1️⃣➡️3️⃣ Two of Eli Lilly’s top minds, Jake Van Naarden and David Hyman, describe themselves as “blunt pharma executives.” In that vein, they said at ASCO this year that Lilly tries as much as possible to avoid running mid-stage trials for new cancer drugs. Phase 2 studies in cancer are for “when you’re not sure” a drug works, Van Naarden told Lei Lei, and the company wants to put more effort toward promising early-stage research and resource-intensive Phase 3 trials.

Lilly is better known for its diabetes and obesity drugs, but its $8 billion acquisition of Loxo Oncology in 2019 gave it a significant foothold in the cancer space. (Van Naarden and Hyman both joined from Loxo and are now president of Lilly Oncology and Lilly’s chief medical officer, respectively.) After the buyout, the pair set about rebuilding the company’s entire cancer business, tossing out 14 of the 19 cancer programs Lilly had before the Loxo acquisition.

The company’s most promising cancer drug is an oral SERD, a category in which competition is heating up among big pharma companies. Lilly’s drug, called imlunestrant, is currently in an 8,000-patient Phase 3 trial that’s testing the treatment after surgery for early-stage breast cancer patients.

Other ASCO highlights:

• I wrote about AstraZeneca’s competing oral SERD trial, in which the company switched patients from their traditional regimen to an experimental drug before their cancer progressed.
• Takeda and Protagonist Therapeutics nabbed a plenary session for their rare blood disease drug, which they hope can reach blockbuster status.
• Much discussion took place over how and when to best use checkpoint inhibitors as they continue to move into earlier lines of treatment.

🥶 The opening months of 2025 have offered no respite to the chilly biotech market of the last few years, biotech correspondent Kyle LaHucik reported this week. Despite the comeback everybody seems to want, there’s been a steady drumbeat of restructurings, pipeline cuts, layoffs and short-lived pivots. Kyle highlighted iTeos Therapeutics, once a darling of the anti-TIGIT class of biotechs, as an embodiment of the current struggles. iTeos had a clinical failure and lost a partnership with GSK this spring. It’s now shut down.

Some of the numbers paint a stark picture of the industry. There were six strategic reviews launched in April alone, with 30 active strategic reviews as of May 4, according to Raymond James bankers who provided data for this story. At least 168 biotechs have negative enterprise value as of May 16, according to Stifel bankers. And the dreariness follows 90 total restructurings in 2024.

The icy environment also appears to be extending to reverse mergers. There were at least 16 reverse mergers in 2024, but fewer than five have been disclosed so far this year — including deals that have been announced but haven’t yet closed. Those that do take place still seem to perform better than traditional IPOs, however. Since the start of 2023, the median stock performance of reverse mergers is negative 10% versus negative 62% for IPOs.

💰 It’s the biggest biopharma deal since January: Sanofi is paying $9.1 billion to acquire Blueprint Medicines, paying $129 per share in cash for a premium of around 27%. The deal also features contingent value rights for one of Blueprint’s drug candidates, bringing the potential value to $9.5 billion.

The big prize is the mastocytosis medicine Ayvakit, but Sanofi CEO Paul Hudson said there’s more value to be found in Blueprint’s mid-stage pipeline and its “established presence among key specialist physicians.” Ayvakit was approved in 2020 and had $479 million in sales last year, with analysts projecting a potential peak value of $2 billion annually.

The deal caps off a recent flurry of activity for Sanofi. In May, Sanofi announced plans to buy Vigil Neuroscience and its TREM2 agonist for Alzheimer’s for $470 million upfront. And in April, it spent $125 million upfront to license two immunology candidates targeting TL1A from a little-known biotech called Earendil Labs.

🤔 FDA and HHS officials laid off by DOGE were supposed to stop working this week. However, many are still collecting paychecks as the restructuring remains in limbo due to a series of court cases challenging the legality of the cuts, according to senior editor Zachary Brennan. Many federal workers are looking for new jobs anyway, but their government salaries are now being paid by taxpayers instead of user fees.

Top FDA officials Marty Makary and Vinay Prasad continued their efforts to shake things up this week. In a series of recent talks, Makary said he’s looking at ways to speed drug approvals while cutting user fees. And Prasad noted he wants to “rapidly make available” even small advances in rare disease, undercutting earlier perceptions of him potentially bringing a higher regulatory bar.

💊 Saynor chatted with senior biopharma correspondent Andrew Dunn this week, sharing his views on President Donald Trump’s impact on the industry, preparing for the launch of generic GLP-1s, and whether Mark Cuban's Cost Plus Drug Company actually competes with generic drugmakers.

Generics may seem like a boring, if vital, part of the drug business. But Saynor is a colorful, outspoken leader who seemingly enjoys the role of pharma’s heel. And more importantly, Wall Street is buying what he’s selling. Since Sandoz spun out of Novartis in October 2023, its share price is up over 80%. Check out their conversation here.