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In the field of biopharmaceuticals, in the face of the cruel and indifferent law of the jungle, how to find their own way of survival is a problem
that every pharmaceutical company needs to think about.
In this regard, the answer of Johnson & Johnson, an overseas big pharmaceutical company, is: seek more security for themselves through a monopoly layout
.
The most intuitive feeling should be Johnson & Johnson's progression in the field of multiple myeloma:
From monoclonal antibody to CAR-T to bispecific antibody, the number of therapeutic lines is pulled from the first line to the last line
.
It seems that Johnson & Johnson hopes that under such encirclement, it will be difficult for latecomers to find a gap
to break through.
So, in the field of innovative drugs, can the "ecological coupling" play keep competitors out?
/ 01 /
/ 01 /Building an "iron barrel array" in the field of multiple myeloma
Building an "iron barrel array" in the field of multiple myelomaAs a hunter who has survived in the medical industry for nearly a hundred years, Johnson & Johnson keenly smelled the opportunity in the
field of multiple myeloma more than two decades ago.
In 2003, Johnson & Johnson made its first move in multiple myeloma, the proteasome inhibitor bortezomib
.
As a breakthrough drug for myeloma, tizomib has many advantages
such as fast onset and significant efficacy.
Bortezomib is the first-line agent
in patients with new or recurrent multiple myeloma.
In 2008, bortezomib had global sales of more than $1 billion and was successfully promoted to a blockbuster drug
.
In 2015, although the sales of bortezomib plummeted after the patent expired, Johnson & Johnson did not lose the multiple myeloma market, and the daratumumab approved for marketing that year quickly completed the relay
.
As the world's first drug targeting CD38, daratumumab still cannot cure multiple myeloma, but it can significantly prolong the life of
patients.
For patients who have developed resistance to all therapies, daratumumab can achieve an objective response rate of 42.
8%, which means that it is effective
in almost half of patients.
After the approval of the end-line therapy, it took only 4 years for daratumumab to complete the leap
from the end-line therapy to the first-line treatment in the United States.
At this point in the story, Johnson & Johnson's layout for multiple myeloma has just begun
.
In 2017, Johnson & Johnson introduced the legendary creature's BCMA
The CAR-T therapy Carvykti was finally approved for marketing in 2022 and became a strong contender for multiple myeloma
.
Carvykti's effect was explosive, with an objective response rate of 98% and a strict complete response of 80%
even for patients who received multiple lines of therapy.
To explain it in plain terms, almost all patients who have no drug available respond to Carvykti, and 80% of patients achieve the best results
of multiple myeloma treatment.
However, Johnson & Johnson's layout in the field of multiple myeloma is far from over
.
In October 2022, Johnson & Johnson's BCMA/CD3 bispecific antibody Teclistamab was approved for marketing, and the indication is the same as CAR-T for the end-line treatment of multiple myeloma, but its effect is not as good as CAR-T on paper, and the objective response rate is 61.
8%.
Then some people may ask, the same indication efficacy is not as good as CAR-T, Johnson & Johnson's wave of operation is not left hand to right hand? This, you are wrong
.
Although the effect of bispecific antibody is not as good as CAR-T, it is better in convenience and can be mass-produced without one person and one drug
.
What's more, it can "clean up"
for the strongest CAR-T.
Even the strongest CAR-T cannot escape the fate
of recurrence in the face of multiple myeloma.
Just imagine, the strongest players are invalid, so wouldn't the patient have to sit and wait for death? But there is no need to panic if there is a double antibody, because there have been many studies that show that even for patients with relapse of CAR-T treatment, the double antibody can still work
.
At present, Teclistamab and Carvykti have laid out clinical studies of first-line, second-line and median-line therapies, and if these clinical trials can be successful, they will be able to cover the full line of multiple
myeloma.
In addition, there is a GPRC5D/CD3 bispecific antibody in the Johnson & Johnson pipeline in clinical phase III, which has shown very good efficacy
in grade III highly refractory multiple myeloma.
In the field of multiple myeloma, Johnson & Johnson is not the absolute king
.
But at least from the current situation, Johnson & Johnson has the momentum
of "one husband is the door, ten thousand fu is open".
