Check­point com­bos for can­cer are all the rage as tri­al spon­sors line up hun­dreds of new stud­ies — re­port

Num­ber of An­ti-PD-1/PD-L1 MAb com­bi­na­tion stud­ies 2015 vs. 2017
Full Re­port: Eval­u­ate Ltd. May 2017


Over the last few months it hasn’t been un­usu­al to see new com­bi­na­tion stud­ies be­ing an­nounced on a dai­ly ba­sis, match­ing one of the 5 ap­proved PD-(L)1 check­point drugs with an­oth­er can­cer ther­a­py. Some morn­ings they come in pairs.

It’s not hard to see why. The check­points typ­i­cal­ly work as a monother­a­py — though there have been some nasty set­backs over the past 6 months. And some of the big play­ers are hap­py to con­tribute their drug to stud­ies spon­sored by oth­ers look­ing to ad­vance a pi­lot Phase I/II ex­plorato­ry study. There are al­so re­cent ex­am­ples of some big tie-ups be­tween Mer­ck (Keytru­da) and Bris­tol-My­ers Squibb (Op­di­vo) check­points with In­cyte in Phase III.

In­cyte has its own PD-1 in the clin­ic as it lines up these ag­nos­tic late-stage tri­als to po­si­tion its lead­ing IDO1 drug.

Now EP Van­tage has tal­lied the whole score on these com­bo tri­als, not co­in­ci­den­tal­ly just ahead of AS­CO, and found a stun­ning 765 com­bi­na­tion stud­ies list­ed on clin­i­cal­tri­als.gov. Keytru­da leads the pack, with 268 — up from 70 just 18 months ago. For Bris­tol-My­ers it’s 242, more than three times the num­ber EP Van­tage’s ed­i­to­r­i­al team found in 2015.

Any­one even mod­er­ate­ly in­ter­est­ed in this field will want to check it out di­rect­ly. There’s a lot of de­tail on what’s now in the clin­ic.

Don’t ex­pect the ris­ing trend lines to start to plateau any­time soon, ei­ther, as Pfiz­er/Mer­ck KGaA (Baven­cio) and As­traZeneca (Imfinzi) start to gain trac­tion on the com­bo front. Roche al­ready emerged as the num­ber three play­er in the field with Tecen­triq, though its re­cent Phase III fail­ure for its check­point may chill oth­er would-be part­ners.

Mean­while, new check­point play­ers like BeiGene and Lil­ly are mov­ing along, the re­port notes, while No­var­tis has been ad­vanc­ing its own in-house check­point pro­grams. The sec­ond wave of PD-(L)1 ther­a­pies will be large.

One of the key next steps in this field is in As­traZeneca’s hands. It has a com­bo of Imfinzi with an in-house CT­LA-4 check­point dubbed treme­li­mum­ab in the MYS­TIC study that will read out soon for lung can­cer. An­a­lysts are wait­ing ea­ger­ly to see if it can beat out the com­pe­ti­tion, or get side­lined by some well-known tox­i­c­i­ty con­cerns.

One thing is ab­solute­ly cer­tain. Bris­tol-My­ers Squibb start­ed as the dom­i­nant play­er in PD-(L)1, then got checked by a surg­ing Mer­ck when it made the wrong clin­i­cal move on non-small cell lung can­cer. As­traZeneca, the last of the big 5 to land an ap­proval, just days ago stunned vir­tu­al­ly every­one with pos­i­tive Phase III da­ta for Imfinzi in un­re­sectable lung can­cer, pro­vid­ing ear­ly dom­i­nance in a sig­nif­i­cant niche mar­ket.

The Big Phar­ma’s stock soared as an­a­lysts be­gan to cal­cu­late what that is worth.

Just at a time when check­points should start get­ting more pre­dictable, the field seems to be ripe for fresh sur­pris­es of all kinds. And that will con­tin­ue to at­tract fresh waves of com­bi­na­tion stud­ies tack­ling all kinds of can­cers.

Brian Kaspar. AveXis via Twitter

AveX­is sci­en­tif­ic founder fires back at No­var­tis CEO Vas Narasimhan, 'cat­e­gor­i­cal­ly de­nies any wrong­do­ing'

Brian Kaspar’s head was among the first to roll at Novartis after company execs became aware of the fact that manipulated data had been included in its application for Zolgensma, now the world’s most expensive therapy.

But in his first public response, the scientific founder at AveXis — acquired by Novartis for $8.7 billion — is firing back. And he says that not only was he not involved in any wrongdoing, he’s ready to defend his name as needed.

I reached out to Brian Kaspar after Novartis put out word that he and his brother Allen had been axed in mid-May, two months after the company became aware of the allegations related to manipulated data. His response came back through his attorneys.

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UP­DAT­ED: An em­bold­ened As­traZeneca splurges $95M on a pri­or­i­ty re­view vouch­er. Where do they need the FDA to hus­tle up?

AstraZeneca is in a hurry.

We learned this morning that the pharma giant — not known as a big spender, until recently — forked over $95 million to get its hands on a priority review voucher from Sobi, otherwise known as Swedish Orphan Biovitrum.

