Cevostamab

SOUTH SAN FRANCISCO, Calif.--( BUSINESS WIRE )--Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY) announced today that it will present more than 40 abstracts across nine blood disorders at the 66th American Society of Hematology (ASH) Annual Meeting and Exposition, held December 7-10, 2024 in San Diego, California. The data underscore Genentech’s commitment to advance patient outcomes in lymphoma with long-term follow-up of its approved medicines Polivy ® (polatuzumab vedotin-piiq), Lunsumio ® (mosunetuzumab-axgb) and Columvi ® (glofitamab-gxbm) as well as new investigational combination data. Key presentations include: Five-year data from the Phase III POLARIX study (abstract #469) reinforce the potential of Polivy in combination with Rituxan ® (rituximab), cyclophosphamide, doxorubicin and prednisone (R-CHP) to provide durable and lasting remissions and for the first time show a positive trend in overall survival (OS) for people with first-line diffuse large B-cell lymphoma (DLBCL), an area that previously had little advancement in nearly two decades. Extended follow-up data of up to four years from the pivotal GO29781 study of Lunsumio (abstract #4407) and NP30179 study of Columvi (abstract #865) show long-lasting remissions and immune system recovery after the end of treatment, supporting the use of fixed-duration bispecific antibodies for third-line or later (3L+) follicular lymphoma (FL) and DLBCL, respectively. First presentation of data for a subcutaneous formulation of Lunsumio monotherapy from the pivotal Phase II GO29781 study (abstract #1645) show high rates of deep and durable responses and low rates and severity of cytokine release syndrome in people with 3L+ FL. Subcutaneously administered Lunsumio could further improve the patient experience by combining shorter administration time with the existing benefits of a fixed-duration and outpatient therapy. New patient-reported outcomes data from the Phase III STARGLO study (abstract #5132) indicate comparable health-related quality of life between treatment arms, despite higher median number of cycles received with the Columvi combination (11 versus 4). Together with the significant improvement in OS observed in the study, these data support the potential benefit for patients with second-line or later DLBCL. New and updated data from investigational study combinations of Polivy with bispecific antibodies Lunsumio and Columvi in relapsed or refractory DLBCL, including the Phase Ib/II NP39488 (abstract #988) and Phase II GO40516 (abstract #989) studies, add to the growing body of evidence demonstrating the potential of novel bispecific antibody/Polivy combinations in earlier treatment lines, and support their ongoing Phase III development. Overview of key presentations featuring Genentech medicines Medicine Abstract title Abstract number/presentation details Polivy Five-Year Analysis of the POLARIX Study: Prolonged Follow-up Confirms Positive Impact of Polatuzumab Vedotin Plus Rituximab, Cyclophosphamide, Doxorubicin, and Prednisone (Pola-R-CHP) on Outcomes #469 oral presentation Session: 626. Aggressive Lymphomas: Clinical and Epidemiological: CARs, Bispecifics, and ADCs: Progress and Challenges in Aggressive B Cell Lymphoma Sunday, December 8, 2024 9:30 AM PST A Multicenter, Prospective, Observational Study of Pola-R-CHP in Patients With Previously Untreated Diffuse Large B-Cell Lymphoma (POLASTAR): A Preliminary Analysis #4475 poster presentation Session: 626. Aggressive Lymphomas: Clinical and Epidemiological: Poster III Monday, December 9, 2024 6:00 - 8:00 PM PST Lunsumio A Randomized Phase II Study of Mosunetuzumab SC Plus Polatuzumab Vedotin Demonstrates Improved Outcomes Versus Rituximab Plus Polatuzumab Vedotin in Patients (Pts) with Relapsed or Refractory (R/R) Large B-Cell Lymphoma (LBCL) #989 oral presentation Session: 627. Aggressive Lymphomas: Pharmacologic Therapies: Chemotherapy-free Combinations for Relapsed Aggressive Lymphomas Monday, December 9, 2024 5:30 PM PST Subcutaneous Mosunetuzumab Leads to High Rates of Durable Responses, Low Rates of Cytokine Release Syndrome, and Non-Inferior Exposure Compared with Intravenous Administration in Patients with Relapsed/Refractory Follicular Lymphoma: Primary Analysis of a Pivotal Phase II Study #1645 poster presentation Session: 623. Mantle Cell, Follicular, Waldenstrom’s, and Other Indolent B Cell Lymphomas: Clinical and Epidemiological: Poster I Saturday, December 7, 2024 5:30 - 7:30 PM PST Mosunetuzumab Continues to Demonstrate Clinically Meaningful Outcomes in Patients with Relapsed and/or Refractory Follicular Lymphoma after ≥2 Prior Therapies Including Those with a History of POD24: 4-Year Follow-up of a Pivotal Phase II Study #4407 poster presentation Session: 623. Mantle Cell, Follicular, Waldenstrom’s, and Other Indolent B Cell Lymphomas: Clinical and Epidemiological: Poster III Monday, December 9, 2024 6:00 - 8:00 PM PST Mosunetuzumab Monotherapy Demonstrates Encouraging Activity and a Manageable Safety Profile in Patients with Heavily Pre-Treated Relapsed or Refractory Mantle Cell Lymphoma #1646 poster presentation Session: 623. Mantle Cell, Follicular, Waldenstrom’s, and Other Indolent B Cell Lymphomas: Clinical and Epidemiological: Poster I Saturday, December 7, 2024 5:30 - 7:30 PM PST Fixed-Duration Subcutaneous Mosunetuzumab is Active and has a Manageable Safety Profile in Patients with Previously Untreated, Low-Tumor Burden Follicular Lymphoma: Updated Results from the Phase II MorningSun Study #3008 poster presentation Session: 623. Mantle Cell, Follicular, Waldenstrom’s, and Other Indolent B Cell Lymphomas: Clinical and Epidemiological: Poster II Sunday, December 8, 2024 6:00 - 8:00 PM PST Travel Burden and Travel Costs of Bispecific Antibodies in Patients with Relapsed/Refractory Diffuse Large B-Cell Lymphoma and Relapsed/Refractory Follicular Lymphoma #782 oral presentation Session: 902. Health Services and Quality Improvement: Lymphoid Malignancies: For a Better Tomorrow - Improving Access to Blood Cancer Treatments and Trials Monday, December 9, 2024 10:45 AM PST Columvi Fixed-duration Glofitamab Monotherapy Continues to Demonstrate Durable Responses in Patients with Relapsed or Refractory Large B-Cell Lymphoma: 3-year Follow-Up From a Pivotal Phase II Study #865 oral presentation Session: 627. Aggressive Lymphomas: Pharmacologic Therapies: New R-CHOP Combinations for Treatment Naïve DLBCL Sunday, December 8, 2024 Midday PST Glofitamab in Combination with Polatuzumab Vedotin Maintains Durable Responses and a Manageable Safety Profile in Patients with Heavily Pre-treated Relapsed/Refractory (R/R) Large B-Cell Lymphoma (LBCL) Including High-Grade B-Cell Lymphoma (HGBCL): Extended Follow-Up of a Phase Ib/II Study #988 oral presentation Session: 627. Aggressive Lymphomas: Pharmacologic Therapies: Chemotherapy-free Combinations for Relapsed Aggressive Lymphomas Monday, December 9, 2024 5:15 PM PST Glofitamab in Combination with Rituximab plus Ifosfamide, Carboplatin, and Etoposide shows Favorable Efficacy and Manageable Safety in Patients with Relapsed or Refractory Diffuse Large B-cell Lymphoma, Eligible for Stem Cell Transplant or Chimeric Antigen Receptor T-cell Therapy: Results from a Phase Ib Study #987 oral presentation Session: 627. Aggressive Lymphomas: Pharmacologic