Macro­mol­e­cules in a pill? Tor­toise-in­spired cap­sule of­fers hope in an ear­ly test de­liv­er­ing in­sulin in­to stom­ach wall

For many di­a­bet­ics, nee­dles that de­liv­er their in­sulin are as cru­cial as taps that run the wa­ter they drink. But a team led by MIT and sci­en­tists from No­vo Nordisk — the world’s biggest in­sulin mak­er — are look­ing to change that. Re­port­ed in Sci­ence, the team has cre­at­ed a blue­ber­ry-sized oral cap­sule that de­liv­ers an in­sulin shot in­side the stom­ach once swal­lowed in rats and swine, and are look­ing to take the work in­to hu­mans in three years.

The cap­sule is in­spired by a leop­ard tor­toise — which bran­dish­es a shell that al­lows the African rep­tile to right it­self if it rolls on­to its back. The cap­sule em­u­lates that, so that no mat­ter how it lands in the gut, a nee­dle in­side the pill made of com­pressed freeze-dried in­sulin will ori­ent it­self to come in con­tact with the stom­ach lin­ing. Wa­ter in the stom­ach dis­solves a sug­ar disk hold­ing the nee­dle in­to place, and since the stom­ach wall does not con­tain pain re­cep­tors, the sci­en­tists an­tic­i­pate that pa­tients will not be able to feel the prick.

In an­i­mal stud­ies, the cap­sule was shown to de­liv­er enough in­sulin to low­er blood sug­ar to lev­els sim­i­lar to in­jec­tions ad­min­is­tered through skin, and the de­vice can po­ten­tial­ly be adapt­ed to de­liv­er oth­er pro­tein drugs, such as im­muno­sup­pres­sants used to treat rheuma­toid arthri­tis or in­flam­ma­to­ry bow­el dis­ease or even nu­cle­ic acids in­clud­ing DNA and RNA.

Bob Langer

“(This) new type of cap­sule could some­day help di­a­bet­ic pa­tients and per­haps any­one who re­quires ther­a­pies that can now on­ly be giv­en by in­jec­tion or in­fu­sion,” said MIT’s Robert Langer who was one of the se­nior au­thor’s of the study. Langer’s lab at MIT has spawned a string of bio­phar­ma com­pa­nies.

“(If) a per­son were to move around or the stom­ach were to growl, the de­vice would not move from its pre­ferred ori­en­ta­tion,” said the study’s lead au­thor and MIT grad­u­ate stu­dent Alex Abram­son.

Once in­ject­ed in­to the stom­ach wall, the cap­sule re­leas­es its con­tents, and dis­in­te­grates as it pass­es harm­less­ly through the di­ges­tive sys­tem and is even­tu­al­ly elim­i­nat­ed, the re­searchers said re­fer­ring to an­i­mal da­ta in their re­port pub­lished on Thurs­day.

The re­search was fund­ed by No­vo Nordisk $NVO, the NIH and oth­ers. To be sure, hu­man tri­als are still to come and must be cleared be­fore the de­vice can be safe­ly and ef­fec­tive­ly used. But for the Dan­ish drug­mak­er, the suc­cess­ful de­ploy­ment of the prod­uct could rein­vig­o­rate its long-term growth as it slow­ly moves away from its de­pen­dence of tra­di­tion­al in­jectable in­sulin amidst in­ten­si­fy­ing com­pe­ti­tion and pric­ing pres­sure with­in the di­a­betes mar­ket.

ZS Per­spec­tive: 3 Pre­dic­tions on the Fu­ture of Cell & Gene Ther­a­pies

The field of cell and gene therapies (C&GTs) has seen a renaissance, with first generation commercial therapies such as Kymriah, Yescarta, and Luxturna laying the groundwork for an incoming wave of potentially transformative C&GTs that aim to address diverse disease areas. With this renaissance comes several potential opportunities, of which we discuss three predictions below.

Allogenic Natural Killer (NK) Cells have the potential to displace current Cell Therapies in oncology if proven durable.

Despite being early in development, Allogenic NKs are proving to be an attractive new treatment paradigm in oncology. The question of durability of response with allogenic therapies is still an unknown. Fate Therapeutics’ recent phase 1 data for FT516 showed relatively quicker relapses vs already approved autologous CAR-Ts. However, other manufacturers, like Allogene for their allogenic CAR-T therapy ALLO-501A, are exploring novel lymphodepletion approaches to improve persistence of allogenic cells. Nevertheless, allogenic NKs demonstrate a strong value proposition relative to their T cell counterparts due to comparable response rates (so far) combined with the added advantage of a significantly safer AE profile. Specifically, little to no risk of graft versus host disease (GvHD), cytotoxic release syndrome (CRS), and neurotoxicity (NT) have been seen so far with allogenic NK cells (Fig. 1). In addition, being able to harness an allogenic cell source gives way to operational advantages as “off-the-shelf” products provide improved turnaround time (TAT), scalability, and potentially reduced cost. NKs are currently in development for a variety of overlapping hematological indications with chimeric antigen receptor T cells (CAR-Ts) today, and the question remains to what extent they will disrupt the current cell therapy landscape. Click for more details.

