans and BD work.

Work taking place in the clean rooms at Vor (Credit: Vor)

Vor Bio opts to keep man­u­fac­tur­ing op­er­a­tions in-house for de­vel­op­ing stem cell, CAR-T ther­a­pies

While it is not uncommon for a biotech to go down the route of having the product manufactured by a contract organization, one small biotech is looking to keep its card close to its chest.

Vor Biopharma has started manufacturing operations at an in-house facility at its HQ in Cambridge, MA after beginning construction last summer.

According to the biotech, the facility aims to develop Vor’s hematopoietic stem cells (eHSCs) and CAR-T therapies for patients with blood cancers. The site will initially manufacture a clinical supply of its candidate VCAR33allo to support its IND, which is slated to be submitted in the first half of next year. It also plans to transfer the production of VOR33 to the facility. Vor is getting to work quickly as engineering runs for VCAR33allo has started this week.

Aim­ing for fourth nod, Sarep­ta files an­oth­er DMD gene ther­a­py to FDA; Ax­some head­ed to­ward mi­graine re­sub­mis­sion

Sarepta Therapeutics has filed the data needed for an FDA accelerated approval, which would be the biotech’s fourth if granted by the agency.

The biotech has yet to complete confirmatory trials for those first three conditional nods. The filing for its fourth Duchenne muscular dystrophy treatment, disclosed Thursday, is not a surprise. Sarepta said in late-July it would do so after releasing positive results for the Roche-partnered gene therapy.

Phillip Gomez, Siga Technologies CEO

Siga nabs $10.7M from the US gov­ern­ment in deal for its mon­key­pox an­tivi­ral

The US government is all set to buy $10.7 million worth of Siga Technologies’ monkeypox oral antiviral, the company announced Thursday.

Of the total doses, $5.1 million worth of oral antivirals called Tpoxx (tecovirimat) will be delivered this year, with the US Department of Defense having the option of buying the rest at a later point.

The new contract follows an earlier one in which the government had purchased $7.4 million worth of Tpoxx from the company.

Tar­sus looks to raise aware­ness of eye­lid mite dis­ease in cam­paign aimed at eye­care spe­cial­ists

Eyelid mite disease may be “gross” but it’s also fairly common, affecting about 25 million people in the US.

Called demodex blepharitis, it’s a well-known condition among eyecare professionals, but they often don’t always realize how common it is. Tarsus Pharmaceuticals wants to change that with a new awareness campaign called “Look at the Lids.”

The campaign and website debut Thursday — just three weeks after Tarsus filed for FDA approval for a drug that treats the disease.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 151,200+ biopharma pros reading Endpoints daily — and it's free.