As­traZeneca chief is bet­ting the com­pa­ny’s fu­ture on a sin­gle roll of the dice

Bioreg­num
The view from End­points
As­traZeneca CEO Pas­cal So­ri­ot

Near­ly five years in­to his stint at the helm of As­traZeneca, CEO Pas­cal So­ri­ot has now reached his year of liv­ing dan­ger­ous­ly.

This morn­ing the phar­ma chief out­lined a steadi­ly de­clin­ing rate of rev­enue. Core EPS is ex­pect­ed to slide in the low to mid teens as gener­ics con­tin­ue to chop away at their Crestor fran­chise. All their old block­busters are be­ing dis­en­fran­chised, in a man­ner of speak­ing.

So­ri­ot, not known to wa­ver in times of a cri­sis, wasn’t about to break down now. He an­nounced: “It is an ex­cit­ing time as we rapid­ly ap­proach the in­flec­tion point for our an­tic­i­pat­ed re­turn to long-term growth, built on the sol­id foun­da­tions of a sci­ence-led pipeline.”

In­vestors weren’t very ex­cit­ed by the num­bers, though, send­ing the com­pa­ny’s shares down by close to 3% this morn­ing.

Af­ter a whole slate of clin­i­cal set­backs in 2016, the fi­nan­cial ero­sion at As­traZeneca has fo­cused an un­wa­ver­ing spot­light on the com­pa­ny’s com­bi­na­tion study for the PD-L1 check­point dur­val­um­ab and treme­li­mum­ab, a CT­LA-4, dubbed MYS­TIC.

A late­com­er to the check­point in­hi­bi­tion field, As­traZeneca is mak­ing a high-risk at­tempt at cut­ting in­to the line of heavy­weights com­pet­ing on lung can­cer, look­ing for ev­i­dence that they have a com­bo that can ri­val the ad­vanc­ing for­tunes of Mer­ck’s Keytru­da/chemo com­bi­na­tion, now un­der re­view.

As­traZeneca re­cent­ly tweaked MYS­TIC, adding months to the time­line as the phar­ma com­pa­ny awaits pro­gres­sion-free sur­vival da­ta this year and over­all sur­vival da­ta in 2018. And the move was wide­ly viewed as sig­nal­ing some un­der­ly­ing con­cerns about how the fi­nal da­ta read­out will look.

De­lays of any kind, though, are poi­son to As­traZeneca, as faster com­pa­nies con­tin­ue to cap­i­tal­ize on the first wave of check­points and more com­pa­nies mus­cle in along­side them. Pfiz­er, al­lied with Mer­ck KGaA, al­so has a check­point now un­der re­view at the FDA. Mer­ck, Bris­tol-My­ers and Roche are al­ready well in­to the mar­ket, with their own fol­low-up plans. And Bris­tol-My­ers’ de­ci­sion not to pur­sue an ac­cel­er­at­ed ap­proval for Op­di­vo (PD-1)/Yer­voy (CT­LA-4) in lung can­cer raised even more doubts about the ap­proach at As­traZeneca.

The stakes for As­traZeneca keep get­ting high­er, cre­at­ing a re­mark­able high-wire act for a Big Phar­ma play­er.

Not on­ly does As­traZeneca have to gain an ap­proval now, the com­pa­ny al­so has to be rec­og­nized as a leader in the field, po­si­tioned to grab bil­lions of dol­lars in new sales. Just falling short of ex­pec­ta­tions will be enough to quash hopes for the near-term turn­around that As­traZeneca needs.

“Rarely has a sin­gle tri­al re­sult been so cru­cial to a com­pa­ny the size of As­traZeneca,” said Mick Coop­er of Trin­i­ty Delta.

And how.

Rev­enue in 2016 hit $23 bil­lion in 2016, down from $24.7 bil­lion. But So­ri­ot promised $45 bil­lion in rev­enue by 2023, now just six years away. The com­pa­ny has al­ready start­ed back­ing away from that num­ber, blam­ing cur­ren­cy val­u­a­tions. But even their new goals will rapid­ly evap­o­rate with­out a big score on the I/O front.

5AM Ven­tures: Fu­el­ing the Next Gen­er­a­tion of In­no­va­tors

By RBC Capital Markets
With Andy Schwab, Co-Founder and Managing Partner at 5AM Ventures

Key Points

Prescription Digital Therapeutics, cell therapy technologies, and in silico medicines will be a vital part of future treatment modalities.
Unlocking the potential of the microbiome could be the missing link to better disease diagnosis.
Growing links between academia, industry, and venture capital are spinning out more innovative biotech companies.
Biotech is now seen by investors as a growth space as well as a safe haven, fuelling the recent IPO boom.

