Top 10 pipeline blowups, set­backs and sna­fus in H1 2016

Some years you have to stretch a bit to find a line­up of 10 no­table set­backs in the pipeline. In the first half of this year, I could have done one in each quar­ter and had a few left over for the dis­hon­or­able men­tion col­umn.

What we have here is a col­lec­tion of grue­some self-in­flict­ed wounds, more ev­i­dence that the home run swing looks good on pa­per and ter­ri­ble in ex­e­cu­tion and a new cat­e­go­ry: the drug that post­ed pos­i­tive da­ta but looked bad com­pared to the com­pe­ti­tion.

You can mark that last one in red; it will be back in fu­ture lists. Get­ting pos­i­tive da­ta against a place­bo or an old­er stan­dard of care is less and less like­ly to cut it. More and more con­tenders will need to be com­pared in­stant­ly against ri­vals in the pipeline. And with ex­pec­ta­tions run­ning high in fields like can­cer, more an­a­lysts (though not all) are go­ing to be mak­ing some re­al de­mands.

No doubt you’ll be think­ing of oth­er set­backs that didn’t make the list. And there were some doozies. J&J walked away from its an­ti-NGF pain drug ful­ranum­ab with bare­ly a nod of the head. No­var­tis’ “break­through” mus­cle drug bima­grum­ab failed a key study. Aduro’s com­bo failed a key test. Es­pe­ri­on was evis­cer­at­ed af­ter it told in­vestors that the FDA was chang­ing course on its tri­al de­mands.

So it goes.

Drug de­vel­op­ment is a tough field. Just ask the fol­low­ing com­pa­nies.

 


1. Clo­vis On­col­o­gy  rocile­tinib

CEO Patrick Ma­haffy

Boul­der, CO
$CLVS

CEO: Patrick Ma­haffy

The prob­lem: Clo­vis On­col­o­gy billed its lead-up to the sub­mis­sion for rocile­tinib as an Olympic dive. For play­ing a di­rect role in turn­ing the dive in­to a world-class bel­ly flop, the biotech wins the top spot as H1’s biggest im­plo­sion.

Clo­vis watch­ers will re­mem­ber that the com­pa­ny once played ri­val to As­traZeneca’s Tagris­so (9291). But then the FDA called them out on some sus­pi­cious tu­mor re­spons­es and a slew of con­firmed hits had to be trad­ed for miss­es. Its stock col­lapsed, FDA in­sid­ers could bare­ly con­ceal their dis­taste and the com­pa­ny lost a con­sid­er­able amount of rep along with the bulk of its mar­ket cap.

Ro­ci was quick­ly buried and now no men­tion is made of it — even when the FDA’s PDU­FA date rolled around June 28 with­out so much as a 2-sen­tence SEC fil­ing to mark the for­mal re­jec­tion.

Cur­rent­ly un­der in­ves­ti­ga­tion by the feds, Clo­vis is now ramp­ing up a new ef­fort to back ru­ca­parib, which finds it­self in yet an­oth­er late-stage horse race with se­ri­ous com­pe­ti­tion. Fail­ure here is not an op­tion, but it’s a very re­al pos­si­bil­i­ty.


2. As­traZeneca — ZS-9/treme­li­mum­ab

CEO Pas­cal So­ri­ot

Lon­don
$AZN

CEO: Pas­cal So­ri­ot

The prob­lems: You don’t pay $2.7 bil­lion for a hy­per­kalemia drug that’s await­ing reg­u­la­to­ry ac­tion at the FDA, tell every­one you’re go­ing to make more than a bil­lion dol­lars a year off of it and then get hand­ed a re­jec­tion with­out hav­ing a few red faces to show for it.

As­traZeneca says it won’t have to run a new tri­al for ZS-9, but it does have some ex­plain­ing to do about man­u­fac­tur­ing that was se­ri­ous enough to war­rant a CRL. As­traZeneca is a Big Phar­ma in a hur­ry, though, and caught up in a bid­ding war it bar­reled in­to a set­back.

ZS-9 is now like­ly on hold un­til around the end of the year or ear­ly 2017 as Re­lyp­sa’s ri­val Veltas­sa con­tin­ues to make progress on the mar­ket. Yet to be de­cid­ed: Which of these drugs will have the most fa­vor­able safe­ty pro­file, though ZS-9 still has sev­er­al ad­vo­cates on its side.

As­traZeneca, mean­while, al­so had to ex­plain a so­lo set­back for the CT­LA-4 drug treme­li­mum last Feb­ru­ary. A top prospect at As­traZeneca, the drug failed a Phase IIb tri­al for mesothe­lioma af­ter in­ves­ti­ga­tors re­cruit­ed 571 pa­tients for the test.