Therapies: Chemotherapy-free Combinations for Relapsed Aggressive Lymphomas Monday, December 9, 2024 5:00 PM PST Primary Results of Patient-Reported Outcomes in Patients with Relapsed/Refractory Diffuse Large B-cell Lymphoma Treated with Glofitamab plus Gemcitabine and Oxaliplatin (Glofit-GemOx) Versus Rituximab plus GemOx (R-GemOx) from the Phase III STARGLO Study #5132 poster presentation Session: 906. Outcomes Research: Lymphoid Malignancies Excluding Plasma Cell Disorders: Poster III Monday, December 9, 2024 6:00 - 8:00 PM PST Glofitamab Induces High Response Rates and Durable Remissions in Patients (Pts) with Heavily Pretreated Relapsed/Refractory (R/R) Mantle Cell Lymphoma (MCL), including those with a Poor Prognosis: Subgroup Results from a Phase I/II Study #1631 poster presentation Session: 623. Mantle Cell, Follicular, Waldenstrom’s, and Other Indolent B Cell Lymphomas: Clinical and Epidemiological: Poster I Saturday, December 7, 2024 5:30 - 7:30 PM PST A Healthcare Utilization Model Comparing Time Toxicity Between Glofitamab and Epcoritamab Treatment Regimens #3647 poster presentation Session: 902. Health Services and Quality Improvement: Lymphoid Malignancies: Poster II Sunday, December 8, 2024 6:00 - 8:00 PM PST Englumafusp alfa Englumafusp Alfa (CD19-4-1BBL) Combined with Glofitamab is Safe and Efficacious in Patients with R/R B-NHL: Extended Follow Up Analysis of the Dose-Escalation Part of Phase I Trial BP41072 #990 oral presentation Session: 627. Aggressive Lymphomas: Pharmacologic Therapies: Chemotherapy-free Combinations for Relapsed Aggressive Lymphomas Monday, December 9, 2024 5:45 PM PST Cevostamab Cevostamab in Patients with Heavily Pretreated Relapsed/Refractory Multiple Myeloma (RRMM): Updated Results from an Ongoing Phase I Study Demonstrate Clinically Meaningful Activity and Manageable Safety and Inform the Doses and Regimen for Combination Studies #1021 oral presentation Session: 654. Multiple Myeloma: Pharmacologic Therapies: Into the Future: New Drugs and Combinations in Multiple Myeloma Monday, December 9, 2024 4:30 PM PST Venclexta ® (venetoclax)* CRISTALLO: Results from a Phase III Trial of Venetoclax–Obinutuzumab versus Fludarabine, Cyclophosphamide and Rituximab or Bendamustine–Rituximab in Patients with Untreated Chronic Lymphocytic Leukemia Without Del(17p) or TP53 Mutations #3237 poster presentation Session: 642. Chronic Lymphocytic Leukemia: Clinical and Epidemiological: Poster II Sunday, December 8, 2024 6:00 - 8:00 PM PST P-CD19CD20-ALLO1 (in collaboration with Poseida Therapeutics) P-CD19CD20-ALLO1: Potent Fully Allogeneic CAR-T Therapy Targeting CD19 and CD20 with Superior Efficacy Over Single-Target Products #4805 poster presentation Session: 702. CAR-T Cell Therapies: Basic and Translational: Poster III Monday, December 9, 2024 6:00 - 8:00 PM PST P-BCMA-ALLO1 (in collaboration with Poseida Therapeutics) A Phase 1 Study of P-BCMA-ALLO1, a Non-viral, Allogeneic BCMA Directed CAR-T in Relapsed/Refractory Multiple Myeloma (RRMM): Results from Optimized Lymphodepletion Cohort #4828 poster presentation Session: 704. Cellular Immunotherapies: Early Phase Clinical Trials and Toxicities: Poster III Monday, December 9, 2024 6:00 - 8:00 PM PST Hemlibra ® (emicizumab) Bleed Patterns in Infants, From Birth to 12 Months of Age, with Hemophilia A Treated with Emicizumab: Exploratory Analysis of the HAVEN 7 Study #1214 poster presentation Session: 322. Hemophilia A and B: Clinical and Epidemiological: Poster I Saturday, December 7, 2024 5:30 - 7:30 PM PST Real-World Experience With Emicizumab for Hemophilia A From the Physician Perspective Based on Survey Data #5078 poster presentation Session: 905. Outcomes Research: Non-Malignant Conditions Excluding Hemoglobinopathies: Poster III Monday, December 9, 2024 6:00 - 8:00 PM PST PiaSky ® (crovalimab) Phase III Randomized COMMODORE 2 Trial: 2-Year Efficacy and Safety of Crovalimab in Patients With Paroxysmal Nocturnal Hemoglobinuria (PNH) Naive to Complement Inhibition #2687 poster presentation Session: 508. Bone Marrow Failure: Acquired: Poster II Sunday, December 8, 2024 6:00 - 8:00 PM PST Phase III COMMODORE 1 Trial: 2-Year Efficacy and Safety of Crovalimab in Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH) Who Switched from Ravulizumab #4078 poster presentation Session: 508. Bone Marrow Failure: Acquired: Poster III Monday, December 9, 2024 6:00 - 8:00 PM PST *Venclexta is being developed by AbbVie and Genentech, a member of the Roche Group. It is jointly commercialized by the companies in the United States and commercialized by AbbVie outside of the United States. About Polivy ® (polatuzumab vedotin-piiq) Polivy is a first-in-class anti-CD79b antibody-drug conjugate (ADC). The CD79b protein is expressed specifically in the majority of B cells, an immune cell impacted in some types of non-Hodgkin’s lymphoma (NHL), making it a promising target for the development of new therapies. Polivy binds to cancer cells such as CD79b and destroys these B cells through the delivery of an anti-cancer agent, which is thought to minimize the effects on normal cells. Polivy is being developed by Genentech using Seagen ADC technology and is currently being investigated for the treatment of several types of NHL. Polivy U.S. Indication Polivy is a prescription medicine used with other medicines (a rituximab product, cyclophosphamide, doxorubicin, and prednisone) as a first treatment for adults who have moderate to high risk diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) or high-grade B-cell lymphoma (HGBL). Polivy is a prescription medicine used with other medicines, bendamustine and a rituximab product, to treat DLBCL in adults who have progressed after at least 2 prior therapies. Important Safety Information Possible serious side effects Everyone reacts differently to Polivy therapy, so it’s important to know what the side effects are. Some people who have been treated with Polivy have experienced serious to fatal side effects. Your doctor may stop or adjust your treatment if any serious side effects occur. Be sure to contact your healthcare team if there are any signs of these side effects. Nerve problems in your arms and legs: This may happen as early as after your first dose and may worsen with every dose. Your doctor will monitor for signs and symptoms, such as changes in your sense of touch, numbness or tingling in your hands or feet, nerve pain, burning sensation, any muscle weakness, or changes to your walking pattern Infusion-related reactions: You may experience fever, chills, rash, breathing problems, low blood pressure, or hives within 24 hours of your infusion Low blood cell counts: Treatment with Polivy can cause severe low blood cell counts. Your doctor will monitor your blood counts throughout treatment with Polivy Infections: If you have a fever of 100.4°F (38°C) or higher, chills, cough, or pain during urination, contact your healthcare team. Your doctor may also give you medication before giving you Polivy, which may prevent some infections Rare and serious brain infections: Your doctor will monitor closely for signs and symptoms of these types of infections. Contact your doctor if you experience confusion, dizziness or loss of balance, trouble talking or walking, or vision changes Tumor lysis syndrome: Caused by the fast breakdown of