# Episode 181 - May 1, 2026

An episode of [Biotech Hangout](https://invisiblenetwork.ai/podcast/1568911820), 8 May 2026, 1 h 00 min.

Audio: https://anchor.fm/s/55bdff38/podcast/play/119711223/https%3A%2F%2Fd3ctxlq1ktw2nl.cloudfront.net%2Fstaging%2F2026-4-8%2F423780556-44100-2-09cda425f20fd.m4a

On this week’s episode, Eric Schmidt, Matt Gline, Chris Garabedian, Sam Fazeli, and Graig Suvannavejh open with a discussion on biotech public‑market dynamics, noting solid year‑to‑date performance for the XBI. Next, the group highlights the reopening of the IPO window, with multiple upsized offerings and strong aftermarket performance, supported by renewed generalist investor interest. The conversation then turns to large‑cap pharma earnings, with focus on Lilly’s continued outperformance driven by its obesity franchise and evolving commercialization strategies. Next, the co-hosts discuss robust deal flow across the sector, led by Lilly’s aggressive M&A activity. On the data front, the co-hosts cover Revolution Medicines’ practice‑changing Phase 3 pancreatic cancer data and the contrasting market reaction to competitor results, as well as key takeaways from Summit Therapeutics’ Harmony‑3 interim analysis in lung cancer. Also in data news, developments in Alzheimer’s disease, including recent trial setbacks, regulatory approvals, and encouraging early commercial traction for new therapies are also mentioned. The episode concludes with reflections on IPO cycles, valuation discipline, and cautious optimism for sustained momentum in biotech markets. *This episode aired on May 1, 2026.

## Transcript

[0:00] If you're listening to The Biotech Hangout, a live and
[0:02] unedited weekly discussion of all the latest news in our
[0:05] industry with a group of biotech leaders and experts, I am Eric
[0:09] Schmidt and my Co host today are Sam Fazeli, Greg Sivanovich,
[0:14] Matt Klein and Chris Garabedian. For more information about our
[0:18] hosts and guest speakers or to listen to the most recent
[0:21] episode, please go to thebiotechhangout.com.
[0:24] We've got a ton of content this this afternoon, so thanks
[0:29] everyone for joining. We're going to cover sort of the
[0:33] broader market dynamics and IPO trends in the biotech industry.
[0:38] We'll talk a lot about some, some deal flow, both M&A and and
[0:42] collaborative deal flow. We'll discuss much of the key
[0:46] data sets and and conferences that are upcoming.
[0:49] And then hopefully we'll have time to end with some some
[0:53] regulatory developments and and maybe even a little bit more
[0:55] company news. We'll try and squeeze that all
[0:58] into the the broader hour here. Before we kick off.
[1:02] Yeah, let me just start with a quick shout out to two
[1:06] scientific luminaries that unfortunately passed away in the
[1:09] last week. Biotech industry is is for the
[1:13] worst off for sure. Specifically referencing Craig
[1:17] Venter, who was a key figure in the Human Genome project, former
[1:21] CEO at Solara Genomics, and the first person ever to not just
[1:25] invent shotgun sequencing, but to use it to analyze a whole
[1:32] genome, H influenza back in the 1990s.
[1:34] And then also Eugene Brownwald. Dr. Brownwald was kind of
[1:38] recognized as the founder of modern day cardiology.
[1:42] His textbook and, and his presence in the cardiology world
[1:47] were pretty much unmatched resources for many of us.
[1:51] I personally got to know Craig a little bit when his when when
[1:54] his Solara days were front and center to many in the industry.
[1:57] He was certainly a force of nature, a true character and
[2:01] doctor Brownwald consulted with with many Wall Street firms and
[2:05] and was revered everywhere he went.
[2:06] So both will be missed and just a quick shout out to each of
[2:10] them. But let's get on to some of the
[2:13] more relevant news in our industry and the market dynamics
[2:20] that continue to be, I don't know, hard to put a finger on
[2:23] them. Greg, I think you're going to
[2:25] help us out understanding what's going on in the markets these
[2:28] days. Thanks, Eric.
[2:29] It's great to be back on the biotech hangout.
[2:31] Yeah. So I thought we'd start with a
[2:32] review of where things are in the biotech market and I'll
[2:35] speak on sector performance and then provide some commentary on
[2:39] the capital markets and and deals we're seeing.
[2:41] So at a high level, I think things overall are still very
[2:44] healthy. And biotech year to date
[2:46] performance is still in a positive territory.
[2:48] The XBI is up about 8% year to date and that's still about 300
[2:53] basis points of out performance versus the S&P 500 and about 100
[2:57] basis points of out performance versus the NASDAQ.
[3:00] Also within healthcare, more broadly speaking, when using the
[3:04] XLV as a proxy with the XLV down 6% year to date, the XBI is
[3:11] outperforming by 1400 basis points.
[3:14] That said, since I last reviewed how biotech is doing about 3
[3:17] weeks ago, the gap between biotech and the S&P and NASDAQ
[3:21] has tightened considerably. Over the past month, the XBI is
[3:26] up 1%, but the S&P and NASDAQ have had huge rebounds.
[3:29] They're up 10 and 14% respectively.
[3:33] We did see a recent 52 week high level for the XPI of almost 139
[3:38] a couple of weeks ago and but since then the XPI has
[3:44] retrenched about 6%. I've tried to dig up some
[3:48] information or dig into what's going on.
[3:50] I'm not exactly sure. I will point out a few things
[3:53] and this is color from our trading desk and also my health
[3:57] Healthcare sector sales specialist, Gerard Holtz.
[4:01] First, data point trading volumes for the XBI have come
[4:05] down a little bit this past week versus the 30 day average.
[4:09] And secondly, and this is an alarming stat that I got today,
[4:13] April 2026 was the worst month relative month for healthcare
[4:18] versus the S&P 500 since 2009. So I'm not really sure what if
[4:24] there are really good reasons behind this.
[4:25] It could purely be apathetic response to healthcare versus
[4:30] perhaps more interesting segments of the market like
[4:32] tech, who knows what. Later in the podcast, we might
[4:37] have some time to talk about the recent phase three data for
[4:39] Revolution medicines. And I think when combined with
[4:42] the recent media coverage of ex US Senator Ben Sasse and his
[4:46] battle with pancreatic cancer, biotech did get a lot of broad
[4:49] attention with that now in the past, perhaps people have moved
[4:52] on. So I do think this is something
[4:55] we'll have to monitor closely. That said, I do think sector
[4:59] fundamentals are still quite good.
[5:02] In the past few weeks, we saw the $719 million upsized APO for
[5:08] Calera Therapeutics, that's an obesity focused company.
[5:12] And just this week we've saw the upsized IPO for Avalyn
[5:18] Pharmaceuticals, that's a respiratory disease company that
[5:20] raised 300 million that deal price at 18 and and in real time
[5:25] as I'm checking my Bloomberg, it's almost at $29.00.
[5:28] So very nice performance there for Allen.
[5:31] Today we are seeing two companies making their debut on
[5:34] the NASDAQ. That's the Port Therapeutics,
[5:37] that's ACNS company that many of us here in the podcast are
[5:40] familiar with and know well. They had an upsized IPO that
[5:44] raised $255,000,000 and also EMAB which is a blood disorder
[5:49] company with an upsized IPO that raised over $300 million.
[5:53] So you know, and what I think is a great sign for biotech year
[5:55] date, we've now had 10 companies IPO raising collectively about
[6:00] $3.2 billion. Given this positivity like to
[6:05] think the window for private companies to consider an IPO
[6:08] remains pretty open. And then just quickly to review
[6:11] other recent capital markets activity and deals.
[6:14] I'm just going to highlight two. First, on Revolution Medicines,
[6:18] they did announce one phase three data for its PAN Ras
[6:22] inhibitor and pancreatic cancer last week.
