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Special Report                                                                 Special Report




 The CDMO/CMO report: The market for high-potency   cial  success, according  to the  IQVIA  evaluated in a fi rst-in-human Phase II  of $1-bn ($500-mn each for patritumab
                                         clinical trial.
       analysis.
                                                                          deruxtecan and ifi natamab deruxtecan),
                                                                          a pro-rated portion of which may be
 manufacturing  ADCs draw interest from Big   Designed using Daiichi  Sankyo’s  refundable in the event of early termi-
  trong growth in the global onco-  volume, and offset by losses of exclu-  Pharma  proprietary DXd  ADC  technology to  nation of development with respect to
 logy  market continues to drive  sivity, including biosimilar impact.  PATRICIA VAN ARNUM  A  recent  and  high-profi le  deal  in  target and deliver a cytotoxic payload  each program. For raludotatug deruxte-
 Sgrowth for high-potency manufac-  Editorial Director   the ADC market is Merck & Co.’s and  inside cancer cells that express a spe-  can, Merck will be responsible for 75%
 turing and opportunities for CDMOs/  Spending on oncology medicines is   Drug, Chemical & Associated  Daiichi Sankyo’s $22-bn ADC pact. In  cifi c  cell  surface  antigen,  each  ADC  of the fi rst $2-bn of R&D expenses. Ex-
 CMOs providing this specialized manu-  expected to reach $375-bn by 2027, ac-  Technologies Association,Inc. (DCAT)  October 2023, the companies  entered  consists of a monoclonal  antibody at-  cept with respect to R&D expenses, the
 facturing. What do the market numbers  cording to the IQVIA Institute analysis.   into a global development and commer-  tached  to a number of topoisomerase  companies will equally share expenses
 show now and in the near term?  The US spending on oncology medi-  2021, according to the IQVIA analysis.   cialization agreement for three of Dai-  I inhibitor  payloads  (an  exatecan  de-  as well as profi ts worldwide, except for
 cines  has risen from $58-bn. in 2018  Since 2013, 27% of US oncology new   ichi  Sankyo’s DXd  ADC candidates:  rivative, DXd)  via  tetrapeptide-based  Japan where Daiichi Sankyo  retains
 Oncology drugs: a major growth driver  to $88-bn in 2022, representing  45%  active  substances have not launched   patritumab deruxtecan (HER3-DXd),  cleavable  linkers.  In aggregate, the  exclusive rights and Merck receives a
 Oncology drugs, the largest thera-  of global spending. Growth in the US  in Europe, and 2% of Europe launch-  ifi natamab  deruxtecan  (I-DXd)  and  three programs have multi-billion dol-  royalty based on sales revenue.
 peutic  sector globally  and in the US,  is expected to increase to the 12-15%  es have not reached the US, accord-  raludotatug  deruxtecan (R-DXd), in a  lar worldwide commercial revenue po-
 continues to be a major driver of growth  range as more than 100 new drugs are  ing to the IQVIA Institute analysis. In   deal worth up to $22-bn ($4-bn upfront,  tential for  each company approaching  Emerging bio/pharma companies: key
 for high-potency manufacturing, both  anticipated to launch across novel mo-  China, 121 new active substances were   $1.5-bn in continuation payments, and  the mid-2030s, according to Merck &  customer base for CDMOs/CMOs
 for commercial products and drugs in  dalities and frequently moving to ear-  launched in oncology in the period   $16.5-bn in milestone payments). The  Co., which outlined the deal in an Octo-  While the  Merck–Daichi Sankyo
 development. Biologics and newer ap-  lier lines of therapy; increases in spend-  from 2003 to 2022; 75 of these were   companies will  jointly develop and  ber 18, 2023, press announcement.  deal is an example of a Big Pharma play
 proaches, such as immunotherapies,  ing will be offset by patent expiries for  launched in the last fi ve years.  potentially commercialize these  ADC   in ADCs, in general, emerging biophar-
 constitute the oncology-drug market,  small molecules and biologics, accord-  candidates worldwide, except in Japan   Under the terms of the pact, Merck  ma companies are leading  innovation
 but small molecules, including cytotox-  ing to the IQVIA Institute’s analysis.  The strength of the global oncology   where Daiichi Sankyo will maintain ex-  will pay Daiichi Sankyo  upfront pay-  in the oncology market. Emerging bio/
 ics, and hybrid approaches, such as an-  market is also evident through the in-  clusive rights. Daiichi Sankyo will be  ments of $1.5-bn for ifi natamab deruxte-  pharma  companies,  defi ned  as  those
 tibody-drug conjugates (ADCs), which   A total  of 115 oncology novel  ac-  dustry’s pipeline. The number of prod-  solely responsible for manufacturing  can due upon execution; $1.5-bn for pa-  with less than $500-mn in annual sales
 consists of a monoclonal  antibody  tive substances (NASs) have launched  ucts under development  in oncology   and supply.  tritumab deruxtecan, where $750-mn is  and R&D spending less than $200-mn
