Is­raeli biotech flunks PhII liv­er can­cer study, but it in­sists drug Can-Fite dis­ease in sub­set of pa­tients

Is­raeli biotech Can-Fite Bio­Phar­ma is hop­ing to trudge ahead with a late-stage study of its ex­per­i­men­tal can­cer drug, de­spite it fail­ing a mid-stage study in pa­tients with ad­vanced liv­er can­cer.

The drug, namodeno­son, was be­ing test­ed in a 78-pa­tient Phase II study in pa­tients with ad­vanced liv­er can­cer in pa­tients with un­der­ly­ing cir­rho­sis, whose dis­ease had pro­gressed de­spite first­line treat­ment with Bay­er’s Nex­avar.

Can-Fite’s drug missed the main goal of over­all sur­vival; in fact namodeno­son-treat­ed pa­tients ac­tu­al­ly per­formed worse: me­di­an OS was 4.1 months for namodeno­son ver­sus 4.3 months for place­bo.

Shares of the com­pa­ny $CANF tum­bled more than 27% in pre-mar­ket trad­ing to 94 cents on Tues­day.

Pa­tients with ad­vanced liv­er can­cer are di­vid­ed in­to sub­class­es based on cir­rho­sis sever­i­ty, us­ing a wide­ly used tool as mea­sured by the Child-Pugh score, which was orig­i­nal­ly de­vel­oped in 1973 to es­ti­mate the risk of op­er­a­tive mor­tal­i­ty in pa­tients with bleed­ing esophageal varices.

In the tri­al, pa­tients giv­en the Child Pugh B (CPB) score were en­rolled, and with­in that cat­e­go­ry pa­tients were fur­ther di­vid­ed in­to three sub­cat­e­gories de­not­ing in­creas­ing sever­i­ty — CPB7, CPB8, and CPB9.

Sec­ondary study end­points in­clud­ed safe­ty, pro­gres­sion free sur­vival (PFS) and the per­cent­age of pa­tients whose tu­mors par­tial­ly shrank af­ter treat­ment, or par­tial re­sponse (PR).

CPB7 pa­tients — the largest sub­cat­e­go­ry in the tri­al (n=56) — did live longer when giv­en namodeno­son. Namodeno­son-treat­ed pa­tients (n=34) ex­pe­ri­enced me­di­an OS of 6.8 months com­pared to place­bo (n=22) with 4.3 months. Sim­i­lar­ly, for these pa­tients, PFS was 3.5 months in the namodeno­son-treat­ed group ver­sus 1.9 months in the place­bo group.

For the en­tire pa­tient pop­u­la­tion, 9% of those treat­ed by namodeno­son achieved PR ver­sus none in the place­bo group.

The drug has al­ready been grant­ed fast-track sta­tus by the FDA, and Can-Fite ap­peared en­cour­aged by the da­ta set.

Josep Llovet

“These da­ta strong­ly sup­port the pro­gres­sion in­to Phase III,” Can-Fite said in a state­ment, adding that the com­pa­ny plans to dis­cuss the re­sults with reg­u­la­to­ry agen­cies to de­ter­mine its next steps.

“The glob­al in­ci­dence of liv­er can­cer con­tin­ues to in­crease and has more than tripled in the Unit­ed States over the last three decades, and cur­rent­ly there are no rec­om­mend­ed sys­temic treat­ment op­tions for pa­tients with ad­vanced HCC and se­vere liv­er dys­func­tion (Child Pugh B),” said Josep Llovet, founder of the Liv­er Can­cer pro­gram at Mount Sinai, in a state­ment. “(T)he cur­rent da­ta from this Phase II tri­al sug­gest a sig­nal of ef­fi­ca­cy that sup­ports con­tin­u­ing the de­vel­op­ment of Namodeno­son with a Phase III study in this pop­u­la­tion. I will be hap­py to help with the de­sign of the Phase III and serve as the prin­ci­pal in­ves­ti­ga­tor of the tri­al.”

Can-Fite’s tech plat­form is based on re­search that points to tar­get­ing the Gi pro­tein cou­pled A3 adeno­sine re­cep­tor (A3AR), which is un­der­stood to be over­ex­pressed in in­flam­ma­to­ry and can­cer cells. The com­pa­ny has a tri­fec­ta of drugs in de­vel­op­ment, in­clud­ing namodeno­son, which is al­so be­ing test­ed for use in NASH.

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.