Ratio Therapeutics, Inc.

Novartis CEO Vas Narasimhan, M.D., wants to see more mature data before deciding whether to venture into the PD-1xVEGF bispecific game in cancer.\n After parting ways with BeiGene in 2023, Novartis effectively bowed out of the PD-1 race. Now, the rising class of bispecifics opened up an opportunity for the Swiss pharma to reenter the space from a new angle. The question is: Will the company take it?“We’re certainly watching the space,” Novartis CEO Vas Narasimhan, M.D., said of PD-1xVEGF bispecifics during a fourth-quarter earnings call with reporters this morning.“I think there were very interesting data that came out of China and then later in Europe, but I think we’re still waiting to see how that data matures before deciding is this something that we want to pursue,” Narasimhan said in response to a question from Fierce.In September, Akeso presented strong phase 3 head-to-head data showing that its Summit Therapeutics-partnered PD-1xVEGF bispecific ivonescimab outperformed Merck & Co.’s Keytruda on progression-free survival in Chinese patients with previously untreated, PD-L1-positive non-small cell lung cancer.While trying to brush off the threat by cautioning that a statistically significant overall survival showing may be hard to achieve, Merck soon got a PD-1xVEGF bispecific for itself, paying $588 million upfront—with up to $2.7 billion in milestones—for rights to LaNova Medicines’ candidate LM-299.Almost simultaneously, BioNTech unveiled a plan to acquire its partner Biotheus to gain full control over their PD-L1xVEGF bispecific candidate, BNT327.  BioNTech shared promising early-phase data for BNT327 in December, which Leerink Partners analysts argued “has potential to usurp and extend [Keytruda] as the backbone checkpoint in 1L triple-negative breast cancer.” Novartis once showed an interest in PD-1 but left the space by ending its collaboration with BeiGene on the PD-1 inhibitor Tevimbra after significant regulatory delay and changing FDA stance in the U.S. At that time, Novartis cited a changing PD-1 inhibitor landscape, basically indicating that the space had become too crowded for yet another similar drug.Novartis didn’t have the best experience with bispecifics in oncology. The company paid Xencor $150 million upfront in 2016 to co-develop two CD3 T-cell engaging bispecifics, only to have dropped both programs by 2021.But the Swiss pharma in July 2024 renewed its hope in the modality, putting down $150 million upfront to work with Dren Bio on bispecifics for cancer.As Narasimhan noted, Novartis have a number of efforts ongoing in bispecifics, primarily in immunology. These include T-cell engagers being developed for systemic lupus erythematosus and bispecific antibodies for atopic dermatitis, all in phase 1 development with readouts not expected until 2027 at the earliest, according to a January presentation.“Our thinking is, can we develop a medicine that’s better than the current standard of care in atopic dermatitis and in some of the relevant indications,” Narasimhan said on Friday’s call.“We’ll have more data in the coming years to guide us on how those will progress,” he added.As to oncology, Novartis’ primary focus is radioligand therapies, plus “a smaller effort on antibody-drug conjugates,” Narasimhan noted.In radioligand therapies, Novartis is waiting to hear back from the FDA on its application for PSMA-targeted Pluvicto in pre-taxane metastatic castration-resistant prostate cancer. After an early progression-free survival win, Novartis delayed its filing for more than year until the overall survival data from the phase 3 PSMAfore trial turned in favor of Pluvicto.The company also didn’t use a priority review voucher as the FDA requested the flexibility to review the final overall survival result. Friday, Novartis disclosed that the final analysis remained in Pluvicto’s favor without adjusting for patient crossovers. Novartis has multiple pipeline candidates in radiopharmaceuticals and last year doubled down on the field with the $1 billion upfront acquisition of Mariana Oncology, with a lead program targeting DLL3, plus a licensing deal with Ratio Therapeutics to develop a somatostatin receptor 2 (SSTR2)-targeting candidate.

