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Tuesday, January 8, 2019

Guardant unveils epigenetic research test for early-stage cancer


Guardant Health has launched a new liquid biopsy test for researchers aimed at spotting cancer in its early stages, by detecting both genomic alterations and epigenomic signatures through a single blood draw.
The company’s Lunar assay is designed for studies that involve screening for tumor DNA in the bloodstream, choosing a course of adjuvant therapy, or monitoring potential recurrence and treatment responses.
“A number of our academic and biopharma partners are thinking more and more about taking their clinical programs into adjuvant and neoadjuvant settings,” Guardant’s senior VP of biopharma business development, Daniel Simon, said at the J.P. Morgan Healthcare Conference. “This is a really interesting application within that space.”
The Lunar assay is based on samples gathered from more than 80,000 cancer patients tested with the company’s Guardant360 test, alongside additional whole-genome sequencing data.
It aims to overcome previous challenges seen in detecting early-stage disease—such as biological noise mutations associated with aging, as well as the limited sensitivity of genomic-only tests—in settings where there is less tumor DNA to be found, compared to the late-stage cancer indications covered by the Guardant360 or GuardantOMNI tests, Simon said.
Detecting epigenetic markers, such as differences in the methylation of DNA from tumor cells compared to that from healthy cells, is critical in increasing the sensitivity of the test, the company said. For example, researchers at the University of Queensland in Australia recently found that the dense clusters of methyl groups lining tumor DNA can cause the molecules to fold into shapes that are easily detectable by the naked eye through a simple test.

“This is where the database of samples that we’ve already amassed becomes incredibly valuable,” he said. “We can continually learn from the 80,000 samples that we’ve run to date. We’ve also used lessons from those samples to improve the sensitivity of Guardant360 and developed Omni to have a comparable performance.”
According to Guardant, the assay improves Guardant360’s performance by reporting genomic alterations at allele frequencies as low as 0.01%. The company plans to launch a clinical version of the test, for investigational use only in prospective studies, in the second half of this year.

In addition, Guardant plans to submit its Guardant360 test to the FDA for premarket approval in the first half of this year, as a companion diagnostic for AstraZeneca’s EGFR inhibitor Tagrisso that is being developed under a multi-year agreement announced last month. It also plans to submit its GuardantOMNI panel for tumor mutational burden score by the end of 2019.

Nektar gains after laying out anticipated milestones for 2019


Shares of Nektar Therapeutics (NKTR) are up nearly 10% following the company’s presentation at JPMorgan’s Healthcare Conference. In addition to saying it ended 2018 with cash and equivalents of $1.92B, Nektar laid out its anticipated milestones in 2019. These include: Initiation of new Bristol-Myers (BMY), Nektar registrational trials in renal cell carcinoma, bladder cancer, non-small cell lung cancer, breast cancer, gastric cancer, colorectal cancer, small cell lung cancer and sarcoma; Presentation of data from PIVOT study of NKTR-214+nivo in patients with bladder cancer at ASCO-GU; Presentation of data from Phase 1 dose-escalation phase of REVEAL study of NKTR-214 + NKTR-262 at ASCO-SITC; Potential approval and launch of NKTR-181; Initiate first Phase 1 clinical trial of NKTR-255 in multiple myeloma; Data from first-in-human Phase 1 single-ascending dose clinical trial of NKTR-358 at EULAR 2019; PIVOT data presentations in lung cancer and Eli Lilly (LLY) initiating two new Phase 1b studies of NKTR-358 in two new auto-immune conditions. Shares of are up over 9%, or $3.45, to $40.07 in afternoon trading.
https://thefly.com/landingPageNews.php?id=2845704

Alkermes sees ‘significant’ news flow in 2019, ALKS 5461 steps to be determined


In presentation slides at the JPMorgan Healthcare Conference, Alkermes today said it sees “significant” news flow in 2019. In schizophrenia, the company expects to report topline results from its Phase 3b Aristada-Invega Sustenna study in the first half of the year. It also expects to present Enlighten-2 data at a medical meeting and submit a new drug application around mid-year. In multiple sclerosis, Alkermes sees reporting topline data for diroximel fumarate in a head-to-head study versus Tecfidera around mid-year. For its immuno-oncology candidate ALKS 4230, the company plans to initiate a subcutaneous study in Q1. It also expects to complete a monotherapy dose-escalation stage of a Phase 1 study and to initiate a monotherapy dose-expansion stage of a Phase 1 study. For depression candidate ALKS 5461, Alkermes said it will determine the drug’s next steps with the FDA action date on January 31 of this year. Shares of Alkermes are up 2%, or 69c, to $31.29 in afternoon trading.