[6:26] They subsequently raised a total of $2.2 billion and a mix of
[6:31] equity and debt and that was upsized from an original $1
[6:34] billion target. And then second, we had an
[6:36] emerging biotech company called Aruka Therapeutics, which is in
[6:39] the INI space. They raised $700 million up from
[6:44] an original 500 million, our goal.
[6:47] So All in all, I, I still think very encouraging and bullish
[6:52] signs for biotech, at least from a public market perspective.
[6:56] And with that, that's my view. I'll, I'll stop here and pass
[6:59] the mic back to Eric. Great.
[7:01] Thank you for that. I'm actually surprised by that
[7:03] underperformance in healthcare relative to the broader market.
[7:07] Certainly a little bit of the bloom seems to have come off the
[7:10] Rose in biotech in the last week or two.
[7:12] But Sam, what are you seeing from the larger Cap Pharma
[7:15] names? Lillian Noble in particular?
[7:18] Yeah. So Eric, the companies have all
[7:21] reported pretty decent numbers. Some clearly beat a lot more,
[7:25] you know, significantly and particularly if you look at the
[7:29] share price performance and still up again today.
[7:31] I think when I'm just doing what Greg just said, checking my
[7:36] Bloomberg here, Lily's up another 3%.
[7:38] He was up about 5%. So that's after having been up
[7:40] 9% or 10% yesterday. So most of large farmers doing
[7:46] OK, some of the beats are better than the better quality for want
[7:50] of a better phrase than others. But the one that really stood
[7:53] out for me, what of course was of course Lily, because I think
[7:56] there'd be some hyper focus on this new launch that they have,
[8:00] which is the true small molecule oral pill for obesity, which has
[8:06] been on the market for a few weeks, just just a very few
[8:09] weeks. And it was hyper focus on that.
[8:12] And some, some analysts had downgraded saying the
[8:16] expectations are too high. And of course they came and beat
[8:19] not because that drug was doing particularly better well because
[8:22] the obesity drugs are flying off the shelves X US.
[8:26] So the $2 billion increase in their full year guidance from 80
[8:31] to 82 billion on the on the low end of the guidance is pretty
[8:35] much well driven, at least a lot of it is driven by X US, which
[8:39] is quite interesting because it's I think mostly an out of
[8:42] pocket market. And you know, they talked about
[8:47] Fundeo and they've now got this new route to which is they're
[8:52] going to be working on. It's not going to be immediate
[8:55] to getting drugs, these drugs to patients, which is the employer
[9:01] direct to with employer work that they're doing, which is
[9:05] quite interesting because as we see the, the, the at least this
[9:08] pharma companies in this space is disenfranchising the, the
[9:14] PBMS to a degree. I'd love to hear what others
[9:17] think about that, because that's an interesting evolution.
[9:20] But you know, so, and then of course, what's weird is that
[9:23] usually what's good for Lily is bad for Novo.
[9:25] But of course, the flip side of this was, well, so the founder
[9:30] drug is not doing that great at the minute.
[9:33] And I think that Lily was kind of saying look, we don't you
[9:36] know, it's going to take a while.
[9:38] And of course Novo was up because the drug that's out
[9:41] there that people are taking is the oral Wegovi, which is the
[9:44] oral peptide which has some issues with not issues, but you
[9:48] need to take it three, half an hour before breakfast etcetera.
[9:51] So that was the most big movies that I saw in the market.
[9:56] Otherwise it was a relatively ordinary results for the large
[10:01] farmers so far over. Thank you, Sam, Maybe Matt for
[10:07] you. I know Greg gave us a few
[10:09] statistics on the IPO market. What are you seeing from where
[10:12] you sit there? Yeah, perfect.
[10:15] And Greg took care of the capital market stuff, which is
[10:17] great because I'm just a CEO. It is fun to see the IPO market
[10:20] working generally. I've had lots of private
[10:23] companies come to me over the years sort of asking for
[10:26] experience in going public, creative ways to go public
[10:28] because frankly, it's been hard. And my hope is they're all
[10:31] pushing the button now because what's the expression about
[10:33] feeding the ducks when they're cracking or whatever?
[10:35] You know, one of the ones that I just wanted to comment on
[10:37] because that was interesting. Other than, by the way, Seaport,
[10:40] I think those of, you know, Daphne's been involved with this
[10:42] program, Congratulations to Daphne.
[10:44] Not a space that I follow very closely, but seems like an
[10:46] awesome deal. You know, Evelyn, which which
[10:50] went public yesterday and had a great outcome.
[10:52] You know, I had a couple comments on sort of that space,
[10:54] which I think is interesting space.
[10:56] First of all, it's new companies focused on on inhaled therapy
[10:58] for respiratory disease, especially IPF, which is a space
[11:01] that's been up until recently I'd say like dominated by Boeing
[11:05] or Engelheim with a couple of of older systemic drugs.
[11:08] I think you've seen a trend in the pulmonary hypertension space
[11:13] where pulmonary hypertension patients with lung disease have
[11:16] increasingly been treated with inhaled versions of classes that
[11:20] have been very successful in pH. So you've got Tyvezo, for
[11:23] example, in the Troponils we have a drug in development of a
[11:26] of a different class, an SGC modulator activator in our case.
[11:31] I you know, you're seeing something similar with Avalon
[11:33] and IPF here where they're taking some of the very same
[11:35] drugs that are multibillion dollar blockbuster drugs as
[11:37] systemic therapies and IPF and developing them in targeted
[11:40] inhaled formulations with the idea of delivering either
[11:43] similar clinical benefit with better safety and tolerability
[11:45] or or maybe even better clinical benefits because you can dose
[11:48] higher if you get the therapy locally.
[11:50] So I think it's an interesting thing to watch them succeed so
[11:53] much in the capital markets here, given these are older
[11:56] drugs, but with some interesting novel science pulling them,
[11:59] pulling them forward. Lynn used to work for one of the
[12:01] royal and companies. So again, congratulations to
[12:03] Lynn and the Avalon team. What a great outcome, but a a
[12:06] cool one to watch. And IPF is a space that's
[12:08] developing quickly, including actually some of the PHLD drugs
[12:10] I mentioned where for example, Tyvezo has put out some data now
[12:13] in IPF directly. So I think IPF, which has as I
[12:16] said, been a pretty concentrated space historically, really going
[12:18] to going to explode an opportunity over the next couple
[12:21] of years and certainly we're watching it closely.
[12:23] So it would be an interesting one to follow.
[12:26] Thank you for that. Yeah, Congrats to to Lynn and
[12:29] team. We weren't part of that IPO, but
[12:31] I know my colleagues know her well and and wish her and Evelyn
[12:35] the best. Sounds like you're off to a
[12:36] great start, Chris. From where you sit in the VC
[12:40] world, what, what do you make of today's IPO market?
[12:43] Are we we getting a little bit overheated or is this a kind of
[12:49] window that you're looking forward to?
[12:52] Yeah, I'll just mention so sorry I keep getting kicked off.
[12:55] So I hopefully you guys can hear me OK and I'm on.
[12:58] So look VCs, we really need the IPO market.
[13:02] I need to be to be working like Matt said, it's you know, we're
[13:05] looking for a healthy IPO market, one that's not too
[13:08] exuberant. We were private investors in
[13:11] Avalyn. We Co led the Series C.
[13:13] So it's always good to see a liquidity event for any
[13:17] portfolio company in, in the venture space.
[13:20] And we also have a, a private company and stealth that we're
[13:22] going to be coming out of stealth probably in the next
[13:24] year in the IPF you know, IE you know pH markets as well.
[13:30] So we're really excited about all of that.
[13:31] And obviously the other IP OS in the queue look good.
[13:34] I think the reason I, I am less concerned about this moving into
[13:40] a frothy territory this year with the number is that we've
[13:43] had so many years of companies that have gotten extended
[13:47] private rounds and got them into the clinic with clinical data
[13:50] really waiting for the big, you know, pivotal value inflections
[13:55] or large Phase 2 value inflections.
