Deaths de­rail Juno's launch count­down, giv­ing Kite and No­var­tis the lead

The FDA’s hold on Juno Ther­a­peu­tics’ lead CAR-T pro­gram, JCAR015, last­ed on­ly six days. But the de­rail­ment was se­ri­ous enough to push its ex­pect­ed ap­proval date from 2017 back in­to 2018, leav­ing Kite Phar­ma and No­var­tis an­gling for the first ap­provals in the field in 2017.

Juno CEO Hans Bish­op

“Re­gard­ing the ROCK­ET tri­al,” Juno CEO Hans Bish­op told an­a­lysts Thurs­day evening, “the process of get­ting IRB ap­proval across mul­ti­ple sites along with the gat­ed en­roll­ment for the next six pa­tients leaves us to now es­ti­mat­ing ap­proval as ear­ly as the first half of 2018.”

The new H1 2018 pro­jec­tion marks a set­back for Juno, which had been seen as run­ning neck and neck with Kite in the race to get the land­mark ap­proval for a new can­cer ther­a­py that takes cells from pa­tients and reengi­neers them in­to a can­cer cell at­tack ve­hi­cle.

The hold last month, fol­low­ing the death of sev­er­al pa­tients from lethal cas­es of cere­bral ede­ma, stunned long­time ob­servers of Juno. The biotech quick­ly and suc­cess­ful­ly ap­pealed to the agency to lift the hold, say­ing they be­lieved that adding flu­dara­bine to its pre­con­di­tion­ing reg­i­men for pa­tients — prep­ping them to bet­ter re­spond to their CAR-T — had cre­at­ed a tox­ic com­bi­na­tion with the ther­a­py, killing 4 pa­tients. Reg­u­la­tors, who had al­so placed the same ther­a­py briefly on hold af­ter cy­tokine re­lease syn­drome al­so killed some pa­tients ear­ly on, were quick to re­spond af­fir­ma­tive­ly.

The de­lay leaves JCAR015 poised to en­ter the mar­ket just a year ahead of JCAR017. Bish­op de­scribes the sec­ond drug as “the back­bone of our CD19 fran­chise,” which is aimed at NHL, pe­di­atric and adult ALL and CLL.

Juno, though, is al­so mov­ing a va­ri­ety of pro­grams across a broad R&D front, and is now go­ing af­ter mul­ti­ple myelo­ma in a new pact that ropes in long­time col­lab­o­ra­tors at Memo­r­i­al Sloan Ket­ter­ing Can­cer Cen­ter.

In a sep­a­rate press re­lease, the Seat­tle-based biotech an­nounced Thurs­day evening that it had struck a deal with MSK and Eu­re­ka Ther­a­peu­tics for IP on bind­ing do­mains need­ed to com­mer­cial­ize a CAR-T for mul­ti­ple myelo­ma. These bind­ing do­mains were de­vel­oped in a pact that Eu­re­ka and MSK had struck ear­li­er.

That deal is par­tic­u­lar­ly sig­nif­i­cant, as it in­volves a ful­ly-hu­man bind­ing do­main tar­get­ing B-cell mat­u­ra­tion anti­gen (BC­MA), along with bind­ing do­mains against two ad­di­tion­al undis­closed mul­ti­ple myelo­ma tar­gets. The BC­MA pact puts Juno on a po­ten­tial col­li­sion course with blue­bird bio, which al­so chose that tar­get in a col­lab­o­ra­tion its pur­su­ing with Cel­gene. Those two play­ers re­struc­tured their deal last year to con­cen­trate on BC­MA and Cel­gene lat­er signed a ma­jor pact with Juno as well.

Pfiz­er and Cel­lec­tis are al­so aim­ing at BC­MA in their col­lab­o­ra­tion, but they’re con­cen­trat­ing on a sec­ond-gen, off-the-shelf prod­uct.

Juno CSO Hy Lev­it­sky

“We ex­pect the BC­MA CAR to en­ter hu­man test­ing as ear­ly as the first half 2017,” Juno CSO Hy Lev­it­sky told an­a­lysts. “We’re op­ti­mistic the CAR T cell ther­a­py can be an im­por­tant com­po­nent in treat­ing pa­tients with mul­ti­ple myelo­ma. And we are pleased to bring ad­di­tion­al ful­ly hu­man body do­main against BC­MA and oth­er tar­gets in­to our pro­gram. We be­lieve that a mul­ti-pronged ap­proach may be nec­es­sary to treat this dis­ease and hence the im­por­tance of ac­cess to sev­er­al hu­man con­structs spe­cif­ic for more than one tar­get.”

This isn’t the first such pact that Juno and Eu­re­ka have struck. Back at the be­gin­ning of the year the two com­pa­nies struck a deal on a ful­ly hu­man bind­ing do­main that tar­gets MUC16. These bind­ing do­mains play a key role in im­prov­ing cell per­sis­tence, amp­ing up their ef­fect on pa­tients. And the in­tense ri­val­ry to dom­i­nate the first wave of com­mer­cial CAR-Ts to hit the mar­ket has spurred an arms race for the best tech with the most po­ten­tial.

Has the mo­ment fi­nal­ly ar­rived for val­ue-based health­care?

RBC Capital Markets’ Healthcare Technology Analyst, Sean Dodge, spotlights a new breed of tech-enabled providers who are rapidly transforming the way clinicians deliver healthcare, and explores the key question: can this accelerating revolution overturn the US healthcare system?