cancer cells. Signs include nausea, vomiting, diarrhea, and lack of energy Potential harm to liver: Some signs include tiredness, weight loss, pain in the abdomen, dark urine, and yellowing of your skin or the white part of your eyes. You may be at higher risk if you already had liver problems or you are taking other medication Side effects seen most often The most common side effects during treatment were Nerve problems in arms and legs Nausea Tiredness or lack of energy Diarrhea Constipation Hair loss Redness and sores of the lining of the mouth, lips, throat, and digestive tract Polivy may lower your red or white blood cell counts and increase uric acid levels. Polivy may not be for everyone. Talk to your doctor if you are Pregnant or think you are pregnant: Data have shown that Polivy may harm your unborn baby Planning to become pregnant: Women should avoid getting pregnant while taking Polivy. Women should use effective contraception during treatment and for 3 months after their last Polivy treatment. Men taking Polivy should use effective contraception during treatment and for 5 months after their last Polivy treatment Breastfeeding: Women should not breastfeed while taking Polivy and for 2 months after the last dose These may not be all the side effects. Talk to your healthcare provider for more information about the benefits and risks of Polivy treatment. You may report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch . You may also report side effects to Genentech at (888) 835-2555. Please see the full Prescribing Information and visit https://www.Polivy.com for additional Important Safety Information. About Lunsumio ® (mosunetuzumab-axgb) Lunsumio is a first-in-class CD20xCD3 T-cell engaging bispecific antibody designed to target CD20 on the surface of B cells and CD3 on the surface of T cells. This dual targeting activates and redirects a patient’s existing T cells to engage and eliminate target B cells by releasing cytotoxic proteins into the B cells. A robust clinical development program for Lunsumio is ongoing, investigating the molecule as a monotherapy and in combination with other medicines, for the treatment of people with B-cell non-Hodgkin’s lymphomas, including follicular lymphoma and diffuse large B-cell lymphoma, and other blood cancers. Lunsumio U.S. Indication Lunsumio (mosunetuzumab-axgb) is a prescription medicine used to treat adults with follicular lymphoma whose cancer has come back or did not respond to previous treatment, and who have already received two or more treatments for their cancer. It is not known if Lunsumio is safe and effective in children. The conditional approval of Lunsumio is based on response rate. There are ongoing studies to establish how well the drug works. What is the most important information I should know about Lunsumio? Lunsumio may cause Cytokine Release Syndrome (CRS), a serious side effect that is common during treatment with Lunsumio and can also be severe or life-threatening. Get medical help right away if you develop any signs or symptoms of CRS at any time, including: fever of 100.4°F (38°C) or higher chills low blood pressure fast or irregular heartbeat tiredness or weakness difficulty breathing headache confusion feeling anxious dizziness or light-headedness nausea vomiting Due to the risk of CRS, you will receive Lunsumio on a “step-up dosing schedule.” The step-up dosing schedule is when you receive smaller “step-up” doses of Lunsumio on Day 1 and Day 8 of your first cycle of treatment You will receive a higher dose of Lunsumio on Day 15 of your first cycle of treatment If your dose of Lunsumio is delayed for any reason, you may need to repeat the step-up dosing schedule Before each dose in Cycle 1 and Cycle 2, you will receive medicines to help reduce your risk of CRS Your healthcare provider will check you for CRS during treatment with Lunsumio and may treat you in a hospital if you develop signs and symptoms of CRS. Your healthcare provider may temporarily stop or completely stop your treatment with Lunsumio, if you have severe side effects. What are the possible side effects of Lunsumio? Lunsumio may cause serious side effects, including: Neurologic problems. Your healthcare provider will check you for neurologic problems during treatment with Lunsumio. Your healthcare provider may also refer you to a healthcare provider who specializes in neurologic problems. Tell your healthcare provider right away if you develop any signs or symptoms of neurologic problems during or after treatment with Lunsumio, including: headache numbness and tingling of the arms, legs, hands, or feet dizziness confusion and disorientation difficulty paying attention or understanding things forgetting things or forgetting who or where you are trouble speaking, reading, or writing sleepiness or trouble sleeping tremors loss of consciousness seizures muscle problems or muscle weakness loss of balance or trouble walking Serious infections. Lunsumio can cause serious infections that may lead to death. Your healthcare provider will check you for signs and symptoms of infection before and during treatment. Tell your healthcare provider right away if you develop any signs or symptoms of infection during treatment with Lunsumio, including: fever of 100.4° F (38° C) or higher chest pain tiredness shortness of breath painful rash sore throat pain during urination feeling weak or generally unwell Low blood cell counts. Low blood cell counts are common during treatment with Lunsumio and can also be severe. Your healthcare provider will check your blood cell counts during treatment with Lunsumio. Lunsumio may cause the following low blood cell counts: low white blood cell counts (neutropenia). Low white blood cells can increase your risk for infection low red blood cell counts (anemia). Low red blood cells can cause tiredness and shortness of breath low platelet counts (thrombocytopenia). Low platelet counts can cause bruising or bleeding problems Growth in your tumor or worsening of tumor related problems (Tumor flare). Lunsumio may cause serious or severe worsening of your tumor. Tell your healthcare provider if you develop any of these signs or symptoms of tumor flare during your treatment with Lunsumio: tender or swollen lymph nodes, chest pain, cough, trouble breathing, and pain or swelling at the site of the tumor Your healthcare provider may temporarily stop or permanently stop treatment with Lunsumio if you develop severe side effects. The most common side effects of Lunsumio include: tiredness, rash, fever, and headache. The most common severe abnormal lab test results with Lunsumio include: decreased phosphate, increased glucose, and increased uric acid levels. Before receiving Lunsumio, tell your healthcare provider about all of your medical conditions, including if you: have ever had an infusion reaction after receiving Lunsumio have an infection, or have had an infection in the past which lasted a long time or keeps coming back have or have had Epstein-Barr Virus are pregnant or plan to become pregnant. Lunsumio may harm your unborn baby. Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with Lunsumio Females who are able to become pregnant: your healthcare provider should do a pregnancy test before you start treatment with Lunsumio you should use an effective method of birth control during your treatment and for 3 months after the last dose of Lunsumio are breastfeeding or plan to breastfeed. It is not known if Lunsumio passes into your breast milk. Do not breastfeed during treatment and for 3 months after the last dose of Lunsumio Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. What should I avoid while receiving Lunsumio? Do not drive, operate heavy machinery, or do other dangerous activities if you develop dizziness, confusion, tremors, sleepiness, or any other symptoms that impair consciousness until your signs and symptoms go away. These may be signs and symptoms of CRS or neurologic problems. These are not all the possible side effects of Lunsumio. Talk to your healthcare provider for more information about the benefits and risks of Lunsumio. You may report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch . You may also report side effects to Genentech at (888) 835-2555. Please see Important Safety Information, including Serious Side Effects, as well as the Lunsumio full Prescribing Information and Medication Guide or visit https://www.Lunsumio.com . About Columvi ® (glofitamab-gxbm) Columvi is a CD20xCD3 T-cell engaging bispecific antibody designed to target CD3 on the surface of T cells and CD20 on the surface of B cells. Columvi was designed with a novel 2:1 structural format. This T-cell engaging bispecific antibody is engineered to have one region that binds to CD3, a protein on T cells, a type of immune cell, and two regions that bind to CD20, a protein on B cells, which can be healthy or malignant. This dual-targeting brings the T cell in close proximity to the B cell, activating the release of cancer cell-killing proteins from the T cell. A clinical development program for Columvi is ongoing, investigating the molecule as a monotherapy and in combination with other medicines for the treatment of people with B-cell non-Hodgkin’s lymphomas, including diffuse large B-cell lymphoma and other blood cancers. Columvi U.S. Indication Columvi (glofitamab-gxbm) is a prescription medicine to treat adults with certain types of diffuse large B-cell lymphoma (DLBCL) or large B-cell lymphoma (LBCL) that has come back (relapsed) or that did not respond to previous treatment (refractory), and who have received 2 or more prior treatments for their cancer. It is not known if Columvi is safe and effective in children. The conditional approval of Columvi is based on response rate and durability of response. There are ongoing studies to establish how well the drug works. What is the most important information I should know about Columvi? Columvi can cause Cytokine Release Syndrome (CRS), a serious side effect that is common during treatment with Columvi, and can also be serious and lead to death. Call your healthcare provider or get emergency medical help right away if you develop any signs or symptoms of CRS, including: fever of 100.4°F (38°C) or higher chills or shaking fast or irregular heartbeat dizziness or light-headedness trouble breathing shortness of breath Due to the risk of CRS, you will receive Columvi on a “step-up dosing schedule”. A single dose of a medicine called obinutuzumab will be given to you on the first day of your first treatment cycle (Day 1 of Cycle 1). You will start the Columvi step-up dosing schedule a week after the obinutuzumab dose. The step-up dosing schedule is when you receive smaller “step-up” doses of Columvi on Day 8 and Day 15 of Cycle 1. This is to help reduce your risk of CRS. You should be hospitalized during your infusion and for 24 hours after receiving the first step-up dose on Day 8. You should be hospitalized during your infusion and for 24 hours after receiving the second step-up dose on Day 15 if you experienced CRS during the first step-up dose. You will receive your first full dose of Columvi a week after the second step-up dose (this will be Day 1 of Cycle 2). If your dose of Columvi is delayed for any reason, you may need to repeat the “step-up dosing schedule”. If you had more than mild CRS with your previous dose of Columvi, you should be hospitalized during and for 24 hours after receiving your next dose of Columvi. Before each dose of Columvi, you will receive medicines to help reduce your risk of CRS and infusion-related reactions. Your healthcare provider will monitor you for CRS during treatment with Columvi and may treat you in a hospital if you develop signs and symptoms of CRS. Your healthcare provider may temporarily stop or completely stop your treatment with Columvi if you have severe side effects. Carry the Columvi Patient Wallet Card with you at all times and show it to all of your healthcare providers. The Columvi Patient Wallet Card lists the signs and symptoms of CRS you should get emergency medical help for right away. What are the possible side effects of Columvi? Columvi may cause serious side effects, including: Cytokine Release Syndrome. Neurologic problems. Columvi can cause serious neurologic problems that may lead to death. Your healthcare provider will monitor you for neurologic problems during treatment with Columvi. Your healthcare provider may also refer you to a healthcare provider who specializes in neurologic problems. Tell your healthcare provider right away if you develop any signs or symptoms of neurologic problems, including: headache confusion and disorientation difficulty paying attention or understanding things trouble speaking sleepiness memory problems numbness, tingling, or weakness of the hands or feet dizziness shaking (tremors) Serious Infections. Columvi can cause serious infections that may lead to death. Your healthcare provider will monitor you for signs and symptoms of infection and treat you as needed. Tell your healthcare provider right away if you develop any signs of an infection, including: fever, chills, weakness, cough, shortness of breath, or sore throat. Growth in your tumor or worsening of tumor related problems (tumor flare). Tell your healthcare provider if you get any of these signs or symptoms of tumor flare: tender or swollen lymph nodes pain or swelling at the site of the tumor chest pain cough trouble breathing The most common side effects of Columvi include: CRS, muscle and bone pain, rash, and tiredness. The most common severe abnormal lab test results with Columvi include: decreased white blood cells, decreased phosphate (an electrolyte), increased uric acid levels, and decreased fibrinogen (a protein that helps with blood clotting). Your healthcare provider may temporarily stop or completely stop treatment with Columvi if you develop certain side effects. Before receiving Columvi, tell your healthcare provider about all of your medical conditions, including if you: have an infection have kidney problems are pregnant or plan to become pregnant. Columvi may harm your unborn baby Females who are able to become pregnant: Your healthcare provider should do a pregnancy test before you start treatment with Columvi. You should use effective birth control (contraception) during treatment and for 1 month after your last dose of Columvi. Talk to your healthcare provider about what birth control method is right for you during this time. Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with Columvi. are breastfeeding or plan to breastfeed. Columvi may pass into your breast milk. Do not breastfeed during treatment and for 1 month after your last dose of Columvi. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. What should I avoid while receiving Columvi? Do not drive, operate heavy machinery, or do other dangerous activities if you develop dizziness, confusion, shaking (tremors), sleepiness, or any other symptoms that impair consciousness until your signs and symptoms go away. These may be signs and symptoms of neurologic problems. These are not all the possible side effects of Columvi. Talk to your health care provider for more information about the benefits and risks of Columvi. You may report side effects to the FDA at (800) FDA-1088 or http://www.fda.gov/medwatch . You may also report side effects to Genentech at (888) 835-2555. Please see Important Safety Information, including Serious Side Effects , as well as the Columvi full Prescribing Information and Medication Guide or visit https://www.Columvi.com . About Venclexta ® (venetoclax) Venclexta is a first-in-class targeted medicine designed to selectively bind and inhibit the B-cell lymphoma-2 (BCL-2) protein. In some blood cancers and other tumors, BCL-2 builds up and prevents cancer cells from dying or self-destructing, a process called apoptosis. Venclexta blocks the BCL-2 protein and works to help restore the process of apoptosis. Venclexta is being developed by AbbVie and Genentech, a member of the Roche Group. It is jointly commercialized by the companies in the United States and commercialized by AbbVie outside of the United States. Together, the companies are committed to research with Venclexta, which is currently being studied in clinical trials across several types of blood cancers. Venclexta U.S. Indications Venclexta is a prescription medicine used: to treat adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). in combination with azacitidine, or decitabine, or low-dose cytarabine to treat adults with newly-diagnosed acute myeloid leukemia (AML) who: ‒ are 75 years of age or older, or ‒ have other medical conditions that prevent the use of standard chemotherapy. It is not known if Venclexta is safe and effective in children. Important Safety Information What is the most important information patients should know about Venclexta? Venclexta can cause serious side effects, including: Tumor lysis syndrome (TLS). TLS is caused by the fast breakdown of cancer cells. TLS can cause kidney failure, the need for dialysis treatment, and may lead to death. The patient’s doctor will do tests to check their risk of getting TLS before they start taking Venclexta. The patient will receive other medicines before starting and during treatment with Venclexta to help reduce the risk of TLS. The patient may also need to receive intravenous (IV) fluids into their vein. The patient’s doctor will do blood tests to check for TLS when the patient first starts treatment and during treatment with Venclexta. It is important for patients to keep appointments for blood tests. Patients should tell their doctor right away if they have any symptoms of TLS during treatment with Venclexta, including fever, chills, nausea, vomiting, confusion, shortness of breath, seizures, irregular heartbeat, dark or cloudy urine, unusual tiredness, or muscle or joint pain. Patients should drink plenty of water during treatment with Venclexta to help reduce the risk of getting TLS. Patients should drink 6 to 8 glasses (about 56 ounces total) of water each day, starting 2 days before the first dose on the day of the first dose of Venclexta, and each time a dose is increased. The patient’s doctor may delay, decrease the dose, or stop treatment with Venclexta if the patient has side effects. When restarting Venclexta after stopping for 1 week or longer, the patient’s doctor may again check for the risk of TLS and change the patient’s dose. What patients should not take Venclexta? Certain medicines must not be taken when the patient first starts taking Venclexta and while the dose is being slowly increased because of the risk of increased TLS. Patients should tell their doctor about all the medicines they take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Venclexta and other medicines may affect each other causing serious side effects. Patients must not start new medicines during treatment with Venclexta without first talking with their doctor. Before taking Venclexta, patients must tell their doctor about all of their medical conditions, including if they: Have kidney or liver problems. Have problems with body salts or electrolytes, such as potassium, phosphorus, or calcium. Have a history of high uric acid levels in the blood or gout. Are scheduled to receive a vaccine. Patients should not receive a “live vaccine” before, during, or after treatment with Venclexta, until the patient’s doctor tells them it is okay. If the patient is not sure about the type of immunization or vaccine, the patient should ask their doctor. These vaccines may not be safe or may not work as well during treatment with Venclexta. Are pregnant or plan to become pregnant. Venclexta may harm an unborn baby. If the patient is able to become pregnant, the patient’s doctor should do a pregnancy test before the patient starts treatment with Venclexta, and the patient should use effective birth control during treatment and for at least 30 days after the last dose of Venclexta. If the patient becomes pregnant or thinks they are pregnant, the patient should tell their doctor right away. Are breastfeeding or plan to breastfeed. It is not known if Venclexta passes into the patient’s breast milk. Patients are instructed to not breastfeed during treatment with Venclexta and for 1 week after the last dose. What to avoid while taking Venclexta: Patients should not drink grapefruit juice or eat grapefruit, Seville oranges (often used in marmalades), or starfruit while they are taking Venclexta. These products may increase the amount of Venclexta in the patient’s blood. What are the possible side effects of Venclexta? Venclexta can cause serious side effects, including: Low white blood cell counts (neutropenia). Low white blood cell counts are common with Venclexta, but can also be severe. The patient’s doctor will do blood tests to check their blood counts during treatment with Venclexta and may pause dosing. Infections. Death and serious infections such as pneumonia and blood infection (sepsis) have happened during treatment with Venclexta. The patient’s doctor will closely monitor and treat the patient right away if they have a fever or any signs of infection during treatment with Venclexta. Patients should tell their doctor right away if they have a fever or any signs of an infection during treatment with Venclexta. The most common side effects of Venclexta when used in combination with obinutuzumab or rituximab or alone in people with CLL or SLL include low white blood cell count; low platelet count; low red blood cell count; diarrhea; nausea; upper respiratory tract infection; cough; muscle and joint pain; tiredness; and swelling of arms, legs, hands, and feet. The most common side effects of Venclexta in combination with azacitidine or decitabine or low-dose cytarabine in people with AML include nausea; diarrhea; low platelet count; constipation; low white blood cell count; fever with low white blood cell