Reimag­in­ing med­i­cine? No­var­tis wraps phar­ma’s first big glob­al pot deal

In a wa­ter­shed mo­ment for med­ical cannabis ad­vo­cates in the Unit­ed States, Swiss gi­ant No­var­tis’ $NVS San­doz AG unit has tied up with Cana­di­an med­ical cannabis pro­duc­er Tilray, mark­ing the first big en­dorse­ment of the con­tro­ver­sial plant by a large, multi­na­tion­al phar­ma­ceu­ti­cal com­pa­ny.

The deal ex­em­pli­fies chang­ing at­ti­tudes in the US, where more Amer­i­cans live in states that have le­gal­ized the sale of med­ical and/or recre­ation­al cannabis than in an­ti-cannabis ju­ris­dic­tions. Tilray, which sup­plies cannabis flower and ex­tract prod­ucts to pa­tients, physi­cians, health­care fa­cil­i­ties and re­searchers in 12 coun­tries, has an ex­ist­ing al­liance with San­doz Cana­da.

Un­der the so-called frame­work agree­ment, San­doz AG may sup­port Tilray in com­mer­cial­iz­ing and brand­ing the Nanaimo, British Co­lum­bia-based com­pa­ny’s non-smok­able/non-com­bustible prod­ucts; the Cana­di­an pot pro­duc­er may sup­ply and/or li­cense such prod­ucts to and from San­doz AG; and sig­nif­i­cant­ly, the two may col­lab­o­rate in de­vel­op­ing such prod­ucts.

“The (ex­pand­ed) part­ner­ship al­so helps le­git­imize cannabis in in­ter­na­tion­al mar­kets, which could im­pact preva­lence with­in ex­ist­ing mar­kets as well as help in­flu­ence coun­tries con­sid­er­ing med­ical cannabis le­gal­iza­tion,” Cowen’s Vivien Az­er wrote in a note.

The land­mark FDA ap­proval of GW Phar­ma’s $GW­PH cannabis-de­rived med­i­cine Epid­i­olex ear­li­er this year paved the way for a pletho­ra of small and mid-sized drug de­vel­op­ers — in­clud­ing In­sys Ther­a­peu­tics $IN­SY, Zyner­ba $ZYNE, In­Med Phar­ma, Kan­nal­ife and Ax­im Biotech $AX­IM — that are hop­ing to hitch their wag­on to the cannabis star, ei­ther by de­vel­op­ing syn­thet­ic or nat­ur­al cannabis-de­rived ther­a­peu­tics or de­vis­ing nov­el de­liv­ery mech­a­nisms for its ab­sorp­tion.

Two big deals over the course of this year have al­so un­der­scored the lu­cra­tive po­ten­tial of the plant, with al­co­hol gi­ant Con­stel­la­tion Brands $STZ spend­ing a mam­moth $4 bil­lion to se­cure a 38% stake in Cana­di­an cannabis com­pa­ny Canopy Growth $CGC, and cig­a­rette mak­er Al­tria $MO fork­ing out $1.8 bil­lion to take a 45% stake in an­oth­er Cana­di­an pot com­pa­ny Cronos $CRON.

Marc Feld­mann

Mean­while, the US fed­er­al gov­ern­ment con­tin­ues to con­sid­er cannabis as a sched­ule 1 sub­stance — on par with LSD and hero­in — with no med­ical val­ue, in­fu­ri­at­ing re­searchers who con­tend the clas­si­fi­ca­tion has dra­mat­i­cal­ly slowed the sci­en­tif­ic and med­ical in­ves­ti­ga­tion of the plant. Nev­er­the­less with House De­moc­rats tak­ing back seats this No­vem­ber, pro-mar­i­jua­na leg­is­la­tion is ex­pect­ed to heat up.

“There is am­ple ev­i­dence that the cannabis plant has nu­mer­ous use­ful ap­pli­ca­tions in med­i­cine and the law is ob­so­lete,” said Marc Feld­mann, an Ox­ford pro­fes­sor and im­mu­nol­o­gist whose work  led to the dis­cov­ery and sub­se­quent com­mer­cial­iza­tion of the world’s largest sell­ing drug class, an­ti-TNF. “This clas­si­fi­ca­tion is chang­ing around the world – it has al­ready hap­pened in Cana­da and will hap­pen in more states in the US in due course,” he said in a pre­vi­ous in­ter­view with End­points News. Feld­mann al­so serves as CEO of CannBioRex, a Cana­da-based com­pa­ny that is de­vel­op­ing syn­thet­ic cannabis-de­rived med­i­cines.

