Roche's big PhI­II Tecen­triq/Cotel­lic com­bo study for colon can­cer fails, dam­ag­ing Ex­elix­is shares

The Tecen­triq team at Roche/Genen­tech has run in­to an­oth­er nasty set­back. Their PD-L1 drug, com­bined with Cotel­lic, failed to make a sig­nif­i­cant dif­fer­ence on over­all sur­vival among col­orec­tal can­cer pa­tients in the Phase III study. And the fail­ure will have the biggest im­pact on Roche’s part­ner Ex­elix­is, which had a lot rid­ing on the IM­blaze370 tri­al.

The key les­son for in­ves­ti­ga­tors: The vast ma­jor­i­ty of the pa­tients in the study had mi­crosatel­lite sta­ble tu­mors, and they’re flag­ging the out­come here as fresh ev­i­dence that check­points in gen­er­al won’t have much chance of suc­cess. They had been bank­ing on ear­ly tri­al re­sults in­di­cat­ing that adding a MEK in­hibitor — Cotel­lic — could make a big dif­fer­ence. But that the­o­ry has gone down in flames.

Michael Mor­ris­sey

A num­ber of an­a­lysts had ear­li­er giv­en this study — which used re­go­rafenib (Sti­var­ga) for the con­trol arm — a good shot at suc­cess. There were no da­ta in the re­lease, which will like­ly be re­leased at a lat­er con­fer­ence.

Ex­elix­is’ shares had dropped by about 13% on af­ter­noon trad­ing.

The Phase III fail­ure comes a month af­ter the de­vel­op­ment part­ners were forced to halt en­roll­ment of pa­tients in the Phase II MOD­UL study af­ter mon­i­tors tracked a string of deaths in a co­hort of pa­tients in the tri­al. One of those deaths was trig­gered by car­dio­genic shock, which was linked to the com­bo.

Tecen­triq has stum­bled bad­ly be­fore in clin­i­cal tri­als. But as the third big PD-1/L1 to hit the mar­ket, it’s al­so had some no­table suc­cess­es. Most re­cent­ly the FDA of­fered a quick de­ci­sion on a triple com­bo us­ing Tecen­triq with Avastin and chemo for front­line lung can­cer, where Mer­ck has dom­i­nat­ed with Keytru­da as Bris­tol-My­ers scram­bled to be com­pet­i­tive.

In Q1 Mer­ck hit $1.46 bil­lion in Keytru­da rev­enue, up 151% as the phar­ma gi­ant con­tin­ued to out­pace Bris­tol-My­ers on lung can­cer. Bris­tol-My­ers’ Op­di­vo, which got out to an ear­ly lead, scored $1.51 bil­lion, leav­ing them vul­ner­a­ble to drop­ping back to the num­ber two spot. Roche, mean­while, re­port­ed Q1 rev­enue of on­ly $139 mil­lion for Tecen­triq.

Roche, of course, will move along with 50 oth­er stud­ies for Tecen­triq, but Ex­elix­is will be forced to work through the sting­ing fail­ure with sig­nif­i­cant­ly less to of­fer in­vestors in terms of fresh cat­a­lysts to look to.

“We will con­tin­ue to work with Genen­tech on the eval­u­a­tion of co­bime­tinib’s po­ten­tial in oth­er tu­mor types, in­clud­ing in melanoma, in which there are two on­go­ing phase 3 piv­otal tri­als,” said Ex­elix­is CEO Michael Mor­ris­sey in a state­ment. “Sep­a­rate­ly, Ex­elix­is re­mains fo­cused on and com­mit­ted to max­i­miz­ing the po­ten­tial of the cabozan­ti­nib fran­chise through our com­mer­cial ac­tiv­i­ties and on­go­ing clin­i­cal de­vel­op­ment pro­gram eval­u­at­ing the com­pound alone, or in com­bi­na­tion with im­mune check­point in­hibitors, across nu­mer­ous tu­mor types.”

We­bi­nar: Re­al World End­points — the brave new world com­ing in build­ing fran­chise ther­a­pies

Several biopharma companies have been working on expanding drug labels through the use of real world endpoints, combing through the data to find evidence of a drug’s efficacy for particular indications. But we’ve just begun. Real World Evidence is becoming an important part of every clinical development plan, in the soup-through-nuts approach used in building franchises.

I’ve recruited a panel of 3 top experts in the field — the first in a series of premium webinars — to look at the practical realities governing what can be done today, and where this is headed over the next few years, at the prodding of the FDA.


ZHEN SU — Merck Serono’s Senior Vice President and Global Head of Oncology


ELLIOTT LEVY — Amgen’s Senior Vice President of Global Development


CHRIS BOSHOFF — Pfizer Oncology’s Chief Development Officer

A premium subscription to Endpoints News is required to attend this webinar. Please upgrade to either an Insider or Enterprise plan for access. Already have Endpoints Premium? Please sign-in below. You can contact our Subscriptions team at help@endpointsnews.com with any issues.

