Staying single: Lilly looks to optimize antibody manufacturing for COVID-19

Eli Lilly is testing several antibodies in its efforts against COVID-19 but says a monotherapy, if successful, would help optimize manufacturing.

Eli Lilly has several potential therapies in the clinic attempting to take on COVID-19, the disease caused by the SARS-CoV-2 novel coronavirus.

But speaking during the firm’s second quarter financial call last week, chief scientific officer Dan Skovronsky said the two programs he is most excited about are virus neutralizing antibodies for the treatment and prevention of COVID-19 are LY-CoV555 and LY-CoV016, respectively forged through a collaboration with AbCellera in March and a license deal with Junshi Biosciences in May.

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“Both the antibodies have completed dosing in their Phase I studies with safety and PK results that support advancing the molecules,” he told investors.

“555 is further along in development and is progressed to a large dose ranging Phase II study in ambulatory patients recently diagnosed with COVID-19. Here we are focused on reducing viral load. The study is enrolling quickly, and we should have data to report by Q4. This will be our first opportunity to share human efficacy data from the neutralizing antibody program.”

He added the two antibody candidates will also be tested in combination together, “in case such a combination is needed to combat viral resistance.”

However, he admitted, the main focus will be to develop a monotherapy to help maximize Lilly’s manufacturing network.

“The advantages of monotherapy are obvious,” he said. “It’s simply that if you have one antibody, you can manufacture twice as much as a combo of two antibodies, three times as much as three antibodies. In a situation like this, I think they are just starting a tradeoff that might indicate maximizing manufacturing capacity is the key objective and so that’s where we’re heading here.”

Skovronsky also questioned whether a combination offers increased efficacy. “A single antibody can generally neutralize the virus just as well as combinations of antibody. The reason that people sometimes try combinations of antibodies, because they’re worried that over time resistance could emerge.”

He continued: “What we’ll be looking for instead is whether or not there’s an emergence of resistance. There are some factors that make that somewhat less likely here. I think the extremely high potency of 555 and its ability to effectively neutralize virus very, very quickly may decrease the risk of resistance. We’ve done some primary studies and we’ve not seen resistance emerge in those studies at all. But we’ll be watching patients carefully and we have the combination therapy that will move forward as a backup if resistance is seen.”