从中国首创到全球首创之路 - ascletis · 2020. 10. 14. · 2 三大疾病领域....

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歌礼制药有限公司 从中国首创到全球首创之路 202010

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  • 歌礼制药有限公司从中国首创到全球首创之路2020年10月

  • 2

    三大疾病领域

    病毒性肝炎非酒精性脂肪性肝炎 艾滋病

    自2018年于香港交易所上市以来,歌礼成功地从一个单一的丙肝平台升级为三大

    疾病领域、技术多元化的综合性平台。歌礼目前拥有三个商业化产品和十一个在

    研产品(其中七个为内部研发)。

  • 3

    病毒性肝炎慢性丙肝

    慢性乙肝靶点 产品/候选药物 Pre-IND IND Approval Ⅰ期临床 Ⅱ期临床 Ⅲ期临床 上市申请 上市

    Licensed From/内部研发 权益区域

    干扰素受体 派罗欣®

    (聚乙二醇干扰素alfa-2a)中国大陆

    程序性细胞死亡配体1(PD-L1) ASC22 大中华区

    未披露 候选药物 内部研发 全球

    法尼醇X受体(FXR) ASC42 内部研发 全球

    靶点 产品/候选药物 Pre-IND IND Approval Ⅰ期临床 Ⅱ期临床 Ⅲ期临床 上市申请 上市Licensed From/

    内部研发 权益区域

    NS3/4A 戈诺卫®

    (达诺瑞韦) 大中华区

    NS5A 新力莱®

    (拉维达韦) 大中华区

    双靶点复方制剂 ASC18 内部研发 大中华区

    NS5B ASC21 大中华区

  • 4

    为中国1000万丙肝患者提供全面的治疗方案

    全口服丙肝治疗方案(RDV/DNV 治疗方案) : 于2020年7月获得中国国家药品监督管

    理局(NMPA)批准上市

    ASC18: 一日一片的全口服复方制剂

    首个由中国本土企业研发的复方制剂丙肝完整治愈方案

    Ⅲ期临床试验数据:两种药物单方制剂联合给药,具备泛基因型抗病毒活性,治愈

    率(SVR12)>95%

    DNV: 戈诺卫® (达诺瑞韦) RDV:新力莱® (拉维达韦)

  • 5

    研发能力和执行效率:戈诺卫®从IND获批到NDA获批历时33个月

    2015年9月IND 获批

    2018年6月NDA 获批

    2015年10月首例受试者入组一期临床试验

    2016年1月首例患者入组二期临

    床试验

    2016年6月首例患者入组三期临床试验

    2017年1月递交滚动新药申请

    2018年2月滚动递交三期临床试验报告

    1个月

    仅33个月

    公司 (靶点) IND 获批时间 NDA 获批时间 IND到NDA 获批时长 (月)

    歌礼 (HCV NS3/4A) 2015年9月 2018年6月 33 百时美施贵宝 (HCV NS3/4A and 5A) 2013年6月 2017年6月 48

  • 6

    研发能力和执行效率:新力莱®从IND获批到NDA获批历时50个月

    2016年5月IND 获批

    2016年7月首例受试者入组一

    期临床试验

    2017年5月首例患者入组二/三期临床试验( 共425 名患者)

    2018年8月提交上市申请

    2015年12月首例患者入组台湾二期临床

    试验

    2016年6月

    2020年7月NDA 获批

  • 7

    中国本土企业开发的首个1类靶向丙肝创新药,打破外资企业在重大传染性疾病领域的垄断

    戈诺卫®是中国本土企业开发的首个1类丙肝DAA创新药

    从临床试验获批到新药上市获批

    33个月 12周完整疗程治愈率97%

    临床受试者人数3000+

  • 8

    SVR12 (%)

    97 9396

    59

    RDV+SOF Epclusa

    非肝硬化 肝硬化

    1017

    3942

    102105

    5153

    406410

    8282

    GT3:SVR12(%)

