The Biotech Beat: 2.23-3.2.25
by Joey Bose and Aruesha Srivastava
??Upshot
The biotech industry is at a pivotal crossroads, with massive investments, scientific breakthroughs, and regulatory challenges shaping the future of drug development ??. AstraZeneca’s camizestrant, a selective estrogen receptor degrader, is making waves in Phase 3 trials for ER-positive, HER2-negative breast cancer, showing a statistically significant progression-free survival benefit, with blockbuster potential pegged at $3.6 billion-$5 billion ??. Meanwhile, Regeneron’s DB-OTO gene therapy has restored hearing in 10 of 11 children with otoferlin-related deafness, proving that gene therapies can reverse congenital conditions, though challenges in scaling remain ??. Eli Lilly has doubled down on molecular glue degraders, pledging $1.25 billion to Magnet Biomedicine to pioneer next-gen oncology therapies, joining a growing field of pharma giants betting big on this promising modality ??. Elsewhere, BridgeBio’s oncology spinout, BBOT, is reviving the biotech SPAC trend, merging with Helix Acquisition Corp. II to unlock $550 million in funding to advance its KRAS and PI3Kα inhibitors through Phase 1 trials ??. On the rare disease front, Harbour BioMed’s $395 million preclinical sale of its anti-CRH antibody therapy for congenital adrenal hyperplasia (CAH) highlights both the promise and peril of early-stage deals, as the field awaits proof-of-concept data ??. But while capital flows into oncology and precision medicine, rare disease research faces a crisis: the expiration of the FDA’s priority review voucher (PRV) program, a crucial funding mechanism, threatens to stall treatments like Phoenix Nest’s Sanfilippo syndrome gene therapy, leaving families and researchers scrambling for alternatives ??.
?? Research, Development & Drug Approvals ??
?? AstraZeneca’s Bold Breast Cancer Play Hinges on Survival Data
The Facts
AstraZeneca’s Phase 3 SERENA-6 trial of camizestrant, an oral selective estrogen receptor degrader (SERD), showed a statistically significant and clinically meaningful progression-free survival (PFS) benefit in ER-positive, HER2-negative breast cancer patients. The trial, which featured a switching design, monitored patients for ESR1 mutations via blood tests and transitioned them to camizestrant plus a CDK4/6 inhibitor if a mutation was detected. While this approach improved PFS, it does not strictly qualify as a first-line setting. AstraZeneca forecasts peak sales above $5 billion, but Barclays analysts project a more conservative $3.6 billion. The drug’s true blockbuster potential depends on survival data from ongoing trials, including the first-line SERENA-4 study expected in 2026.
Our Opinion
AstraZeneca is making a calculated bid for dominance in breast cancer treatment, but this interim data, while promising, leaves unanswered questions. The switching design muddies the claim of first-line use, and regulators may hesitate without clear overall survival (OS) benefits. The commercial outlook is also uncertain—$5 billion peak sales seems ambitious given that ESR1-mutant patients represent a niche subset of the broader ER-positive population. The real litmus test will be whether camizestrant can outperform standard aromatase inhibitor/CDK4/6 therapy in truly treatment-na?ve patients. Until SERENA-4 reads out, AstraZeneca’s blockbuster aspirations remain speculative.
Your Turn
How does AstraZeneca’s strategy compare to previous blockbuster oncology drugs that required survival data to secure widespread adoption?
?? Regeneron’s Gene Therapy Brings Sound to the Silent—But Can It Scale?
The Facts
Regeneron’s gene therapy, DB-OTO, has demonstrated significant hearing improvements in 10 of 11 children treated for otoferlin-related genetic hearing loss in a Phase 1/2 trial. The therapy, delivered via intracochlear injection, restored hearing to “nearly normal” or “normal” levels in three of five children assessed at 24 weeks. With no serious treatment-related adverse events and FDA designations including orphan drug and fast track status, DB-OTO is positioned as a breakthrough. However, regulatory and commercialization hurdles remain, especially as Eli Lilly’s competing gene therapy, AK-OTOF, pursues a different delivery mechanism. Regeneron is actively engaging with global regulators to determine whether CHORD could serve as a pivotal trial.
