Game on: Re­gen­eron's BC­MA bis­pe­cif­ic makes clin­i­cal da­ta de­but, kick­ing off mul­ti­ple myelo­ma matchup with Bris­tol-My­ers

As J&J at­tempts to jos­tle past Bris­tol-My­ers Squibb and blue­bird for a land­mark ap­proval of its an­ti-BC­MA CAR-T — and while Glax­o­SmithK­line maps a quick path to the FDA rid­ing on its own BC­MA-tar­get­ing an­ti­body-drug con­ju­gates — the bis­pecifics are ar­riv­ing on the scene to stake a claim for a mar­ket that could cross $10 bil­lion per year.

The main ri­val­ry in mul­ti­ple myelo­ma is shap­ing up to be one be­tween Re­gen­eron and Bris­tol-My­ers, which picked up a bis­pe­cif­ic an­ti­body to BC­MA through its re­cent­ly closed $74 bil­lion takeover of Cel­gene. Both pre­sent­ed promis­ing first-in-hu­man da­ta at the ASH 2019 meet­ing.

Bri­an Sko­r­ney

“Al­though Cel­gene has both a time and myelo­ma ex­pe­ri­ence ad­van­tage, we be­lieve Re­gen­eron is close be­hind and could even catch up if the megamerg­er leads to some pro­gram de­lays” was Baird an­a­lyst Bri­an Sko­r­ney’s take as he scored the first myelo­ma da­ta for REGN5458.

With bis­pecifics the gen­er­al idea is to bridge T cells and tu­mors cells, there­by in­duc­ing the killing of can­cer. REGN5458, in par­tic­u­lar, binds to the CD3 re­cep­tor on the im­mune cells and BC­MA on mul­ti­ple myelo­ma cells.

In­ves­ti­ga­tors had da­ta on the first two dose groups to re­port from the on­go­ing Phase I/II dose es­ca­la­tion study, in which 3 pa­tients were giv­en 3mg week­ly dos­es and 4 pa­tients re­ceived 6mg. Over­all, 4 of them record­ed a re­sponse — giv­ing rise to a 57% re­sponse rate over­all — 3 of them from the 6mg group (75% re­sponse rate there). Among those three tak­ing the high­er dose, two passed the cru­cial test of be­ing min­i­mal resid­ual dis­ease (MRD) neg­a­tive, a high bar sug­gest­ing no can­cer cells were de­tectable in their bone mar­row.

Is­rael Lowy

No­tably, these pa­tients have had a me­di­an of sev­en lines of pri­or ther­a­py and had all failed CD38 an­ti­body treat­ment. And at the 6mg dose lev­el, the me­di­an num­ber of pri­or treat­ment was even high­er at 9.5, Sko­r­ney not­ed.

Cy­tokine re­lease syn­drome, ane­mia and lym­phope­nia were all doc­u­ment­ed, though Re­gen­eron said the ad­verse events were not dose lim­it­ing.

Their re­sults come on the heels of Bris­tol-My­ers/Cel­gene’s da­ta re­veal, in which CC-93269 showed an 89% re­sponse rate in the high­est dose of 10mg af­ter be­ing in­ves­ti­ga­tors went up from 0.15mg with 30 pa­tients to­tal.

“CC-93269 shows promis­ing dose-de­pen­dent ef­fi­ca­cy, in­clud­ing MRD-neg­a­tive sCRs, with a con­ve­nient ad­min­is­tra­tion sched­ule in pa­tients with heav­i­ly pre­treat­ed re­lapsed/re­frac­to­ry mul­ti­ple myelo­ma.”

Most of the grade 3 or high­er ad­verse events were neu­trope­nia, ane­mia and in­fec­tions, the in­ves­ti­ga­tors not­ed, though cy­tokine re­lease syn­drome al­so cropped up in 76% of all pa­tients in the tri­al.

In the Re­gen­eron tri­al, three pa­tients ex­pe­ri­enced CRS, amount­ing to a 42% oc­cur­rence.

“We are en­cour­aged to see promis­ing, rapid clin­i­cal ac­tiv­i­ty even at the ini­tial two dos­es of REGN5458 in heav­i­ly pre­treat­ed pa­tients with mul­ti­ple myelo­ma,” Is­rael Lowy, head of clin­i­cal and trans­la­tion­al sci­ences for on­col­o­gy at Re­gen­eron, said in a state­ment. “We are ac­tive­ly re­cruit­ing pa­tients in­to high­er dose groups in this tri­al and look for­ward to shar­ing fur­ther re­sults in 2020.”

Lowy added that the Tar­ry­town, NY-based biotech has ini­ti­at­ed a tri­al for its sec­ond BC­MA/CD3 bis­pe­cif­ic, which binds dif­fer­ent­ly. They are mov­ing fast — and they need to in a field brim­ming with com­peti­tors.

Pfiz­er is ad­vanc­ing its own ver­sion, al­though the ab­sence of equiv­a­lent­ly promis­ing da­ta at ASH pushed Sko­r­ney to sur­mise “not all bis­pecifics are cre­at­ed equal­ly.” Ab­b­Vie al­so got its hands on a bis­pe­cif­ic hook­ing to the same tar­gets from a $90 mil­lion deal with Teneo­bio.

