Early Research Could Lead the Way to a Universal Cancer Vaccine

Hopes for a universal cancer vaccine received a boost from a new antigen discovery made by researchers at Arizona State University‘s Biodesign Institute.
Stephen Albert Johnston and his team have focused on treating cancer as if it was an infectious disease. That led the team to take a deep dive into the tumors where they discovered 200,000 cancer neoantigens, which had previously been missed by other researchers, Arizona State announced this morning. The neoantigens are the components of a potential vaccine and the researchers discovered that these neoantigens occurred repeatedly in different tumors. That means, they speculate, it’s possible these neoantigens can serve as the base for a universal vaccine.
The source of the neoantigens was found in RNA errors of tumors, ASU said. These errors involve changing the reading of the coding for proteins. Johnston said in cancer cells, levels of information transfer from DNA to RNA to protein become more error-prone.
“We proposed that these mistakes made in cancer cells may also be the source to make a cancer vaccine,” Johnston said.
Proof-of-concept data was published in Scientific Reports. The ASU study looked at mutation in more than 50 cancer cell lines, and 85 tissue samples from Mayo Clinic Arizona cancer patients, as well as the blood from patients from five different late-stage cancer types — lung, breast, brain, gastric and pancreatic cancers. They found in all five cancer types, with the exception of glioblastoma, the samples had significant peptides reacting with antibodies in the cancer patients, they said.
In their research, the ASU scientists found a new source of tumor mutations that can provide three levels of therapy with a cancer vaccine. The levels are a pan-cancer vaccine, a vaccine for a specific type of cancer such as breast or pancreatic and personalized cancer vaccines based on mutations unique to an individual.
So far, the ASU research has been conducted in animal models, but it is progressing. Johnston’s team developed a new type of chip that screens for the antibodies in blood samples. It’s a much simpler procedure than gene sequencing, the team said. It also serves as a starting point for personal cancer vaccines, Johnston said.
The team has moved from mouse studies to the first-ever dog cancer vaccine trial, funded by the Open Philanthropy Project. If that trial is successful, Johnston said the research can move into the clinic for human trials.
https://www.biospace.com/article/early-research-could-lead-the-way-to-a-universal-cancer-vaccine/

M&A Will Continue to Be a Mainstay for Growth in the Pharma Industry

For the past five years, there have been more than 400 mergers and acquisitions with companies in the gene therapy, immuno-oncology, microbiome and orphan drugs therapeutic space in North America and that trend is likely to continue, according to a new analysis.
In its Deal-Making Trends in Pharma analysis, GlobalData’s research shows that in North America, the pharmaceutical industry saw twice the number of M&S activity that the European market saw. When compared to the Asian-Pacific (APAC) market, the U.S. market had seven times the number of M&A deals. Europe had three times as many acquisitions than APAC, GlobalData said.
From 2014 to the first half of 2019, there were 2,882 deals that fell within the gene therapy, immuno-oncology, microbiome and orphan drug space. These deals were worth more than $1 trillion, according to GlobalData. During this time frame, the largest deal types were in the immuno-oncology space with 270 deals in 2018 alone, GlobalData said. That represents a growth of 63% since 2014. Gene therapy showed similar growth of 62% with 133 deals in 2018 compared to 82 deals in 2014.
Jesus Cuaron, associate director of Cardiovascular and Metabolic Disease and Gender Health Pharma at GlobalData, said North America is not only the top region for mergers and acquisitions, but also across each therapeutic theme.
“Acquisitions revolving around immuno-oncology assets were the most prominent across the three geographic regions, while acquisitions of microbiome therapies remained low across the board. In the APAC region, no acquisitions were made that involved significant microbiome assets,” Cuaron said in a statement.
While many of the M&A deals were on the small side, there have been a number of mega-mergers over the past few years. Among those are Takeda’s $60 billion acquisition of Shire; Bristol-Myers Squibb’s $74 billion deal for Celgene; and AbbVie’s $63 billion plan to acquire Allergan. Other notable deals include Novartis’ $8 billion deal for gene therapy company AveXis and Roche’s $4.8 billion bid for Spark Therapeutics. Other mergers and acquisitions over the past few years can be found here.
Pointing to the mega-deals like BMS’ bid for Celgene, Cuaron said large-value deals are becoming more common, which signals a “new strategy in which stakeholders capitalize on the strengths of other companies.” These large-value deals are game-changers for the pharmaceutical industry, Cuaron said, and will cause a “ripple of activity” within the top pharmaceutical companies.
According to its latest analysis, GlobalData said it anticipates the pharmaceutical industry will continue to be attractive for high volumes of deal activity in the future. That prediction, the analyst said, is based on the fact that the pharmaceutical industry has a track record of “making deals with companies that focus on highly specialized biologics and other high-value therapies.”
Looking at the potential future of M&A activity, Cuaron said companies are looking to boost their pipelines with more innovative assets and technologies. While licensing agreements are less expensive routes for companies to take to gain an asset, Cuaron said acquisitions are more desirable for most companies because those deals allow the acquiring company to gain complete control over the assets of interest. Cuaron noted that pharmaceutical companies that have few revenue drivers or face patent expiration or generic competition, will be the ones to more quickly flex their M&A muscle. For example, AbbVie has significantly benefited from Humira, which last year generated nearly $30 billion in revenue. However, Humira is facing a patent cliff in 2023 and was seeking a “transformational move” when it made the bid for Botox-maker Allergan.
At the time Allergan struck the deal, AbbVie said: “Smaller bolt-on acquisitions provide opportunities for future growth, but also require significant R&D investment amid scientific and clinical uncertainty. This transaction offers immediate compelling financial and strategic value to our shareholders with a much lower risk profile,” which echoes what Cuaron said.
https://www.biospace.com/article/big-m-and-a-deals-will-likely-continue-analyst-predicts/

