Mer­ck’s lead­ing PhI­II BACE drug im­plodes in lat­est Alzheimer’s dis­as­ter

Roger M. Perl­mut­ter, Mer­ck

Scratch yet an­oth­er Phase III Alzheimer’s drug hope­ful.

Mer­ck $MRK an­nounced late Tues­day that it is shut­ter­ing its EPOCH tri­al for the BACE in­hibitor verube­ce­s­tat in mild-to-mod­er­ate Alzheimer’s af­ter the ex­ter­nal da­ta mon­i­tor­ing com­mit­tee con­clud­ed that the drug was a bust, with “vir­tu­al­ly” no chance of suc­cess. A sep­a­rate Phase III study in pro­dro­mal pa­tients, set to read out in two years, will con­tin­ue as in­ves­ti­ga­tors found no signs of safe­ty is­sues.

This is one of Mer­ck’s top late-stage drugs, and news of the fail­ure drove down the phar­ma gi­ant’s shares in af­ter-mar­ket trad­ing by 2.45%.

BACE drugs es­sen­tial­ly seek to in­ter­fere in the process that cre­ates amy­loid be­ta, a tox­ic pro­tein of­ten found in the brains of Alzheimer’s pa­tients. As the top amy­loid be­ta drugs like bap­ineuzum­ab and solanezum­ab — which sought to ex­tract ex­ist­ing amy­loid be­ta loads — ground their way to re­peat­ed fail­ures, de­vel­op­ers in the field turned in­creas­ing­ly to BACE ther­a­pies as an al­ter­na­tive mech­a­nism that could pro­vide the key to slow­ing this dis­ease down.

Mer­ck’s ef­fort was the most ad­vanced in the pipeline, but Eli Lil­ly $LLY and oth­ers are still in hot pur­suit with their own per­sis­tent BACE ef­forts. Teams from Bio­gen/Ei­sai and No­var­tis/Am­gen are al­so beaver­ing away on BACE.

“Alzheimer’s dis­ease is one of the most press­ing and daunt­ing med­ical is­sues of our time, with in­her­ent, sub­stan­tial chal­lenges to de­vel­op­ing an ef­fec­tive dis­ease-mod­i­fy­ing ther­a­py for peo­ple with mild-to-mod­er­ate dis­ease. Stud­ies such as EPOCH are crit­i­cal, and we are in­debt­ed to the pa­tients in this study and their care­givers,” said Dr. Roger M. Perl­mut­ter, pres­i­dent, Mer­ck Re­search Lab­o­ra­to­ries. “While we are dis­ap­point­ed that a ben­e­fit was not ob­served in this study, our work con­tin­ues with APECS, which is study­ing verube­ce­s­tat in peo­ple with less ad­vanced dis­ease.”

Lil­ly re­cent­ly de­cid­ed to go ahead and stop its own prodomal Phase III for solanezum­ab af­ter con­clud­ing that there was no log­i­cal rea­son to be­lieve it could suc­ceed af­ter the study in pa­tients with a mild form of the mem­o­ry-wast­ing dis­ease end­ed in dis­as­ter.

No sig­nif­i­cant new drug for Alzheimer’s has been ap­proved in the past 14 years, de­spite mas­sive­ly ex­pen­sive tri­als aimed at tack­ling the dis­ease. The pipeline has been lit­tered with big fail­ures, which have come in a steady drum­beat of de­feat and dis­cour­age­ment.

Cu­ri­ous­ly, the next Phase III in Alzheimer’s to read out will be­long to Ax­o­vant $AX­ON, a start­up from Vivek Ra­maswamy, who bought in a failed drug from GSK and put it back in­to the clin­ic. Their 5-HT6 ther­a­py fol­lows a se­ries of fail­ures in the field for drugs that aimed at amp­ing up cog­ni­tion. The next big drug in the clin­ic — ad­u­canum­ab — be­longs to Bio­gen $BI­IB, which has stirred some sig­nif­i­cant ex­pec­ta­tions for a ther­a­py that al­so has a trou­bling safe­ty his­to­ry.

Hal Barron and Rick Klausner (GSK, Lyell)

Ex­clu­sive: GSK’s Hal Bar­ron al­lies with Rick Klaus­ner’s $600M cell ther­a­py start­up, look­ing to break new ground blitz­ing sol­id tu­mors

LONDON — Chances are, you’ve heard little or nothing about Rick Klausner’s startup Lyell. But that ends now.

Klausner, the former head of the National Cancer Institute, former executive director for global health at the Gates Foundation, co-founder at Juno and one of the leaders in the booming cell therapy field, has brought together one of the most prominent teams of scientists tackling cell therapy 2.0 — highlighted by a quest to bridge a daunting tech gap that separates some profound advances in blood cancers with solid tumors. And today he’s officially adding Hal Barron and GlaxoSmithKline as a major league collaborator which is pitching in a large portion of the $600 million he’s raised in the past year to make that vision a reality.

“We’ve being staying stealth,” Klausner tells me, then adding with a chuckle: “and going back to stealth after this.”

