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Replies to #89687 on Biotech Values
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gym gravity

01/27/10 7:09 AM

#89695 RE: DewDiligence #89687

Do you ever get the feeling the HCV landscape is way too crowded?

Isn't your most likely to succeed post screeming "HCV bubble"?

Not that I think that bubble will burst soon.

In 5 years or so there could be three or four regimens to choose from,

at least two of them with no INF, at least one of them all oral, maybe one with no rib.

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ghmm

01/28/10 8:38 PM

#89743 RE: DewDiligence #89687

Its no where near as up-to-date as Dew's Most Likely to Succeed but it does have pretty colors, links and a development chart.
http://hcvdrugs.com/
Maybe if enough people e-mail them they'll update the site. Maybe DD can license out his HCV: MLtS list :-).
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DewDiligence

01/29/10 6:04 AM

#89764 RE: DewDiligence #89687

HCV: Most Likely to Succeed (IMHO)

[Updated entries for GILD’s GS9190 and Conatus
Pharma’s CTS-1027; new entry for ACHN’s ACH-2684.]



The following paragraphs are in descending order of likelihood of success. There is no claim of completeness here; i.e. paragraphs 3-7 do not necessarily mention all of the applicable drug candidates within the grouping. (Within each numbered paragraph 3-7, the order of the listed entries is not intended to convey any meaning.)

Please see #msg-42396728 for the distinction between a nucleoside and a nucleotide, and see #msg-43114117 for some 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-37316151 (PROVE-3 study), #msg-42965441 (‘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. ITMN-191 (a/k/a/ RG7227) and RG7128, the two oral drugs that Roche is testing in the INFORM-1 study that does not include interferon or ribavirin: #msg-43185247 (AASLD 2009), #msg-37309589 (EASL 2009), #msg-37312942 (viral-load chart from EASL 2009 with annotations by ghmm), #msg-37208214 (Apr 2009 PR on expanded trial design), #msg-37209844 (clinicaltrials.gov listing).

ITMN-191 (ITMN/Roche; phase-2b) is a protease inhibitor: #msg-45340745 (phase-2b design change and delay), #msg-44330890 (slide presentation); #msg-43632598, #msg-43674521, #msg-43666728 (liver tox causes dosing adjustment in phase-2b); #msg-42016434, #msg-43666728 (boosting with ritonavir).

RG7128 (VRUS/Roche; phase-2b) is a nucleoside polymerase inhibitor: #msg-43836489, #msg-34746768.

Although ITMN-191 and RG7128 are not necessarily the best drugs in their respective classes, the fact that Roche is testing them in INFORM-1 gives them a leg up on competing drugs at the same stage of development, IMO.


3. Other agents in phase-2b or later: Albuferon/Zalbin/Joulferon (HGSI/NVS; BLA and MAA submitted): #msg-36140577 (phase-3 data), #msg-36254180 (lack of SPA!), #msg-34770426 (new trial with monthly dosing); BI 201335 (B-I; phase-2b), a protease inhibitor: #msg-42086185, #msg-33564560; and Locteron (Biolex; phase-2b), a long-acting interferon made in transgenic plants that may qualify for the 505b2 approval pathway: #msg-37298340 (phase-2a data from EASL 2009), #msg-37178496 (phase-2b design), #msg-40953698 (manufacturing agreement).


