Med­i­cines Co., Al­ny­lam pre­pare to throw the dice on a late-stage ef­fort to leapfrog PC­SK9 gi­ants

While Am­gen and its ri­vals at Re­gen­eron/Sanofi strug­gle to es­tab­lish a mar­ket for their pi­o­neer­ing PC­SK9 ther­a­pies — while grap­pling over a nasty law­suit over the IP — Al­ny­lam $AL­NY and The Med­i­cines Com­pa­ny $MD­CO are hatch­ing plans for a come-from-be­hind at­tempt to leapfrog the squab­bling fron­trun­ners.

Clive Mean­well, The Med­i­cines Com­pa­ny

This morn­ing the com­pa­nies an­nounced that the FDA has signed off on their Phase III pro­gram, which will en­roll a to­tal of 3,000 sub­jects with ath­er­o­scle­rot­ic car­dio­vas­cu­lar dis­ease and fa­mil­ial hy­per­c­ho­les­terolemia to test the abil­i­ty of in­clisir­an to slash LDL over 18 months. And they aren’t wait­ing for the re­sults to be­gin their car­dio out­comes study.

Re­searchers plan to sweep up 14,000 pa­tients for the out­comes study, look­ing to see if this new drug can im­press pay­ers with da­ta on a com­pos­ite of coro­nary heart dis­ease death, non-fa­tal my­ocar­dial in­farc­tion and fa­tal and non-fa­tal is­chemic stroke.

That’s a tricky propo­si­tion, though.

Am­gen hit marks for sev­er­al out­comes with their car­dio fol­low-up tri­al ear­li­er this year, but was slapped with a back­lash of skep­ti­cism from an­a­lysts and pay­ers who want­ed to see bet­ter da­ta to jus­ti­fy the price of the drug — par­tic­u­lar­ly on re­duc­ing mor­tal­i­ty. Am­gen’s mon­ey-back guar­an­tee for pa­tients on their drug who go on to ex­pe­ri­ence a heart at­tack failed to win over the doubt­ful, who were quick to do the math on costs and sav­ings.

Learn­ing from the pi­o­neers, The Med­i­cines Com­pa­ny and Al­ny­lam — which de­vel­oped the RNA drug — want to nail down the right da­ta and then an­gle in with a drug that may on­ly have to be giv­en two or three times each year. Af­ter that, the whole glob­al bat­tle for mar­ket share could get down to price.

Last fall re­searchers in the Phase II study re­port­ed that a sin­gle 300 mg in­jec­tion of their RNAi drug — now dubbed in­clisir­an — reg­is­tered a mean 43% re­duc­tion in bad LDL cho­les­terol af­ter 180 days, trig­ger­ing some ex­cit­ed buzz among the an­a­lysts fol­low­ing this pro­gram.

Not­ed Med­i­cines Co. CEO Clive Mean­well:

Al­though not re­quired for the NDA, we will al­so per­form an ag­gres­sive car­dio­vas­cu­lar out­comes tri­al in high-risk sub­jects with AS­CVD and/or risk-equiv­a­lents, such as di­a­betes. We be­lieve that pos­i­tive out­comes da­ta, with pri­ma­ry out­come clin­i­cal ef­fects greater than those re­port­ed for an­ti-PC­SK9 mon­o­clon­al an­ti­bod­ies, will dri­ve a high lev­el of com­pet­i­tive­ness in the world­wide mar­ket – which we ex­pect to be­come very large.

Sanofi and Re­gen­eron, mean­while, ex­pect to have their car­dio da­ta avail­able lat­er this year, hop­ing to trump Am­gen as the com­pa­nies fight it out on the patent front.

As­traZeneca trum­pets the 'mo­men­tous' 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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Sanofi brings in 4 new ex­ec­u­tives in con­tin­ued shake-up, as vac­cines and con­sumer health chief head out the door

In the middle of Sanofi’s multi-pronged race to develop a Covid-19 vaccine, David Loew, the head of their sprawling vaccines unit, is leaving – part of the final flurry of moves in the French giant’ months-long corporate shuffle that will give them new-look leadership under new CEO Paul Hudson.

The company also said today that Alan Main, the head of their consumer healthcare unit, is out, and they named 4 executives to fill new or newly vacated positions, 3 of whom come from both outside both Sanofi and from Pharma.

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Ab­b­Vie wins an ap­proval in uter­ine fi­broid-as­so­ci­at­ed heavy bleed­ing. Are ri­vals My­ovant and Ob­sE­va far be­hind?

Women expel on average about 2 to 3 tablespoons of blood during their time of the month. But with uterine fibroids, heavy bleeding is typical — a third of a cup or more. Drugmakers have been working on oral therapies to try and stem the flow, and as expected, AbbVie and their partners at Neurocrine Biosciences are the first to make it across the finish line.

Known chemically as elagolix, the drug is already approved as a treatment for endometriosis under the brand name Orilissa. It targets the GnRH receptor to decrease the production of estrogen and progesterone.

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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David Chang, Allogene CEO (Jeff Rumans)

Head­ed to PhII: Al­lo­gene CEO David Chang com­pletes a pos­i­tive ear­ly snap­shot of their off-the-shelf CAR-T pi­o­neer

Allogene CEO David Chang has completed the upbeat first portrait of the biotech’s off-the-shelf CAR-T contender ALLO-501 at virtual ASCO today, keeping all eyes on a drug that will now try to go on to replace the first-wave personalized pioneers he helped create.

The overall response rate outlined in Allogene’s abstract for treatment-resistant patients with non-Hodgkin lymphoma slipped a little from the leadup, but if you narrow the patient profile to treatment-naïve patients — removing the 3 who had previous CAR-T therapy who didn’t respond, leaving 16 — the ORR lands at 75% with a 44% complete response rate. And 9 of the 12 responders remained in response at the data cutoff, offering a glimpse on durability that still has a long way to go before it can be completely nailed down.

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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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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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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:”.

As­traZeneca’s $7B ADC suc­ceeds where Roche failed, im­prov­ing sur­vival in gas­tric can­cer

Another day, another win for Enhertu.

The antibody-drug conjugate AstraZeneca promised up-to $7 billion to partner on has had a quite a few months, beginning with splashy results in a Phase II breast cancer trial, a rapid approval and, earlier this month, breakthrough designations in both non-small cell lung cancer and gastric cancer.

Now, at ASCO, the British pharma and their Japanese partner, Daiichi Sankyo, have shown off the data that led to the gastric cancer designation, which they’ll take back to the FDA. In a pivotal, 187-person Phase II trial, Enhertu shrunk tumors in 42.9% of third-line patients with HER2-positive stomach cancer, compared with 12.5% in a control arm where doctors prescribed their choice of therapy. Progression-free survival was 5.4 months for Enhertu compared to 3.5 months for the control.