Loxo takes cen­ter stage at AS­CO with its ground­break­ing shot at a bio­mark­er-based can­cer drug ap­proval

CHICA­GO — Loxo On­col­o­gy made it in­to the AS­CO show­case over the week­end, boast­ing of a small but grow­ing num­ber of cas­es where chil­dren and adults with TRK fu­sion can­cer re­spond­ed to their lead drug, larotrec­tinib (LOXO-101). And they’re pack­ag­ing it in­to a new drug ap­pli­ca­tion they ex­pect to hus­tle to reg­u­la­tors ei­ther lat­er this year or ear­ly 2018, while show­ing off a next-gen drug com­ing up the pipeline that they’re al­ready claim­ing has es­tab­lished proof-of-con­cept ev­i­dence of ef­fi­ca­cy in two cas­es.

This Stam­ford, CT-based biotech $LOXO is all about hus­tle.

For a small com­pa­ny with just 35 staffers, Loxo has enor­mous am­bi­tions that in­clude shoot­ing at some ground­break­ing ad­vances in drug de­vel­op­ment. At AS­CO, the biotech boast­ed a 76% tu­mor re­sponse rate among pa­tients with mul­ti­tude of dif­fer­ent tu­mor types. Un­like a typ­i­cal can­cer drug fo­cused on the anato­my, Loxo is go­ing af­ter a bio­mark­er — tropomyosin re­cep­tor ki­nase (TRK) fu­sions — and at AS­CO it cob­bled to­geth­er re­sponse da­ta from three ear­ly-stage tri­als.

Specif­i­cal­ly there were 50 pa­tients — 43 adults and 12 chil­dren — with 12% com­plete and 64% par­tial re­spon­ders. That’s a high rate of suc­cess and it fits with their ear­li­er state­ments on progress in the clin­ic. Small groups of pa­tients like this are al­so not un­usu­al for a can­cer type shared by on­ly a few thou­sand US pa­tients.

The in­vestor crowd ate it up. Loxo’s shares spiked 51% mid­day Mon­day.

Just days ago Mer­ck won the first pi­o­neer­ing ap­proval for the ge­net­i­cal­ly de­fined use of a can­cer drug, an­oth­er boost for its glob­al star Keytru­da. Larotrec­tinib is be­ing pushed down the same path­way, but it is ex­per­i­men­tal. And Loxo is the po­lar op­po­site of a gi­ant like Mer­ck, which has been pour­ing cash in­to its well-es­tab­lished Keytru­da pro­gram in si­mul­ta­ne­ous pur­suit of dozens of tar­gets.

Josh Bilenker, Loxo On­col­o­gy

Go­ing af­ter an FDA ap­proval for both chil­dren and adults like this “has nev­er been done be­fore,” Loxo CEO Josh Bilenker tells me. But he is ab­solute­ly con­vinced that the da­ta he has is enough to form the ba­sis of a win­ning ap­pli­ca­tion.

It’s not un­usu­al these days to see bio­phar­ma com­pa­nies use ear­ly-stage da­ta to go af­ter an ac­cel­er­at­ed ap­proval at the FDA. What was once the ex­cep­tion is now the rule. But Loxo — which part­nered with Ar­ray on the pro­gram — is press­ing the en­ve­lope, us­ing small groups of pa­tients across Phase I and II tri­als to pro­vide the ev­i­dence they need that larotrec­tinib works. That strat­e­gy is nec­es­sary to achieve their goal, they say, and they have the agency’s break­through ther­a­py des­ig­na­tion to pro­vide an open door, which Bilenker says led to a meet­ing with the FDA 18 months ago that set them on this path.

As a pub­lic com­pa­ny, Loxo al­so has tout­ed — and ben­e­fit­ed — from just about every scrap of da­ta ex­ecs can lay its hands on, with new in­stances of par­tial re­spons­es used to rev up its stock price.