Our Opinion
This study is a major milestone for genetic medicine, showcasing the power of targeted gene therapies to restore lost function. However, the challenges ahead are considerable. Otoferlin-related hearing loss is an ultra-rare condition, making the commercial viability of DB-OTO uncertain unless the technology can expand to broader indications like age-related or noise-induced hearing loss. Furthermore, the high costs of gene therapies and the necessity of a specialized surgical procedure for delivery may limit accessibility. The real question is whether Regeneron can translate this early success into a scalable platform for hearing restoration beyond this niche patient population.
Your Turn
With gene therapy advancing into rare conditions, what lessons can be learned from the pricing and market access challenges faced by previous gene therapies like Zolgensma and Luxturna?
?? Investment, M&A, and IPOs ??
?? Eli Lilly’s Billion-Dollar Bet on Molecular Glues Could Reshape Oncology
The Facts
Eli Lilly is doubling down on molecular glue degraders, committing up to $1.25 billion in milestone payments and royalties to Magnet Biomedicine for developing next-generation protein-targeting therapeutics. Magnet will receive $40 million upfront, along with an equity investment, to leverage its TrueGlue platform for oncology applications. This deal is part of a broader industry trend, with Lilly previously pledging $1.6 billion to Lycia Therapeutics and companies like AbbVie, Eisai, and Biogen also pouring billions into molecular glue partnerships. The promise of these molecules lies in their ability to induce targeted protein interactions and degrade disease-driving proteins, opening up new possibilities for previously undruggable targets.
Our Opinion
Molecular glues represent one of the most exciting frontiers in drug development, but their long-term success is far from guaranteed. While Big Pharma is racing to secure a foothold, no molecular glue therapy has yet reached blockbuster status, and challenges around specificity, delivery, and safety persist. Lilly's deepening commitment signals confidence in the platform, yet its ultimate value will depend on clinical validation and commercialization. The question remains: is this another biotech hype cycle, or are we witnessing the birth of a new drug development paradigm? If these deals pay off, molecular glues could revolutionize how we approach diseases with limited treatment options, particularly in oncology and neurodegeneration.
Your Turn
Given the growing interest in molecular glues, how should investors evaluate their potential compared to other emerging modalities like targeted protein degraders or RNA-based therapeutics?
?? SPACs Make a Biotech Comeback as BridgeBio’s Cancer Spinout Eyes $550M War Chest
The Facts
BridgeBio Oncology Therapeutics (BBOT) is reviving an old trend, opting to go public through a merger with the blank-check company Helix Acquisition Corp. II. The deal, combined with a $260 million PIPE financing led by Cormorant Asset Management and Novo Holdings, will give the newly merged company access to roughly $550 million. The funds will fuel BBOT’s early-stage oncology programs, including KRAS inhibitor BBO-8520 and PI3Kα-AKT pathway inhibitor BBO-10203, both in Phase 1 trials for lung, breast, and colorectal cancers. This SPAC merger is a rare sight in biotech’s post-2022 landscape, where enthusiasm for the model had largely faded.
Our Opinion
This deal could mark a turning point for biotech SPACs, but skepticism is warranted. While BBOT boasts a strong pipeline and backing from major investors, the track record of SPAC-led biotech listings is mixed at best—many post-merger companies have struggled with valuation drops and investor skepticism. The question is whether BBOT’s oncology assets justify this unconventional route or if the public market is simply more forgiving than private fundraising right now. If the company’s KRAS and PI3Kα inhibitors show clinical promise, this could serve as a proof-of-concept for biotech SPACs to return as a viable financing mechanism. Otherwise, it could be yet another high-risk, high-reward experiment.
Your Turn
With public biotech markets still recovering, do SPACs offer a genuine alternative for early-stage companies, or are they simply a last resort when private funding dries up?
?? Harbour BioMed Bets on CAH Therapy Exit, But Will CRH Targeting Deliver?
