Lit­tle vTv once again cir­cles sub­group num­ber, strug­gling to find some­thing good to say about failed Alzheimer's drug

The biotech vTv raised $117 mil­lion from their 2015 IPO $VTVT based on a pitch that they could take a failed Alzheimer’s drug from Pfiz­er and fol­low a trail of pos­i­tive sub­set da­ta to a big win. That didn’t work, with Phase A of the piv­otal pro­gram fail­ing both co-pri­ma­ry end­points re­cent­ly.

In fact, the drug arm once again did worse than a place­bo group.

Steve Hol­combe

But now they’ve had a chance to do some post hoc analy­sis of the first round of Phase III da­ta, and they’re back to spot­light­ing a pos­i­tive batch of da­ta for a sub­pop­u­la­tion.

So here it is. In a state­ment out Wednes­day night, vTv says that a group of pa­tients with a con­cen­tra­tion of the drug azeli­ragon un­der a bar of 7.5 ng/mL hit a sta­tis­ti­cal­ly sig­nif­i­cant score for ADAS-cog, p=0.02. It failed on an­oth­er score — CDR-sb — with a p-val­ue of 0.06. And they want to re­vise their sta­tis­ti­cal analy­sis plan for the FDA.

The sub­group in­clud­ed 48 of the 400 pa­tients in the study, which was di­vid­ed be­tween the drug and a place­bo. 

The biotech’s shares — which were crushed on the ini­tial Phase III fail­ure — bounced high­er in pre-mar­ket trad­ing Thurs­day. Whether they can sus­tain that with ad­di­tion­al sub­group analy­sis re­mains to be seen, but vTv is once again go­ing down a path that has led to the de­struc­tion of bil­lions of dol­lars of in­vestors’ cash on a wide range of drug stud­ies.

The com­pa­ny de­signed the 18-month Phase III pro­gram based on da­ta that the small 5 mg dose of the drug per­formed well in Pfiz­er’s study, where the 20 mg failed. And just like about every­thing else in the Alzheimer’s pipeline, that strat­e­gy has proved to be a re­peat los­er.

In­vestors in the field keep buy­ing in­to the idea that ac­quir­ing shares in an Alzheimer’s stock is just like buy­ing lot­tery tick­ets — ul­tra high risk with the pos­si­bil­i­ty of ul­tra high re­wards. But with no win­ners in more than a decade, that ar­gu­ment has been wear­ing thin.

This biotech, though, is still de­ter­mined to keep rolling the dice.

“We are en­cour­aged by the pos­i­tive im­prove­ments in cog­ni­tive and func­tion­al out­comes rel­a­tive to place­bo based up­on low azeli­ragon con­cen­tra­tion lev­els,” said vTv CEO Steve Hol­combe in a state­ment. “With this un­der­stand­ing, we are con­tin­u­ing to an­a­lyze the da­ta and then plan to ex­am­ine the rel­e­vant pop­u­la­tion prospec­tive­ly in the Part B study and an­nounce re­sults in June.”

Lessons for biotech and phar­ma from a doc­tor who chased his own cure

After being struck by a rare disease as a healthy third year medical student, David Fajgenbaum began an arduous journey chasing his own cure. Amidst the hustle of this year’s JP Morgan conference, the digital trials platform Medable partnered with Endpoints Studio to share Dr. Fajgenbaum’s story with the drug development industry.

What follows is an edited transcript of the conversation between Medable CEO Dr. Michelle Longmire and Dr. Fajgenbaum, and it is full of lessons for biotech executives charged with bringing the next generation of medicines to patients.

Gilead los­es two more patent chal­lenges on HIV pill, set­ting up court­room fight in Delaware

Gilead sustained two more losses in their efforts to rid themselves of an activist-backed patent lawsuit from the US government over a best-selling HIV pill.

Urged on by activists seeking to divert a portion of Gilead’s revenue to clinics and prevention programs, the Department of Health and Human Services made a claim to some of the patents for the best-selling HIV prevention drug, Truvada, also known as PrEP. Gilead responded by arguing in court that HHS’s patents were invalid.

Today, the US Patent and Trademark Office ruled that Gilead was likely to lose the last two of those challenges as well. The USPTO ruled against Gilead on the first two patents earlier this month.

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Jim Scholefield via PR Newswire

Mer­ck los­es its chief dig­i­tal of­fi­cer, spot­light­ing tal­ent hunt for the hottest ti­tle in Big Phar­ma

Over the last few years we’ve seen the chief digital officer title become one of the hottest commodities in Big Pharma as global organizations hunt the best talent to sharpen the cutting edge of their tech platforms.

But Merck just discovered how hard it may be to keep them focused on pharma.

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Bank­rupt an­tibi­otics mak­er Ar­a­digm turns to old part­ner/in­vestor for fi­nal $3M fire sale

Grifols once paid Aradigm $26 million for a stake in its inhaled antibiotics. But with Aradigm now in bankruptcy, the Spanish drugmaker is dishing out a final $3.2 million to buy it all.