    99 96100 97 95

    87

    GT1a GT1b GT2 GT3 GT4 GT6

    9697

    2728

    22

    153158

    284298

    1315

    首个由中国本土企业开发的全口服、无干扰素的丙肝治愈方案

    新力莱®为同类最佳的泛基因型丙肝NS5A抑制剂,2020年7月获批上市。在中国已经完成的II/ III期临床试验

    结果显示,经过12周治疗,RDV/DNV治疗方案在基因1型非肝硬化患者中治愈率(SVR12)达99%。

    RDV+SOF方案对多种基因型疗效显著

    数据来源:(1)DNV+RDV中国II/III期临床研究;(2)RDV+SOF马来西亚、泰国II/III期临床研究;(3)SOF/VEL(Epclusa)中国III期临床研究。

    DNV: 戈诺卫® (达诺瑞韦) RDV:新力莱® (拉维达韦)SOF: 索磷布韦

  • 9

    歌礼HBV临床治愈攻略

    基石药物:已上市的派罗欣®和通过皮下注射的PD-L1抗体ASC22

    将派罗欣®与内部研发的针对新靶点的候选药物相结合

    将PD-L1抗体ASC22与内部研发的针对新靶点的候选药物相结合

    将派罗欣®或PD-L1抗体ASC22与行业领军企业的候选药物合作

    siRNA药物

    HBV入胞抑制剂

    FXR激动剂

    治疗性疫苗

  • 10

    派罗欣® (聚乙二醇干扰素α-2a注射液),于2002年获

    批上市,用于治疗成人慢性乙型肝炎和丙型肝炎。全球

    上市18年,超过115个国家和地区获准使用,惠及250

    万病毒性肝炎患者,发表相关文献3986篇。

    20.7%

    31.3%

    15.0%

    5%

    10%

    15%

    20%

    25%

    30%

    35%

    New Switch研究 瑞金团队研究 香港研究

    NA经治患者HBsAg清除率

    58.7%

    49.4% 50.0%

    10%

    20%

    30%

    40%

    50%

    60%

    70%

    New Switch研究 瑞金团队研究 香港研究

    NA经治优势患者HBsAg清除率

    派罗欣® :慢乙肝患者追求临床治愈的重要治疗方案

    1、New switch研究:Hu P, et al. J Clin Transl Hepatol. 2018;6:25-34.2、瑞金团队研究:Ren PP, et al. Hepatology, 2019, AASLD2019(Abstracts (poster 466)).3、香港研究:Chan HLY, et al. J Viral Hepat, 2019, 26(1): 126-135.

  • 11

    PD-L1抗体疗法对抗慢性乙肝的核心机制

    ASC22(KN035)可以通过抑制PD-1/PD-L1通路,重建T细胞免疫功能,从而抑制乃至消除

    HBV。

    1. Peng G, et al. PD-1 upregulation is associated with HBV-specific T cell dysfunction in chronic hepatitis B patients. Mol Immunol. 2008;45(4):963-70.2. B Ye, et al.T-cell exhaustion in chronic hepatitis B infection: current knowledge and clinical significance. Cell Death Dis. 2015 Mar 19;6:e1694.

    PD-1/PD-L1 interaction leads to T cell

    exhaustion

    ——Persistent HBV infection

    Blockade of PD-1/PD-L1 pathway restores T cell

    function

    ——Elimination of HBV

  • 12

    HBV临床治愈: PD-1 抑制剂: Opdivo (纳武单抗)

    Gane, EASL 2017

    纳武单抗: 已上市的用于治疗实体器官肿瘤和淋巴瘤,抗PD-1单克隆抗体

    概念性试验证明了PD-1 抗体能清除HBV表面抗原并在停药后得以维持

    Study Week

    纳武单抗 0.3 mg/kg

    ∆H

    BsA

    g fr

    om B

    asel

    ine

    (Log

    10 IU

    /mL)

