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KEYTRUDA plus CRT is the first immunotherapy-based regimen to demonstrate a statistically significant improvement in OS in these patients
KEYNOTE-A18, also known as ENGOT-cx11/GOG-3047, is a randomized, double-blind Phase 3 trial
https://www.biospace.com/article/releases/merck-s-keytruda-pembrolizumab-plus-chemoradiotherapy-crt-significantly-improved-overall-survival-os-versus-crt-alone-in-patients-with-newly-diagnosed-high-risk-locally-advanced-cervical-cancer/?keywords=pancreatic+cancer+phase+3
MRK reports 2Q23 results…
PR:
https://www.businesswire.com/news/home/20230801830764/en
Reuters:
https://finance.yahoo.com/news/1-merck-beats-quarterly-sales-104937970.html
Merck & Co raised its full-year revenue forecast on Tuesday as second-quarter sales of its top-selling products, cancer immunotherapy Keytruda and human papillomavirus (HPV) vaccine Gardasil, sailed past Wall Street estimates.
Merck said Keytruda sales for the quarter jumped 19% to $6.3 billion, surpassing analysts' average estimate of $5.9 billion.
…Sales of Gardasil…surged 47% to $2.5 billion, also well above Wall Street estimates of $2.1 billion.
MRK’s V116 shows non-inferiority to Prevnar-20 in two phase-3 trials (one for pneumococcal-vaccine naïve patients and one for patients who received a prior pneumococcal vaccine):
https://www.businesswire.com/news/home/20230727120762/en
V116 is a 21-valent pneumococcal vaccine intended for the adult market only. PFE’s Prevnar-20 currently owns virtually the entire adult market for pneumococcal vaccines because CDC/ACIP’s recommendations give preferential treatment to Prevnar-20 vs MRK’s 15-valent V114 (a/k/a Vaxneuvance) (#msg-166441188).
The V116 results announced today put MRK back in the ballgame for the adult segment of the market.
See #msg-168548763 for related info.
MRK sues US over IRA drug-price “negotiation”:
https://www.wsj.com/articles/merck-challenges-u-s-governments-new-powers-to-negotiate-drug-prices-127d4b0c
Drugmaker Merck & Co. filed a lawsuit on Tuesday challenging the U.S. government’s plan to negotiate drug prices, saying it is unconstitutional.
Drugmakers were expected to file lawsuits challenging the program, especially as Medicare neared the date later this year when it began naming some drugs it would target for price negotiations.
Among the drugs that analysts expected to face price negotiations are Merck’s top-selling product, the cancer immunotherapy Keytruda.
Merck’s complaint takes issue with the negotiation program’s enforcement rules, which include the power to levy an excise tax of up to 95% of a drug’s U.S. sales if a pharmaceutical company refuses to sell the drug to Medicare patients. Merck said the tax would be coercive and violate the constitution’s Fifth Amendment ban on private property being taken for public use without just compensation. [The so-called “takings” clause.]
Merck also said the law would force companies to agree that the government-mandated prices are “fair,” violating its free speech rights under the First Amendment.
MRK reports 1Q23 results—raises non-GAAP EPS guidance:
https://finance.yahoo.com/news/merck-announces-first-quarter-2023-103000788.html
https://finance.yahoo.com/news/merck-earnings-better-expected-keytruda-103855413.html
2023 non-GAAP EPS guidance was raised to $6.88-7.00 (from $6.80-6.95).
A Delaware judge ruled today that MRK remains liable for talc lawsuits relating to Dr. Scholl’s foot powder, even though MRK sold its OTC- healthcare business to Bayer in 2014:
https://finance.yahoo.com/news/bayer-defeats-merck-lawsuit-over-215120183.html
MRK inherited Dr. Scholl’s in the 2009 takeover of Schering-Plough.
Keytruda shows statsig-superior PFS as addend to chemo in Stage-III/IV (or recurrent) endometrial cancer:
https://www.businesswire.com/news/home/20230327005147/en
The HR for PFS was 0.54 in the pMMR subgroup and 0.30(!) in the dMMR subgroup.
The OS results are not disclosed in the PR, so they are presumably not mature. (OS was a secondary endpoint.)
EMA rejects MRK’s MAA for Molnipiravir:
https://www.businesswire.com/news/home/20230223006077/en
Merck and Ridgeback Biotherapeutics today announced that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has recommended the refusal of the marketing authorization for LAGEVRIO (molnupiravir) for the treatment of certain adults who have been diagnosed with COVID-19 in the European Union (EU). Merck and Ridgeback will appeal the decision and request a re-examination of the CHMP’s opinion.