[13:56] So I think these, this is a different profile of company
[13:59] that is going IPO And I think, you know, from my vantage point,
[14:03] I think there's a lot of them out there.
[14:04] We might have a big year, but most importantly we want to see
[14:08] them trade well. We want to see good aftermarket
[14:10] performance and it does seem like Avalyn at least had, you
[14:14] know, you know demand there and it traded well in the
[14:18] aftermarket. So I think we're going to be
[14:20] watching that pretty closely. On the venture side.
[14:21] I'll just mention also, you know, a venture changes their
[14:24] behavior if there's a thriving IPO market and we're starting to
[14:28] see maybe a little bit of looking at more of the earlier
[14:32] stage VC and startups and all of that.
[14:34] So I'll just highlight two things.
[14:35] One MPM has a company, K2. They announced 3 products out of
[14:41] China. This is a little bit of a Nimbus
[14:44] type model where they're gonna have each of them in their own
[14:47] kind of subsidiary underneath the K2 umbrella.
[14:50] They expect to do this a lot. They're calling it complementary
[14:53] and kind of a synergistic with their other strategies, but they
[14:56] wanted to keep all of these China assets in under one roof.
[15:00] And the the thesis is is if they can even go after newer targets,
[15:03] not me too targets, but test out novel targets more quickly in
[15:07] China. This can add a lot of value.
[15:10] So it'll be interesting to watch.
[15:11] It's the more formalized. A lot of VCs have moved into the
[15:14] China space, but often in a one off manner.
[15:17] So this is a more formal and you know, kind of clear, you know,
[15:21] Mark in the sand of of this China strategy by MPM.
[15:25] And then Deerfield did something I think really a service to the
[15:28] industry. It's always hard to try to reach
[15:30] into academic Centers for early projects to start companies
[15:34] around. And they launched this week a
[15:37] database that's accessible to really value different academic
[15:43] institutions, the programs within it, and they have
[15:46] different like parameters that that you can screen by.
[15:49] So I haven't tested it out fully yet, but it was nice to see
[15:52] somebody in the industry, in the VC space stepping into that.
[15:58] Thanks Chris. I, I think you're right with
[16:00] regard to the IPO market, it's certainly start has started with
[16:03] some very good quality companies that have been incubating very
[16:07] for lengthy periods of time in the private markets.
[16:10] But maybe to play devil's advocate, you know, doesn't,
[16:12] doesn't, isn't that always the way that we start these IPO
[16:15] windows? And then when, when people make
[16:17] a little bit money on the, the good quality companies and the
[16:19] stocks go up, it's hard for, for venture investors and, and
[16:24] others, even investment banks to really police the quality And
[16:29] things seem to slip and, and, and eventually we, we end up
[16:34] maybe swallowing or biting off more than we can chew.
[16:36] Is there any reason to think we're going to be different?
[16:38] This time around, you're, you're absolutely right, 100%.
[16:41] And I don't think anybody's figured out how to stop that.
[16:44] I think we saw it in the last bubble where we kind of knew
[16:47] this isn't going to end well. But like, you can't be an
[16:50] investor in the space and not try to take advantage of that,
[16:53] right? It, you know, it's, it's a
[16:55] little, I mean, I don't want to call it a Ponzi scheme, but it's
[16:57] kind of like, as long as it's working and no one's getting
[17:00] hurt, you're going to see that behavior continue.
[17:03] And I, I think you're right. If there was a mechanism, a
[17:05] governor on that, that we could implement, I think that would be
[17:08] helpful. But when the markets are good,
[17:11] everybody's, I think, you know, Matt said at the ducks, right?
[17:13] Like they're, you know, they're, they're going to try to get
[17:15] their money, they're going to try to get their, you know, you
[17:19] know, liquidity. And so I, I, I have always seen
[17:22] these cycles and they, you know, and what we hope, what I'm
[17:25] hoping for is that this one is sustained, that we're not going
[17:30] to see this escape velocity and that we're going to be in a
[17:33] problem 2 years from now. But I, I think it's, it's, it's
[17:37] a worthy discussion to talk about.
[17:39] And but I I don't know that you can convince a company or a
[17:42] board not to go public if the markets are working.
[17:44] I mean, I, I feel like the answer is these IPO markets stop
[17:47] working when people stop buying deals, right?
[17:49] And that happens for one of two reasons.
[17:51] Either it happens because the IP OS themselves are not working
[17:54] because you've worked through the good companies and you start
[17:56] taking less good companies public and deals start breaking
[17:59] and investors stop buying them, which is maybe sort of what
[18:03] happened in like the last quote UN quote bubble.
[18:05] Or it's like early last year where you had a couple of IP OS.
[18:09] If there's anything like specifically wrong with the
[18:11] companies that went public, but just like the biotech market
[18:14] didn't do well enough and so there weren't enough buyers for
[18:16] deals and they went away. I guess I feel like this will
[18:18] end one of those two ways. Right out of the biotech market
[18:21] will get weak and good companies won't be able to go public
[18:24] anymore. Or we'll get through the backlog
[18:26] of good companies and eventually too much will go public and
[18:29] deals will start breaking. I think you're right, Madam.
[18:35] I think maybe the only other thing to say here is that many
[18:37] of these IPO markets seemingly have this undercurrent of it of
[18:41] general investor interest that drives the IPO window to open
[18:45] and and things are good for a period of time as general funds
[18:48] are flowing into the sector. And I don't think any of us as
[18:51] specialists quite understand how and and why generous money comes
[18:54] in or out. But unfortunately, when the
[18:57] faucet turns off and and the drain opens up, we're left
[19:01] holding the bag. So maybe there's nothing we
[19:03] could do. As Chris said, there is no
[19:05] governor on the system but Sam Craig either.
[19:07] You want to chime in on the IPO topic I.
[19:11] Mean, I will just simply add that it does seem that from
[19:17] period to period we do get this exuberance that seems to be
[19:21] unstoppable. I think we do want to see a
[19:25] rational market. We've talked about the volume
[19:29] that we're anticipating in 2026 and think without being able to
[19:33] predict the future, I think it is going to be a good year for
[19:36] IP OS. Let's just see how market
[19:39] participants are able to be somewhat rational during this
[19:46] this period. Hopeful.
[19:48] Hopeful thinking maybe? My question Eric is, is how much
[19:53] of this is, I mean, there has to be some generalist money coming
[19:57] in, although even the big one from Revmed, sorry, follow on
[20:00] from Revmed apparently didn't have generalists particularly a
[20:03] lot of, but you guys tell me is generalist money coming in,
[20:06] That's what we're always looking for, right?
[20:09] Oh, I, from where I sit, absolutely.
[20:11] You can't do a $2.2 billion follow on or a $700 million IPO
[20:16] as as Greg was pointing out earlier, without that kind of
[20:19] money, specialists just aren't that deep pocketed and and don't
[20:24] have that kind of new capital put to work.
[20:26] So I think, you know, again, Greg, I'm interested in your
[20:29] views, but from where we say we don't talk to a lot of
[20:32] journalists because honestly they don't want to talk to us.
[20:35] But you can kind of sense when an analyst at a plain vanilla
[20:39] mutual fund calls you up and ask you for new ideas that he's not
[20:43] necessarily asking for his specialized fund within that
[20:47] investment group. He's asking for his PMS. Who you
[20:51] know right now at least see biotech is potentially the best
[20:54] performing sub sector in the marketplace.
[20:56] But but Greg, your thoughts? Yeah.
[20:58] I think that at least based on my conversations, I am getting
[21:03] generalist inquiries about names that I cover.
[21:06] But I, I do think that they are still very much into de wrist
[21:11] names and that they already have clinical data in hand.
