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CD19 is worth $700m to Merck

Merck turns to China for a molecule against one of biopharma’s most extensively studied antigens.

It seems that what Merck & Co really needed, after gaining rights through various licensing deals to projects against targets from ROR1 through Claudin18.2 to B7-H3, was access to one that hits the tried and tested CD19.Under today’s tie-up with the private Chinese company Curon Biopharmaceutical, Merck has acquired global rights to a CD19-targeting T-cell engager coded CN201. It’s likely that the driver for the deal was phase 1 CN201 data released at ASCO in May, but the big surprise is that CD19 – the target of over 500 industry projects, according to OncologyPipeline – should have attracted a $700m up-front fee from Merck.CN201 is in a phase 1 trial in B-cell non-Hodgkin’s lymphoma, and an ASCO poster revealed this to have yielded a 100% ORR among 19 patients with follicular/mantle cell/marginal zone lymphomas given doses above 5mg. However, the trial actually included 59 efficacy-evaluable subjects, 37 of whom got doses above 5mg, but nothing was said about the 18 with more aggressive lymphomas.Still, perhaps the really attractive feature of CN201 was the low 7% rate of any-grade cytokine release syndrome (none at grade 3 or above), and complete absence of neurotoxicity in a 74-patient safety dataset. Approved anti-CD19 Car-T therapies, and Amgen’s Bite format T-cell engager Blincyto, carry boxed warnings of both toxicities. CN201 efficacy in indolent lymphomasSource: ASCO & Dr Yan Xie. Until now Curon was perhaps best known in the west for having licensed China rights to Rhizen Pharmaceuticals’ PI3K delta & gamma inhibitor tenalisib. Curon, which has also been known as Tongrun Biomedicine, raised $150m in a series A round six years ago.Little is known about the detailed structure of CN201, but the ASCO poster revealed it to use a standard MAb format, binding CD19 with one arm and CD3 with the other. The bispecific was said to have a prolonged half life, “lower affinity” to CD3, and an active Fc domain.Given such unexpected big pharma interest in the saturated space of CD19, investors might now be wondering what other T-cell engagers are in development that also use this approach. OncologyPipeline reveals several, and Roche is also known to have patented multispecific anti-CD19 immunoglobulins that use this modality.Notable also is Cullinan’s CLN-978. As Cullinan turned to autoimmune disease it discontinued this project’s development in lymphoma in April – one month before Curon presented its ASCO poster and, presumably, started licensing talks with Merck. Selected clinical-stage anti-CD19 x CD3 T-cell engagersNameCompanyStatusBlincyto*AmgenApproved for CD19+ve B-cell ALLYK012Excyte BiotechPh2 China trial in ALLAZD0486AstraZenecaPh1/2 for CD19+ve B-cell ALLGNR-084GeneriumPh1/2 for B-cell ALLCN201Merck & Co (ex Curon)Ph1 in B-cell non-Hodgkin’s lymphomaPIT565**NovartisPh1 in B-cell malignanciesVNX-101^VironexisPh1 for B-cell ALLA-319ITabMedPh1 in r/r B-cell lymphomaK193Beijing LuzhuPh1 China trial in indolent lymphomaLNF1904LunanPh1 China trial in lymphomaCLN-978Cullinan TherapeuticsPh1 lymphoma development discontinued to focus on autoimmune diseaseNotes: *uses Bite format, a MAb fragment; **also hits CD2; ^generated via AAV gene transfer. Source: OncologyPipeline.
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Molecular Drug Targets