ON APPEAL FROM THE HIGH COURT OF JUSTICE
CHANCERY DIVISION
PATENTS COURT
THE HON MR JUSTICE ARNOLD
[2015] EWHC 1796 (Pat)
Strand, London, WC2A 2LL |
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B e f o r e :
LORD JUSTICE KITCHIN
and
LORD JUSTICE FLOYD
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HOSPIRA UK LIMITED |
Appellant |
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- and - |
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GENENTECH, INC. |
Respondent |
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Richard Meade QC, Thomas Mitcheson QC and Jeremy Heald (instructed by Taylor Wessing LLP) for the Respondent
Hearing dates: 8 November 2016
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Crown Copyright ©
Lord Justice Floyd:
The patent
"However, despite the association of ErbB2 overexpression with poor prognosis, the odds of a HER2-positive patients responding clinically to treatment with taxanes were greater than three times those of HER2-negative patients… [Trastuzumab] was shown to enhance the activity of paclitaxel… against breast cancer xenografts in nude mice… which express high levels of HER-2."
"These data indicate that the combination of anti-ErbB2 antibody treatment with chemotherapy markedly increases the clinical benefit, as assessed by response rates and the evaluation of disease progression."
The claims
"[1] Use of an anti-ErbB2 antibody in the preparation of a medicament
[2] for treatment to provide clinical benefit as measured by increased time to disease progression of malignant breast cancer characterised by overexpression of ErbB2 in a human patient,
[3] wherein said antibody binds to epitope 4D5 within the ErbB2 extracellular domain sequence as determined by a cross-blocking assay using said antibody and antibody 4D5 obtainable from deposit ATCC CRL 10463,
[4] and wherein the method comprises combined administration of the antibody with a chemotherapeutic agent which is a taxoid and not in combination with an anthracycline derivative,
[5] wherein the combined administration has:
[a] clinical efficacy as measured by determining time to disease progression and
[b] reduced myocardial dysfunction compared with combined administration of the antibody and anthracycline derivatives."
Baselga 97
"Overexpression by the HER2 gene plays a significant role in breast cancer pathogenesis, and the phenomenon is commonly regarded as a predictor of a poor prognosis. HER2 overexpression has been linked to sensitivity and/or resistance to hormone therapy and chemotherapeutic regimens, including CMF (cyclophosphamide, methotrexate, and fluorouracil) and anthracyclines. Studies of patients with advanced disease demonstrate that, despite the association of HER2 overexpression with poor prognosis, the odds of HER2-positive patients responding clinically to taxanes were greater than three times those of HER2-negative patients. Further studies in preclinical models used combination therapy for breast cancer cells that overexpress HER2, and the use of agents that interfere with HER2 function plus paclitaxel (Taxol) resulted in significant antitumor effects."
"An area of increasing interest in clinical research on taxanes is the possible role of oncogenes, such as HER2, in determining clinical response to paclitaxel. Studies have examined whether strategies can be designed to increase the agent's efficacy (or curb resistance to it) in breast cancers that overexpress HER2. Available data that will be presented in this review suggest that HER2 overexpression may influence the response to paclitaxel in patients with metastatic breast cancer and that anti-HER2 monoclonal antibodies significantly increase the antitumor activity of paclitaxel in vitro and in vivo."
"found to be safe and to have dose-dependent pharmacokinetics in two prior phase I clinical trials."
"In 37.7% of patients, tumors were positive by immunohistochemistry with the 4D5 antibody. The overall response to taxanes for all patients in this analysis was 46.7%. Remarkably, 65.2% of patients with HER2-positive tumors responded vs 35.5% of patients with HER2-negative tumors ...
Thus, despite a positive correlation of HER2 expression and poor prognostic features, the odds of HER2-positive patients responding clinically to taxanes were greater than 3 times those of HER2-negative patients."
"A novel approach that is currently being explored is the combined use of therapies directed at p185HER2, such as MoAbs given alone or in combination with conventional chemotherapeutic agents, including paclitaxel."
"Thus, [trastuzumab] is clinically active in patients who have metastatic breast cancers that overexpress HER2 and have received extensive prior therapy. A confirmatory study that will include 200 patients with less heavily pretreated metastatic disease is currently underway."
"Therapy with MoAb 4D5 alone produced a 35% growth inhibition, and paclitaxel alone resulted in a 35% growth inhibition when compared with animals treated with a control MoAb. The treatment with paclitaxel plus 4D5 resulted in major antitumor activity, with 93% inhibition of growth. This result was markedly better than an equipotent dose of doxorubicin … and 4D5… In addition, paclitaxel combined with 4D5 resulted in the disappearance of well-established xenografts."
"In this group of patients with expected cisplatin resistance, the observed response rate to the combined therapy was 25%, suggesting that the synergy observed in the laboratory was reproducible in the clinic. In addition the combined therapy was no more toxic than cisplatin alone."
"The predictive value of HER2 overexpression for paclitaxel response requires independent confirmation in advanced disease and early breast cancer. This question could be addressed in ongoing studies of paclitaxel-based adjuvant therapy in breast cancer. In preclinical models, the combined therapy of breast cancer cells that overexpress HER2 with agents that interfere with HER2 function and paclitaxel results in a marked antitumor effect. One such strategy, the combination of anti-HER2 MoAb with paclitaxel, is currently being evaluated. If the results of these studies are positive, we might be faced with a novel paradox, in which expression of a receptor that confers a worse prognosis provides us with an opportunity for increased response to taxanes."
