Following the news that Merck is to acquire Imago Biosciences, a clinical-stage biotech developing the lysine-specific demethylase 1 (LSD1) inhibitor bomedemstat for the treatment of myelofibrosis (MF);

Sam Warburton, Oncology Analyst at GlobalData, a leading data and analytics company, offers his view:

“Big pharma appears to be setting its sights on the relatively small but potentially highly lucrative myelofibrosis market. This is the second acquisition this year to exceed $1 billion in value for a myelofibrosis drug, the first being when GSK acquired Sierra Oncology in June 2022 for $1.9 billion to acquire the rights to momelotinib—a promising new myelofibrosis drug.

“Bomedemstat treatment alone has shown efficacy in patients that are heavily pre-treated and have advanced-stage disease; a patient population with limited therapeutic options. Moreover, bomedemstat showed a very unique set of advantages for these patients, such as reducing their symptom burden and mitigating anemia—a common symptom in advanced patients.

“Merck is now recruiting for a Phase II trial that will evaluate how effective bomedemstat is in combination with Incyte’s Jakafi/Jakavi, the current most effective myelofibrosis drug given as a first-line treatment. This provides a competitive advantage over GSK’s momelotinib, which is currently under FDA review for approval early next year.

“An area where bomedemstat seems less promising is for reducing spleen size in myelofibrosis patients. However, if the drug is shown to be effective in combination with Jakafi/Jakavi, which is well-known to significantly reduce spleen size but exacerbate anemia, then this could make for a very powerful combination therapy and could out compete momelotinib.

“GSK has had a tumultuous year in the oncology market, with the market withdrawal of an expected blockbuster cell therapy Blenrep, axing of the development of a promising cell therapy NY-ESO-1 with Lyell Immunopharma, and the FDA imposing restricted use for Zejula in ovarian cancer. Merck’s bomedemstat poses a serious threat to momelotinib’s market position in myelofibrosis, which could present a further loss for the British pharma giant.”