Welcome back to This Week in Biotech by Biotech Blueprint, edition 125, covering biotech and pharma news from October 30th to November 5th, 2026.
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VIDEO SUMMARY
THIS WEEK’S KEY TAKEAWAYS 🔑
Revolution Medicines sold $197.6M of Rasonque in five weeks. More than 5,000 patients received a drug that doubled survival in second line pancreatic cancer, a disease where almost nothing has worked, and about 60% of the prescriptions came from community oncologists rather than academic centers.
AstraZeneca offered up to $134 a share for Rhythm Pharmaceuticals, about $10B. Rhythm sells Imcivree for rare genetic disorders where patients can’t regulate hunger. In March it was approved for people who gain severe weight after brain injury, usually following tumor surgery, and more than 700 patients have started on it since. AstraZeneca would run it through Alexion, its rare disease arm. Rhythm closed up 28%, so the market expects a deal without being certain of one.
Democrats took both chambers on Tuesday. Bernie Sanders is likely to chair the Senate health committee, which matters because the FDA user-fee law comes up for renewal and that’s the bill the agency depends on for most of its drug review budget. Analysts don’t expect a drug pricing fight right away. The Inflation Reduction Act already runs on its own, and the Most favored nation deals are signed. The nearer-term question is FDA commissioner nominee Heidi Overton, whose nomination could simply lapse, leaving the agency without a confirmed leader into next year. Separately, CVS said Wednesday it will split into two companies by 2028, with Aetna and Caremark on one side and its 9,000 retail pharmacies on the other. Arkansas and Tennessee have already banned common ownership of pharmacies and pharmacy benefit managers, and a bipartisan federal bill would do the same.
Novartis confirmed nine tumor reports among more than 6,000 children treated with Zolgensma since 2019. Zolgensma is a one time gene therapy for spinal muscular atrophy, a disease that used to kill most patients before their second birthday. Two of the nine showed the delivery vector had inserted itself into the patient’s DNA. The cases appeared 18 to 60 months after dosing, and families found out through their neurologists rather than any public notice.
BIOTECH/PHARMA NEWS 🧬
🔹 Rasonque, approved August 26 for second-line metastatic pancreatic cancer, generated $197.6M in net revenue in roughly five weeks. More than 5,000 US patients were treated and about 2,700 prescribers wrote for it, about 40% academic and the rest community. TD Cowen called it “the best oncology drug launch in history,” and RBC now models $426M in Q4 and more than $3B in 2027. Pricing is the other story: $39,800 list for 30 days, above Keytruda, with plans covering more than 90% of patients paying claims. However, the quarter included a one time transfer of expanded access patients, many of them sicker and likely to stop sooner, so Q4 will be the first clean read. Revolution still lost $407.5M in the quarter and holds $3.7B in cash. A drug that doubled survival, approved in 35 days under a priority voucher, priced at a premium, but paid for anyway.
🔹 AstraZeneca made a non-binding offer of up to $134 per share including milestones for Rhythm Pharmaceuticals, about $10B. An earlier $124 per share approach came last month. Rhythm closed up 28% at $110.68, a market cap of about $7.64B, so the market is pricing a deal but not a certain one. Neither company commented. The asset is Imcivree (setmelanotide), which posted $92.1M in Q3 sales, up 29% from the prior quarter but below the $98.7M consensus. Since its March 19 approval in acquired hypothalamic obesity, which is weight gain following brain injury and often tumor surgery, Rhythm has collected more than 700 patient start forms. The deal would run through Alexion, AstraZeneca’s rare disease arm. It lands days after AstraZeneca unveiled a $1.5B annual cost savings program with a $2B one time charge, aimed at keeping its $80B 2030 revenue target alive. Rhythm doesn’t put AstraZeneca in the mass market obesity fight. It buys a rare disease launch with clear pricing power, which is a cleaner use of capital than the Bristol Myers merger talk from August.
🔹 Novo Nordisk’s Wegovy pill brought in DKK 5.39B, about $811M, in Q3 against consensus of DKK 4.96B. Novo raised its outlook to as much as 2% growth in sales and operating profit at constant currency, up from a forecast as low as a 4% decline in May. Lilly’s oral rival Foundayo did $184M, $44M short of estimates. Shares rose more than 6%, to just above $42, against more than $140 in June 2024. CFO Karsten Munk Knudsen is leaving and Galderma’s Luigi La Corte replaces him. The pill is the only obesity front Novo is currently winning. Lilly claims 63% of the US incretin market, retatrutide just beat Ozempic head to head, and semaglutide patents expire years before tirzepatide’s. One good quarter in oral doesn’t change that, but being first in a new format still counts for something.