IM­brave150: Roche’s reg­u­la­to­ry crew plans a glob­al roll­out of Tecen­triq com­bo for liv­er can­cer as PhI­II scores a hit

Just weeks after Bristol-Myers Squibb defended its failed pivotal study pitting Opdivo against Nexavar in liver cancer, Roche says it’s beat the frontline challenge with a combination of their PD-L1 Tecentriq with Avastin. And now they’re rolling their regulatory teams in the US, Europe and China in search of a new approval — badly needed to boost a trailing franchise effort.
Given their breakthrough and Big Pharma status as well as the use of two approved drugs, FDA approval may well prove to be something of a formality. And the Chinese have been clear that they want new drugs for liver cancer, where lethal disease rates are particularly high.
Researchers at their big biotech sub, Genentech, say that the combo beat Bayer’s Nexavar on both progression-free survival as well as overall survival — the first advance in this field in more than a decade. We won’t get the breakdown in months of life gained, but it’s a big win for Roche, which has lagged far, far behind Keytruda and Opdivo, the dominant PD-1s that have captured the bulk of the checkpoint market so far.
Researchers recruited hepatocellular carcinoma — the most common form of liver cancer — patients for the IMbrave150 study who weren’t eligible for surgery ahead of any systemic treatment of the disease.
Roche has a fairly low bar to beat, with modest survival benefit for Nexavar, approved for this indication 12 years ago. But they also plan to offer a combo therapy that could have significantly less toxicity, offering patients a much easier treatment regimen.
Cowen’s Steven Scala recently sized up the importance of IMbrave150, noting:

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Clay Sie­gall’s $614M wa­ger on tu­ca­tinib pays off with solid­ly pos­i­tive piv­otal da­ta and a date with the FDA

Back at the beginning of 2018, Clay Siegall snagged a cancer drug called tucatinib with a $614 million cash deal to buy Cascadian. It paid off today with a solid set of mid-stage data for HER2 positive breast cancer that will in turn serve as the pivotal win Siegall needs to seek an accelerated approval in the push for a new triplet therapy.

And if all the cards keep falling in its favor, they’ll move from 1 drug on the market to 3 in 2020, which is shaping up as a landmark year as Seattle Genetics prepares for its 23rd anniversary on July 15.
The oral TKI, designed to zero in on HER2 with a bonus for penetrating the blood brain barrier, delivered a 46% hazard ratio — reduction in risk of disease progression or death — when combined with Herceptin and Xeloda compared to the branded combo alone. That was the primary endpoint. And then two key secondaries followed, starting with a 34% reduction in risk of death alone with a p value for overall survival that hit an approval worthy p=0.0048. There was a more dramatic 52% HR among almost half of the patients who had a brain metastasis at the time of the trial, which some of the analysts see as a key to market success.
We’ll have to wait until the San Antonio Breast Cancer Symposium for the breakdown on just how many months of PFS and OS Seattle Genetics is talking about.
While the researchers were after drug resistant third-line cases in the study, where regulators are generous in allowing high levels of toxicity for dying patients, the safety profile is still key here to the drug’s competitive position on the market. By steering clear of EGFR-linked toxicity, the company is looking for a better safety profile. And while the triplet led to a 5.7% drop out rate due to adverse events, compared to 3% for the double, analysts have been scoring this one much better than Nerlynx or Tykerb.

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Med­ical an­i­ma­tion: Mak­ing it eas­i­er for the site and the pa­tient to un­der­stand

Medical animation has in recent years become an increasingly important tool for conveying niche information to a varied audience, particularly to those audiences without expertise in the specialist area. Science programmes today, for example, have moved from the piece-to-camera of the university professor explaining how a complex disease mechanism works, to actually showing the viewer first-hand what it might look like to shrink ourselves down to the size of an ant’s foot, and travel inside the human body to witness these processes in action. Effectively communicating a complex disease pathophysiology, or the novel mechanism of action of a new drug, can be complex. This is especially difficult when the audience domain knowledge is limited or non-existent. Medical animation can help with this communication challenge in several ways.
Improved accessibility to visualisation
Visualisation is a core component of our ability to understand a concept. Ask 10 people to visualise an apple, and each will come up with a slightly different image, some apples smaller than others, some more round, some with bites taken. Acceptable, you say, we can move on to the next part of the story. Now ask 10 people to visualise how HIV’s capsid protein gets arranged into the hexamers and pentamers that form the viral capsid that holds HIV’s genetic material. This request may pose a challenge even to someone with some virology knowledge, and it is that inability to effectively visualise what is going on that holds us back from fully understanding the rest of the story. So how does medical animation help us to overcome this visualisation challenge?

