A proxy fight is brew­ing at Il­lu­mi­na as ac­tivist in­vestor Carl Ic­ahn ar­gues that the DNA se­quenc­ing gi­ant is cost­ing share­hold­ers bil­lions by fol­low­ing through with its Grail pur­chase amid an­tirust chal­lenges.

In a let­ter to Il­lu­mi­na share­hold­ers on Mon­day morn­ing, Ic­ahn stat­ed that $50 bil­lion of val­ue has been wiped from the com­pa­ny’s mar­ket cap­i­tal­iza­tion since Au­gust 2021.

“This val­ue de­struc­tion is a di­rect re­sult of a se­ries of ill-ad­vised (and frankly in­ex­plic­a­ble) ac­tions tak­en by the board of di­rec­tors of our com­pa­ny in con­nec­tion with the ac­qui­si­tion of GRAIL, Inc.,” Ic­ahn wrote. “To para­phrase William Shake­speare’s Ham­let, some­thing is rot­ten in the state of Il­lu­mi­na.”

Lat­er in the day, Il­lu­mi­na re­spond­ed, say­ing its Chair John Thomp­son and CEO Fran­cis deS­ouza had “mul­ti­ple con­ver­sa­tions” with Ic­ahn’s three pro­posed board ad­di­tions: VDA Cap­i­tal Man­age­ment CEO and Hertz board mem­ber Vin­cent In­tri­eri, Ic­ahn En­ter­pris­es gen­er­al coun­sel Jesse Lynn and Ic­ahn Cap­i­tal port­fo­lio man­ag­er An­drew Teno. The com­pa­ny called Ic­ahn’s nom­i­nees lack­ing in “rel­e­vant skills and ex­pe­ri­ence.”

The Wall Street Jour­nal first re­port­ed late Sun­day night that the bil­lion­aire want­ed to nom­i­nate three peo­ple to the board of Il­lu­mi­na. The San Diego com­pa­ny record­ed a $3.91 bil­lion good­will im­pair­ment charge on the Grail ac­qui­si­tion, Il­lu­mi­na said in its re­cent quar­ter­ly up­date, fol­low­ing an­titrust probes in­to the deal.

Il­lu­mi­na said Ic­ahn’s let­ter “nei­ther rec­og­nizes the re­al val­ue that GRAIL can pro­vide to Il­lu­mi­na’s share­hold­ers, nor re­flects an un­der­stand­ing of the reg­u­la­to­ry process.” In De­cem­ber, the Eu­ro­pean Com­mis­sion or­dered Il­lu­mi­na to un­wind the deal. Il­lu­mi­na said it is “mov­ing as quick­ly as pos­si­ble to ar­rive at a res­o­lu­tion” and work­ing to­ward a di­ves­ture if its ap­peal fails.

Grail was orig­i­nal­ly part of Il­lu­mi­na but was spun out. Il­lu­mi­na lat­er re­ab­sorbed Grail, ar­gu­ing the deal would speed up the com­mer­cial­iza­tion of can­cer tests. Ic­ahn dis­agreed with the moves in his let­ter.

“The man­age­ment team and board of di­rec­tors that cre­at­ed this mess would be fired im­me­di­ate­ly and a thor­ough in­ves­ti­ga­tion would be con­duct­ed to as­cer­tain whether they en­gaged in gross neg­li­gence (or even worse),” Ic­ahn added in his let­ter.

Il­lu­mi­na’s stock jumped jumped as much as 20% on the news, re­flect­ing that in­vestors have grown im­pa­tient over head­winds from the Grail ac­qui­si­tion. For­mer CEO Jay Flat­ley re­cent­ly told the Fi­nan­cial Times that Grail was over­priced when Il­lu­mi­na bought it for $7 bil­lion. Be­sides scruti­ny over Grail, Il­lu­mi­na faces in­creased com­pe­ti­tion, in­clud­ing from a Chi­nese ri­val that re­cent­ly be­gan sell­ing its se­quencers in the US.

Il­lu­mi­na’s board in­cludes No­bel lau­re­ate Frances Arnold, for­mer FDA Com­mis­sion­er Scott Got­tlieb, ex-IBM vet­er­an John Thomp­son and soon-to-be Bio­gen chair Car­o­line Dor­sa, among oth­ers.

Ed­i­tor’s note: This sto­ry has been up­dat­ed to in­clude news about Il­lu­mi­na’s stock price this morn­ing, de­tails from Carl Ic­ahn’s let­ter to share­hold­ers and Il­lu­mi­na’s re­sponse.

Microcap biotech Seelos Therapeutics is halting enrollment of its study in spinocerebellar ataxia type 3 (also known as Machado-Joseph disease) because of “financial considerations,” and in order to focus on other studies, the company said today, adding that the pause would be temporary.

The study will continue with the patients who have already enrolled, and the data from them will be used to decide whether to continue enrolling others in the future.

Paul McKenzie took over as CEO of Australian pharma giant CSL this month, following in the footsteps of long-time CSL vet Paul Perreault.

With an eye on mRNA, and quickly commercializing its new, $3.5 million-per-shot gene therapy for hemophilia B, McKenzie and chief medical officer Bill Mezzanotte answered some questions from Endpoints News this afternoon about where McKenzie is going to take the company and what advances may be coming to market from CSL’s pipeline. Below is a lightly edited transcript.

Otonomy may be shutting down, but the lessons learned there will live on at another biotech working on new treatments for hearing loss.

San Francisco-based Spiral Therapeutics has bought certain assets related to three of Otonomy’s programs, ranging from data, patent rights, and know-how to inventory. That includes data around Otonomy’s twice-failed lead program, OTO-104 (Otividex), a sustained-exposure formulation of dexamethasone.

Boehringer Ingelheim reported human pharma sales of €18.5 billion on Wednesday, led by type 2 diabetes and heart failure drug Jardiance and pulmonary fibrosis med Ofev. Jardiance sales reached €5.8 billion, growing 39% year over year, while Ofev took in €3.2 billion, notching its own 20.6% annual jump.

However, Boehringer is also looking ahead with its pipeline, estimating “In the next seven years the company expects about 20 regulatory approvals in human pharma.”