Eli Lil­ly fi­nal­ly pub­lished its dis­as­trous EX­PE­DI­TION3 da­ta, a cost­ly les­son in re­think­ing Alzheimer's

Eli Lil­ly $LLY had hoped that EX­PE­DI­TION3 would prove to the world that amy­loid be­ta was the cause of Alzheimer’s and that solanezum­ab could bend the curve of cog­ni­tive de­cline back to pa­tients’ fa­vor — or at least for pa­tients with an ear­ly-stage, mild form of the dis­ease.

In­stead, the land­mark fail­ure — ac­knowl­edged well over a year ago — is rais­ing fresh ques­tions about whether in­ves­ti­ga­tors have been aim­ing at the wrong tar­get for more than a decade of flops and dis­as­trous fail­ures.

It took awhile, but Lil­ly fi­nal­ly laid out the last big round of EX­PE­DI­TION da­ta in the New Eng­land Jour­nal of Med­i­cine. And while solanezum­ab may have helped slow the mem­o­ry-wast­ing ail­ment, the im­pact was far too slight to make an im­por­tant dif­fer­ence for pa­tients.

Com­par­ing 1,057 pa­tients on drug com­pared to 1,072 on place­bo, the re­search team found a mod­est trend in its fa­vor:

The mean change from base­line in the ADAS-cog14 score was 6.65 in the solanezum­ab group of pa­tients with mild form of the dis­ease and 7.44 in the place­bo group, with no sig­nif­i­cant be­tween-group dif­fer­ence at week 80 (dif­fer­ence, −0.80; 95% con­fi­dence in­ter­val, −1.73 to 0.14; P=0.10)….The change from base­line in the MMSE score was −3.17 in the solanezum­ab group and −3.66 in the place­bo group.

John Lech­leit­er

And that’s where Lil­ly’s and for­mer CEO John Lech­leit­er’s dreams of cash­ing in a gold­en tick­et on a $10 bil­lion drug were fi­nal­ly ham­mered in­to scrap — though there is still work un­der­way to see if the drug can work to pre­vent the dis­ease from oc­cur­ring in the first place.

Lil­ly spent a for­tune on its three big tri­als of solanezum­ab, prod­ded on by not­ed Alzheimer’s re­searcher Paul Aisen. Every big fail­ure, though, in­spired a new hunt for da­ta that would back up a new the­o­ry of how it could work. And each fresh at­tempt went down to de­feat.

Now some in the field are start­ing to ask if the Alzheimer’s re­search com­mu­ni­ty should re­think the amy­loid the­o­ry, look­ing for new ev­i­dence on the con­flu­ence of events that cause the dis­ease.

In an ac­com­pa­ny­ing ed­i­to­r­i­al Paul Mur­phy from the Uni­ver­si­ty of Ken­tucky, Lex­ing­ton, wrote: “We may very well be near­ing the end of the amy­loid hy­poth­e­sis rope, at which point one or two more fail­ures will cause us to loosen our grip and let go.”

That would have ma­jor im­pli­ca­tions for Bio­gen and oth­ers, though, who are still bound and de­ter­mined to find the gold­en tick­et for them­selves. But that is look­ing more elu­sive than ever. In the mean­time, there’s a big dri­ve on to divvy up pa­tients in­to small­er, ge­net­i­cal­ly de­fined buck­ets in search of new drugs that could work. And there’s no sign that EX­PE­DI­TION3 or any oth­er set­back has de­flect­ed that sin­gu­lar­ly de­ter­mined set of in­ves­ti­ga­tors.

Paul Hudson, Sanofi CEO (Getty Images)

Sanofi CEO Paul Hud­son has $23B burn­ing a hole in his pock­et. And here are some hints on how he plans to spend that

Sanofi has reaped $11.1 billion after selling off a big chunk of its Regeneron stock at $515 a share. And now everyone on the M&A side of the business is focused on how CEO Paul Hudson plans to spend it.

After getting stung in France for some awkward politicking — suggesting the US was in the front of the line for Sanofi’s vaccines given American financial support for their work, versus little help from European powers — Hudson now has the much more popular task of managing a major cash cache to pull off something in the order of a big bolt-on. Or two.

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The Advance Clinical leadership team: CEO Yvonne Lungershausen, Sandrien Louwaars - Director Business Development Operations, Gabriel Kremmidiotis - Chief Scientific Officer, Ben Edwards - Chief Strategy Officer

How Aus­tralia De­liv­ers Rapid Start-up and 43.5% Re­bate for Ear­ly Phase On­col­o­gy Tri­als

About Avance Clinical

Avance Clinical is an Australian owned Contract Research Organisation that has been providing high-quality clinical research services to the local and international drug development industry for 20 years. They specialise in working with biotech companies to execute Phase 1 and Phase 2 clinical trials to deliver high-quality outcomes fit for global regulatory standards.

As oncology sponsors look internationally to speed-up trials after unprecedented COVID-19 suspensions and delays, Australia, which has led the world in minimizing the pandemic’s impact, stands out as an attractive destination for early phase trials. This in combination with the streamlined regulatory system and the financial benefits including a very favourable exchange rate and the R & D cash rebate makes Australia the perfect location for accelerating biotech clinical programs.

