C5

1 整体表现 虎落平阳的肿瘤一哥罗氏，医药板块的业绩增长只能说看起来有了起色的一点微弱的迹象，因而市值也就只能在$250b左右徘徊不前。 全年收入增长预计在mid single digit，EPS增长也就high single digit，就很符合欧洲的调性。 2 已上市产品 罗氏的增量依然是几乎只来源于眼科单一品种Vabysmo，而在医药史上那一堆其灿如言的商品名，如今基本都已经成为下滑的来源。 肿瘤板块实在是标准的英雄末路，从Rituximab到Atezolizumab这一堆说多都是泪，哪怕Kadcyla和Obinutuzumab也都陷入停滞，更令人失望的是两款身处末线的CD20/CD3双抗单季距离$100m都相去甚远，这一派萧瑟令人唯有扼腕；唯二还能看一看的品种，HER2复方抗体Phesgo还在不断替代市场、不过转化率已经爬到43%、与公司自称的50%目标距离也所剩无几，Polivy在这个季度突然跃升到$300m以上、在1L DLBCL的份额爬升到28%。 自免板块纵不至于像肿瘤那样绝望，但增量也已经相当有限，CD20单抗Ocrelizumab的LTM累计接近$6.7b、已经基本上开始走平，尽管公司再次强调在皮下制剂获批后能带来新的增量，峰值看到$2b，且现在80%新患都开始用皮下剂型；IgE单抗Omalizumab在哮喘的份额不断被侵蚀、但公司斩钉截铁且不给任何解释地断定其生物类似药明年并不会出现，而IL6单抗Tocilizumab的生物类似药则已经快要杀到面前。 最终扛住公司业绩的反倒是当年的闲棋冷子：眼科双抗Emicizumab目前还基本保持着线性的爬坡曲线，目前LTM累计已达到$3.6b，公司明确披露在AMD/DME/RVO等几个适应症的份额都还在持续提升，新患的份额已经提升到50%左右，看样子上个季度嘲讽的隔壁Eylea HD拿J-code确实尚未产生可见的“任何影响”，而且公司也明确表示Eylea生物类似药也并不会带来什么实质的影响、毕竟Avastin和Lucentis的生物类似药早已充斥了整个眼科市场；眼科下一个被寄予厚望的就是坎坷归来的Susvimo植入剂，公司给了今年几百、明年几千、后年上万的种植例数目标；血友病双抗Emicizumab看起来确实扛住了长效八因子的竞争冲击，重新进入增长轨道，目前LTM累计已达到$4.3b，未来还能维持5%增长；SMA药物Risdiplam如预期地在上个季度的招标等一次性因素之后，本季度环比有所回落，目前LTM累计已达到$1.6b；小惊喜的是基因治疗Elevidys获批后，已经迅速治疗了50多例，单季销售额也突破$100m。 3 在研管线 首先就是PI3Kα抑制剂Inavolisib终于获得FDA批准治疗PIK3CA突变的HR+/HER2-乳腺癌，在PI3K哀鸿遍野（参见【药海听涛】PI3K之殇：确定性的不确定性？）和Roche在乳腺癌的霸权全面崩溃（参见【药海听涛】Roche已死，AZ当立？SABCS 2022回眸）的形式下，总算留下了一口气。 紧接着还是在HR+HER2-乳腺癌上，Roche豪掷$850m首付款拿下齐鲁锐格的CDK2/4/6抑制剂RGT-419B，该药仍在临床一期，去年底SABCS公布过单药Ph1a剂量爬坡试验的初步结果，12例患者中做出了3例PR。 除此以外，值得关注的进展还包括：获批消息包括PD-L1单抗Atezolizumab的皮下注射剂型，CD20单抗Ocrelizumab的半年一次皮下注射剂型，C5单抗Crovalimab在欧盟获批，Vabysmo在欧盟获批RVO适应症等；临床读出包括CD20单抗Obinutuzumab在狼疮肾炎的三期临床积极结果，BTK C481S抑制剂Fenebrutinib在多发性硬化症的三期临床结果，流感药物Baloxavir首个降低传染性的三期临床结果，SMN2药物Risdiplam针对儿童SMA的三期临床结果等；但更吸引眼球的反而是Roche不声不响的瘦身，一下抹掉了好多管线，其中还不乏TLR7和siRNA的乙肝管线、PD1/LAG3双抗、Tau单抗等多个曾经红极一时的热点方向。 4 有关减肥的审美疲劳 在电话会最后，CEO居然戏剧性地对没人提问减肥相关问题进行了吐槽，仿佛小学生花了一晚上背课文却发现老师抽查没抽到自己的失落^_^ 罗氏总给人一种值得进商学院教科书的感觉，其兴也肿瘤、其落也肿瘤，最强大的能力铸就了曾经的辉煌、也可能恰恰成为眼下的桎梏，而打破它的方法是否就需要跳出那些舒适区呢？看起来，让这个在肿瘤领域叱咤风云凡二十余载的巨头走出困境，很有可能要靠眼科和减肥品种了？

— First Ever Trial in Pregnant Women at Higher Risk of Alloimmunization and FNAIT — — Screening in the Phase 2 Clinical Trial On Track to Initiate in 4Q 2024 — NEW HAVEN, CT, USA I October 29, 2024 I Rallybio Corporation (Nasdaq: RLYB), a clinical-stage biotechnology company translating scientific advances into transformative therapies for patients with devastating rare diseases, today announced the approval of its clinical trial applications (CTAs) for a Phase 2 clinical trial of RLYB212 in pregnant women at higher risk for HPA-1a alloimmunization and fetal and neonatal alloimmune thrombocytopenia (FNAIT). With these approvals from the European Medicines Agency (EMA) and the United Kingdom’s Medicines and Healthcare products Regulatory Agency (MHRA), Rallybio will begin to activate Phase 2 clinical sites and expects to initiate screening of participants in the fourth quarter of 2024. “Securing these CTA approvals from European health authorities to advance RLYB212 into a Phase 2 trial is a significant achievement. These approvals are a testament to the dedication and innovation of our team and our partners as we advance this first ever program to prevent maternal alloimmunization and FNAIT,” said Stephen