count; tiredness; vomiting; swelling of arms, legs, hands, or feet; fever; infection in lungs; shortness of breath; bleeding; low red blood cell count; rash; stomach (abdominal) pain; infection in your blood; muscle and joint pain; dizziness; cough; sore throat; and low blood pressure. Venclexta may cause fertility problems in males. This may affect the ability to father a child. Patients should talk to their doctor if they have concerns about fertility. These are not all the possible side effects of Venclexta. Patients should call their doctor for medical advice about side effects. Report side effects to the FDA at 1-800-FDA-1088 or http://www.fda.gov/medwatch . Report side effects to Genentech at 1-888-835-2555. Please see the Venclexta full Prescribing Information , including the Medication Guide , for additional Important Safety Information or visit https://www.venclexta.com/ . About Hemlibra Hemlibra is a bispecific factor IXa- and factor X-directed antibody. It is designed to bring together factor IXa and factor X, proteins required to activate the natural coagulation cascade and restore the blood clotting process for hemophilia A patients. Hemlibra is a prophylactic (preventative) treatment that can be administered by an injection of a ready-to-use solution under the skin (subcutaneously) once weekly, every two weeks or every four weeks. Hemlibra was created by Chugai Pharmaceutical Co., Ltd. and is being co-developed globally by Chugai, Roche and Genentech . Hemlibra U.S. Indication Hemlibra is a prescription medicine used for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adults and children, ages newborn and older, with hemophilia A with or without factor VIII inhibitors. Important Safety Information What is the most important information to know about Hemlibra? Hemlibra increases the potential for blood to clot. People who use activated prothrombin complex concentrate (aPCC; Feiba ® ) to treat breakthrough bleeds while taking Hemlibra may be at risk of serious side effects related to blood clots. These serious side effects include: Thrombotic microangiopathy (TMA), a condition involving blood clots and injury to small blood vessels that may cause harm to one’s kidneys, brain, and other organs Blood clots (thrombotic events), which may form in blood vessels in the arm, leg, lung, or head Patients should talk to their doctor about the signs and symptoms of these serious side effects, which can include Confusion Stomach, chest, or back pain Weakness Nausea or vomiting Swelling, pain, or redness Feeling sick or faint Decreased urination Swelling of arms and legs Yellowing of skin and eyes Eye pain, swelling, or trouble seeing Fast heart rate Numbness in your face Headache Shortness of breath Coughing up blood If patients experience any of these symptoms during or after treatment with Hemlibra, they should get medical help right away. Patients should carefully follow their healthcare provider’s instructions regarding when to use an on demand bypassing agent or factor VIII, and the dose and schedule to use for breakthrough bleed treatment. If aPCC (Feiba ® ) is needed, patients should talk to their healthcare provider in case they feel they need more than 100 U/kg of aPCC (Feiba ® ) total. Patients’ bodies may make antibodies against Hemlibra, which may stop Hemlibra from working properly. Patients should contact their healthcare provider immediately if they notice that Hemlibra has stopped working for them (e.g., increase in bleeds). The most common side effects of Hemlibra include: injection site reactions (redness, tenderness, warmth, or itching at the site of injection), headache, and joint pain. These are not all of the possible side effects of Hemlibra. Patients can speak with their healthcare provider for more information. What else should patients know about Hemlibra? Patients should see the detailed “Instructions for Use” that comes with Hemlibra for information on how to prepare and inject a dose of Hemlibra, and how to properly throw away (dispose of) used needles and syringes. Patients should stop taking their prophylactic bypassing therapy the day before they start Hemlibra Patients may continue taking their prophylactic factor VIII for the first week of Hemlibra Hemlibra may interfere with laboratory tests that measure how well blood is clotting and create an inaccurate result. Patients should speak with their healthcare provider about how this may affect their care. Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Patients should only use Hemlibra for the condition it was prescribed. Patients should not give Hemlibra to other people, even if they have the same symptoms that they have. It may harm them. Patients should tell their healthcare provider about all the medicines they take , including prescription medicines, over-the-counter medicines, vitamins, or herbal supplements. Patients should keep a list of them to show their healthcare provider and pharmacist. Before using Hemlibra, patients should tell their healthcare provider about all of their medical conditions , including if they are pregnant, plan to become pregnant, are breastfeeding, or plan to breastfeed. Since Hemlibra was tested in males, there is no information on whether Hemlibra may impact an unborn baby or breast milk. Females who are able to become pregnant should use birth control during treatment. Side effects may be reported to the FDA at (800) FDA-1088 or www.fda.gov/medwatch . Side effects may also be reported to Genentech at (888) 835-2555. Please see Important Safety Information, including Serious Side Effects, as well as the Hemlibra full Prescribing Information and Medication Guide or visit https://www.hemlibra.com/ . Indications & Important Safety Information What is PIASKY? PIASKY is a prescription medicine used to treat a disease called paroxysmal nocturnal hemoglobinuria (PNH) in adults and children 13 years of age or older who weigh at least 88 pounds (40 kg). It is not known if PIASKY is safe and effective in children under 13 years of age and in people who weigh less than 88 pounds (40kg). What is the most important information I should know about PIASKY? PIASKY is a medicine that can affect your immune system. PIASKY may lower the ability of your immune system to fight infections PIASKY increases your chance of getting serious infections caused by Neisseria meningitidis . Meningococcal infections may quickly become life-threatening or cause death if not recognized and treated early. You must complete or update your meningococcal vaccines at least 2 weeks before your first dose of PIASKY. If your healthcare provider decides that immediate treatment with PIASKY is needed and your meningococcal vaccination is not up to date, you should receive meningococcal vaccination as soon as possible, and receive antibiotics for as long as your healthcare provider tells you. If you have been given a meningococcal vaccine in the past, you might need additional vaccines before starting PIASKY. Your healthcare provider will decide if you need additional meningococcal vaccine. Meningococcal vaccines do not prevent all meningococcal infections. Call your healthcare provider or get emergency medical care right away if you get any of these signs and symptoms of a serious meningococcal infection: fever fever and a rash fever with a high heart rate