[21:15] Sometimes they're looking at commercial stage companies that
[21:18] I cover because they screen well.
[21:21] I don't think we're at a place, I could be wrong, but from my
[21:25] perspective, I don't think we're at a place where we're getting
[21:27] generalists coming in and playing earlier stage riskier
[21:33] names. You know, we'll see how the next
[21:35] 12 months works and and how biotech performs, but I think
[21:39] we're still in very early days of a wide swath of generalist
[21:43] money coming into biotech. One, just like comment about
[21:47] that as ACEO, because we had a ton of shareholder rotation last
[21:51] year as larger lung only institutions came into our
[21:55] stock. And I'll say there's nothing
[21:57] more confusing or difficult to predict or understand as a
[22:01] company in that if you're used to dealing with biotech
[22:04] specialist investors, I don't know how many of you have like
[22:06] pitched biotech specialist investors as an issuer, but it's
[22:09] basically a terrible experience, right?
[22:11] Like you go and you spend months, months or years and
[22:14] years getting grilled by the same people on the same specific
[22:16] questions, much of which is competitive diligence for other
[22:19] things they're doing. And like when they come in, they
[22:21] come in, you know, most positions held by specialists or
[22:25] 30 to $100 million or something, they can own a decent amount of
[22:28] stock, but whatever. And then my experience with
[22:31] generalist investors loan only is who are like phenomenal
[22:33] shareholders and have some really smart people is like,
[22:36] they don't meet with you and they don't meet with you and
[22:37] they don't meet with you. And then one day you meet with
[22:39] their analysts a few times, and then you get invited to a room
[22:42] with 15 PMS who you've never met before, who don't ask any
[22:44] questions. And then the next time A13F
[22:47] comes out, they own $400 million of your stock.
[22:48] And it's just like this weird transformative mystery that's
[22:51] very hard to predict. So it's a, it's a, it's a
[22:53] totally different animal from our perspective.
[22:57] Very well said, Matt. That's my experience as well.
[23:00] Well, let's move on from from IP, OS and generalist investment
[23:04] current to deal flow and M&A activity in particular.
[23:08] And and Sam, yet another deal from Eli Lilly.
[23:10] What do you want to tell us about that?
[23:12] Yeah. Look, Lilly's done to my count,
[23:15] 6 deals, M&A, not licensing. Of course, there's a longer tail
[23:20] of licensing deals, 14 1/2 billion dollars upfront.
[23:23] So far from the numbers that I've added up there are there
[23:26] abouts and it you know, if you think about the number of weeks
[23:31] that we've had in the in the year, it feels like every couple
[23:34] of weeks they're doing a deal now that's about I think half of
[23:40] the large pharma deals in terms of M&A that we've seen.
[23:43] So they're helping our our sector quite nicely.
[23:46] Although a lot of the companies they're buying are, are private
[23:50] companies and they're in all sorts of areas.
[23:53] You know, I mean everybody's jaw dropped a little bit, I suppose
[23:57] when this we saw the the colonial deal in terms of the
[24:02] upfront payment of 3.25 billion. You know, we also the data at
[24:06] ASH in terms of a in Viva CAR T for myeloma, they already had a,
[24:12] a, a, a CAR T deal earlier, but more for the which was or no
[24:20] therapeutics. Also in this year more for I and
[24:23] I and the latest one they've done, which is Ajax is also in a
[24:27] very specific space with a, with a Jack inhibitor that's in the
[24:35] in the myelofibrosis and polysyphemia Vera space.
[24:39] So they're really panning out there.
[24:41] And these are all, much of them are in like phase one or maybe
[24:45] very early development stage. Some areas that they've never
[24:48] been to like a sleep disorders like myeloma, they're not in
[24:52] that space. So it's interesting how they're
[24:55] building this portfolio to, you know, wind on 10 years and we'll
[25:01] all be sitting here thinking, Oh my God, what's going to happen
[25:04] to this? I don't know.
[25:05] Whatever the number is, 70 billion dollar, $80 billion drug
[25:09] that they have, whatever the number is, right, it's going to
[25:11] be a big one and it's going to be bigger than all the ones that
[25:14] we've had so far Keytruda, Himira, etcetera.
[25:16] So and and and the portfolio of Skyrizi plus Rinvoq, let's not
[25:20] forget that that's doing magically in in the hands of
[25:23] Abby. So they're going to have to be
[25:26] feathering that nest and I think that's that's what they're
[25:28] doing. So it'd be interesting to see
[25:29] how these things pan out. But thank you Lily for helping
[25:32] our sector over. Thank you, Sam for covering
[25:37] that. Now maybe to to Greg or to
[25:41] Chris, I'm not sure who wanted to cover Ajax might be in more
[25:44] depth or do you want to move on to the Cal Vista acquisition?
[25:47] Yeah, I'll, I'll just briefly talk about Ajax.
[25:49] So again, Lily who's dry powder continues to seemingly grow
[25:54] every day off of the success of its GLP One franchise, this week
[25:57] announced the acquisition of privately held Ajax Therapeutics
[26:00] for a total consideration of up to $3.2 billion.
[26:04] Ajax is developing a novel and what could be a first in class
[26:07] type 2 Jack inhibitor and it's currently in phase one for rare
[26:13] blood cancers known as myeloproliferative neoplasms.
[26:17] These include myelofibrosis and cythemia Vera as Sam mentioned.
[26:22] And I think the interesting thing here is while there are
[26:25] approved Jack inhibitors for use already in these
[26:29] myeloproliferative diseases as well as an autoimmune diseases,
[26:33] the older ones that are approved, they bind to the type
[26:36] 1 confirmation of Jack 2. But Ajax's lead acid is a type 2
[26:41] Jack inhibitor and that gives it the potential to improve on
[26:45] efficacy and perhaps more importantly improve on safety
[26:48] tolerability. Recall that there is a black box
[26:51] warning for all Jack inhibitors on higher rates of all cause
[26:55] mortality. So I think this could be a
[26:57] really exciting class of compounds.
[26:59] I'll be interested in seeing what whether there are other
[27:01] companies that are going to interrogate these Type 2 Jack
[27:04] inhibitors for perhaps autoimmune and inflammatory
[27:08] diseases. I guess we'll have to wait and
[27:09] see. And then just quickly I'll
[27:11] comment on another deal and there have been several in our
[27:15] space this week. But we saw Kiazi, which is a
[27:18] private, I believe Italian pharmaceutical company, acquire
[27:22] publicly traded Calvista in a $1.9 billion acquisition.
[27:26] And acquiring Calvista, Kiazi will get a drug called Ectorly,
[27:29] I believe it's called. And this is approved for
[27:32] hereditary angioedema or HAE. And the HAE space has become
[27:37] quite the commercial market since I first took a look at it
[27:40] some 20 years ago. We've got multiple drugs
[27:42] approved. So an interesting deal in this
[27:46] space. With that, I think Chris, did
[27:48] you want to comment a little bit more on Kiazi perhaps?
[27:51] Yeah, Yeah. Well, first that we had a HAE
[27:54] company acquired by Biochrist earlier this year and or maybe
[28:00] late last year. But it is a space I think 1.9
[28:03] billion for a oral drug in the space that did about 60 million
[28:07] I think last year seems rich, which is good that you got high
[28:11] premiums for commercial stage products.
[28:13] Ours was a clinical stage product that was required for
[28:16] not quite a billion. But I really want to do a shout
[28:19] out to these deals that are not Lily.
[28:22] Lily is becoming a little bit of an outlier and I almost feel
[28:26] like we should look at the M and A market, you know, excluding
[28:29] Lily and to see how healthy it is because they're, they got so
[28:33] much cash and they are doing definitely land grabs early and
[28:36] late. And so, but Casey's one that I
[28:39] really didn't have too much on my radar.
