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Wednesday, March 2, 2022

COVID-19, Manufacturing Challenges Trip up Finch's C. Difficile Trial

 The US Food and Drug Administration has issued a clinical hold letter regarding Finch Therapeutics' Phase III PRISM4 trial, requiring the company to submit additional information on its screening protocols.

The letter, dated February 24, 2022, asked Finch to pause enrollment for the trial on CP101 in recurrent C. difficile infection, pending details on how SARS-CoV-2 donor samples will be shipped to the vendor that will perform the testing, as well as how they would handle inconclusive results. 

Finch said it would cooperate closely with the FDA and provide all the needed data to lift the hold order as soon as possible. As of this writing, the company is still evaluating how the hold will affect the trial's timeline. The letter also reportedly only mentioned the lack of data and did not say anything about adverse reactions experienced during the trial. 

In March 2020, the FDA had issued a warning on the possible risk of SARS-CoV-2 transmission in donor-derived investigational trials and called on companies to implement extra precautionary measures to prevent this. 

At the time, Finch's investigational new drug application for CP101 was placed on partial clinical hold, alongside then-contract manufacturer OpenBiome, requiring the implementation of safety protocols for data collected on or after December 1, 2019. Despite the partial hold notice, Finch was still able to continue dosing patients in its then-active PRISM-EXT Phase II study of CP101 because all of the data used in this study were taken before the December 1 cutoff. 

In January 2021, the hold on OpenBiome was lifted after it solved the issue using a direct-testing method via a third party provider. Finch then began dosing participants in the PRISM4 trial in November 2021. However, the latest FDA letter also notified Finch that the regulator would conduct a review of the trial's processes after Finch said it was dosing patients under the PRISM4 study while the hold was already in effect. 

Finch is largely known for its Human-First Discovery platform, which aims to develop a new class of orally administered biological medications to address a wide range of unmet medical needs. CP101, its lead candidate, managed to meet its primary efficacy endpoint in the PRISM3 trial in June 2020. 

The PRISM4 study is the second pivotal trial of the drug for recurrent CDI. The company is also developing CP101 for chronic hepatitis B and another product called FIN-211 for behavioral and gastrointestinal symptoms in children diagnosed with an autism spectrum disorder. 

News of the FDA's hold letter comes just a few weeks after the company appointed new members of its leadership team, namely Bryan Gillis, MBA as chief technology officer, Alka Batycky, Ph.D., as chief development officer and Howard Franklin, MD, MBA as senior vice president for the late-stage development and GI therapeutic unit. 

https://www.biospace.com/article/finch-pauses-phase-iii-prism-4-trial-after-fda-requests-more-data/

FDA slaps hold on Celyad phase 1 colorectal cancer trial

 

  • The FDA has issued a clinical hold on Celyad Oncology SA's  (Get Free Alerts for CYAD) CYAD-101-002 (KEYNOTE-B79) Phase 1b trial due to insufficient information to assess risk to study subjects.
  • As previously disclosed, the Company announced that it was voluntarily pausing the CYAD-101-002 trial to investigate reports of two fatalities in the study.
  • Celyad Oncology is a clinical-stage biotechnology company focused on discovering and developing chimeric antigen receptor T cell (CAR T) therapies for cancer. 
  • The Company is developing a pipeline of allogeneic (off-the-shelf) and autologous (personalized) CAR T cell therapy candidates for hematological malignancies and solid tumors.

Inovio Covid vax candidate weaker against omicron

 Tucked in the Q4 earnings release, Inovio Pharmaceuticals Inc 

 (Get Free Alerts for INO) has paused enrollment for an ongoing INNOVATE Phase 3 trial of its lead COVID-19 vaccine candidate.

  • The decision follows as the shot showed significantly lower antibody levels against the omicron variant in lab testing.
  • The vaccine, INO-4800, maintained a robust T-cell response in the lab tests, leading Inovio to plan changes to the trial design.
  • T-cells are a vital part of the immune system's second line of defense.
  • The Company plans to seek regulatory approval to change the study's main goal to "prevention of severe disease due to COVID-19" from the earlier goal of "prevention of virologically confirmed COVID-19 disease."
  • An independent data safety monitoring board recommended that Inovio pause enrollment to reflect Omicron's potential impact on the trial. 
  • As a result, interim efficacy data from the trial will not be available in 1H of 2022 as previously expected.
  • In November, Inovio resumed the late-stage trial of its vaccine in the U.S. after 14 months on clinical hold.
  • The FDA in September 2020 put the study on hold as it sought more information, including details on a delivery device used to inject genetic material into cells.
  • Inovio held $401.3 million in cash and cash equivalents and short-term investments at the end of 2021.

Sorrento to Proceed With Phase 1 for Intranasal STI-9199 (COVISHIELD) Antibody

 

  • FDA granted IND clearance today for STI-9199 (COVISHIELD) for a Phase 1 safety and pharmacokinetic study in healthy volunteers.

  • Initial trials are expected to be followed by a multinational Phase 2/3 trial in both mild and moderate COVID-19 patients.

