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Novartis CEO Vas Narasimhan is raising the bar on second-gen cancer drug studies

Novartis $NVS has been noticeably absent from the center ring of PD-1/L1 research, quietly advancing its own checkpoint as an in-house asset to match up with a growing pipeline of cancer therapies. But that doesn’t mean that newly promoted CEO Vas Narasimhan hasn’t been thinking a lot about the pharma giant’s development strategy or what it has to do to position itself as the industry faces readouts on a tsunami of more than 1,000 combination studies now in the clinic.

In a conversation with analysts for the Q1 review, Narasimhan made these comments on I/O:

I think there is of course very impressive data and certainly from the PD-1 from one of our competitors (that’s a reference to Merck’s Keytruda/chemo combo), which I think is transformative for patients in lung cancer. So, it’s a great thing in general for society and for patients. 

And then he moved on to second-generation oncology assets and I/O, where the CEO sees a rising set of standards on what it’s going to take to demonstrate a success.

We evaluate our second-generation assets now at a higher bar. We…increasingly want to ensure that we have appropriate control arms so that we can see whether or not the combination is having an impact on top of the PD-1 mono.

And I think one of the things we’re also putting a very heavy lens on: 

Do we have single-agent activity? Because I think single agent activity will increase the likelihood that whether in combination or not we might have a medicine that’s going to matter. We evaluate and have a higher bar on what we progress. 

The nice thing for us in oncology is we have a broad set of platforms. We are a leader in targeted therapy. You see that in Mekinist and Tafinlar as well as a leader in nonmalignant hematology as you see with Promacta, Revolade, Exjade and Jakavi. So, we have that strong position.

Second, we are a leader in CAR-T. We have Kymriah we have a broad portfolio of CAR-Ts coming behind that. So, we have that as a platform. We have immuno-oncology, we have the 20 or so assets that are in the clinic evaluating them, but we’ll take a stronger look at them. And then we brought in radionuclide therapy (Lutathera), transformative in neuroendocrine tumors. We’ll see how it unfolds in prostate cancer, also looking at gastric cancers. So, we are strategically trying to take a broad position. 

We’re not overexposed to I/O per se. And it’s not a binary event for us whether I/O pans out for the company.


Image: Vas Narasimhan. NOVARTIS


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