Keytru­da PhI­II fail­ure in gas­tric can­cer blights Mer­ck­'s quest for front­line dom­i­nance

A year and a half af­ter scor­ing an ap­proval to use Keytru­da in third-line gas­tric can­cer, Mer­ck has run in­to a wall try­ing to ap­ply the PD-1 star in the front­line set­ting.

In an up­date for the KEYNOTE-062, the com­pa­ny $MRK dis­closed that Keytru­da as a monother­a­py proved non-in­fe­ri­or to chemother­a­py — the cur­rent stan­dard of care for ad­vanced gas­tric or gas­troe­sophageal junc­tion ade­no­car­ci­no­ma — in over­all sur­vival. In com­bi­na­tion, though, Keytru­da plus chemo was not found to be su­pe­ri­or for ei­ther OS or pro­gres­sion-free sur­vival com­pared with chemo alone. That like­ly meant more miss­es than hits in the pri­ma­ry end­points, list­ed as PFS and OS on clin­i­cal­tri­

As a spokesper­son ex­plained:

Based on the pre-spec­i­fied sta­tis­ti­cal analy­sis plan, su­pe­ri­or­i­ty test­ing for OS in the KEYTRU­DA monother­a­py group was con­duct­ed, how­ev­er as an­nounced, the fi­nal analy­sis showed that KEYTRU­DA monother­a­py was non-in­fe­ri­or, not su­pe­ri­or, to the chemother­a­py arm in pa­tients whose tu­mors were CPS ≥1. For KEYNOTE-062, it made sense to test for non­in­fe­ri­or­i­ty in the event that KEYTRU­DA monother­a­py had com­pa­ra­ble ef­fi­ca­cy as chemother­a­py with a po­ten­tial­ly fa­vor­able safe­ty and tol­er­a­bil­i­ty pro­file.

Roy Baynes

Mer­ck went ahead with the Phase III tri­al de­spite a flop in the sec­ond-line set­ting of the same in­di­ca­tion in 2017. Grant­ed, the drug had pos­i­tive third-line da­ta go­ing for it in a tough dis­ease where Pfiz­er and Mer­ck KGaA’s PD-L1 drug Baven­cio failed.

All pa­tients in the tri­al had tu­mors that ex­press PD-L1. In­ves­ti­ga­tors did not tease out any dif­fer­ences be­tween those with a high com­bined pos­i­tive score (CPS ≥10) and those with low CPS, of 1 or above.

“Gas­tric can­cer is his­tor­i­cal­ly dif­fi­cult to treat, and un­for­tu­nate­ly con­tin­ues to be as­so­ci­at­ed with high mor­tal­i­ty rates in many coun­tries, par­tic­u­lar­ly in the metasta­t­ic stage,” said Roy Baynes, Mer­ck’s head of glob­al de­vel­op­ment, in a state­ment.

The brief state­ment al­so didn’t cov­er any of the sec­ondary end­points, in­clud­ing over­all re­sponse rate, du­ra­tion of re­sponse, qual­i­ty of life and a gas­tric can­cer score.

Mer­ck says it plans to dis­cuss the fi­nal analy­sis with the FDA, as well as oth­er on­go­ing gas­tric stud­ies that might serve as con­fir­ma­to­ry tri­als, in­clud­ing KEYNOTE-811 and KEYNOTE-859. Then there’s the Phase III KEYNOTE-585 to watch, where Keytru­da in com­bi­na­tion with chemother­a­py is test­ed in a neoad­ju­vant/ad­ju­vant set­ting.

Paul Hudson, Sanofi CEO (Getty Images)

Sanofi CEO Paul Hud­son has $23B burn­ing a hole in his pock­et. And here are some hints on how he plans to spend that

Sanofi has reaped $11.1 billion after selling off a big chunk of its Regeneron stock at $515 a share. And now everyone on the M&A side of the business is focused on how CEO Paul Hudson plans to spend it.

After getting stung in France for some awkward politicking — suggesting the US was in the front of the line for Sanofi’s vaccines given American financial support for their work, versus little help from European powers — Hudson now has the much more popular task of managing a major cash cache to pull off something in the order of a big bolt-on. Or two.

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As­traZeneca trum­pets the good da­ta they found for Tagris­so in an ad­ju­vant set­ting for NSCLC — but many of the ex­perts aren’t cheer­ing along

AstraZeneca is rolling out the big guns this evening to provide a salute to their ADAURA data on Tagrisso at ASCO.

Cancer R&D chief José Baselga calls the disease-free survival data for their drug in an adjuvant setting of early stage, epidermal growth factor receptor-mutated NSCLC patients following surgery “momentous.” Roy Herbst, the principal investigator out of Yale, calls it “transformative.”

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Pablo Legorreta, founder and CEO of Royalty Pharma AG, speaks at the annual Milken Institute Global Conference in Beverly Hills, California (Patrick T. Fallon/Bloomberg via Getty Images)

Cap­i­tal­iz­ing Pablo: The world’s biggest drug roy­al­ty buy­er is go­ing pub­lic. And the low-key CEO di­vulges a few se­crets along the way

Pablo Legorreta is one of the most influential players in biopharma you likely never heard of.

