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Monday, May 7, 2018

Pfizer putting vaccines front and center in R&D

On Pfizer’s first-quarter earnings call, CEO Ian Read drew up a long list of R&D programs the company’s expecting to drive future growth. But when Bernstein analyst Tim Anderson asked him to narrow it down, Read mentioned vaccines first.
“It’s difficult to pick out one specific product. But I would say when you look at the totality, I would focus on our vaccine franchise, especially C. difficile,” said Read. He maintained that Pfizer pipeline is “undervalued,” but the question is, could the collective vaccine pipeline make Pfizer watchers up their expectations?
After Sanofi abandoned its Clostridium difficile vaccine last December in light of ominous phase 3 interim data, Pfizer’s PF-06425090 took over as the leading C. diff hopeful. The recombinant vaccine is undergoing a 16,000-patient phase 3 scheduled to read out in September 2020.
Analysts have pegged the C. diff vaccine market at about $1 billion, but Pfizer might have to split it with French firm Valneva, which has also passed phase 2 with its own candidate. And as GlobalData analysts previously said, the Valneva vaccine’s contrasting method of action “could give it an advantage when it comes to successfully meeting phase 3 trial endpoints.”
Pfizer needs that C. diff boost to the top line, as its pneumococcal blockbuster Prevnar 13—the world’s best-selling vaccine—continues to decline. For the first quarter, global Prevnar 13 sales slightly decreased by 3% to $1.38 billion. While the precipitous 12% drop in the U.S. is particularly alarming, COO Albert Bourla turned to the 45% jump in emerging markets for a better picture.

“The most important is, we just launched in China, where we expect that we will have very good uptake,” said Bourla, who recently took the COO title. But growth from China might not last for long. Local firm Walvax recently submitted to Chinese authorities its version of a pneumococcal 13-strain recombinant shot, which was put under expedited review in March.
Planning to fill the gap left by Prevnar, the New York pharma has a next-generation candidate that could cover 20 serotypes of pneumococcal disease. It expects proof-of-concept data later this year and plans to begin a pivotal trial in 2019. But competition awaits there, too.
Merck & Co.’s 15-valent shot V114 has just embarked on two phase 3 trials. For one of them, investigators will test it against Pfizer’s 13-strain Prevnar shot, and Merck executives say they’re confident their version can triumph.

“The serology data … are really very, very strong for the V114 vaccine. And it provides the opportunity to both strengthen the response to serotypes covered by other pneumococcal conjugate vaccines, but also to add additional stereotypes which will be important in terms of preventing invasive pneumococcal disease,” said Merck R&D head Roger Perlmutter on the company’s Q1 call.
A partnership between Astellas and Affinivax is also working on a new challenger to Prevnar, but the competition between Pfizer and Merck seems more imminent. Bourla said he anticipates “launching in a competitive timeframe to Merck, a much broader spectrum of coverage quality.”
Other than those products, Pfizer has a phase 2 Staphylococcus aureus vaccine program, and the company is in discussions with the FDA about expanding that study into a phase 3 pivotal trial, Read said during the call.

Aurobindo bids $1.6B for Novartis’ U.S. dermatology generics: report

As Novartis tries to shed some of its Sandoz offerings in the U.S. under intense pricing pressure, the drugmaker may have found a buyer for a generic dermatology business. India’s Aurobindo has submitted a $1.6 billion offer for the unit, according to Livemint.
The deal would include manufacturing facilities and other infrastructure to support the products, according to the publication, which cites unnamed sources. Private equity funds and other drugmakers have also expressed interest in the business, according to one of Livemint’s sources.
Novartis has been looking at selling, or abandoning, some generic offerings as pricing in the U.S. has come under fire. The drugmaker’s CEO Vas Narasimhan confirmed on a conference call last month that the review is still underway.
The drugmaker picked up generic dermatology business Fougera for $1.5 billion back in 2012 and started considering a sale late last year, Bloomberg reported. Between those two decisions, the situation at both at Novartis and around the generic industry has changed. Originally, the drugmaker planned to invest in and grow the business.
The Sandoz business review comes following years of tough pricing dynamics in the U.S. At Novartis, the company has increased its presence in oncology, biosimilars and complex generics.
As struggling generics players face intense pricing pressure, they’ve turned to M&A as one way to fight back. Amneal and Impax have merged to gain scale, and market watchers predict Endo could try dealmaking of its own.
The Novartis deal talk closely follows Sanofi and Advent International’s announcement that the companies are in exclusive talks for Sanofi’s €2 billion European generics unit.

