Watch out Al­ny­lam/Io­n­is: Pfiz­er’s pos­i­tive PhI­II tafamidis da­ta makes drug a new ri­val

Pfiz­er $PFE re­port­ed out some good news from a late-stage tri­al test­ing its drug tafamidis against a rare con­di­tion that leads to heart fail­ure. The pos­i­tive re­sults of the Phase III study have both Al­ny­lam $AL­NY and Io­n­is $IONS in­vestors squea­mish, as it could be com­pe­ti­tion for patisir­an and in­ot­ersen.

Bren­da Coop­er­stone

The Pfiz­er tri­al, called AT­TR-ACT, test­ed its drug tafamidis in pa­tients with transthyretin car­diomy­opa­thy, an in­her­it­ed con­di­tion in which pro­teins don’t fold in­to their nor­mal shapes cor­rect­ly. The mis­fold­ing makes them build up and cause dam­age to the nerves, heart, and oth­er or­gans. In the tri­al, the drug met its pri­ma­ry end­point, Pfiz­er said, and demon­strat­ed a sta­tis­ti­cal­ly sig­nif­i­cant re­duc­tion in the com­bi­na­tion of all-cause mor­tal­i­ty and fre­quen­cy of car­dio­vas­cu­lar-re­lat­ed hos­pi­tal­iza­tions com­pared to place­bo at 30 months.

Fol­low­ing news on the da­ta, Al­ny­lam stock fell 5%, po­ten­tial­ly on fear of an up­com­ing ri­val as the phar­ma com­pa­ny is al­so pur­su­ing a car­diomy­opa­thy ap­pli­ca­tion for patisir­an. And Io­n­is, which owns a ma­jor­i­ty stake in its spin­out Akcea (which is de­vel­op­ing in­ot­ersen for the same con­di­tion), al­so sank 5%.

Pfiz­er land­ed tafamidis when it ac­quired Fol­dRx in a buy­out back in 2010 as it pushed in­to the rare dis­ease field. Like oth­er phar­ma com­pa­nies, Pfiz­er was lured by the prospect of big re­turns for drugs that meet an ur­gent need in tiny pa­tient pop­u­la­tions.

Pfiz­er test­ed the drug in a rare neu­rode­gen­er­a­tive dis­ease called TTR-FAP, but got re­ject­ed by the FDA in 2012 af­ter try­ing to gain ap­proval with on­ly one tri­al as proof of the drug’s ef­fi­ca­cy. Tafamidis was ap­proved in 40 coun­tries — in­clud­ing the EU in 2011 — how­ev­er. It sells un­der the brand name Vyn­daquel.

In a state­ment ear­li­er this year, Pfiz­er said it’s still work­ing on a way for­ward in the US for tafamidis in TTR-FAP.

“As a leader in TTR amy­loi­do­sis, Pfiz­er Rare Dis­ease con­tin­ues to part­ner with the FDA re­gard­ing a po­ten­tial path to ap­proval for tafamidis for TTR-FAP, as we hope to achieve the ob­jec­tive of pro­vid­ing TTR-FAP pa­tients liv­ing in the Unit­ed States with the same treat­ment op­tion as those pa­tients liv­ing in many oth­er parts of the world.”

For now, tack­ling transthyretin car­diomy­opa­thy gives the drug a new av­enue for rev­enue gen­er­a­tion in the US. Bren­da Coop­er­stone, SVP and chief de­vel­op­ment of­fi­cer in Pfiz­er’s rare dis­ease unit, had this to say about the re­cent Phase III da­ta:

These topline re­sults are im­por­tant for peo­ple with transthyretin car­diomy­opa­thy and bring us one step clos­er to re­al­iz­ing the po­ten­tial for a new treat­ment for those in des­per­ate need. Pfiz­er Rare Dis­ease has been at the fore­front of im­prov­ing the un­der­stand­ing of transthyretin car­diomy­opa­thy, and we thank the pa­tients who par­tic­i­pat­ed in the tri­al and their fam­i­lies, as well as the physi­cians and in­ves­ti­ga­tion­al sites that con­tributed to this im­por­tant study. We look for­ward to shar­ing the de­tailed re­sults of the study with the car­dio­vas­cu­lar com­mu­ni­ty and dis­cussing these da­ta with health au­thor­i­ties to de­ter­mine an ap­pro­pri­ate reg­u­la­to­ry path for­ward.

 

NYU surgeon transplants an engineered pig kidney into the outside of a brain-dead patient (Joe Carrotta/NYU Langone Health)

No, sci­en­tists are not any clos­er to pig-to-hu­man trans­plants than they were last week

Steve Holtzman was awoken by a 1 a.m. call from a doctor at Duke University asking if he could put some pigs on a plane and fly them from Ohio to North Carolina that day. A motorcyclist had gotten into a horrific crash, the doctor explained. He believed the pigs’ livers, sutured onto the patient’s skin like an external filter, might be able to tide the young man over until a donor liver became available.

Biotech Half­time Re­port: Af­ter a bumpy year, is biotech ready to re­bound?

The biotech sector has come down firmly from the highs of February as negative sentiment takes hold. The sector had a major boost of optimism from the success of the COVID-19 vaccines, making investors keenly aware of the potential of biopharma R&D engines. But from early this year, clinical trial, regulatory and access setbacks have reminded investors of the sector’s inherent risks.

RBC Capital Markets recently surveyed investors to take the temperature of the market, a mix of specialists/generalists and long-only/ long-short investment strategies. Heading into the second half of the year, investors mostly see the sector as undervalued (49%), a large change from the first half of the year when only 20% rated it as undervalued. Around 41% of investors now believe that biotech will underperform the S&P500 in the second half of 2021. Despite that view, 54% plan to maintain their position in the market and 41% still plan to increase their holdings.