MRK 4Q22 results—2023 guidance:
https://s21.q4cdn.com/488056881/files/doc_financials/2022/q4/Merck-News-Release-02-02-23-Merck-Announces-4Q-and-FY-2022-Financial-Results.pdf
2023 guidance for non-GAAP EPS is $6.80-6.95; at the midpoint, this is an 8% decline from 2022’s $7.48.
CC slides:
https://s21.q4cdn.com/488056881/files/doc_financials/2022/q4/Q4-2022-Merck-Earnings-Deck-(Final).pdf
Prepared remarks:
https://s21.q4cdn.com/488056881/files/doc_financials/2022/q4/Q4-2022-Merck-Earnings-Prepared-Remarks-(Final).pdf
FDA approves Keytruda for adjuvant NSCLC following adjuvant treatment with platinum chemo:
https://www.businesswire.com/news/home/20230127005078/en
Keytruda’s HR for DFS (compared to placebo) was 0.73 [95% CI: 0.60-0.89]. This is slightly better than the HR=0.76 that MRK reported when the KEYNOTE-091 trial reported in Mar 2022 (#msg-168241140); I do not know the reason for the discrepancy.
Curiously, in an exploratory analysis of patients (n=167) who did not receive adjuvant chemo, Keytruda’s HR for DFS (relative to placebo) was 1.25 (i.e. the Keytruda arm did worse than placebo), but the 95% confidence interval was wide [0.76-2.05].
That would be the best , most productive purchase they could ever make , but Merck mgt is too stupid. They try to build equivalent to DCVax with every asinine purchase they make. Maybe a new mgt team at Merck with common sense, would get DCVax , the most incredible advancement in GBM and immunology in history.
Keytruda fails again in prostate cancer—one of the few cancer indications where it has not seen a positive outcome:
https://www.businesswire.com/news/home/20230124006084/en/Merck-Announces-KEYNOTE-991-Trial-Evaluating-KEYTRUDA%C2%AE-pembrolizumab-Plus-Enzalutamide-and-Androgen-Deprivation-Therapy-in-Patients-With-Metastatic-Hormone-Sensitive-Prostate-Cancer-to-Stop-for-Futility
Merck…today announced that it will stop the Phase 3 KEYNOTE-991 trial investigating KEYTRUDA…in combination with enzalutamide and androgen deprivation therapy (ADT) for the treatment of patients with metastatic hormone-sensitive prostate cancer (mHSPC).
…At the interim analysis, KEYTRUDA in combination with enzalutamide [Xtandi] and ADT did not demonstrate an improvement in overall survival (OS) or radiographic progression-free survival (rPFS), the trial’s dual primary endpoints, compared to placebo plus enzalutamide and ADT.
The MRK-SGEN deal reputed to be nearly done last summer (#msg-169332904) can probably be dismissed after MRK’s ADC collaboration with China’s Kelun-Biotech today:
https://finance.yahoo.com/news/merck-kelun-biotech-announce-exclusive-114500834.html
MRK/MRNA cancer vaccine shines in adjuvant melanoma (RFS HR=0.56):
https://www.accesswire.com/731571/Moderna-and-Merck-Announce-mRNA-4157V940-an-Investigational-Personalized-mRNA-Cancer-Vaccine-in-Combination-with-KEYTRUDAR-pembrolizumab-Met-Primary-Efficacy-Endpoint-in-Phase-2b-KEYNOTE-942-Trial
…the Phase 2b KEYNOTE-942/mRNA-4157-P201 trial of mRNA-4157/V940, an investigational personalized mRNA cancer vaccine, in combination with KEYTRUDA…demonstrated a statistically significant and clinically meaningful improvement in the primary endpoint of recurrence-free survival (RFS) versus KEYTRUDA alone for the adjuvant treatment of patients with stage III/IV melanoma following complete resection.
Adjuvant treatment with mRNA-4157/V940 in combination with KEYTRUDA reduced the risk of recurrence or death by 44% (HR=0.56 [95% CI, 0.31-1.08]; one-sided p-value=0.0266) compared with KEYTRUDA alone.
MRK acquires IMGO for $36.00/sh cash—a 107% premium to Friday’s close:
https://finance.yahoo.com/news/merck-acquire-imago-biosciences-inc-114500059.html
The nominal deal value is $1.35B. The buyout price is a 125% premium to IMGO’s IPO price 16 months ago (#msg-164945919).
