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Lilly wins appeal for donanemab, drug to be reconsidered for NHS

Eli Lilly’s appeal against guidance which did not recommend donanemab has been upheld, forcing authorities to reconsider the drug for NHS use.
The National Institute for Health and Care Excellence (NICE) published the outcome for Lilly’s appeal, after final draft guidance had not recommended NHS reimbursement of donanemab for the treatment of mild cognitive impairment and mild dementia due to Alzheimer’s disease.
Donanemab is an amyloid-targeting treatment for people with mild cognitive impairment and mild dementia due to Alzheimer’s disease in adult patients who are apolipoprotein E ε4 (ApoE ε4) heterozygotes or non-carriers.
The decision means the final draft guidance will be returned to the relevant programme, and the committee will meet to consider estimates for infusion cost seen in the NHS and long-term data for donanemab.
“This is a big moment in the battle against Alzheimer’s disease,” Chris Stokes, General Manager of the Northern European Hub at Lilly, said in a statement.
“NICE was right to look again at the evidence in front of them and it’s welcome that our appeal has been upheld. For people living with Alzheimer’s disease, and for the families and carers who support them, this matters, perhaps now more than ever.
“We now look to NICE to use the flexibilities outlined in the manual, as it reassesses the evidence that Lilly, clinical experts and patient advocates have put forward, so that we can work towards our shared goal of ensuring all eligible patients with Alzheimer’s disease can access approved treatment options on the NHS as quickly as possible.”
The post Lilly wins appeal for donanemab, drug to be reconsidered for NHS appeared first on Drug Discovery World (DDW).
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Opinion: What a recent op-ed got wrong about our Covid study
First Opinion is STAT’s platform for interesting, illuminating, and provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others.
To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT publishes selected Letters to the Editor received in response to them. You can submit a Letter to the Editor here, or find the submission form at the end of any First Opinion essay.
First Opinion is STAT’s platform for interesting, illuminating, and provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others.
To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT publishes selected Letters to the Editor received in response to them. You can submit a Letter to the Editor here, or find the submission form at the end of any First Opinion essay.
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Spatiotemporal Multiomics Charts Cellular Dynamics of Liver Metastasis
Metastasis remains one of cancer’s most difficult biological transitions to capture: tumor cells must leave a primary tumor, survive circulation, enter a distant organ, and then either disappear, persist, or eventually grow into clinically detectable lesions. A spatiotemporal study in mice and human samples identifies transient tumor-cell and immune-niche states that may offer windows for intercepting metastatic colonization.
A new study published in Science provides a high-resolution look at that process in liver cancer, suggesting that metastatic colonization unfolds through ordered changes in both disseminated tumor cells and the immune microenvironments that surround them.
In the study, “Spatiotemporal multiomics uncover tumor ecosystem dynamics during metastatic colonization,” researchers led by Yunfan Sun, MD, PhD, at Zhongshan Hospital, Fudan University, applied spatiotemporal multiomics to experimental hepatocellular carcinoma mouse models and human metastatic samples. Their goal was to reconstruct how disseminated tumor cells, or DTCs, survive the earliest stages of lung colonization and later transition into metastatic outgrowth.
The team integrated high-resolution spatial transcriptomics, single-cell RNA sequencing, and chromatin-accessibility profiling across nine sequential stages of lung colonization in mouse models. The resulting atlas followed liver cancer cells from their first arrival in the lungs through later metastatic progression, while also mapping changes in nearby immune cells.
The analysis indicated that early metastatic seeding is not simply a random survival event. “After a massive innate immune clearance, primarily by neutrophils and natural killer (NK) cells, a rare subpopulation of DTCs survived by entering a transient, quiescent Phgdhhigh state,” the authors write. These cells were associated with an immune-scarce niche, allowing them to avoid elimination during a vulnerable early window.
Mechanistically, the authors linked this state to metabolic and epigenetic remodeling. Alveolar type 2 cells enriched near surviving DTCs appeared to promote the Phgdhhigh phenotype. Elevated PHGDH activity fueled one-carbon metabolism and increased levels of S-adenosylmethionine (SAM). That shift was tied to H3K27me3-mediated silencing of proinflammatory chemokine genes, including Ccl2 and Cxcl10, which would otherwise help recruit immune cells to the niche.
Perturbing this axis genetically or pharmacologically restored chemokine expression, increased immune surveillance, and reduced metastatic outgrowth in the models, according to the study. Lineage-tracing experiments further suggested that many macrometastases derived from ancestors that had passed through the transient Phgdhhigh state.
The researchers also identified a second niche-remodeling step before rapid metastatic expansion. At this stage, Cx3cr1high interstitial macrophages accumulated in the DTC niche. These “macrophages recruited immunosuppressive cells (T regulatory cells, neutrophils, and alveolar macrophages) and provided growth signals through the IGF1-IGF1R axis that trigger the transition of DTCs from quiescence to rapid proliferation,” the authors report in the study. Depleting these macrophages reduced metastatic burden in mouse experiments.
Together, the findings point to metastatic colonization as a temporally organized process shaped by reciprocal interactions between tumor cells and their local microenvironment. First, a rare tumor-cell state helps establish early immune evasion. Later, macrophage-driven remodeling appears to convert a quiescent niche into one that supports metastatic outgrowth.
Although the work is largely preclinical, the authors suggest that these transient states may represent vulnerabilities for micrometastasis-targeting approaches. By defining when and how early DTCs evade immune attack, the study offers a framework for developing interventions aimed not only at established metastases, but also at the earliest stages of metastatic colonization.
The post Spatiotemporal Multiomics Charts Cellular Dynamics of Liver Metastasis appeared first on GEN – Genetic Engineering and Biotechnology News.
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Replimune overcomes ‘messy data’ to secure positive adcomm vote for melanoma therapy
The FDA’s Cellular, Tissue and Gene Therapies advisory committee voted 10 to 3 in favor of Replimune’s immunotherapy for advanced melanoma in combination with Bristol Myers Squibb’s Opdivo, but trial design was a major sticking point as the panel deliberated.
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