The Facts
Harbour BioMed’s antibody spinoff, HBM Alpha Therapeutics (HBMAT), has sold the global rights (excluding China) to its preclinical corticotropin-releasing hormone (CRH) therapy for congenital adrenal hyperplasia (CAH) in a deal worth up to $395 million in milestone payments and royalties. The unnamed buyer, described as having strong drug development expertise, will take over development of HAT001 (HBM9013), an anti-CRH-neutralizing antibody designed to reduce excessive adrenocorticotropic hormone levels. The goal is to allow CAH patients to minimize their reliance on high-dose glucocorticoids, which can cause severe metabolic and cardiovascular side effects. This move follows the FDA approval of Neurocrine Biosciences' Crenessity in December 2024, marking the first major therapeutic advance in CAH in decades.
Our Opinion
While this deal injects fresh momentum into CAH treatment, several uncertainties remain. Neurocrine’s success with Crenessity has redefined the treatment landscape, but whether an anti-CRH antibody can offer superior or complementary benefits is unknown. Additionally, preclinical success does not guarantee clinical viability, and HBMAT is ceding control at an early stage, raising questions about its confidence in taking HAT001 through trials. The sale may reflect strategic prioritization, but it could also signal hesitation about the therapy’s long-term potential. If HAT001 succeeds, Harbour’s partial exit may be seen as a missed opportunity.
Your Turn
Given the challenges in rare disease drug development, does the preclinical sale of HAT001 suggest smart risk management by Harbour BioMed, or does it reflect a lack of conviction in the antibody’s clinical and commercial potential?
?? Politics & Policy ???
?? The Rare Disease Funding Crisis: Did Politics Just Kill Lifesaving Innovation?
The Facts
The expiration of the rare pediatric disease priority review voucher (PRV) program has sent shockwaves through the rare disease community, leaving families and biotech startups scrambling for alternative funding. The program, which granted tradable FDA fast-track vouchers worth up to $150 million, incentivized drugmakers to invest in ultra-rare diseases with little commercial appeal. It was eliminated in December 2024 as a casualty of last-minute budget cuts pushed by the Trump administration and Elon Musk. Now, companies like Phoenix Nest, working on a gene therapy for Sanfilippo syndrome, fear their treatments may never reach approval due to funding shortfalls. While efforts to revive the program are underway, advocates warn that rare disease research is already suffering from NIH staff cuts, grant delays, and regulatory uncertainty.
Our Opinion
This decision reflects a fundamental failure to balance fiscal discipline with scientific progress. While critics argue that large pharmaceutical companies exploited the PRV program for blockbuster drugs like Vertex’s cystic fibrosis therapies, the vouchers undeniably fueled innovation for diseases that would otherwise be ignored. Killing the program without a well-defined replacement risks setting back rare disease research by decades, leaving small biotechs without the necessary incentives to develop lifesaving therapies. If Congress doesn’t act swiftly, we may witness a chilling effect on orphan drug development, forcing families to rely solely on philanthropy and venture capital in a sector that already struggles for funding.
Your Turn
With biotech funding tightening and government support diminishing, what alternative models—such as public-private partnerships or alternative incentive structures—could replace the PRV program and sustain rare disease drug development?
Disclaimer: The contents of this article are not to be construed with investment advice. The information presented in this article is a compilation of current events, technical analyses, corporate press releases, and the author's personal viewpoints about the biotechnology industry. While efforts have been made to provide accurate and timely information, there may be inadvertent errors, omissions, or inaccuracies. Therefore, investment decisions should not be made solely based on the content of this article. The article may contain statements that are forward-looking in nature, encompassing predictions and future expectations that are subject to inherent risks and uncertainties; as such, actual outcomes may significantly deviate from those expressed or implied herein. This article serves purely as an informational and entertainment resource, and should not be construed as an endorsement to purchase or sell any financial securities. Prior to engaging in any investment activities, it is imperative that you conduct comprehensive due diligence and consult with a qualified financial advisor.