Mark Enyedy, ImmunoGen CEO

Im­muno­Gen touts a PhI­II come­back in ovar­i­an can­cer, eye­ing a 2022 ac­cel­er­at­ed ap­proval

When Im­muno­Gen’s lead an­ti­body-drug con­ju­gate flunked a Phase III study in ovar­i­an can­cer a cou­ple years ago, the com­pa­ny clung to hope that it would per­form bet­ter in a sub­group of pa­tients with high fo­late re­cep­tor al­pha (FRα) ex­pres­sion.

On Tues­day, re­searchers un­corked topline Phase III re­sults sug­gest­ing it was right — and in­vestors cheered on the news with a 40% boost to Im­muno­Gen’s stock price $IMGN. CEO Mark Enyedy says he’s go­ing af­ter an ac­cel­er­at­ed ap­proval and plans to file in the first quar­ter of 2022.

A to­tal of 106 plat­inum-re­sis­tant ovar­i­an can­cer pa­tients who had tak­en a me­di­an of three pri­or ther­a­pies — at least one of them be­ing Genen­tech’s Avastin — en­rolled in the SO­RAYA study. Im­muno­Gen’s drug, called mirve­tux­imab so­rav­tan­sine, shrank tu­mors in 32.4% of pa­tients at a me­di­an fol­low-up of 8.1 months. And five of those pa­tients achieved a com­plete re­sponse.

“Any CR is ground­break­ing,” co-prin­ci­pal in­ves­ti­ga­tor Rob Cole­man said in a call with in­vestors on Tues­day. “Re­mem­ber, these are pa­tients who have pro­gressed through our best ther­a­pies mul­ti­ple times, and they have ac­tu­al vis­i­ble tu­mor that went away.”

The me­di­an du­ra­tion of re­sponse was 5.9 months, with near­ly half of re­spon­ders con­tin­u­ing on the ther­a­py, ac­cord­ing to Im­muno­Gen — though the com­pa­ny ex­pects to have more da­ta on DOR at a med­ical con­fer­ence next quar­ter.

While Im­muno­Gen says mirve­tux­imab was well-tol­er­at­ed, 41% of pa­tients ex­pe­ri­enced blurred vi­sion re­lat­ed to the treat­ment (though on­ly 6% ex­pe­ri­enced cas­es Grade 3 or high­er). Ker­atopa­thy, a dis­ease of the cornea, oc­curred in 35% of pa­tients and 29% ex­pe­ri­enced nau­sea.

“Com­pared to oth­er tox­i­c­i­ties that we deal with, with oth­er types of ther­a­pies, this one is very straight­for­ward to deal with,” co-prin­ci­pal in­ves­ti­ga­tor Ur­su­la Mat­u­lo­nis said of the vi­sion prob­lems. “I’ve been work­ing with this drug for many years now, and we have a set group of oph­thal­mol­o­gists we re­fer pa­tients to, and pa­tients are giv­en lu­bri­cat­ing eye drops, steroid eye drops.”

The oc­u­lar tox­i­c­i­ties are re­versible, she said, adding they “re­al­ly did not re­sult in very many pa­tients drop­ping out of the study.”

Be­yond SO­RAYA, Im­muno­Gen ex­pects to read out topline da­ta from a con­fir­ma­to­ry study called MI­RA­SOL in the third quar­ter of 2022 in the hopes of win­ning a full ap­proval for mirve­tux­imab.

In an­ti­body-drug con­ju­gates, a can­cer-killing tox­in is at­tached to a spe­cif­ic an­ti­body us­ing a biodegrad­able link­er. Im­muno­Gen has been a long­time play­er in the ADC field, but a Phase III fail­ure for mirve­tux­imab back in 2019 sent shares spi­ral­ing.

Pa­tients in that tri­al, dubbed FOR­WARD I, were giv­en ei­ther mirve­tux­imab or the physi­cian’s choice of sin­gle-agent chemother­a­py. Al­though the over­all re­sponse rate was high­er for mirve­tux­imab than chemother­a­py, the drug did not in­duce a sta­tis­ti­cal­ly sig­nif­i­cant im­prove­ment in pro­gres­sion-free sur­vival, which was the main goal. It al­so failed to sig­nif­i­cant­ly im­prove over­all sur­vival. Two months lat­er, the FDA bat­ted back an at­tempt at an ac­cel­er­at­ed ap­proval based on a sec­ondary end­point.

At the end of 2019, Im­muno­Gen an­nounced it was launch­ing SO­RAYA in pa­tients with high FRα ex­pres­sion, which it said could sup­port ac­cel­er­at­ed ap­proval of the drug.

Enyedy is al­ready prep­ping a com­mer­cial launch, which he says could take off next year if all goes well.

The Fac­tors Dri­ving a Rapid Evo­lu­tion of Gene & Cell Ther­a­py and CAR-T Clin­i­cal Re­search in APAC

APAC is the fastest growing region globally for cell & gene therapy trials representing more than a third of all cell & gene studies globally, with China leading in the region. 

