Mer­ck high­lights cru­cial hit for Keytru­da in sec­ond-line esophageal car­ci­no­ma — but there are al­so 2 miss­es

Mer­ck has un­veiled a Phase III da­ta pack­age back­ing Keytru­da’s case as a sec­ond-line treat­ment for the tough in­di­ca­tions of esophageal and esoph­a­gogas­tric junc­tion car­ci­no­ma, un­der­scor­ing its ear­li­er con­fi­dence that the PD-1 in­hibitor rep­re­sents a sig­nif­i­cant ad­vance in this field de­spite on­ly hit­ting one of three pri­ma­ry end­points.

The key num­ber the com­pa­ny wants to fo­cus on is 31% — the de­gree by which Keytru­da re­duced the risk of death com­pared to chemother­a­py in pa­tients with squa­mous cell car­ci­no­ma or ade­no­car­ci­no­ma, who had pro­gressed af­ter stan­dard ther­a­py and whose tu­mors ex­pressed PD-L1 (as quan­ti­fied by a com­bined pos­i­tive score, or CPS, of 10 or above).

That sub­group, which con­sti­tutes 222 out of 628 to­tal pa­tients in the KEYNOTE-181 study, reached a me­di­an OS of 9.3 months ver­sus 6.7 months for the chemo group. They al­so had a 12-month OS rate of 43% while the chemo arm ex­pe­ri­enced 20%.

These are pa­tients whose can­cer — in the esoph­a­gus or the esoph­a­gogas­tric junc­tion — pro­gressed af­ter ini­tial treat­ment, fol­low­ing a poor prog­no­sis to be­gin with, re­searchers added.

For the en­tire in­ten­tion-to-treat pop­u­la­tion, though, the dif­fer­ence in OS be­tween two arms was not sta­tis­ti­cal­ly sig­nif­i­cant with a me­di­an OS of 7.1 months for both treat­ment groups. Same goes for the oth­er sub­group an­a­lyzed for the study — the 401 pa­tients with squa­mous cell car­ci­no­ma — with the Keytru­da group see­ing a me­di­an OS of 8.2 months com­pared to 7.1 months in those re­ceiv­ing chemo.

These fail­ures kept in­ves­ti­ga­tors from for­mal­ly test­ing the sec­ondary end­points, mean­ing that we won’t know the pro­gres­sion-free sur­vival and ob­jec­tive re­sponse rate.

Mean­while, a sep­a­rate Phase III study — dubbed KEYNOTE-590 — is putting the block­buster check­point in­hibitor to first-line use in com­bi­na­tion with chemother­a­py for pa­tients with esophageal car­ci­no­ma.

Ri­vals are lin­ing up their own shots at esophageal and esoph­a­gogas­tric can­cers, with late-stage of­fer­ings from chief ri­val Bris­tol-My­ers Squibb. Cel­gene and BeiGene, which were slat­ed to notch the 7th PD-1 ap­proval in the US, were al­so in the game, though the pro­gram’s fate re­mains un­clear as Bris­tol-My­ers com­pletes its $74 bil­lion ac­qui­si­tion of Cel­gene.

Janet Woodcock (Greg Nash/Pool via AP Images)

'I re­al­ly don’t look back': Janet Wood­cock on her tran­si­tion away from drugs

Janet Woodcock may have one of the most historically long and drug-intense tenures in FDA history, but her new role is outside of all things pharma and the once-acting FDA commissioner isn’t looking back.

“No I really don’t look back,” Woodcock told Endpoints News via email on Monday morning. “Yes I will be transitioning. Longer discussion on infrastructure needed.”

An NYU surgeon transplants an engineered pig kidney into the outside of a brain-dead patient (Joe Carrotta/NYU Langone Health)

'Xeno­trans­plan­ta­tion is com­ing': New NE­JM pa­per gives de­tailed look in­to 2 pig-to-hu­man kid­ney trans­plant cas­es

The thymokidney is a curious organ, if you could call it that. It’s a sort of Frankensteinian creation — a system of pig thymus embedded underneath the outer layer of a pig’s kidney, made for human transplantation.

In the first case of pig-to-human xenotransplantation of a kidney into a brain-dead patient, the thymokidney quietly featured front and center.

In that experiment, which took place in September of last year, NYU researchers led by Robert Montgomery sutured a pig thymokidney onto the leg of a brain-dead 66-year-old woman. That case was widely reported on by a horde of major media outlets, including the New York Times, the BBC, and an in-depth feature by USA Today.

