Biotech Values

[DewDiligence]

HCV: Most Likely to Succeed (IMHO)

[Updated entries for AZN’s A-831, IDIX’s
IDX184/IDX320, and Presidio’s PPI-461.]


The following paragraphs are in descending order of likelihood of success. There is no claim of completeness in this compilation, i.e. paragraphs 2-6 do not necessarily mention all of the applicable drug candidates within a given grouping.

Please see #msg-49115388 for the distinction between a nucleoside and a nucleotide; also see #msg-43114117 for historical perspective from the HIV arena.


1. The two leading protease inhibitors: Telaprevir (VRTX/JNJ; phase-3) and Boceprevir (MRK; phase-3). The Telaprevir program is further advanced, so let’s call Telaprevir and Boceprevir 1a and 1b, respectively. Both drugs have shown very impressive efficacy in phase-2 trials, although neither has a completely clean safety profile (see references below).

Telaprevir in the treatment-naïve setting: phase-3 program: #msg-27623529 (ADVANCE study), #msg-26228377 (both studies); phase-2b program: #msg-29019931 (PROVE-1/2 trials made simple), #msg-28746843 (PROVE-1/2 detailed results); C208 study of BID vs TID dosing: #msg-43114192.

Telaprevir in the second-line setting: phase-3 program (REALIZE study): #msg-32901932; phase-2 program: #msg-48759554 (PROVE-3 study), #msg-49096436 (‘107’ open-label extension for PROVE-1/2 failures).

Boceprevir in the treatment-naïve setting: phase-3 program (SPRINT-2 and RESPOND-2): #msg-29474929; phase-2b program: #msg-42086185 (AASLD 2009 abstract re SPRINT-1), #msg-37298987, (interim SPRINT-1 results at EASL 2009), #msg-37298085 (EPO usage), #msg-31190433 (Dew’s musings on SPRINT-1 data).

Boceprevir in the second-line setting: phase-3 (RESPOND-2) study: #msg-29474929.


2. Programs in phase-2b or later: BI 201335 (B-I; phase-2b), a protease inhibitor: #msg-33564560 (phase-2b design), #msg-47877812 (2010 EASL), #msg-42086185 (2009 AASLD); Debio 025 (NVS/Debiopharm; phase-2b), a cyclophilin inhibitor: #msg-46432280; GI-5005 (GlobeImmune; phase-2b), an injectable immunomodulator: #msg-49095438 (phase-2b data); #msg-49171909 (IL-28 B genotype data); ITMN-191 (Roche/ITMN; phase-2b; a/k/a Danoprevir/RG7227), a protease inhibitor: #msg-49099924 (phase-2b data without ritonavir), #msg-46797334 (Dew’s bearish take), #msg-43632598 (first report of liver tox), #msg-45340745 (phase-2b design change and delay), #msg-49046274 (phase-1b data with ritonavir [PR]), #msg-47860488 (phase-1b data with ritonavir [abstract]), #msg-49056848 (ghmm’s musings on ritonavir data), #msg-44330890 (slides from 2009 HepDart), #msg-43185247 (INFORM-1 data from 2009 AASLD); Locteron (Biolex; phase-2b), a long-acting interferon made in transgenic plants that may qualify for the 505b2 approval pathway: #msg-49286341 (interim phase-2b data from 2010 EASL), #msg-37298340 (final phase-2a data), #msg-40953698 (manufacturing agreement); RG7128 (Roche/VRUS; phase-2b), a nucleoside polymerase inhibitor: #msg-46762882 (phase-2b overview), #msg-43836489 (safety evaluation passes in first phase-2b in genotype-1/4), #msg-43185247 (INFORM-1 data from AASLD 2009); TMC435 (Medivir/JNJ; phase-2b), a protease inhibitor: #msg-49286281 (presentations at 2010 EASL), #msg-45415884 (in-progress PK trial re hepatic impairment), #msg-43361309 (overview of phase-2 program at 2009 AASLD), #msg-37298740 (phase-2a data at 2009 EASL.