[28:41] They have 3 franchises Air, they call it air for like pulmonary
[28:46] rare and care for like they have neonatal drugs and they have
[28:51] prophylaxis for transplant. But they're doing over 4 billion
[28:54] in U.S. dollars, their their pulmonary franchises, over 2
[28:58] billion in U.S. dollars. The other two franchises are a
[29:01] billion. The billion dollar franchises
[29:03] are growing in double digits. And like they're very active out
[29:06] there because in our portfolio, we have companies that fit into
[29:09] each of those categories and they're always at the table.
[29:12] They're always wanting to meet. So I, I just get the impression
[29:16] that at least in their verticals, they are really doing
[29:19] it if they can write. And this is a private European
[29:22] company like most of European companies are.
[29:23] But to write a, you know, a check for 1.9 billion for a
[29:27] single asset, Calvista didn't really have much a pipeline
[29:30] beyond that besides maybe some preclinical work.
[29:34] So yeah, I just think it was it's good.
[29:36] We need to see more of this M&A outside of Lily.
[29:39] We want to keep Lily, to keep being aggressive, but I thought
[29:42] it was important to to make that distinction.
[29:44] Just quickly. And Matt speaking.
[29:46] Sorry, Eric, remember that we had another one of these deals
[29:50] just about a month before that of which was Servier in France
[29:54] that what day one by pharmaceuticals.
[29:55] So it's quite interesting that these smaller, smaller these
[29:59] private to European companies are active in this M&A and and
[30:03] I'm I, I, I don't think I've seen this before.
[30:05] So it's it's good to see you as Chris says, sorry, sorry, Eric,
[30:10] over. No thanks for that.
[30:12] And Matt, Speaking of non Lily buyers, I think you wanted to
[30:15] highlight the deal between Sun and Organon.
[30:18] Yeah. And by the way, I also just to
[30:20] echo what was just said, I think it's like fun and interesting to
[30:24] see other buyers showing up. Some some farmers are cool
[30:27] company to be out there buying. They are, you know, I think like
[30:30] historically I would have thought of them as an Indian
[30:31] generics company that's been working on building a, a, a
[30:34] branded business in the US or at least a business in the US for a
[30:37] long time. And then, you know, Organon is a
[30:40] reminder that, you know, whatever biotech companies never
[30:43] die. It was like acquired by sharing
[30:44] plow and then became a part of Merck and then got spun out
[30:47] again and has now been acquired by son that told your value is
[30:51] like 11 1/2 billion dollars. Obviously a lot of that that was
[30:53] not equity, it was organized was it was a relatively leverage
[30:56] spec pharma company that had a rough couple of years in some
[31:01] ways, but has some interesting things.
[31:02] I mean one of them Roy even sold them a skin drug called Vitama a
[31:05] couple years ago or yeah, maybe a couple years ago.
[31:09] But an interesting business and should significantly further
[31:13] son's objectives of having AUS presence.
[31:16] So that'll be an interesting one to watch and son is a sneaky
[31:19] great operator. I mean, they're $45 billion
[31:22] company, they've grown a ton in the last little while.
[31:25] I think they're, they're, you know, effectively founder LED
[31:29] out of India and just incredibly sort of strong operator.
[31:32] So it'll be interesting to see what they do with Organon and,
[31:34] and bluntly, I would not be that surprised to see them continuing
[31:37] to acquire things in the US as they look to grow here.
[31:41] So I think this could be a little bit of a beach head to
[31:43] another, another sort of regular acquirer in the US So that
[31:47] that's that's been cool to watch as well.
[31:51] Thank you for that. We had one other deal on the
[31:53] tape this morning, Asperion Therapeutics Company that's been
[31:55] around for a while and probably seen better days being acquired
[31:59] by Arcimed, which is an investment firm for about a
[32:02] billion dollars. I think the share price of the
[32:05] acquisitions a little over $3 per share.
[32:08] And back in the game, many, many of us will remember that
[32:10] Asperion was a high flyer, wants $100 stock.
[32:13] So certainly well off those highs.
[32:16] But nonetheless, it's a decent premium to the last few months,
[32:20] bit of a smaller deal, again, a private equity firm coming in,
[32:23] bit of a, an off the beaten path type of an acquisition.
[32:28] And I guess that brings up the the broader question.
[32:30] We have seen some of these smaller cats and dogs type
[32:33] transactions lately. We've seen a bunch of private
[32:37] company transactions somewhere, good premiums or at least good
[32:41] valuations. Outside of Lily, we really
[32:43] haven't seen as much of the kind of blue chip, plain vanilla,
[32:48] five, ten, $15 billion large pharma acquisitions and would
[32:53] love to hear the group's view on what's going on here with that
[32:57] trend. Or are we passed the window of
[33:00] Pharma's acquiring biotechs for five, ten, $15 billion?
[33:04] I know obviously Rev Med didn't get acquired.
[33:06] There's been some speculation around a few other names we
[33:09] haven't seen maybe a more substantive deal in a while.
[33:12] Who would like to take that? I'll just comment this goes back
[33:16] to my Gilead days. You know, we always felt we were
[33:19] sitting on more value internally than the external pharma
[33:23] audiences believed we were worth.
[33:25] And I think as valuations have like ticked up and, you know,
[33:30] on, you know, midcap and large cap, I think it honestly, as
[33:34] someone who used to do corporate development for Gilead and
[33:37] Celgene, you know, I think a lot of times they can't get to the
[33:42] justification to pay a premium on these companies.
[33:45] You know, that's usually, we know a lot of deals are done
[33:48] where they can never recoup their, you know, the cash flow
[33:51] doesn't work on a, you know, discounted the present value
[33:54] basis. But you know, I think there is
[33:56] this idea of are we going to put that much money in now Lily has
[33:59] enough of, you know, currency where, you know, again, like
[34:03] they're in a kind of rarefied air to be able to do some of
[34:05] these things. But I think for a lot of the
[34:08] other pharma companies, I, I think there's a challenge of
[34:10] paying premium on very high valuations even even in growing
[34:14] businesses. So Chris, you think the public
[34:17] market valuations have kind of escaped the range that that
[34:20] pharma might be comfortable paying a premium?
[34:22] On that, that's what I'm. Suggesting for now I.
[34:24] I'm not saying they're they're overvalued, I'm saying that
[34:27] pharma might believe they're overvalued.
[34:32] I will. Yeah, it's Greg.
[34:35] I'll, I'll comment where it's really hard.
[34:38] As we all know, it's hard to predict when deals will get
[34:41] announced. Remember JP Morgan, we had a
[34:44] sell off I think in, in the XBI and and biotech names because we
[34:49] didn't really see a level or, or any real deals consequence
[34:54] announced during JP Morgan. And the people started to
[34:56] question like, oh, is this going to be a bad year for M&A?
[34:59] And I don't think that's turned out to be the case.
[35:02] I mean, we're only in May now our our diligence talking to
[35:10] different folks within the industry, especially those that
[35:12] have portfolio companies when they speak to bankers.
[35:15] I think this is going to be a record year for M and AI could
[35:18] be wrong, but you know, we've got these LO ES that are coming
[35:23] for all these companies. They do have good balance
[35:26] sheets. They do have access to, you
[35:28] know, debt capital and relatively lower interest rates
[35:33] than perhaps other companies. And so I, I'd say it's just a
[35:36] matter of timing. And I, I think as we look
[35:40] through the balance of the year, I, I think we're going to see
[35:42] steady M&A continue. I mean, Turns got acquired for
[35:47] what, almost $7 billion like a month and a half ago?
[35:50] Santessa, which I know we're pretending Lily doesn't exist
[35:53] for this conversation, but that was pretty recent too.
[35:56] Feels like it's hard to call. And to be clear, I was thinking
[35:59] really in the, you know, north of 20 billion, right, like 7
[36:04] billion is not exactly a bolt on, but the 20304060 billion
[36:08] that that's what I'm saying might be tough.
