This isn’t really about Allogene as a company - it's about which allogeneic CAR T therapy can cement itself as the first-in-class. Multiple lines of evidence show that being first is often commercially more important than being better (1,2).
Cema-cel holds a commanding clinical lead, with over 250 patients already consented for measurable residual disease (MRD) screening in its pivotal trial (3). It targets a significantly larger market: frontline LBCL patients who have detectable MRD after initial treatment. In contrast, Azer-cel is confined to a narrower slice - third-line DLBCL patients who have relapsed after CAR T therapy. Not only is DLBCL just a subset of LBCL, but Azer-cel is positioned in a salvage setting with only ~3,000 eligible patients per year.
Cema-cel is designed to improve frontline outcomes and can be readily administered - sidestepping many of the logistical and manufacturing challenges that plague autologous CAR T therapies. If successful, it won't compete with autologous CAR T - it will replace them before relapse even occurs.
Basically, allogene has strategically positioned Cema-cel to exploit these advantages, and received RMAT designation from the FDA long before IMU even acquired Azer-cel (4). While Azer-cel faces a crowded, competitive niche, Cema-cel is collecting pivotal data now with the potential to redefine the CAR T treatment landscape entirely for LBCL.
I started discussing the impact of Allogene's technology on IMU a fair while ago and was met with the usual nonsense:
https://hotcopper.com.au/threads/why-imu-is-a-multi-multi-bagger.5431324/page-26269?post_id=75672898
1.
https://web-assets.bcg.com/img-src/What_Matters_Most_Biopharma_tcm9-95831.pdf
2.
https://www.nature.com/articles/d41573-023-00048-2
3.
https://ir.allogene.com/news-releas...apeutics-reports-first-quarter-2025-financial
4.
https://ir.allogene.com/news-releas...erapeutics-announces-fda-granted-regenerative
(20min delay)