Pfiz­er and Lil­ly's tanezum­ab large­ly makes the ef­fi­ca­cy cut in sec­ond PhI­II study, but safe­ty is­sues con­tin­ue to blight an­ti-NGF drug

Stark safe­ty is­sues in the field of an­ti-NGF pain drugs have led a num­ber of high pro­file drug­mak­ers to press pause on de­vel­op­ment, re­duce dos­es or aban­don their ef­forts al­to­geth­er. On Tues­day, Lil­ly and Pfiz­er’s of­fer­ing — tanezum­ab — large­ly passed muster in terms of ef­fi­ca­cy in pa­tients with os­teoarthri­tis (OA) pain in a late-stage study, but was un­able to shake off that safe­ty is­sue — trig­ger­ing ag­gres­sive os­teoarthri­tis in a small per­cent­age of pa­tients.

The Phase III 849-pa­tient tri­al test­ed two dos­es of tanezum­ab (2.5 mg and 5 mg) against a place­bo in mod­er­ate-to-se­vere pa­tients that suf­fered symp­toms de­spite treat­ment or in­tol­er­ance to at least three dif­fer­ent class­es of anal­gesics, and on av­er­age had OA for more than six years. Pa­tients giv­en the high­er dose met all three co-pri­ma­ry goals ver­sus the place­bo at 24 weeks: a sta­tis­ti­cal­ly sig­nif­i­cant im­prove­ment in pain, phys­i­cal func­tion and over­all OA as­sess­ment. Al­though those on the low­er dose met the first two end­points, the 2.5 mg dose failed to spur a sta­tis­ti­cal dif­fer­ence in over­all OA as­sess­ment against the place­bo.

Mean­while, a num­ber of safe­ty is­sues emerged, akin to the re­sults of a pre­vi­ous Phase III study re­port­ed last Oc­to­ber that eval­u­at­ed the use of the drug for 16 weeks. In the new tri­al, rapid­ly pro­gres­sive os­teoarthri­tis was ob­served in 2.1% of tanezum­ab-treat­ed pa­tients, while no such events were ob­served in the place­bo arm.

There was al­so one event of os­teonecro­sis (a loss of blood to the bone that caus­es the bone to die) and one event of sub­chon­dral in­suf­fi­cien­cy frac­ture (a slow­ly heal­ing frac­ture of the bone sit­u­at­ed im­me­di­ate­ly be­low the car­ti­lage of a joint) ob­served in pa­tients treat­ed with the drug, and once again no such events were re­port­ed in pa­tients who got the place­bo, the com­pa­nies said, adding that de­tailed da­ta would be pre­sent­ed at a fu­ture med­ical meet­ing.

Years ago, the promise of an­ti-nerve growth fac­tor an­ti­bod­ies in­spired an­a­lysts to project multi­bil­lion-dol­lar mar­kets for the class of drugs. But a slew of safe­ty is­sues forced the FDA to im­pose clin­i­cal holds on keen­ly watched drugs af­ter re­ports of pa­tients blow­ing their joints out — some have spec­u­lat­ed that the drugs al­most work too well, dulling pain and thus help­ing pa­tients be­come more ac­tive, but al­so ac­cel­er­at­ing the pace of car­ti­lage de­te­ri­o­ra­tion at the joints.

Nonethe­less, such safe­ty set­backs forced Pfiz­er $PFE to cut back on tanezum­ab dos­es, al­though it did not de­ter Lil­ly $LLY from pour­ing as much as $1.8 bil­lion to buy in­to the drug. Te­va $TE­VA and Re­gen­eron $REGN too were com­pelled to trim down their dose of an­ti-NGF drug fas­inum­ab af­ter sim­i­lar con­cerns, while drug­mak­ers such as J&J $JNJ , As­traZeneca $AZN and Ab­b­Vie $AB­BV washed their hands of their an­ti-NGF of­fer­ings.

Tanezum­ab is be­ing test­ed in a slate of Phase III tri­als, out­side of the two whose re­sults have been al­ready re­port­ed. Piv­otal da­ta in pa­tients with chron­ic low­er back pain are ex­pect­ed lat­er this year, and da­ta from pa­tients with can­cer pain due to bone metas­tases are al­so in­com­ing.