APAC is the leading location globally for CAR-T trials with China attracting ~60% of all CAR-T trials globally between 2015-2022. The number of CAR-T trials initiated by Western companies has rapidly increased in recent years (current CAGR of about 60%), with multiple targets being explored including CD19, CD20, CD22, BCMA, CD30, CD123, CD33, CD38, and CD138.

The End­points 11; blue­bird's $3M gene ther­a­py; Bio­gen tout new neu­ro da­ta; Harsh re­views for can­cer drugs; 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.

Reading about John Carroll’s pick of biotech’s most promising startups has become a treasured tradition. If you ever get curious about previous classes of the Endpoints 11, you can find all of them (plus a number of our other regular specials) here.

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EMA warns of short­ages of two Boehringer heart drugs due to a spike in de­mand

The EMA is putting EU member states on alert over the shortage of two drugs that counter heart attacks due to an uptick in demand.

On Friday, the EMA sent out a warning that two Boehringer Ingelheim drugs are experiencing a shortage: Actilyse and Metalyse. The drugs are used as emergency treatments for adults experiencing acute myocardial infarction, or a heart attack, by dissolving blood clots that have formed in the blood vessels.

The End­points 11: The top pri­vate biotechs in pur­suit of new drugs. Push­ing the en­ve­lope with pow­er­ful new tech­nolo­gies

Right around the beginning of the year, we got a close-up look at what happens after a boom ripples through biotech. The crash of life sciences stocks in Q1 was heard around the world.

In the months since, we’ve seen the natural Darwinian down cycle take effect. Reverse mergers made a comeback, with more burned out shells to go public at a time IPOs and road shows are out of favor. And no doubt some of the more recent arrivals on the investing side of the business are finding greener pastures.

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FDA's out­side ex­perts vote in fa­vor of Fer­ring's fe­cal trans­plant for C. dif­fi­cile, set­ting the stage for Seres

FDA’s outside advisors voted in favor of Ferring Pharmaceuticals’ RBX2660, an experimental poop-based drug implant that the company says would be the first microbiota-based live biotherapeutic to receive an FDA green light.

That was a point repeatedly discussed during the Vaccines and Related Biological Products Advisory Committee, or VRBPAC, meeting Thursday when evaluating Ferring’s fecal microbiota transplant, or FMT, for reducing the recurrence of Clostridioides difficile infection in adults who have received antibiotics. Multiple members brought up the need for a regulated product amid a landscape of unregulated FMTs already happening in clinical care.

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Mene Pangalos (AstraZeneca via YouTube)

As­traZeneca shuts the PhI­II door for Ion­is' PC­SK9 drug de­spite pos­i­tive PhI­Ib

When Ionis and AstraZeneca unveiled the first round of mid-stage data for their antisense PCSK9 drug, Mene Pangalos, AstraZeneca’s EVP of biopharmaceuticals R&D, underscored the drug’s “potential best-in-class efficacy profile.”

But now that the second batch is in, it appears AZD8233 isn’t hitting the mark after all.

Ionis announced Friday morning that although the candidate, also dubbed ION449, met the primary endpoint in the Phase IIb SOLANO trial, its partners at AstraZeneca have decided not to move it into Phase III studies because the “results did not achieve pre-specified efficacy criteria.”

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Up­dat­ed: Bio­gen throws it­self back in­to mud­dled da­ta ar­gu­ments with more de­tails on its an­ti­sense ALS drug

With a highly watched FDA decision deadline coming in late January, Biogen and Ionis dropped the full data on the Phase III study of their ALS drug tofersen in the New England Journal of Medicine on Wednesday.

Biogen is looking for approval for tofersen in a very small subset of ALS patients — some 2%, according to the paper — who have a SOD1 gene mutation, which has previously been linked to ALS. Tofersen is meant to reduce levels of mutant SOD1 proteins.

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Richard Pazdur, FDA's OCE director (Flatiron Health via YouTube)

FDA's OCE makes the case for ac­cel­er­at­ed ap­proval rid­er in user fee reau­tho­riza­tion

Four experts from the FDA’s Oncology Center of Excellence took to the New England Journal of Medicine yesterday to make the case for not only improving the agency’s ability to expeditiously pull dangling accelerated approvals when, on the rare occasion, confirmatory trials fail, but also better building “quality and efficiency into the AA on-ramp.”

The timely perspective arrives as Congress has exactly one week left to draft, release and sign off on the reauthorized user fee deals before layoff notices will be sent to drug reviewers. That package, which is likely to hitch a ride with the continuing resolution, may or may not include several policy riders (opposed by Republicans), including one that would allow the FDA to require confirmatory trials to be underway before an AA is granted, and would improve the process by which FDA can withdraw AAs.

As­traZeneca, Mer­ck cull one Lyn­parza in­di­ca­tion in heav­i­ly pre­treat­ed ovar­i­an can­cer pa­tients

Just one day after blockbuster Lynparza got access to another indication in China, its Big Pharma owners have decided to withdraw it in certain patients after reviewing Phase III data.

The two companies that work together on Lynparza decided to recall one of the indications several weeks ago in a specific type of ovarian cancer, Lynparza’s first indication when it was first FDA-approved in 2014. Initial data showed that rates of overall survival in patients with at least three rounds of chemo before getting on the PARP inhibitor were lower than in patients with less previous chemo treatment.

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