As­traZeneca spells out a ma­jor drop in the risk of death for stage 3 NSCLC pa­tients tak­ing Imfinzi — and why that's im­por­tant

As­traZeneca’s top team un­der Pas­cal So­ri­ot $AZN has spent the past 5 years prov­ing that it could do se­ri­ous block­buster de­vel­op­ment work. And few tri­als have been as im­por­tant to forg­ing that rep as PA­CIF­IC, which of­fered clear ev­i­dence that its PD-L1 check­point Imfinzi al­lowed pa­tients with un­re­sectable stage 3 non-small cell lung can­cer to live longer.

Dave Fredrick­son

This morn­ing, As­traZeneca ex­ecs turned up at the World Con­fer­ence on Lung Can­cer in Toron­to to spell out the promis­ing over­all sur­vival da­ta the phar­ma gi­ant had claimed with a top-line re­port last spring. The study was pub­lished in the New Eng­land Jour­nal of Med­i­cine.

Their pre­sen­ta­tion spot­light­ed a 32% re­duc­tion in the risk of death — HR 0.68 — for these stage 3 pa­tients, while the me­di­an OS rate had yet to be hit. 

Why is a one-third drop in the risk of death that im­por­tant?

At stage 3, says Dave Fredrick­son, the head of the On­col­o­gy Busi­ness Unit at As­traZeneca, pa­tients can still hold on to a rea­son­able hope that they can be cured.

“At stage 4,” he tells me, “the 5-year sur­vival rate is be­low 10%.” Adding this ther­a­py af­ter chemora­dio­ther­a­py of­fers some ex­pec­ta­tion that they’re not nec­es­sar­i­ly fac­ing a death sen­tence and “maybe bend­ing 5-year sur­vival times.”

Re­searchers have yet to do that. Map­ping out a durable re­sponse takes some time. 

Over­all Sur­vival in the In­ten­tion-to-Treat Pop­u­la­tion. Source: NE­JM

Click on the im­age to see the full-sized ver­sion

In the mean­time, says Fredrick­son, “we have seen quite brisk up­take since we have had ap­proval in the US of the PA­CIF­IC reg­i­men.” And that is mak­ing this drug the stan­dard of care in a ma­jor niche mar­ket.

“Half of pa­tients in stage 3 are treat­ed with ra­diochemother­a­py. Half of those pa­tients are be­ing treat­ed with Imfinzi af­ter­wards,” he says, a 50% share that’s cru­cial for a com­pa­ny an­gling in be­hind Mer­ck and Bris­tol-My­ers Squibb, the two dom­i­nant gi­ants in im­muno-on­col­o­gy.

Fredrick­son adds that As­traZeneca’s de­vel­op­ment strat­e­gy gives it an 18- to 24-month win­dow ahead of the ar­rival of any ri­vals. Dur­ing that time, the R&D group is work­ing on more re­search pro­grams to see if they can take the reg­i­men to ear­li­er stages of the dis­ease, with a spe­cial tri­al in Chi­na de­signed to quick­ly break in­to that boom­ing health­care mar­ket.

The pos­i­tive re­sults for As­traZeneca on PA­CIF­IC were es­pe­cial­ly im­por­tant af­ter their PD-L1 drug failed to make the first hur­dle on MYS­TIC. OS da­ta on that study are due some­time be­fore the end of the year. And if it’s a fail­ure, as many sus­pect it is, the phar­ma gi­ant will still have PA­CIF­IC and stage 3 NSCLC to boast about.

That’s a big deal for As­traZeneca.

De­vel­op­ment of the Next Gen­er­a­tion NKG2D CAR T-cell Man­u­fac­tur­ing Process

Celyad’s view on developing and delivering a CAR T-cell therapy with multi-tumor specificity combined with cell manufacturing success
Transitioning potential therapeutic assets from academia into the commercial environment is an exercise that is largely underappreciated by stakeholders, except for drug developers themselves. The promise of preclinical or early clinical results drives enthusiasm, but the pragmatic delivery of a therapy outside of small, local testing is most often a major challenge for drug developers especially, including among other things, the manufacturing challenges that surround the production of just-in-time and personalized autologous cell therapy products.

Roger Perlmutter, Merck

#ASH19: Here’s why Mer­ck is pay­ing $2.7B to­day to grab Ar­Qule and its next-gen BTK drug, lin­ing up Eli Lil­ly ri­val­ry

Just a few months after making a splash at the European Hematology Association scientific confab with an early snapshot of positive data for their BTK inhibitor ARQ 531, ArQule has won a $2.7 billion buyout deal from Merck.

Merck is scooping up a next-gen BTK drug — which is making a splash at ASH today — from ArQule in an M&A pact set at $20 a share $ARQL. That’s more than twice Friday’s $9.66 close. And Merck R&D chief Roger Perlmutter heralded a deal that nets “multiple clinical-stage oral kinase inhibitors.”

