CymaBay scraps key NASH, PSC pro­grams af­ter lead drug trig­gers safe­ty alarms — share price im­plodes

When CymaBay Ther­a­peu­tics re­cent­ly ac­knowl­edged de­feat in a 12-week read­out of its Phase II tri­al of se­ladel­par, the biotech grasped at “sig­nif­i­cant im­prove­ments in bio­chem­i­cal mark­ers of liv­er in­jury” as a rea­son to re­main hope­ful about the 52-week biop­sy re­sults. But that hope is now dashed.

Not on­ly did the drug fail to re­duce liv­er fat, it al­so ap­peared to cause cell in­jury.

These “atyp­i­cal his­to­log­i­cal find­ings” — in­clud­ing cas­es of sus­pect­ed in­ter­face he­pati­tis — ob­served in pa­tients who re­spond­ed to their drug forced CymaBay to slam the brakes to its se­ladel­par clin­i­cal pro­gram, ter­mi­nat­ing the Phase IIb study in NASH in ques­tion and a Phase IIa in pri­ma­ry scle­ros­ing cholan­gi­tis (PSC) as well as putting all stud­ies in pri­ma­ry bil­iary cholan­gi­tis on hold.

“We are very dis­ap­point­ed in hav­ing to halt the de­vel­op­ment of se­ladel­par at this time but pa­tient safe­ty and care is para­mount,” CEO Su­jal Shah said in a state­ment.

Shares of the biotech $CBAY, which dipped in the wake of dis­ap­point­ing da­ta in June, are down a fur­ther 76.22% to $1.32 Mon­day morn­ing.

SVB Leerink an­a­lysts called it “a worst case sce­nario el­e­vat­ing safe­ty is­sues that are un­like­ly to be re­solved in the near fu­ture, in our opin­ion.”

“The risk/re­ward clear­ly fa­vors sig­nif­i­cant risk, even as we await ad­di­tion­al in­for­ma­tion and clar­i­ty from CBAY,” they wrote in a note. “Our mod­el is cur­rent­ly un­der re­view.”

But CymaBay’s good day turned out to be a good one for In­ter­cept, which has just clinched pri­or­i­ty re­view and a March 26, 2020 PDU­FA for their NASH drug obeti­cholic acid (OCA).

From Baird’s Bri­an Sko­r­ney:

This fol­lows a long his­to­ry of PPAR ag­o­nists blow­ing up (muragli­tazar, trogli­ta­zone) and high­lights what we be­lieve is an un­der­ap­pre­ci­a­tion of the risks of clin­i­cal de­vel­op­ment in the NASH space. OCA re­mains the on­ly med­ica­tion, to date, that has shown a fi­brot­ic ben­e­fit in a prospec­tive­ly de­fined con­trolled study, and its done it twice. We con­tin­ue to be­lieve OCA is like­ly to be the on­ly game in town for NASH for the fore­see­able fu­ture.

Safe­ty is­sues have pre­vi­ous­ly ben raised in the PPAR ag­o­nist class. This fam­i­ly of drugs ac­ti­vate pro­teins called per­ox­i­some pro­lif­er­a­tor-ac­ti­vat­ed re­cep­tors, which reg­u­late gene ex­pres­sion and are be­lieved to play a role in bile acid syn­the­sis, in­flam­ma­tion, fi­bro­sis and lipid me­tab­o­lism.

Back in 2007 Glax­o­SmithK­line aban­doned its own ef­fort in the field — a col­lab­o­ra­tion with Lig­and Phar­ma­ceu­ti­cals — af­ter their agent led to the for­ma­tion of tu­mors in an­i­mal tests. (The com­pound, GW501516, sub­se­quent­ly took on a sec­ond life as an il­le­gal per­for­mance-en­hanc­ing drug for ath­letes).

France’s Gen­fit and In­ven­ti­va are al­so work­ing on their own PPAR ag­o­nists for NASH. Gen­fit $GN­FT took a small­er toll on CymaBay’s ter­mi­na­tion news than it did fol­low­ing CymaBay’s ini­tial read­out, slid­ing 3.35% to $14.72. Al­most a year ago the drug­mak­er tout­ed that their elafi­bra­nor in­duced a sta­tis­ti­cal­ly sig­nif­i­cant de­crease in serum al­ka­line phos­phatase (ALP) lev­els for PBC pa­tients, and ear­li­er this year it won or­phan sta­tus for that in­di­ca­tion.