3. Bio­Marin  dris­apersen

San Rafael, CA
$BM­RN

CEO: Jean-Jacques Bi­en­aimé

The prob­lem: Bio­Marin paid $680 mil­lion to get dris­apersen in its buy­out of Pros­en­sa. But that big gam­ble end­ed up be­ing more than a com­plete write-off.

First, the FDA re­ject­ed the drug, which had al­ready failed a Phase III in the hands of Glax­o­SmithK­line, which quick­ly washed its hands of the drug and walked away. Then the EMA said no as well, and Bio­Marin not on­ly jet­ti­soned the lead drug, the com­pa­ny deep-sixed three fol­low-up ther­a­pies it was work­ing with in Phase II.

The com­pa­ny’s in­ves­ti­ga­tors couldn’t get any­where with their ar­gu­ment that there was a treat­ment strat­e­gy that could help boys af­fect­ed by the lethal dis­ease. The out­side and in­side ex­perts at the FDA gave that dis­cus­sion short shrift. Now the R&D group is go­ing back to the draw­ing board as Sarep­ta pre­pares to see if it can sur­vive an at­tempt at an ac­cel­er­at­ed ap­proval.


4. Alk­er­mes — ALKS-5461

CEO Richard Pops

Dublin
$ALKS

CEO Richard Pops

The prob­lem: A few weeks be­fore the read­out on the first two stud­ies for ALKS-5461 hit in Jan­u­ary, CEO Richard Pops called it a pend­ing “seis­mic” event.

And how.

The first six months of this year was no time to dis­ap­point in­vestors grap­pling with a bear mar­ket for biotech stocks. Alk­er­mes learned that les­son the hard way when its de­pres­sion drug failed two stud­ies and the mar­ket quick­ly re­lieved it of $4 bil­lion in mar­ket cap.

The rea­son de­vel­op­ers have three or four Phase III stud­ies for a de­pres­sion drug is be­cause they are like­ly to fail. One af­ter an­oth­er has been done in by the place­bo ef­fect, but Alk­er­mes be­lieved that it had an edge with a nov­el new tri­al de­sign aimed at thwart­ing that out­come. So two down means the drug is dead, right?

Not quite. The com­pa­ny came up with some post hoc rea­sons to be­lieve they were still on to some­thing and some an­a­lysts be­lieve that a pos­i­tive read­out for the third study could yet sal­vage the sit­u­a­tion. But it’s a nar­row, dan­ger­ous path to be trav­el­ing at this stage.

Alk­er­mes’ stock has been mak­ing a come­back since the com­pa­ny was blast­ed, but it’s been a slow climb.


5. In­fin­i­ty Phar­ma­ceu­ti­cals — du­velis­ib

CEO Ade­lene Perkins

Cam­bridge, MA
$IN­FI

CEO Ade­lene Perkins

The prob­lem: Some­times even a sta­tis­ti­cal win can be a big los­er. Case in point: Du­velis­ib.

A few weeks ago their lead drug hit the pri­ma­ry end­point in the Phase II study for in­do­lent non-Hodgkin lym­phoma, and its part­ner Ab­b­Vie quick­ly fold­ed its tent, dis­missed their $250 mil­lion up­front part­ner­ing pay­ment and hit the streets.

It was good, but just not good enough con­sid­er­ing the com­pe­ti­tion.

In­fin­i­ty suf­fered a thump­ing on Wall Street, but af­ter back-to-back re­struc­tur­ings that cost 146 jobs (for­mer “cit­i­zen-own­ers”) the com­pa­ny says it can work things out in its fa­vor. Perkins, top sci­en­tist Ju­lian Adams and every­one else still in for the ride can earn a re­ten­tion bonus for stay­ing on board. But af­ter three strikes for three top drugs, some may start to ques­tion why they still have the bat.


6. Celldex — Rin­te­ga rindopepimut

Hamp­ton, NJ
$CLDX

CEO: An­tho­ny Maruc­ci

Can­cer vac­cines have had a woe­ful record over the last cou­ple of years. Celldex added an­oth­er dose of dis­as­ter af­ter its try with Rin­te­ga proved so in­ef­fec­tive at treat­ing glioblas­toma the in­de­pen­dent mon­i­tors sug­gest­ed that in­ves­ti­ga­tors go ahead and pull the plug on the piv­otal study last March.

The over­all sur­vival rate ac­tu­al­ly fa­vored the con­trol arm over the drug.

This was a drug that had in­spired con­sid­er­able con­fi­dence from the Phase II, which some in­vestors thought should have been good enough to fu­el an at­tempt at an ac­cel­er­at­ed ap­proval. Some an­a­lysts were al­so let down at the time.

Celldex has sev­er­al da­ta read­outs com­ing up. It’s in bad need of good news.


7. PTC Ther­a­peu­tics — Translar­na ataluren

CEO Stu­art Peltz

South Plain­field, NJ
$PTCT

CEO Stu­art Peltz

The prob­lem: The FDA doesn’t of­ten refuse to file an ap­pli­ca­tion, but it made an ex­cep­tion for PTC.