Uden, M.D., Chief Executive Officer of Rallybio. “We are activating clinical sites and expect to initiate screening this quarter, which will mark another important step toward achieving our mission to prevent FNAIT and its potentially devastating consequences.” The single-arm Phase 2 dose confirmation trial ( 2024-512651-20 / NCT06435845 ) will be conducted in Belgium, the Netherlands, Norway, Sweden, and the UK, and is designed to assess the pharmacokinetics (PK) and safety of RLYB212, a monoclonal anti-HPA-1a antibody, in a total of eight pregnant women at higher risk for HPA-1a alloimmunization and FNAIT. Secondary objectives include assessments of pregnancy and neonatal/infant outcomes, and the occurrence of emergent HPA-1a alloimmunization. Subcutaneous administration of RLYB212 will be initiated by Gestational Week 16 and will continue every 4 weeks through parturition. “These approvals recognize Rallybio’s commitment to safely and effectively progress a novel prophylactic approach for preventing alloimmunization in pregnant women at higher FNAIT risk,” said Steven Ryder, M.D., Chief Medical Officer at Rallybio. “We are proud to be leaders in bringing much needed innovation to this area of women’s health, which has gone unaddressed for far too long.” About FNAIT Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) is a potentially life-threatening rare disease that can cause uncontrolled bleeding in fetuses and newborns. FNAIT can arise during pregnancy due to an immune incompatibility between an expectant mother and her fetus in a specific platelet antigen called human platelet antigen 1, or HPA-1. There are two predominant forms of HPA-1, known as HPA-1a and HPA-1b, which are expressed on the surface of platelets. Individuals who are homozygous for HPA-1b, meaning that they have two copies of the HPA-1b allele and no copies of the HPA-1a allele, are also known as HPA-1a negative. Upon exposure to the HPA-1a antigen, these individuals can develop antibodies to that antigen in a process known as alloimmunization. In HPA-1a-negative expectant mothers bearing a HPA-1a-positive fetus, alloimmunization can occur upon mixing of fetal blood with maternal blood. When alloimmunization occurs in an expectant mother, the anti-HPA-1a antibodies that develop in the mother can cross the placenta and destroy platelets in the fetus. The destruction of platelets in the fetus can result in severely low platelet counts, or thrombocytopenia, and potentially lead to devastating consequences including miscarriage, stillbirth, death of the newborn, or severe lifelong neurological disability in those babies who survive. There is currently no approved therapy for the prevention or prenatal treatment of FNAIT. About Rallybio Rallybio (NASDAQ: RLYB) is a clinical-stage biotechnology company with a mission to develop and commercialize life-transforming therapies for patients with severe and rare diseases. Rallybio has built a broad pipeline of promising product candidates aimed at addressing diseases with unmet medical need in areas of maternal fetal health, complement dysregulation, hematology, and metabolic disorders. The