Gene Therapies for Hemophilia Could Hit $1.5M Price

As we get closer to seeing the U.S. Food and Drug Administration (FDA) green light the first gene therapy for hemophilia, analysts estimate that the cost of the probable one-time treatment could have a whopping price-tag of $1.5 million.
The predictions are primarily based on the current pricing of Spark Therapeutics’ recently-approved gene therapy treatment Luxturna, which costs about $425,000 for a treatment. Luxturna was the first gene therapy for eye disease approved by the FDA. Its approval marks the first time the FDA has approved a directly administered gene therapy that targets a disease caused by mutations in a specific gene.
When Luxturna was approved earlier this year FDA Commissioner Scott Gottlieb said he believes gene therapy “will become a mainstay in treating, and maybe curing, many of our most devastating and intractable illnesses.”
Hemophilia could be one of those devastating illnesses that gene therapy can cure. In December Spark Therapeutics and its partner Pfizer showed off stunning interim data that showed a dramatic turnaround in some hemophilia patients. In the Phase I/II trial the patients were injected with SPK-9001, a therapy that helps hemophilia patients generate Factor IX, a blood-clotting protein missing in people with hemophilia B. Following a single treatment with SPK-9001 the presence of Factor IX activity in the body was 34 percent of normal. That is a huge change in the lives of the patients. As a result, annualized bleeding rate (ABR) was cut by 97 percent, from a mean rate of 11.1 events annually before treatment to 0.4 events per year after treatment. Factor IX concentrate use was cut by 99 percent, BioSpace reported at the time. Treatment for hemophilia B is repeated intravenous infusions of either plasma-derived or recombinant factor IX. If the clinical data holds up, SPK-9001 could be a veritable cure for the disease.
And that cure will have a cost. A Leering analyst estimated that the price for a gene therapy cure for hemophilia B will be about $1.5 million per patient. Leerink did note that the price could actually approach $2 million, but given uncertainties about responsiveness to the treatment, rebates and other pricing factors, the $1.5 million was considered to be a “reasonable estimate.” That is an increase in cost from the previously estimated $350,000 to $500,000.
“We believe the manufacturers are testing the waters currently as they embark on Phase 3 trials in order to determine where payors push back significantly. Based on our checks, a price somewhere in the range of $1-2M per patient seems most likely,” Leerink said in its note.
To keep things in perspective, Genentech’s approved hemophilia A clotting drug Hemlibra has a price tag of $425,000. During clinical trials, Hemlibra was shown to substantially reduce bleeds in adults and children who have hemophilia A with Factor VIII inhibitors. Hemlibra is not a one-and-done type of gene therapy. What the price will be for that kind of treatment is still to be determined. Companies like Spark and BioMarin will have to complete clinical studies and gain approval before a final cost will be determined.