In Chica­go Sat­ur­day, that strat­e­gy was on full view as they not­ed the first glim­mer of ev­i­dence that its next-gen drug LOXO-195 trig­gered two par­tial re­spons­es af­ter it was used in emer­gency cas­es in­volv­ing re­sis­tance to a TRK fu­sion in­hibitor.

Cour­tesy Loxo On­col­o­gy.

If in fact they can prove that it can work against cas­es of TRK fu­sion drug re­sis­tance, their drug could be­come a reg­u­lar part of the treat­ment land­scape for pa­tients with their bio­mark­er. And they will tout any ev­i­dence of ef­fi­ca­cy they gath­er on their next trip to reg­u­la­tors.

Loxo’s mar­ket cap is up to $1.3 bil­lion as some mar­ket an­a­lysts cheer them at every stage.

Loxo, though, al­so has com­pe­ti­tion in the field. Igny­ta $RXDX has a Phase II un­der­way for en­trec­tinib for TRK-fu­sion pos­i­tive adult and pe­di­atric pa­tients. Just a cou­ple of weeks ago Igny­ta won their own break­through stays for their drug, giv­ing them the same easy ac­cess that Loxo en­joys. And not all an­a­lysts are ig­nor­ing the po­ten­tial for a matchup as these two small out­fits com­pete for the lime­light in can­cer R&D.

“The com­pa­ny guid­ed for NDAs for Trk+ and ROS1+ pts in 2018 and a U.S. launch in 2019 (MAA sub­mis­sion in 2019),” not­ed Jef­feries re­cent­ly. “The break­through des­ig­na­tion for en­trec­tinib helps lev­el the play­ing field some with LOXO-101, which re­ceived BTD in Ju­ly 2016 (NDA sub­mis­sion ex­pect­ed in late-2017 or ear­ly-2018).”

If they do make it to the mar­ket, Bilenker says Loxo plans to set up a com­mer­cial group and launch this it­self. “We own world­wide rights to the drug and that’s our plan,” he says, shrug­ging off the sug­ges­tion of a com­pa­ny sale.

It’s a big goal.

An em­bold­ened As­traZeneca splurges $95M on a pri­or­i­ty re­view vouch­er. Where do they need the FDA to hus­tle up?

AstraZeneca is in a hurry.

We learned this morning that the pharma giant — not known as a big spender, until recently — forked over $95 million to get its hands on a priority review voucher from Sobi, otherwise known as Swedish Orphan Biovitrum.

That marks another step down on price for a PRV, which allows the holder to slash 4 months off of any FDA review time.

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Brian Kaspar. AveXis via Twitter

AveX­is sci­en­tif­ic founder fires back at No­var­tis CEO Vas Narasimhan, 'cat­e­gor­i­cal­ly de­nies any wrong­do­ing'

Brian Kaspar’s head was among the first to roll at Novartis after company execs became aware of the fact that manipulated data had been included in its application for Zolgensma, now the world’s most expensive therapy.

But in his first public response, the scientific founder at AveXis — acquired by Novartis for $8.7 billion — is firing back. And he says that not only was he not involved in any wrongdoing, he’s ready to defend his name as needed.

I reached out to Brian Kaspar after Novartis put out word that he and his brother Allen had been axed in mid-May, two months after the company became aware of the allegations related to manipulated data. His response came back through his attorneys.

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Martin Shkreli [via Getty]

Pris­on­er #87850-053 does not get to add drug de­vel­op­er to his list of cred­its

Just days after Retrophin shed its last ties to founder Martin Shkreli, the biotech is reporting that the lead drug he co-invented flopped in a pivotal trial. Fosmetpantotenate flunked both the primary and key secondary endpoints in a placebo-controlled trial for a rare disease called pantothenate kinase-associated neurodegeneration, or PKAN.