fever with a headache headache with nausea or vomiting headache with a stiff neck or stiff back confusion muscle aches, with flu-like symptoms eyes sensitive to light Your healthcare provider will give you a Patient Safety Card about the risk of serious meningococcal infection. Carry it with you at all times during treatment and for 11 months after your last dose of PIASKY. Your risk of meningococcal infection may continue for several months after your last dose of PIASKY. It is important to show this card to any healthcare provider who treats you. This will help them diagnose and treat you quickly. PIASKY is only available through a program called the PIASKY Risk Evaluation and Mitigation Strategy (PIASKY REMS). Before you can receive PIASKY, your healthcare provider must: enroll in the PIASKY REMS program. counsel you about the risk of serious meningococcal infection. give you information about the signs and symptoms of serious meningococcal infection. make sure that you are vaccinated with a meningococcal vaccine and that you receive antibiotics if you need to start PIASKY right away if you are not up to date on your vaccines. give you a Patient Safety Card about your risk of meningococcal infection. Immune system reactions called Type III hypersensitivity reactions are common during treatment with PIASKY and can be serious. If you are currently being treated with or have been treated with another C5 inhibitor medicine and you switch to PIASKY , PIASKY may cause Type III hypersensitivity reactions. People may also develop Type III hypersensitivity reactions when they switch from PIASKY to another C5 inhibitor medicine. If you have been treated with another C5 inhibitor medicine and you switch to PIASKY, or if you have been treated with PIASKY and you switch to another C5 inhibitor medicine, your healthcare provider should monitor you for 30 days after you switch medicines. Call your healthcare provider or go to the nearest emergency room right away if you have any signs or symptoms of Type III hypersensitivity reaction including: joint pain muscle or bone pain rash or skin problems itching headache kidney problems numbness and tingling or a feeling of pins and needles especially of the hands and feet fever weakness, tiredness, or lack of energy stomach trouble or pain PIASKY may also increase the risk of other types of serious infections , including infections caused by Neisseria spp. , Streptococcus pneumoniae , Haemophilus influenzae , and Neisseria gonorrhoeae . If you receive treatment with PIASKY, you should receive vaccines against Streptococcus pneumoniae . If your child receives treatment with PIASKY, your child should receive vaccines against Streptococcus pneumoniae and may receive vaccines against Haemophilus influenzae , depending on their age. Call your healthcare provider right away if you have any new signs or symptoms of infection such as: fever of 100.4°F (38°C) or higher cough chest pain tiredness feeling short of breath painful rash sore throat burning pain when passing urine feeling weak or generally unwell Who should not receive PIASKY? Do not receive PIASKY if you: Have a serious meningococcal infection caused by Neisseria meningitidis when you are starting PIASKY treatment. Are allergic to crovalimab or any of the ingredients in PIASKY. Before receiving PIASKY tell your healthcare provider about all of your medical conditions, including if you: have an infection or fever. are pregnant or plan to become pregnant. It is not known if PIASKY may harm your unborn baby. are breastfeeding or plan to breastfeed. It is not known if PIASKY passes into your breast milk. Tell your healthcare provider about all the medicines you take , including prescription and over-the-counter medicines, vitamins, and herbal supplements. PIASKY and other medicines can affect each other, causing side effects. Especially tell your healthcare provider if you are currently being treated with or have ever been treated with any other complementary C5 inhibitor (C5 inhibitor) medicine. PIASKY is a C5 inhibitor medicine. Know the medicines you take and the vaccines you receive. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine. How should I receive PIASKY? Your healthcare provider will give you your PIASKY treatment. Your first dose will be given through a vein by intravenous (IV) infusion on Day 1 by your healthcare provider. This is the first loading dose. Another loading dose will be given as an injection under the skin (subcutaneous) on Days 2, 8, 15, and 22. Your maintenance doses will begin on Day 29 and then will be given every 4 weeks as a subcutaneous injection. Your healthcare provider will prescribe the dose based on your weight. If your weight changes, tell your healthcare provider. Talk to your healthcare provider if you miss receiving your dose of PIASKY. If you are changing treatment from another C5 inhibitor such as eculizumab or ravulizumab to PIASKY , you should receive your first loading dose of PIASKY no sooner than the time you would have received your next scheduled dose of eculizumab or ravulizumab. If you stop taking PIASKY and do not switch to another treatment for your PNH, your healthcare provider will need to monitor you closely for at least 20 weeks after stopping PIASKY. Stopping treatment with PIASKY may cause a breakdown of red blood cells due to PNH. Symptoms or problems that can happen due to red blood cell breakdown include: a lower number of red blood cells (anemia) blood in your urine or dark urine feeling short of breath feeling tired or low energy (fatigue) stomach pain blood clotting (thrombosis) difficulty swallowing difficulty getting or keeping an erection (erectile dysfunction) kidneys not working properly What are the possible side effects of PIASKY? PIASKY can cause serious side effects including: Infusion- and injection-related reactions. Infusion- or injection-related reactions may happen during or after your PIASKY administration. Symptoms may include headache, pain at infusion or injection site or in other parts of your body, swelling, bruising or bleeding, red skin, itching and rash. PIASKY can also cause serious allergic reactions. Tell your healthcare provider right away or go to the nearest emergency room if you get any of the following symptoms or symptoms of a serious allergic reaction: shortness of breath or trouble breathing pain or tightness in your chest wheezing feeling dizzy or lightheaded swelling of the throat, lips, tongue, or face skin itching, hives, or rash fever or chills The most common side effects of PIASKY are: infusion-related reactions respiratory tract infections including infections of the lungs, cold symptoms, and pain or swelling of the nose or throat viral infections Type III hypersensitivity reactions Tell your healthcare provider about any side effect that bothers you or that does not go away. These are not all the possible side effects of PIASKY. Call your healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . You may also report side effects to Genentech at (888) 835-2555. Please see the full Prescribing Information and Medication Guide for additional Important Safety Information, including Serious Side Effects , or visit https://www.piasky.com/ . About Genentech in Hematology For more than 20 years, Genentech has been developing medicines with the goal to redefine treatment in hematology. Today, we’re investing more than ever in our effort to bring innovative treatment options to people with diseases of the blood. For more information visit http://www.gene.com/hematology . About Genentech Founded more than 40 years ago, Genentech is a leading biotechnology company that discovers, develops, manufactures and commercializes medicines to treat patients with serious and life-threatening medical conditions. The company, a member of the Roche Group, has headquarters in South San Francisco, California. For additional information about the company, please visit http://www.gene.com .