    0 1 2 3 4 6 8 12 16 20 24

    • 十位患者中一位HBV表面抗原完全清除并且停药后疗效维持

    • 十位患者中一位HBV表面抗原在第八周达到最低点,但之后反弹

    • 十位患者中一位HBV表面抗原下降达到中等幅度

  • 13

    HBV临床治愈:全球首创皮下注射PD-L1 抗体

    全球首创

    阻断PD-1/PD-L1通路可以

    有效提高特异性T细胞功能

    最佳的乙肝免疫疗法

    仅皮下注射的PD-1 / PD-L1抗体

    已进入后期临床开发

    表现出良好的安全性

    中、美、日三国开展多项临床试验,包

    括在中国开展的两项验证性试验,入组

    癌症患者超过1000名

    差异化特性

    • 可皮下注射

    • 常温下稳定

    ASC22是一种全球首创的PD-L1抗体免疫疗法,有望为临床治愈乙肝带来重大突破。

  • 14

    HBV临床治愈: 皮下注射PD-L1抗体ASC22 vs 静脉注射PD-L1抗体

    公司 罗氏 默克 阿斯利康 歌礼

    通用名/代号 Atezolizumab Avelumab Durvalumab ASC22(KN035)

    作用靶点 PD-L1 PD-L1 PD-L1 PD-L1

    剂量 1200 mg/3 weeks 800mg/2 weeks 10mg/kg/2 weeks 1-2.5mg/kg/1 week

    给药方式 静脉注射 静脉注射 静脉注射 皮下注射

    适应症局部晚期或转移性尿

    路上皮癌;转移性非小细胞肺癌

    成人和12岁以上儿童转移性默克尔细胞癌

    (MCC)患者;局部晚期或转移性尿

    路上皮癌患者

    局部晚期或转移性尿路上皮癌;

    不可切除,III期非小细胞肺癌(NSCLC)

    慢性乙肝

    1、ASC22(KN035)对比已上市的PD-L1抗体,剂量更低,给药方式安全便捷;2、ASC22是首个已进入后期临床开发的皮下注射的PD-1 / PD-L1抗体;3、ASC22已在中、美、日三国开展多项临床试验,包括在中国开展的两项验证性试验,入组癌症患者超过1000名。

  • 15

    ASC22 慢性乙型肝炎Ⅱ期临床研究设计

    CHB患者Ⅱa期研究 (N=9)

    CHB患者Ⅱb期研究(N=150)

    安全性评估

    ASC22三个剂量组的单次给药PK/PD (n=9)

    ASC22 剂量1 +NAs

    (n=60)

    ASC22 剂量2+NAs

    (n=60)

    NAs

    (n=30)

    治疗周期: 12周 or 24周

    CHB:Chronic HBV Infection, 慢性乙型肝炎病毒感染PK:Pharmacokinetic, 药代动力学 PD=Pharmacodynamics, 药效动力学Nas: Nucleoside Analogues 核苷类似物

  • 16

    非酒精性脂肪肝病人群:3.14亿非酒精性脂肪肝炎患者:4,826万

    NASH 市场规模及产品线一览

    FASN: fatty acid synthase,脂肪酸合成酶

    非酒精性脂肪肝病人群:0.85亿非酒精性脂肪肝炎患者:1,730万

    非酒精性脂肪肝病人群:2.44亿非酒精性脂肪肝炎患者:3,281万2016

    非酒精性脂肪肝病人群:1.01亿非酒精性脂肪肝炎患者:2,700万2030

    C. Estes et al., J HEP 2018 (69): 896–904

    靶点 产品/候选药物 Pre-IND IND Approval Ⅰ期临床 Ⅱ期临床 Ⅲ期临床 上市申请 上市Licensed From/

    内部研发 权益区域

    脂肪酸合成酶(FASN) ASC40 大中华区

    甲状腺激素β受体(THR-beta) ASC41 内部研发 全球

    法尼醇X受体(FXR) ASC42 内部研发 全球

  • 17

    ASC40, 全球首创用于治疗NASH的口服FASN抑制剂

    非酒精性脂肪肝炎(NASH):百亿美元市场,至今尚无上市产品

    改善重要代谢生物标志物

    肝脏脂肪合成随药剂量增加而降低24%-73%

    减少新生肝脂肪合成 降低总肝脏脂肪

    临床作用机制证明

    抑制肝脂肪合成

    抗纤维化

    抗炎症

    C. Estes et al., J HEP 2018 (69): 896–904

  • 18

    与ACC抑制剂不同, FASN抑制剂的应用不会导致血浆中甘油三酯的升高

    ACC 抑制剂导致丙二酰辅酶A和PUFAs的降低, 但是 PUFAs 的降低导致血浆中甘油三酯的升高

    FASN 抑制剂只阻断棕榈酸酯的合成,但是没有参与降低PUFA的通路,因此没有引起血浆中甘油三酯升高

    FASN InhibitionACC Inhibition

    ACC

    Acetyl-CoAGS-0976MK-4074PF-1304

    FASN

    Low PUFA levels activatepathways that increase VLDL transport from the liver – thereby increasing plasma triglycerides