Wave of Regenerative Therapies are Being Developed to Treat Patient Needs

Artificial body parts have been around for some time. Patients have access to artificial limbs, hearts, eyes, skin and more thanks to the innovation of biomedical engineers. As technology improves, so do the advancements in these man-made devices.
But there’s a new trend in personalized medicine that is capable of harnessing parts of a patient’s own body, typically with autologous cells, to develop regenerative therapies. Of late there have been a number of companies involved in this groundbreaking area. One of the companies leading the charge is Utah-based PolarityTE. This week the company announced that its preclinical OsteoTE product “regenerated complex, hierarchically-organized, corticocancellous bone within critically-sized bone defects in standard preclinical large animal models.” Not only that, but the company said OsteoTE regenerated bone with function and composition reflective of native bone. The company said this is something that has never been seen before.
OsteoTE uses bone from the patient as a base for its regeneration process. The bone is prepared and used to treat the defect in less than 24 hours, the company announced.
Denver Lough, chairman and chief executive officer of PolarityTE, said the results of the preclinical OsteoTE studies mirror those that were seen with the company’s SkinTE product, which has been designed to regenerate full-thickness, fully-functional skin. Lough said the OsteoTE studies are a confirmation of the company’s platform technologies.
“We believe there are substantial limitations of the existing treatment options across the numerous applications of OsteoTE, including treatment of bone defects and nonhealing bone within craniomaxillofacial, orthopedic, spine, hand, and foot/ankle specialties. We look forward to continued development and commercialization of products that will change the practice of medicine,” Lough said in a statement.
PolarityTE is so confident in the capabilities of OsteoTE that it is planning for an initial limited-market release of OsteoTE in late 2018. PolarityTE said it will target specialty markets in a stepwise fashion, similar to what it did with SkinTE.  Last fall PolarityTE registered SkinTE with the U.S. Food and Drug Administration in order to accelerate commercialization.
PolarityTE’s technology uses parts of the patient’s body to support the regenerative process as opposed to artificially manipulated individual cells. From the healthy autologous tissue, PolarityTE is able to create a “self-propagating product designed to enhance and stimulate the patient’s own cells to regenerate the target tissues.”
PolarityTE is part of a growing number of companies that are developing these regenerative treatments for body parts. Another company nearing what it hopes will be approval from the U.S. Food and Drug Administration is Massachusetts-based Histogenics. The company has initiated a Phase III clinical trial in the United States under a Special Protocol Assessment with the U.S. Federal Drug Administration to study its proprietary NeoCart replacement cartilage technology. Top-line, one-year superiority data is expected to be reported in the third quarter of 2018, followed by a potential Biologics License Application (BLA) filing. If all goes as hoped, Histogenics could launch NeoCart by 2019.
Like other personalized medicine programs, Histogenics’ technology harnesses the body’s own cells to engineer a treatment, in this case, new cartilage that can be surgically placed in a patient’s knee to alleviate knee pain from osteoarthritis. NeoCart is a cartilage-like, tissue-engineered implant created from a patient’s own cartilage cells.
Last year Amgen leaped into the world of regenerative medicine with the intention of developing a complex therapy for lost neuronal tissue due to neurodegeneration and neurotrauma. Amgen forged an agreement with Fortuna Fix to use a patient’s own neural stem cells (autologous) produced by direct reprogramming (“drNPCs”) in order to replace lost neuronal tissue.

