Good one ma420, not sure if this has been posted before. Probably, but worth raising again and something that came to mind when the trial results were posted.
Gilead bought 'Forty Seven' for $4.9b in 2020 to obtain a midphase cd47 antibody magromilab (magromilab was breakthrough for myelodysplastic sydrome MDS) and also treats AML. The P2 Clinical trial results for this drug for patients with AML and MDS were unarguably great,
- "Among the 24 patients with MDS in the study, the ORR observed with magrolimab/azacitidine administered at 75 mg/m2 was 92%, including a 50% CR rate, a 33% marrow CR rate, and an 8% hematologic improvement. Stable disease was also observed in 8% of patients.3".
- "In the AML cohort (n = 22), magrolimab plus azacitidine achieved an ORR of 64%, which consisted of a 41% CR rate, CR with complete blood count recovery in 14% of patients, and morphologic-leukemia-free state in 5%. Thirty-two percent of patients in the cohort had SD while 5% had progressive disease."
Now, are these results better than Bistantrene? Yes, for the most recent trial results, undoubtedly. However, what does the bigger picture look like and are these comparable? The magromilab trial was in combination with azacitidine and the design did not look at those patients who were heavily pre-treated. Is there a possibility for Bistantrene magomilab combination therapy?
The Forty Seven stock price went through a bit of a monumental shift through the release of the trial results and ultimately into the Gilead buyout. Chart is shown below.
However, the buyout of Forty Seven is yet to pay off for Gilead. At the start of 2022 the FDA put a partial hold on some of the P3 clinical trials of AML/ MDS for Magolimab with Azacitidine combo due to an imbalance of investigator reported adverse reactions across the study arms. This was later lifted in April this year (still keeping the hold on evaluating magrolimab in diffuse large B-cell lymphoma and multiple myeloma).
Where does this leave Race Oncology in the AML/ MDS space? I think there is still a strong argument that Bisantrene combination therapy is required to treat patients and as we have seen its unique cardio protective effects may push its desired use ahead of other drugs.
The important question I have is, if Gilead bought magromilab for $5b (18x from where we are now). What value do you put on Bisantrene for its efficacy against not only MDS, AML but the numerous other cancers. What is the value of the only feasible clinical FTO inhibitor? I'm guessing somewhere north of $5b. And as you suggest ma420, if Gilead has a track record of buying these pipeline drugs, (magromilab, trodelvy) I wouldnt be suprised that bisantrene is at the top of their watchlist.
(20min delay)