Af­ter get­ting skunked by ri­vals, Pfiz­er touts ‘break­through’ can­cer drug lor­la­tinib, heads to the FDA

Mace Rothen­berg, Pfiz­er

Pfiz­er’s Xalko­ri has be­come a Phase III punch­ing bag of sorts for top ri­vals in the can­cer field. In June No­var­tis’ Zyka­dia picked up an FDA ap­proval to chal­lenge Xalko­ri in front­line ALK-pos­i­tive lung can­cer. And Roche’s Ale­cen­sa has been whup­ping up on Xalko­ri as well, prov­ing bet­ter at cut­ting the risk of dis­ease pro­gres­sion.

So it’s no won­der that Pfiz­er is tak­ing its pos­i­tive Phase II da­ta — post­ed to­day — for its next-gen suc­ces­sor lor­la­tinib straight to reg­u­la­tors.

Now in Phase III, Pfiz­er won a break­through ther­a­py des­ig­na­tion for lor­la­tinib from the FDA ear­li­er this year, promis­ing a speedy re­view at an agency that has be­come a mas­ter at mak­ing ac­cel­er­at­ed can­cer drug de­ci­sions.

De­signed for ALK-pos­i­tive and ROS1-pos­i­tive ad­vanced non-small cell lung can­cer, re­searchers high­light­ed a slate of the mid-stage da­ta on the drug.

The key da­ta points:

  • In ALK-pos­i­tive treat­ment-naïve pa­tients, the over­all re­sponse rate was 90%. The in­tracra­nial ORR (IC-ORR) was 75%.
  • For ALK-pos­i­tive pa­tients pre­vi­ous­ly treat­ed with Xalko­ri (crizo­tinib) with or with­out chemother­a­py: ORR was 69%, the IC-ORR was 68%.
  • In ALK-pos­i­tive pa­tients pre­vi­ous­ly treat­ed with a non-crizo­tinib ALK in­hibitor with or with­out chemother­a­py: ORR was 33%.
  • ALK-pos­i­tive pre­vi­ous­ly treat­ed with two or three pri­or ALK in­hibitors with or with­out chemother­a­py: ORR was 39%.
  • ROS1-pos­i­tive re­gard­less of pri­or treat­ment: ORR was 36%.

Now look for Pfiz­er to press hard to punch back at No­var­tis and Roche in de­fense of its can­cer drug fran­chise. Pfiz­er’s made on­col­o­gy a chief fo­cus in the pipeline, scor­ing some of its biggest gains in the field as it added new drugs through the Medi­va­tion buy­out. And as bil­lions gets poured in­to new re­search, pa­tients have ben­e­fit­ed from the quick adop­tion of some game-chang­ing ther­a­pies.

“Lor­la­tinib is an ex­tra­or­di­nary ex­am­ple of what can be achieved through trans­la­tion­al re­search and pre­ci­sion med­i­cine de­vel­op­ment. Re­call that Xalko­ri (crizo­tinib) was the first drug ap­proved for pa­tients with ALK-pos­i­tive and ROS1-pos­i­tive NSCLC. By un­der­stand­ing the mu­ta­tions that oc­curred in pa­tients that ren­dered their tu­mors re­sis­tant to Xalko­ri and oth­er ALK in­hibitors, med­i­c­i­nal chemists work­ing at Pfiz­er were able to de­sign a mol­e­cule with the po­ten­tial to over­come that re­sis­tance and in­hib­it ALK de­spite these mu­ta­tions. We are very en­cour­aged by the re­sults of this Phase 2 tri­al that pro­vide the first clin­i­cal ev­i­dence of the ac­tiv­i­ty of lor­la­tinib in this set­ting,” said Mace Rothen­berg, chief de­vel­op­ment of­fi­cer, on­col­o­gy, Pfiz­er glob­al prod­uct de­vel­op­ment.

Jean-Paul Clozel, Idorsia CEO (Patrick Straub/Keystone via AP Images)

Idor­si­a's brain bleed drug flunks PhI­II tri­al, a decade af­ter pre­vi­ous flop

Idorsia’s long journey with clazosentan came to an abrupt “unexpected result” Monday morning with a Phase III flop.

The Swiss biopharma said the drug did not meet the main goal of the late-stage REACT study, conducted in the US, Canada and Europe since early 2019.

The 409-patient trial tested the intravenous drug’s ability to prevent complications due to delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage (aSAH), in which blood vessels in the brain narrow and blood accumulates around the brain’s surface, which then dials up the pressure on the brain.

