Glax­o­SmithK­line sets its sights on a quick leap in­to the big PD-1/L1 game — will any­one no­tice?

Some­what lost in the news last fall that Glax­o­SmithK­line was buy­ing Tesaro and leap­ing in­to the com­mer­cial end of the chal­leng­ing PARP mar­ket was a PD-1 check­point in­hibitor called TSR-042 that was be­ing point­ed to a quick fil­ing for en­dome­tri­al can­cer. On Tues­day, the GSK sub­sidiary spot­light­ed a promis­ing set of Phase I/II da­ta from their GAR­NET study, and the fil­ing is on track for lat­er this year as the phar­ma gi­ant looks to make its own en­try in­to an in­creas­ing­ly crowd­ed field.

Hal Bar­ron

The snap­shot for the new­ly dubbed dostar­limab: Over­all re­sponse rates in the full pop­u­la­tion of 125 women with a com­mon form of gy­ne­co­log­i­cal can­cer — then bro­ken in­to mi­crosatel­lite in­sta­bil­i­ty-high (MSI-H) and mi­crosatel­lite sta­ble (MSS) pa­tients — were 30%, 49%, and 20%, re­spec­tive­ly. “Dis­ease con­trol rate in the full pop­u­la­tion, MSI-H pop­u­la­tion, and MSS pop­u­la­tion was 53%, 63% and 47%, re­spec­tive­ly.”

It’s a small, ear­ly study, but the ma­jors in the field have been giv­en the green light for less.

In on­col­o­gy, any op­por­tu­ni­ty to use a new drug to help pa­tients is gen­er­al­ly avid­ly wel­comed. And GSK’s re­lease notes that there’s on­ly one ap­proved drug for the same set­ting in en­dome­tri­al can­cer, giv­ing them at least a leg up as ri­vals like Mer­ck fol­low up with their own check­point com­bo ap­proach­es.

It’s easy, though, to over­look an­oth­er quick en­try on the PD-1/L1 front. There are six ap­proved in the US, two that reg­is­ter mega block­buster sta­tus, a new ar­rival from Re­gen­eron sup­port­ed by a re­search chief known to bring a lit­tle fire and brim­stone to his lead­ing drug can­di­dates, and sev­er­al al­so rans, with Baven­cio from Pfiz­er/Mer­ck KGaA — which is rais­ing eye­brows af­ter a long string of clin­i­cal duds. And then there are the mul­ti­tude of new drugs com­ing up from be­hind, and from mul­ti­ple con­ti­nents.

Ax­el Hoos

GSK’s chal­lenge will be to grab at­ten­tion as a play­er, with Hal Bar­ron lead­ing the charge and Ax­el Hoos play­ing the lead role in can­cer. The phar­ma gi­ant is promis­ing to trans­form it­self in­to a heavy­weight in on­col­o­gy, af­ter es­sen­tial­ly miss­ing out on the can­cer rev­o­lu­tion that has shak­en the in­dus­try for the past 5 years. And a PD-1 back­bone drug can play a big part.

What’s in­ter­est­ing, though, is how lit­tle at­ten­tion they’re get­ting for their work. As­traZeneca and Mer­ck rule the PARP roost with Lyn­parza, grow­ing stronger at seem­ing­ly every turn. And Mer­ck’s Keytru­da is clear­ly the dom­i­nant drug in the PD-1/L1 crowd.

Play­ing in the back of this busy field won’t be easy. But no one is count­ing Bar­ron out.

Con­quer­ing a silent killer: HDV and Eiger Bio­Phar­ma­ceu­ti­cals

Hepatitis delta, also known as hepatitis D, is a liver infection caused by the hepatitis delta virus (HDV) that results in the most severe form of human viral hepatitis for which there is no approved therapy.

HDV is a single-stranded, circular RNA virus that requires the envelope protein (HBsAg) of the hepatitis B virus (HBV) for its own assembly. As a result, hepatitis delta virus (HDV) infection occurs only as a co-infection in individuals infected with HBV. However, HDV/HBV co-infections lead to more serious liver disease than HBV infection alone. HDV is associated with faster progression to liver fibrosis (progressing to cirrhosis in about 80% of individuals in 5-10 years), increased risk of liver cancer, and early decompensated cirrhosis and liver failure.
HDV is the most severe form of viral hepatitis with no approved treatment.
Approved nucleos(t)ide treatments for HBV only suppress HBV DNA, do not appreciably impact HBsAg and have no impact on HDV. Investigational agents in development for HBV target multiple new mechanisms. Aspirations are high, but a functional cure for HBV has not been achieved nor is one anticipated in the forseeable future. Without clearance of HBsAg, anti-HBV investigational treatments are not expected to impact the deadly course of HDV infection anytime soon.