🔹 Democrats regained the House and Senate on Tuesday. Sanders is likely to chair the Senate health committee and will have major sway over reauthorizing the FDA user-fee law, the industry’s must-pass bill. Analysts see limited drug pricing risk. Leerink says Democrats have “bigger fish to fry,” and RBC calls the IRA “too complicated to materially change.” The live risk is FDA commissioner nominee Heidi Overton. Her nomination may lapse, reopening the one FDA post still lacking a confirmed leader. The XBI has posted positive six-month returns after each of the last four midterms.
🔹 On Wednesday, CVS said it will split into two companies by the first half of 2028: Aetna and Caremark in one, its 9,000 retail pharmacies in the other. Arkansas and Tennessee have already passed laws barring common ownership of pharmacies and pharmacy benefit managers, and a bipartisan federal bill would do the same.
🔹 Novartis confirmed nine tumor reports among more than 6,000 patients treated with Zolgensma since 2019. Zolgensma is the one time gene therapy for spinal muscular atrophy, given mostly to infants. Two cases showed evidence of the AAV vector integrating into patient DNA, and seven have not been causally linked. Parents report the two confirmed cases arose 18 to 60 months after dosing. Families learned through their neurologists, and SMA Europe says regulators are assessing the evidence. The label already warns of a theoretical tumor risk from integration. What is new is that it’s no longer theoretical. Novartis ADRs slipped. The same day, reporting showed China’s investigator-initiated trial pipeline, the low cost proof of concept route behind many US licensing deals, slowing to a trickle after the patient deaths disclosed this summer. Since May 1, Order 818 confines new technology trials to top tier hospitals and carries million yuan fines. Both stories add cost and time to one time genetic medicines: years of follow up in the US, and slower early data out of China.
🔹 ASH abstracts posted Wednesday put four myeloma trispecific antibodies on the map. A trispecific grabs three targets at once, in this case a T cell plus two separate markers on the cancer, which is meant to stop tumors escaping by shedding a single antigen. J&J’s ramantamig hits CD3, BCMA and GPRC5D, the two myeloma targets of its already-approved Tecvayli and Talvey, in one molecule. Combined with Darzalex and Revlimid as induction in newly diagnosed, transplant-eligible patients, it produced minimal residual disease negativity, meaning no detectable myeloma cells, in all 20 patients evaluable after three cycles. AbbVie’s ABBV-2001 drew responses in 75 to 85% of relapsed or refractory patients, with 83 to 88% of complete responders MRD-negative. Innovent’s IBI3003 reached 77% at its Phase 2 dose, and Shanghai Xianxiang’s SIM0500 up to 86% at the highest doses. However, there were 20 patients is a cohort, it was not a trial, and ramantamig’s induction setting is where MRD negativity comes easiest. The open question is whether one trispecific beats two sequenced bispecifics, and none of this answers it. Two of the four are from China.
🔹 Sanofi stopped development of its Nurix-partnered oral STAT6 degrader for eczema. STAT6 sits downstream of IL-4 and IL-13, the targets of Dupixent, and protein degraders are the most credible route to hitting it in pill form. Sanofi told Leerink that “emerging nonclinical findings” didn’t warrant further work, but that STAT6 remains “an important pathway.” Nurix had collected $10M when phase 1 began in August and fell more than 40%. The distinction worth holding onto is molecule versus mechanism. A nonclinical finding specific to one compound says little about Kymera’s STAT6 degrader, whose mid-stage readout is due later this year, and Sanofi has said it has another STAT6 approach. But an oral Dupixent remains a hypothesis, and the first pharma-backed attempt at it is gone.
🔹 Amgen published a study of more than 544k adults comparing Repatha against ezetimibe, followed for up to four years. Among patients with a baseline LDL measurement, four year heart attack risk was 5.88% on Repatha versus 7.76% on ezetimibe, about 20% lower. It’s in the American Journal of Preventive Cardiology. The clinical question is: when a statin isn’t enough, what comes next? No randomized trial has ever compared the two head to head. But this is observational data with a careful design rather than a trial. Patients who get an expensive injectable differ from patients who get a cheap generic pill in ways you can only partly adjust for. Amgen ran it and Amgen announced it. The commercial timing explains more than the science does. Merck’s oral PCSK9 inhibitor Lipfendra launched in July at $315 a month, so Amgen now needs evidence that an injectable earns its slot ahead of ezetimibe and against a pill.
WATCHLIST 👀
Capricor deramiocel: FDA decision Nov 22 in Duchenne, the next test of the agency’s second-chance posture on rare disease
Vertex povetacicept: FDA decision Nov 30 in IgA nephropathy; a late-October citizen petition asks for mandatory antibody-level monitoring
AstraZeneca / Rhythm: whether the reported approach becomes a signed deal, and at what premium to $110.68
Treasury COINS Act rule: comments due Dec 7
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Front cover image source: Revolution Medicines