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Kenji Yasukawa, Astellas CEO (Photographer: Akio Kon/Bloomberg via Getty Images)

Astel­las taps chief strat­e­gy of­fi­cer as next CEO to 'go on the ag­gres­sive'

Five years into its big R&D revamp, Astellas says it’s time for a changing of the guard.

Kenji Yasukawa, who took over as president and CEO in 2018, will step down to become chairman of the board in April, making room for Naoki Okamura to take over. Okamura joined the company in 1986 and has served in a variety of finance, business and strategy roles, including most recently as chief strategy officer.

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Clin­i­cal tri­al di­ver­si­ty da­ta show mis­match be­tween en­roll­ment and dis­ease preva­lence, GSK says

A lack of diversity in clinical trials has persisted despite decades of initiatives to try to turn the tide.

In a recent review of 17 years of clinical trials, drugmaker GSK found that there were some mismatches between the demographics of its US-based trials and how prevalent diseases were in those populations.

The results, the company says, will help GSK and others design studies that better represent epidemiological rates within races and ethnicities.

The Big Phar­ma dis­card pile; Lay­offs all around while some biotechs bid farewell; New Roche CEO as­sem­bles top team; and more

Welcome back to Endpoints Weekly, your review of the week’s top biopharma headlines. Want this in your inbox every Saturday morning? Current Endpoints readers can visit their reader profile to add Endpoints Weekly. New to Endpoints? Sign up here.

With earnings seasons in full swing, we’ve listened in on all the calls so you don’t have to. But news is popping up from all corners, so make sure you check out our other updates, too.

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Ma­gen­ta halts stem cell work and may sell it­self fol­low­ing pa­tient death, clin­i­cal hold

Magenta Therapeutics said it is halting work on its stem cell transplant drug pipeline and may sell itself, a week after the company reported the death of a patient in an early stage trial of its antibody-drug conjugate.

The Cambridge, MA-based company said it will conduct a “review of strategic alternatives,” and that could include an “acquisition, merger, business combination, or other transaction.”

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How to use ex­ter­nal con­trols: FDA spells out think­ing in new draft guid­ance

The use of real-world evidence to inform the FDA’s decision-making continues apace, with the agency releasing new draft guidance yesterday on how sponsors can compare outcomes of trial participants receiving a test treatment with outcomes in a group of people external to the trial.

The practice of externally controlled trials is common, particularly in oncology or other difficult areas where it’s not ethical or feasible to use internal controls.

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The Big Phar­ma axe: Mer­ck cuts chikun­gun­ya vax, Bris­tol My­ers drops Cy­tomX-part­nered pro­gram, and more

As fourth quarter earnings come in, Big Pharmas are disclosing changes to their pipelines during their investor calls, and sometimes more quietly in presentation appendices.

Merck dropped its chikungunya vaccine candidate, which completed a Phase II study. Merck acquired the vaccine through its purchase of Themis Bioscience in 2020. In developing a vaccine for chikungunya, a mosquito-borne virus, Valneva is the frontrunner, as it submitted its vaccine to the FDA at the end of December.

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Goldfinch Bio CEO Tony Johnson (L) and Karuna Therapeutics CEO Bill Meury

Karuna li­cens­es Goldfinch as­sets to com­pete with Boehringer In­gel­heim in neu­ro­science

Karuna Therapeutics is looking to compete with Boehringer Ingelheim on depression and anxiety with a new license to Goldfinch Bio’s assets, starting with $15 million to the shuttered biotech.

Karuna steps into an arena already being tested by Boehringer in multiple Phase II studies — the two are targeting transient receptor potential canonical 4 and 5, or TRPC4/5, which is thought to have a role in neuroscience indications. Goldfinch’s asset went through a Phase II in kidney diseases, but Karuna’s sights are set on mood and anxiety disorders for now.

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Roche's headquarters in Basel, Switzerland (Kyle LaHucik for Endpoints News)

Roche ditch­es fi­nal PhI­II for can­cer hope­ful, re­ports set­back for key drug in $1.4B buy­out

Over the past few years, Roche has released news about its AKT inhibitor ipatasertib in drips — most of them negative. The drug yielded mixed data in a key prostate cancer trial, Phase III flops in triple-negative breast cancer forced the pharma giant to pull the plug there, and in mid-2022 Roche trimmed two more early-stage indications in prostate cancer after completing the trials.

Now, the last piece of the program is gone.

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