In a stun­ner, Mer­ck leaps ahead of ri­vals with com­bo Keytru­da/chemo at­tack on lung can­cer

Mer­ck’s im­muno-on­col­o­gy team has be­come ex­pert at press­ing an ear­ly ad­van­tage.

The Keytru­da com­pa­ny, which re­cent­ly trounced Bris­tol-My­ers in their ri­val­ry on lung can­cer, has now filed an ear­ly and stun­ning ap­pli­ca­tion to mar­ket a com­bi­na­tion of Keytru­da and chemo for first-line lung can­cer. And the move has the po­ten­tial to carve out a short­cut that will al­low them to cut ahead of a strug­gling As­traZeneca and a po­tent Roche.

Mer­ck’s stock $MRK spiked close to 5% on the news of its lat­est ad­vance in the field as an­a­lysts pon­dered the im­pli­ca­tions in a field with block­buster po­ten­tial. Check­points alone treat on­ly a por­tion of all can­cer pa­tients, and a front­line com­bo could cap­ture the li­on’s share of the mar­ket.

The FDA ac­cept­ed the sup­ple­men­tal ap­pli­ca­tion and agreed to give the ap­pli­ca­tion a speedy re­view, of­fer­ing a de­ci­sion by May 10. And giv­en the agency’s go-go record on rush­ing ahead on promis­ing I/O ther­a­pies, Mer­ck may be on the verge of mak­ing an even ear­li­er break­through with its first com­bo ap­proach.

As­traZeneca ear­li­er re­tooled its im­muno-on­col­o­gy ef­fort for dur­val­um­ab, its all-im­por­tant check­point pro­gram, as it lagged be­hind the fron­trun­ners in the field. It’s now lin­ing up for the fourth or pos­si­bly fifth new ap­proval for a check­point, as it looks to en­ter a crowd­ed mar­ket in­volv­ing some of the most ag­gres­sive play­ers in the in­dus­try. And af­ter mul­ti­ple set­backs over the past year, the UK gi­ant can ill af­ford to con­tin­ue get­ting beat in I/O if it ever ex­pects to de­liv­er on am­bi­tious fore­casts of rev­enue growth.

As­traZeneca’s stock dropped 1% on the news.

Mer­ck’s play here is not with­out risk. Sea­mus Fer­nan­dez at Leerink not­ed:

MRK’s an­nounce­ment of the ac­cep­tance of an sBLA fil­ing for Keytru­da (pem­brolizum­ab) + chemother­a­py in first-line (1L) non-squa­mous non-small cell lung can­cer (NSCLC) re­gard­less of PD-L1 sta­tus comes as a sig­nif­i­cant sur­prise, po­ten­tial­ly es­tab­lish­ing Keytru­da as the first IO agent to be used broad­ly in non-squa­mous NSCLC re­gard­less of PDL1 sta­tus. FDA’s will­ing­ness to ac­cept the fil­ing based on such a small study (with no ev­i­dence of a sur­vival ben­e­fit in the da­ta pre­sent­ed at ES­MO) sug­gests to us that the agency may have vis­i­bil­i­ty in­to the like­li­hood of suc­cess on the PFS end­point in the on­go­ing Phase 3 Keynote-189 tri­al. If this com­bo re­ceives ac­cel­er­at­ed ap­proval by its PDU­FA date of 5/10/17, it like­ly would give MRK an­oth­er leg-up in the 1L NSCLC race over AZN (OP) and BMY’s (OP) IO+IO com­bos and RHH­BY’s (NR) IO+chemo com­bo. While we con­tin­ue to be­lieve that IO+IO com­bos will even­tu­al­ly pro­duce more durable re­spons­es (par­tic­u­lar­ly in pa­tients with high­er lev­els of PD-L1 ex­pres­sion), an ear­ly and broad ac­cel­er­at­ed ap­proval for this IO+chemo com­bo could fur­ther es­tab­lish Keytru­da as the PD-1 of choice in the 1L set­ting – at least un­til oth­er agents are ap­proved in this set­ting.

Roger Dansey, Mer­ck

Mer­ck has mount­ed hun­dreds of stud­ies around its Keytru­da fran­chise, of­ten part­ner­ing on po­ten­tial com­bos as the team mar­ries an im­mune sys­tem at­tack with com­ple­men­tary ther­a­pies.

Bris­tol-My­ers has al­so been la­bor­ing long and hard with Op­di­vo. But it’s ear­ly lead in the field was bad­ly dam­aged in 2016 as an over­ly am­bi­tious at­tempt to grab proof of ef­fi­ca­cy as a stand­alone lung can­cer drug end­ed in dis­as­ter.

Dr. Roger Dansey, se­nior vice pres­i­dent and ther­a­peu­tic area head, on­col­o­gy late-stage de­vel­op­ment, Mer­ck Re­search Lab­o­ra­to­ries, has this to say:

“Keytru­da in com­bi­na­tion with chemother­a­py has shown promise ver­sus chemother­a­py alone in the first-line treat­ment of non-squa­mous metasta­t­ic non-small cell lung can­cer, re­gard­less of PD-L1 lev­els. If ap­proved, this could be the first reg­i­men com­bin­ing chemother­a­py with an im­muno-on­col­o­gy agent for pa­tients with ad­vanced non-small cell lung can­cer.”

Image courtesy of The Janssen Pharmaceutical Companies of Johnson & Johnson.