4. Agents in phase-1b or phase-2a that use an established MoA. These include ACH-1625 (ACHN;phase-1b), a protease inhibitor: #msg-45339022, #msg-44560695, #msg-44566075; BMS-650032 (BMY, phase-2), a protease/NS3 inhibitor that’s being tested in an all-oral phase-2 trial with BMS-790052 (see paragraph 6 below): #msg-44700187, #msg-40361108; TMC435 f/k/a/ TMC435350 (Medivir/JNJ; phase-2b), a protease inhibitor: #msg-43361309 (overview of phase-2a/2b program at 2009 AASLD), #msg-37298740 (phase-2a data at EASL 2009), #msg-45415884 (2010 PK trial re hepatic impairment); SCH 900518 a/k/a/ Narlaprevir (MRK; phase-2a), a protease inhibitor: #msg-43169835 (interim phase-2a data), #msg-34338549 (final phase-1b data); 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-2), a nucleotide polymerase-inhibitor: #msg-45350536 (first phase-2 combo data), #msg-39719159, #msg-39720566 (phase-1b monotherapy data), #msg-26915921 (how IDX184 is better than NM283); PSI-7977 (VRUS, phase-2a), a nucleotide polymerase inhibitor that’s a single-isomer version of PSI-7851: #msg-45735193 (start of phase-2a), #msg-40115833 (phase-1b data for PSI-7851); IFN-alpha-XL (FLML; phase-2a): #msg-44688995; ABT-450 (ABT/Enanta, phase-1), a protease inhibitor: #msg-35708745; VCH-222 (VRTX, phase-1b), a non-nucleoside “thumb” polymerase inhibitors that VRTX acquired from ViroChem: #msg-45333756, #msg-37089807; 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; ABT-333 (ABT, phase-1b), a polymerase inhibitor: #msg-42098204; and ANA598 (ANDS, phase-2), a non-nucleoside “palm” polymerase inhibitor: #msg-44635086 (interim phase-2 PR), #msg-44647384 (interim tabular data), #msg-44645147 (musings on interim data), #msg-40064675 (musings on phase-1b data).


5. Very-early-stage compounds that use an established MoA. These include IDX320 (IDIX, phase-1), a macrocyclic protease inhibitor: #msg-45598790); IDX375 (IDIX,phase-1), a non-nucleoside “palm” polymerase inhibitor: #msg-45350536; MK-3281 (MRK, phase-1), a non-nucleoside “thumb” polymerase inhibitor: #msg-42093301 (safety signal in AASLD 2009 abstract); PSI-938 and PSI-879 (VRUS, preclinical), a pair of purine-analog nucleotide prodrugs: #msg-39322313, #msg-42245955; ‘hyperglycosylated’ interferon (Alios BioPharma, preclinical): #msg-35612425; ACH-2684 (ACHN, preclinical), a (presumed) NS3/helicase/protease inhibitor: #msg-46027189.


6. Agents in phase-2 or earlier that use a novel MoA. These include BMS-790052 (BMY, phase-2), an NS5A inhibitor that’s being tested in an all-oral phase-2 trial with BMS-650032 (see paragraph 4 above): #msg-44700187, #msg-33270670; CTI-1027 (Conatus, phase-2): #msg-46034554; CF-102 (Can-Fite, phase-1/2), a polymerase inhibitor that purportedly induces apoptosis: #msg-39588570; MB11362 (Roche/MBRX, preclinical), MoA undisclosed: #msg-38456136; A-831 (AZN, status unknown), an NS5A inhibitor: #msg-16682361; an unnamed NS5A inhibitor that GSK acquired from Genelabs (status unknown): #msg-33209281, #msg-33211420; IL-7 (Cytheris, phase-1/2) an injectable immunomodulator: #msg-33152073; Debio 025 (Debiopharm, phase-2a), a cyclophilin inhibitor: #msg-37359213; NIM811 (NVS, status unknown), a cyclophilin inhibitor: #msg-36507550; GI-5005 (GlobeImmune, phase-2), an injectable immunomodulator: #msg-37298510; ACH-1095 (ACHN, preclinical), an NS4A inhibitor that GILD dropped while retaining the right to opt back in: #msg-41217537; an unnamed NS5A inhibitor that VRTX acquired from ViroChem (preclinical): #msg-36022752; an unnamed NS5A inhibitor from Presidio Pharma (status unknown): #msg-27791536; clemizole (Stanford University, preclinical), an NS4B inhibitor: #msg-39883747; nitazoxanide (Romark/Chugai, phase-2): #msg-35738696; ITX5061 (iTherX, phase-2a), MoA unknown: #msg-35319690; IMO-2125 (IDRA, phase-1), a TLR9 agonist: #msg-44746537; SD-101 (DVAX, phase-1b), a TLR9 agonist: #msg-45932364; a preclinical entry inhibitor from PGNX: #msg-38519885; SPC3649 (Santaris, preclinical), MoA based on microRNA: #msg-44177354.


7. Programs that are nominally alive but are not active. These include ANA773 (ANDS, phase-1), an oral TLR7 modulator that ANDS discontinued in Jun 2009 and is nominally available for partnering: #msg-38418158; 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); and VX-813/VX-985 (VRTX, phase-1/preclinical), protease inhibitors that were previously touted as the backups to Telaprevir: #msg-45333927.


JMHO, FWIW