FDA hands ac­cel­er­at­ed nod to Seagen, Gen­mab's so­lo ADC in cer­vi­cal can­cer, but com­bo stud­ies look even more promis­ing

Bio­phar­ma’s res­i­dent an­ti­body-drug con­ju­gate ex­pert Seagen has scored a clutch of on­col­o­gy ap­provals in re­cent years, find­ing gold in what are known as “third-gen” AD­Cs. Now, an­oth­er of their part­nered con­ju­gates is ready for prime time.

The FDA on Mon­day hand­ed an ac­cel­er­at­ed ap­proval to Seagen and Gen­mab’s Tiv­dak (ti­so­tum­ab ve­dotin-tftv, or “TV”) in sec­ond-line pa­tients with re­cur­rent or metasta­t­ic cer­vi­cal can­cer who pre­vi­ous­ly pro­gressed af­ter chemother­a­py rather than PD-(L)1 sys­temic ther­a­py, the com­pa­nies said in a re­lease.

Tiv­dak is an ADC that links a tis­sue fac­tor-di­rect­ed an­ti­body with a pay­load of monomethyl au­ris­tatin E (MMAE). It’s the third ADC ap­proved for Seagen, which has emerged as an ADC spe­cial­ist in re­cent years.

The agency based its re­view on da­ta from the Phase II in­no­vaTV 204 study in 101 pa­tients, with Tiv­dak post­ing a 24% re­sponse rate, as as­sessed by an in­de­pen­dent re­view com­mit­tee, with a me­di­an du­ra­tion of re­sponse of 8.3 months. In keep­ing with the FDA’s ac­cel­er­at­ed ap­proval pro­gram, Seagen and Gen­mab will run a con­fir­ma­to­ry tri­al to de­ter­mine the drug’s clin­i­cal out­comes.

The drug will come with a boxed warn­ing for oc­u­lar tox­i­c­i­ty, which in­cludes a risk of changes in the corneal ep­ithe­li­um and con­junc­ti­va re­sult­ing in changes in vi­sion, in­clud­ing se­vere vi­sion loss, and corneal ul­cer­a­tion, ac­cord­ing to the drug’s la­bel.

Tiv­dak’s whole­sale ac­qui­si­tion cost is $5,885 per 40mg sin­gle dose vial, with pa­tients’ in­di­vid­ual costs de­ter­mined by body weight and du­ra­tion of ther­a­py, a spokesper­son said by email. The com­pa­nies es­ti­mate an av­er­age WAC per pa­tient per month of $34,000, be­fore dis­counts or re­bates.

TV will com­pete with Mer­ck’s Keytru­da in sec­ond-line cer­vi­cal can­cer, but that com­pe­ti­tion may quick­ly turn in­to col­lab­o­ra­tion with new com­bo da­ta show­ing stronger re­sponse rates. The FDA al­so grant­ed Keytru­da an ac­cel­er­at­ed ap­proval in 2018, based on da­ta show­ing a 14% re­sponse rate — pret­ty abysmal re­sults but a sign of promise in a big un­met clin­i­cal need.

Seagen and Gen­mab this week­end re­leased da­ta from the Phase Ib/II in­no­vaTV 205 study, show­ing some strong re­sults for TV in com­bi­na­tion with the chemother­a­py car­bo­platin or Keytru­da across mul­ti­ple lines of ther­a­py for re­cur­rent or metasta­t­ic pa­tients.

A com­bi­na­tion of TV and Keytru­da in sec­ond- or third-line cer­vi­cal can­cer pa­tients post­ed a 38% re­sponse rate in 34 pa­tients, with two com­plete re­spons­es and 11 par­tial re­spons­es re­port­ed. Mean­while, the TV-car­bo com­bo post­ed a re­sponse rate of 55%, in­clud­ing four com­plete re­spons­es and 14 par­tial re­spons­es, in first-line re­cur­rent or metasta­t­ic cer­vi­cal can­cer pa­tients. At a me­di­an fol­low-up of 7.9 months, the com­bo’s du­ra­tion of re­sponse was 8.3 months with a me­di­an pro­gres­sion-free sur­vival of 9.5 months.

Al­so this week­end, Mer­ck un­corked full da­ta from the KEYNOTE-826 study show­ing a com­bi­na­tion of Keytru­da and chemother­a­py with or with­out Roche’s Avastin cut the risk of death by 33% over chemo with or with­out Avastin (p=<0.001) in first-line ad­vanced cer­vi­cal can­cer pa­tients. The Keytru­da arm post­ed a me­di­an OS of 24.4 months com­pared with 16.5 months for the chemo arm, Mer­ck said.

So­cial: Clay Sie­gall, Seagen CEO (Life Sci­ence Wash­ing­ton via YouTube)

Biotech Half­time Re­port: Af­ter a bumpy year, is biotech ready to re­bound?

The biotech sector has come down firmly from the highs of February as negative sentiment takes hold. The sector had a major boost of optimism from the success of the COVID-19 vaccines, making investors keenly aware of the potential of biopharma R&D engines. But from early this year, clinical trial, regulatory and access setbacks have reminded investors of the sector’s inherent risks.

RBC Capital Markets recently surveyed investors to take the temperature of the market, a mix of specialists/generalists and long-only/ long-short investment strategies. Heading into the second half of the year, investors mostly see the sector as undervalued (49%), a large change from the first half of the year when only 20% rated it as undervalued. Around 41% of investors now believe that biotech will underperform the S&P500 in the second half of 2021. Despite that view, 54% plan to maintain their position in the market and 41% still plan to increase their holdings.

