Once seen as a bright hope for immuno-oncology, the reputation of anti-TIGIT checkpoint inhibitors has yet to recover from the double whammy of trial flops that Roche experienced last year. So you can perhaps forgive fellow Swiss drugmaker Novartis for not putting its own TIGIT ambitions front and center.
Quizzed on this morning’s full-year earnings call about why a pivotal phase 3 trial of ociperlimab in solid tumors didn't launch in the second half of 2022 as originally planned, CEO Vas Narasimhan, M.D., insisted the TIGIT hadn’t been scrapped.
“We continue to pursue the TIGIT through the deal we have with BeiGene, and we have that as an option deal,” Narasimhan said on the call. “We also are assessing what other lines of therapy to take that TIGIT into given the competitive landscape. That's something we're actively evaluating.”
It may not have been the most effusive support the CEO could have given, but it’s clear that Novartis hasn’t totally turned its back on TIGITs. In the meantime, a late-stage trial of ociperlimab run by Novartis’ Chinese partner BeiGene is ongoing.
There are two types of anti-TIGIT candidates. Some, like ociperlimab, have an FC receptor function. FC receptors are found on the cell surface and contribute to the protective functions of the immune system by binding to antibodies that are attached to infected cells or invading pathogens.
Other TIGITs have mutated out the receptor function. They include Gilead and Arcus Biosciences’ domvanalimab, which offered a ray of hope for the therapy class when they teased phase 2 data last November that they claimed showed a combination of the TIGIT and anti-PD-L1 med zimberelimab were more effective than zimberelimab alone.
A Fierce Biotech analysis found that as of May 2022, Big Pharmas had bet north of $6 billion in deals for anti-TIGITs. But back-to-back phase 3 flops of Roche’s tiragolumab rattled confidence. Fellow player and GSK partner iTeos Therapeutics announced shortly thereafter that it would be re-evaluating its plans. GSK’s deal with iTeos topped the list of TIGIT deals at the time, with more than $2 billion in biobucks on the line.
Elsewhere in Novartis’ current oncology pipeline, Narasimhan was keen to use his earnings presentation to highlight the company's phase 2 CD19-directed CAR-T YTB323 and phase 1 radioligand therapy AAA603 as examples of earlier-stage assets that could become “high-impact medicines.”
When it comes to finding fresh oncology assets to buy or license, Narasimhan said the company remains “active” in the space. “If we can find attractive assets within our core cancers—lung cancer, prostate cancer, the gastric cancers, etc.—those are certainly things we would actively look at,” he said on the call.
But tempting assets in any disease area will still need to have a price tag of under $5 billion—a limit that Narasimhan reiterated on this morning’s call. “We look at the full range of M&A possibilities, but our focus is on sub-$5 billion assets where we believe we have the opportunity to generate strong returns and find the most value,” the CEO explained.