J & J’s growth strategy in lung cancer borrows from its experience in multiple myeloma

Johnson & Johnson currently has one of the largest ranges of multiple myeloma products. Since his first FDA approval of a drug for this type of blood cancer ten years ago, the pharmaceutical giant has developed in this space with additional drugs representing different methods. In Joshua Bauml, vice-president, chief of the lung cancer area at J & J, the experience of the company in multiple myelome is a plan for its strategy in lung cancer.

“Look at what we have done in multiple myeloma,” said Bauml. “We started an area where there was nothing and we really built a pipeline. And that’s exactly what we intend to do in lung cancer. ”

The multiple myelome portfolio of J&J is anchored by Darzalex. Today, this medication is not only the best -selling cancer product in J & J, it is the best drug in the company as a whole. J & J also has successful expectations for his medication against lung cancer, a rybrevant. Lung cancer is one of the areas of interest of J & J, what the company calls “bastions of the disease”. In an interview at the annual meeting of the American Society of Clinical Oncology in Chicago, Bauml presented the J&D strategy for Rybrevant.

Some cases of lung cancer are driven by mutations to a protein called EGFR. Bauml, who has treated patients with lung cancer as a clinician for about 10 years, said that lung cancer transferred by the EGFR tends to develop in people who have little or no history of exposure to tobacco. Lung cancer non -small cells (NSCLC) represents approximately 85% of lung cancers; EGFR mutant cancer represents between 15% and 30% of these cancers. The upper end of this beach is in Asia.

Targeted therapies are available that approach the EGFR. Tagrisso, the best product in astrazeneca cancer, counting around $ 6.6 billion in income last year, is one of these drugs. This small oral molecule is designed to block enzymes that stimulate cancer growth and has become standard therapy for patients with certain EGFR mutations. But a problem with these drugs is that when cancer lumps, it becomes resistant to medication.

Rybrevant of J & J is a bispecific antibody which offers two action mechanisms. In addition to blocking the EGFR, it blocks a second receiver called MET. The two receptors are overexpimized on the surface of cancer cells. If cancer plays around the EGFR, the activity of Rybrevant on Met Target always addresses cancer. The blocking of the two targets is intended to prevent resistance to drugs. Rybrevant won the approval of the FDA accelerated in 2021 as a second -line treatment for the CBNPC driven by an exon 20 insertion mutation at the EGFR. In March 2024, the FDA approved as a first line treatment for these cancers, a decision that also converted the status of the drug in full approval.

Last August, the FDA approved another J & J drug, Lazertinib (Lazcluze brand name), as a front line treatment for the CBNPC transferred by EGFR. Lazcluze also blocks the EGFR, but as a small oral molecule, it passes through the cellular membrane and binds to the target of the interior of the cell, said Bauml. This medication was approved for use alongside Rybrevant.

“They will prevent resistance before it even occurs,” said Bauml about the two drugs together. “If you play with the rybrovant link on the top [of the cell]I always have the interior. The idea is that this double approach allows even more activity. »»

There is more in the way rybrevant works. The end of the tail of a bispecific antibody, called the FC region, interacts with the immune system. Bauml said that the Rybrevant FC region has been optimized to recruit immune cells. If it is difficult to show this effect in humans, in laboratory tests, the exposure of tumors to the drug has led to the activity of immune cells against them, said Bauml.

The portfolio of multiple j & J multiple myeloma extends over antibodies (Darzalex), bispecific engagers of T cells (Talvey and Tecvayli) and cell therapy (Carvykti). I literally borrow from multiple myeloma to develop its lung cancer pipeline. The company explored Talvey and Tecvayli in lung cancer, said Bauml. The other types of drugs that the company have studied for lung cancers include small molecules and radioligand therapies.

“Due to the expertise we have at J & J, I don’t need to limit myself to a modality,” said Bauml. “In fact, what I can do is say that we find the best target, then we determine the modality. Is it an ADC (combined with antibody medication)? Is it radioligand therapy? Is it a bispecific? “

J & J has planned $ 5 billion in advanced revenue for Rybrevrevant. He has a long way to go. In the first quarter of 2025, Rybrevant and Lazcluze represented $ 141 million in revenues, against $ 47 million in the same period the previous year. This is the first time that the company has exploded specific financial figures for therapy.

Rybrevant growth could occur in different ways. As a bispecific anticorps, the drug is administered as a infusion that takes between two and five hours. A subcutaneous version of the drug takes only five minutes, which makes patients a lot. During the ASCO meeting last year, J&J reported the results of phase 3 showing that the subcutaneous rybrovant was not only roughly comparable to intravenous formulation, which resulted in an improvement in overall survival. But last December, the FDA refused this version of the drug citing problems with the manufacturing installation. No concern has been raised regarding the safety or efficiency of the drug, and Bauml noted that this injectable version of Rybrevant is already available in Europe. He added that the company is committed to bringing an injectable rybrovant to American patients as soon as possible.

Additional growth for the Rybrier could come from the outside of lung cancer. Bauml noted that the EGFR and the MET are associated with other malignant tumors. A phase 1/2 study assesses the Rybrier in head and neck cancer. Bauml expects the data to be presented during a future scientific meeting. Another opportunity is colorectal cancer. During the annual meeting of the European Society of Medical Oncology last year, J & J presented the data of an open phase 1B / 2 study which evaluated the rybrier, alongside standard chemotherapy, in 43 patients with metastatic colorectal cancer. The results have shown that the drug J&J has led to an overall response rate of 49%. Bauml noted that metastatic colorectal cancer cannot generally be cured. But at nine participants, tumors became so small and showed such a good response to therapy that patients were able to get out of the study because they were eligible for curative surgery.

“So, the impact of Rybrevant, it really starts,” said Bauml. “We are very delighted with the data in which we have demonstrated [the] Mariposa [study with Lazcluze]But we believe that the best is yet to come. »»

Photo: Mario Tama, Getty Images