I would take the other side of that bet!
Ehhhhh seems a lot more likely today
Unlikely, haha.
MRK exercises option_to_commercialize MRNA cancer vaccine:
https://www.accesswire.com/720004/Merck-and-Moderna-Announce-Exercise-of-Option-by-Merck-for-Joint-Development-and-Commercialization-of-Investigational-Personalized-Cancer-Vaccine
https://finance.yahoo.com/news/1-merck-opts-jointly-develop-113551661.html
MRNA receives $250M in immediate cash from MRK’s opt-in.
Sotatercept phase-3 in PAH hits primary endpoint:
https://finance.yahoo.com/news/merck-announces-positive-top-line-104500840.html
Sotatercept is the drug MRK picked up in the $11.5B XLRN acquisitions last year (#msg-166156870).
Lagevrio misses_primary_endpoint_in_large_Oxford_U_trial:
https://ca.finance.yahoo.com/news/merck-ridgeback-biotherapeutics-clinical-non-235000071.html
The PANORAMIC study, a UK-based clinical trial sponsored by the University of Oxford, included 25,783 participants who were randomized to open label treatment with LAGEVRIO plus usual care (n=12,821) or usual care alone (n=12,962); mean age of participants was 56.6 years. Primary outcome data were available in 25,000 (97%) participants. Nearly all (>98%) participants were vaccinated, with approximately 95% receiving three or more doses of a SARS-CoV-2 vaccine.
In the preliminary analysis, the primary endpoint of reduction of hospitalizations and deaths within 28 days of randomization, compared to usual care, was not met; 0.8% of patients in both the LAGEVRIO group (n=103/12,516) and the usual care group (n=96/12,484) were hospitalized or died in the first 28 days.
FDA allows some Islatravir trials to_resume_at_a lower dose:
https://finance.yahoo.com/news/merck-initiate-phase-3-clinical-104500524.html
Keytruda narrowly_misses_statsig OS/PFS as_addend_to Lenvina in_ first-line HCC:
https://finance.yahoo.com/news/merck-eisai-present-results-phase-063000955.html
In the final analysis of the trial, there was a trend toward improvement for one of the study’s dual primary endpoints, overall survival (OS), for patients treated with KEYTRUDA plus LENVIMA versus LENVIMA monotherapy; however, the results did not meet statistical significance per the pre-specified statistical plan (HR=0.84 [95% CI: 0.71-1.00]; p=0.0227). The median OS was 21.2 months (95% CI: 19.0-23.6) for KEYTRUDA plus LENVIMA and 19.0 months (95% CI: 17.2-21.7) for LENVIMA monotherapy.
Additionally, treatment with KEYTRUDA plus LENVIMA resulted in a trend toward improvement in the trial’s other dual primary endpoint of progression-free survival (PFS) versus LENVIMA monotherapy; however, the results did not meet the pre-specified threshold at the first interim analysis for statistical significance (HR=0.87 [95% CI: 0.73-1.02]; p=0.0466).
Merck snatched up ROR1 veslobio for 2.75 Billion I think they may try and Buy ONCT better acting drug partnered with ABBV ibrutinib the combo works 50% better than the drug alone. Pcyc ibrutinib now ABBV is going to do 9.5-10 Billion in sales next year. I think Merck might buy ONCT more data further along in trials very robust pipeline. ROR1 expression on many tumor types
• Potential safety and efficacy advantages
• MK-2140 ADC data at ASH 2021: no apparent off-
tumor, on-target ROR1 toxicities.
ROR1 Expressed on Multiple
Solid and Liquid Tumor's
MCL 95%
CLL 95%
Uterus 96%
Lymphoma 90%
Prostate 90%
Skin 89%
Insiders have been buying it up just broke the 50 day moving average. I think Merck might come in to add to there Ror1 portfolio.
https://www.fiercebiotech.com/biotech/boehringer-inks-1-5b-nbe-buyout-joining-merck-ror1-adc-race
$MRK
Keytruda fails phase-3 in CRPC:
https://www.businesswire.com/news/home/20220803005334/en
Merck…today announced that the Phase 3 KEYNOTE-921 trial evaluating KEYTRUDA in combination with chemotherapy (docetaxel) compared to chemotherapy alone did not meet its dual primary endpoints of overall survival (OS) and radiographic progression-free survival (rPFS) for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC). In the study, there were modest trends toward an improvement in both OS and rPFS for patients who received KEYTRUDA plus chemotherapy compared with chemotherapy alone; however, these results did not meet statistical significance per the pre-specified statistical plan.
