Ac­er Ther­a­peu­tics’ bid to re­pur­pose celipro­lol — a be­ta-block­er on the mar­ket for hy­per­ten­sion — as a treat­ment for a rare, in­her­it­ed con­nec­tive tis­sue dis­or­der has hit a se­vere set­back. The New­ton, Mass­a­chu­setts-based com­pa­ny on Tues­day said the FDA re­ject­ed the drug and has asked for an­oth­er clin­i­cal tri­al.

The com­pa­ny’s shares $AC­ER cratered near­ly 77% to $4.47 in Tues­day morn­ing trad­ing.

Chris Schelling LinkedIn

The drug, brand­ed as Ed­si­vo, is un­der de­vel­op­ment for vas­cu­lar Ehlers-Dan­los syn­drome (vEDS) — a rare dis­or­der caused by mu­ta­tions large­ly in the COL3A1 gene, which caus­es ar­te­r­i­al dis­sec­tions and rup­tures that can lead to an ear­ly death. It is es­ti­mat­ed to af­fect be­tween 1 in 50,000 and 1 in 200,000 peo­ple, and there are no treat­ments ap­proved to treat it.

The com­pa­ny sub­mit­ted an ap­pli­ca­tion to mar­ket the drug based on a small, 54-pa­tient study — the Be­ta-Block­ers in Ehlers-Dan­los Syn­drome Treat­ment (BBEST) —  which was de­signed to show the drug could pre­vent ar­te­r­i­al dis­sec­tions and rup­tures in vEDS pa­tients. The tri­al test­ed the drug against a place­bo and was stopped ear­ly as celipro­lol was work­ing well; pa­tients giv­en the drug, com­pared with no treat­ment, saw a re­duc­tion in ar­te­r­i­al events, such as rup­ture or dis­sec­tion, by three­fold. How­ev­er, the study was un­der­pow­ered. Re­searchers ac­knowl­edged that they did not “reach our tar­get num­ber of pa­tients”.

In April, Paris vEDS Pa­tient Reg­istry Da­ta was pub­lished in the Jour­nal of the Amer­i­can Col­lege of Car­di­ol­o­gy. It “de­scribed the long-term out­come of 144 COL3A1+ vEDS pa­tients, most of whom (~90%) were treat­ed with celipro­lol and mon­i­tored for up to 20 yrs (me­di­an 5.3 yrs). Key da­ta high­lights in­clude low­er rates of mor­tal­i­ty and ar­te­r­i­al com­pli­ca­tions in this pa­tient group than that ex­pect­ed from the nat­ur­al his­to­ry of the dis­ease. Celipro­lol-treat­ed pa­tients had an 80.7% sur­vival rate at ~11 yrs vs 48.5% for those not treat­ed,” Need­ham’s Serge Be­langer wrote in a note.

Be­langer was op­ti­mistic the drug would win ap­proval, and es­ti­mat­ed a tar­get mar­ket op­por­tu­ni­ty be­tween $200 mil­lion and $400 mil­lion, based on ex­pect­ed Ed­si­vo an­nu­al pric­ing of $100,000-$200,00 per pa­tient.

On Tues­day, Ac­er chief Chris Schelling said the com­pa­ny is ex­pect­ed to re­spond to the FDA in the third quar­ter.

The top career staff at the FDA has vowed not to let politics overrule science when looking at vaccine data this fall. But Alex Azar, who happens to be their boss’s boss, apparently won’t even give them a chance to stand in the way.

In a new memorandum issued Tuesday last week, the HHS chief stripped the FDA and other health agencies under his purview of their rule making ability, asserting all such power “is reserved to the Secretary.” Sheila Kaplan of the New York Times first obtained and reported the details of the September 15 bulletin.

Having worked in parallel for years to move their respective PD-1 inhibitors up to the first-line treatment of gastrointestinal cancers, Merck and Bristol Myers Squibb finally have the data at ESMO for a showdown.

Comparing KEYNOTE-590 and CheckMate-649, of course, comes with the usual caveats. But a side-by-side look at the overall survival numbers also offer some perspective on a new frontier for the reigning checkpoint rivals, both of whom are claiming to have achieved a first.

President Donald Trump, who seems intent on announcing a COVID-19 vaccine before Election Day, could legally authorize a vaccine over the objections of experts, officials at the FDA and even vaccine manufacturers, who have pledged not to release any vaccine unless it’s proved safe and effective.

In podcasts, public forums, social media and medical journals, a growing number of prominent health leaders say they fear that Trump — who has repeatedly signaled his desire for the swift approval of a vaccine and his displeasure with perceived delays at the FDA — will take matters into his own hands, running roughshod over the usual regulatory process.

Moving into earlier and earlier treatment lines, Bristol Myers Squibb is reporting that adjuvant treatment with Opdivo has doubled the time that esophageal or gastroesophageal junction cancer patients stay free of disease.

With the CheckMate-577 data at ESMO, CMO Samit Hirawat said, the company believes it can change the treatment paradigm.

While a quarter to 30% of patients typically achieve a complete response following chemoradiation therapy and surgery, the rest do not, said Ronan Kelly of Baylor University Medical Center. The recurrence rate is also high within the first year, Hirawat added.

Does Seattle Genetics have another approval on its hands?

The last 12 months, not so great for the world, has been great for Seattle Genetics. The company landed two separate FDA approvals, signed a $4.5 billion deal with Merck and watched antibody-drug conjugates — the technology they spent years developing to broad industry skepticism — emerge suddenly as one of the most popular approaches in oncology. And on Monday at ESMO, the company and their partners at Genmab unveiled the data behind the ADC it hopes will provide its next major FDA approval.

A little under two years after a company rebranding, Immune Regulation is taking an even bigger step toward advancing its goals.

Formerly known as Peptinnovate, the British biotech announced a $53.4 million Series B early Monday morning, helping to further advance two clinical programs in rheumatoid arthritis and asthma. Though those are the two initial indications the company is focusing on, CEO Jonathan Rigby told Endpoints News he hopes the candidates can be applied to a broad swath of autoimmune disorders.

Regeneron entered the PD-(L)1 game late, so they devised a two-pronged strategy to catch up with Big Pharma rivals: They would push it into cancers where PD-1s had yet been tested, and they would prove that it’s as powerful in the big indications as any other on the market.

They cleared a hurdle on the first goal Friday, showing a 31% response in patients with the rare skin cancer basal cell carcinoma. And with the data they’re rolling out Monday, Regeneron cancer chief Israel Lowy is ready to declare success on the second.