As­traZeneca joins Mer­ck, Bris­tol-My­ers in Chi­na's check­point race as reg­u­la­tors OK first PD-L1

As­traZeneca has made a stride to­ward re­al­iz­ing its am­bi­tions in Chi­na as reg­u­la­tors green­light Imfinzi as a treat­ment for non-small cell lung can­cer.

In par­tic­u­lar, the PD-L1 agent is fill­ing a void for im­munother­a­pies in Stage III un­re­sectable case, the com­pa­ny said, where the can­cer has not spread to the rest of the body. It is to be used, with cu­ra­tive in­tent, in pa­tients whose can­cer hasn’t pro­gressed fol­low­ing con­cur­rent plat­inum-based chemother­a­py and ra­di­a­tion ther­a­py.

Dave Fredrick­son

“This ap­proval il­lus­trates our long-stand­ing com­mit­ment to im­prov­ing health out­comes in Chi­na, where more than one-third of the world’s lung can­cer di­ag­noses and deaths oc­cur,” said Dave Fredrick­son, who heads As­traZeneca’s on­col­o­gy busi­ness unit, in a state­ment.

Imfinz’s ap­proval al­so marks the en­try of a PD-L1 in­hibitor to the coun­try, where PD-1 drugs have been pil­ing up. Bris­tol-My­ers Squibb scored the first-ever Chi­nese ap­proval for a check­point in­hibitor in June 2018, with Op­di­vo in­di­cat­ed for sec­ond-line treat­ment of NSCLC, and Mer­ck has been rack­ing up OKs for dif­fer­ent reg­i­mens in­volv­ing Keytru­da.

Then there are the do­mes­tic ri­vals, whose drugs are cur­rent­ly lim­it­ed to lym­phoma or melanoma but al­so have plans for a lu­cra­tive lung can­cer mar­ket. And they are ea­ger to com­pete on price.

Leon Wang

For As­traZeneca, this is just more rea­son to roll up its sleeves and get to ne­go­ti­at­ing with pay­ers. Its head of Chi­na, Leon Wang, has pre­vi­ous­ly told Bloomberg that he sees new treat­ments con­tribut­ing to 60% of all its Chi­na rev­enue with­in five years. To il­lus­trate that dri­ve, Wang of­fered the ex­am­ple of its first-gen EGFR-tar­get­ing lung can­cer Ires­sa, in which they won the drug sup­ply con­tract in by slash­ing the price more than 70%.

Quick ap­provals for third-gen EGFR TKI Tagris­so (which is now on the Na­tion­al Re­im­burse­ment Drug List), as well as the PARP in­hibitor Lyn­parza, helped — and now it’s time for Imfinzi to shine. No­tably, Roche’s PD-L1 Tecen­triq — which gained FDA ap­proval ear­li­er than Imfinzi — is not yet avail­able in Chi­na.

In the Phase III PA­CIF­IC tri­al, Imfinzi cut the risk of death by 32% and pro­longed pro­gres­sion-free sur­vival by 11.2 months ver­sus place­bo (me­di­an PFS 16.8 vs 5.6 months), when paired with chemo or ra­di­a­tion ther­a­py. At the three-year mark, 57% of pa­tients on the Imfinzi arm are still alive com­pared to 43.5% on place­bo, ac­cord­ing to a post hoc analy­sis pre­sent­ed at AS­CO.

Imfinzi sales have gone over the $1 bil­lion mark in the first three quar­ters of the year, grow­ing 182% com­pared to the same pe­ri­od last year.

2019 Trin­i­ty Drug In­dex Eval­u­ates Ac­tu­al Com­mer­cial Per­for­mance of Nov­el Drugs Ap­proved in 2016

Fewer Approvals, but Neurology Rivals Oncology and Sees Major Innovations

This report, the fourth in our Trinity Drug Index series, outlines key themes and emerging trends in the industry as we progress towards a new world of targeted and innovative products. It provides a comprehensive evaluation of the performance of novel drugs approved by the FDA in 2016, scoring each on its commercial performance, therapeutic value, and R&D investment (Table 1: Drug ranking – Ratings on a 1-5 scale).

How to cap­i­talise on a lean launch

For start-up biotechnology companies and resource stretched pharmaceutical organisations, launching a novel product can be challenging. Lean teams can make setting a launch strategy and achieving your commercial goals seem like a colossal undertaking, but can these barriers be transformed into opportunities that work to your brand’s advantage?
We spoke to Managing Consultant Frances Hendry to find out how Blue Latitude Health partnered with a fledgling subsidiary of a pharmaceutical organisation to launch an innovative product in a
complex market.
What does the launch environment look like for this product?
FH: We started working on the product at Phase II and now we’re going into Phase III trials. There is a significant unmet need in this disease area, and everyone is excited about the launch. However, the organisation is still evolving and the team is quite small – naturally this causes a little turbulence.

Aymeric Le Chatelier, Ipsen

A $1B-plus drug stum­bles in­to an­oth­er big PhI­II set­back -- this time flunk­ing fu­til­i­ty test -- as FDA hold re­mains in ef­fect for Ipsen

David Meek

At the time Ipsen stepped up last year with more than a billion dollars in cash to buy Clementia and a late-stage program for a rare bone disease that afflicts children, then CEO David Meek was confident that he had put the French biotech on a short path to a mid-2020 launch.