Company has two clinical stage programs: RLYB212, an anti-HPA-1a antibody for the prevention of fetal and neonatal alloimmune thrombocytopenia (FNAIT) and RLYB116, an inhibitor of complement component 5 (C5), with the potential to treat several diseases of complement dysregulation, as well as additional programs in preclinical development. Rallybio is headquartered in New Haven, Connecticut. For more information, please visit www.rallybio.com and follow us on LinkedIn and Twitter . SOURCE: Rallybio

Plus, news about Astellas, Clover, ElevateBio, Monopar, Idorsia and Neurocrine Biosciences: Vera Therapeutics plans $300M offering: The California biotech is selling shares after presenting Phase 2b data for an experimental drug called atacicept over the weekend. The company shared 96-week data for patients with immunoglobulin A nephropathy. — Kyle LaHucik Abeona Therapeutics resubmits rare skin disease therapy: Back in April, the FDA rejected Abeona’s cell therapy, called pz-cel, requesting more information about manufacturing. Abeona is developing pz-cel for recessive dystrophic epidermolysis bullosa, a rare genetic skin disease. — Lei Lei Wu Astellas yanks Izervay’s submission in Europe: The company said it withdrew its marketing authorization application for Izervay, a C5 protein inhibitor for geographic atrophy secondary to age-related macular degeneration. Astellas did not detail feedback from the Committee for Medicinal Products for Human Use, but said it is still “confident” in Izervay’s risk-benefit profile and will continue to engage with regulators in Europe and elsewhere. There are currently no treatments approved for GA secondary to AMD outside of the US, where Izervay was greenlit in August of last year. — Ayisha Sharma Clover releases early RSV vaccine data: The Shanghai-based biotech said its bivalent vaccine candidate, SCB-1019, produced “comparable” levels of RSV neutralizing antibodies to GSK’s Arexvy at 28 days in a Phase 1 test. Based on these data, Clover plans to advance the asset into studies focused on re-vaccination next year. — Ayisha Sharma ElevateBio lays off 4%: The genetic medicines company, which employs about 500 people, is ending its preclinical cellular engineering work, a spokesperson told Endpoints News on Monday. The Waltham, MA-based biotech laid off about 13% of its staff in October 2023. It’s one of the most well-funded private biopharma startups after having raised about $1.25 billion, including its $401 million Series D last year. Partnerships with companies like Novo Nordisk, Moderna, Kyverna and Affini-T are unaffected, the spokesperson confirmed. — Kyle LaHucik Monopar Therapeutics prices $19.2M offering: The Chicago-area biotech sold shares to Janus Henderson, RA Capital and others. A few days ago, Monopar licensed a Wilson disease drug candidate from AstraZeneca’s Alexion. — Kyle LaHucik Idorsia ends work with Neurocrine Biosciences: The companies were developing Idorsia’s T-type calcium channel blocker for patients with a rare form of pediatric epilepsy. The treatment failed a Phase 2 study in 2022, and further analysis led to the decision to stop work. — Jaimy Lee