Viela Bio prices IPO at $19

Viela Bio (NASDAQ:VIE) prices its IPO of 7.9M common shares at $19/share, for gross proceeds of ~$150M.

Underwriters over-allotment will be an additional ~1.185M shares.

Trading commences today.

Closing date is October 7.

Source: Press Release

https://seekingalpha.com/news/3503629-viela-bio-prices-ipo-19

Walmart tests healthcare programs in the U.S.

Walmart (NYSE:WMT) will begin several healthcare pilot programs for its U.S. employees starting Jan. 1 as it looks for ways to slash healthcare costs – one of the largest expenses for the retailer after wages.

Plans include connecting patients with local doctors, testing a concierge service, video chats with medical professionals and access to fitness clubs.

Others in the industry are also targeting healthcare, with Amazon recently launching a virtual primary care clinic with an option to send nurses to employees’ homes.

https://seekingalpha.com/news/3503632-walmart-tests-healthcare-programs-u-s

Reconstruction Of U.S. Healthcare Has Just Begun

A combination of technological change and the introduction of the Affordable Care Act, along with many efforts to control escalating costs, have already remade how U.S. healthcare professionals deliver care to patients, but these forces are not finished transforming the market.

“It’s really time for us to reimagine how we do healthcare,” Sinai Health System CEO Karen Teitelbaum said at Bisnow’s National Healthcare Series: Midwest Real Estate Summit Sept. 24.

A complex set of factors are increasing overall demand for care, including the aging of the U.S. population, the epidemic of opioid abuse and greater demand for mental health services, among other factors, according to Teitelbaum. But simultaneously, other developments are decreasing the need for care at large, centralized hospitals. For one thing, new technologies such as telemedicine, which allows physicians or other professionals to remotely consult patients on many needs without the inconvenience of in-person visits, have gotten more popular.

And the search for lower costs has led to the proliferation of an array of outpatient clinics, which provide both specialty and basic care to patients closer to home. That has led to a lot of empty hospital beds, even as the total amount of care provided has increased across the board.

“We know there is excess capacity,” Illinois Health and Hospital Association CEO A.J. Wilhelmi said. He estimates that one-third of the beds in some hospitals are typically unoccupied. That means developers, providers and other stakeholders should start thinking about how to repurpose many of these buildings, even as the construction of off-site care facilities continues.

That won’t be an easy task, Skender Director of Healthcare Design Jenny Han said. The watchword for any healthcare effort is affordability, and that puts a lot of pressure on builders. To have any chance of combating rising construction costs, and completing the redevelopment of the U.S. healthcare system, the methods of construction have to change.

“We are an archaic industry,” she said. By using factory-produced modular components, Skender intends to drastically reduce costs. It also plans to do all of the architecture, design and manufacturing in-house, a more efficient process than the traditional methods of construction, which typically involve an assortment of firms working in silos.

“I look forward to the day [modular construction] is no longer the shiny new object,” Han said.

Even if cost-effective methods of construction can be found, the changes up ahead could be gut-wrenching for many.