Biotech and Big Phar­ma: A blue­print for a suc­cess­ful part­ner­ship

Strategic partnerships have long been an important contributor to how drugs are discovered and developed. For decades, big pharma companies have been forming alliances with biotech innovators to increase R&D productivity, expand geographical reach and better manage late-stage commercialization costs.

Noël Brown, Managing Director and Head of Biotechnology Investment Banking, and Greg Wiederrecht, Ph.D., Managing Director in the Global Healthcare Investment Banking Group at RBC Capital Markets, are no strangers to the importance of these tie-ups. Noël has over 20 years of investment banking experience in the industry. Before moving to the banking world in 2015, Greg was the Vice President and Head of External Scientific Affairs (ESA) at Merck, where he was responsible for the scientific assessment of strategic partnership opportunities worldwide.

Credit: Shutterstock

How Chi­na turned the ta­bles on bio­phar­ma's glob­al deal­mak­ing

Fenlai Tan still gets chills thinking about the darkest day of his life.

Three out of eight lung cancer patients who received a tyrosine kinase inhibitor developed by his company, Betta Pharma, died in the span of a month. Tan, the chief medical officer, was summoned to Peking Union Medical College Hospital, where the head of the clinical trial department told him that the trial investigators would be conducting an autopsy to see if the patients had died of the disease — they were all very sick by the time they enrolled — or of interstitial lung disease, a deadly side effect tied to the TKI class that’s been reported in Japan.

An­gion's or­gan dam­age drug strikes out again, this time in high-risk kid­ney trans­plant pa­tients

After flopping a test in Covid-19 earlier this year, Angion’s lead organ damage drug has now hit the skids again in kidney transplant patients.

Angion and partner Vifor Pharma’s ANG-3777 failed to beat out placebo in terms of improving eGFR, a measure of kidney function, in patients who had received a deceased donor kidney transplant and were at high risk of developing what is known as delayed graft function, according to Phase III results released Tuesday.

An image of Alzheimer's brain tissue. The red show gingipains, a protein from P. gingivalis, intermixing with neurons (yellow) and glial cells (green)

An Alzheimer's dark­horse fails its first big tri­al, but of­fers hope for a long-over­looked hy­poth­e­sis

Three years ago, Cortexyme emerged out of obscurity with some big-name backers and an unorthodox approach to treating Alzheimer’s.

They moved their drug into a pivotal study the next year, offering one of the first major tests for a hypothesis that has fluttered on the outskirts of Alzheimer’s research for decades: that, in many cases, the disease is driven by infectious agents — the havoc they wreak in the brain and the inflammation the body uses to try to fend them off. And that quashing the infection could slow patients’ cognitive decline.

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No­var­tis dumps AveX­is pro­gram for Rett syn­drome af­ter fail­ing re­peat round of pre­clin­i­cal test­ing

Say goodbye to AVXS-201.

The Rett syndrome gene therapy drug made by AveXis — the biotech that was bought, kept separate, then renamed and finally absorbed by Novartis into its R&D division — has been dropped by the biopharma.

In Novartis’ third quarter financial report, the pharma had found that preclinical data did not support development of the gene therapy into IND-enabling trials and beyond. The announcement comes a year after Novartis told the Rett Society how excited it was by the drug — and its potential benefits and uses.

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Peter Nell, Mammoth Biosciences CBO

UP­DAT­ED: Jen­nifer Doud­na spin­out inks a Mam­moth CRISPR deal with Ver­tex worth near­ly $700M

When a company gets its start in gene editing pioneer Jennifer Doudna’s lab, it’s bound to make headlines. But three years in, the fanfare still hasn’t died down for Mammoth Biosciences. Now, the Brisbane, CA-based company is cheering on its first major R&D pact.

Mammoth unveiled a nearly $700 million deal with Vertex on Tuesday morning, good for the development of in vivo gene therapies for two mystery diseases. The stars of the show are Mammoth’s ultra-small CRISPR systems, including two Cas enzymes licensed from Doudna’s lab over the past couple years, Cas14 and Casɸ.

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FDA is much worse than its reg­u­la­to­ry peers at proac­tive­ly dis­clos­ing da­ta, re­searchers find

The European Medicines Agency and Health Canada continue to outpace the FDA when it comes to proactively releasing data on drugs and biologics the agency has reviewed, leading to further questions of why the American agency can’t be more transparent.

In a study published recently in the Journal of Law, Medicine, & Ethics, Yale and other academic lawyers and researchers found that between 2016 and April 2021, the EMA proactively released data for 123 unique medical products, while Health Canada proactively released data for 73 unique medical products between 2019 and April 2021. What’s more, the EMA and Health Canada didn’t proactively release the same data on the same drugs. In stark contrast, the FDA in 2018 only proactively disclosed data supporting one drug that was approved that year.

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No­var­tis' sec­ond at­tempt to repli­cate a stun­ning can­cer re­sult falls flat

Novartis’ hopes of turning one of the most surprising trial data points of the last decade into a lung cancer drug has taken another setback.

The Swiss pharma announced Monday that its IL-1 inhibitor canakinumab did not significantly extend the lives or slow the disease progression of patients with previously untreated locally advanced or metastatic non-small cell lung cancer when compared to standard of-care alone.

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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.