Color to Move Whole Genome Sequencing Into Clinical Care


Color announced an initiative to help build the foundation for the first mainstream application of whole genome sequencing in clinical care, through the use of polygenic risk scores. Polygenic risk scoring can help clinicians identify populations who are at risk for diseases such as cancer and heart disease in order to optimize prevention and treatment regimens according to an individualized understanding of risk.
The initiative, in which Illumina will provide sequencing reagents and hardware, aims to enroll 100,000 volunteers, including those from historically underrepresented groups, in Color’s research platform (data.color.com). As part of this effort, Color will develop research tools to improve the accuracy of polygenic risk scores applications in diverse populations.
Previously, Color demonstrated the ability to utilize NGS sequencing technology through instruments developed by Illumina, to produce polygenic risk score data, instead of relying on older genotyping technology. This approach unlocks a more versatile approach to assessing risk across a wide variety of conditions and addresses the historical limitations of sensitivity across ethnicities found in other polygenic techniques.
Illumina’s NovaSeq platform enables Color to offer low-pass whole genomes to help provide robust information to any patient and clinician that may help inform clinical care. Color will begin releasing its first polygenic risk score for cardiovascular disease early this year. With the consent of participants, anonymized data tools on Color Data will enable academic scientific researchers to access this information freely for their own research, in turn advancing discoveries relevant to historically underrepresented groups and advancing health equity.
“We believe in the tremendous potential of whole genome sequencing to improve the healthcare of individuals around the world,” said Othman Laraki, Color CEO. “We are committed to ensuring similar access to this kind of information for individuals who have historically been underrepresented in genomics research, which is critical not only to advancing biomedical discoveries, but also to ensuring the best possible care for individuals of any background around the world.”
“A high polygenic risk score is the main risk factor in about 20% of people with a premature heart attack. Color’s test will allow patients and clinicians to catch this risk prior to a heart attack and to consider interventions – lifestyle and/or medicines – to reduce risk,” said Sekar Kathiresan, MD, Director, Center for Genomic Medicine at Massachusetts General Hospital, an Institute Member at the Broad Institute, and Professor of Medicine at Harvard Medical School.  Dr. Kathiresan and his colleagues have pioneered the development of the polygenic score test for heart disease.
“This is an exciting endeavor that we are proud to be a part of,” said Mark Van Oene, Chief Commercial Officer for Illumina. “Polygenic risk scoring is becoming increasingly valuable in the identification of specific populations who may carry a higher risk of disease.”
“For most people, their risk for developing a health condition is not going to be explained by a strong single gene like BRCA1/2 in hereditary cancer.  To reach the full potential of personalized medicine at the population level, incorporating polygenic risk score is critical – everyone has a polygenic risk score,” said Peter Hulick, MD, Medical Director, Neaman Center for Personalized Medicine, NorthShore University HealthSystem, Evanston, IL.
About Color
Color is a population genomics technology company. Color’s clinical-grade sequencing, software and analytics platform makes it easy and affordable for people around the world to access their genetic information to learn about their hereditary risk for cancer and heart disease, and how their genes affect medication management. Simply providing a saliva sample from home gives Color clients access to an ongoing service that provides tools and insights to manage key aspects of their long-term health. Large populations such as employers (Visa, Levi Strauss, Salesforce, SAP, dozens of others) and health systems (including UCSF, Jefferson and University of Chicago) are partnering with Color to bring genetics and preventive health to their populations in a streamlined and integrated way. Learn more at www.color.com.

IPO bonanza as biotechs get in while the iron’s hot


It feels like there’s a little more than just precipitation in the air at the J.P. Morgan Healthcare Conference this year: a dash of optimism and cash.
We’ve already seen two major deals in Eli Lilly snapping up biotech-of-the-moment Loxo Oncology for $8 billion, a hefty premium, and Bristol-Myers Squibb’s left field purchase of Celgene.
While smaller biotechs aren’t going to be having billions thrown at them, they’re still seeking to go public, and as JPM 2019 ramps up, three companies are making their pitch: bladder cancer biotech Anchiano Therapeutics, which has filed for a $35 million public offering; Poseida Therapeutics, which wants $115 million for its BCMA CAR-T therapy work; and a $150 million attempt from Alzheimer’s biotech Alector, a 2015 Fierce 15 winner.

