red lungs
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Adam Feuerstein is a senior writer and biotech columnist, reporting on the crossroads of drug development, business, Wall Street, and biotechnology. He is also a co-host of the weekly biotech podcast The Readout Loud and author of the newsletter Adam’s Biotech Scorecard. You can reach Adam on Signal at stataf.54.

This is the online version of Adam’s Biotech Scorecard, a subscriber-only newsletter. STAT+ subscribers can sign up here to get it delivered to their inbox.

Gossamer Bio will be reporting the outcome of a Phase 3 clinical trial in pulmonary arterial hypertension, a progressive lung disease, before the end of February. I’m watching this readout with particular interest because it could help answer one of my favorite biotech questions: Is it ever a good idea to run a Phase 3 study based on a “positive” post-hoc subgroup observed in an otherwise negative Phase 2 study?

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Never, would normally be my skeptical, absolutist answer, except I’m trying to be more open-minded in my older age. Look at Nektar Therapeutics, which has a drug that was given up for dead but might actually prove to be a blockbuster. It can happen. And in Gossamer’s defense, the Phase 2 study results were modest and disappointing, not an outright failure. The company’s explanations for the mid-stage setback — too many stable, low-risk patients enrolled and Covid pandemic disruptions — are also not unreasonable.

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