IDO rout: Piv­otal tri­als with Bris­tol-My­ers, Mer­ck and As­traZeneca dumped in wake of In­cyte's PhI­II im­plo­sion

The IDO R&D pipeline is in dan­ger of be­ing ex­ter­mi­nat­ed.

In the wake of a piv­otal fail­ure of In­cyte’s $IN­CY lead IDO drug epaca­do­stat, Bris­tol-My­ers Squibb $BMY be­came the third play­er forced to re­trench in that im­muno-on­col­o­gy field, drop­ping three late-stage stud­ies of a ri­val drug it bagged in a $1.25 bil­lion buy­out. But that was just the start of a rout.

In­cyte re­port­ed this morn­ing that its wide-rang­ing col­lab­o­ra­tions with Big Phar­ma play­ers are com­ing un­done. In their Q1 an­nounce­ment, echo­ing the fail­ure of ECHO-301, the com­pa­ny not­ed:

En­roll­ment will be dis­con­tin­ued in the four ad­di­tion­al piv­otal tri­als of epaca­do­stat in com­bi­na­tion with pem­brolizum­ab (Mer­ck’s Keytru­da), and in the two piv­otal tri­als of epaca­do­stat in com­bi­na­tion with nivolum­ab (Bris­tol-My­ers’ Op­di­vo); each of these stud­ies will be amend­ed to en­able pa­tients and their physi­cians to con­sid­er al­ter­na­tive ther­a­peu­tic op­tions. The piv­otal tri­al in com­bi­na­tion with dur­val­um­ab (As­traZeneca’s Imfinzi) in Stage 3 lung can­cer will not be ini­ti­at­ed.

A spokesper­son for As­traZeneca al­so tells me that there is “an­oth­er Phase II (com­bi­na­tion study) in sol­id tu­mors and we’re go­ing to stop en­roll­ment there too.” That will be all for the ECHO-203 study — epaca­do­stat plus dur­val­um­ab again. “In­cyte did present some da­ta from ECHO-203 at AACR: 15 pa­tients with pan­cre­at­ic can­cer were en­rolled across mul­ti­ple dose lev­els, no clin­i­cal ac­tiv­i­ty was ob­served.”

In ad­di­tion, In­cyte said that it is “sig­nif­i­cant­ly down­siz­ing the epaca­do­stat de­vel­op­ment pro­gram,” sig­nal­ing a painful re­treat for a one-time star drug that com­mand­ed pro­jec­tions of block­buster peak sales.

Ac­cord­ing to clin­i­cal­tri­als.gov, in­ves­ti­ga­tors for the big biotech to­day ter­mi­nat­ed a Phase III study of BMS-986205 in com­bi­na­tion with Bris­tol-My­ers’ Op­di­vo for front­line head and neck can­cer. An­oth­er Phase III study for front­line Stage IV or re­cur­rent non-small cell lung can­cer us­ing BMS-986205 and Op­di­vo with or with­out chemo ver­sus chemo alone was with­drawn. And there’s a third study for melanoma that’s now ac­tive but not re­cruit­ing af­ter en­list­ing 72 pa­tients.

A spokesper­son for Bris­tol-My­ers told us Mon­day night:

Based on emerg­ing da­ta on the IDO path­way, we closed reg­is­tra­tional stud­ies of our IDO in­hibitor, BMS-986205, in melanoma, SC­CHN and NSCLC. We re­main com­mit­ted to con­tin­ued re­search of BMS-986205-based com­bi­na­tions in an in­formed and sci­en­tif­i­cal­ly ro­bust man­ner. We will con­tin­ue to eval­u­ate BMS-986205-based com­bi­na­tions in our Phase 1/2 study, CA017-003.

Sep­a­rate­ly, we are work­ing quick­ly with In­cyte to as­sess our pro­gram un­der the col­lab­o­ra­tion.

NewLink $NLNK was the first to over­haul its ap­proach on IDO fol­low­ing the In­cyte dis­as­ter.  The biotech scrapped a melanoma study that would have eval­u­at­ed in­dox­i­mod in com­bi­na­tion with check­point in­hibitors Keytru­da or Op­di­vo in 600 pa­tients. In a press re­lease, NewLink ex­plained the de­ci­sion was made “in the con­text of the fail­ure of a com­peti­tor’s tri­al of its en­zy­mat­ic IDO in­hibitor in a sim­i­lar clin­i­cal set­ting.