UP­DAT­ED: In a land­mark first glimpse of hu­man da­ta from Ver­tex, CRISPR/Cas9 gene ther­a­py sig­nals ear­ly ben­e­fit

Preliminary data on two patients with blood disorders that have been administered with Vertex and partner CRISPR Therapeutics’ gene-editing therapy suggest the technology is safe and effective, marking the first instance of the benefit of the use of CRISPR/Cas9 technology in humans suffering from disease.

Patients in these phase I/II studies give up peripheral blood from which hematopoietic stem and progenitor cells are isolated. The cells are tinkered with using CRISPR/Cas9 technology, and the edited cells — CTX001 — are infused back into the patient via a stem cell transplant. The objective of CTX001 is to fix the errant hemoglobin gene in patents with two blood disorders: beta-thalassemia and sickle cell disease, by unleashing the production of fetal hemoglobin.

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UP­DAT­ED: Make that 2 ap­proved RNAi drugs at Al­ny­lam af­ter the FDA of­fers a speedy OK on ul­tra-rare dis­ease drug

Seventeen years into the game, Alnylam’s pivot into commercial operations is picking up speed.
The bellwether biotech $ALNY has nabbed their second FDA OK for an RNAi drug, this time for givosiran, the only therapy now approved for acute hepatic porphyria. This second approval came months ahead of the February deadline — even after winning priority review following their ‘breakthrough’ title earlier.
AHP is an extremely rare disease, with some 3,000 patients in Europe and the US, not all diagnosed, and analysts have projected peak revenue of $600 million to $700 million a year. The drug will be sold as Givlaari.

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David Ricks. Eli Lilly

Eli Lil­ly touts $400M man­u­fac­tur­ing ex­pan­sion, 100 new jobs to much fan­fare in In­di­anapo­lis — even though it's been chop­ping staff

Eli Lilly is pouring in $400 million to beef up manufacturing facilities at its home base of Indianapolis. The investment, which was lauded by the city’s mayor, is expected to create 100 new jobs.

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Am­gen chops 172 more staffers in R&D, op­er­a­tions and sales amid neu­ro­science ex­it, rev­enue down­turn

Neuroscience wasn’t the only unit that’s being hit by a reorganization underway at Amgen. As well as axing 149 employees in its Cambridge office, the company has disclosed that 172 others nationwide, including some from its Thousand Oaks, CA headquarters, are being let go.

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Stephen Hahn (via Senate HELP Committee)

Stephen Hahn gets through Sen­ate’s soft­ball job in­ter­view — but most­ly plays dodge­ball on the is­sues fac­ing the FDA

Anyone looking for fresh insights on what kind of FDA commissioner Stephen Hahn will be got precious few clues during Wednesday’s Senate hearing on the nomination.

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Op­di­vo/Yer­voy com­bo for melanoma fails in key pa­tient pop­u­la­tion

Bristol-Myers Squibb’s efforts to expand their checkpoint inhibitor combination have run into another recalcitrant cancer.

The NJ-based pharma announced that a combination of Yervoy and Opdivo didn’t beat out Opdivo alone in patients with resected high-risk melanoma who had very low levels of PD-L1. The drug combo couldn’t improve recurrence-free survival in these post-surgery patients.

Ver­tex's stel­lar quar­ter car­ries on with French re­im­burse­ment deal

Vertex’s golden quarter just got brighter. About a month after the US drugmaker finally clinched a deal with UK authorities to cover its slate of cystic fibrosis (CF) drugs following years of protracted negotiations, the company on Wednesday secured a deal with France for its CF therapy, Orkambi.

After the UK, France has one of the largest CF populations outside the United States. Achieving French reimbursement unlocks an ~7000-patient CF population, around ~2500-3000 of which will likely be eligible to receive (and be reimbursed for) Orkambi, Stifel’s Paul Matteis wrote in a note.

Nello Mainolfi, Kymera via Youtube

Kymera hands the helm to No­var­tis vet — and found­ing CSO — Nel­lo Main­olfi

Kymera Therapeutics is turning to a co-founder to run the company.
The protein degradation specialist with a deep-pocket syndicate behind them has opted to give the helm officially to Nello Mainolfi. The new CEO is a veteran of the Novartis Institutes for Biomedical Research. He joined Atlas Venture in their entrepreneur-in-residence program and helped launch Kymera as the CSO three years ago with Atlas’ Bruce Booth.
The boast at Kymera is that they’re angling to create a new class of protein degraders, a popular field where there’s been a variety of startups. One of its chief advocates is NIBR head Jay Bradner, who launched C4 just ahead of joining Novartis, where he’s also been doing new work in the field.