  • STI-9199 has demonstrated in vitro and in vivo activity against all SARS-CoV-2 variants tested, including the Omicron strain BA.1, Omicron BA.1+R346K and Omicron BA.2.

WTI Extends Gains After Cushing Stocks Drop Near 'Tank Bottoms', Crude Draws

 Oil prices are significantly higher this morning from yesterday's settlement, with WTI around $109 (having topped $112 earlier), as the market shrugs off Biden's plans to release some of the SPR, focusing still on geopolitical risk premia (and the fact that Russia's supply has been implicitly cut from the market as the tender for Urals crude received no bids this morning - it seems buyers are afraid of the potential for forthcoming sanctions to impact any purchases made now).

OPEC+ stuck to its plan this morning to increase production by 400k bbl/day:

“The situation in energy markets is very serious and demands our full attention,” IEA Executive Director Fatih Birol said in a statement. “Global energy security is under threat, putting the world economy at risk during a fragile stage of the recovery.”

For now, all eyes will be on the official data to see if API's big crude draw is confirmed...

API

  • Crude -6.1mm (+2.8mm exp) - biggest draw since September

  • Cushing -1mm

  • Gasoline -2.5mm

  • Distillates +0.4mm

DOE

  • Crude -2.597mm (+2.8mm exp)

  • Cushing -972k

  • Gasoline -468k

  • Distillates -574k

Draws across the board. Cushing stocks fell for the 8th straight week and crude inventories confirmed API's report with a sizable (though smaller than API) draw against expectations of a build...

Source: Bloomberg

This pushes Cushing stocks ever nearer operational lows as 'tank bottoms' are in sight...

Source: Bloomberg

US crude production was unchanged despite fresh urgings from the Biden admin and rising rig counts...

Source: Bloomberg

WTI was hovering around $109 ahead of the official data.

Perhaps unsurprisingly, crude imports from Russia last week dropped to zero.

We had three consecutive weeks of zero crude imports from Russia in Jan. Traders have said there is little evidence of new bookings. So far in 2022, Russian crude flows to the U.S. are on track for the slowest annual pace since 2017, according to data from Kpler.

Bloomberg Intelligence Energy Analyst Fernando Valle:

A potential coordinated release of global oil stockpiles, including a possible 60 million-barrel sale from the U.S. Strategic Petroleum Reserve, may not do much to stop the surge in prices for WTI and Brent crude, only decelerate the advance. The threat that financial sanctions against Russia for its invasion of Ukraine may limit movement for Urals crude is behind the rise, even though energy exports aren’t specifically targeted. Urals crude is unlikely to be replaced in the short run, as U.S. shale producers have already winnowed their inventories of drilled but uncompleted wells in recent months. Labor and equipment shortages may limit producers’ ability to raise output in 1H.

Meanwhile, the market's tightness is evident in the extreme backwardation in WTI - a record $20 spread from M1 to M6...

Source: Bloomberg

And right now, we are staring $4 gas national average in the face...

Source: Bloomberg

This is - in a very uncomfortable way - good news, since demand destruction tends to occur once gas pump prices top $3... and topping $4 will severely crimp demand.

And here - in one simple chart - is why the market is ignoring the SPR release - prices have exploded higher as SPR levels have plunged for two years...

Source: Bloomberg

So The Fed will be hiking into a recession!

https://www.zerohedge.com/energy/wti-extends-gains-after-cushing-stocks-drop-near-tank-bottoms-crude-draws

Powell Kills March 50bps Rate Hike, But Leaves Door Open For Later In 2022

 Rest in Peace 50bps March rate hike.

Moments ago, Fed Chair Powell said that he is "inclined to support a 25 basis point rate hike" in March, which immediately killed any market expectation of a 1+ rate hike in two weeks.

However, in the very next sentence, Powell said that if inflation stays hot, he could move more than 25 basis points at upcoming meetings, which in turn pushed the full year rate hike expectations sharply higher, from 5.2 to 5.6.

Of course, this is not the end of this story, and should oil continue to surge - and it will - unleashing inflationary shockwaves and crippling global growth, expect this hawkish consensus to once again unwind... but not yet, because as noted earlier, the VaR shock in the STIR space is now in full-blown reverse mode, with Dec 2022 ED futs collapsing and undoing their entire Tuesday move...

... even though absolutely nothing has changed in the past 24 hours. More remarkably, looking at the Eurodollar strip, today is shaping up as an even bigger hawkish "surprise" reversal than the July 2013 taper tantrum.