While the mar­ket ea­ger­ly awaits Phase III re­sults from Gen­fit, it has al­so se­cured a deal with Terns Phar­ma­ceu­ti­cals to bring the ther­a­py to Chi­na.

On CymaBay’s part, ex­ecs said they are in­ves­ti­gat­ing the sur­prise find­ings, which in­volved pa­tients who “demon­strat­ed on-study im­prove­ment or sta­bi­liza­tion of their bio­chem­i­cal mea­sures of in­flam­ma­tion and liv­er in­jury and no liv­er-re­lat­ed ad­verse events af­ter 52 weeks of treat­ment.”

Amarin CEO John Thero discussing the company's plans for Vascepa, August 2019 — via Bloomberg

Amarin wins a block­buster ap­proval from the FDA. Now every­one can shift fo­cus to the patent

For all those people who could never quite believe that Amarin $AMRN would get an expanded label with blockbuster implications, the stress and anxiety on display right up to the last minute on Twitter can now end. But new, pressing questions will immediately surface now that the OK has come through.

On Friday afternoon, the FDA stamped its landmark approval on the industrial strength fish oil for reducing cardio risks for a large and well defined population of patients. The approval doesn’t give Amarin everything it wants in expanding its use, losing out on the primary prevention group, but it goes a long way to doing what the company needed to make a major splash. The approval was cited for patients with “elevated triglyceride levels (a type of fat in the blood) of 150 milligrams per deciliter or higher. Patients must also have either established cardiovascular disease or diabetes and two or more additional risk factors for cardiovascular disease.”

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Sanofi CEO Hud­son lays out new R&D fo­cus — chop­ping di­a­betes, car­dio and slash­ing $2B-plus costs in sur­gi­cal dis­sec­tion

Earlier on Monday, new Sanofi CEO Paul Hudson baited the hook on his upcoming strategy presentation Tuesday with a tell-tale deal to buy Synthorx for $2.5 billion. That fits squarely with hints that he’s pointing the company to a bigger future in oncology, which also squares with a major industry tilt.

In a big reveal later in the day, though, Hudson offered a slate of stunners on his plans to surgically dissect and reassemble the portfoloio, saying that the company is dropping cardio and diabetes research — which covers two of its biggest franchise arenas. Sanofi missed the boat on developing new diabetes drugs, and now it’s pulling out entirely. As part of the pullback, it’s dropping efpeglenatide, their once-weekly GLP-1 injection for diabetes.

“To be out of cardiovascular and diabetes is not easy for a company like ours with an incredibly proud history,” Hudson said on a call with reporters, according to the Wall Street Journal. “As tough a choice as that is, we’re making that choice.”

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Sarep­ta was stunned by the re­jec­tion of Vyondys 53. Now it's stun­ning every­one with a sur­prise ac­cel­er­at­ed ap­proval

Sarepta has a friend in the FDA after all. Four months after the agency determined that it would be wrong to give Sarepta an accelerated approval for their Duchenne MD drug golodirsen, regulators have executed a stunning about face and offered the biotech a quick green light in any case.

It was the agency that first put out the news late Thursday, announcing that Duchenne MD patients with a mutation amenable to exon 53 skipping will now have their first targeted treatment: Vyondys 53, or golodirsen. Having secured the OK via a dispute resolution mechanism, the biotech said the new drug has been priced on par with their only other marketed drug, Exondys 51 — which for an average patient costs about $300,000 per year, but since pricing is based on weight, that sticker price can even cross $1 million.

Sarepta shares $SRPT surged 23% after-market to $124.

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Arie Belldegrun (Photo: Jeff Rumans for Endpoints News)

Ju­ry finds Gilead li­able for $585M and big roy­al­ties in Kite CAR-T patent case

A Kite deal that’s already become a burden on Gilead’s back just got heavier as a California jury has ruled Gilead must pay Bristol-Myers Squibb and Sloan Kettering $585 million plus a 27.6% royalty for patent infringement committed by its subsidiary. The ruling is almost certain to be appealed.