The top 10 block­buster drugs in the late-stage pipeline — Eval­u­ate adds 6 new ther­a­pies to heavy-hit­ter list

Vertex comes in for a substantial amount of criticism for its no-holds-barred tactical approach toward wresting the price it wants for its commercial drugs in Europe. But the flip side of that coin is a highly admired R&D and commercial operation that regularly wins kudos from analysts for their ability to engineer greater cash flow from the breakthrough drugs they create.

Both aspects needed for success in this business are on display in the program backing Vertex’s triple for cystic fibrosis. VX-659/VX-445 + Tezacaftor + Ivacaftor — it’s been whittled down to 445 now — was singled out by Evaluate Pharma as the late-stage therapy most likely to win the crown for drug sales in 5 years, with a projected peak revenue forecast of $4.3 billion.

The latest annual list, which you can see here in their latest world preview, includes a roster of some of the most closely watched development programs in biopharma. And Evaluate has added 6 must-watch experimental drugs to the top 10 as drugs fail or go on to a first approval. With apologies to the list maker, I revamped this to rank the top 10 by projected 2024 sales, instead of Evaluate's net present value rankings.

It's how we roll at Endpoints News.

Here is a quick summary of the rest of the top 10:

Endpoints News

Basic subscription required

Unlock this story instantly and join 53,100+ biopharma pros reading Endpoints daily — and it's free.

John Reed at JPM 2019. Jeff Rumans for Endpoints News

Sanofi's John Reed con­tin­ues to re­or­ga­nize R&D, cut­ting 466 jobs while boost­ing can­cer, gene ther­a­py re­search

The R&D reorganization inside Sanofi is continuing, more than a year after the pharma giant brought in John Reed to head the research arm of the Paris-based company.
Endpoints News

Basic subscription required

Unlock this story instantly and join 53,100+ biopharma pros reading Endpoints daily — and it's free.

How small- to mid-sized biotechs can adopt pa­tient cen­tric­i­ty in their on­col­o­gy tri­als

By Lucy Clos­sick Thom­son, Se­nior Di­rec­tor of On­col­o­gy Pro­ject Man­age­ment, Icon

Clin­i­cal tri­als in on­col­o­gy can be cost­ly and chal­leng­ing to man­age. One fac­tor that could re­duce costs and re­duce bar­ri­ers is har­ness­ing the pa­tient voice in tri­al de­sign to help ac­cel­er­ate pa­tient en­roll­ment. Now is the time to adopt pa­tient-cen­tric strate­gies that not on­ly fo­cus on pa­tient needs, but al­so can main­tain cost ef­fi­cien­cy.

In­vestor day prep at Mer­ck in­cludes a new strat­e­gy to pick up the pace on M&A — re­port

Mer­ck’s re­cent deals to buy up two bolt-on biotechs — Ti­los and Pelo­ton — weren’t an aber­ra­tion. In­stead, both ac­qui­si­tions mark a new strat­e­gy to beef up its dom­i­nant can­cer drug op­er­a­tions cen­tered on Keytru­da while look­ing to ad­dress grow­ing con­cerns that too many of its eggs are in the one I/O bas­ket for their PD-1 pro­gram. And Mer­ck is go­ing af­ter more small- and mid-sized buy­outs to calm those fears.

John Chiminski, Catalent CEO - File Photo

'It's a growth play': Catal­ent ac­quires Bris­tol-My­er­s' Eu­ro­pean launch pad, ex­pand­ing glob­al CD­MO ops

Catalent is staying on the growth track.

Just two months after committing $1.2 billion to pick up Paragon and take a deep dive into the sizzling hot gene therapy manufacturing sector, the CDMO is bouncing right back with a deal to buy out Bristol-Myers’ central launchpad for new therapies in Europe, acquiring a complex in Anagni, Italy, southwest of Rome, that will significantly expand its capacity on the continent.

