Blue­print stum­bles in PhI­II GIST tri­al, send­ing stock slid­ing, but an­a­lysts preach cau­tion

When the FDA ap­proved Blue­print’s first drug three months ago, they split their de­ci­sion. Ay­vak­it would be ap­proved for gas­troin­testi­nal stro­mal tu­mors (GIST) with a rare mu­ta­tion called PDGFRa. The oth­er half of their ap­pli­ca­tion for plain old fourth line GIST would have to wait. Reg­u­la­tors want­ed to know how the drug per­formed in a Phase III tri­al.

Re­sults are now in from that Phase III tri­al and they spelled a death-knell. In a study of 476 pa­tients with third or fourth line GIST, Ay­vak­it (avapri­tinib) per­formed worse on the pri­ma­ry end­point than the al­ready-ap­proved Bay­er GIST drug, re­go­rafenib. Pro­gres­sion-free sur­vival was 4.2 months, com­pared with 5.6 months for Ay­vak­it.

Blue­print’s drug did have a high­er re­sponse rate — 17% com­pared with 7% — but that ap­peared as lit­tle con­so­la­tion. The com­pa­ny is dis­con­tin­u­ing de­vel­op­ment of the drug for those pa­tients.

“We will con­tin­ue to ad­vance our pipeline with clear near-term pri­or­i­ties in sys­temic mas­to­cy­to­sis and RET-al­tered can­cers,” CEO Jeff Al­bers said in a state­ment.

The com­pa­ny’s stock $BPMC took a sig­nif­i­cant hit, falling 20% from $70.90 to $56.71, ef­fec­tive­ly eras­ing over $800 mil­lion in val­ue.

Cowen’s Marc Frahm sug­gest­ed, though, that this was an over­re­ac­tion, writ­ing in a note to in­vestors that “GIST was not the the­sis.” The drug could still be po­ten­tial­ly used off-la­bel in fourth line GIST, Frahm wrote, but they were still re­mov­ing 3rd and 4th line GIST from their fu­ture sales pro­jec­tions. Nev­er­the­less, he ar­gued the tri­al said lit­tle about Ay­vak­it’s po­ten­tial in sys­temic mas­to­cy­to­sis — a rare dis­ease where mast cells ac­cu­mu­late in or­gans — or, in com­bi­na­tion with an­oth­er ex­per­i­men­tal drug, in can­cers with RET mu­ta­tions.

“We have re­moved sales for the broad 3/4L GIST in­di­ca­tions but con­tin­ue to view BPMC shares as un­der­val­ued,” Frahm wrote, pric­ing them at $83.

An­drew Berens at SVB Leerink was less up­beat but echoed the call for cau­tion. The fail­ure will “fun­da­men­tal­ly hit” Blue­print, he said, but the greater po­ten­tial lay else­where.

“Over­all, we be­lieve that GIST is less im­por­tant to the BPMC the­sis and think that in­vestors are like­ly to step in af­ter this read­out for more long-term op­por­tu­ni­ties in RET-dri­ven ma­lig­nan­cies and sys­temic mas­to­cy­to­sis (SM) with up­com­ing cat­a­lyst,” Berens wrote.

Blue­print had been in a two-per­son race with De­ci­phera to get a drug ap­proved for GIST — a rare form of sar­co­ma in the di­ges­tive sys­tem — dri­ven by a mu­ta­tion to the platelet-de­rived growth al­pha gene, or PDGFRa. Ay­vak­it was ap­proved un­der ac­cel­er­at­ed ap­proval, while De­ci­phera awaits an Au­gust de­ci­sion date from the FDA. Both com­pa­nies are al­so pur­su­ing sys­temic mas­to­cy­to­sis and 2nd line GIST.

De­ci­phera does not have a tri­al for 3rd line GIST, but Berens said the com­pa­ny could ben­e­fit if on­col­o­gists de­cide to try their drug off-la­bel in that set­ting.

So­cial im­age: Jeff Al­bers, Blue­print CEO (CN­BC)

Health­care Dis­par­i­ties and Sick­le Cell Dis­ease

In the complicated U.S. healthcare system, navigating a serious illness such as cancer or heart disease can be remarkably challenging for patients and caregivers. When that illness is classified as a rare disease, those challenges can become even more acute. And when that rare disease occurs in a population that experiences health disparities, such as people with sickle cell disease (SCD) who are primarily Black and Latino, challenges can become almost insurmountable.

Jacob Van Naarden (Eli Lilly)

Ex­clu­sives: Eli Lil­ly out to crash the megablock­buster PD-(L)1 par­ty with 'dis­rup­tive' pric­ing; re­veals can­cer biotech buy­out

It’s taken 7 years, but Eli Lilly is promising to finally start hammering the small and affluent PD-(L)1 club with a “disruptive” pricing strategy for their checkpoint therapy allied with China’s Innovent.