    Essential fatty acids (dietary )

    Polyunsaturated fatty acids (PUFAs)

    ACC

    Acetyl-CoA

    Malonyl-CoAFASN

    Polyunsaturated fatty acids (PUFAs)

    Essential fatty acids (dietary )

    Malonyl-CoA Palmitate(Liver fat)

    ASC40

    Palmitate(Liver fat)

  • 19

    与其他 Ⅱ/Ⅲ期临床NASH候选药物比较, ASC40 (TVB2640)Ⅱ期数据具有优势

    去除安慰剂效应后,肝脏脂肪含量降低≥ 30%的患者比例

    Rohit Loomba et al. Gastroenterology. 2018 Nov;155(5):1463-1473.e6; Lucas, KJ et al. 2019. Late-breaking Abstracts at AASLD. Boston, Massachusetts; Harrison SA et al. Lancet. 2019;394(10213):2012-2024. doi:10.1016/S0140-6736(19)32517-6

    Ⅱ期临床(FASCINATE-1)研究共

    入组99名美国患者,初步数据显示,

    ASC40(TVB-2640)显著降低了

    肝脏脂肪含量(该试验的主要疗效

    终点),在50 mg剂量组中应答率

    为61%(17/28)。

    1728

    药物 安慰剂ASC40 (TVB-2640) Sagimet/歌礼 FASN 50 mg 12 60.7 11.1 49.6 副作用极小

    Firsocostat 吉利德 ACC 20 mg 12 47.8 15.4 32.4 甘油三酯

    Tropiflexor 诺华 FXR 200 ug 12 64 20 44 低密度脂蛋白胆固醇 ,瘙痒

    Resmetirom Madrigal THR-β 80 mg 36 74.4 29.4 45 腹泻,恶心

    候选药物 公司 靶点 剂量 周期 安全性肝脏脂肪含量降低≥30%的

    患者比例, %去除安慰剂效应后,肝脏脂肪含量降低≥ 30%的患

    者比例, %

    Sheet1

    Drug CandidateCompanyTargetDoseWeeks≥ 30% liver fat reduction responder rate, %Placebo adjusted ≥ 30% liver fat reduction responder rate, %Side effects

    drugPlacebo

    ASC40 (TVB2640)Sagimet/AscletisFASN50 mg1260.711.149.6minimal

    FirsocostatGileadACC20 mg1247.815.432.4TG

    TropiflexorNovartisFXR200 ug12642044LDL-C , pruritus

    ResmetiromMadrigalTHRβ80 mg3674.429.445diarrhea,nausea

    候选药物公司靶点剂量周期肝脏脂肪含量降低≥30%的患者比例, %去除安慰剂效应后,肝脏脂肪含量降低≥ 30%的患者比例, %安全性

    药物安慰剂

    ASC40 (TVB-2640)Sagimet/歌礼FASN50 mg1260.711.149.6副作用极小

    Firsocostat吉利德ACC20 mg1247.815.432.4甘油三酯

    Tropiflexor诺华FXR200 ug12642044低密度脂蛋白胆固醇 ,瘙痒

    ResmetiromMadrigalTHR-β80 mg3674.429.445腹泻,恶心

  • 20

    ASC41

    前体药物(ASC41)具有肝脏靶向性,其活性成分(ASC41-A)对THR-β具有选择性

    两个NASH动物模型中,在剂量为1/10的MGL-3196的条件下,ASC41对肝脂肪变性、炎症和纤维化均有相同程度的改善

    高活性和高选择性的THR-β激动剂,预计每天给药一次,每次小于10毫克

    专有技术开发的口服片剂,常温下稳定,在比格犬中的暴露量与口服溶液的暴露量相同

    预计将在2020年底获得在LDL-C大于110mg/dL的健康志愿者中的Ⅰ期安全性、药代和初步疗效(LDL-C)的顶线数据( Topline data )