There are no terms being offered, but this is no small deal. The Anagni campus employs some 700 staffers, and Catalent is planning to go right in — once the deal closes late this year — with a blueprint to build up the operations further as they expand on oral solid, biologics, and sterile product manufacturing and packaging.

This is an uncommon deal, Catalent CEO John Chiminski tells me. But it offers a shortcut for rapid growth that cuts years out of developing a green fields project. That’s time Catalent doesn’t have as the industry undergoes unprecedented expansion around the world.

Endpoints News

Basic subscription required

Unlock this story instantly and join 53,100+ biopharma pros reading Endpoints daily — and it's free.

Right back at you, Pfiz­er: BeiGene and a Pfiz­er spin­out launch a new­co to de­vel­op a MEK/BRAF in­hibitor that could ri­val $11.4B com­bo

A day af­ter Pfiz­er bought Ar­ray and its ap­proved can­cer com­bo, BeiGene and Pfiz­er spin­out Spring­Works have part­nered in launch­ing a new biotech that has an eye on the very same mar­ket the phar­ma gi­ant just paid bil­lions for. And they’re plan­ning on us­ing an ex-Pfiz­er drug to do it.

In a nut­shell, Chi­na’s BeiGene is toss­ing in a pre­clin­i­cal BRAF in­hibitor — BGB-3245, which cov­ers both V600 and non-V600 BRAF mu­ta­tions — for a big stake in a new, joint­ly con­trolled biotech called Map­Kure with Bain-backed Spring­Works.

Sanofi aligns it­self with Google to stream­line drug de­vel­op­ment

Tech­nol­o­gy is bleed­ing in­to health­care, and big phar­ma is rid­ing the wave. Sanofi $SNY ap­point­ed its first chief dig­i­tal of­fi­cer this Feb­ru­ary, fol­low­ing the foot­steps of its peers. By May, the French drug­mak­er and some of its big phar­ma com­pa­tri­ots joined forces with Google par­ent Al­pha­bet’s Ver­i­ly unit to aug­ment clin­i­cal tri­al re­search. On Tues­day, the Parisian com­pa­ny tied up with Google to ac­cess its cloud com­put­ing and ar­ti­fi­cial in­tel­li­gence tech to spur the de­vel­op­ment of new ther­a­pies.

UP­DAT­ED: Roche fields first ap­proval for Ro­z­lytrek in the run-up to a show­down with Bay­er, Pfiz­er

While it’s wait­ing to hear back from FDA reg­u­la­tors, Roche is be­gin­ning the vic­to­ry lap for en­trec­tinib in Japan.

Roche is giv­ing Bay­er a run for their mon­ey with this tu­mor-ag­nos­tic drug, which tar­gets NTRK gene fu­sions. Now dubbed Ro­z­lytrek, it’s sanc­tioned to treat adult and pe­di­atric pa­tients in Japan with neu­rotroph­ic ty­ro­sine re­cep­tor ki­nase fu­sion-pos­i­tive, ad­vanced re­cur­rent sol­id tu­mors.

Arc­turus ex­pands col­lab­o­ra­tion, adding $30M cash; Ku­ra shoots for $100M raise

→  Rare dis­ease play­er Ul­tragenyx $RARE is ex­pand­ing its al­liance with Arc­turus $ARCT, pay­ing $24 mil­lion for eq­ui­ty and an­oth­er $6 mil­lion in an up­front as the two part­ners ex­pand their col­lab­o­ra­tion to in­clude up to 12 tar­gets. “This ex­pand­ed col­lab­o­ra­tion fur­ther so­lid­i­fies our mR­NA plat­form by adding ad­di­tion­al tar­gets and ex­pand­ing our abil­i­ty to po­ten­tial­ly treat more dis­eases,” said Emil Kakkis, the CEO at Ul­tragenyx. “We are pleased with the progress of our on­go­ing col­lab­o­ra­tion. Our most ad­vanced mR­NA pro­gram, UX053 for the treat­ment of Glyco­gen Stor­age Dis­ease Type III, is ex­pect­ed to move in­to the clin­ic next year, and we look for­ward to fur­ther build­ing up­on the ini­tial suc­cess of this part­ner­ship.”