Instead of prepping a launch, though, the company was hit with a hold on the FDA’s concerns that a therapy designed to prevent overgrowth of bone for cases of fibrodysplasia ossificans progressiva might actually stunt children’s growth. So they ordered a halt to any treatments for kids 14 and under. Meek left soon after to run a startup in Boston. And today the Paris-based biotech is grappling with the independent monitoring committee’s decision that their Phase III had failed a futility test.

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UP­DAT­ED: Eli Lil­ly’s $1.6B can­cer drug failed to spark even the slight­est pos­i­tive gain for pa­tients in its 1st PhI­II

Eli Lilly had high hopes for its pegylated IL-10 drug pegilodecakin when it bought Armo last year for $1.6 billion in cash. But after reporting a few months ago that it had failed a Phase III in pancreatic cancer, without the data, its likely value has plunged. And now we’re getting some exact data that underscore just how little positive effect it had.

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Roche's check­point play­er Tecen­triq flops in an­oth­er blad­der can­cer sub­set

Just weeks after Merck’s star checkpoint inhibitor Keytruda secured FDA approval for a subset of bladder cancer patients, Swiss competitor Roche’s Tecentriq has failed in a pivotal bladder cancer study.

The 809-patient trial — IMvigor010 — tested the PD-L1 drug in patients with muscle-invasive urothelial cancer (MIUC) who had undergone surgery, and were at high risk for recurrence.

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UP­DAT­ED: FDA’s golodirsen CRL: Sarep­ta’s Duchenne drugs are dan­ger­ous to pa­tients, of­fer­ing on­ly a small ben­e­fit. And where's that con­fir­ma­to­ry tri­al?

Back last summer, Sarepta CEO Doug Ingram told Duchenne MD families and investors that the FDA’s shock rejection of their second Duchenne MD drug golodirsen was due to some concerns regulators raised about the risk of infection and the possibility of kidney toxicity. But when pressed to release the letter for all to see, he declined, according to a report from BioPharmaDive, saying that kind of move “might not look like we’re being as respectful as we’d like to be.”

He went on to assure everyone that he hadn’t misrepresented the CRL.

But Ingram’s public remarks didn’t include everything in the letter, which — following the FDA’s surprise about-face and unexplained approval — has now been posted on the FDA’s website and broadly circulated on Twitter early Wednesday.

The CRL raises plenty of fresh questions about why the FDA abruptly decided to reverse itself and hand out an OK for a drug a senior regulator at the FDA believed — 5 months ago, when he wrote the letter — is dangerous to patients. It also puts the spotlight back on Sarepta $SRPT, which failed to launch a confirmatory study of eteplirsen, which was only approved after a heated internal controversy at the FDA. Ellis Unger, director of CDER’s Office of Drug Evaluation I, notes that study could have clarified quite a lot about the benefit and risks associated with their drugs — which can cost as much as a million dollars per patient per year, depending on weight.

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Gilead claims Tru­va­da patents in HHS’ com­plaint are in­valid

Back in November, the Department of Health and Human Services took the rare step of filing a complaint against Gilead for infringing on government-owned patents related to the HIV drug Truvada (emtricitabine/tenofovir disoproxil fumarate) for pre-exposure prophylaxis (PrEP).

But on Thursday, Gilead filed its own retort, making clear that it does not believe it has infringed on the Centers for Disease Control and Prevention’s (CDC) Truvada patents because they are invalid.

Gilead dusts off a failed Ebo­la drug as coro­n­avirus spreads; Ex­elix­is boasts pos­i­tive Ph I/II da­ta

→ Less than a year ago Gilead’s antiviral remdesivir failed to make the cut as investigators considered a raft of potential drugs that could be used against an Ebola outbreak. But it may gain a new mission with the outbreak of the coronavirus in China, which is popping up now around the world.

Gilead put out a statement saying that they’re now in discussions with health officials in the US and China about testing their NUC against the virus. It’s the latest in a growing lineup of biopharma companies that are marshaling R&D forces to see if they can come up with a vaccine or therapy to blunt the spread of the virus, which has now sickened hundreds, killed at least 17 people and led the Chinese government to start quarantining cities.

Alex Karnal (Deerfield)

Deer­field vaults to the top of cell and gene ther­a­py CD­MO game with $1.1B fa­cil­i­ty at Philadel­phi­a's newest bio­phar­ma hub

Back at the beginning of 2015, Deerfield Management co-led a $10 million Series C for a private gene therapy startup, reshaping the company and bringing in new leaders to pave way for an IPO just a year later.

Fast forward four more years and the startup, AveXis, is now a subsidiary of Novartis marketing the second-ever gene therapy to be approved in the US.

For its part, Deerfield has also grown more comfortable and ambitious about the nascent field. And the investment firm is now putting down its biggest bet yet: a $1.1 billion contract development and manufacturing facility to produce everything one needs for cell and gene therapy — faster and better than how it’s currently done.