[36:11] Yeah, in turns, not the quite, not quite the premium that many
[36:14] of us had hoped or expected for either, but but point well taken
[36:17] that that was certainly a good company being acquired for a
[36:20] good asset. Sam, anything you want to add?
[36:24] Now just to say that we should just celebrate when the cash
[36:27] comes back into the market and, and a lot of the specialists are
[36:30] the ones who are holding these smaller biotechs, which are the
[36:33] ones are going to be then financing, you know, the next,
[36:37] the next round of early biotechs.
[36:39] So, you know, the big, the big names.
[36:42] I, I think it's much harder for a farmer company to, to, to do
[36:46] that unless their backs against the wall when it comes to
[36:48] thinking about their revenue growth or earnings profile in
[36:52] the next few years. And, and according to our
[36:55] analysis, quite a lot of these patent expertise aren't as bad
[36:58] as they first look. Keytruda as a particular one, we
[37:02] don't think it's going to go in 2029.
[37:03] We think it's going to keep lasting till 2033, at least in
[37:07] the US And then you've got, you know, and you've got the lilies
[37:11] of this world who have the, the time to wait or, or at least
[37:15] start doing things at an earlier stage, which by definition
[37:18] should be smaller. So back to Greg.
[37:20] Did you think it's going to be a record year volume wise or
[37:24] dollar wise over? Either 1, I don't know if I'm
[37:30] going to commit to one versus the other, but maybe I do think
[37:34] that generally speaking, when we look back, I think 2026 is going
[37:37] to be a very good year for for biotech Mini.
[37:42] Let's leave Patent X Breeze to patent settlements and and Matt,
[37:46] I know you wanted to comment on this week's news.
[37:49] Yeah. You know, we were in the news in
[37:51] March for our own litigation on patents sort of unrelated to
[37:56] expiry, which is it's an interesting one to watch.
[38:00] It's, you know, as somebody who's developing a Jack
[38:03] inhibitor. We watched AbbVie get a 2037 Loe
[38:06] for Rinvoq and thought that was interesting.
[38:09] And then to see Pfizer in these deals.
[38:12] There's been a bunch of speculation around what was
[38:14] going to happen here. This was on on Defamidis, which
[38:17] is their HTR drug. Obviously a bunch of
[38:19] speculation, especially as people follow bridge bio and
[38:21] there was a debate about whether it's going to be 2031 or 2033 or
[38:24] whatever. It feels like a reasonable
[38:26] outcome. And it's sort of interesting to
[38:29] see these setups where there's a biotech company that's affected
[38:32] by the Loe negotiations of a pharma partner that sort of
[38:37] brought it into the front. It turns out the chairman of our
[38:39] board is the CEO of one of the endolitigants.
[38:43] So I didn't have a, he didn't talk to me about it.
[38:45] I didn't have one of the, I didn't have a particularly close
[38:47] seat on it, but it's sort of interesting to watch and hear
[38:49] about it from his perspective as well.
[38:50] I think he was obviously, you know, happy with the outcome and
[38:53] felt like it was a fair deal for everybody.
[38:54] So, you know, it's a, it's a outcome that move bridge stock.
[38:58] It may move Pfizer stock a little bit, but interesting just
[39:01] to see all that, all that play through.
[39:04] Matt, we always used to talk how it was always favorable
[39:07] economically for everyone to find middle ground and and sell
[39:10] and no one was ever paid for for breaking a patent.
[39:13] Is that kind of still the case? Yeah.
[39:17] I mean look again, I can't say I've been in an and of
[39:20] litigation settlement personally.
[39:23] I think like the truth is that these generic companies that we
[39:29] don't talk about or follow the generic space very closely in
[39:32] the biotech world, but these companies are really good at
[39:34] what they do. They're creative, they're
[39:36] aggressive, they've built. I mean, they're these are as
[39:38] real as businesses get. They are low margin businesses,
[39:41] they're manufactured low ish margin businesses.
[39:43] They're manufacturing oriented, they're very operational and
[39:45] these these these people know what they're doing.
[39:48] And I think it's a, you know, I think it's a fair fight.
[39:50] It's like it's it's very good for the industry.
[39:54] It's very good for like the health of the US population, for
[39:58] innovation generally, that we have a system where these drugs
[40:01] become available inexpensively. It's sort of weird that the way
[40:05] it works is like really smart lawyers figure out how to sue
[40:08] each other and then get in the room and settle and pick a date.
[40:11] But you know, I ultimately watching amazing drugs like
[40:15] tafamidis go generic. Even in 2031, you know, my, my
[40:19] neighbor has HTR amyloidosis is on to Faminus.
[40:22] And I think about the fact that, you know, that'll be much less
[40:25] expensive drug four or five years from now.
[40:28] It's it's an amazing, it's an amazing thing to see.
[40:31] So I think in that sense, everybody wins.
[40:34] Obviously there's a lot of reapportionment of dollars as
[40:37] the dates are chosen and exactly when who gets what, but but you
[40:41] know, I think ultimately it's for the good.
[40:44] Thank you for that. Let's move on to some of the
[40:47] data updates for the week. And it, it, it seems like
[40:49] pancreatic cancer is kind of the new hot area of biotechnology.
[40:55] Maybe it's even equip the Eclipse clip one in, in terms of
[40:58] some of the data sets and and the visibility we're getting
[41:01] there. And I don't know, Greg, did you
[41:03] want to start with Rev Med and Araska or or Sam?
[41:06] Yeah. Yeah.
[41:07] So I'll go ahead and let, let's just put into context, Eric,
[41:10] your right, pancreatic cancer, certainly high unmet medical
[41:14] need. We've seen a lot of progress in
[41:17] terms of data coming out from biotech companies on hopefully
[41:21] getting drugs and not only the second line setting, but the
[41:24] first line setting. And we've talked about
[41:27] revolution medicines a bit in this podcast today, but just to
[41:32] put it things in perspective for everyone.
[41:34] So recall in the middle of last month, Rev Med Revolution
[41:39] Medicines reported positive top line results for its lead drug
[41:43] called Dyroxon rasib, which is a pan Ras inhibitor.
[41:46] They reported phase three data in a second line pancreatic
[41:50] cancer trial. And again, this came concurrent
[41:55] with some media interviews with with Ben Sasse and his role with
[42:00] pancreatic cancer and he is on that drug.
[42:02] But in in any case, on progression free survival and
[42:06] overall survival, we saw just very, very good data on overall
[42:10] survival, a 60% reduction in the risk of death.
[42:14] Median overall survival of 13.2 months for directs on RASIB and
[42:19] that compares to 6.7 months for chemotherapy.
[42:22] So basically a doubling of overall survival.
[42:26] And with that said, this is what allowed the company to go out to
[42:31] the markets and and raise over 2 billion in equity and debt.
[42:34] And then the following week they followed that up with a first
[42:37] look at data in the first line pancreatic cancer setting.
[42:40] And again the data were very promising as a monotherapy.
[42:43] We saw an overall response rate of 47%, six month progression of
[42:48] free survival rate of 71%, of 6 month overall survival rate of
[42:52] 83%. And then the numbers were even
[42:55] better when they combined it with the standard of care or one
[42:58] of the standards of care, which is gemcitabine and that
[43:02] paglitaxel or or GNP. And so that kind of set the
[43:05] stage for then another company or the RASCA, which is a, a
[43:11] biotech company out in San Diego that I used to cover for a short
[43:14] time. We had been waiting for very
[43:17] first clinical data for its PAN or for its Ras inhibitors and we
[43:23] got data for one particular compound called ERAS 0015.
[43:28] This was in license from China. You know this is an interesting
[43:33] company and that the company used to have a different
[43:36] pipeline several years ago. It was in mid to late stage
[43:40] clinical trials and then the company in a strategic shift
[43:44] just kind of shelved that portfolio altogether and they
[43:48] pivoted to two preclinical assets they that were in license
[43:52] from China. And so we we've been waiting for
[43:54] over a year or so for our first clinical data.