Over the last 24 years, Legorreta’s Royalty Pharma group has become, by its own reckoning, the biggest buyer of drug royalties in the world. The CEO and founder has bought up a stake in a lengthy list of the world’s biggest drug franchises, spending $18 billion in the process — $2.2 billion last year alone. And he’s become one of the best-paid execs in the industry, reaping $28 million from the cash flow last year while reserving 20% of the cash flow, less expenses, for himself.

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The Avance Clinical leadership team: CEO Yvonne Lungershausen, Sandrien Louwaars - Director Business Development Operations, Gabriel Kremmidiotis - Chief Scientific Officer, Ben Edwards - Chief Strategy Officer

How Aus­tralia De­liv­ers Rapid Start-up and 43.5% Re­bate for Ear­ly Phase On­col­o­gy Tri­als

About Avance Clinical

Avance Clinical is an Australian owned Contract Research Organisation that has been providing high-quality clinical research services to the local and international drug development industry for 20 years. They specialise in working with biotech companies to execute Phase 1 and Phase 2 clinical trials to deliver high-quality outcomes fit for global regulatory standards.

As oncology sponsors look internationally to speed-up trials after unprecedented COVID-19 suspensions and delays, Australia, which has led the world in minimizing the pandemic’s impact, stands out as an attractive destination for early phase trials. This in combination with the streamlined regulatory system and the financial benefits including a very favourable exchange rate and the R & D cash rebate makes Australia the perfect location for accelerating biotech clinical programs.

Dan O'Day, Gilead CEO (Andrew Harnik, AP Images)

UP­DAT­ED: Gilead leas­es part­ner rights to TIG­IT, PD-1 in a $2B deal with Ar­cus. Now comes the hard part

Gilead CEO Dan O’Day has brokered his way to a PD-1 and lined up a front row seat in the TIGIT arena, inking a deal worth close to $2 billion to align the big biotech closely with Terry Rosen’s Arcus. And $375 million of that comes upfront, with cash for the buy-in plus equity, along with $400 million for R&D and $1.22 billion in reserve to cover opt-in payments and milestones..

Hotly rumored for weeks, the 2 players have formalized a 10-year alliance that starts with rights to the PD-1, zimberelimab. O’Day also has first dibs on TIGIT and 2 other leading programs, agreeing to an opt-in fee ranging from $200 million to $275 million on each. There’s $500 million in potential TIGIT milestones on US regulatory events — likely capped by an approval — if Gilead partners on it and the stars align on the data. And there’s another $150 million opt-in payments for the rest of the Arcus pipeline.

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Bryan Roberts, Venrock

Ven­rock sur­vey shows grow­ing recog­ni­tion of coro­n­avirus toll, wan­ing con­fi­dence in ar­rival of vac­cines and treat­ments

When Venrock partner Bryan Roberts went to check the results from their annual survey of healthcare leaders, what he found was an imprint of the pandemic’s slow arrival in America.

The venture firm had sent their form out to hundreds of insurance and health tech executives, investors, officials and academics on February 24 and gave them two weeks to fill it out. No Americans had died at that point but the coronavirus had become enough of a global crisis that they included two questions about the virus, including “Total U.S. deaths in 2020 from the novel coronavirus will be:”.

Roger Perlmutter, Merck R&D chief (YouTube)

UP­DAT­ED: Backed by BAR­DA, Mer­ck jumps in­to Covid-19: buy­ing out a vac­cine, part­ner­ing on an­oth­er and adding an­tivi­ral to the mix

Merck execs are making a triple play in a sudden leap into the R&D campaign against Covid-19. And they have more BARDA cash backing them up on the move.

Tuesday morning the pharma giant simultaneously announced plans to buy an Austrian biotech that has been working on a preclinical vaccine candidate, added a collaboration on another vaccine with the nonprofit IAVI and inked a deal with Ridgeback Biotherapeutics on an early-stage antiviral.

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David Hoey (Vaxxas)

In for the long vac­cine game, Mer­ck buys in­to patch de­liv­ery tech with pan­dem­ic po­ten­tial

When Merck dived into the R&D fray for a Covid-19 vaccine earlier this week, execs made it clear that they’re not necessarily looking to be first — with CEO Ken Frazier throwing cold water on the hotly-discussed 12- to 18-month timelines. But when it does emerge from behind, the pharma giant clearly expects to play a significant part.

Part of that will depend on next-generation delivery technology that reshapes the world’s imagination of a vaccine.

No­var­tis jumps in­to Covid-19 vac­cine hunt, as Big Phar­ma and big biotech com­mit to bil­lions of dos­es

After spending most of the pandemic on the sidelines, Novartis is offering its aid in the race to develop a Covid-19 vaccine.

AveXis, the Swiss pharma’s gene therapy subsidiary, has agreed to manufacture the vaccine being developed by Massachusetts Eye and Ear and Massachusetts General Hospital. The biotech will begin manufacturing this month, while the vaccine undergoes further preclinical testing. They’ve agreed to provide the vaccine for free for clinical trials beginning in the second half of 2020, but have not disclosed financials for after.

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