Bris­tol-My­ers’ de­ci­sion — first re­port­ed by Xcon­o­my — un­der­scores a grow­ing be­lief that In­cyte’s fail­ure was as much a fail­ure of the class as an in­di­vid­ual ther­a­py, po­ten­tial­ly tor­pe­do­ing a wide swath of clin­i­cal tri­als now in the pipeline.

In­cyte frankly con­ced­ed that its piv­otal fail­ure raised doubts about its en­tire ef­fort, which in­cludes a host of com­bi­na­tion stud­ies with check­point lead­ers like Mer­ck and As­traZeneca. In this case, Bris­tol-My­ers is cut­ting back on a drug that it ac­quired in a block­buster deal to ac­quire Flexus 3 years ago. In­ves­ti­ga­tors have re­peat­ed­ly tout­ed the drug as a po­ten­tial lynch­pin in im­muno-on­col­o­gy, fo­cus­ing on an en­zyme that sup­press­es the im­mune cells Op­di­vo and a whole new class of PD-1/L1 check­points are de­signed to un­leash in an at­tack on can­cer cells.

Iron­i­cal­ly, In­cyte has been pur­su­ing lit­i­ga­tion against one of its for­mer sci­en­tists, claim­ing he de­fect­ed to Flexus with IDO trade se­crets in hand, well be­fore the buy­out. Bris­tol-My­ers, though, has stead­fast­ly as­sert­ed — with some sup­port from an­a­lysts — that it had the bet­ter IDO that could leapfrog epaca­do­stat. The leap­ing in IDO, though, has stopped. At least for now.

Biotech Half­time Re­port: Af­ter a bumpy year, is biotech ready to re­bound?

The biotech sector has come down firmly from the highs of February as negative sentiment takes hold. The sector had a major boost of optimism from the success of the COVID-19 vaccines, making investors keenly aware of the potential of biopharma R&D engines. But from early this year, clinical trial, regulatory and access setbacks have reminded investors of the sector’s inherent risks.

RBC Capital Markets recently surveyed investors to take the temperature of the market, a mix of specialists/generalists and long-only/ long-short investment strategies. Heading into the second half of the year, investors mostly see the sector as undervalued (49%), a large change from the first half of the year when only 20% rated it as undervalued. Around 41% of investors now believe that biotech will underperform the S&P500 in the second half of 2021. Despite that view, 54% plan to maintain their position in the market and 41% still plan to increase their holdings.

How to col­lect and sub­mit RWD to win ap­proval for a new drug in­di­ca­tion: FDA spells it out in a long-await­ed guid­ance

Real-world data is messy. There can be differences in the standards used to collect different types of data, differences in terminologies and curation strategies, and even in the way data is exchanged.

While acknowledging this somewhat controlled chaos, the FDA is now explaining how biopharma companies can submit study data derived from real-world data (RWD) sources in applicable regulatory submissions, including new drug indications.

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David Lockhart, ReCode Therapeutics CEO

Pfiz­er throws its weight be­hind LNP play­er eye­ing mR­NA treat­ments for CF, PCD

David Lockhart did not see the meteoric rise of messenger RNA and lipid nanoparticles coming.

Thanks to the worldwide fight against Covid-19, mRNA — the genetic code that can be engineered to turn the body into a mini protein factory — and LNPs, those tiny bubbles of fat carrying those instructions, have found their way into hundreds of millions of people. Within the biotech world, pioneers like Alnylam and Intellia have demonstrated just how versatile LNPs can be as a delivery vehicle for anything from siRNA to CRISPR/Cas9.

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No­vo CEO Lars Fruer­gaard Jør­gensen on R&D risk, the deal strat­e­gy and tar­gets for gen­der di­ver­si­ty

 

I kicked off our European R&D summit last week with a conversation involving Novo Nordisk CEO Lars Fruergaard Jørgensen. Novo is aiming to launch a new era of obesity management with a new approval for semaglutide. And Jørgensen had a lot to say about what comes next in R&D, how they manage risk and gender diversity targets at the trendsetting European pharma giant.

