Tired of be­ing dumped by phar­ma part­ners, Van­der­bilt’s neu­ro­science team takes a bold aim at the clin­ic

Jeff Conn

As the di­rec­tor of the Van­der­bilt Cen­ter for Neu­ro­science Drug Dis­cov­ery, Jeff Conn has spe­cial­ized in pre­clin­i­cal de­vel­op­ment work on new drugs bio­phar­ma com­pa­nies can take in­to the clin­ic. He’s al­so seen two of the big com­pa­nies he’s part­nered with — Bris­tol-My­ers Squibb and As­traZeneca — make sud­den, un­ex­pect­ed re­treats from the field, which has known a steady di­et of fail­ures and set­backs in re­cent years.

So this time, in­stead of li­cens­ing out his drug and tak­ing the risk of an­oth­er ear­ly dis­ap­pear­ance, Conn and his col­leagues at Van­der­bilt are tak­ing their drug di­rect­ly in­to an ear­ly-stage hu­man study in a rare — per­haps unique — dis­play of aca­d­e­m­ic risk-tak­ing in the clin­ic.

“This drug can­di­date is a pos­i­tive al­losteric mod­u­la­tor of an M1 (mus­carinic) re­cep­tor,” says Conn, re­fer­ring to a neu­ro­trans­mit­ter dis­rupt­ed in Alzheimer’s and schiz­o­phre­nia. This is a well plumbed field, with drugs that have been tried in the clin­ic and failed, says Conn, but no one was able to de­vel­op high­ly se­lec­tive mol­e­cules—at least not un­til now.

“That’s what we are now ad­vanc­ing,” he tells me, fo­cus­ing on cog­ni­tive im­pair­ment in ear­ly to mod­er­ate Alzheimer’s and al­so in schiz­o­phre­nia. And his team is con­cen­trat­ing on some symp­toms that haven’t been ad­dressed so far, in­clud­ing: so­cial with­draw­al, lack of mo­ti­va­tion and a lack of abil­i­ty to ex­pe­ri­ence re­ward.

“The mod­el we fo­cused on has been to part­ner with com­pa­nies rel­a­tive­ly ear­ly, cer­tain­ly be­fore clin­i­cal de­vel­op­ment,” Conn adds. “The shift­ing land­scape in the phar­ma in­dus­try (which in­clud­ed As­traZeneca’s re­cent de­ci­sion to qui­et­ly scut­tle its vir­tu­al iMed mod­el for neu­ro­science) has re­al­ly caused us to re­think that.”

“For this tar­get, we’re tak­ing it through Phase I, make sure there are none of the ad­verse ef­fect li­a­bil­i­ty seen in the ‘90s,” he adds. “That would be a ma­jor step for de-risk­ing, a good point for part­ner­ing with a ma­jor com­pa­ny. We can al­so show we could en­gage the re­cep­tor in the CNS.”

Craig Lind­s­ley

This is no small un­der­tak­ing for an aca­d­e­m­ic group, em­pha­sizes Craig Lind­s­ley, co-di­rec­tor and chief of med­i­c­i­nal chem­istry at the cen­ter.

“We all came from in­dus­try,” he notes. “Do­ing an IND on your own is quite an un­der­tak­ing, in­clud­ing tasks large­ly un­known in aca­d­e­m­ic cir­cles,” such as meet­ing rules on man­u­fac­tur­ing and prod­uct for­mu­la­tion. “It’s an ex­tra day job for every­body. It helped us un­der­stand we could do this. And next time it will be eas­i­er and faster.”

Next time will come soon enough, he says, with an ear­ly stage pipeline in the mak­ing. The NIH and non­prof­its — in­clud­ing The William K. War­ren Foun­da­tion — have pro­vid­ed the ad­di­tion­al fi­nan­cial fire­pow­er need­ed to push ahead in­to the clin­ic. Af­ter they get through Phase I, he and Conn be­lieve that they can go back and do high­er val­ue deals af­ter nail­ing down some sol­id hu­man da­ta on safe­ty and ear­ly ef­fi­ca­cy sig­nals in healthy vol­un­teers. And if Big Phar­ma isn’t in­ter­est­ed, then per­haps a small­er biotech or spin­out can do the job.

The key point, they both say, is that they want their drugs to go as far as pos­si­ble through the clin­ic, and all the way to pa­tients if they can. Next time one of their drugs fails to make it, they don’t want it to be be­cause yet an­oth­er com­pa­ny pulled a sud­den and un­ex­pect­ed left turn in their clin­i­cal strat­e­gy. And for that, they’re will­ing to as­sume some of the added risk that has fright­ened much big­ger play­ers out of the Val­ley of Death.

Biogen CEO Michel Vounatsos (via Getty Images)

With ad­u­canum­ab caught on a cliff, Bio­gen’s Michel Vounatsos bets bil­lions on an­oth­er high-risk neu­ro play

With its FDA pitch on the Alzheimer’s drug aducanumab hanging perilously close to disaster, Biogen is rolling the dice on a $3.1 billion deal that brings in commercial rights to one of the other spotlight neuro drugs in late-stage development — after it already failed its first Phase III.

The big biotech has turned to Sage Therapeutics for its latest deal, close to a year after the crushing failure of Sage-217, now dubbed zuranolone, in the MOUNTAIN study.

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Pascal Soriot (AP Images)

UP­DAT­ED: As­traZeneca, Ox­ford on the de­fen­sive as skep­tics dis­miss 70% av­er­age ef­fi­ca­cy for Covid-19 vac­cine

On the third straight Monday that the world wakes up to positive vaccine news, AstraZeneca and Oxford are declaring a new Phase III milestone in the fight against the pandemic. Not everyone is convinced they will play a big part, though.

