Cancer and neuroscience have dominated pharmaceuticals and investment over the past year. So, where is the "wind" of innovative drugs blowing in 2024?
In the view of the market, the above two areas are still the tuyere of pharmaceutical investment. At the same time, some new changes are also taking place. For example, the next generation of solid tumor therapy is becoming the new darling of cancer, and in neuroscience, psychedelics seem to be on the rise.
In addition, the field of self-exemption and obesity will remain lively and continue to attract money.
01 New focus: psychedelics
In late December, AbbVie announced an $8.7 billion acquisition of Cerevel. Cerevel There are many pipelines, but the core pipeline is emraclidine, a selective positive allosteric modulator of the muscarinic receptor M4. The indication for this drug development is for the treatment of schizophrenia and has entered phase 2 clinical practice.
On December 22, Bristol-Myers Squibb became even more aggressive, announcing the acquisition of Karuna for $14 billion. The core pipeline of Karuna is also a drug acting on muscarinic receptors.
This puts the neuroscience field in second place in M & A activity in 2023, according to an IQVIA report.
In neuroscience, MPM BioImpact managing partner Ansbert Gadicke is more bullish on the potential. In his view, compounds such as psilocybin exist naturally and therefore lack novelty and do not qualify for intellectual property protection, which hinders the development of the field.
Recently, however, pharmaceutical companies have synthesized new molecules that mimic the function of compounds, "but probably of a better nature" and are eligible for intellectual property protection.
The so-called psilocybin, that is, the magic mushroom. Psilocybin is a psychoactive ingredient in the "hallucinogenic mushroom", which belongs to a class of controlled drugs in China. This means that it currently does not have any legitimate medical use and there is a high risk of abuse.
But in frontier medicine, scientists have been studying the possibility of using it to treat depression and anxiety disorders.
Gadicke pointed out that psilocybin has long-acting psychoactivity and requires patient supervision after administration. The core is that you can't give someone a magic mushroom and send them home.
But he says the new compounds work slightly short, so patients need less time to supervise and are easier to manage. Some of these compounds already have a substance composition IP.
Gadicke Said: Once used, LSD drugs have great potential for neuropsychiatric indications such as depression.
In 2019, the FDA esketamine (esketamine) nasal spray Spravato, a new drug for adult refractory depression, Spravato was officially approved in China last year.
Spravato In 24 hours, it can significantly and quickly reduce depressive symptoms, so that its market performance is outstanding, in 2023, the sales reached $689 million, up 84.22% year on year.
In addition, Incannex Healthcare has announced positive results for Psi-GAD 1, a phase 2 trial of psilocybin therapy for generalized anxiety disorders. The analysis showed that the trial reached the primary endpoint, demonstrating a greater clinical therapeutic effect of psilocybin compared with placebo. Based on these results, the Incannex is expected to submit an IND application to the US FDA for a related multicenter phase 2b clinical trial.
In Gadicke's view, psychedelic drugs are much better effective than the antidepressants seen historically.
02 Continuous tuyere: autoimmunity and obesity
According to jpmorgan's report on Biopharmaceutical License and Venture Capital 2023, the self-exempt sector ranked fourth in early investments last year. And Gadicke says it could replace ophthalmology and move up to third place this year.
Gadicke said the self-exemption sector is now more or less exploding and will be bigger this year. To illustrate this development, Gadicke points to a 2022 study showing that five patients with SLE were in remission after eight months of CAR-T therapy.
Last month, a study published in the New England Journal of Medicine showed that CD19 CAR-T therapy has a high potential in the field of self-exemption. Eight patients with SLE were in remission after 15 months of treatment.
In the field of self-exemption, CAR-T therapy does continue to move forward, but "lagging behind" is also happening. The Belgian biotech company Galapagos unexpectedly fell behind. In its earnings report, the company announced that it would exit CAR-T GLPG5101 in lupus for strategic reasons.
Biotech entrepreneur Andrew Pannu says the metabolic space is huge, led by obesity and GLP-1 drugs."We've seen all the major players already been poached, so it'll be interesting to see which venture capital goes into the field to fund new companies, new ideas.
Recently acquired obesity companies include Carmot Therapeutics and Inversago Pharma, which were acquired by Roche in January 2024 for $2.2 billion, and by Novo Nordisk over $1 billion in August 2023.
In addition, the field of inflammation and immunology (I & I) may also be attractive because it has more potential for indication expansion. Pharmaceutical companies are always committed to constantly expanding the indications for drugs, which is the most common in the oncology field. At the same time, it is also common in I & I, because a drug that is effective in rheumatoid arthritis may also work in psoriatic arthritis.
Overall, the trend over the past two years has been for drug companies to make acquisitions after phase II or III clinical readings to reduce risk, Kim said. Now, he thinks the situation is back to the era before COVID-19, when the company was acquired after early data was read out. That's because biotech who survived the winter stay focused and believe in science. And for now, also let the market to see this new hope.
