Months af­ter IPO, No­var­tis spin­out resTOR­bio wins on PhI­Ib da­ta — stock soars

Just six months af­ter its de­but on the Nas­daq, resTOR­bio is trot­ting out late-stage da­ta this morn­ing for its lead drug can­di­date — a TORC1 in­hibitor they’re hop­ing will pre­vent res­pi­ra­to­ry in­fec­tions in el­der­ly folks. While it flopped in a com­bo tri­al, the com­pa­ny’s drug met its pri­ma­ry end­point when test­ed by it­self.

In­vestors are thrilled with the news, with resTOR­bio’s share price $TORC fly­ing up 161% as of press time. Yes­ter­day’s close was at $9.01 per share, and to­day its so far climbed to $23.50. If it holds, that’s a de­cent jump from its IPO price of $14 to $16 per share.

Joan Man­nick

The drug — spun out of No­var­tis in­to its own start­up just last year — is now called RTB101, al­though it once went un­der the code name BEZ235. In a Phase IIb tri­al, the 10 mg dose of the drug showed a sta­tis­ti­cal­ly sig­nif­i­cant re­duc­tion in res­pi­ra­to­ry in­fec­tions when tak­en by pa­tients once a day. That co­hort saw a 30.6% de­crease in the per­cent­age of pa­tients who de­vel­oped a res­pi­ra­to­ry in­fec­tion when com­pared to the place­bo co­hort: p=0.026.

In­ter­est­ing­ly, the drug flopped big time when test­ed in com­bi­na­tion with an al­ready-ap­proved im­muno­sup­pres­sant called everolimus, an mTOR in­hibitor of­ten used to pre­vent the re­jec­tion of or­gan trans­plants. When resTOR­bio test­ed RTB101 com­bi­na­tion with everolimus, they found no de­crease in the per­cent­age of pa­tients with res­pi­ra­to­ry in­fec­tions. The drug al­so saw lousy re­sults when the 10 mg dose was tak­en twice dai­ly in­stead of once.

“We’re find­ing that less TORC1 in­hi­bi­tion works bet­ter than more TORC1 in­hi­bi­tion,” the com­pa­ny’s co-founder and CMO Joan Man­nick tells me. They saw a sim­i­lar re­sponse in their Phase IIa tri­al, she said.

Chen Schor

The com­pa­ny’s CEO Chen Schor said he wasn’t too con­cerned that the com­bo and dou­ble dos­es didn’t per­form well. In fact, the drug work­ing as a monother­a­py is ben­e­fi­cial.

“We pre­fer to move for­ward with the monother­a­py, be­cause it’s eas­i­er to man­u­fac­ture,” he said. “That was our hope.”

The com­pa­ny al­so homed in on a few spe­cif­ic pa­tient groups in which they saw more promis­ing re­sults. For ex­am­ple, in asth­ma pa­tients, they saw a 68% re­duc­tion in res­pi­ra­to­ry in­fec­tions (p=0.0002), and in pa­tients 85 years or old­er they saw 67% (p=0.007). The tri­al in­volved some 650 pa­tients, ac­cord­ing to clin­i­cal­tri­als.gov, but when resTOR­bio whit­tles down the pa­tient group to these se­lect pop­u­la­tions, we’re talk­ing much few­er peo­ple. I asked Man­nick just how many we’re talk­ing here. In asth­ma, it was on­ly 47 pa­tients, she said, and a mere 27 peo­ple were 85 years old and old­er.

But Man­nick de­fend­ed the da­ta’s sig­nif­i­cance re­gard­less of the small­er pa­tient group. “When you have few­er pa­tients, it’s much hard­er to reach sta­tis­ti­cal sig­nif­i­cance,” she said. “You have to have a big ef­fect.”

The com­pa­ny is meet­ing with the FDA at the end of this year to dis­cuss how it should move for­ward with a Phase III tri­al. Man­nick and Schor said the com­pa­ny will be shoot­ing for a sim­i­lar tri­al de­sign, in which they test co­horts of nar­row pa­tient groups with­in the same tri­al.

A new era of treat­ment: How bio­mark­ers are chang­ing the way we think about can­cer

AJ Patel was recovering from a complicated brain surgery when his oncologist burst into the hospital room yelling, “I’ve got some really great news for you!”

For two years, Patel had been going from doctor to doctor trying to diagnose his wheezing, only to be dealt the devastating news that he had stage IV lung cancer and only six months to live. And then they found the brain tumors.