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Brian Kaspar. AveXis via Twitter

AveX­is sci­en­tif­ic founder fires back at No­var­tis CEO Vas Narasimhan, 'cat­e­gor­i­cal­ly de­nies any wrong­do­ing'

Brian Kaspar’s head was among the first to roll at Novartis after company execs became aware of the fact that manipulated data had been included in its application for Zolgensma, now the world’s most expensive therapy.

But in his first public response, the scientific founder at AveXis — acquired by Novartis for $8.7 billion — is firing back. And he says that not only was he not involved in any wrongdoing, he’s ready to defend his name as needed.

I reached out to Brian Kaspar after Novartis put out word that he and his brother Allen had been axed in mid-May, two months after the company became aware of the allegations related to manipulated data. His response came back through his attorneys.

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UP­DAT­ED: Pay­back? An­a­lysts say Sarep­ta was blind­sided by an FDA re­jec­tion dri­ven by reg­u­la­to­ry re­venge

In one of the least anticipated moves of the year, the FDA has rejected Sarepta’s application for an accelerated approval of its Duchenne MD drug golodirsen after fretting over safety issues.

In a statement that arrived after the bell on Monday, Sarepta explained the CRL, saying:

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FDA de­ci­sion on Ver­tex's CF triple will come just ahead of planned CEO shake­up

Vertex has clinched a priority review for the all-important cystic fibrosis triple that will blaze the trail for treating a large group of patients unhelped by its current drugs.

FDA regulators have set a PDUFA date of March 19, 2020, just a year after the Boston biotech posted positive Phase III results showing that people with two F508del mutations experienced statistically significant improvements in lung function after a 4-week regimen of VX-445, tezacaftor and ivacaftor. After reviewing 24-week data among patients with one F508del mutation and one minimal function mutation — and thoroughly comparing the VX-445 triple with another combo featuring VX-659 on scores like safety, drug-drug interactions, and photosensitivity — Vertex ultimately went with VX-445.

An MIT spin­out kills one of its ‘liv­ing ther­a­peu­tics’ af­ter flunk­ing an ear­ly-stage study — shares rout­ed

Just a few weeks after bagging $80 million in a deal to collaborate with Gingko Bioworks on its special blend of engineered bacteria used for “living therapeutics,” little Synlogic in Boston $SYBX is tossing one of its two clinical programs after watching an early-stage study go down in defeat.

Their Phase Ib/IIa study for SYNB1020 to counter the accumulation of ammonia in the body, a condition called hyperammonemia or urea cycle disorder, floundered at the interim readout, forcing the biotech to kill it and reserve its cash for pipeline therapies with greater potential.

Elan­co to buy Bay­er's an­i­mal health busi­ness for $7.6B, as deal­mak­ing gath­ers steam in the sec­tor

Last week, Elanco explicitly dodged answering questions about its rumored interest in Bayer’s animal health business in its post-earnings call. On Tuesday, the Eli Lilly spinoff disclosed it was purchasing the German drug maker’s veterinary unit in a cash-and-stock deal worth $7.6 billion. 

Elanco $ELAN has been busy on the deal-making front. In April, it laid out plans to swallow its partner, Kansas-based pet therapeutics company Aratana $PETX. A July report by Reuters suggested a potential Bayer deal was being explored, and Bloomberg last week said the deal was imminent, citing sources. 

As­traZeneca's di­a­betes drug Farx­i­ga helps pa­tients with heart dis­ease and with­out di­a­betes in land­mark tri­al

Months ago, data on J&J’s $JNJ Invokana indicated the diabetes drug conferred cardiovascular (CV) benefit in patients who do and do not have preexisting CV disease. On Tuesday, AstraZeneca’s $AZN rival treatment, Farxiga, was shown to cut the risk of CV death or the worsening of heart failure in patients with heart disease, in a landmark trial.

The treatments, in addition to Jardiance from Eli Lilly $LLY, belong to a class of diabetes drugs called sodium-glucose co-transporter 2 (SGLT2) inhibitors, which work by curbing the absorption of glucose via the kidneys so that surplus glucose is excreted through urination.

Levi Garraway. Broad Institute via Youtube

Roche raids Eli Lil­ly for its next chief med­ical of­fi­cer as San­dra Horn­ing plans to step down

We found out Monday morning where Levi Garraway was headed after he left Eli Lilly as head of oncology R&D a few days ago. Roche named Garraway as their new chief medical officer, replacing Sandra Horning, who they say is retiring from the company.

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Af­ter a posse of Wall Street an­a­lysts pre­dict a like­ly new win for Sarep­ta, we're down to the wire on a crit­i­cal FDA de­ci­sion

As Bloomberg notes, most of the Wall Street analysts that cover Sarepta $SRPT are an upbeat bunch, ready to cheer on the team when it comes to their Duchenne MD drugs, or offer explanations when an odd setback occurs — as happened recently with a safety signal that was ‘erroneously’ reported last week.

Ritu Baral Cowen
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