3. Programs in phase-1b/2a with an established MoA: ABT-072 (ABT; phase-2), a non-nucleoside polymerase inhibitor: #msg-47086871; #msg-47060142; ABT-333 (ABT; phase-2a), a nucleoside polymerase inhibitor: #msg-47060142, #msg-42098204; ABT-450 (ABT/Enanta; phase-2a), a protease inhibitor: #msg-47060142, #msg-35708745; ACH-1625 (ACHN; phase-1b), a protease inhibitor: #msg-49003593 (PR from EASL 2010 [no new news]), #msg-45339022 (data from 500mg BID cohort), #msg-44560695 (data from 600mg BID cohort); ANA598 (ANDS; phase-2a), a non-nucleoside “palm” polymerase inhibitor: #msg-49048685 (8-week interim data from 400mg cohort), #msg-47053147 (12-week interim data from 200mg cohort [PR and Dew’s musings]), #msg-47098741 (graphs of 12-week data from 200mg and placebo cohorts), #msg-47087879 (musings on the 12-week graphs), #msg-40064675 (musings on phase-1b data); BMS-650032 (BMY; phase-2a), a protease/NS3 inhibitor that’s being tested in an all-oral trial with BMS-790052: #msg-44700187, #msg-40361108; BMS-790052 (BMY; phase-2a), an NS5A inhibitor that’s being tested in an all-oral trial with BMS-650032: #msg-44700187 (phase-2 combination trial), #msg-49176213 (phase-2a monotherapy data from 2010 EASL); GS9190 (GILD; phase-2), a non-nucleoside polymerase inhibitor with QT-prolongation issues that GILD is testing in an all-oral combination with GILD’s newly disclosed protease inhibitor GS9256: #msg-46036072; IDX184 (IDIX; phase-2a), a nucleotide polymerase inhibitor: #msg-49096739, #msg-49003061 (interim phase-2a data [table]), #msg-49096739 (interim phase-2a data [PR]), #msg-49115305 (comparison to PSI-7977 data), #msg-49731578 (plan to combine with IDX320), #msg-39719159, (phase-1b monotherapy data), #msg-49115388, #msg-26915921 (nucleotide/liver-targeted MoA), #msg-49055353, #msg-47954632 (in vitro data in combination with other IDIX drugs); IFN-alpha-XL (FLML; phase-2a): #msg-44688995; IFN-Lambda (BMY/ZGEN; phase-2): #msg-34768182 (BMY partnership), #msg-43123220 (final phase-1b data), #msg-43360640 (start of phase-2); MK-7009 (MRK; phase-2a), a protease inhibitor: #msg-34337398, #msg-34335327; PSI-7977 (VRUS; phase-2a), a nucleotide polymerase inhibitor that’s a single-isomer version of PSI-7851: #msg-49048250 (4-week interim phase-2a data), #msg-49115305 (comparison to IDX184 data), #msg-40115833 (phase-1b data for PSI-7851); VX-222 (VRTX; phase-2; f/k/a VCH-222), a non-nucleoside “thumb” polymerase inhibitor (acquired from ViroChem) being tested with Telaprevir+SoC as well as with Telaprevir alone: #msg-47189924 (combo trial with Telaprevir), #msg-47242513 (musings on combo trial), #msg-49096553 (phase-1b monotherapy data [PR]), #msg-47879091 (phase-1b monotherapy data [abstract]).


