The tissue matters
Selecting the second-best indication might be a strategic move to avoid fierce competition. But you have to be sure it’s not getting from a frying pan into the fire.
Investment lessons · EGFR × TGFβ
Superior product wins
Genmab paid $8B for Merus and its EGFR × LGR5 bispecific, whose data beat BiCara’s EGFR × TGFβ product: 63% vs 54% response rate, 79% vs 62% alive at 12 months. Patient data favors Merus in head and neck cancer, only the second-strongest tissue for EGFR × TGFβ. Selecting the second-best tissue can be very expensive.
The EGFR-TGFβ competition with EGFR-LGR5 · by Pawel Zawadzki, PhD
$8B
In September 2025, Genmab acquired Merus for its lead asset, an EGFR-LGR5 BiAb.
~$0.9B
Invested in EGFR-TGFβ BiCara’s product.
The case
Superior product wins
The BiCara clinical trial is behind Merus. But more importantly, Merus’s clinical data was simply better:
- 63% response rate
- 79% alive at 12 months
- Works in HPV-positive AND HPV-negative patients
vs BiCara:
- 54% response rate
- 62% alive at 12 months
- Only works in HPV-negative patients (27% response in HPV-positive).
Patient data
What the patient data revealed
Deep, AI-augmented analysis of patient data uncovered a dependency most likely undetectable in cell line models:
- Both products’ MoA are supported by patient data, but in a head-to-head comparison, patient data favors Merus in head and neck cancer.
- Data suggests that BiCara’s product relies on a double-hit into the MAPK signaling pathway, the right patients should have been selected for such MoA.
- The head and neck is only second strongest tissue for EGFR-TGFβ. BiCara could have increased the response rates and avoided head-to-head competition by selecting the most optimal tissue.
The take-home message
Selecting the second-best tissue might be very expensive
AI opportunity
Data, compute, and algorithms are here. Do expect from your AI team/partner selection of the best tissue, but also the assessment of the probability of success of your competitor’s program.
Recommendations
Consult patient data for reliable outcomes
01
Use patient data early
Assess your and your competitor’s Probability of Success as early as possible.
02
Drug combinations can save the day
Patient data identified opportunities for a combination of EGFR-TGFβ product that could further improve response rates.
03
Translatable patient data
Use patient data that are not coming from your clinical trial, then validate novel insights with your proprietary data.
Medicines intended to work in patients should be developed with patient data in mind.