Alex­ion clinch­es aHUS ap­proval for Ul­tomiris as the clock ticks on Soliris con­ver­sion

Alexion has racked up a second approval for Ultomiris, the successor therapy to Soliris, as its mainstay blockbuster therapy faces a patent review process that could drastically shorten its patent exclusivity.

The FDA OK for atypical hemolytic uremic syndrome (aHUS) on Friday was widely expected after Alexion posted a full slate of positive Phase III data in January. But regulators also flagged concerns about serious meningococcal infections, slapping a black box warning on the label and mandating a REMS.

FDA ap­proval lets Foamix set its maid­en ac­ne ther­a­py on course for US mar­ket launch

Months ago, Foamix leaned on its biggest shareholders — Perceptive Advisors and OrbiMed — to financially grease its wheels, ahead of the FDA decision date for its acne therapy. On Friday, that approval came in — and the topical formulation of the antibiotic minocycline is set for a January launch.

The therapy, Amzeeq (formerly known as FMX101), was approved to treat inflammatory lesions of non-nodular moderate-to-severe acne vulgaris in patients aged 9 and older.

Alice Shaw, Lung Cancer Foundation of America

Top ALK ex­pert and can­cer drug re­searcher Al­ice Shaw bids adieu to acad­e­mia, hel­lo to No­var­tis

Jay Bradner has recruited a marquee oncology drug researcher into the ranks of the Novartis Institutes for BioMedical Research. Alice Shaw is jumping from prestigious posts intertwined through Mass General, Harvard and Dana-Farber to take the lead of NIBR’s translational clinical oncology group.

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Hal Barron, GSK's president of R&D and CSO, speaks to Endpoints News founder and editor John Carroll in London at Endpoints' #UKBIO19 summit on October 8, 2019

[Video] Cel­e­brat­ing tri­al fail­ures, chang­ing the cul­ture and al­ly­ing with Cal­i­for­nia dream­ers: R&D chief Hal Bar­ron talks about a new era at GSK

Last week I had a chance to sit down with Hal Barron at Endpoints’ #UKBIO19 summit to discuss his views on R&D at GSK, a topic that has been central to his life since he took the top research post close to 2 years ago. During the conversation, Barron talked about changing the culture at GSK, a move that involves several new approaches — one of which involves celebrating their setbacks as they shift resources to the most promising programs in the pipeline. Barron also discussed his new alliances in the Bay Area — including his collaboration pact with Lyell, which we covered here — frankly assesses the pluses and minuses of the UK drug development scene, and talks about his plans for making GSK a much more effective drug developer.

This is one discussion you won’t want to miss. Insider and Enterprise subscribers can log-in to watch the video.

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Christine Bunt, Robert Langer. Verseau

Armed with Langer tech and $50M, Verseau hails new check­point drugs un­leash­ing macrophages against can­cer

The rising popularity of CD47 has propelled the “don’t-eat-me” signal to household name status in the immuno-oncology world: By blocking that protein, the theory goes, one can stop cancer cells from fooling macrophages. But just as PD-(L)1 merely represents the most fruitful of all checkpoints regulating T cells, Verseau Therapeutics is convinced that CD47 is one of many regulators one can modulate to stir up or tame the immune system.

Mi­rati preps its first look at their KRAS G12C con­tender, and they have to clear a high bar for suc­cess

If you’re a big KRAS G12C fan, mark your calendars for October 28 at 4:20 pm EDT.

That’s when Mirati $MRTX will unveil its first peek at the early clinical data available on MRTX849 in presentations at the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics in Boston.

Mirati has been experiencing the full effect of a rival’s initial success at targeting the G12C pocket found on KRAS, offering the biotech some support on the concept they’re after — and biotech fans a race to the top. Amgen made a big splash with its first positive snapshot on lung cancer, but deflated sky-high expectations as it proved harder to find similar benefits in other types of cancers.

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