The acquisition provides Lantheus access to Evergreen’s radioligand therapy (RLT) manufacturing infrastructure. Credit: Love Employee via Getty Images. US-based radiopharmaceutical company Lantheus has announced a definitive agreement to acquire clinical-stage radiopharma contract development and manufacturing organisation (CDMO) Evergreen Therapeutics. Lantheus will make an upfront payment of $250m, with the potential for an additional $752.5m in milestone payments. This marks Lantheus’ fifth acquisition since January 2024, as it expands its radiopharma capabilities. The acquisition provides Lantheus access to Evergreen’s radioligand therapy (RLT) manufacturing infrastructure, which includes a revenue-generating contract manufacturing business. The company expects this will help supply its clinical trials, scale production for commercial launches, and reduce reliance on third-party manufacturing partners. The deal also brings Octevy, a registrational-stage PET diagnostic being evaluated for detecting neuroendocrine tumours in both adults and paediatric patients. Lantheus said that Octevy could be seen as complementary to PNT2003 (lutetium Lu 177 edotreotide), one of the company’s therapeutic agents co-developed with POINT Biopharma, which is currently in Phase III testing for neuroendocrine tumours. Using radioactive isotopes to diagnose and treat diseases, radiopharmaceuticals have recently gained traction due to their potential in oncology and other indications. However, their development and manufacturing require specialised infrastructure , stringent regulatory compliance, and just-in-time delivery to ensure product efficacy. Manufacturing radiopharmaceuticals has been a key challenge for companies in this space. In August 2023, Lantheus’s subsidiary Progenics discontinued the production of the approved radiopharmaceutical Azedra at its site in Somerset, New Jersey, due to “the combination of limited usage and fixed costs associated with the manufacturing of Azedra”, which made it untenable, as per an SEC filing. With this latest deal, Lantheus noted that Evergreen’s facility is equipped to handle various diagnostic and therapeutic isotopes. Lantheus’ CEO Brian Markison said: “With Evergreen’s manufacturing and development capabilities, we become fully integrated and will ultimately make a difference in the lives of more patients.” This acquisition follows a series of recent transactions by Lantheus aimed at expanding its radiopharmaceutical pipeline. In July 2024, the company acquired Meilleur Technologies, gaining access to an Alzheimer’s PET diagnostic for detecting beta-amyloid plaques in the brain. Earlier this month, Lantheus agreed to acquire Life Molecular Imaging for an upfront payment of $350m, which is expected to support commercial expansion into Alzheimer’s disease diagnostics. The broader radiopharma sector has seen increased investment and consolidation in recent years. In November 2024, Novartis partnered with US-based startup Ratio Therapeutics in a $745m deal to develop a somatostatin receptor 2 (SSTR2) radiotherapeutic for cancer treatment. In May 2024, Novartis acquired Mariana Oncology for $1.75bn, adding radioligand therapy MC-339 to its pipeline. Other major pharma companies such as Bristol Myers Squibb (BMS) and Eli Lilly have also entered the arena, with acquisition deals worth $4.2bn and $1.4bn, respectively. Venture capital investment for US-based companies with radiopharmaceutical drugs saw a rise of 550% between 2017 and 2023, according to GlobalData. GlobalData is the parent company of Pharmaceutical Technology .

PPrat/Getty Images/iStockphoto The J.P. Morgan Healthcare Conference started off with a flurry of deals that reinvigorated excitement across the biopharma industry. Johnson & Johnson moved to acquire Intra-Cellular Therapies for $14.6 billion, breaking a dealmaking barrier that kept Big Pharma’s 2024 biotech buyouts to under $5 billion. While J&J stole the headlines, GSK got there first at JPM this year with a $1 billion upfront offer to buy precision therapy specialist IDRx and its rare cancer drug candidate. Eli Lilly also threw down a cool $1 billion for Scorpion Therapeutics’ PI3Kα inhibitor program. Biogen also made an unsolicited bid for embattled partner Sage Therapeutics, valuing the neuroscience biotech at $469 million, which got more complicated days later when Sage sued. This week, Sage rejected the unsolicited offer , setting up a deal–no deal battle to watch this year. All in all, the transactions helped bring a little shine back to biopharma at the meeting, which typically sets the tone for the year. I was on the ground in San Francisco, reporting for BioSpace on what biopharma executives were plotting for this year. My conversations with Biogen , Daiichi Sankyo , BioNTech , Gilead and Novavax were among the highlights. JPM is, of course, also the time for the industry to make its predictions for the year . Executives I spoke to foresaw the return of M&A in a big way this year. Mark McKenna, CEO of Mirador Therapeutics, even boldly claimed that 2025 will be the year of the megamerger, with biopharma returning to the heyday of 2019 when $60 billion-plus deals were not uncommon. BioSpace also makes some predictions of its own, each January releasing its picks for biotech startups to watch. This year we’re featuring 25 companies that run the gamut of biopharma innovation , from ADCs to radiopharmaceuticals to cell and gene therapy and more. At JPM, we got the chance to meet several of our star companies to hear what is driving them in this challenging time for the industry. As just one example, neuropsychiatry-focused Seaport Therapeutics is looking to perpetuate the momentum started last year with the approval of BMS’ schizophrenia drug Cobenfy. That drug came from the nearly $9 billion acquisition of Karuna, whose former execs now work together at Seaport. We’ll have more to come from our NextGen Class of 2025 in the coming weeks. At JPM I spoke with the CEOs of Cour Pharmaceuticals, Delphia Therapeutics, Ratio Therapeutics and Mirador. Stay tuned for more content from the BioSpace team. Editor‘s note: This article was originally published as a Special Edition of Biopharm Executive, BioSpace ‘s weekly newsletter covering business and financial news. You can subscribe here .