Key points

Tech-enabled healthcare providers are poised to help the US transition to value, not volume, as the basis for reward.
The move to value-based care has policy momentum, but is risky and complex for clinicians.
Outsourced tech specialists are emerging to provide the required expertise, while healthcare and tech are also converging through M&A.
Value-based care remains in its early stages, but the transition is accelerating and represents a huge addressable market.

Andy Plump, Takeda R&D chief (Jeff Rumans for Endpoints News)

What kind of PhI­Ib da­ta is worth $4B cash? Take­da’s Andy Plump has some thoughts on that

A few months back, when Takeda caused jaws to drop with its eye-watering $4 billion cash upfront for a mid-stage TYK2 drug from Nimbus, it had already taken a deep dive on the solid Phase IIb data Nimbus had assembled from its dose-ranging study in psoriasis.

Now, it’s rolling that data out, eager to demonstrate what inspired the global biopharma to go long in a neighboring, but new, disease arena for the pipeline. And the most avid students of the numbers will likely be at Bristol Myers Squibb, who will have a multi-year head start on pioneering the TYK2 space with Sotyktu (deucravacitinib) as Takeda makes its lunge for best-in-class status.

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No­vo Nordisk re­mains un­der UK scruti­ny as MHRA con­ducts its own re­view in 'in­cred­i­bly rare' case

The UK’s Medicines and Healthcare products Regulatory Agency is now reviewing Novo Nordisk’s marketing violation that resulted in its loss of UK trade group membership last week. Novo Nordisk was suspended on Thursday from the Association of the British Pharmaceutical Industry (ABPI) for two years after an investigation by its regulatory arm found the pharma broke its conduct rules.

MHRA said on Tuesday that its review of the Prescription Medicines Code of Practice Authority (PMCPA) investigation is standard practice. An MHRA spokesperson emphasized in an email to Endpoints News that the situation with Novo Nordisk is “incredibly rare” while also noting ABPI took “swift and proportionate action.”

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FDA in­di­cates will­ing­ness to ap­prove Bio­gen ALS drug de­spite failed PhI­II study

Ahead of Wednesday’s advisory committee hearing to discuss Biogen’s ALS drug tofersen, the FDA appeared open to approving the drug, newly released briefing documents show.

Citing the need for flexibility in a devastating disease like ALS, regulators signaled a willingness to consider greenlighting tofersen based on its effect on a certain protein associated with ALS despite a failed pivotal trial. The documents come after regulatory flexibility was part of the same rationale the agency expressed when approving an ALS drug last September from Amylyx Pharmaceuticals, indicating the FDA’s openness to approving new treatments for the disease.

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Vipin Garg, Altimmune CEO

Al­tim­mune’s shares halved af­ter in­ter­im look at PhII weight loss drug da­ta

Altimmune’s attempt to catch up to Novo Nordisk and Eli Lilly’s GLP-1 drugs hit an investor snag Tuesday after the biotech shared interim Phase II weight loss data.

The Maryland biotech’s pemvidutide is a GLP-1/glucagon dual receptor agonist meant to activate GLP-1 receptors to squash appetite and glucagon to ramp up energy use. The 2.4 mg dose showed a placebo-adjusted weight loss of 9.7% at week 24 of 48, which Jefferies analysts said would be comparable to Novo Nordisk’s semaglutide (Wegovy) and Eli Lilly’s tirzepatide (Mounjaro).

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FDA warns Proc­ter & Gam­ble over NyQuil la­bel's in­gre­di­ent list­ings

The FDA on Tuesday released a warning letter sent earlier this month to the Mason, OH-based site of Procter & Gamble Manufactura, raising questions about the list of ingredients on the label and in the electronic filing.

The warning says that for P&G’s over-the-counter Vicks Nyquil Severe Hot Remedy Cold and Flu Plus Congestion, there’s a “mismatched” list of active ingredients between the labeling and the electronic listing file. The listing file for the active ingredients did not match the active ingredients in the electronic file.

FTC says patent bat­tle over Parkin­son's drug could have 'sig­nif­i­cant im­pli­ca­tion­s' for pa­tients

The Federal Trade Commission has gotten involved in a patent feud over Supernus’ Parkinson’s drug Apokyn, a case the agency said may have ‘‘significant implications” for patients who rely on the drug.

Sage Chemical won the first generic approval for its Apokyn formulation (also known as apomorphine hydrochloride injection) back in 2022. The non-ergoline dopamine agonist is approved to treat Parkinson’s symptoms during “off episodes,” such as difficulty moving, tremors and intense cramping. However, regulators specified that the approval pertained to the generic drug cartridges only, not the injector pen required for administration.

Harpreet Singh, Immatics CEO

Im­mat­ics an­nounces mul­ti­ple pipeline changes with lat­est fi­nan­cial re­sults

The T-cell biotech Immatics is looking to make some changes to its pipeline.

Immatics released its 2022 financial results on Tuesday and announced that it’s planning to discontinue its program for IMA201, an experimental cell therapy for solid tumors that express the antigens known as MAGE4/8. It plans to shift focus to IMA401, a TCR bispecific which goes after the same target.

The German-based biotech said it will treat the remaining patients enrolled in the program before the discontinuation. No other reasons were given for the discontinuation. Endpoints News reached out to Immatics for more details but did not receive a response by press time.

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Growth hor­mone from No­vo Nordisk is in short­age over man­u­fac­tur­ing de­lays

Novo Nordisk’s growth hormone Norditropin is in shortage because of manufacturing delays, according to an FDA site that tracks drug shortages as well as the American Society of Health-System Pharmacists’ shortages list.

The FDA has shortages of the drug listed for its 5, 10, 15 and 30 mg doses, while the pharmacists’ group, also known as ASHP, reported shortages of the same doses, except for the 15 mg version.

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