Biohaven CEO Vlad Coric (Photo Credit: Andrew Venditti)

Pssst: That big Bio­haven Alzheimer's study? It was a bust. Even the sub­group analy­sis ex­ecs tout­ed was a flop

You know it’s bad when a biopharma player plucks out a subgroup analysis for a positive take — even though it was way off the statistical mark for success, like everything else.

So it was for Biohaven $BHVN on MLK Monday, as the biotech reported on the holiday that their Phase II/III Alzheimer’s study for troriluzole flunked both co-primary endpoints as well as a key biomarker analysis.

The drug — a revised version of the ALS drug riluzole designed to regulate glutamate — did not “statistically differentiate” from placebo on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale 11 (ADAS-cog) and the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB).  The “hippocampal volume” assessment by MRI also failed to distinguish itself from placebo for all patients fitting the mild-to-moderate disease profile they had established for the study.

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CEO Stephen Yoder (Pieris)

Pieris fi­nal­ly vaults FDA hold on next-gen sol­id tu­mor hunter, clear­ing the path for mid-stage tri­al

Finally freed from the restraints of a partial FDA clinical hold on its lead HER2-positive solid tumor candidate, Pieris Pharmaceuticals is now racing toward Phase II.

The FDA slapped a partial hold on Pieris’ PRS-343 back in July, restricting the biotech from enrolling new patients in a Phase I trial. While Pieris was allowed to continue dosing patients who were already enrolled, the agency requested they conduct an additional “in-use and compatibility study” before recruiting any more.

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Two weeks after joining Verastem Oncology as chief medical officer, Frank Neumann is leaving the company for another job.

Neumann had joined Verastem after leaving bluebird bio, which surprisingly split into two companies last week, one in oncology and one in rare diseases. It’s not yet clear to where Neumann is headed next, but he noted in a statement that Verastem’s data and strategy were “truly exciting.”

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A month after filing the IND application for its human extracellular matrix designed to regenerate knee cartilage, Histogen has hit a roadblock.

The FDA on Tuesday verbally notified the San Diego-based biotech that it was placing a clinical hold on the planned Phase I/II clinical trial of HST-003 due to pending CMC information and additional questions needed to complete their review.

Histogen had planned to test the safety and efficacy of implanting hECM within microfracture interstices and related cartilage defects to regenerate that cartilage in conjunction with a microfracture procedure. The company said in a press release that it expects to receive written notice of the clinical hold from the FDA by Feb 12.

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Glax­o­SmithK­line's $4B bis­pe­cif­ic can­cer drug al­liance with Mer­ck KGaA hit by big set­back with a PhI­II fail­ure on NSCLC

Close to 2 years ago, GSK’s R&D team eagerly agreed to pay up to $4 billion-plus to ally itself with Merck KGaA on a mid-stage bispecific called bintrafusp alfa, which intrigued them with the combination of a TGF-β trap with the anti-PD-L1 mechanism in one fusion protein.

But today the German pharma company says that their lead study on lung cancer was a bust, as independent monitors said there was no reason to believe that the experimental drug — targeting PD-L1/TGF-Beta — could beat Keytruda.

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It’s time for a new FDA commissioner to come on board, a rite of passage for Joe Biden’s administration that should help seal the new president’s rep on seeking out the experts to lead the government over the next 4 years.

As of now, the competition for the top job appears to have narrowed down to 2 people: The longtime CDER chief Janet Woodcock and Joshua Sharfstein, the former principal deputy at the FDA under Peggy Hamburg. Both were appointed by Barack Obama.

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Grit­stone con­tin­ues Covid-19 push with deal to de­vel­op 'self-am­pli­fy­ing RNA' vac­cines, as shares con­tin­ue bal­loon­ing

Gritstone Oncology has had a big week, and it’s only Wednesday.

On Tuesday, the biotech revealed plans to start clinical testing of an experimental Covid-19 vaccine — in tandem with NIAID — that can also target other coronaviruses, with the goal of preventing future pandemics should SARS-CoV-2 prove difficult to cure with current vaccines. Then, on Wednesday morning, Gritstone licensed lipid nanoparticle technology from Genevant Sciences to develop what it’s calling “self-amplifying RNA vaccines” against Covid-19.

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The past two months have been tough for Bristol Myers Squibb and its checkpoint inhibitor Opdivo after setbacks in lung and brain cancers. But in the battle against Merck’s Keytruda, any success matters — and now Bristol could be looking at a quick approval for Opdivo in an unmatched indication.

The FDA will launch a speedy review of a combination of Bristol Myers Squibb’s Opdivo and chemotherapy to treat first-line patients with advanced or metastatic gastric cancer, gastroesophageal junction cancer or esophageal adenocarcinoma, the drugmaker said Wednesday. The agency set an action date of May 25 for the application.