The fire sale — which comes one year after Aradigm filed for Chapter 11 following a regulatory trifecta for disaster — will see Grifols obtain assets and IP to Apulmiq (formerly Pulmaquin and Linhaliq in Europe), Lipoquin and free ciprofloxacin. In addition to waiving its claims in the bankruptcy case, Grifols also agreed to milestone payments up to $3 million more upon any regulatory approvals.

DB­V's peanut pre­ven­tion patch ap­proach­es key stage of ap­proval process

Almost a year and a half after DBV Technologies pulled its peanut allergy immunotherapy patch from FDA review, the biotech will get their day in court. The FDA has scheduled an advisory committee hearing for May 15.

In the two-horse race to develop the first immunotherapy for peanut allergy, DBV had the early lead, filing an NDA for their patch in 2018. But on December 20 of that year, the company withdrew their application after, they said, meeting with regulators and determining they had not submitted “sufficient detail regarding data on manufacturing procedures and quality controls.” Aimmune filed their BLA 3 days later and won approval as the first immunotherapy for peanuts this month.

Kathy High (file photo)

Gene ther­a­py pi­o­neer Kathy High has left Spark af­ter com­plet­ing $4.3B union with Roche

Kathy High dedicated the past seven years of her life shepherding experimental gene therapies she’s developed at Children’s Hospital of Philadelphia toward the market as president and head of R&D at Spark Therapeutics. Now that the biotech startup is fully absorbed into Roche — with an FDA approval, a $4.3 billion buyout and a promising hemophilia program to boast — she’s ready to move on.

Roche confirmed her departure with Endpoints News and noted “she will take some well-deserved time off and then will begin a new chapter in a sabbatical at a university.”

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An­to­nio Gual­ber­to starts post-Ku­ra ca­reer at Ei­sai sub­sidiary H3; eF­FEC­TOR co-founder Siegfried Re­ich jumps to Turn­ing Point

→ Days after Kura Oncology announced the departure of co-founder Antonio Gualberto, we finally know where he wound up. Eisai subsidiary H3 Biomedicine has recruited him as CMO to finding the right patients to its four clinical-stage small molecule assets hitting genomic drivers of cancer.

“Challenges of these and many other precision medicine approaches are on one hand technical — a need for robust and precise diagnostics — and on the other hand derived by the challenge to alter standard clinical practice in settings where patient screening, e.g. by tumor DNA sequencing, is not standard practice,” he wrote to Endpoints News on his way back to Boston from Eisai’s Tokyo offices. “Only compelling clinical activity can drive clinicians and pathologists to modify standard clinical practice.”

Gen­fit de­lays high-stakes PhI­II NASH read­out; Bris­tol-My­ers grabs first Op­di­vo OK in esophageal can­cer

→ Genfit is delaying a highly anticipated Phase III readout of its NASH drug elafibranor. It now expects to report topline interim results some time in the second quarter, after incorporating new “FDA insights” to be delivered by the end of March. The French biotech insists that the delay — which is technically a delay in unblinding — isn’t related to efficacy and safety concerns or any business matters. The stakes are high: The RESOLVE-IT trial was set up to be a crucial test of the PPAR approach in tackling the fatty liver disease and support a historic accelerated approval.

Tal Zaks (Moderna via YouTube)

For two decades, a new vac­cine tech­nol­o­gy has been slow­ly ap­proach­ing prime time. Now, can it stop a pan­dem­ic?

Two months before the outbreak, Moderna CMO Tal Zaks traveled from Cambridge, MA to Washington DC to meet with Anthony Fauci and the leaders of the National Institutes of Health.

For two years, Moderna had worked closely with NIH researchers to build a new kind of vaccine for MERS, one of the deadliest new viruses to emerge in the 21st century. The program was one test for a new technology designed to be faster, cheaper and more precise than the ways vaccines had been made for over a century. They had gathered evidence the technology could work in principle, and Fauci, the longtime head of the National Institute of Allergy and Infectious Diseases and a longtime advocate for better epidemic preparedness, wanted to see if it, along with a couple of other approaches, could work in a worst-case scenario: A pandemic.

“[We were] trying to find a test case for how to demonstrate if our technology could rapidly prepare,” Zaks told Endpoints News.

Zaks and Fauci, of course, wouldn’t have to wait to develop a new test. By year’s end, an outbreak in China would short circuit the need for one and throw them into 24/7 work on a real-world emergency. They also weren’t the only ones with new technology who saw a chance to help in a crisis.

An ocean away, Lidia Oostvogels was still on vacation and relaxing at her mother’s house in Belgium when her Facebook started changing. It was days after Christmas and on most people’s feeds, the news that China had reported a novel virus to the World Health Organization blurred into the stream of holiday sweaters and fir trees. But on Oostvogels’s feed, full of vaccine researchers and virus experts, speculation boiled: There was a virus in China, something contained to the country, but “exotic,” “weird,” and maybe having to do with animals. Maybe a coronavirus.

Lidia Oostvogels

“I was immediately thinking like, ‘Hey, this is something that if needed, we can play a role,'” Oostvogels told Endpoints.

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