FDA approves MRK’s pneumococcal vaccine, Vaxneuvance for infants/children:
https://finance.yahoo.com/news/u-fda-approves-merck-vaxneuvance-104500312.html
Vaxneuvance was already FDA-approved for adults (#msg-164961310), but I don’t think Vaxneuvance will compete effectively with PFE’s Prevnar-20, which has broader coverage of pneumococcal serotypes and a simpler (one-shot) treatment course (#msg-166441188).
PFE's Prevnar-20 is FDA approved for adults, but is not yet approved for infants/children, so MRK does have a head start in the pediatric market.
MRK pays PFE a royalty of 7.25% on worldwide Vaxneuvance sales during 2022-2026 and a 2.5% royalty during 2027-2035 (#msg-166075692).
WHAT ARE YOU TALKING ABOUT??? COVID-19 IS JUST RENAMED INFLUENZA.... ITS A TOTAL SCAM!!!!!
BIG PHARMA ARE CRIMINALS DUPING THE PUBLIC!!!!!!!!
ENOUGH WITH THE MINDLESS HYSTERIA ALREADY!!!!!!!
Pay attention, looks like we have a change in the last immune escape variants. They may have also become more heat tolerant, or more stupid monkeys are hanging out with eachother. Uptick in Delta.
MRK slides from ASCO webcast:
https://s21.q4cdn.com/488056881/files/doc_events/2022/06/ASCO-2022-Slide-Presentation-Final.pdf
Synopsis of (anti-LAG-3) favezelimab data from ASCO abstract:
https://www.biopharmadive.com/news/asco-merck-favezelimab-lag3-hodgkin-trial/624457/
Favezelimab might eventually compete with BMY’s Opdualag (#msg-168259768), but it has a long way to go.
Please see #msg-168259803 and https://twitter.com/DewDiligence/status/1395141087413538822 for related info.
CHMP approves Keytruda/chemo in the neoadjuvant setting followed by Keytruda monotherapy in the adjuvant setting for non-metastatic TNBC:
https://www.businesswire.com/news/home/20220425005161/en
Approval based on KEYNOTE-522 trial.
MRK’s V116—(follow-on_to Vaxneuvance)—receives FDA BTD for prevention of pneumococcal disease in adults:
https://finance.yahoo.com/news/merck-announces-u-fda-granted-104500278.html
The phase-3 trial is expected to start during 2022.
V116 is a 21-valent vaccine; the 21 strains are: 3, 6A/C, 7F, 8, 9N, 10A, 11A, 12F, 15A, 15B/C, 16F, 17F, 19A, 20, 22F, 23A, 23B, 24F, 31, 33F, 35B.
MRK—Vaxneuvance sBLA for pediatrics gets 3-month extension to 7/1/22:
https://finance.yahoo.com/news/merck-provides-fda-review-supplemental-104500754.html
Vaxneuvance is already FDA-approved for adults (#msg-164961310), but I don’t think Vaxneuvance will compete effectively with PFE’s Prevnar-20, which has broader coverage of pneumococcal serotypes and a simpler (one-shot) treatment course (#msg-166441188).
p.s. MRK pays PFE a royalty of 7.25% on worldwide Vaxneuvance sales during 2022-2026 and a 2.5% royalty during 2027-2035 (#msg-166075692).
FDA approves Keytruda monotherapy for recurrent endometrial cancer with MSI-H or dMMR:
https://finance.yahoo.com/news/fda-approves-merck-keytruda-pembrolizumab-203000436.html
The approval is based on ORR from single-arm cohorts of the KEYNOTE-158 trial.
Note: Keytruda plus Lenvima is already FDA-approved in the same setting for patients without either MSI-H or dMMR.
Thanks DewDiligence. The reason I ask, is that after no trial updates since January 2013, on October 27, 2021, ANIP or an undisclosed partner filed a Clinical Trial Certification/Extension request for their 3,656 patient long-term safety/efficacy Libigel trial. A request to delay submitting results for up to 2 years or 30 days after approval. Though it does not specify if it was a Certification or Extension request, a Certification is usually submitted in relation to filing an NDA.
Certification/Extension Submission
In looking at the study design, the trial was completed on December 2012 (pre-commercialization part of the study). However even the if full trial was completed in August 2016, as listed in the clinical trial history (full safety/efficacy study including post approval observations), there is no obligation to submit results, let alone make request for a delay in submitting results, unless they have or were about to file an NDA.