PTC gets some cred­it for ad­mit­ting that the agency said it didn’t have the da­ta need­ed for an ap­proval of Translar­na (ataluren), which pos­si­bly wasn’t too sur­pris­ing as their drug had failed a mid-stage and piv­otal study for Duchenne mus­cu­lar dy­s­tro­phy.

Reg­u­la­tors have carved out a spe­cial sta­tus for ex­per­i­men­tal drugs that treat Duchenne, though. That helps ex­plain why the Eu­ro­peans gave it a con­di­tion­al ap­proval two years ago and still have done noth­ing af­ter the lat­est set­back. Even NICE is ne­go­ti­at­ing over what it will pay to cov­er the drug, while it has gath­ered sig­nif­i­cant ev­i­dence that the drug doesn’t work well at all.

PTC may have thought that same reg­u­lar­i­ty gen­eros­i­ty would ex­tend to Wash­ing­ton DC. But that was wrong.


8. Io­n­is Phar­ma­ceu­ti­cals — IO­N­IS-TTRR

CEO Stan­ley Crooke

Carls­bad, CA
$IONS

CEO Stan­ley Crooke

The prob­lem: Io­n­is changed its name from Isis to put a lit­tle dis­tance be­tween it­self and the no­to­ri­ous ter­ror­ist group. But late­ly, it’s been ter­ror­iz­ing in­vestors with a safe­ty haz­ard on its lead an­ti­sense pro­gram.

Io­n­is CEO Stan­ley Crooke took the lead role in the dra­ma, ex­plain­ing dur­ing a call with an­a­lysts in May that their drug – at high dos­es — had been linked to per­plex­ing low platelet counts in pa­tients. That caused the FDA to trig­ger a clin­i­cal hold on a pro­gram, spurring Glax­o­SmithK­line to put a planned Phase III on a back burn­er.

Rather than re­as­sure in­vestors, Crooke seemed on­ly to make mat­ters steadi­ly worse on his call, de­clin­ing to an­swer some ques­tions, such as whether any pa­tients had died. He pled for more time, but in­vestors are im­pa­tient with un­cer­tain­ty and fear.

Fur­ther com­pli­cat­ing Io­n­is’ po­si­tion is its close com­pe­ti­tion with Al­ny­lam, which was boost­ed on the tra­vails of its ri­val.


9. Ab­b­Vie — Ro­va-T

CEO Richard Gon­za­lez

North Chica­go, IL
$AB­BV

CEO: Richard Gon­za­lez

The prob­lem: Ab­b­Vie is de­vel­op­ing a rep­u­ta­tion as an undis­ci­plined buy­er. And you can put much of that down to Ro­va-T now.

Ab­b­Vie paid $5.8 bil­lion in cash to buy Stem­cen­trx, large­ly based on the promise of the lit­tle-known can­cer drug, which plays along a path­way for stem cells. And it has promised $4 bil­lion more in mile­stones.

But at AS­CO the pre­lim­i­nary da­ta for small cell lung can­cer showed a one-month sur­vival ad­van­tage over his­tor­i­cal trends, caus­ing more than a few an­a­lysts to do a dou­ble take on the drug and the deal. Ab­b­Vie can still turn this around, but the pub­lic de­but of this drug turned in­to a prat­fall.


10. Reg­u­lus — RG-101

CEO Paul Grint

La Jol­la, CA
$RGLS

CEO: Paul Grint

The prob­lem: Reg­u­lus got start­ed nine years ago as a promis­ing joint ven­ture of Al­ny­lam and Io­n­is, which you passed in the num­ber eight spot on this list. Now in the lead up to its 10th an­niver­sary, the com­pa­ny is faced with a fresh clin­i­cal hold on its lead pro­gram.

The biotech’s whole rea­son for be­ing cen­ters on its mi­croR­NA tech. The plat­form led it to a drug, RG-101, that is billed as a po­ten­tial one-time treat­ment for he­pati­tis C. It’s al­so now been linked to two cas­es of jaun­dice, which trig­gered the hold.

The reg­u­la­to­ry ac­tion raised all sorts of thorny is­sues for the com­pa­ny, in­clud­ing why it would have a top pipeline drug in a field where sev­er­al new cures dom­i­nate the field. Even if RG-101 turns out to be a suc­cess, it would still face tough com­pe­ti­tion. (There is no tougher com­peti­tor than Gilead, which al­ways plays to win.)

He­pati­tis C is al­so a huge mar­ket with mil­lions of po­ten­tial pa­tients, of course, but that al­so means the reg­u­la­to­ry bar on safe­ty is high. And now it has to face these tra­vails with a bad­ly beat­en down stock price.

That’s not a pret­ty pic­ture.

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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UP­DAT­ED: 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.

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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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