“Cell therapy has a lot of challenges,” notes Barron, the R&D chief at GSK, ticking off the resistance put up by solid tumors to cell therapies, the vein-to-vein time involved in taking immune cells out of patients, engineering them to attack cancer cells, and getting them back in, and more. “Over the years Rick and I talked about how it would be wonderful to take that on as a mission.”

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First place fin­ish: Eli Lil­ly just moved to fran­chise leader with their sec­ond mi­graine drug OK in 1 year

In a rare twist for Eli Lilly’s historically slow-moving R&D group, the pharma giant has seized bragging rights to a first-in-class new drug approval. And all signs point to an aggressive marketing followup as they look to outclass some major franchise rivals hobbled by internal dissension.

The FDA came through with an OK for lasmiditan on Friday evening, branding it as Reyvow and lining it up — once a substance classification comes through from the DEA — for a major market release. The oral drug binds to 5-HT1F receptors and is designed to stop an acute migraine after it starts. That makes it a complementary therapy to their CGRP drug Emgality, which has a statistically significant impact on preventing attacks.

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Patrick Mahaffy, Getty Images

Court green-lights Clo­vis case af­ter de­tail­ing ev­i­dence the board ‘ig­nored red flags’ on false safe­ty and ef­fi­ca­cy da­ta

Clovis investors have cleared a major hurdle in their long-running case against the board of directors, with a Delaware court making a rare finding that they had a strong enough case against the board to proceed with the action.

In a detailed ruling at the beginning of the month that’s been getting careful scrutiny at firms specializing in biotech and corporate governance, the Delaware Court of Chancery found that the attorneys for the investors had made a careful case that the board — a collection of experts that includes high-profile biotech entrepreneurs, a Harvard professor and well-known investigator as well as Clovis CEO Patrick Mahaffy — repeatedly ignored obvious warnings that Mahaffy’s executive crew was touting inflated, unconfirmed data for their big drug Roci. Serious safety issues were also reportedly overlooked while the company continued a fundraising campaign that brought in more than a half-billion dollars. And that leaves the board open to claims related to their role in the fiasco.

The bottom line:

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Allogene HQ Open House on September 17, 2019 in South San Francisco. (Jeff Rumans, Endpoints News)

The next 10 years: Where is biotech head­ed?

The last 10 years have seen a revolution in drug development. Timelines have shortened, particularly in oncology. Regulators have opened up. Investment has skyrocketed. China became a player. Biotechs have multiplied as gene and cell therapy has exploded — offering major new advances in the way diseases are treated, and sometimes cured.

So where are we headed from here? I journeyed out to San Francisco in September to discuss the answer to that question at Allogene’s open house. If the last 10 years have been an eye-opener, what does the next decade hold in store?

George Scangos / Credit: Cornell University

ARCH, Soft­Bank-backed Vir Biotech­nol­o­gy un­der­whelms with $143 mil­lion IPO

George Scangos went back to Wall Street, and came back 700 million pennies short.

Scangos’ vaunted startup Vir Biotechnology raised $143 million in an IPO they hoped would earn $150 million. Shares were priced at $20, the low-end of the $20-$22 target.

Launched with backing from ARCH Venture’s Robert Nelsen, Masayoshi Son’s SoftBank Vision Fund, and the Bill & Melinda Gates Foundation, the infectious disease startup was one of a new wave of well-resourced biotechs that emerged with deep enough coffers to pursue a full R&D line rather than slowly build their case by picking off a single lead program.

Bill Gates backs Gink­go Biowork­s' $350M raise to fu­el the buzzy syn­thet­ic bi­ol­o­gy 'rev­o­lu­tion'

If you want to understand Ginkgo Bioworks, the name should suffice: Bioworks, a spin off “ironworks,” that old industrial linchpin devoted to leveraging scale as a wellspring for vast new industries capable of remaking society. Ginkgo wants to be the ironworks for the revolution it’s heralded with as much fanfare as they can, playing off of one of the buzziest technologies in biotech.

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UCB bags a ri­val to Soliris in $2.1B buy­out deal — but will an in­creas­ing­ly vig­i­lant FTC sign off?

UCB is buying out Ra Pharma $RARX, announcing an acquisition deal that rings up at $48 a share, or $2.1 billion net of cash, and puts them toe-to-toe with Alexion on a clinical showdown.

Ra shares closed at $22.70 on Wednesday.

There’s a small pipeline in play at Ra, but UCB is going for the lead drug — a C5 inhibitor called zilucoplan in Phase III for myasthenia gravis (MG) looking to play rival to Alexion’s Soliris. Soliris has the market advantage, though, with a much earlier approval in MG in late 2017 that UCB feels confident in challenging.

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A new play­er is tak­ing the field in a push for a he­mo­phil­ia A gene ther­a­py, and it’s a big one

BioMarin, the execs at Spark (and buyer-to-be Roche) as well as the Sangamo/Pfizer team have a new rival striding onto the hemophilia block. And it’s a big one.

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Stuck with a PhI­II gene ther­a­py fail­ure at 96 weeks, Gen­Sight prefers the up­beat as­sess­ment

Two years after treatment, the best thing that GenSight Biologics $SIGHT can say about their gene therapy for vision-destroying cases of Leber Hereditary Optic Neuropathy is that it’s just a bit better than a placebo — just maybe because one treatment can cover both eyes.

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