/ 02 /
/ 02 /Ecological breakthrough in the innovative drug market
Ecological breakthrough in the innovative drug marketJohnson & Johnson's "ecological breakthrough" strategy is not a whim, and in previous planning, the company has clearly mentioned that the calculation of future performance growth is a "three-step strategy"
.
The first wave of growth came from the expansion of the
product portfolio.
Still take the field of multiple myeloma as an example
.
In this area, Johnson & Johnson is constantly enriching its product matrix
.
With bortezomib and daratome as the cornerstone, continuous research and development have been carried out to expand CAR-T with stronger efficacy and stronger bispecific antibodies
with stronger flexibility.
The second wave of growth will come from driving innovative therapies to market
.
That's what Johnson & Johnson is doing
now.
As mentioned above, since the beginning of this year, in the field of multiple myeloma, Johnson & Johnson's innovative therapies have been launched
one after another.
At present, these new products are gradually beginning to contribute
to Johnson & Johnson's performance.
The third wave of growth will come from driving the development of
oncology.
With the launch of these products, Johnson & Johnson further dominates the multiple myeloma field
.
But Johnson & Johnson's ultimate goal is much broader: to reshape the landscape of multiple myeloma
.
According to Johnson & Johnson's plan, it will redefine the treatment model of multiple myeloma through the combined strategy of monoclonal antibody, bispecific antibody and CAR-T product matrix, and ultimately leave latecomers with nowhere to go
.
In fact, Johnson & Johnson's layout on multiple myeloma is only a microcosm
of its layout in the tumor chess game.
In the field of lung cancer, Johnson & Johnson is also laid out
.
In the area of lung cancer, Johnson & Johnson aims to build the optimal combination around the EGFR exon 20-targeted drug Rybrevant for all treatments
for EGFR-mutant NSCLC.
Does Johnson & Johnson's script look familiar?
Yes, AstraZeneca has the same strategy
in the field of oncology.
In the field of breast cancer, AstraZeneca's ADC drug DS-8201, almost "contracted" HER2 breast cancer indications, regarding HER
2 The treatment model for breast cancer has also been redefined
.
At the same time, AstraZeneca has also deployed HR-positive breast cancer
through a new generation of oral SERD and a potential new AKT inhibitor, Camizestrant.
In addition to AstraZeneca and Johnson & Johnson, many pharmaceutical companies such as Roche and Merck are also doing the same ecological layout
.
It seems that in the field of drug development, the goals of the strong are similar
.
/ 03 /
/ 03 /Who can keep up with domestic pharmaceutical companies?
Who can keep up with domestic pharmaceutical companies?For any enterprise, no matter what the process, in the end, it is still the hero
of capital gains.
If any company says that it doesn't care about earnings at all, it is likely to be deceiving
.
After all, in addition to actively developing new drugs, pharmaceutical companies are still trying to build a wide moat for drugs
.
In the final analysis, pharmaceutical companies want to reshape the treatment model of diseases in order to defend their drug more
firmly.
For latecomers, whether you are a large-scale big pharmaceutical company or a small pharmaceutical company with unique ingenuity, it is obviously not an easy task
to cross this moat if you want to compete with the "aborigines" for territory.
From the perspective of the direction of these pharmaceutical companies, the options for obtaining the final benefits are different
.
You can choose to gather in popular R&D fields to make a wave of excitement, or you can choose to go deep into some no-man's land to continue exploring
.
As Merck's founder put it, "We should remember that pharmaceuticals are for people and not for profit, but profits will follow
.
" If we remember this, profits never disappear: the more you remember, the more
profits will come.
”
Obviously, for some pharmaceutical companies such as Johnson & Johnson, this path is chosen
.
For example, in the field of myeloma, even if drugs with multiple mechanisms of action have been approved for marketing, it is still a beautiful fantasy
to completely cure multiple myeloma.
With the advent of innovative therapies for CAR-T and bispecific antibodies, patients see more possibilities
.
As a result, Johnson & Johnson competed on the same stage with multiple technologies, and finally completed the construction
of the moat in the form of ecological breakthrough.
This is not a revelation
for domestic pharmaceutical companies.