Finally, what all of this means is that bond market volatility is exploding, and assuring that the Fed will have to be on its toes as any geopolitical news can spark a liquidation or short-covering frenzy in a bond market where there is now also virtually no liquidity.

https://www.zerohedge.com/markets/powell-kills-march-50bps-rate-hike-leave-door-open-later-2022

US FDA approval tracker: February

 The last day of February brought FDA joy for Johnson & Johnson, Legend Biotech and CTI Biopharma but anguish for Gilead and Amryt. The latter's epidermolysis bullosa therapy, Oleogel-S10, was knocked back with the FDA requesting additional confirmatory evidence of efficacy, and it is not yet known whether Amryt will need to run another trial. Meanwhile, Gilead’s lenacapavir was turned down owing to vial compatibility issues; the drug had been filed in heavily treatment-experienced individuals with multi-drug resistant HIV-1 infection. In December ten clinical studies, including Purpose-1 and 2 in pre-exposure prophylaxis, were put on hold due vial concerns. The long-acting HIV-1 capsid inhibitor is seen as an important pipeline asset for Gilead and was expected to be one of the biggest launches of 2022, but approval this year now looks very uncertain. J&J and Legend's Car-T agent, newly approved for multiple myeloma, is also slated as one of this year's biggest launches. The developers believe that last month's green light is only the beginning for Carvykti, and expect peak sales to reach at least $5bn, assuming success is achieved in earlier lines of therapy.   

Notable first-time US approval decisions in February
ProjectCompanyIndication(s)2026e sales by indication (SBI) ($m)Outcome
Carvykti (ciltacabtagene autoleucel/cilta-cel) Johnson & Johnson/
Legend Biotech
3L+ multiple myeloma1,692Approved
LenacapavirGileadMulti-drug resistant HIV in heavily treatment experienced patients 877CRL (vial compatibility issues)
177Lu-PSMA-617 NovartisRadioligand therapy for mCRPC851Pending, expected H1
Enjaymo (sutimlimab)SanofiHaemolysis in adults with cold agglutinin disease440Approved
Vonjo
(Enpaxiq/pacritinib)
CTI BiopharmaMyelofibrosis patients with severe thrombocytopenia368Approved
PriorixGSKMMR vaccine364Pending
Pyrukynd
(mitapivat)
AgiosPK deficiency287Approved
Oleogel-S10
(Filsuvez)
AmrytJunctional and dystrophic epidermolysis bullosa269CRL (additional confirmatory evidence needed)
BardoxoloneReataAlport syndrome-CRL (provide evidence of effectiveness)
GC5107
(immune globulin intravenous, 10% liquid)
GC PharmaPrimary humoral immunodeficiency-CRL (pre-license inspection)
d-amphetamine transdermal system
(ATS)
Noven/
Hisamitsu
ADHD-Pending
Annik
(penpulimab)
Akeso/Sino3rd-line nasopharyngeal carcinoma-Pending, expected H1
TerlipressinMallinckrodtHepatorenal syndrome-Second CRL (manufacturing facility inspection)
Zynquista (sotagliflozin)LexiconHeart failure in adults with type 2 diabetes-NDA filing withdrawn due to technical issue, resbumission targeted for Q2
Source: Evaluate Pharma & company releases.

 

Advisory committee meetings in February
ProjectCompanyIndication2026e SBI ($m)Outcome
ComirnatyPfizer/BiontechAmend the EUA for administration to children 6 months through 4 years of age7,668Postponed, waiting for three-dose data (expected in April)
Tyvyt (sintilimab) +
pemetrexed +
platinum chemotherapy 
Lilly/
Innovent
1L stage IIIB, IIIC, or Stage IV non-squamous NSCLC-14-1 against, Pdufa March 22
IV tramadolAvenueAcute pain-14-8 against
Source: Evaluate Pharma, FDA ad com calendar company releases.

 

Supplementary and other notable approval decisions in February
ProductCompanyIndication (clinical trial)Outcome
Generic Restasis
(cyclosporine)
ViatrisIncrease tear production in patients with dry eyeApproved (first FDA generic)
SolosecLupin PharmaTreatment of bacterial vaginosis and trichomoniasis  in patients aged 12  and olderApproved
JardianceEli Lilly/Boehringer IngelheimHeart failure regardless of left ventricular ejection fraction (Emperor-Preserved)Approved
Generic Farxiga (dapagliflozin)ZydusType 2 diabetesFinal approval
RuzurgiJacobus PharmaceuticalPaediatric patients with Lambert-Eaton myasthenic syndromeRevoked, as approval violated Catalyst's exclusivity for Firdapse
KymriahNovartisr/r FL after two prior lines of treatment (Ph2 Elara)Pending
LynparzaAstrazenecaAdjuvant BRCA-mutated Her2-negative breast cancer (OlympiA)Pending, expected Q1
FasenraAstrazenecaNasal polypsPending, expected H1
OlumiantLillyAtopic dermatitis (Breeze-AD programme)Pending
RinvoqAbbviePsoriatic arthritis, ankylosing spondylitis and ulcerative colitis UC decision expected March, Q2 for ankylosing spondylitis and Q4 for non-radiographic axial SpA
Source: Evaluate Pharma & company releases. 

 

FDA issued EUAs to treat Covid-19
ProjectCompanySetting
Bebtelovimab
(LY-CoV1404)
Eli LillyFor certain non-hospitalised patients with mild-to-moderate Covid-19 at high risk of progression to severe disease 
Source: Evaluate Pharma & company releases. 

https://www.evaluate.com/vantage/articles/insights/nme-approvals-snippets/us-fda-approval-tracker-february