What lured Hal Bar­ron away?; Top FDA minds on ac­cel­er­at­ed ap­proval re­forms; ‘Dead wrong’ Aduhelm ad blitz; and more

Welcome back to Endpoints Weekly, your review of the week’s top biopharma headlines. Want this in your inbox every Saturday morning? Current Endpoints readers can visit their reader profile to add Endpoints Weekly. New to Endpoints? Sign up here.

Nothing can really compete with Hal Barron’s departure from GlaxoSmithKline as the news of the week, but we do have plenty of original reporting and analysis from the Endpoints team in this edition. Enjoy and have a nice weekend.

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Mer­ck wins le­gal bat­tle over in­sur­ance cov­er­age af­ter ran­somware at­tack

Merck has emerged victorious from a years-long legal battle with insurers over the coverage of more than a billion dollars in losses from the malware NotPetya, with a New Jersey Superior Court judge concluding that the responsibility is on insurers to clarify their policies around cyber attacks.

The pharma giant was one of several victims of a global cyber attack back in 2017 that also hit Danish shipping company Maersk, American food company Mondelēz, French construction giant Saint-Gobain and even the systems monitoring the Chernobyl nuclear power stations, Bloomberg reported back in 2019.

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Crit­ics push back on Alzheimer’s As­so­ci­a­tion ad blitz to get Medicare to change its Aduhelm rul­ing: 'Dead wrong'

The latest Alzheimer’s Association advertising campaign encourages people to fight.

Not against the disease or for more research or treatments, but against the Centers for Medicare and Medicaid Services. More specifically, CMS’ recent reimbursement decision to only pay for Biogen and Eisai’s controversial Alzheimer’s drug Aduhelm for patients in clinical trials.

With CMS’ preliminary decision now in a 30-day comment period, patient advocates’ goal is to convince CMS to reverse its decision with a marketing blitz and public pressure.

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Dan O'Day, Gilead CEO (Jim Watson/AFP via Getty Images)

Fail­ing to con­firm clin­i­cal ben­e­fit, Gilead pulls 2 ac­cel­er­at­ed ap­proval in­di­ca­tions for can­cer drug

Gilead recently decided to pull two indications for its cancer drug Zydelig — in relapsed follicular B-cell non-Hodgkin lymphoma (FL) and relapsed small lymphocytic leukemia (SLL) — after failing to complete the confirmatory trials required as part of the accelerated approvals from 2014.

“As the treatment landscape for FL and SLL has evolved, enrollment into the confirmatory study has been an ongoing challenge,” Gilead said in a statement, noting it formally notified the FDA of its decision to voluntarily withdraw these indications.

Executive Director of the EMA Emer Cooke (AP Photo/Geert Vanden Wijngaert)

Eu­ro­pean Par­lia­ment signs off on strength­en­ing drug reg­u­la­tor's abil­i­ty to tack­le short­ages

The European Parliament on Thursday endorsed a plan to increase the powers of the European Medicines Agency, which will be better equipped to monitor and mitigate shortages of drugs and medical devices.

By a vote of 655 to 31, parliament signed off on a provisional agreement reached with the European Council from last October, in which the EMA will create two shortage steering groups (one for drugs, the other for devices), a new European Shortages Monitoring Platform to facilitate data collection and increase transparency, and on funding for the work of the steering groups, task force, working parties and expert panels that are to be established.

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Sec­ondary patents prove to be key in biosim­i­lar block­ing strate­gies, re­searchers find

While the US biosimilars industry has generally been a disappointment since its inception, with FDA approving 33 biosimilars since 2015, just a fraction of those have immediately followed their approvals with launches. And more than a handful of biosimilars for two of the biggest blockbusters of all time — AbbVie’s Humira and Amgen’s Enbrel — remain approved by FDA but still have not launched because of legal settlements.

Hal Barron, Endpoints UKBIO20 (Jeff Rumans)

'Al­tos was re­al­ly a once-in-a-life­time op­por­tu­ni­ty': Hal Bar­ron re­flects on his big move

By all accounts, Hal Barron had one of the best jobs in Big Pharma R&D. He made more than $11 million in 2020, once again reaping more than his boss, Emma Walmsley, who always championed him at every opportunity. And he oversaw a global R&D effort that struck a variety of big-dollar deals for oncology, neurodegeneration and more.

Sure, the critics never let up about what they saw as a rather uninspiring late-stage pipeline, where the rubber hits the road in the Big Pharma world’s hunt for the next big near-term blockbuster, but the in-house reviews were stellar. And Barron was firmly focused on bringing up the success rate in clinical trials, holding out for the big rewards of moving the dial from an average 10% success rate to 20%.

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FDA+ roundup: FDA's neu­ro­science deputy de­parts amid on­go­ing Aduhelm in­ves­ti­ga­tions; Califf on the ropes?

Amid increased scrutiny into the close ties between FDA and Biogen prior to the controversial accelerated approval of Aduhelm, the deputy director of the FDA’s office of neuroscience has called it quits after more than two decades at the agency.

Eric Bastings will now take over as VP of development strategy at Ionis Pharmaceuticals, the company said Wednesday, where he will provide senior clinical and regulatory leadership in support of Ionis’ pipeline.

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