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Monday, September 9, 2019

FDA cracks down on Juul marketing

The FDA sends a warning letter to Juul Labs (JUUL) on the sale and distribution of modified risk tobacco products.
The agency says Juul illegally promoted its e-cigarettes as less harmful than cigarettes and orders the company to correct the marketing practices.
“Regardless of where products like e-cigarettes fall on the continuum of tobacco product risk, the law is clear that, before marketing tobacco products for reduced risk, companies must demonstrate with scientific evidence that their specific product does in fact pose less risk or is less harmful,” notes Acting FDA Commissioner Ned Sharpless in the missive.
Some sort of action by the FDA was widely anticipated for this week. Shares of Altria (MO +0.4%) are holding up fine.

Slovakian biotech firm signals tentative Alzheimer’s drug hope

An Alzheimer’s vaccine developed by a privately held Slovakian biotech firm showed early signs of efficacy in a mid-stage trial, a rare step forward in the fight against the brain-wasting disease, the company said on Monday.
Axon Neuroscience said its AADvac1 drug, which targets pathological changes in the brain to the so-called tau protein that is a hallmark of the disease, slowed deterioration in trial patients when compared with a reference group given a placebo.
The search for an effective drug against Alzheimer’s dementia, which affects about 5.8 million Americans, has so far resulted in a string of high-profile failures, many in the third and last phase, despite the involvement of several major pharmaceutical players.
The close-to-200 participants in the Axon trial, in eight European countries, were between 50 and 85 years of age and had shown early signs of the disease, which affects memory and language as it progresses.
Among younger participants in the trial, a number of assessments of cognitive abilities, including memory, orientation and performing everyday tasks, showed “positive signals” for those on AADvac1 versus those that were not, Axon said.
A blood test measuring neurodegeneration, known as Neurofilament Light Chain (NfL), indicated a “marked slowdown” of deterioration across the age range, it said, adding that the reading was statistically reliable.
The trial was in the second of three phases of testing typically required for regulatory approval.
Axon would now look to sign a collaboration agreement with a global drug company to fund larger trials in the third phase of testing, which is typically the most costly, it said.
AADvac1 was shown to be safe and well-tolerated in the 24-month trial, Axon added.

“These results, which strongly reveal a disease-modifying effect on the disease, underpin our confidence to take the next steps in bringing a life-changing treatment to patients as soon as possible,” Chief Executive Michal Fresser said in the statement.
Axon was established in 1999 with Slovakian neuroscientist Michal Novak, who had previously worked at the University of Cambridge, among other institutions, as a co-founder.
Backed by Slovakian businessman Mario Hoffmann, Axon has a staff of about 110, most of whom are based in Bratislava.
Finding an effective treatment for Alzheimer’s is a compelling target for drugmakers, as the numbers affected across the globe swell with an aging population.
Among the most recent setbacks in the search for a cure, Biogen and partner Eisai ended two late-stage trials in March, wiping billions off their market value. Similarly, Roche and partner AC Immune SA in January gave up on two trials they had held high hopes for.
The failures undermined the so-called amyloid beta treatment hypothesis, in which protein plaques in the brain are believed to play a pivotal role in the disease.
Attempts to target tau, another protein that is more closely linked with the onset of Alzheimer’s symptoms, have come to the fore but trials are at early stages.
Companies with tau drugs in development include Roche, AC Immune, Biogen and Eli Lilly.

Alzheimer’s treatments currently available can only ease the symptoms of the disease, without slowing progression.
AADvac1 is designed to prevent malformed tau proteins from spreading and sticking together in Alzheimer’s patients’ brains, keeping them from forming tangles that disrupt signaling between nerve cells.

Pfizer Positive Prelim Phase 2 Results for 20-Valent Vaccine Candidate in Infants

Pfizer Inc. (PFE) on Monday reported positive preliminary results from a phase 2 proof-of-concept study of its 20-valent pneumococcal conjugate vaccine candidate in infants.
The New York drug maker said the initial three doses in the four-dose study showed preliminary evidence that the vaccine candidate in infants has an overall safety profile similar to Pfizer’s Prevnar 13 vaccine.
Pfizer said the findings should support the program’s advancement to phase 3 studies, adding that it will discuss phase 3 plans with regulators once data with the fourth dose are available.
Pfizer said the study is assessing the safety and immunogenicity of the 20vPnC candidate for the prevention of invasive disease and otitis media caused by Streptococcus pneumoniae serotypes contained in the vaccine in healthy infants.
The 20vPnC candidate includes the 13 serotypes contained in Prevnar 13, plus seven additional Streptococcus pneumoniae serotypes that represent prevalent circulating global disease strains, the company said.