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Paul Hudson. Sanofi

New Sanofi CEO Hud­son adds next-gen can­cer drug tech to the R&D quest, buy­ing Syn­thorx for $2.5B

When Paul Hudson lays out his R&D vision for Sanofi tomorrow, he will have a new slate of interleukin therapies and a synthetic biology platform to boast about.

The French pharma giant announced early Monday that it is snagging San Diego biotech Synthorx in a $2.5 billion deal. That marks an affordable bolt-on for Sanofi but a considerable return for Synthorx backers, including Avalon, RA Capital and OrbiMed: At $68 per share, the price represents a 172% premium to Friday’s closing.

Synthorx’s take on alternative IL-2 drugs for both cancer and autoimmune disorders — enabled by a synthetic DNA base pair pioneered by Scripps professor Floyd Romesberg — “fits perfectly” with the kind of innovation that he wants at Sanofi, Hudson said.

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Game on: Re­gen­eron's BC­MA bis­pe­cif­ic makes clin­i­cal da­ta de­but, kick­ing off mul­ti­ple myelo­ma matchup with Bris­tol-My­ers

As J&J attempts to jostle past Bristol-Myers Squibb and bluebird for a landmark approval of its anti-BCMA CAR-T — and while GlaxoSmithKline maps a quick path to the FDA riding on its own BCMA-targeting antibody-drug conjugates — the bispecifics are arriving on the scene to stake a claim for a market that could cross $10 billion per year.

The main rivalry in multiple myeloma is shaping up to be one between Regeneron and Bristol-Myers, which picked up a bispecific antibody to BCMA through its recently closed $74 billion takeover of Celgene. Both presented promising first-in-human data at the ASH 2019 meeting.

FDA lifts hold on Abeon­a's but­ter­fly dis­ease ther­a­py, paving way for piv­otal study

It’s been a difficult few years for gene and cell therapy startup Abeona Therapeutics. Its newly crowned chief Carsten Thiel was forced out last year following accusations of unspecified “personal misconduct,” and this September, the FDA imposed a clinical hold on its therapy for a form of “butterfly” disease. But things are beginning to perk up. On Monday, the company said the regulator had lifted its hold and the experimental therapy is now set to be evaluated in a late-stage study.

Roche faces an­oth­er de­lay in strug­gle to nav­i­gate Spark deal past reg­u­la­tors — but this one is very short

Roche today issued the latest in a long string of delays of its $4.3 billion buyout of Philadelphia-based Spark Therapeutics. The delay comes as little surprise — it is their 10th in as many months — as their most recent delay was scheduled to expire before a key regulatory deadline.

But it is notable for its length: 6 days.

Previous extensions had moved the goalposts by about 3 weeks to a month, with the latest on November 22 expiring tomorrow. The new delay sets a deadline for next Monday, December 16, the same day by which the UK Competition and Markets Authority has to give its initial ruling on the deal. And they already reportedly have lined up an OK from the FTC staff – although that’s only one level of a multi-step process.

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KalVis­ta's di­a­bet­ic mac­u­lar ede­ma da­ta falls short — will Mer­ck walk away?

Merck’s 2017 bet on KalVista Pharmaceuticals may have soured, after the UK/US-based biotech’s lead drug failed a mid-stage study in patients with diabetic macular edema (DME).

Two doses of the intravitreal injection, KVD001, were tested against a placebo in a 129-patient trial. Patients who continued to experience significant inflammation and diminished visual acuity, despite anti-VEGF therapy, were recruited to the trial. Typically patients with DME — the most frequent cause of vision loss related to diabetes — are treated with anti-VEGF therapies such as Regeneron’s flagship Eylea or Roche’s Avastin and Lucentis.

UP­DAT­ED: Ob­sE­va makes case for best-in-class hor­mone sup­pres­sive ther­a­py in pos­i­tive uter­ine fi­broid study

About a month after the Swiss biotech disclosed a failed late-stage study in its IVF program, ObsEva on Monday unveiled positive pivotal data on its experimental treatment for heavy menstrual bleeding triggered by uterine fibroids.

ObsEva in-licensed the drug, linzagolix, from Japan’s Kissei Pharmaceutical in 2015. Two doses of the drug (100 mg and 200 mg) were tested against a placebo in the 535-patient Phase III study, dubbed PRIMROSE 2, in patients who were both on and off hormonal add-back therapy (ABT).

Samit Hirawat. Bristol-Myers Squibb

Bris­tol-My­ers is mak­ing a bee-line to the FDA with pos­i­tive liso-cel da­ta — but is it too late in the CAR-T game?

Bristol-Myers Squibb came to ASH this past weekend with a variety of messages on the new cancer drugs they had acquired in the big Celgene buyout, including liso-cel, the lead CAR-T program picked up in the $9 billion Juno acquisition. And one of the most important was that they had the pivotal efficacy and safety data needed to snag an approval from the FDA next year, with the BLA on track for a filing this month.