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We­bi­nar: Re­al World End­points — the brave new world com­ing in build­ing fran­chise ther­a­pies

Several biopharma companies have been working on expanding drug labels through the use of real world endpoints, combing through the data to find evidence of a drug’s efficacy for particular indications. But we’ve just begun. Real World Evidence is becoming an important part of every clinical development plan, in the soup-through-nuts approach used in building franchises.

I’ve recruited a panel of 3 top experts in the field — the first in a series of premium webinars — to look at the practical realities governing what can be done today, and where this is headed over the next few years, at the prodding of the FDA.

ZHEN SU — Mer­ck Serono’s Se­nior Vice Pres­i­dent and Glob­al Head of On­col­o­gy
EL­LIOTT LEVY — Am­gen’s Se­nior Vice Pres­i­dent of Glob­al De­vel­op­ment
CHRIS BOSHOFF — Pfiz­er On­col­o­gy’s Chief De­vel­op­ment Of­fi­cer

A premium subscription to Endpoints News is required to attend this webinar. Please upgrade to either an Insider or Enterprise plan for access. Already have Endpoints Premium? Please sign-in below. You can contact our Subscriptions team at help@endpointsnews.com with any issues.

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Ver­sant-backed Chi­nook gets a $65M launch round for its dis­cov­ery quest in a resur­gent kid­ney field

Versant is once again stepping off the beaten track in biotech to see if they can blaze a trail of their own in a field that has looked too thorny to many investors for years.

The venture group and their partners at Apple Tree are bringing their latest creation out of stealth mode today. Born in Versant’s Inception Sciences’ Chinook Therapeutics is betting that its preclinical take on kidney disease can get an early lead among the companies starting up in the field.

Sir An­drew Dil­lon, NICE's first — and on­ly — chief ex­ec­u­tive to step down next year

Using a laptop borrowed from his former employer, South London’s St George’s Hospital, Sir Andrew Dillon set about establishing NICE — launched by the then health secretary Frank Dobson — in 1999.  On Thursday, the UK cost-effectiveness watchdog said its first and only chief executive — Dillon — is stepping down in March 2020.

Back in the day, decisions about which drugs and interventions were funded by the National Health Service (NHS) were made at the local level, but this ‘postcode prescribing’ system was fraught with skewed healthcare deployment making the structure unsustainable. A national system was deemed necessary — and NICE was formed to bridge that gap.

Eight weeks be­tween each HIV treat­ment? GSK notch­es PhI­II win as it chas­es OK for long-act­ing reg­i­men

GSK has cleared another test in its grand plan to topple Gilead’s HIV dominance by offering alternative treatments that consist of fewer drugs and last longer. A year after scoring positive Phase III data on a four-week course of cabotegravir and rilpivirine, its ViiV subsidiary now says that an eight-week regimen seem to work just as well.

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Finch grabs a $53M round de­signed to take their ‘break­through’ mi­cro­bio­me treat­ment through a po­ten­tial­ly piv­otal tri­al

With a breakthrough designation in one hand and a fresh $53 million in venture backing in the other, Somerville, MA-based Finch Therapeutics is taking a shot at a one-trial pathway to a possible FDA OK for their new treatment for preventing recurrent C. difficile infections.

The funding brings their total raise for the microbiome company to $130 million, CEO Mark Smith tells me — enough money to pave a runway past the FDA approval they’ve sketched into the most optimistic version for their near-term future. 

Bob Smith, Pfizer

Pfiz­er is mak­ing a $500M state­ment to­day: Here’s how you be­come a lead play­er in the boom­ing gene ther­a­py sec­tor

Three years ago, Pfizer anted up $150 million in cash to buy Bamboo Therapeutics in Chapel Hill, NC as it cautiously stuck a toe in the small gene therapy pool of research and development.

Company execs followed up a year later with a $100 million expansion of the manufacturing operations they picked up in that deal for the UNC spinout, which came with $495 million in milestones.

And now they’re really going for it.

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