So — that pig-to-hu­man trans­plant; Po­ten­tial di­a­betes cure reach­es pa­tient; Ac­cused MIT sci­en­tist lash­es back; and more

Welcome back to Endpoints Weekly, your review of the week’s top biopharma headlines. Want this in your inbox every Saturday morning? Current Endpoints readers can visit their reader profile to add Endpoints Weekly. New to Endpoints? Sign up here.

We’re incredibly excited to welcome Beth Bulik, seasoned pharma marketing reporter, to the team. You can find much of her work in our new Marketing channel — and in her weekly newsletter, Endpoints PharmaRx, which will launch in early November. Add it to your subscriptions here.

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UP­DAT­ED: Agenus calls out FDA for play­ing fa­vorites with Mer­ck, pulls cer­vi­cal can­cer BLA at agen­cy's re­quest

While criticizing the FDA for what may be some favoritism towards Merck, Agenus on Friday officially pulled its accelerated BLA for its anti-PD-1 inhibitor balstilimab as a potential second-line treatment for cervical cancer because of the recent full approval for Merck’s Keytruda in the same indication.

The company said the BLA, which was due for an FDA decision by Dec. 16, was withdrawn “when the window for accelerated approval of balstilimab closed,” thanks to the conversion of Keytruda’s accelerated approval to a full approval four months prior to its PDUFA date.

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How to col­lect and sub­mit RWD to win ap­proval for a new drug in­di­ca­tion: FDA spells it out in a long-await­ed guid­ance

Real-world data are messy. There can be differences in the standards used to collect different types of data, differences in terminologies and curation strategies, and even in the way data are exchanged.

While acknowledging this somewhat controlled chaos, the FDA is now explaining how biopharma companies can submit study data derived from real-world data (RWD) sources in applicable regulatory submissions, including new drug indications.

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NYU surgeon transplants an engineered pig kidney into the outside of a brain-dead patient (Joe Carrotta/NYU Langone Health)

No, sci­en­tists are not any clos­er to pig-to-hu­man trans­plants than they were last week

Steve Holtzman was awoken by a 1 a.m. call from a doctor at Duke University asking if he could put some pigs on a plane and fly them from Ohio to North Carolina that day. A motorcyclist had gotten into a horrific crash, the doctor explained. He believed the pigs’ livers, sutured onto the patient’s skin like an external filter, might be able to tide the young man over until a donor liver became available.

David Livingston (Credit: Michael Sazel for CeMM)

Renowned Dana-Far­ber sci­en­tist, men­tor and bio­phar­ma ad­vi­sor David Liv­ingston has died

David Livingston, the Dana-Farber/Harvard Med scientist who helped shine a light on some of the key molecular drivers of breast and ovarian cancer, died unexpectedly last Sunday.

One of the senior leaders at Dana-Farber during his nearly half century of work there, Livingston was credited with shedding light on the genes that regulate cell growth, with insights into inherited BRCA1 and BRCA2 mutations that helped lay the scientific foundation for targeted therapies and earlier detection that have transformed the field.

Marty Duvall, Oncopeptides CEO

On­copep­tides stock craters as it pulls can­cer drug Pepax­to from the mar­ket

Shares of Oncopeptides crashed more than 70% in early Friday trading after the company said it’s pulling its multiple myeloma drug Pepaxto (melphalan flufenamide) from the US market after failing a confirmatory trial. The move will force the company to close its US and EU business units and enact significant layoffs.

The FDA had scheduled an adcomm meeting next Thursday to discuss Pepaxto, which first won accelerated approval in February and costs about $19,000 per course of treatment. The committee was to weigh in on whether the confirmatory trial demonstrated a worse overall survival in the treatment arm compared to the control arm.

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Pfiz­er pitch­es its Covid-19 vac­cine for younger chil­dren ahead of ad­comm next week

Pfizer will present its case to the FDA’s vaccine adcomm next week, seeking authorization for a lower-dose version of its Covid-19 vaccine for kids ages 5 through 12, which the Biden administration said will likely begin rolling out early next month.

Two primary doses of the 10 µg vaccine (the dose for those ages 12 and up is 30 μg) given 3 weeks apart in this group of children “have shown a favorable safety and tolerability profile, robust immune responses against all variants of concern including Delta, and vaccine efficacy of 90.7% against laboratory-confirmed symptomatic COVID-19,” the company said in briefing documents ahead of next Tuesday’s meeting of the FDA’s Vaccines and Related Biological Products Advisory Committee.

No­vo CEO Lars Fruer­gaard Jør­gensen on R&D risk, the deal strat­e­gy and tar­gets for gen­der di­ver­si­ty


I kicked off our European R&D summit last week with a conversation involving Novo Nordisk CEO Lars Fruergaard Jørgensen. Novo is aiming to launch a new era of obesity management with a new approval for semaglutide. And Jørgensen had a lot to say about what comes next in R&D, how they manage risk and gender diversity targets at the trendsetting European pharma giant.

John Carroll: I’m here with Lars Jørgensen, the CEO of Novo Nordisk. Lars, it’s been a really interesting year so far with Novo Nordisk, right? You’ve projected a new era of growing sales. You’ve been able to expand on the GLP-1 franchise that was already well established in diabetes now going into obesity. And I think a tremendous number of people are really interested in how that’s working out. You have forecast a growing amount of sales. We don’t know specifically how that might play out. I know a lot of the analysts have different ideas, how those numbers might play out, but that we are in fact embarking on a new era for Novo Nordisk in terms of what the company’s capable of doing and what it’s able to do and what it wants to do. And I wanted to start off by asking you about obesity in particular. Semaglutide has been approved in the United States for obesity. It’s an area of R&D that’s been very troubled for decades. There have been weight loss drugs that have come along. They’ve attracted a lot of attention, but they haven’t actually ever gained traction in the market. My first question is what’s different this time about obesity? What is different about this drug and why do you expect it to work now whereas previous drugs haven’t?

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