43. Talzenna

Pfizer building
(Tracy Staton)

Active ingredient: talazoparib
Disease: BRCA-mutated, HER2-negative breast cancer
Peak sales estimate: n/a
Approved: Oct. 16
Company: Pfizer

The scoop: Once a forgotten backwater of cancer therapies when CAR-T and CRISPR were turning heads, PARP inhibitors became sexy again when exciting data came out from several biopharma companies showing that, while not a headline-grabbing mechanism of action, the inhibitors were making some quiet but serious inroads in treating a number of cancers. Pfizer wanted in and spent $14 billion on Medivation a few years back to grab, among other drugs, its PARP talazoparib (originally sold to Medivation from BioMarin in 2015) in the hope it could break into this market. But, it’s a crowded one. Pfizer's October approval keeps it way behind now-established PARP players AstraZeneca/Merck, Tesaro and Clovis Oncology, and analysts wondered just how Pfizer could make any headway, especially as the latter two companies are also looking to expand into breast cancer.  This challenge is compounded by potential safety issues, with Evercore ISI analyst Steve Breazzano saying he was worried about how Talzenna would fit into the breast cancer market given its side effect profile is slightly worse than that of AstraZeneca’s PARP Lynparza, which has a similar breast cancer license. In particular, hair loss has been reported among patients taking Pfizer’s drug, a side effect “unique among PARP inhibitors,” Breazzano said in a note to clients posted earlier in the year. Pfizer has an initial FDA license for BRCA-mutated, HER2-negative breast cancer that's locally advanced or metastatic, but it’s looking to get to work on other cancers including ovarian, pancreatic and lung and has teamed up with biotechs such as Array BioPharma to see if it can be the underdog that makes good in the PARP space. — Ben Adams 

43. Talzenna
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