Let’s start with the biggest, and likely disease-wise most difficult, Alector. The South San Francisco, California-based company was set up in 2013 and plans to list on the Nasdaq under the symbol ALEC.
According to its SEC-1, Alector, which raised $133 million in a series E round last year (an IPO clearly long beckoning when you start getting that far into the alphabet) is seeking a pretty substantial $150 million for its work on Alzheimer’s and dementia—eschewing common research patterns that focus on amyloid beta and/or tau build-up in the brain—and instead focusing on whether the disease is caused by immune cells within the brain itself.
The approach, dubbed immuno-neurology, targets immune dysfunction as a root cause of multiple pathologies seen as drivers of degenerative brain disorders, such as AD.
In its prospectus, the OrbiMed and Polaris-backed biotech said, “We are developing therapies designed to simultaneously counteract these pathologies by restoring healthy immune function to the brain […] In the last five years, we have identified over forty immune system targets, progressed over ten programs into preclinical research, and advanced two product candidates, AL001 and AL002, into clinical development.”
In the second half of 2018, AL001, which was initially aimed at treating a genetic subset of patients with frontotemporal dementia (FTD) carrying a progranulin loss of function mutation (FTD-GRN), was dosed in forty-two healthy subjects in a single ascending dose phase 1 study.
“There were no serious adverse events or dose limiting adverse events reported in the study, achieving the primary endpoint,” the company noted, adding, “We plan to advance AL001 into a phase 1b study with proof-of-mechanism data in FTD-GRN patients expected in the first half of 2019 and into a phase 2 study with proof-of-concept data in FTD-GRN patients expected in the first half of 2020.”
Also in the second half of 2018, it kick-started a dose-escalation phase 1 in healthy volunteers with AL002, its attempt to treat Alzheimer’s, with plans also slated for clinical studies of AL003, another AD candidate (and both partnered with AbbVie), and AL101, aimed at “multiple neurodegenerative disorders,” set to start later this year.
Then there’s Poseida Therapeutics, a San Diego, California-based company founded back in 2014, which wants $115 million for a listing on the Nasdaq under the symbol PSTX.
The biotech is working on P-BCMA-101, a BCMA CAR-T therapy for multiple myeloma, and also has earlier, preclinical shots on goal.
But at the ASH 2018 blood cancer conference back in early December, Jefferies dumped on Poseida’s recent results for its-BCMA-01 as “inferior” (43% ORR) at the lower dose of 456 million cells tested. Raising the dose to 845 million cells improved the ORR to 100%, but it looks like the dose is going to have to be higher than those of its rivals.
For comparison, Celgene and Juno’s JCARH125 had an ORR of 83% in patients receiving 150 million cells or more, while at the lowest 50 million dose it still managed 79% ORR.
It’s a crowded research field, and last year’s ASH saw a plethora of presentations on BCMA-targeting drugs, but analysts at Jefferies still believe Bluebird Bio’s CAR-T therapy bb2121 “is leading the pack.”
In its most recent update for its therapy, shared in its SEC filing, Poseida said, “Preliminary results from our ongoing Phase 1 dose escalation clinical trial of P-BCMA-101 showed that as of November 21, 2018, of the 19 patients that were evaluable by International Myeloma Working Group, or IMWG, criteria, 14 had meaningful responses (either stringent complete response, complete response, very good partial response, partial response or minimal response, by IMWG criteria), with an objective response rate, or ORR, of 100% in three evaluable patients that had received the dose of P-BCMA-101 we expect to advance into phase 2 clinical development.”
Given some serious safety concerns with other therapies in this area, toxicity remains a concern for all. “In addition, as of November 21, 2018, P-BCMA-101 continued to be well tolerated in the trial, with two mild and transient instances of cytokine release syndrome, or CRS, observed, and one patient with possible neurotoxicity, each of which occurred at doses below the planned phase 2 dose,” the company said.
The company added that serious adverse events of neutropenia, thrombocytopenia, anemia and infection “were observed”, but believed these SAEs “are not related to P-BCMA-101 as they are consistent with conditioning lymphodepletion therapy and the underlying disease.” It added the caveat: “While we believe these preliminary results are encouraging, they are derived from a small number of patients and may not be predictive of future results or the durability of responses over time.”
Hence the need for a midstage test, slated for the first half of the year, moving toward a potential BLA filing with FDA “by the end of 2020.”
How come so quick? “We believe our planned phase 2 clinical trial has the potential to be a registrational trial, which is a trial that could support a BLA filing,” although the FDA “has not indicated its agreement or that a phase 3 clinical trial will not be required.”
And finally the Jerusalem, Israel-based company Anchiano Therapeutics, a late-stage biotech developing gene therapies for early-stage bladder cancer, wants $35 million in an initial public offering, with Insiders set to snap up $17.5 million of the IPO, according to Renaissance Capital.
According to its SEC filing, the biotech is working on a targeted gene therapy for early-stage bladder cancer, specifically on inodiftagene vixteplasmid, or just inodiftagene, that it believes “can deliver a new treatment to patients who have options that are limited in efficacy and problematic in toxicity.”
Inodiftagene is a recombinant DNA construct that will be administered to patients whose therapy for early stage bladder cancer has failed. Preclinical and clinical trials completed so far “have demonstrated that our product candidate can deliver a lethal gene specifically to bladder cancer cells in a patient’s bladder.,” the biotech says, and: “Based on our phase 1 and phase 2 clinical trial results, we believe our product candidate, inodiftagene, has the potential to improve patient outcomes substantially by delaying or in some cases eliminating disease progression, and consequently may significantly improve patients’ quality of life.”
After a bumper biotech IPO year in 2018 and Moderna’s monster IPO attempt, there is concern the window may start to close very soon, so don’t be surprised if a few more companies try to get in on the act in the coming weeks.