That marks another step down on price for a PRV, which allows the holder to slash 4 months off of any FDA review time.

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Martin Shkreli [via Getty]

Pris­on­er #87850-053 does not get to add drug de­vel­op­er to his list of cred­its

Just days after Retrophin shed its last ties to founder Martin Shkreli, the biotech is reporting that the lead drug he co-invented flopped in a pivotal trial. Fosmetpantotenate flunked both the primary and key secondary endpoints in a placebo-controlled trial for a rare disease called pantothenate kinase-associated neurodegeneration, or PKAN.

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We­bi­nar: Re­al World End­points — the brave new world com­ing in build­ing fran­chise ther­a­pies

Several biopharma companies have been working on expanding drug labels through the use of real world endpoints, combing through the data to find evidence of a drug’s efficacy for particular indications. But we’ve just begun. Real World Evidence is becoming an important part of every clinical development plan, in the soup-through-nuts approach used in building franchises.

I’ve recruited a panel of 3 top experts in the field — the first in a series of premium webinars — to look at the practical realities governing what can be done today, and where this is headed over the next few years, at the prodding of the FDA.

ZHEN SU — Merck Serono’s Senior Vice President and Global Head of Oncology
ELLIOTT LEVY — Amgen’s Senior Vice President of Global Development
CHRIS BOSHOFF — Pfizer Oncology’s Chief Development Officer

A premium subscription to Endpoints News is required to attend this webinar. Please upgrade to either an Insider or Enterprise plan for access. Already have Endpoints Premium? Please sign-in below. You can contact our Subscriptions team at help@endpointsnews.com with any issues.

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Am­gen, Al­ler­gan biosim­i­lar of Roche's block­buster Rit­ux­an clears an­oth­er US piv­otal study 

Novartis $NVS may have given up, but Amgen $AMGN and Allergan $AGN are plowing ahead with their knockoff of Roche’s blockbuster biologic Rituxan in the United States.

Their copycat, ABP 798, was found to have a clinically equivalent impact as Rituxan — meeting the main goal of the study involving CD20-positive B-cell non-Hodgkin’s lymphoma patients. This is the second trial supporting the profile of the biosimilar. In January, it came through with positive PK results in patients with rheumatoid arthritis.

BeiGene and Mus­tang nail down spe­cial FDA sta­tus for top drugs; Roche bags added cov­er­age for Hem­li­bra

→ BeiGene $BGNE is getting a boost in its drive to field a rival to Imbruvica. The FDA has offered an accelerated review to zanubrutinib, a BTK inhibitor that has posted positive results for mantle cell lymphoma. The PDUFA date lands on February 27, 2020. The drug scored breakthrough status at the beginning of the year.

→ BeiGene isn’t the only biopharma company to gain special regulatory status today. Mustang Bio $MBIO and St. Jude Children’s Research Hospital announced that MB-107, a lentiviral gene therapy for the treatment of X-linked severe combined immunodeficiency, also known as bubble boy disease, has been granted Regenerative Medicine Advanced Therapy status.

Trump ad­min­is­tra­tion re­vives bid to get drug list prices on TV ads

The Trump administration is not giving up just yet. On Wednesday, the HHS filed an appeal against a judge’s decision in July to overturn a ruling obligating drug manufacturers to disclose the list price of their therapies in television adverts — hours before it was stipulated to go into effect.

In May, the HHS published a final ruling requiring drugmakers to divulge the wholesale acquisition cost— of a 30-day supply of the drug — in tv ads in a bid to enhance price transparency in the United States. The pharmaceutical industry has vehemently opposed the rule, asserting that list prices are not what a typical patient in the United States pays for treatment — that number is typically determined by the type of (or lack thereof) insurance coverage, deductibles and out-of-pocket costs. Although there is truth to that claim, the move was considered symbolic in the Trump administration’s healthcare agenda to hold drugmakers accountable in a climate where skyrocketing drug prices have incensed Americans on both sides of the aisle.

Ver­sant-backed Chi­nook gets a $65M launch round for its dis­cov­ery quest in a resur­gent kid­ney field

Versant is once again stepping off the beaten track in biotech to see if they can blaze a trail of their own in a field that has looked too thorny to many investors for years.

The venture group and their partners at Apple Tree are bringing their latest creation out of stealth mode today. Born in Versant’s Inception Sciences’ Chinook Therapeutics is betting that its preclinical take on kidney disease can get an early lead among the companies starting up in the field.

Sir An­drew Dil­lon, NICE's first — and on­ly — chief ex­ec­u­tive to step down next year

Using a laptop borrowed from his former employer, South London’s St George’s Hospital, Sir Andrew Dillon set about establishing NICE — launched by the then health secretary Frank Dobson — in 1999.  On Thursday, the UK cost-effectiveness watchdog said its first and only chief executive — Dillon — is stepping down in March 2020.

Back in the day, decisions about which drugs and interventions were funded by the National Health Service (NHS) were made at the local level, but this ‘postcode prescribing’ system was fraught with skewed healthcare deployment making the structure unsustainable. A national system was deemed necessary — and NICE was formed to bridge that gap.