4. Very-early-stage programs with an established MoA: ACH-2684 (ACHN; preclinical), a protease inhibitor: #msg-46160360; AVL-181 and AVL-192 (Avila Therapeutics; preclinical): a pair of related protease inhibitors: #msg-49093995; EDP-239 (Enanta; preclinical): an NS5A inhibitor: #msg-47301187; ‘hyperglycosylated’ interferon (Alios BioPharma; preclinical): #msg-35612425; IDX320 (IDIX; phase-1), a macrocyclic protease inhibitor: #msg-49731578 (plan to combine with IDX184), #msg-45598790 (rationale for compound), #msg-49055353, #msg-47954632 (PK, DDI, in vitro data in combination with other IDIX drugs); IDX375 (IDIX; phase-1), a non-nucleoside “palm” polymerase inhibitor: #msg-45350536 (phase-1 PK data), #msg-49055353, #msg-47954632 (in vitro data in combination with other IDIX drugs); INX-189 (INHX, preclinical), a nucleotide polymerase inhibitor: #msg-48567678; MK-3281 (MRK; phase-1), a non-nucleoside “thumb” polymerase inhibitor: #msg-42093301 (safety signal in AASLD 2009 abstract); PPI-461 (Presidio Pharma; phase-1), an NS5A inhibitor: #msg-49466514; PSI-938 (VRUS; phase-1), a purine-analog nucleotide prodrug: #msg-48719338; PSI-879 (VRUS; preclinical), a purine-analog nucleotide prodrug billed as the successor to PSI-938: #msg-42245955; three unnamed compounds with undisclosed MoA’s (GILD; phase-1): #msg-49224935; an unnamed NS5A inhibitor (IDIX; preclinical): #msg-47110147; an unnamed NS5A inhibitor (GSK via Genelabs; status unknown): #msg-33209281, #msg-33211420; an unnamed NS5A inhibitor (VRTX via ViroChem; preclinical): #msg-36022752.


5. Programs in phase-2 or earlier with a novel MoA: ACH-1095 (ACHN; preclinical), an NS4A inhibitor that GILD dropped while retaining the right to opt back in: #msg-41217537; AVL-181 (Avila Therapeutics; preclinical), a small-molecule drug that purportedly binds to an infected hepatocyte: #msg-47113598; CF-102 (Can-Fite; phase-1/2), a polymerase inhibitor that purportedly induces apoptosis: #msg-39588570; clemizole (Stanford University; preclinical), an NS4B inhibitor: #msg-39883747; CTI-1027 (Conatus; phase-2): #msg-46034554; IL-7 (Cytheris; phase-1/2) an injectable immunomodulator: #msg-33152073; IMO-2125 (IDRA; phase-1), a TLR9 agonist: #msg-49094332; ITX5061 (iTherX; phase-2a), MoA unknown: #msg-35319690; MB11362 (Roche/MBRX; preclinical), MoA undisclosed: #msg-38456136; nitazoxanide (Romark/Chugai; phase-2): #msg-35738696; NOV-205 (NVLT, phase-2), supposedly an immunomodulator: #msg-48269914; SCY-635 (Scynexis; phase-1b), a cyclophilin inhibitor: #msg-46669845; SD-101 (DVAX; phase-1b), a TLR9 agonist: #msg-45932364; SPC3649 (Santaris; preclinical), MoA based on microRNA: #msg-44177354; an unnamed entry inhibitor (PGNX; preclinical): #msg-38519885; an unnamed miR-122 inhibitor (GSK/Regulus; preclinical): #msg-47081015.


6. Programs on the back burner: A-831 (AZN; status unknown), an NS5A inhibitor: #msg-49610323; Albuferon/Zalbin (HGSI/NVS; BLA submitted/MAA withdrawn): #msg-49185693 (MAA withdrawal), #msg-36140577 (phase-3 data), #msg-36254180 (lack of SPA), #msg-48180658, #msg-48213975 (tepid phase-2 data with monthly dosing); ANA773 (ANDS; phase-1), an oral TLR7 modulator that ANDS discontinued in Jun 2009 and is nominally available for partnering: #msg-38418158; SCH 900518/narlaprevir (MRK; phase-2a), a protease inhibitor originally owned by Schering-Plough that MRK discontinued following a pipeline pruning: #msg-47224801 (3/1/10 announcement of discontinuation), #msg-43169835 (interim phase-2a data), #msg-34338549 (final phase-1b data); taribavirin (VRX; phase-2b), a “legacy” prodrug of ribavirin that has been floating around for a long time: #msg-38280961 (musings on final phase-2b data), #msg-37299101 (detailed 60-week data); VX-813/VX-985 (VRTX; phase-1/preclinical), protease inhibitors that were previously touted as the backups to Telaprevir: #msg-45333927.


JMHO, FWIW