UP­DAT­ED: Agenus calls out FDA for play­ing fa­vorites with Mer­ck, pulls cer­vi­cal can­cer BLA at agen­cy's re­quest

While criticizing the FDA for what may be some favoritism towards Merck, Agenus on Friday officially pulled its accelerated BLA for its anti-PD-1 inhibitor balstilimab as a potential second-line treatment for cervical cancer because of the recent full approval for Merck’s Keytruda in the same indication.

The company said the BLA, which was due for an FDA decision by Dec. 16, was withdrawn “when the window for accelerated approval of balstilimab closed,” thanks to the conversion of Keytruda’s accelerated approval to a full approval four months prior to its PDUFA date.

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How to col­lect and sub­mit RWD to win ap­proval for a new drug in­di­ca­tion: FDA spells it out in a long-await­ed guid­ance

Real-world data are messy. There can be differences in the standards used to collect different types of data, differences in terminologies and curation strategies, and even in the way data are exchanged.

While acknowledging this somewhat controlled chaos, the FDA is now explaining how biopharma companies can submit study data derived from real-world data (RWD) sources in applicable regulatory submissions, including new drug indications.

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No­vo CEO Lars Fruer­gaard Jør­gensen on R&D risk, the deal strat­e­gy and tar­gets for gen­der di­ver­si­ty

 

I kicked off our European R&D summit last week with a conversation involving Novo Nordisk CEO Lars Fruergaard Jørgensen. Novo is aiming to launch a new era of obesity management with a new approval for semaglutide. And Jørgensen had a lot to say about what comes next in R&D, how they manage risk and gender diversity targets at the trendsetting European pharma giant.

John Carroll: I’m here with Lars Jørgensen, the CEO of Novo Nordisk. Lars, it’s been a really interesting year so far with Novo Nordisk, right? You’ve projected a new era of growing sales. You’ve been able to expand on the GLP-1 franchise that was already well established in diabetes now going into obesity. And I think a tremendous number of people are really interested in how that’s working out. You have forecast a growing amount of sales. We don’t know specifically how that might play out. I know a lot of the analysts have different ideas, how those numbers might play out, but that we are in fact embarking on a new era for Novo Nordisk in terms of what the company’s capable of doing and what it’s able to do and what it wants to do. And I wanted to start off by asking you about obesity in particular. Semaglutide has been approved in the United States for obesity. It’s an area of R&D that’s been very troubled for decades. There have been weight loss drugs that have come along. They’ve attracted a lot of attention, but they haven’t actually ever gained traction in the market. My first question is what’s different this time about obesity? What is different about this drug and why do you expect it to work now whereas previous drugs haven’t?

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Marty Duvall, Oncopeptides CEO

On­copep­tides stock craters as it pulls can­cer drug Pepax­to from the mar­ket

Shares of Oncopeptides crashed more than 70% in early Friday trading after the company said it’s pulling its multiple myeloma drug Pepaxto (melphalan flufenamide) from the US market after failing a confirmatory trial. The move will force the company to close its US and EU business units and enact significant layoffs.

The FDA had scheduled an adcomm meeting next Thursday to discuss Pepaxto, which first won accelerated approval in February and costs about $19,000 per course of treatment. The committee was to weigh in on whether the confirmatory trial demonstrated a worse overall survival in the treatment arm compared to the control arm.

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Oc­u­lar Ther­a­peu­tix ham­mered by a PhII fail­ure in dry eye dis­ease — shares tank

Ocular Therapeutix $OCUL has had its ups and downs in the 7 years since it went public. Friday was one of those down days.

The Bedford, MA-based biotech reported that its lead experimental eye drug, OTX-CSI (cyclosporine intracanalicular insert), failed a Phase II trial for dry eye disease. And the stock experienced one of its periodic meltdowns, dropping more than 30% ahead of the bell.

The therapy flat failed the primary endpoint: increased tear production at 12 weeks as measured by the Schirmer’s Test compared to the vehicle control group. And while investigators called out an improvement from baseline in “signs of dry eye disease as measured by total corneal fluorescein staining (CFS) and symptoms of dry eye disease as measured by the visual analogue scale (VAS) eye dryness in subjects treated with the OTX-CSI insert,” it wasn’t statistically significant.

Pfiz­er pitch­es its Covid-19 vac­cine for younger chil­dren ahead of ad­comm next week

Pfizer will present its case to the FDA’s vaccine adcomm next week, seeking authorization for a lower-dose version of its Covid-19 vaccine for kids ages 5 through 12, which the Biden administration said will likely begin rolling out early next month.

Two primary doses of the 10 µg vaccine (the dose for those ages 12 and up is 30 μg) given 3 weeks apart in this group of children “have shown a favorable safety and tolerability profile, robust immune responses against all variants of concern including Delta, and vaccine efficacy of 90.7% against laboratory-confirmed symptomatic COVID-19,” the company said in briefing documents ahead of next Tuesday’s meeting of the FDA’s Vaccines and Related Biological Products Advisory Committee.

David Lockhart, ReCode Therapeutics CEO

Pfiz­er throws its weight be­hind LNP play­er eye­ing mR­NA treat­ments for CF, PCD

David Lockhart did not see the meteoric rise of messenger RNA and lipid nanoparticles coming.

Thanks to the worldwide fight against Covid-19, mRNA — the genetic code that can be engineered to turn the body into a mini protein factory — and LNPs, those tiny bubbles of fat carrying those instructions, have found their way into hundreds of millions of people. Within the biotech world, pioneers like Alnylam and Intellia have demonstrated just how versatile LNPs can be as a delivery vehicle for anything from siRNA to CRISPR/Cas9.

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