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.”

Un­pack­ing the Aduhelm de­ci­sion, Ver­tex's half full glass, a $525M J&J breakup, and more

Welcome back to Endpoints Weekly, your review of the week’s top biopharma headlines. Want this in your inbox every Saturday morning? Current Endpoints readers can visit their reader profile to add Endpoints Weekly. New to Endpoints? Sign up here.

By now you have surely read about the FDA’s controversial approval of Biogen’s Alzheimer’s drug and all its reverberations. But I’d still recommend checking out the meaty recap below to make sure you didn’t miss all the angles that the Endpoints team has covered. If you’d rather look ahead, look no further than our three-day virtual panels next week at BIO, where we will discuss what the new normal means for every part of the industry.

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What does a clear ma­jor­i­ty of the bio­phar­ma in­dus­try think of the FDA ap­proval of ad­u­canum­ab? 'Hor­ri­fy­ing' 'Dan­ger­ous' 'Con­fus­ing' 'Dis­as­ter'

Over the years, we’ve become used to seeing a consensus emerge early in our industry polls at Endpoints News. And when we took the pulse of drug hunters on the heels of a controversial FDA approval for aducanumab this week, it became immediately apparent that the vast majority of our readers — heavily concentrated among biopharma staffers and execs — were incensed by what they had just witnessed.

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Aaron Kesselheim (Scott Eisen/AP Images for AIDS Healthcare Foundation)

Har­vard’s Aaron Kessel­heim re­signs from ex­pert pan­el in wake of ad­u­canum­ab OK, blast­ing FDA for ‘worst drug ap­proval de­ci­sion in re­cent U.S. his­to­ry'

A third member of the FDA’s Peripheral and Central Nervous System Drugs Advisory Committee has resigned in the wake of Biogen’s controversial Aduhelm approval, slamming the agency as he left and further deepening the controversy surrounding the decision.

Harvard University professor Aaron Kesselheim quit in protest Thursday afternoon, calling the Aduhelm OK “probably the worst drug approval decision in recent U.S. history.” Kesselheim follows both Joel Perlmutter, a neurologist from Washington University in St. Louis, and David Knopman, a neurologist from the Mayo Clinic, out the door.

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David Knopman (Mayo Clinic via YouTube)

A sec­ond ad­comm mem­ber aban­dons his post in af­ter­math of con­tro­ver­sial ad­u­canum­ab de­ci­sion

As the fallout from the FDA’s approval of Alzheimer’s med aducanumab grows, a second member of the adcomm overseeing that drug’s review has walked away. But even with two experts now having resigned from that committee in protest, is there enough broad-level outrage to prevent another aducanumab from getting approved?

The FDA on Wednesday lost another member of its Peripheral and Central Nervous System Drugs Advisory Committee as Mayo Clinic neurologist David Knopman hit the exit over the agency’s decision to approve Biogen’s Alzheimer’s drug Aduhelm despite the committee’s near-unanimous vote against it.

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Reshma Kewalramani, Vertex CEO (BIO via YouTube)

UP­DAT­ED: Ver­tex strikes out on its lat­est big shot at a rare ge­net­ic dis­ease. But they're go­ing to keep on swing­ing

It’s been several months since Vertex culled one of its small molecules for alpha-1 antitrypsin deficiency (AATD), taking a big hit after evidence of liver damage surfaced in a key Phase II trial. Now we learned that the company has whiffed on its second shot, and there’s nothing left in the clinic to treat the rare genetic disease — but that won’t stop it from trying.

Despite avoiding the safety issues that plagued the last candidate, Vertex $VRTX is taking the axe to VX-864 after Phase II results revealed the magnitude of the drug’s response is “unlikely to translate into substantial clinical benefit.” As a result of the news, the company’s stock fell 12.5% after hours.

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FDA au­tho­rizes about 10M J&J vac­cine dos­es, trash­es 60M more from trou­bled Emer­gent plant

The FDA on Friday released about 10 million doses of J&J’s vaccine for use, and disposed of another 60 million doses that were manufactured at the now-shuttered Emergent BioSolutions facility in Baltimore where cross-contamination occurred.

The agency said it’s not yet ready to allow the Emergent plant to be included in the J&J EUA, but that may occur soon. FDA came to the decision to authorize some of the doses after reviewing facility records and quality testing results.

Paul Hudson, Sanofi CEO (Eric Piermont/AFP via Getty Images)

Months af­ter FDA re­jec­tion, Sanofi touts piv­otal win for rare dis­ease drug su­tim­limab as it preps to re­file

One of the pillar drugs of Sanofi’s $11.6 billion pickup of Bioverativ hit a big setback late last year when the FDA sent its application for approval back. Now, as Sanofi gears up to resubmit the drug for review, the drugmaker is touting pivotal data it hopes will help take it over the finish line.

Sanofi’s sutimlimab nailed all three of its primary endpoints in its Phase III CADENZA study for patients with cold agglutinin disease, a rare disorder that can cause severe anemia, without a recent history of blood transfusion, the French drugmaker said Friday. The topline results will be presented at this weekend’s virtual EHA meeting.

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Ver­tex and CRISPR Ther­a­peu­tics un­veil more pos­i­tive gene ther­a­py da­ta, but busul­fan again casts a shad­ow over the field

Less than 12 hours after revealing a flop on its second shot for alpha-1 antitrypsin deficiency, Vertex plowed ahead with another data drop from its partnership with CRISPR Therapeutics. And though the topline proved positive, concerns over conditioning agents continue to linger over the collaboration, as well as the entire gene therapy space.

Presenting data from two trials at the European Hematology Association annual meeting, the pair announced that follow-up data of at least three months for 22 patients with genetic blood disorders indicated a “consistent and sustained” response to the experimental drug CTX001. All 15 patients with transfusion-dependent beta thalassemia did not need further blood transfusions and all seven with severe sickle cell disease were pain free, the biotechs announced.

Janet Woodcock, acting FDA commissioner, at Thursday's Senate Appropriations hearing (Bill Clark/CQ Roll Call via AP Images)

Sen­a­tors lam­bast new Alzheimer’s drug’s price but give Janet Wood­cock a free pass on the ap­proval de­ci­sion

Senate Finance Democrats took aim at Biogen’s pricey new Alzheimer’s drug on Thursday, but members on both sides of the aisle at a separate appropriations hearing didn’t question acting FDA commissioner Janet Woodcock on the approval.

“I was appalled that Biogen priced their Alzheimer’s drug approved by the FDA at $56,000 per year — I’m not going to debate whether this is effective or not, but it’s double the household median income for Michiganders over the age of 65,” Sen. Debbie Stabenow (D-MI) said at the finance hearing.