Daily Newsletter

22 August 2023

Daily Newsletter

22 August 2023

FDA pauses Gilead’s magrolimab studies in acute myeloid leukaemia

The news follows the pharma company’s decision to terminate a Phase III trial of the drug in myelodysplastic syndromes due to poor efficacy.

Robert Barrie

Gilead Sciences has announced the US Food and Drug Administration’s decision to pause screening and enrolment of patients in US studies investigating the treatment of acute myeloid leukaemia (AML) with magrolimab.

The partial clinical hold follows the discontinuation of a Phase III trial investigating the same drug combined with azacitidine in patients with higher-risk myelodysplastic syndromes (MDS). Gilead shelved the study following poor efficacy results, not due to safety concerns.

Despite the FDA's hold on the AML studies, which include evaluating therapies in combination with venetoclax and azacitidin, patients who have already been enrolled can continue to receive treatment. The FDA action only pertains to AML studies, with Gilead stating that magrolimab studies in solid tumours can continue as planned.

In a statement announcing the clinical hold, Gilead said it “is working with regulatory authorities to determine next steps to release the partial clinical hold for new patient enrolment in the magrolimab AML studies”.

Gilead gained the candidate when it acquired Forty Seven for $4.9bn in 2020. Magrolimab is an investigational immunotherapy that works by blocking the inhibitory CD47-signal regulatory protein (SIRPα) interaction.

This enhances the ability of the body’s immune cells to fight malignant cells. By removing the signalling safety net of cancer cells, macrophages and phagocytes are able to identify and destroy them. The FDA hold delays the candidate’s route to be a potential first-in-class investigational anti-CD47 immunotherapy.

Multiple Myeloma (MM) pipeline is dominated by CAR-T cells

The success of CAR-Ts in MM has fueled R&D investment into this class of therapy, with more CAR-Ts in development than all other cell and gene therapy classes combined. The approval of the autologous CAR-T cell therapies Abecma and Carvykti sees the CAR-T pipeline mostly constituted of autologous drugs. However, there are also multiple allogeneic CAR-Ts in the pipeline, with these therapies having an “off-the-shelf” advantage over autologous therapies.

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