Novartis backs brolucizumab with new head-to-head Eylea trial

Novartis is launching a head-to-head trial of its experimental brolucizumab therapy for age-related macular degeneration (AMD) against Bayer/Regeneron’s Eylea, the market leader.
The TALON trial in the wet form of AMD will compare brolucizumab against Eylea (aflibercept) on a range of measures, including visual acuity and treatment interval duration, to see if it can outperform Bayer and Regeneron’s drug.
An FDA verdict on brolucizumab is due shortly based on two earlier trials – HAWK and HARRIER – and the company is hoping to launch its new therapy before the end of the year in the US.
Brolucizumab is a follow-up to Novartis’ blockbuster AMD therapy Lucentis (ranibizumab), which has been competing toe-to-toe in the AMD market with Eylea for several years.
Novartis reported sales of $2 billion for Lucentis last year, with its marketing partner Roche adding another $1.7 billion in US sales. In comparison, Regeneron posted $4 billion revenues from the US while Bayer made $2.1 billion in ex-US Eylea sales.
Brolucizumab is seen as Novartis’ big chance to claim back dominance of the wet AMD market, which has seen first-to-market Lucentis progressively caught up and overtaken by Eylea over the last few years, and the company spent a priority review voucher in order to get the FDA review done as quickly as possible.
Like its predecessors the new drug is a VEGF inhibitor, blocking the growth of abnormal blood vessels in the back of the eye that are responsible for the progressive loss of vision in wet AMD.
They all need to be injected directly into the eyeball to be effective, so reducing the frequency of dosing is important. Brolucizumab need only be delivered every 12 weeks, versus four to eight weeks with Eylea and every four weeks with Lucentis.
HAWK and HARRIER also compared brolucizumab and Eylea directly, and TALON will put the dosing differences to a further test, attempting to show that brolucizumab is at least as effective as Eylea at a 12-week injection frequency and also exploring use of the drug every 16 weeks in some patients.
The 64-week trial is comparing Novartis’ drug with the current formulation of Eylea. Last year, the FDA rejected a filing for a 12-weekly injection formulation of Eylea, providing an opportunity for brolucizumab to exploit.
GlobalData has previously forecasted that brolucizumab’s sales will top $1 billion in 2021 and reach around $4.1 billion by 2026.
The wild card in the wet AMD market is off-label use of Roche’s VEGF inhibitor Avastin (bevacizumab), which continues to be used as a low-cost alternative to the two approved treatments.
Avastin needs to be diluted and repackaged before it can be used in the eye, with dosing every four to six weeks, and is much less expensive. That hasn’t stopped the branded wet AMD drugs from making blockbuster sales of course, and shouldn’t be a drag on brolucizumab if approved.
Meanwhile, patents on both Lucentis and Eylea are due to expire in the US in 2020, raising the prospect of additional low-cost biosimilar competitors. Regeneron has previously suggested it can claim an extension until 2023, at around the same time as Eylea loses protection in Europe.

AstraZeneca’s Imfinzi improved survival in late-stage lung cancer study

Results from a Phase 3 clinical trial, CASPIAN, evaluating AstraZeneca’s (NYSE:AZN) Imfinzi (durvalumab), combined with chemo (etoposide with either cisplatin or carboplatin), in patients with previously untreated extensive-stage (metastatic) small cell lung cancer showed a significant improvement in overall survival (OS). The data were presented at the World Conference on Lung Cancer in Barcelona.
Median OS was 13.0 months in the Imfinzi group compared to 10.3 months for chemo alone with 27% less risk of death (hazard ratio = 0.73). Progression-free survival at month 12 also favored Imfinzi (17.5% vs. 4.7%) as did objective response rate (67.9% vs. 57.6%) and duration of response (22.7% vs. 6.3%).
Shares down 1% premarket on light volume.

Integra Lifesciences acquires Rebound Therapeutics

Integra LifeSciences Holdings (NASDAQ:IART) has acquired Rebound Therapeutics, developers of single-use medical devices that enable minimally invasive access for therapeutic use in neurosurgery.
Financial details are not disclosed.
Integra does not expect this acquisition to have a material financial impact in 2019.

Thermo Fisher to develop companion diagnostic for Lilly’s selpercatinib

Thermo Fisher Scientific (NYSE:TMO) inks an agreement with Eli Lilly (NYSE:LLY) to develop its next-generation sequencing (NGS)-based Oncomine Dx Target Test as a companion diagnostic aimed at identifying suitable NSCLC and thyroid cancer patients for the latter’s RET inhibitor selpercatinib (LOXO-292).
Under the terms of the deal, TMO will retain commercialization rights in all markets and will be responsible for regulatory filings. Financial terms are not disclosed.