Bris­tol-My­ers Squibb $BMY has a fresh Phase III set­back to re­port to­day on its all-im­por­tant PD-1 drug Op­di­vo. The phar­ma gi­ant says that their drug com­bined with ra­di­a­tion failed to sig­nif­i­cant­ly im­prove the over­all sur­vival rate of glioblas­toma pa­tients com­pared to a con­trol group re­ceiv­ing chemo plus ra­di­a­tion.

As usu­al, re­searchers will hold back the da­ta for a fu­ture con­fer­ence, but Check­Mate-498 is an­oth­er write-off.

“GBM is a no­to­ri­ous­ly ag­gres­sive can­cer,” notes Bris­tol-My­ers on­col­o­gy R&D chief Fouad Namouni, who ex­pressed their dis­ap­point­ment with the fail­ure.

Fouad Namouni

Op­di­vo earned $1.8 bil­lion in Q1 alone for Bris­tol-My­ers Squibb, a 19% gain over the same pe­ri­od a year ago. That’s no small ac­com­plish­ment in bio­phar­ma, but it al­so marks a sec­ond place po­si­tion be­hind an in­creas­ing­ly dom­i­nant Mer­ck — $2.3 bil­lion in Q1, up 55% — which has had far more suc­cess­es to re­port from the R&D group.

It’s un­like­ly that any of the an­a­lysts had much up­side built in for glioblas­toma, the most com­mon brain can­cer which has proven to be in­cred­i­bly dif­fi­cult to slow down. So don’t look for any dra­mat­ic stock moves. On the oth­er hand, the phar­ma gi­ant has been plagued by set­backs in the clin­ic. 

The com­pa­ny had to yank its ap­pli­ca­tion us­ing a high tu­mor mu­ta­tion­al bur­den af­ter get­ting some neg­a­tive feed­back from the FDA. Their com­bo ap­proach us­ing Yer­voy failed in non-small cell lung can­cer, and that fol­lowed a fail­ure against the stan­dard of care for sec­ond-line small cell lung can­cer. A brain can­cer flop may have been pre­dictable, but it al­so rais­es ques­tions about their R&D strat­e­gy at a time Mer­ck has been ad­vanc­ing with its chemo com­bo ap­proach.

With some key read­outs due on front­line lung can­cer, Bris­tol-My­ers is in a make-or-break po­si­tion with Op­di­vo, with an­a­lysts like Wolfe’s Tim An­der­son won­der­ing if they’re head­ed for a peak in Op­di­vo sales in 2020, fol­lowed by a flat line as com­pe­ti­tion builds around the world. That al­ready may have dri­ven their $74 bil­lion Cel­gene ac­qui­si­tion, which will shift fo­cus to a slate of 6 late-stage drugs up for an ap­proval de­ci­sion.

Blue­bird bio $BLUE has un­veiled its price for the new­ly ap­proved gene ther­a­py Zyn­te­glo (Lenti­Glo­bin), which came as a big sur­prise. And it wasn’t the on­ly un­ex­pect­ed twist in to­day’s sto­ry.

With some an­a­lysts bet­ting on a $900,000 price for the β-tha­lassemia treat­ment in Eu­rope, where reg­u­la­tors pro­vid­ed a con­di­tion­al ear­ly OK, blue­bird CEO Nick Leschly said Fri­day morn­ing that the pa­tients who are suc­cess­ful­ly treat­ed with their drug over 5 years will be charged twice that — $1.8 mil­lion — on the con­ti­nent. That makes this drug the sec­ond most ex­pen­sive ther­a­py on the plan­et, just be­hind No­var­tis’ new­ly ap­proved Zol­gens­ma at $2.1 mil­lion, with an­a­lysts still wait­ing to see what kind of pre­mi­um can be had in the US.

Re­gen­eron’s close­ly-watched bis­pe­cif­ic con­tin­ues to ring up high re­sponse rates

Re­gen­eron’s high-pro­file bis­pe­cif­ic REGN1979 is back in the spot­light at the Eu­ro­pean Hema­tol­ogy As­so­ci­a­tion sci­en­tif­ic con­fab. And while the stel­lar num­bers we saw at ASH have erod­ed some­what as more blood can­cer pa­tients are eval­u­at­ed, the re­sponse rates for this CD3/CD20 drug re­main high.

A to­tal of 13 out of 14 fol­lic­u­lar lym­phomas re­spond­ed to the drug, a 93% ORR, down from 100% at the last read­out. In 10 out of 14, there was a com­plete re­sponse. In dif­fuse large B-cell lym­phoma the re­sponse rate was 57% among pa­tients treat­ed at the 80 mg to 160 mg dose range. They were all com­plete re­spons­es. And 2 of these Cars were for pa­tients who had failed CAR-T ther­a­py.

In­vestors are in no mood to hear biotechs tout the suc­cess of a “key” sec­ondary end­point when the piv­otal Phase III flunks the pri­ma­ry goal. Just ask Savara. 

The Texas biotech $SVRA went look­ing for a sil­ver lin­ing as com­pa­ny ex­ecs blunt­ly con­ced­ed that Mol­gradex, an in­haled for­mu­la­tion of re­com­bi­nant hu­man gran­u­lo­cyte-macrophage colony-stim­u­lat­ing fac­tor (GM-CSF), failed to spur sig­nif­i­cant­ly im­proved treat­ment out­comes for pa­tients with a rare res­pi­ra­to­ry dis­ease called au­toim­mune pul­monary alve­o­lar pro­teinosis, or aPAP.

Late-stage da­ta pre­sent­ed at the Amer­i­can Di­a­betes As­so­ci­a­tion an­nu­al meet­ing in 2010 pushed Eli Lil­ly to put a crimp on teplizum­ab as the phar­ma gi­ant found it un­able to re­set the clock on new­ly di­ag­nosed type 1 di­a­betes. At the same con­fer­ence but in dif­fer­ent hands nine years lat­er, the drug is mak­ing a crit­i­cal come­back by scor­ing suc­cess in an­oth­er niche: de­lay­ing the on­set of the dis­ease.

In a Phase II tri­al with 76 high-risk in­di­vid­u­als — rel­a­tives of pa­tients with type 1 di­a­betes who have di­a­betes-re­lat­ed au­toan­ti­bod­ies in their bod­ies — teplizum­ab al­most dou­bled the me­di­an time of di­ag­no­sis com­pared to place­bo (48.4 months ver­sus 24.4 months). The haz­ard ra­tio for di­ag­no­sis was 0.41 (p=0.006).