Shionogi pays up for rare novel antifungal

Antifungals are not known for its lightning-quick innovation – last year saw the first new mechanism in 20 years – but growing resistance to existing drugs and an expanding population of immunocompromised patients means that demand is higher than ever. This helps explains the impressive $100m up-front fee that F2G negotiated for olorifim, a project that the private UK group describes as the first of the orotomide class. Olorifim works differently from existing treatments and thus holds promise against a wide range of invasive and hard-to-treat moulds and fungi, according to F2G. These attributes persuaded Shionogi to buy Europe and Asia rights, share development costs and commit to $380m in further milestones, as well as double-digit royalties. It has taken F2G a long time to get here, having first put the project into the clinic back in 2014; results from a phase 2b trial could emerge later this year, and a phase 3 study is poised to start. A thin pipeline guarantees scarcity value for anything that looks promising in this field, but commercial companies face similar problems to those working with novel antibiotics: effective treatments get held back as last-resort options.

Selected novel antifungals: recent progress and in the pipeline
Product Company Mechanism Details Deals? 
Brexafemme  Scynexis Glucan synthase inhibitor Approved in US June 2021 Wholly owned
Vivjoa (oteseconazole) Mycovia/Gedeon  Next-generation azole  Approved in US April 2022  Gedeon Richter bought European and other region rights in 2019, terms undisclosed
Rezafungin Cidara/Mundipharma Echinocandin (once weekly)  To be filed in the US mid-2022 Mudipharma bought ex-US/Japan rights for $30m up front in 2019
Olorofim F2G DHODH inhibitor (orotiomide class) Ph2b ongoing, ph3 planned Shionogi bought European, Asia rights for $100m up front 
Fosmanogepix Pfizer Novel antifungal class Ph2 ongoing Pfizer bought Amplyx in 2021, terms undisclosed 
MAT2203 Matinas Biopharma Novel polyene  Potentially pivotal ph2 trial ongoing  Asset wholly owned
Source: Evaluate Pharma & company statements. 

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