With an average efficacy of 70%, the headline number struck analysts as less impressive than the 95% and 94.5% protection that Pfizer/BioNTech and Moderna have boasted in the past two weeks, respectively. But the British partners say they have several other bright spots going for their candidate. One of the two dosing regimens tested in Phase III showed a better profile, bringing efficacy up to 90%; the adenovirus vector-based vaccine requires minimal refrigeration, which may mean easier distribution; and AstraZeneca has pledged to sell it at a fraction of the price that the other two vaccine developers are charging.

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Covid-19 roundup: Eu­rope pur­chas­es 80M dos­es of Mod­er­na's vac­cine; CO­V­AXX se­cures $2.8B in emerg­ing mar­ket pre-or­ders

With the announcement of its vaccine efficacy data last week, Moderna is starting to line up customers for its Covid-19 mRNA jabs.

The Massachusetts-based biotech announced Wednesday it has agreed to sell an initial round of 80 million doses to the European Commission, with the option to double the amount to 160 million. Once the member states rubber stamp the approval, the deal will be finalized.

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Bahija Jallal (file photo)

TCR pi­o­neer Im­muno­core scores a first with a land­mark PhI­II snap­shot on over­all sur­vival for a rare melanoma

Bahija Jallal’s crew at TCR pioneer Immunocore says they have nailed down a promising set of pivotal data for their lead drug in a frontline setting for a solid tumor. And they are framing this early interim readout as the convincing snapshot they need to prove that their platform can deliver on a string of breakthrough therapies now in the clinic or planned for it.

In advance of the Monday announcement, Jallal and R&D chief David Berman took some time to walk me through the first round of Phase III data for their lead TCR designed to treat rare, frontline cases of metastatic uveal melanoma that come with a grim set of survival expectations.

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Jason Kelly, Ginkgo Bioworks CEO (Kyle Grillot/Bloomberg via Getty Images)

Af­ter Ko­dak de­ba­cle, US lends $1.1B to a syn­thet­ic bi­ol­o­gy com­pa­ny and their big Covid-19, mR­NA plans

In mid-August, as Kodak’s $765 million government-backed push into drug manufacturing slowly fell apart in national headlines, Ginkgo Bioworks CEO Jason Kelly got a message from his company’s government liaison: HHS wanted to know if they, too, might want a loan.

The government’s decision to lend Kodak three quarters of a billion dollars raised eyebrows because Kodak had never made drugs before. But Ginkgo, while not a manufacturing company, had spent the last decade refining new ways to produce materials inside cells and building automated facilities across Boston.

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Vivek Ramaswamy (Jeff Rumans/JPM 2020)

Urovan­t's lead drug dis­ap­points in mid-stage study as first big FDA de­ci­sion looms

Just as Urovant gets ready for its first big FDA decision on vibegron, the drug has flopped in what would’ve been a follow-on indication.

In a Phase IIa trial involving women with abdominal pain due to irritable bowel syndrome, vibegron failed to meet the bar on improving “average worst abdominal pain” over 12 weeks, compared to placebo, among IBS-D patients.

There were actually slightly more responders in the placebo group than in the drug arm, with only 40.9% of those randomized to vigebron achieving at least a 30% decrease in “worst abdominal pain” in the past 24 hours. The trial enrolled 222 women but only 189 completed the study.

Gen­mab ax­es an ADC de­vel­op­ment pro­gram af­ter the da­ta fail to im­press

Genmab $GMAB has opted to ax one of its antibody-drug conjugates after watching it flop in the clinic.

The Danish biotech reported Tuesday that it decided to kill their program for enapotamab vedotin after the data gathered from expansion cohorts failed to measure up. According to the company:

While enapotamab vedotin has shown some evidence of clinical activity, this was not optimized by different dose schedules and/or predictive biomarkers. Accordingly, the data from the expansion cohorts did not meet Genmab’s stringent criteria for proof-of-concept.

Vas Narasimhan, Novartis CEO (Jason Alden/Bloomberg via Getty Images)

Vas Narasimhan's 'Wild Card' drugs: No­var­tis CEO high­lights po­ten­tial jack­pots, as well as late-stage stars, in R&D pre­sen­ta­tion

Novartis is always one of the industry’s biggest R&D spenders. As they often do toward the end of each year, company execs are highlighting the drugs they expect will most likely be winners in 2021.

And they’re also dreaming about some potential big-time lottery tickets.

As part of its annual investor presentation Tuesday, where the company allows investors and analysts to virtually schmooze with the bigwigs, Novartis CEO Vas Narasimhan will outline what he thinks are the pharma’s “Wild Cards.” The slate of five experimental drugs are those that Novartis hopes can be high-risk, high-reward entrants into the market over the next half-decade or so, and cover a wide range of indications.

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The ad­u­canum­ab co­nun­drum: The PhI­II failed a clear reg­u­la­to­ry stan­dard, but no one is cer­tain what that means any­more at the FDA

Eighteen days ago, virtually all of the outside experts on an FDA adcomm got together to mug the agency’s Billy Dunn and the Biogen team when they presented their upbeat assessment on aducanumab. But here we are, more than 2 weeks later, and the ongoing debate over that Alzheimer’s drug’s fate continues unabated.

Instead of simply ruling out any chance of an approval, the logical conclusion based on what we heard during that session, a series of questionable approvals that preceded the controversy over the agency’s recent EUA decisions has come back to haunt the FDA, where the power of precedent is leaving an opening some experts believe can still be exploited by the big biotech.

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