Goldman Sachs recommends Sarepta ahead of ‘key’ Q1 catalyst


Goldman Sachs analyst Salveen Richter said he recommends Sarepta shares ahead of key Q1 catalyst — the MYO-101 Ph1/2 limb girdle muscular dystrophy 60-day biopsy data. Richter added that Sarepta is positioned for a strong year in 2019, as he looks to execution across multiple fronts, including selective BD to drive the R&D engine, golodirsen US approval around Q3, casimersen dystrophin expression data with a potential filing in the middle of the year, SRP-5051 Ph1 data by year end, and additional gene therapy trial progress. The analyst maintained a Buy rating and $191 price target on Sarepta.
https://thefly.com/landingPageNews.php?id=2845631

Retrophin Provides Corporate Update and 2019 Outlook


Retrophin, Inc. (NASDAQ: RTRX) today announced that, based on preliminary and unaudited financial data, the Company expects net product sales for the fourth quarter of 2018 to be approximately $44 million. For the fiscal year 2018, the Company expects total net product sales of approximately $164 million. The Company also provided a general update on its development programs, including anticipated milestones for 2019.
With key data readouts from the FORT Study of fosmetpantotenate in PKAN and the CNSA-001 Phase 2 proof-of-concept study expected in 2019, Retrophin is positioned to create significant value for patients and shareholders this year, said Stephen Aselage, former chief executive officer of Retrophin. The Company closed 2018 with the initiation of the PROTECT Study of sparsentan in IgA nephropathy, our third pivotal development program, continued growth of the base commercial business and most recently hired its new president and chief executive officer, Eric Dube, Ph.D. These clinical and commercial achievements provide strong momentum entering the new year, and I look forward to working with Eric to ensure a seamless transition to drive our continued success.
Program Updates and Anticipated 2019 Milestones
In December 2018, the pivotal Phase 3 FORT Study of fosmetpantotenate in pantothenate kinase-associated neurodegeneration (PKAN) completed patient enrollment. The FORT Study is designed to be registration-enabling in the U.S. and Europe, and top-line data are expected to become available in the third quarter of 2019.
The Phase 2 proof-of-concept study evaluating CNSA-001 in patients with phenylketonuria (PKU) continues to progress, and top-line data are expected to be available in the first half of 2019. CNSA-001 is advancing under a joint development and option agreement with Censa Pharmaceuticals, and the Company expects to make a determination on its option to acquire Censa following the data readout.
The New Drug Application (NDA) for a new, more patient-friendly formulation of Thiola is currently under review by the U.S. Food and Drug Administration (FDA) with an assigned Prescription Drug User Fee Act (PDUFA) target action date of June 30, 2019. Pending approval, the Company expects to begin marketing the new formulation in the second half of 2019.
Enrollment in the Phase 3 DUPLEX Study of sparsentan in focal segmental glomerulosclerosis (FSGS) continues. The Company expects to reach enrollment of 190 patients with FSGS during the second half of 2019, which would enable a top-line readout of the 36-week interim efficacy analysis of proteinuria in the second half of 2020. Successful achievement of the interim efficacy endpoint is expected to serve as the basis for submission of an NDA under the Subpart H accelerated approval pathway in the U.S. and Conditional Marketing Authorization (CMA) consideration in Europe.
In December 2018, the Company announced that the first patient had been dosed in the PROTECT Study, a global, pivotal Phase 3 clinical trial evaluating the long-term nephroprotective potential of sparsentan for the treatment of IgA nephropathy (IgAN). The Company expects that the study will complete enrollment of approximately 280 patients with IgAN in the first half of 2021. Top-line data from the 36-week primary endpoint efficacy analysis of proteinuria is expected to become available in the first half of 2022. Retrophin expects that successful achievement of this endpoint will support submission of an NDA under the Subpart H accelerated approval pathway in the U.S., as well as an application for CMA consideration in Europe.
In late February, the Company expects to announce final financial results from the fourth quarter and full-year 2018, as well as provide a corporate update.