ADC热潮之后，很多制药巨头在布局前沿技术赛道时瞄准了一个共同的方向——双抗。 根据医药魔方数据库，2024年前9个月，全球药企围绕双抗药物达成了31笔交易，数量上比之前三年的每一年都要多。 这其中也不乏制药巨头的重量级押注。8月，默沙东以7亿美元的首付款将同润生物一款处于I期阶段的CD3/CD19双抗CN201收入囊中。7月，诺华与Dren Bio就髓系细胞募集双抗的开发达成合作，交易总额达30亿美元。 与此同时，一些药企也在加快双抗药物的临床开发布局。比如阿斯利康在今年接连启动了TIGIT/PD-1双抗rilvegostomig的4项注册性临床试验，包括联合化疗对比K药的III期头对头研究。 更早下注的玩家已经步入收获。比如，罗氏的眼科双抗法瑞西单抗已成为其业绩增长的核心驱动，上市第2年的销售额便轻松突破25亿美元。强生的埃万妥单抗则在研发端实现了重要突破，联合兰泽替尼头对头击败奥希替尼，并借此拓展了新适应症。 本文对制药巨头的双抗产品管线进行梳理，并对管线较丰富的几家企业进行分析，揭示它们不同的布局重点与扩张策略。 制药巨头双抗产品及临床管线 罗氏：打造畅销产品，站上赛道制高点 在双抗赛道，罗氏已展现王者风采，强大的已上市产品阵容就是其实力的最好印照。根据医药魔方数据库，全球共有15款双抗获批上市，罗氏独占4款，与Genmab并列为全球拥有最多上市双抗产品的药企。不仅仅是数量上的领先，这些产品的商业化成绩亦斐然。立足于已有产品，罗氏徐徐铺开布局版图。 艾美赛珠单抗是首个非凝血因子类血友病药物，可每4周皮下给药一次。它巧妙地利用双抗的作用模式，同时结合凝血因子IXa（FIXa）和FX来模拟FVIII的凝血功能。凭借创新性与变革性治疗价值，艾美赛珠单抗逐步“征服”广大患者，销售额一路攀升，2024上半年创收21.43亿瑞士法郎（约合24.21亿美元），是全球销售额最高的双抗药物。 新一代FX/FIXa双抗RG6512也已推进至I/II期临床阶段，其与FIX和FX形成三元复合物的能力显著优于艾美赛珠单抗，有望以更低的剂量和更长的给药间隔实现突破。继罗氏之后，诺和诺德也看好血友病双抗的开发前景。Mim8的III期研究已传来捷报，预计年内申报上市。 在血液疾病领域，罗氏还先后推出了两款CD3/CD20双抗莫妥珠单抗和格菲妥单抗，形成差异化布局。莫妥珠单抗被设计成典型的1:1结构，疗效相对温和，更适用于惰性淋巴瘤，而格菲妥单抗具有2:1比例的CD20与CD3结合位点，对表达CD20的恶性B细胞产生更强的靶向作用，可以攻克侵袭性和难治淋巴瘤。 除淋巴瘤外，罗氏还希望借力双抗打破多发性骨髓瘤（MM）的现有格局。针对发病率第二高的血液肿瘤，与多数企业押注CD3/BCMA双抗不同，罗氏主要将希望寄托于FCRH5/CD3双抗cevostamab和GPRC5D/CD3双抗forimtamig。I/II期CAMMA 2研究显示，cevostamab针对三重难治性MM患者的总缓解率（ORR）为67%。 法瑞西单抗是当下罗氏增长势头最强劲的双抗产品。今年上半年，法瑞西单抗销售收入几近翻倍，达17.94亿瑞士法郎（+93%，约20.27亿美元），未来销售峰值或将超越巅峰时期的阿柏西普。 法瑞西单抗的成功不是偶然，这依赖于罗氏在眼科赛道的深厚底蕴，此前罗氏已打造出全球首个应用于眼科的抗血管内皮生长因子（VEGF）药物雷珠单抗。法瑞西单抗同时靶向VEGF-A和血管生成素2（Ang-2）两条不同的信号通路，获批了湿性年龄相关性黄斑变性（wAMD）、糖尿病黄斑水肿（DME）和视网膜静脉阻塞（RVO）继发黄斑水肿三大适应症。与单纯抗VEGF疗法相比，法瑞西单抗显著减少了眼部注射给药频率，只需每4个月给药1次。 眼科赛道，罗氏继续向着“进一步提高护理标准”的战略目标前进。两款靶向VEGF的双抗应运而生。下一代Ang2/VEGF-A双抗zifibancimig采用港式给药系统（PDS）尝试进一步延长nAMD治疗间隔；VEGF/IL-1β双抗经玻璃体内给药，用于治疗RVO继发黄斑水肿。 罗氏在实体瘤领域推进最快的双抗是靶向PD-1/LAG-3的tobemstomig，处于II期临床阶段。PD-1与LAG-3的协同作用已经得到充分验证，BMS的双免疗法Opdualag于2022年3月获批上市。围绕tobemstomig，罗氏重点开启了一项单药或联合TIGIT单抗tiragolumab一线治疗尿路上皮癌的注册性临床（NCT05645692）。 另有三款CD3双抗夯实罗氏在实体瘤领域的布局。CD3/HER2靶向的runimotamab主攻乳腺癌和胃癌；CD3/GPC3靶向的ERY974在探索治疗肝细胞癌的可行性；CD3/CLDN6靶向的SAIL66具备FIC潜质，CLDN6靶点尚未成药，其开发过程必定充满挑战，今年7月安进已终止开发同靶点双抗AMG 794。 双抗的身影也出现在罗氏的神经科学布局中。Aβ/TfR靶向的trontinemab是罗氏在阿尔茨海默病领域的一次大胆创新。 从作用机制上，trontinemab就体现出了与众不同之处，它运用罗氏大脑穿梭技术（brainshuttle），将靶向Aβ的单抗（gantenerumab）与可以和转铁蛋白受体1（TfR1）相结合的蛋白域融合，通过TfR1介导的胞吞转运有效协助抗体穿越血脑屏障。早期临床数据显示，与标准Aβ单抗相比，trontinemab能以相对较低的剂量（1.8和3.6mg/kg）快速且稳健地减少淀粉样蛋白斑块。 手握如此丰富的产品管线，罗氏已率先占据双抗赛道的竞争高地。在不断地开疆拓土中，罗氏还将继续扩大优势。 强生：血液肿瘤、实体瘤、自免全面出击 近几年，强生以每年推出1款产品的速度在双抗赛道强势崛起。2021年5月，全球首款c-Met/EGFR双抗埃万妥单抗在美获批EGFR外显子20插入突变非小细胞肺癌（NSCLC）适应症，其只需5分钟给药的皮下剂型也已申报上市。 埃万妥单抗正在抢占奥希替尼的市场份额，后者2024上半年销售额达32亿美元。MARIPOSA研究中，埃万妥单抗联合兰泽替尼头对头击败奥希替尼，显示出一线治疗EGFR外显子19缺失或外显子21 L858R置换突变NSCLC的PFS获益。MARIPOSA-2研究则聚焦奥希替尼耐药后的未满足需求。凭借这两项研究，埃万妥单抗接连拓展了2项新适应症。 2022年8月，全球首款CD3/BCMA双抗特立妥单抗首次在欧盟获批上市；一年后，全球首款CD3/GPRC5D双抗塔奎妥单抗也问世了。这两款双抗是强生统治MM业务的重要接力产品。 在MM领域，强生早已建立了霸主地位，从FIC蛋白酶体抑制剂硼替佐米到全球首款CD38单抗达雷妥尤单抗，再到BCMA CAR-T西达基奥仑赛和双抗，产品护城河深厚，持续引领着MM治疗手段的演变。MM这块大蛋糕也有很多玩家竞争，仅双抗这一类型药物的相关管线就达到65项，辉瑞的CD3/BCMA双抗elranatamab已经获批上市。 对于后续的双抗药物储备，强生着重开辟实体瘤，前列腺癌是强生下一个进攻方向。靶向CD3/PSMA的JNJ-8114、靶向CD3/KLK2的JNJ-8343、靶向PSMA/CD28的JNJ-9401都已进入临床阶段。 不过JNJ-8114的一项I期研究（NCT05441501）在今年3月刚刚完成，但却已消失在强生2024Q1的管线图中。此前，强生还放弃了另一款治疗前列腺癌的CD3/TMEFF2双抗管线JNJ-8902。 JNJ-8343建立在强生和Zymeworks 2017年的合作基础上。交易背后，强生看中了Zymeworks的Azymetric和EFECT平台，其中Azymetric平台通过对IgG样抗体的重链和轻链进行专有的氨基酸修饰，从而实现单抗到多抗的转换。 JNJ-9401同样诞生于合作模式。2021年10月，强生与Xencor就CD3/CD20双抗plamotamab和CD28双抗达成一笔超13亿美元的交易。不过并不是所有交易都能走到最后。今年6月，强生已经退回了plamotamab的全球权益。至于CD28双抗的开发，除JNJ-9401外，还延伸出了CD28/CD20双抗JNJ-1493这一产品，剑指非霍奇金淋巴瘤（NHL）领域。 靶向CD3/CD22的JNJ-8780也主要用于NHL，强生于2020年9月启动了该药物的首次临床试验（NCT04540796）。2022年9月，JNJ-8780的临床足迹扩张至中国，然而在2023年10月强生主动终止了这一研究（CTR20222211）。 事实上，之后强生仍开展了有关JNJ-8780的临床试验，不过主要作为联合的选项出现。2023年11月，强生启动了JNJ-1493联合JNJ-8780或CD3/CD20/CD79b三抗JNJ-8543的试验（NCT06139406）。双抗+双抗甚至三抗的组合，还是一个待验证的新方向，也期待强生的突破。 血液疾病领域，强生还布局了一款潜在FIC双抗JNJ-9968，用于治疗骨髓纤维化。该药物靶向CD3/CALR，而CALR（钙网蛋白）是一个极其新颖的未成药靶标，全球在研药物也仅有4款。有研究[1]证实，暴露在表面的CALR可以作为NK细胞的内源性激活剂，向骨髓细胞传递强大的促吞噬信号，协调先天免疫监视的各个方面。 在自免领域，强生也扎下了较深的根基，乌司奴单抗、英夫利昔单抗、古赛奇尤单抗、戈利木单抗等生物制剂每年为其带来了可观的业绩增量。从药物类型来看，这些产品都属于单抗，自免领域双抗药物的迭代也在推进中。 靶向IL-4Rα/IL-31的NM26治疗特应性皮炎（AD）的I期研究于2023年5月启动。一年后，强生又以8.5亿美元现金收购了聚焦于免疫学的Proteologix，目的就是丰富自免双抗管线。收购而来的IL-13/TSLP双抗PX128和IL-13/IL-22双抗PX130均处于临床前阶段，两者主要适应症都覆盖了AD。 针对AD，强生全球免疫疗法负责人David Lee认为双抗有“实现最佳疾病疗效的机会”[2]。AD是一种异质性疾病，不同的患者亚群有不同的致病通路，“目前的AD疗法要么仅能抑制单一致病通路且疗效有限，要么具有广泛的免疫抑制作用，但又会导致严重的安全性问题”，而双抗可以同时针对两种不同的致病通路，可能提供高标准疗效和缓解。 强生在双抗赛道的布局，策略性覆盖了实体瘤、血液学和自免领域这几个优势业务板块。目标明确，火力集中，如此步步为营之下，强生的收获是必然的。 阿斯利康：倾力打造肿瘤免疫双抗“双子星” 阿斯利康在双抗赛道上的布局渐近收获期。靶向PD-1/CTLA-4的volrustomig和靶向TIGIT/PD-1的rilvegostomig这两款肿瘤免疫（IO）双抗均已进入III期临床阶段，共同瞄准NSCLC大适应症，也是阿斯利康着重打造的“双子星”。 在肺癌领域，阿斯利康凭借一个个重磅产品持续引领着临床治疗变革，从一代EGFR-TKI吉非替尼到三代的奥希替尼，PD-L1单抗度伐利尤单抗和HER2 ADC德曲妥珠单抗肺癌适应症的快速拓展，又不断稳固阿斯利康肺癌领导者的地位。阿斯利康与第一三共合力打造的TROP2 ADC药物Dato-DXd也已申报上市，尝试覆盖非鳞状NSCLC人群。 有了小分子、单抗、ADC不同类型的产品之后，阿斯利康并没有停止对新技术的追逐，而且它希望立足现有产品基础打出一套更强的组合拳。双抗就是阿斯利康实现上述目标的重要资产。 透视现有的临床布局，可以发现阿斯利康为IO双抗开辟的版图主要围绕联合治疗展开。一方面是IO双抗与化疗的联合，可能实现比PD-1单抗更强的疗效。2023年10月，阿斯利康启动了volrustomig联合化疗一线治疗PD-L1表达＜50%的NSCLC的III期研究（NCT05984277），头对头K药。今年10月，阿斯利康又登记了rilvegostomig联合化疗一线治疗PD-L1阳性的非鳞状NSCLC的III期头对头研究（NCT06627647），同样对标K药。 在挑战K药的道路上，已经有先行者取得胜利。在一线治疗PD-L1阳性NSCLC的III期HARMONi-2研究中，康方生物的PD-1/VEGF双抗依沃西单抗相较于K药实现了更显著的PFS获益。 另一方面，阿斯利康倾力挖掘更具竞争力的“IO+ADC”组合。比如，rilvegostomig与Dato-DXd的联用。围绕该组合，阿斯利康已先后启动TROPION-Lung10和TROPION-Lung12两项III期研究，分别针对一线治疗PD-L1高表达的非鳞状NSCLC和辅助治疗IB-IIIB期NSCLC场景。 此外，靶向PD-1/TIM-3的sabestomig和靶向EGFR/c-Met的FPI-2053也可能有治疗NSCLC的潜力。Sabestomig已读出单药二线治疗IIIB-IV期NSCLC的I/IIa期研究数据（NCT04931654），19例患者中有2例实现未确认的部分缓解（PR）。 值得一提的是，上述双抗不仅在阿斯利康的肺癌布局中扮演重要角色，也是其进击消化道肿瘤领域的潜在利器。II期GEMINI-Gastric研究显示，接受rilvegostomig联合化疗治疗的40例HER2阴性胃或胃食管交界腺癌患者的确认ORR为52.5%。 靶向CD3/CLDN18.2的AZD5863（HBM7022）主攻胃癌、食管癌和胰腺癌等，由阿斯利康于2022年4月从和铂医药引进来的，交易时其还处于临床前开发阶段。“通过临床前资料，我们发现HBM7022在包括胃癌和胰腺癌在内的实体瘤中表现出强大的潜在功效。”阿斯利康肿瘤研发负责人Susan Galbraith当时表示。敢于在早期就出手押注，也充分说明阿斯利康对于这款中国创新资产的看好。 在实体瘤领域之外，阿斯利康也有两款双抗已推进至III期临床阶段，即gefurulimab和AZD0486。开发gefurulimab的主要目的是为涉及末端补体途径激活的慢性疾病患者提供皮下治疗选择。这是一种迷你双抗（25kD），由一个N端白蛋白结合型VHH和一个C端C5结合型VHH通过柔性linker连接而成。如此设计的巧妙之处在于，较小的分子量可以带来更好的渗透性，与白蛋白的结合能够延长其半衰期。 CD3/CD19靶向的AZD0486由阿斯利康以超12亿美元收购TeneoTwo获得。通过单药或联合BTK抑制剂、CD20靶向疗法治疗，AZD0486有望解锁滤泡性淋巴瘤（FL）、弥漫性大B细胞淋巴瘤（DLBCL）等血液肿瘤适应症。今年8月，阿斯利康已经启动AZD0486联合CD20单抗利妥昔单抗一线治疗FL的III期试验（NCT06549595），计划招募1005例患者。 随着4款不同作用机制的双抗管线相继进入III期临床阶段，阿斯利康已经成为双抗赛道上实力不容小觑的明星玩家。结合联合治疗的策略打法，这些双抗可能将与更多已上市产品形成紧密捆绑的关系，为未来的市场竞争做好铺垫。 参考资料： [1]Jitka Fucikova, Radek Spisek, et al. Calreticulin and cancer[J]. Cell Research volume 31, pages5–16 (2021) [2]https://www.jnj.com/media-center/press-releases/johnson-johnson-to-acquire-proteologix-inc-to-lead-in-atopic-dermatitis-treatment 推荐阅读 安进双抗业务布局的启示 制药巨头的核药版图 制药巨头ADC布局：辉瑞有钱任性，罗氏抢占先机，AZ异军突起，默沙东雄心勃勃...... Copyright © 2024 PHARMCUBE. All Rights Reserved. 欢迎转发分享及合理引用，引用时请在显要位置标明文章来源；如需转载，请给微信公众号后台留言或发送消息，并注明公众号名称及ID。 免责申明：本微信文章中的信息仅供一般参考之用，不可直接作为决策内容，医药魔方不对任何主体因使用本文内容而导致的任何损失承担责任。