[43:58] And in that time, especially if you if you take a look at the
[44:02] stock run for Araska ahead of this first data which came out I
[44:07] believe Monday, Araska had become like a 7 billion market
[44:11] cap company on no clinical data. So a lot of anticipation from
[44:14] the data. I think many investors were
[44:17] taking a bet that the data would be as good as what we've seen
[44:20] for Revolution Medicines. And, you know, we all know that
[44:23] Revolution Medicines has become, you know, one of the the hits of
[44:27] the year. It is, you know, a company that
[44:31] is now like a 30 billion market cap company.
[44:34] So I think investors were looking at Araska's maybe a
[44:36] cheaper way to play the space. But the data came out and a
[44:40] couple of interesting things. And I won't go into all the the
[44:44] minutiae of the the the qualitative data or the
[44:48] quantitative data, but the data actually were quite good and
[44:51] even better than the data that Revolution Medicines had
[44:56] presented several years ago for each drug at a similar stage.
[45:00] So this should have easily been a big win.
[45:03] That said, the stocks sold off considerably on the data
[45:07] announcement. And that's because the data
[45:09] disclosed that there was unfortunately one patient death.
[45:12] So the efficacy was good, but the patient death kind of, you
[45:18] know, put a damper on how people were thinking of the totality of
[45:21] the data. Obviously, it's just one
[45:22] patient. You know, the company will
[45:25] obviously look to do larger trials and we'll see whether
[45:29] those data, you know, on safety repeat, but you know, they'll
[45:33] also see about safety and tolerability.
[45:36] So unfortunately the stock did not participate in, you know, on
[45:41] the efficacy data. And then there was like a second
[45:44] double whammy for the company that later that day since
[45:51] actually filed A lawsuit against Araska.
[45:54] This was a lawsuit claim that this 010015 compound was
[46:04] substantially equivalent certain formulations that Revolution
[46:10] Medicines drug, you know is comprised of.
[46:14] And so with this patent infringement study, I mean a
[46:18] lawsuit, it just created just another bit of an overhang for
[46:23] Araska. So good clinical data, I think
[46:26] on efficacy, but now you've got one patient death and now a
[46:30] lawsuit from its biggest rival. And so it, it creates a really
[46:33] interesting situation when looking at these two companies
[46:36] in the pancreatic cancer lens or just the landscape we're
[46:42] generally speaking and and we might have time to talk about
[46:44] what in that landscape a bit. So I'll stop here.
[46:49] Thank you for that recap. Sam, do you want to add on?
[46:53] Yeah, I'll just say that it is possible that that Grade 5
[46:59] unfortunate patient death due to pneumonitis at some point may be
[47:03] seen also in the Revolution data because they do have they do get
[47:07] Grade 4 pneumonitis under Axon Rasab.
[47:11] The interesting angle is that the dose that that Erasco is
[47:15] using is like a 10th of that that Revolution is using and yet
[47:21] Revolution hasn't seen a a Grade 5 event.
[47:25] So maybe there's, it might have just been bad luck.
[47:29] And then we do have patent lawyers in our group.
[47:33] So I'm very proud of that. So I've asked her what is the
[47:36] situation with this? So her direct response, which
[47:39] I'm going to because I'm not a lawyer.
[47:41] Rev Med probably just wants to get them to license their IP,
[47:44] get them to the negotiating table.
[47:46] Unless Rev Med takes them to court, wins and gets the judge
[47:49] to permanently and join instead of awarding damages and.
[47:59] Then if I cut off there. We we, we, we lost you, but we
[48:04] can hear you now. No, no so and and so basically
[48:07] bottom line is unless they can prove that there's been
[48:11] malicious intent and stealing and other bad stuff, a judge
[48:14] would be unlikely to allow Revmed to get the the whole
[48:18] thing stopped now. So it's going to be interesting
[48:22] to watch if this is a tactic to get them to come and license the
[48:25] IP or genuinely they believe that they did steal their IP.
[48:29] What Rasca can do is continue to develop.
[48:33] It's not that they can't stop that happening.
[48:35] So that's what I'm hearing from my colleague, yeah.
[48:39] Certainly we have, we have safe harbor to develop drugs pretty
[48:42] commercially in the States. So as you say, unless there was
[48:45] someone toward underhanded activity, they, they can
[48:48] develop. I'll just chime in.
[48:50] I, I'm biased, admittedly, I used to be on the, the red Med
[48:54] board. So Congrats to my friends Mark
[48:56] and, and Peg and Jack. You guys have done an amazing
[48:59] job developing this drug. I actually don't think it's all
[49:01] about the, the deaf. I think investors are, I don't
[49:04] know, maybe a little bit more savvy than we're giving them
[49:07] credit for. They can put that death into
[49:08] context. These are pancreatic cancer
[49:10] patients. They're obviously going to have
[49:12] bad outcomes and deaths and clinical trials are not that
[49:15] unusual. I kind of just thought the setup
[49:17] in Araska into the data, as you described, Greg was a little bit
[49:22] a little bit juiced a little bit maybe overheated and that there
[49:27] was probably no data set that was going to satisfy investors.
[49:30] Given that once the news was out, we're waiting another 12
[49:34] months or so for another update now from Araska and they won't
[49:38] be starting a pivotal trial anytime soon and they're years
[49:41] behind revved. So I think it's just going to be
[49:44] hard for a drug that's not clearly differentiated.
[49:47] You could swint and and look at the Araska data and say, well,
[49:50] maybe it's a little bit better and lung, but I don't think it's
[49:54] any different in pancreatic cancer, which is where most of
[49:57] the money is likely to be made here.
[49:59] And I think given that lack of differentiation, you know why,
[50:03] why kind of do we need a me too? I'm sticking with the pancreatic
[50:07] theme. I'll just throw out the PRMT 5
[50:09] inhibitor class. Tango and and Bristol are
[50:12] leading the charge here. They're both collaborating and
[50:15] combining their PRMT 5 inhibitors with K Ras inhibitors
[50:19] with with Redman in particular, but others too.
[50:22] And I think that's where kind of the excitement should be in
[50:24] combination therapies with novel, novel targeted therapies
[50:28] that could could potentially obviate the need for
[50:31] chemotherapy. So we'll see how this this
[50:33] pancreatic cancer market develops.
[50:35] It's it's amazingly robust, it's amazingly large.
[50:39] And I don't know, maybe maybe for the for the group.
[50:42] Do others think that we're a little bit overheated with the
[50:44] excitement here or could this be the next clip, one type of
[50:48] marketplace that that gets people excited?
[50:50] That's a big one, Eric. Big one, Eric, just.
[50:54] Just how do you size it, Sam? How do you size it up, Sam?
[50:56] Do you have an? Estimate we're Yeah, we do.
[50:58] We're in the 8 to 10 billion for or post all second line and and
[51:08] and risk adjusted first line. I mean this it all depends how
[51:11] they get priced. So that's where we're at.
[51:13] I think some people wanted to be 15 billion in pancreatic, right.
[51:17] And but Eric, what about the AES?
[51:19] Isn't that where folks? I mean, you're not going to
[51:22] really get so far with BT the the, the, the, the efficacy, but
[51:28] a ES do play a role here and there aren't those reductions,
[51:31] plenty of them and there are some dose holidays.
[51:35] So wouldn't a ES be an an angle that they can differentiate?
[51:40] Possibly, I mean I I guess the thought is, is there a wider
[51:44] therapeutic window with this next generation Araska compound?
[51:47] It's certainly being dosed much, much lower than the Rev Med
[51:50] doses. But we've also seen that they
[51:53] can't go much above 40 milligrams.
