Bris­tol-My­ers Squibb has suf­fered an­oth­er painful set­back in its years-long quest to ex­pand the reach of Op­di­vo. The phar­ma gi­ant this morn­ing not­ed that their Check­mate-459 study com­par­ing Op­di­vo with Bay­er’s Nex­avar in front­line cas­es of he­pa­to­cel­lu­lar car­ci­no­ma — the most com­mon form of liv­er can­cer — failed to hit the pri­ma­ry end­point on over­all sur­vival.

This was a sig­nif­i­cant mile­stone in Bris­tol-My­ers’ tal­ly of PD-1 cat­a­lysts this year. Nex­avar (so­rafenib) has been the stan­dard of care in front­line HCC for the past decade, though Op­di­vo has been mak­ing head­way in sec­ond-line HCC cas­es, where it’s go­ing toe-to-toe with Bay­er’s Sti­var­ga (re­go­rafenib) af­ter re­cent ap­provals shook up the mar­ket.

The OS rate on Op­di­vo fell well short of sta­tis­ti­cal sig­nif­i­cance, with a p val­ue of 0.0752. We’ll have to wait for an up­com­ing sci­ence con­fer­ence to get the full pic­ture.

Bris­tol-My­ers shares $BMY were down 4.5% ahead of the open­ing bell Mon­day as in­vestors re­act­ed to the news that the com­pa­ny is sell­ing Ote­zla to sat­is­fy reg­u­la­tors ahead of its big Cel­gene buy­out.

Re­searchers looked for a sil­ver lin­ing in the lat­est cut of the da­ta onOp­di­vo, say­ing “the re­sults showed a clear trend to­wards im­prove­ment in OS for pa­tients treat­ed with Op­di­vo com­pared to so­rafenib (Nex­avar), a cur­rent stan­dard of care.”

Bruno San­gro Clíni­ca Uni­ver­si­dad de Navar­ra

“We are en­cour­aged by the promis­ing ef­fi­ca­cy and safe­ty trends seen with Op­di­vo in Check­Mate-459, es­pe­cial­ly as HCC is a dev­as­tat­ing and dif­fi­cult-to-treat can­cer, for which there have been no sig­nif­i­cant ad­vances over so­rafenib, a stan­dard treat­ment, in more than a decade,” said Bruno San­gro, head of the liv­er unit, Clíni­ca Uni­ver­si­dad de Navar­ra, Pam­plona, Spain.

But an­a­lysts saw the down­side clear­ly. Vamil Di­van from Cred­it­Su­isse not­ed: “While the tri­al showed a trend to­wards an over­all sur­vival ben­e­fit, the lack of sta­tis­ti­cal sig­nif­i­cance opens the door for com­peti­tors such as Mer­ck, Roche and As­tra to be­come the dom­i­nant play­er(s) in this in­di­ca­tion with the var­i­ous com­bi­na­tion tri­als they are cur­rent­ly run­ning.”

Michael Schmidt at SVB Leerink re­cent­ly not­ed:

In the US, Op­di­vo is gain­ing rapid mar­ket share in 2nd line HCC dri­ven by an ag­gres­sive mar­ket­ing ef­fort by BMY and mas­sive free sam­pling with some off-la­bel use not­ed in front-line pa­tients which is sup­port­ed by strong CM-040 re­sults. In Eu­rope, re­go­rafenib is ex­pect­ed to re­main the pre­ferred 2nd line agent in the near term, giv­en dif­fer­ences in treat­ment pat­tern and pref­er­ences.

Bris­tol-My­ers is by no means fin­ished here, with more re­sults ex­pect­ed on their com­bo with the CT­LA-4 Yer­voy. That match-up, though, has al­ready failed in small cell lung can­cer while in­ves­ti­ga­tors have had to deal with a strong push­back from the FDA in their quest to use high tu­mor mu­ta­tion­al bur­den de­f­i­n­i­tions to de­fine a new ap­proach to iden­ti­fy­ing lung can­cer pa­tients most like­ly to re­spond to Op­di­vo.

Mer­ck, mean­while, has fa­mous­ly pressed ahead in its suc­cess­ful dri­ve to gain the lead po­si­tion in the race to com­mand the PD-1 field. Both Keytru­da and Op­di­vo, though, are ex­pect­ed to re­main the two dom­i­nant drugs in their field for some time.

After being struck by a rare disease as a healthy third year medical student, David Fajgenbaum began an arduous journey chasing his own cure. Amidst the hustle of this year’s JP Morgan conference, the digital trials platform Medable partnered with Endpoints Studio to share Dr. Fajgenbaum’s story with the drug development industry.

What follows is an edited transcript of the conversation between Medable CEO Dr. Michelle Longmire and Dr. Fajgenbaum, and it is full of lessons for biotech executives charged with bringing the next generation of medicines to patients.

November 2019 proved to be a fruitful month for patients with blood disorders known as hemoglobinopathies. Within days, the FDA ushered two drugs for sickle cell disease and another for beta thalassemia to the market — livening up a barren field.

Imara, a relatively young plower, is riding on that enthusiasm as it shoots for an $86.25 million IPO.

Imara emerged from New Enterprise Associates’ orphan drug accelerator Cydan in 2016 as a single-product company. $77.3 million in private financing later IMR-687 remains the sole asset in its pipeline; the difference is the drug is now in Phase II for sickle cell disease, with topline data slated for later this year and two other mid-stage beta thalassemia studies lined up.

A Beijing-based rare disease and oncology player has raised $98 million to help fund the expansion of its pipeline as well as a commercial portfolio.

CANbridge put out word Tuesday that the global private equity player General Atlantic joined forces with Chinese CRO Wuxi AppTec to lead the Series D, with both ready to chip in an extra $10 million each under the right conditions. The syndicate includes RA Capital Management, Hudson Bay Capital Management, YuanMing Prudence Fund and Tigermed.

The technology used to detect explosives at airports — mass spectrometry — is being piloted as an engine for drug discovery.

Mass spectrometry is a tool designed to measure with profound accuracy the mass of a single molecule. Typically, mass spectrometers can be used to identify unknown compounds, to quantify known compounds, and to determine the structure and chemical properties of molecules.

One of the three drugs that China’s Ministry of Science and Technology has tapped as potential COVID-19 treatments to watch has notched its first Chinese OK — for the flu.

While there’s no proof yet that fapilavir, or favipiravir, is the cure that patients and physicians are yearning for, it stands out for a unique constellation of qualities. It’s been commercially available in Japan for several years (unlike Gilead’s experimental remdesivir) yet it’s new to China (unlike the malaria drug chloroquine phosphate). Perhaps more importantly, a domestic biotech — Zhejiang Hisun Pharma — owns the rights to manufacture and market the drug, preempting any concerns about patents.