FDA Gives Genentech Tecentriq Priority Review for Lung Cancer Triple Combo

The U.S. Food and Drug Administration (FDA) granted Genentech’s Tecentriq triple combination with Avastain (bevacizumab), paclitaxel and carboplatin (chemotherapy) Priority Review for first-line treatment of patients with metastatic non-squamous non-small cell lung cancer (NSCLC). The agency also accepted the supplemental Biologics License Application (sBLA).
The sBLA was based on data from the Phase III IMpower150 trial, which met its co-primary endpoints of overall survival (OS) and progression-free survival (PFS). The safety data was consistent with the safety profiles of each of the individual medicines.
Tecentriq is one of five currently commercially available PD-1/L1 drugs, inclulding Bristol-Myers Squibbs Opdivo, Merck’s Keytruda, AstraZenecas Imfinzi and Pfizer/Merck KGaA’s Bavencio.
If this combination therapy is approved, it should help Genentech and its parent company, Roche, remain in the competition for anti-PD/L1 drugs. Bristol-Myers Opdivo brought in $1.51 billion in this year’s first quarter, followed by Merck’s Keytruda, which brought in $1.46 billion in the same quarter. Tecentriq is far behind, bringing in $139 million in the first quarter.
And the market is expected to get even more crowded, with Sanofi and Regeneron Pharma’s cemiplimab reporting positive Phase III data in December for advanced cutaneous squamous cell carcinoma (CSCC), a type of skin cancer, and a regulatory submission in the first quarter of 2018.
The FDA will make a decision on cemiplimab by October 28, 2018. It has also been granted a priority review. The FDA will also consider Phase I data from two advanced CSCC expansion cohorts. The drug is also being reviewed in Europe. The European Medicines Agency (EMA) accepted the Marketing Authorization Application in early April.
There are also three more checkpoint inhibitors being reviewed in China, with many more being evaluated in the clinic. The Journal of Hematology & Oncology reported in July 2017, that Chinese pharmaceutical companies have developed eight anti-PD-1/PD-L1 inhibitors as of January 7, 2017, and four of those drugs had been approved by Chinese regulatory officials for Phase I clinical trials in patients with advanced solid tumors and NSCLC. “Another four drugs,” the authors wrote, “(Jirnuo monoclonal antibodies, GLS-0101, KN035, and WBP3155) are now being considered by the CFDA for clinical trial approval. In November 2016, the PD-1 inhibitor KN035, that is administered by subcutaneous injection, received approval from the American Food and Drug Administration for clinical trial conduction.”
Tecentriq has been approved by the FDA for people with metastatic NSCLC whose disease has progressed during or after platinum-containing chemotherapy, and have progressed on an appropriate FDA-approved targeted therapy if their cancer has ALK or EGFR gene abnormalities.
“Our Phase III results showed Tecentriq in combination with Avastin, paclitaxel and carboplatin has the potential to provide a significant survival benefit in the initial treatment of metastatic non-squamous non-small cell lung cancer,” said Sandra Horning, Roche’s chief medical officer and head of Global Product Development, in a statement. “We are working closely with the FDA to bring this treatment regimen to people with this type of lung cancer as soon as possible.”

Lannett (LCI) Acquires Portfolio of Generic Products From Endo

Lannett Company, Inc. (NYSE: LCI) today announced that it has acquired 23 approved and one pending drug product applications from a subsidiary of Endo International (Nasdaq: ENDP) plc for an upfront payment plus future milestone payments. The portfolio primarily consists of oral solutions with a few semi-solid products. For the 12 months ended March 2018, combined sales of the acquired products were in excess of $175 million, according to IMS.
“This transaction perfectly dovetails with our strategy to grow our top and bottom lines and diversify our product offering by complementing internal development efforts with the acquisition of commercially ready products,” said Tim Crew, chief executive officer of Lannett. “The acquired products, combined with our planned launches of our previously approved and other recently acquired products, create new, near-term revenue and profitability streams. We expect to begin launching the products, under the Lannett label, as soon as the transfer activities are completed and appropriate regulatory filings are made, currently estimated to be in the second half of fiscal 2019. We believe there is an abundance of similar opportunities in the market today; our team is in various stages of negotiation on a number of transactions to add products to our portfolio.”
Crew went on to say that the acquired portfolio of products will be manufactured at Lannett’s liquid generics facility in Carmel, New York, which has the capacity, capability and expertise.
Bourne Partners acted as lead financial advisor to Endo International plc for this transaction.

Neurotrope completes study design for Phase 2 trial in Alzheimer’s

Neurotrope’s wholly-owned operating subsidiary Neurotrope Bioscience has completed the study design for its confirmatory Phase 2 clinical trial in moderate to severe Alzheimer’s disease. The study was designed in consultation with a team of experts in the AD field. The primary efficacy endpoint is defined as the change in the SIB score between the baseline and the average of weeks 13 and 15. Patients will be randomized 1:1 Bryostatin-1 20ug vs. placebo. The company has assembled a team of expert advisors in the areas of neurology, statistical analysis and clinical trial management in AD. Neurotrope will recruit approximately 30 US sites for participation in the upcoming trial.