History of Change Comparison
Then Ms. Elizabeth Powell joined the Rare Disease Business Unit at ANI as Chief Compliance Officer and Head of Legal, Rare Disease in February 2022, assuming responsibility for the Legal and Compliance functions. For the past 24 years, Ms. Powell worked at Merck & Co., Inc., where she was responsible for strategic counsel related to commercial, compliance and FDA regulatory issues, and most recently served as Managing Counsel and Executive Director, U.S. Commercial & Compliance Legal.
Ironically, ANIP advanced their Annual Stockholder meeting from June 2, 2021 to April 27, 2022, which is exactly 6 months after they submitted their Certification/Extension request. It makes me wonder if ANIP or more likely a partner filed an NDA and got a 6-month Priority Review for Libigel.
To date ANIP has never publicly released that Libigel reduced Cardiovascular events in post menopausal women at risk of cardiovascular events by at least 70% (discovered in 2011 or earlier) and they never announced the that it reduced Breast Cancer events by an undisclosed amount (discovered in December 2015 or sooner). Both discoveries are only publicly available in patent applications and related prosecutions.
I realize Merck is facing an LOE for Januvia and Janumet in 2022 (China and EU) and January 2023 (US) and wondered if they are looking to Libigel to offset some of the losses. It would be the first FDA approved female testosterone drug with an instant market in replacing existing off label and compounded testosterone, currently being prescribed.
It appears to fit Merck's criteria for acquisition and partnership
- Fills an unmet need.
- Looking at their R&D and Products page, it appears to fit into at least two of their Areas of Focus, Cardio-metabolic disorders and Oncology.
Areas of Focus
If Merck is interested in female testosterone the Global Consensus Position Statement on the Use of Testosterone Therapy for Women will help in marketing it out of the gate.
The following are some indications that the Position Statement identified as needing more information before making recommendations:
- Cognitive performance, or to delay cognitive decline, in postmenopausal women.
- Impact of testosterone treatment on musculoskeletal tissues
- Prevention of breast cancer (Libigel trial appears to answer this)
- Cardiovascular safety in women at risk (Libigel trial appears to answer this and indicates prevention capbilities).
It creates an R&D roadmap, with the potential of female testosterone eventually becoming a franchise drug with multiple indications.
FYI the patient population from the of the Libigel safety/efficacy trial included postmenopausal women suffering from the following.
- Hypertension
- Dyslipidemia
- Diabetes mellitus
It also included smokers.
It may all be coincidences, but evidence supporting an NDA filing, Ms. Powell coming over ANIP after 24 years with Merck, the Areas of Focus for Merck that Libigel addresses and the Pipeline Page's Key Therapeutic Ares having an empty Women's Health box, left me wondering if as you stated was a clerical error. Or, if Merck and ANIP have entered into a yet to be disclosed partnership.
Keep up the good work DewDilligence.
Keytruda monotherapy-vs-placebo DFS HR=0.76 in adjuvant* NSCLC, irrespective of PD-L1 status, in phase-3 KEYNOTE-091 trial:
https://www.businesswire.com/news/home/20220317005084/en
Although the DFS endpoint was statig, the effect size was so-so (HR=0.76). The statsig outcome was reported on 1/10/22 (https://www.merck.com/news/mercks-keytruda-pembrolizumab-showed-statistically-significant-improvement-in-disease-free-survival-versus-placebo-as-adjuvant-treatment-for-patients-with-stage-ib-iiia-non-small-cell/ ), but the details were not disclosed until today.
Curiously, in the pre-specified subgroup with PD-L1>=50%, Keytruda’s DFS compared to placebo had a non-statsig HR=0.82—a worse result than in the overall trial.
The HR for OS, a secondary endpoint that is not yet mature, was 0.87.
All told, this is not a great dataset, IMO, but it may be enough for FDA approval. These data may put Keytruda at a competitive disadvantage to Tecentriq and Opdivo in early-stage NSCLC.
*Stage 1b-IIIa.
That’s a clerical error.
Upon looking at Merck's Pipeline webpage I see that Women's Health is included in their Therapeutic Key Areas, yet when you look at Phase two, Phase 3 and Under Review Sections there are no products in this category.
https://www.merck.com/research-and-products/product-pipeline/
I thought they spun off Women's Health into Organon.
Is this a precursor for an expansion into select women's health products?
COVID SCAM IS OVER... ALL THESE GRIFTER COMPANIES PROFITING OFF BS WILL END PAYING A HEAVY PRICE!!!!!!!
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