 linked to  a cytotoxic small molecule,  globally in the past fi ve years and 237  has  grown  signifi cantly  over  the  last   due upon execution and $750-mn is due  per year, originated 70% of new US
 are also part of the market and repre-  over the last 20 years, with large geo-  decade, with more than 2,000 products   All  three  potentially  fi rst-in-class  after 12 months; and $1.5-bn for raludo-  oncology drugs in 2022 and launched
 sent  opportunities for CDMOs/CMOs  graphic variations, according to the  currently under  development, accord-  DXd  ADCs are in various stages of  tatug deruxtecan, where $750-mn is due  71% of their own products, according
 providing high-potency manufacturing.  IQVIA Institute  analysis.  There  were  ing to the IQVIA Institute study. Global   clinical  development for  the treat-  upon execution and $750-mn is due af-  to the IQVIA analysis. Emerging bio-
 10 new  cancer medicines launched in  research and  development activity in   ment  of multiple solid tumours both  ter 24 months. Merck also will pay Dai-  pharma companies were also responsi-
 Overall, on a global basis, spending  the US in 2022, and nine were orphan  oncology remained at historically high   as monotherapy and/or in combina-  ichi Sankyo up to an additional $5.5-bn  ble for 71% of the oncology pipeline in
 on  cancer medicines rose  to $196-bn  designated. In the US, 53 unique new  levels in 2022, up 22% from 2018, and   tion with other treatments. Patritumab  for each DXd ADC contingent upon the  2022, up from 45% a decade ago.
 globally in 2022, growing at an average  haematological cancer medicines have  the global number of patients  treated   deruxtecan  was granted Breakthrough  achievement of certain sales milestones.
 12% annually over the last fi ve years,  been launched since 2013, with 89 to  with approved medicines increased at   Therapy Designation by the US Food  When combined with the additional   In comparison, large pharma compa-
 according to a recent study, Global On-  treat solid tumours. In 2022, the Euro-  an average of  5% annually over the   and Drug Administration in December  refundable  upfront  payment  of  $1-bn,  nies, those with greater than $10-bn in
 cology Trends 2023: Outlook to 2027,  pean  Medicines Agency approved  six  same period, according to the IQVIA   2021 for the treatment of patients with  total potential consideration across the  annual sales, have seen a declining share
 by the IQVIA Institute for Human Data  small molecules and eight biologic new  Institute study.  In  addition, oncology   EGFR-mutated  locally  advanced or  three programs is up to $22-bn.  of the oncology pipeline, responsible for
 Science. The growth in major markets  active substances for oncology in 2022,  clinical trial starts remained at histori-  metastatic  non-small  cell lung cancer   21% of products currently under devel-
 is driven  by new products  and brand  compared  to the 10 total  approved in  cally high levels in 2022, up 22% from   (NSCLC) with disease progression on   In addition, Merck may opt out of  opment, down from 36% in 2017. Since
 2018 and primarily focused on rare   or after treatment with a third-genera-  the collaboration for patritumab derux-  2020, overall oncology pipeline growth
 cancers. Oncology development is fo-  tion tyrosine kinase inhibitor (TKI) and  tecan and raludotatug deruxtecan and  has slowed, growing just 5% over the
 cused on solid tumours, with next-gen-  platinum-based therapies. The submis-  elect  not to pay the two continuation  last two years, but with 15% growth
 eration biotherapeutics growing across   sion of a biologics license application  payments of $750-mn each that are due  in the Emerging Bio/Pharma pipeline
 all cancers. Among the various classes   (BLA) in the US is planned by the end  after 12 months and 24 months, respec-  compared to a 13% decline across larger
 of oncology drugs, clinical trials started   of March 2024 for patritumab  derux-  tively. If Merck opts out of patritumab  companies. Of the emerging biopharma
 for PD-1/PD-L1 inhibitors grew 54%   tecan.  Ifi natamab  deruxtecan  is  cur-  deruxtecan and/or raludotatug deruxte-  companies working in oncology, 77%
 over the last fi ve years, accounting for   rently being evaluated as monotherapy  can, the upfront payments already paid  are solely focused on oncology drug re-
 81% of ongoing single-country  late-  in a Phase II clinical  trial  in patients  will be retained by Daiichi Sankyo and  search and development and of those fo-
 stage trials.  ADCs are also emerging   with previously treated extensive-stage  rights related to such DXd ADCs will  cused solely on oncology, 72% are only
 with signifi cant effi cacy across a broad   small cell lung cancer  (SCLC). Ralu-  be returned to Daiichi Sankyo. Merck  developing a single drug, according to
 range of targets, with varying commer-  dotatug deruxtecan  is  currently being  will pay an additional upfront payment  the IQVIA Institute study.

 186  Chemical Weekly  January 2, 2024  Chemical Weekly  January 2, 2024                               187


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