Lilly in-licensed global rights to sintilimab a year ago, building on the China alliance they have with Innovent. That cost the pharma giant $200 million in cash upfront, which they plan to capitalize on now with a long-awaited plan to bust up the high-price market in lung cancer and other cancers that have created a market worth tens of billions of dollars.

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So what hap­pened with No­var­tis' gene ther­a­py group? Here's your an­swer

Over the last couple of days it’s become clear that the gene therapy division at Novartis has quietly undergone a major reorganization. We learned on Monday that Dave Lennon, who had pursued a high-profile role as president of the unit with 1,500 people, had left the pharma giant to take over as CEO of a startup.

Like a lot of the majors, Novartis is an open highway for head hunters, or anyone looking to staff a startup. So that was news but not completely unexpected.

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Who are the women su­per­charg­ing bio­phar­ma R&D? Nom­i­nate them for this year's spe­cial re­port

The biotech industry has faced repeated calls to diversify its workforce — and in the last year, those calls got a lot louder. Though women account for just under half of all biotech employees around the world, they occupy very few places in C-suites, and even fewer make it to the helm.

Some companies are listening, according to a recent BIO survey which showed that this year’s companies were 2.5 times more likely to have a diversity and inclusion program compared to last year’s sample. But we still have a long way to go. Women represent just 31% of biotech executives, BIO reported. And those numbers are even more stark for women of color.

David Meek, new Mirati CEO (Marlene Awaad/Bloomberg via Getty Images)

Fresh off Fer­Gene's melt­down, David Meek takes over at Mi­rati with lead KRAS drug rac­ing to an ap­proval

In the insular world of biotech, a spectacular failure can sometimes stay on any executive’s record for a long time. But for David Meek, the man at the helm of FerGene’s recent implosion, two questionable exits made way for what could be an excellent rebound.

Meek, most recently FerGene’s CEO and a past head at Ipsen, has become CEO at Mirati Therapeutics, taking the reins from founding CEO Charles Baum, who will step over into the role of president and head of R&D, according to a release.

Volker Wagner (L) and Jeff Legos

As Bay­er, No­var­tis stack up their ra­dio­phar­ma­ceu­ti­cal da­ta at #ES­MO21, a key de­bate takes shape

Ten years ago, a small Norwegian biotech by the name of Algeta showed up at ESMO — then the European Multidisciplinary Cancer Conference 2011 — and declared that its Bayer-partnered targeted radionuclide therapy, radium-223 chloride, boosted the overall survival of castration-resistant prostate cancer patients with symptomatic bone metastases.

In a Phase III study dubbed ALSYMPCA, patients who were treated with radium-223 chloride lived a median of 14 months compared to 11.2 months. The FDA would stamp an approval on it based on those data two years later, after Bayer snapped up Algeta and christened the drug Xofigo.

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Mi­rati tri­umphs again in KRAS-mu­tat­ed lung can­cer with a close­ly watched FDA fil­ing now in the cards

After a busy weekend at #ESMO21, which included a big readout for its KRAS drug adagrasib in colon cancer, Mirati Therapeutics is ready to keep the pressure on competitor Amgen with lung cancer data that will undergird an upcoming filing.

In topline results from a Phase II cohort of its KRYSTAL-1 study, adagrasib posted a response rate of 43% in second-line-or-later patients with metastatic non-small cell lung cancer containing a KRAS-G12C mutation, Mirati said Monday.

When ef­fi­ca­cy is bor­der­line: FDA needs to get more con­sis­tent on close-call drug ap­provals, agency-fund­ed re­search finds

In the exceedingly rare instances in which clinical efficacy is the only barrier to a new drug’s approval, new FDA-funded research from FDA and Stanford found that the agency does not have a consistent standard for defining “substantial evidence” when flexible criteria are used for an approval.

The research comes as the FDA is at a crossroads with its expedited-review pathways. The accelerated approval pathway is under fire as the agency recently signed off on a controversial new Alzheimer’s drug, with little precedent to explain its decision. Meanwhile, top officials like Rick Pazdur have called for a major push to simplify and clarify all of the various expedited pathways, which have grown to be must-haves for sponsors of nearly every newly approved drug.

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Ted White, Verrica CEO

Ver­ri­ca hits an­oth­er bump in the road with CMO re­lat­ed let­ter from FDA

The FDA has rejected Verrica’s new drug application for VP-102 again, with the company pinning the CRL on problems at a CMO that it was partnered with, the company announced Monday.

The FDA didn’t raise issues that directly relate to the manufacturing of VP-102, the company said, but raised “general quality issues” at the CMO’s facility. There were also no clinical concerns, it said, or need to collect more data.