John Carroll: I’m here with Lars Jørgensen, the CEO of Novo Nordisk. Lars, it’s been a really interesting year so far with Novo Nordisk, right? You’ve projected a new era of growing sales. You’ve been able to expand on the GLP-1 franchise that was already well established in diabetes now going into obesity. And I think a tremendous number of people are really interested in how that’s working out. You have forecast a growing amount of sales. We don’t know specifically how that might play out. I know a lot of the analysts have different ideas, how those numbers might play out, but that we are in fact embarking on a new era for Novo Nordisk in terms of what the company’s capable of doing and what it’s able to do and what it wants to do. And I wanted to start off by asking you about obesity in particular. Semaglutide has been approved in the United States for obesity. It’s an area of R&D that’s been very troubled for decades. There have been weight loss drugs that have come along. They’ve attracted a lot of attention, but they haven’t actually ever gained traction in the market. My first question is what’s different this time about obesity? What is different about this drug and why do you expect it to work now whereas previous drugs haven’t?

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Pascal Soriot, AstraZeneca CEO (via Getty images)

UP­DAT­ED: FDA slaps As­traZeneca's MCL-1 can­cer drug with a hold af­ter safe­ty is­sue — 2 years af­ter Am­gen axed a trou­bled ri­val

There are new questions being posed about a class of cancer drugs in the wake of the second FDA-enforced clinical hold in the field.

Two years after the FDA hit Amgen with a clinical hold on its MCL-1 inhibitor AMG 397 following signs of cardiac toxicity, AstraZeneca says that regulators hit them with a hold on their rival therapy of the same class.

The pharma giant noted on clinicaltrials.gov that its Phase I/II study for the MCL-1 drug AZD5991 “has been put on hold to allow further evaluation of safety related information.”

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Sur­geons suc­cess­ful­ly at­tach pig kid­ney to a hu­man for the first time, us­ing tech from Unit­ed's Re­vivi­cor

In a first, researchers reportedly successfully transplanted a pig kidney into a human without triggering an immediate immune response this week. And the technology came from the biotech United Therapeutics.

Surgeons spent three days attaching the kidney to the patient’s blood vessels, but when all was said and done, the kidney appeared to be functioning normally in early testing, Reuters and the New York Times were among those to report. The kidney came from a genetically altered pig developed through United’s Revivicor unit.

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Leen Kawas (L) has resigned as CEO of Athira and will be replaced by COO Mark Litton

Ex­clu­sive: Athi­ra CEO Leen Kawas re­signs af­ter in­ves­ti­ga­tion finds she ma­nip­u­lat­ed da­ta

Leen Kawas, CEO and founder of the Alzheimer’s upstart Athira Pharma, has resigned after an internal investigation found she altered images in her doctoral thesis and four other papers that were foundational to establishing the company.

Mark Litton, the company’s COO since June 2019 and a longtime biotech executive, has been named full-time CEO. Kawas, meanwhile, will no longer have ties to the company except for owning a few hundred thousand shares.

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Sen. Richard Durbin (D-IL, foreground) and Sen. Richard Blumenthal (D-CT) (Patrick Semansky/AP Images)

Sen­a­tors back FDA's plan to re­quire manda­to­ry pre­scriber ed­u­ca­tion for opi­oids

Three Senate Democrats are backing an FDA plan to require mandatory prescriber education for opioids as overdose deaths have risen sharply over the past decade, with almost 97,000 American opioid-related overdose deaths in the past year alone.

While acknowledging a decline in overall opioid analgesic dispensing in recent years, the FDA said it’s reconsidering the need for mandatory prescriber training through a REMS given the current situation with overdoses, and is seeking input on the aspects of the opioid crisis that mandatory training could potentially mitigate.

Bris­tol My­ers pledges to sell its Ac­celeron shares as ac­tivist in­vestors cir­cle Mer­ck­'s $11.5B buy­out — re­port

Just as Avoro Capital’s campaign to derail Merck’s proposed $11.5 billion buyout of Acceleron gains steam, Bristol Myers Squibb is leaning in with some hefty counterweight.

The pharma giant is planning to tender its Acceleron shares, Bloomberg reported, which add up to a sizable 11.5% stake. Based on the offer price, the sale would net Bristol Myers around $1.3 billion.

To complete its deal, Merck needs a majority of shareholders to agree to sell their shares.