Pablo Legorreta, founder and CEO of Royalty Pharma AG, speaks at the annual Milken Institute Global Conference in Beverly Hills, California (Patrick T. Fallon/Bloomberg via Getty Images)

Cap­i­tal­iz­ing Pablo: The world’s biggest drug roy­al­ty buy­er is go­ing pub­lic. And the low-key CEO di­vulges a few se­crets along the way

Pablo Legorreta is one of the most influential players in biopharma you likely never heard of.

Over the last 24 years, Legorreta’s Royalty Pharma group has become, by its own reckoning, the biggest buyer of drug royalties in the world. The CEO and founder has bought up a stake in a lengthy list of the world’s biggest drug franchises, spending $18 billion in the process — $2.2 billion last year alone. And he’s become one of the best-paid execs in the industry, reaping $28 million from the cash flow last year while reserving 20% of the cash flow, less expenses, for himself.

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Bryan Roberts, Venrock

Ven­rock sur­vey shows grow­ing recog­ni­tion of coro­n­avirus toll, wan­ing con­fi­dence in ar­rival of vac­cines and treat­ments

When Venrock partner Bryan Roberts went to check the results from their annual survey of healthcare leaders, what he found was an imprint of the pandemic’s slow arrival in America.

The venture firm had sent their form out to hundreds of insurance and health tech executives, investors, officials and academics on February 24 and gave them two weeks to fill it out. No Americans had died at that point but the coronavirus had become enough of a global crisis that they included two questions about the virus, including “Total U.S. deaths in 2020 from the novel coronavirus will be:”.

Dan O'Day, Gilead CEO (Andrew Harnik, AP Images)

UP­DAT­ED: Gilead leas­es part­ner rights to TIG­IT, PD-1 in a $2B deal with Ar­cus. Now comes the hard part

Gilead CEO Dan O’Day has brokered his way to a PD-1 and lined up a front row seat in the TIGIT arena, inking a deal worth close to $2 billion to align the big biotech closely with Terry Rosen’s Arcus. And $375 million of that comes upfront, with cash for the buy-in plus equity, along with $400 million for R&D and $1.22 billion in reserve to cover opt-in payments and milestones..

Hotly rumored for weeks, the 2 players have formalized a 10-year alliance that starts with rights to the PD-1, zimberelimab. O’Day also has first dibs on TIGIT and 2 other leading programs, agreeing to an opt-in fee ranging from $200 million to $275 million on each. There’s $500 million in potential TIGIT milestones on US regulatory events — likely capped by an approval — if Gilead partners on it and the stars align on the data. And there’s another $150 million opt-in payments for the rest of the Arcus pipeline.

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Roger Perlmutter, Merck R&D chief (YouTube)

UP­DAT­ED: Backed by BAR­DA, Mer­ck jumps in­to Covid-19: buy­ing out a vac­cine, part­ner­ing on an­oth­er and adding an­tivi­ral to the mix

Merck execs are making a triple play in a sudden leap into the R&D campaign against Covid-19. And they have more BARDA cash backing them up on the move.

Tuesday morning the pharma giant simultaneously announced plans to buy an Austrian biotech that has been working on a preclinical vaccine candidate, added a collaboration on another vaccine with the nonprofit IAVI and inked a deal with Ridgeback Biotherapeutics on an early-stage antiviral.

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David Hoey (Vaxxas)

In for the long vac­cine game, Mer­ck buys in­to patch de­liv­ery tech with pan­dem­ic po­ten­tial

When Merck dived into the R&D fray for a Covid-19 vaccine earlier this week, execs made it clear that they’re not necessarily looking to be first — with CEO Ken Frazier throwing cold water on the hotly-discussed 12- to 18-month timelines. But when it does emerge from behind, the pharma giant clearly expects to play a significant part.

Part of that will depend on next-generation delivery technology that reshapes the world’s imagination of a vaccine.

No­var­tis jumps in­to Covid-19 vac­cine hunt, as Big Phar­ma and big biotech com­mit to bil­lions of dos­es

After spending most of the pandemic on the sidelines, Novartis is offering its aid in the race to develop a Covid-19 vaccine.

AveXis, the Swiss pharma’s gene therapy subsidiary, has agreed to manufacture the vaccine being developed by Massachusetts Eye and Ear and Massachusetts General Hospital. The biotech will begin manufacturing this month, while the vaccine undergoes further preclinical testing. They’ve agreed to provide the vaccine for free for clinical trials beginning in the second half of 2020, but have not disclosed financials for after.

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De­nali un­veils new way of cross­ing blood brain bar­ri­er as the big neu­ro­science bet en­ters its clin­i­cal years

Five years ago, as much of pharma began leaving neuroscience, three big-name scientists from Genentech and some A-list investors, including ARCH and Flagship, made a $217 million bet that new genetic insights and a reliance on biomarkers could bring them success. They called it Denali Therapeutics.

Still, Denali faced the problem that neuroscience developers have faced for decades: How do you get a large molecule across the blood-brain barrier, a natural defense evolved precisely to keep them out? Enzyme replacement therapy, for instance, would be a great candidate to treat several neurological disorders, but enzymes can’t cross the barrier.