[51:55] That was the top dose and they backed off and when I think the
[51:58] 32 megs so so that top dose 32 megs is still like 10 or 20X
[52:03] lower than and Rev meds dose. So yes.
[52:06] Are they more potent? Yes, I would agree.
[52:08] Are they safer or have a better therapeutic window at that lower
[52:12] dose? I'm not I'm not sure, Sam.
[52:14] I think we we just need more data and I don't know time will
[52:19] tell. The mechanisms are pretty
[52:20] similar and the the drug compounds themselves are pretty
[52:22] similar. Well, let's move on Sam.
[52:25] You can take the Harmony 3 interim analysis, which I think
[52:28] is the other big news at least of today and maybe even this
[52:31] week that a lot of people are talking about both in in my
[52:34] space where biotech investors are following Summit and and
[52:37] even Crescent Bio and and maybe more your space with Mark and
[52:41] the PD once. Yeah, sure, let's see if I can
[52:44] do this in 2 minutes. So how many 3 is even is the map
[52:47] which is APD 1 VEGF by specific in combination with chemo versus
[52:53] KEYTRUDA with chemo in squamous cell lung, non small cell lung
[52:57] cancer about 600 patients. Phase three trial data had
[53:02] always been expected in terms of final PFS and interim OS in the
[53:06] second-half of the year. What what we heard about a
[53:09] couple of months ago, two or three months ago is that Summit
[53:12] Therapeutics who has been licensed this drug from a KISO
[53:15] from China a few years ago now decided to do an interim
[53:19] analysis, interim PFS. You look at the capital Maya
[53:23] curve for PFS from the China trial Harmony 6 and you would
[53:29] know that they hit a interim positive statistical significant
[53:35] interim PFS on Harmony six with a very wide dispersion between
[53:41] the that's the right phrase between the treated arm and the
[53:44] control arm. The only difference being that
[53:46] or the key difference being it was China and it was also TIS
[53:49] lenzumab that was used in the in the combination arm comparative
[53:54] arm. So they did that.
[53:56] My theory was that he was there to help them as they said, to
[54:00] start discussing with the FDA and give them an opportunity to
[54:03] go and raise money because this is expensive work.
[54:07] Unfortunately last night after hours they said that they didn't
[54:11] hit the interim and they're continuing.
[54:13] So logical conclusions here can be that just not enough stat sig
[54:19] there because they didn't want to spend a lot of alpha on that.
[54:22] So maybe the difference is there, but it just wasn't
[54:25] enough. Next conclusion is that actually
[54:28] the difference in the capital MI, the distance between the two
[54:31] arms isn't as much as one would have expected from Harmony 6th,
[54:36] which of course then has ramifications as to how much.
[54:39] Can you translate China data to Europe?
[54:41] US? And if the HR has a ratio for
[54:44] PFS in the final read doesn't come up to .6 which is what it
[54:48] is for Harmony 6, what does that then mean for the OS hit?
[54:52] Because expectation is that OS will be lower than PFS because
[54:56] of the the veg F angle there. I think I've done it 2 minutes
[55:01] over. That that was amazing.
[55:05] Not only was it short, but sweet and clear and to the and and and
[55:09] all of facts that that anyone could possibly want to know.
[55:11] I'll just add, you know the obviously this is a
[55:13] disappointing update from from Summit standpoint.
[55:17] Any PFS benefit is clearly likely lower than what was
[55:20] observed in Harmony sex. So hazard ratio is likely higher
[55:24] than .6 O and and also any PFS benefit is likely less strong
[55:30] and someone had hoped when they concocted this interim.
[55:33] So that's disappointing. You also mentioned, Sam, that
[55:36] they do need to raise some capital so that, that could be
[55:40] an overhang going forward. The 1 silver lining here though,
[55:43] is that we do have survival data coming at ASCO from Harmony 6.
[55:48] That's the China only study that you referenced, and it sounds
[55:51] like that's going to be very good.
[55:52] That's a late breaker presentation, one that ACASO is
[55:55] really promoting aggressively. And so if there's little
[55:59] diminution between PFS and OS in Harmony 6, that that could bode
[56:04] well for future Harmony 3 results.
[56:06] We'll have to see. But let's continue to move on.
[56:09] And I think, let's see, is it Greg who's going to start with
[56:13] some of the obesity trials? You know what I was going to do
[56:18] in the interest of time, I was actually going to skip the
[56:21] obesity trials just because we talk about obesity all the time.
[56:24] But if I could, I just want to briefly mention that I'm going
[56:27] to switch the Alzheimer's disease space.
[56:29] And I think we might have some other comments as well.
[56:31] But I just wanted to highlight that there's a small biotech
[56:35] company called Elector, which had a partnership with Glaxo
[56:39] Smith, Kline or they still have a partnership.
[56:42] They had a phase two trial outcome for a very novel target
[56:46] pro granulin with an antibody called Nevisnavart.
[56:50] This was in early Alzheimer's patients.
[56:53] There's a futility analysis that was announced this week.
[56:55] If the drug did not meet futility or did not pass
[56:59] utility. So they're going to discontinue
[57:00] the trial. But I think from an elector
[57:03] perspective, they this will allow the company in silver
[57:10] lining to pivot to its blood brain barrier technology
[57:14] efforts. They've got a proprietary
[57:16] platform called ABC. That's where I think most of the
[57:19] excitement is in the Alzheimer's disease modifying therapy space.
[57:24] So there are tons of companies we've talked about on the
[57:26] podcast of lots of companies in this space.
[57:30] Roche is in the lead with Trantanamab phase three trial
[57:33] started last year. So I do think that kind of a
[57:38] small piece of data, but at the same time didn't want to think
[57:43] that there's nothing promising in Alzheimer's.
[57:46] And in fact just yesterday another company that I covered
[57:49] called ACM got FDA approval for a drug for agitation in
[57:54] Alzheimer's in patients drug will not have a black box
[57:58] warning as the only other drug called Rexulti does.
[58:01] So I do think that we still have good progress in the Alzheimer's
[58:04] space. And let's stick with
[58:06] Alzheimer's, Sam, you get the last word today because I think
[58:09] the the analysis was done by a third party on anti amyloids was
[58:14] was certainly noteworthy. I mean, noteworthy to be honest
[58:17] with you, Eric, it's, I'm surprised that anybody, I mean,
[58:20] you'd made front pages of some newspapers and this is a meta
[58:24] analysis that somebody had done putting together 14 trials,
[58:28] whether which had failed with the original, some of the older
[58:31] antibodies. And I have to say, I was shocked
[58:34] that anybody even looked at that because it just doesn't, it's
[58:39] just wrong because you can't mix those kind of data up.
[58:42] But so it's unfortunate that happened.
[58:45] But what was also nice was that we then saw Lily report and the
[58:48] Kasinda, I mean it really knocked the cover off the ball.
[58:54] The consensus of that $76 million for one Q and they
[58:58] reported 124. You know that's pretty much
[59:02] close to what the can be from Biogen is reporting.
[59:06] So it's sub subcutaneous. I think that really helps.
[59:09] So we'll see if these amyloid antibodies continue to actually
[59:13] get to a point where they make a huge dent in the disease and get
[59:20] used a lot. It's tough because of the
[59:22] biomarker testing etcetera. So definitely a lot of time to a
[59:28] lot of room to improve here, but it was really interesting to see
[59:31] that casino London print over. Thanks for that.
[59:35] And yes, Lacambie from Baijin also had a pretty good print.
[59:37] So maybe these things are finally catching on.
[59:40] We all know there's a ton of unmet need.
[59:42] We had a few other topics we wanted to get to today.
[59:46] My apologies to all for poor moderation.
[59:50] We just had too much to try and fit into a very, very busy week
[59:53] at biotech. It did.
[59:54] A great job. Eric, we are out of time and and
[59:57] this sends our call, but thank you Greg, Sam, Matt and Chris
[1:00:01] for another wonderful session.

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