Stu's line of assault28 Nov 2023 22:39
He was setting Hemo up for a trade with anticipating no RNS for IND by end of month, but the FDA CAR-T article was a bit of a gifthorse to trade on so cant really blame the chap. However rather than just dismiss it out of hand I decided to share some actual research.
1, Companies affected include: Gilead whos shares were down marginally, Legend's stock fell 2.5% to 11bn. Autolus Therapeutics, which is also developing CAR-T therapies, down nearly 5% to 800m so yea companies with licenced products had a whopping drop.....
2, RBC analysts in a note said the concerns could be higher for Novartis' Kymriah, and extremely rare for all the other marketed CAR-Ts. Kymriah is a CD19-directed genetically modified autologous T cell. The FDA is investigating the reports amongst patients who received BCMA- or CD19-directed CAR-T cell immunotherapies. Hemogenyx are targeting FLT3, this is NOT the target of this investigation.
3, Benefits outweigh the potential risk, with rates reported looking very low (early days but I saw figures of 0.5%) its better to risk cancer down the line than to not get CAR-T even if it is CD19.... FDA recommendation is "Patients and clinical trial participants receiving treatment with these products should be monitored life-long for new malignancies." They are NOT placing a clinical hold, they are NOT stopping treating patients and they are NOT stopping new approvals.
4, This is the result of an FDA investigation with future investigation to be done, it did not materialise today, when the FDA applied their clinical hold it was not done in a vacuum as such it MAY have been a side effect of this investigation. Likewise when the CH lift plan was lifted recently they would already be investigating this issue, potentially this could put Hemo AHEAD of existing treatments where there is risk which Hemo not yet in trials was forced to mitigate.
5, Here : https://www.sciencedirect.com/science/article/pii/S2329050121000280 is interesting reading, I cannot find details on the issue with Kymriah however a study showed malignancy caused by unintentional transduction of residual malignant B cells (CAR-B cells) presented on the surface of lentiviral vectors. And what was the cause of the clinical hold here?
Bottom line is, despite fear mongering from Stu, the leaders in this field suffered a mere 2.5%-5% dip on this news, the impact is quite low and IF it were applicable to HEMO-CAR-T of all companies, the ones on CH actively communicating with the FDA would be first to be told to make changes. HH called out the emphasis being placed on EoM for an IND RNS, but honestly, this WAS a gift to him, most of this board can hardly read and the majority of those will never bother to do any actual research.
https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/fda-investigating-serious-risk-t-cell-malignancy-following-bcma-directed-or-cd19-directed-autologous