Kite Pharma — founded by Arie Belldegrun, now focused on a next-gen CAR-T company — has been facing a lawsuit since the day its first CAR–T therapy won approval in October, 2017. Juno Therapeutics and Sloan Kettering filed a complaint saying Kite had copied its technology. Gilead acquired Kite in June of that year for $11.9 billion.  Juno was acquired the following year by Celgene for $9 billion, before Celgene was acquired by Bristol-Myers Squibb in 2019.

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FDA ex­pert pan­el unan­i­mous­ly rec­om­mends ap­proval for Hori­zon Ther­a­peu­tics eye drug

An FDA advisory committee noted with concern a small safety database but unanimously endorsed a Horizon Therapeutics drug for a rare eye autoimmune disease that can blind patients: teprotumumab for thyroid eye disease (TED).

“It was a pretty easy vote,” said Erica Brittain, an NIH biostatistician and one of the 12 panelists on FDA’s Dermatologic and Ophthalmic Drugs Advisory Committee.

Paul Biondi (File photo)

Paul Biondi's track record at Bris­tol-My­ers cov­ered bil­lions in deals of every shape and size. Here's the com­plete break­down

Paul Biondi was never afraid to bet big during his stint as business development chief at Bristol-Myers Squibb. And while the gambles didn’t all pay out, by any means, his roster of pacts illustrates the broad ambitions the pharma giant has had over the last 5 years — capped by the $74 billion Celgene buyout.

On Thursday, we learned that Biondi had exited the company. And Chris Dokomajilar at DealForma came up with the complete breakdown on every buyout, licensing pact and product purchase Bristol-Myers forged during his tenure in charge of the BD team at one of the busiest companies in biopharma.

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Paul Biondi (File photo)

Bris­tol-My­er­s' strat­e­gy, BD chief Paul Bion­di ex­it­ed the com­pa­ny — just ahead of the $74B Cel­gene deal close

Paul Biondi, who orchestrated billions of dollars in deals for Bristol-Myers Squibb over the 5 years he’s run their business development team, has exited the company. Biondi left last month, according to a company spokesperson, in pursuit of another — unspecified — external opportunity.

After 17 years with Bristol-Myers Squibb, Paul Biondi, Head of Strategy and Business Development, decided to leave the company to pursue an external opportunity. The company wishes him well in his new endeavors. Bristol-Myers Squibb  is actively searching for Paul’s successor, and will make an announcement, as appropriate.

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Arie Belldegrun at UKBIO 2019. Shai Dolev for Endpoints News

Kite Phar­ma's ex-CEO con­tra­dicts founder as CAR-T patent tri­al heats up, with con­flict­ing val­u­a­tions

Two days after Kite Pharma founder Arie Belldegrun told a federal courtroom that a meeting he had with a Memorial Sloan Kettering executive wasn’t about licensing their immunotherapy patent, Kite’s ex-CEO Aya Jakobovits said it was.

The admission came Tuesday during cross-examination in a patent infringement case that features two of the biggest cancer biotechs and some of the most well-known names in American medicine.

Jakobovits initially said she was not in attendance, didn’t know it was going to happen and didn’t know what took place, according to Law360. But then the plaintiff’s lawyer handed her a document – whose contents were not publicly revealed – and asked again if she learned after-the-fact that the meeting involved a potential patent license.

“Yes,” Jakobovits eventually said.

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On the heels of promis­ing MCL da­ta, Kite hus­tles its 2nd CAR-T to the FDA as the next big race in the field draws to the fin­ish line

Three days after Gilead’s Kite subsidiary showed off stellar data on their number 2 CAR-T KTE-X19 at ASH, the executive team has pivoted straight to the FDA with a BLA filing and a shot at a near-term approval.

In a small, 74-patient Phase II trial reported out at the beginning of the week, investigators tracked a 93% response rate with two out of three mantle cell lymphoma patients experiencing a complete response.

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