Pro­tect­ing the glob­al phar­ma­ceu­ti­cal in­no­va­tion ecosys­tem – what’s at stake?

We are living in a new era of healthcare that is rapidly advancing progress impacting patient outcomes and experiences. We’ve seen a remarkable pace of transformational innovation, applied research, and advanced clinical development over the last decade.

Despite this tremendous progress, there is much more work to be done, and patients are counting on us – now more than ever – to continue that momentum. At the heart of our industry is a focus on developing and delivering medicines for some of the world’s most challenging diseases, including those that have few or no effective treatments today.

Mi­rati’s drug sitra­va­tinib flops PhI­II in com­bo with Op­di­vo for cer­tain lung can­cer

Mirati Therapeutics’ path to a second drug approval will likely have to wait. The San Diego biotech company said Wednesday that its investigational lung cancer drug failed a Phase III trial testing it in combination with Bristol Myers Squibb’s Opdivo.

The drug, sitravatinib, and Opdivo weren’t better than the chemo drug docetaxel at keeping patients alive, Mirati said in a press release. The spectrum-selective kinase inhibitor missed the primary goal of overall survival in patients with second- or third-line advanced non-squamous, non-small cell lung cancer.

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End­points 20(+2) un­der 40, 2023; Bio­phar­ma's high­est-paid CEOs; N-of-1 CRISPR sto­ry goes on af­ter tragedy; 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 will be off Monday in observance of Memorial Day — and when we get back, it will be a straight march to ASCO, BIO and more. Enjoy the (long) weekend!

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Rich Horgan (R) with his late brother, Terry

Rich Hor­gan spear­head­ed a gene ther­a­py for his broth­er. The tri­al end­ed in tragedy, but the work con­tin­ues for more pa­tients

Rich Horgan’s quest to create a custom gene therapy for his brother, Terry, ended in tragedy. But Horgan doesn’t believe it’s the end of the story.

Terry, a 27-year-old patient with Duchenne muscular dystrophy, died last October just eight days after receiving the therapy in a clinical trial in which he was the only participant. The case raised questions about the safety of certain gene therapies and what would happen to other drug programs under a nonprofit that Horgan created, called Cure Rare Disease.

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Bio­phar­ma's 20 high­est-paid CEOs of 2022, each bring­ing in $20M+ pay­days

Even in a down year for much of the biopharma market, 20 CEOs brought in pay packages valued at more than $20 million, an Endpoints News analysis found.

Endpoints collected data on more than 350 CEO compensation packages, covering a wide range of pharma, biotech, and life sciences companies. All told, the 20 largest earners made over $725 million in 2022 — an average package of $36.4 million. Three brought in paydays over $50 million, and one CEO broke the $100 million mark.

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FDA ap­proves Lex­i­con’s heart-fail­ure drug af­ter de­feat in di­a­betes

The FDA on Friday approved Lexicon’s heart failure drug sotagliflozin following a string of setbacks for the pharma company, including an FDA rejection in diabetes and the loss of a development deal with Sanofi.

The dual SGLT1 and SGLT2 inhibitor will be marketed as Inpefa and is a once-daily tablet. It’s been approved to reduce the risk of cardiovascular death and heart failure-related hospitalization or urgent visits in adults with heart failure or type 2 diabetes mellitus, chronic kidney disease, and other cardiovascular risk factors. The label spans the range of left ventricular ejection fraction, including preserved ejection fraction and reduced ejection fraction, as well as patients with or without diabetes, Lexicon said Friday.

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The 20(+2) un­der 40: Your guide to the next gen­er­a­tion of biotech lead­ers

This year’s list of 20 biotech leaders under the age of 40 includes a huge range of ambitions. Some of our honorees are planning to create the next big drug giant. Others are pushing the bounds of AI. One is working to revolutionize TB testing. All are compelling talents who are still young in age, but already far along in achievement.

And, as in years past, we went over. The 20 are actually 22 because of two double profiles that reflect how important teamwork is in the industry. As one of our honorees, Joe Illingworth of DJS Antibodies, told me in our interview, “It takes a village to raise a biotech.”

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Eu­ro­pean Com­mis­sion to re­ceive few­er Pfiz­er-BioN­Tech vac­cine dos­es un­der amend­ed con­tract

The European Commission has made a few changes to its vaccine contract with Pfizer and BioNTech, reducing the dose volume while extending the delivery timeline to cope with “evolving public health needs.”

The Commission previously struck a contract in May 2021 for 900 million doses, with the option to purchase another 900 million. Of those, 450 million were expected to be delivered in 2023, though an amendment now calls for fewer doses. While neither the Commission nor Pfizer and BioNTech have revealed an exact amount, an unnamed source told Reuters that the amendment reduces the remaining expected doses by about a third.

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Teresa Bitetti, Takeda's president of the global oncology business unit

Take­da wins pri­or­i­ty re­view for $400M col­orec­tal can­cer drug, li­censed from Hutchmed in Jan­u­ary

Takeda and Hutchmed scored a priority review Thursday afternoon for a colorectal cancer drug, the companies announced.

The experimental drug in question is fruquintinib, previously approved in China in 2018 to treat metastatic colorectal cancer. Takeda and Hutchmed are aiming to bring fruquintinib to the US and other countries outside China in the same indication, and the FDA set its decision date for Nov. 30 of this year.

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