On the same day that Glax­o­SmithK­line sought to as­sure in­vestors that the com­pa­ny’s new R&D team would de­liv­er im­por­tant drugs in the fu­ture, its re­searchers work­ing on Nu­cala (mepolizum­ab) were slapped down in their at­tempt to gain an added OK for COPD.

A pan­el of out­side ex­perts vot­ed 16 to 3 against a mar­ket­ing ap­proval. That isn’t bind­ing, but af­ter the in­ter­nal re­view­ers at the FDA of­fered a scathing re­view of their da­ta, it’s all but a done deal now — bar­ring some un­ex­pect­ed last minute in­ter­ven­tion in its fa­vor.

AD­COMM VOTE: Is the ben­e­fit-risk pro­file ad­e­quate to sup­port ap­proval of #mepolizum­ab as add-on treat­ment to in­haled cor­ti­cos­teroid-based main­te­nance treat­ment for the re­duc­tion of ex­ac­er­ba­tions in pa­tients with #COPD guid­ed by blood eosinophil counts? $GSK
3-Yes
16-No
0-Ab­stain

— SAC Track­er (@FDAad­comm) Ju­ly 25, 2018

The FDA was clear­ly unim­pressed with GSK’s pack­age.

GSK’s drug failed one late-stage test while scor­ing a suc­cess in the oth­er. With on­ly two Phase III stud­ies in this in­di­ca­tion, that left the pan­el to con­sid­er an ap­proval with­out sup­port­ing da­ta from two well-con­trolled stud­ies — the agency gold stan­dard.

There was no dose re­sponse they could find in the two dosage arms, which didn’t help.

The FDA added:

Some key sec­ondary end­points, such as time to first mod­er­ate-to-se­vere COPD ex­ac­er­ba­tion showed nu­mer­i­cal trends fa­vor­ing mepolizum­ab. How­ev­er, there were no con­sis­tent and clin­i­cal­ly mean­ing­ful dif­fer­ences in se­vere COPD ex­ac­er­ba­tion rate, FEV1, or SGRQ be­tween mepolizum­ab 100 mg and place­bo.

GSK’s tri­al de­sign al­so spurred ques­tions, with no base­line col­lec­tion of asth­ma his­to­ry — which could have in­flu­enced the out­come of the study. How will GSK prop­er­ly de­fine the pa­tient pop­u­la­tion for this drug?

By Lucy Clos­sick Thom­son, Se­nior Di­rec­tor of On­col­o­gy Pro­ject Man­age­ment, Icon

Clin­i­cal tri­als in on­col­o­gy can be cost­ly and chal­leng­ing to man­age. One fac­tor that could re­duce costs and re­duce bar­ri­ers is har­ness­ing the pa­tient voice in tri­al de­sign to help ac­cel­er­ate pa­tient en­roll­ment. Now is the time to adopt pa­tient-cen­tric strate­gies that not on­ly fo­cus on pa­tient needs, but al­so can main­tain cost ef­fi­cien­cy.

Blue­bird bio $BLUE chief Nick Leschly court­ed con­tro­ver­sy last week when he re­vealed the com­pa­ny’s be­ta tha­lassemia treat­ment will car­ry a jaw-drop­ping $1.8 mil­lion price tag over a 5-year pe­ri­od in Eu­rope — mak­ing it the plan­et’s sec­ond most ex­pen­sive ther­a­py be­hind No­var­tis’ $NVS fresh­ly ap­proved spinal mus­cu­lar at­ro­phy ther­a­py, Zol­gens­ma, at $2.1 mil­lion. A Chica­go biotech, mean­while, has been fum­ing at the side­lines. In a law­suit filed ear­li­er this month, Er­rant Gene Ther­a­peu­tics al­leged that blue­bird and ven­ture cap­i­tal group Third Rock un­law­ful­ly prised a vi­ral vec­tor, de­vel­oped in part­ner­ship with the Memo­r­i­al Sloan Ket­ter­ing Can­cer Cen­ter (MSK), from its grasp, and thwart­ed the de­vel­op­ment of its sem­i­nal gene ther­a­py.

→  Rare dis­ease play­er Ul­tragenyx $RARE is ex­pand­ing its al­liance with Arc­turus $ARCT, pay­ing $24 mil­lion for eq­ui­ty and an­oth­er $6 mil­lion in an up­front as the two part­ners ex­pand their col­lab­o­ra­tion to in­clude up to 12 tar­gets. “This ex­pand­ed col­lab­o­ra­tion fur­ther so­lid­i­fies our mR­NA plat­form by adding ad­di­tion­al tar­gets and ex­pand­ing our abil­i­ty to po­ten­tial­ly treat more dis­eases,” said Emil Kakkis, the CEO at Ul­tragenyx. “We are pleased with the progress of our on­go­ing col­lab­o­ra­tion. Our most ad­vanced mR­NA pro­gram, UX053 for the treat­ment of Glyco­gen Stor­age Dis­ease Type III, is ex­pect­ed to move in­to the clin­ic next year, and we look for­ward to fur­ther build­ing up­on the ini­tial suc­cess of this part­ner­ship.”

The shock of Neil Wood­ford’s de­ci­sion to block with­drawals for his flag­ship fund is still rip­pling through the rest of his port­fo­lio — and be­yond. Un­der po­lit­i­cal pres­sure, UK fi­nan­cial reg­u­la­tors are now tak­ing a hard look while in­vestors con­tin­ue to flee.

In a re­sponse let­ter to an MP, the Fi­nan­cial Con­duct Au­thor­i­ty re­vealed that it’s opened an in­ves­ti­ga­tion in­to the sus­pen­sion fol­low­ing months of en­gage­ment with Link Fund So­lu­tions, which tech­ni­cal­ly del­e­gat­ed Wood­ford’s firm to man­age its funds.

Gilead is jump­ing on board the pro­tein degra­da­tion band­wag­on. And they’re turn­ing to a low-pro­file Third Rock start­up for the ex­per­tise. But if you were look­ing for a trans­for­ma­tion­al deal to kick up fresh en­thu­si­asm for Gilead, you’ll have to re­main pa­tient.

This one will have a long way to go be­fore they get in­to the clin­ic.

The big biotech said Wednes­day morn­ing that it is pay­ing $45 mil­lion up­front and re­serv­ing a whop­ping $2.3 bil­lion in biotech bucks if San Fran­cis­co-based Nurix can point the way to new can­cer ther­a­pies, as well as drugs for oth­er, un­spec­i­fied dis­eases.