“What are you talking about?” Patel asked. He had never seen an oncologist so happy.

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Michael Corbo, Pfizer CDO of inflammation & immunology

UP­DAT­ED: Plan­ning ahead for crowd­ed ul­cer­a­tive col­i­tis mar­ket, Pfiz­er spells out PhI­II da­ta on $6.7B Are­na drug

Pfizer has laid out the detailed results behind its boast that etrasimod — the S1P receptor modulator at the center of its $6.7 billion buyout of Arena Pharma — is the winner of the class, potentially leapfrogging an earlier entrant from Bristol Myers Squibb.

Pivotal data from the ELEVATE program in ulcerative colitis — which consists of two Phase III trials, one lasting 52 weeks and the other just 12 weeks — illustrate an “encouraging balance of efficacy and safety,” according to Michael Corbo, chief development officer of inflammation & immunology at Pfizer. The company is presenting the results as a late breaker at Digestive Disease Week.

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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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Mihael Polymeropoulos, Vanda Pharmaceuticals CEO

Phar­ma com­pa­ny con­tin­ues its FDA law­suit spree, this time af­ter agency de­nies fast-track des­ig­na­tion

Vanda Pharmaceuticals is making a name for itself, at least in terms of suing the FDA.

The DC-headquartered firm on Monday filed its latest suit against the agency, with the company raising concerns over the FDA’s failure to grant a fast track designation for Vanda’s potential chronic digestive disorder drug tradipitant, which is a neurokinin 1 receptor antagonist.

Specifically, Vanda said FDA’s “essential point” in its one-page denial letter on the designation pointed to “the lack of necessary safety data,” which was “inconsistent with the criteria for … Fast Track designation.”

Mod­er­na seeks to dis­miss Al­ny­lam suit over Covid-19 vac­cine com­po­nent, claim­ing wrong venue

RNAi therapeutics juggernaut Alnylam Pharmaceuticals made a splash in March when it sued and sought money from both Pfizer and Moderna regarding their use of Alnylam’s biodegradable lipids, which Alnylam claims have been integral to the way both companies’ mRNA-based Covid-19 vaccines work.

But now, Moderna lawyers are firing back, telling the same Delaware district court that Alnylam’s claims can only proceed against the US government in the Court of Federal Claims because of the way the company’s contract is set up with the US government. The US has spent almost $10 billion on Moderna’s Covid-19 vaccine so far.

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(Credit: Shutterstock)

Cracks in the fa­cade: Is phar­ma's pan­dem­ic ‘feel good fac­tor’ wan­ing?

The discordant effects of the Covid-19 pandemic on pharma reputation continues. While the overall industry still retains a respectable halo from its Covid-19 quick response and leadership, a new patient group study reveals a different story emerging in the details.

On one hand, US patient advocacy groups rated the industry higher-than-ever overall. More than two-thirds (67%) of groups gave the industry a thumbs up for 2021, a whopping 10 percentage point increase over the year before, according to the PatientView annual study, now in its 9th year.

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Saqib Islam, SpringWorks CEO

Pfiz­er spin­out Spring­Works will ship its first drug to the FDA be­fore year’s end with PhI­II win

SpringWorks Therapeutics thinks it has cemented the backbone for its first “pipeline-in-a-product” oncology treatment and will send it to the FDA before the clock strikes 2023 with a Phase III win on Tuesday.

The oral gamma secretase inhibitor, dubbed nirogacestat, beat placebo on the primary goal of progression-free survival in adults with progressing desmoid tumors.

The soft-tissue tumors can lead to long-lasting pain, disfigurement and amputation, and there are currently no approved meds for the rare oncology indication. The tumors typically impact patients aged 20 to 44 years old and disproportionately affect women at rates 2 to 3 times higher, with up to a total of 1,650 new cases diagnosed in the US annually, according to SpringWorks.

Robert Califf (Michael Brochstein/Sipa USA via AP Images)

House Re­pub­li­cans at­tack Chi­na-on­ly da­ta in FDA sub­mis­sions, seek new in­ves­ti­ga­tion in­to re­search in­spec­tions

Three Republican representatives are calling on the FDA to take a closer look at the applications including only clinical data from China.

The letter to FDA commissioner Rob Califf late last week comes as the agency recently rejected Eli Lilly’s anti-PD-1 antibody, which attempted to bring China-only data but ran into a bruising adcomm that may crush the hopes of any other companies looking to bring cheaper follow-ons based only on Chinese data.

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