In 2016, after deciding it could no longer sustain operations, Wilhelmi said, Springfield, Illinois-based Hospital Sisters Health System closed the nearly 130-year-old St. Mary’s Hospital in Streator, Illinois. Last year, however, Peoria, Illinois-based OSF HealthCare showed what the future may look like for many communities that lose such institutions. It launched a $30M renovation of St. Mary’s, an effort that demolished a portion and transformed the remainder into an outpatient center with a 24/7 emergency center. Other long-term needs can be met by St. Elizabeth Medical Center in nearby Ottawa, Wilhelmi said.

Teitelbaum’s Sinai Health System, located on Chicago’s West Side, largely serves a low- to moderate-income population, and like many providers these days, has to carefully watch its funds.

“We don’t have a lot of money to invest in big, beautiful buildings,” she said. Instead, it plans on making strategic investments that divert patients into less-expensive care settings. Earlier this summer, it opened a $6.5M Crisis Stabilization Unit at Holy Cross Hospital for patients experiencing mental health crises.

“Mental health has never been a big moneymaker, these are patients that no one is running after,” she said. But a pilot program launched in 2015 found that 70% of its 5,000 patients were stabilized without emergency room visits or hospitalization. Instead, they received lower-level care in their own communities, and also avoided incarceration.

Still, Teitelbaum knows the future of health systems like Sinai won’t be easy.

“There aren’t many healthcare CEOs that would push me down the stairs to get my job.”https://www.bisnow.com/chicago/news/healthcare/healthcare-forecast-101075

Aspirin may prevent air pollution harms

A new study is the first to report evidence that nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin may lessen the adverse effects of air pollution exposure on lung function. The team of researchers from the Columbia Mailman School of Public Health, Harvard Chan School of Public Health, Boston University School of Medicine published their findings in the American Journal of Respiratory and Critical Care Medicine.
The researchers analyzed a subset of data collected from a cohort of 2,280 male veterans from the greater Boston area who were given tests to determine their lung function. The average age of participants was 73 years. The researchers examined the relationship between test results, self-reported NSAID use, and ambient particulate matter (PM) and black carbon in the month preceding the test, while accounting for a variety of factors, including the health status of the subject and whether or not he was a smoker. They found that the use of any NSAID nearly halved of the effect of PM on lung function, with the association consistent across all four weekly air pollution measurements from same-day to 28 days prior to the lung function test.
Because most of the people in the study cohort who took NSAIDs used aspirin, the researchers say the modifying effect they observed was mainly from aspirin, but add that effects of non-aspirin NSAIDs are worthy of further exploration. While the mechanism is unknown, the researchers speculate that NSAIDs mitigate inflammation brought about by air pollution.
“Our findings suggest that aspirin and other NSAIDs may protect the lungs from short-term spikes in air pollution,” says first and corresponding author Xu Gao, PhD, a post-doctoral research scientist in the Department of Environmental Health Sciences at the Columbia Mailman School. “Of course, it is still important to minimize our exposure to air pollution, which is linked to a host of adverse health effects, from cancer to cardiovascular disease.”
“While environmental policies have made considerable progress toward reducing our overall exposure to air pollution, even in places with low levels of air pollution, short-term spikes are still commonplace,” says senior author Andrea Baccarelli, MD, PhD, chair of the Department of Environmental Health Sciences at the Columbia Mailman School. “For this reason, it is important to identify means to minimize those harms.”
An earlier study by Baccarelli found that B vitamins may also play a role in reducing the health impact of air pollution.

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Co-authors include Brent Coull, Xihong Lin, and Joel Schwartz at Harvard; and Pantel Vokonas at the Boston University School of Medicine.The current study was supported by grants from the National Institute of Environmental Health Sciences (ES009089, ES021733, ES025225, ES027747). The VA Normative Aging Study is supported by the Cooperative Studies Program/Epidemiology Research and Information Center of the U.S. Department of Veterans Affairs and is a component of the Massachusetts Veterans Epidemiology Research and Information Center in Boston.
https://www.eurekalert.org/pub_releases/2019-10/cums-amp100219.php

Aprea Therapeutics prices IPO at midpoint

Aprea Therapeutics (APRE) has priced its initial public offering at the midpoint of its range, IPO Boutique says.

The company priced an upsized 5.7M shares (up from 5M) at $15, after marketing the range at $14-$16/share.

That marks a raise of $85.5M vs. the planned $75M; that means an enterprise value over $227M.

https://seekingalpha.com/news/3503626-aprea-therapeutics-prices-ipo-midpoint