  • 21

    ASC42

    一种新型高效选择性非甾类法尼醇X受体(FXR)激动剂

    美国IND于2020年10月获批

    在两个NASH动物模型中,ASC42表现出对肝脏脂肪变性、炎症和纤维化的显著改善

    专有技术开发的口服片剂,常温下稳定

  • 22

    艾滋病

    我们正在拓展产品管线

    用免疫疗法进行功能性治愈

    治疗

    预防

  • 23

    品牌建立和市场研究

    患者研究及分析

    提高丙型肝炎和乙型肝炎认知度

    约1,000家医院位于中国丙肝和乙肝最流行的地区 约6,000位肝炎领域的专家和关键意见领袖 已与19家经销商签订分销协议,建立全国分销商网络

    品牌策略网络覆盖资深团队

    约135人商业化团队,五大职能部门:包括医学事务、销售、市场策略、市场准入、渠道/分销

    总监及以上管理层在上述代表性公司有超过10年丙肝和乙肝领域的相关工作经验

    全国首单销售

    19 天2018年

    3 个月

    戈诺卫®

    以学术推广为核心的商业化能力

    获新药证书 获GMP证书

    6月8日 6月14日 6月27日

    获批3个月后进入天津市基本医疗保险,至今已进入成都和浙江基本医疗医保

  • 24

    行业规范 生产基地从设计、建设到

    运行均严格遵循最严苛的cGMP规范

    品质保障 广泛采用国际高端设备和

    先进生产技术,确保每一颗药品的高品质

    国际水准 来自跨国药企的生产技术人

    员确保我们的生产质量管理体系保持国际水准

    产能保障 充足产能为持续推出的创新

    药物产业化奠定基础,保障临床用药供应

    热熔挤出机

    以品质为核心的制造能力

  • 25

    全球合作

  • 26

    总结

    过去两年,歌礼成功地从一个单一的丙肝平台升级为三大疾病领域、技术多元化的综合性平台

    病毒性肝炎: 1)戈诺卫® /新力莱®全口服丙肝治疗方案的商业化推广; 2)派罗欣®用于慢乙肝临床治愈的

    商业化推广; 3)开发乙肝临床治愈的具有重大突破的疗法

    非酒精性脂肪性肝炎:在全球范围内开发针对脂肪酸合成酶(FASN)、甲状腺激素受体ß (THR-ß)及

    法尼醇X受体(FXR)这三个不同靶点的新型候选药物

    艾滋病:扩大现有的治疗、预防和功能性治愈组合

    未来两年,歌礼对已有的病毒性肝炎、脂肪性肝炎和艾滋病三大疾病领域的研发、商务拓展、

    商业化的投入会更多、更快,同时拓展新的疾病领域

    公司约30亿元人民币的现金储备和产品销售收入为公司后续的研发、商业化产品的管线升级和新疾病

    领域的拓展提供了有力的支撑。

  • 27

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    幻灯片编号 1三大疾病领域病毒性肝炎为中国1000万丙肝患者提供全面的治疗方案研发能力和执行效率:戈诺卫®从IND获批到NDA获批历时33个月研发能力和执行效率:新力莱®从IND获批到NDA获批历时50个月幻灯片编号 7首个由中国本土企业开发的全口服、无干扰素的丙肝治愈方案歌礼HBV临床治愈攻略派罗欣® :慢乙肝患者追求临床治愈的重要治疗方案PD-L1抗体疗法对抗慢性乙肝的核心机制HBV临床治愈: PD-1 抑制剂: Opdivo (纳武单抗)HBV临床治愈:全球首创皮下注射PD-L1 抗体HBV临床治愈: 皮下注射PD-L1抗体ASC22 vs 静脉注射PD-L1抗体幻灯片编号 15NASH 市场规模及产品线一览ASC40, 全球首创用于治疗NASH的口服FASN抑制剂与ACC抑制剂不同, FASN抑制剂的应用不会导致血浆中甘油三酯的升高与其他 Ⅱ/Ⅲ期临床NASH候选药物比较, ASC40 (TVB2640)Ⅱ期数据具有优势ASC41ASC42艾滋病以学术推广为核心的商业化能力幻灯片编号 24全球合作总结Disclaimer