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Vlad Coric, Biohaven CEO

UP­DAT­ED: Fresh off $11.6B sale to Pfiz­er, New Bio­haven hits Phase III set­back just weeks af­ter Vlad Coric chalked up promise

When Pfizer bought up Biohaven’s migraine portfolio in the largest M&A deal of the year earlier this month, Biohaven CEO Vlad Coric promised the rest of the pipeline, which will live on under the umbrella of New Biohaven, still has a lot to offer. But that vision took a dent Monday as the drugmaker revealed it’s once again flopped on troriluzole.

The glutamate regulator failed to meet the primary endpoint on a Phase III study in patients with spinocerebellar ataxia, an inherited disorder that impairs a person’s ability to walk, speak and swallow. SCA can also lead to premature death.

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Bay­er sounds re­treat from a $670 mil­lion CAR-T pact in the wake of a pa­tient death

Two months after Atara Biotherapeutics hit the hold button on its lead CAR-T 2.0 therapy following a patient death, putting the company under the watchful eye of the FDA, its Big Pharma partners at Bayer are bowing out of a $670 million global alliance. And the move is forcing a revamp of Atara’s pipeline plans, even as research execs vow to continue work on the two drugs allied with Bayer 18 months ago, which delivered a $60 million cash upfront.

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Co­pay coupons gone wrong, again: Pfiz­er pays al­most $300K to set­tle com­plaints in four states

Pfizer has agreed to pay $290,000 to settle allegations of questionable copay coupon practices in Arizona, Colorado, Kansas, and Vermont from 2014 to 2018.

While the company has not admitted any wrongdoing as part of the settlement, Pfizer has agreed to issue restitution checks to about 5,000 consumers.

A Pfizer spokesperson said the company has “enhanced its co-pay coupons to alleviate the concerns raised by states and agreed to a $30,000 payment to each.”

Delaware court rules against Gilead and Astel­las in years-long patent case

A judge in Delaware has ruled against Astellas Pharma and Gilead in a long-running patent case over Pfizer-onwed Hospira’s generic version of Lexiscan.

The case kicked off in 2018, after Hospira submitted an Abbreviated New Drug Application (ANDA) for approval to market a generic version of Gilead’s Lexiscan. The drug is used in myocardial perfusion imaging (MPI), a type of nuclear stress test.

Taye Diggs (courtesy Idorsia)

Idor­sia inks an­oth­er celebri­ty en­dors­er deal with ac­tor and dad Taye Dig­gs as Qu­viviq in­som­nia am­bas­sador

Idorsia’s latest Quviviq insomnia campaign details the relatable dad story of a well-known celebrity — actor and Broadway star Taye Diggs.

Diggs stopped sleeping well after the birth of his son, now more than 10 years ago. Switching mom-and-dad nightly shifts to take care of a baby interrupted his sleep patterns and led to insomnia.

“When you’re lucky enough to be living out your dream and doing what you want, but because of something as simple as a lack of sleep, you’re unable to do that, it felt absolutely — it was treacherous,” he says in an interview-style video on the Quviviq website.

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Belén Garijo, Merck KGaA CEO (Kevin Wolf/AP Images for EMD Serono)

Mer­ck KGaA pumps €440M in­to ex­pand­ing and con­struct­ing Irish man­u­fac­tur­ing fa­cil­i­ties

The area of Ireland famous for Blarney Castle and its cliffsides along the Atlantic Ocean is seeing Merck KGaA expand its commitment there.

The German drug manufacturer is expanding its membrane and filtration manufacturing capabilities in Ireland. The company will invest approximately €440 million ($470 million) to increase membrane manufacturing capacity in Carrigtwohill, Ireland, and build a new manufacturing facility at Blarney Business Park, in County Cork, Ireland.

Rep. Katie Porter (D-CA) (Michael Brochstein/Sipa USA/Sipa via AP Images)

House Dems to Sen­ate lead­er­ship: Quick­ly move a rec­on­cil­i­a­tion bill with drug price ne­go­ti­a­tion re­forms

Twenty House Democrats, including Reps. Katie Porter of California and Susan Wild of Pennsylvania, are calling on Senate leaders to move quickly with a reconciliation bill (meaning they only need a simple majority for passage) with prescription drug pricing reforms, and to include adding new authority for Medicare to negotiate drug prices.

They also called on the Senate to specifically follow suit with the House passage of a $35 per month insulin cap (as Senate Majority Leader Chuck Schumer’s deadline for a vote on that provision has come and gone), and to cap Medicare Part D costs at $2,000 per year for seniors.