Obviousness – law
"9. I start with the well-known passage from the judgment of Kitchin J (as he then was) in Generics (UK) Ltd v H. Lundbeck A/S [2007] EW HC 1040 (Pat), at [72], which has been approved at the highest level:
"The question of obviousness must be considered on the facts of each case. The court must consider the weight to be attached to any particular factor in the light of all the relevant circumstances. These may include such matters as the motive to find a solution to the problem the patent addresses, the number and extent of the possible avenues of research, the effort involved in pursuing them and the expectation of success."
10. It follows that the court is required to embark on a multi-factorial assessment. The approach of the appellate court to such questions is well-known: the decision is not open to independent evaluation in this court unless the judge has made an error of principle: see Biogen Inc v Medeva Plc [1997] RPC 1 at [45] per Lord Hoffmann.
11. It is also well-settled that "obvious to try" is not a substitute test for obviousness: see e.g. per Lewison LJ in Medimmune Ltd v Novartis Pharmaceuticals UK Ltd [2012] EWCA Civ 1234, [2013] RPC 27 at [181]. There is only one statutory question, namely whether the invention was obvious at the priority date. In the same case at [90] to [95] Kitchin LJ explained that whether the invention was obvious to try was merely one of many considerations which it may be appropriate for the court to take into account in addressing the statutory question. It must in any case be coupled with a reasonable or fair prospect of success. At [91] Kitchin LJ emphasised:
"Whether a route has a reasonable or fair prospect of success will depend upon all the circumstances including an ability rationally to predict a successful outcome, how long the project may take, the extent to which the field is unexplored, the complexity or otherwise of any necessary experiments, whether such experiments can be performed by routine means and whether the skilled person will have to make a series of correct decisions along the way."
12. Thus a judge's assessment whether an approach has a reasonable or fair prospect of success is itself another multi-factorial assessment, where this court should again pay proper respect to the evaluation of a trial judge.
13. There is also no single standard of what amounts to a fair expectation of success. Thus Jacob LJ's statement in Saint Gobain PAM SA v Fusion-Provida Ltd [2005] EWCA Civ 177 at [35] that it must be "more-or-less self-evident that what is being tested ought to work" is far from being a test of universal application. In Novartis AG v Generics (UK) Ltd (trading as Mylan) [2012] EWCA Civ 1623 Kitchin LJ (with whom Lewison and Munby LJJ agreed) warned against imposing a straitjacket on the law by adopting any form of words as a standard. He said at 55:
"What is a reasonable or fair expectation of success will again depend upon all the circumstances and will vary from case to case. Sometimes, as in Saint Gobain, it may be appropriate to consider whether it is more or less self-evident that what is being tested ought to work. So, as this court explained in that case, simply including something in a research project in the hope that something might turn up is unlikely to be enough. But I reject the submission that the court can only make a finding of obviousness where it is manifest that the test ought to work. That would be to impose a straitjacket on the assessment of obviousness which is not warranted by the statutory test and would, for example, preclude a finding of obviousness in the case where the results of an entirely routine test are unpredictable."
14. Indeed, so much was confirmed by Lord Hoffmann in Conor Medsystems v Angiotech Pharmaceuticals [2008] UKHL 49, [2008] RPC 28 at [42], approving Jacob LJ's comprehensive review of the authorities in this area in the Court of Appeal in that case, including his view that "how much of an expectation depended upon the particular facts of the case.""
The judgment of Arnold J
"The issue is whether the skilled person would have a fair expectation of success, meaning a fair expectation of increased efficacy as measured by TTP of the combination compared to taxanes alone if he were to undertake such a trial".
"Putting it simplistically, would the skilled person think that the glass was half full (or more than half full, as Hospira contend) or half empty (or more than half empty as Genentech contend)?"
i) He first considered motivation, concluding that the skilled person would be strongly motivated to find an effective treatment for HER2-positive breast cancer, which was badly needed.ii) Next the judge tackled whether the trial would be a routine one. He said that it was common ground that phase III trials were regarded as routine in the sense that they were well-known and frequently undertaken. Moreover in the present case that was particularly so, given that the design of the trial had already been established and described in Baselga 97.
iii) Nevertheless, it was common ground that phase III trials were regarded as logistically complicated, time-consuming and expensive. That, however, did not mean that the trial described in Baselga 97 would be regarded as technically burdensome. The trials would be no more technically burdensome than carrying out the teaching of the patent itself. They would thus take time and money, but would not be technically burdensome.
iv) Next, the judge considered whether the trial would present a risk to patients. He pointed out that the skilled person would appreciate that trastuzumab, as a humanised antibody, was designed to present a low risk of side effects, and that Baselga 97 presented evidence that this was indeed the case. Moreover, as all the patients in the trial would receive standard chemotherapy, they would not miss out on a treatment they would otherwise receive.
v) The judge also summarised what he considered to be the alternative options for the skilled person to follow. These were (a) taking monotherapy with trastuzumab further prior to combining the therapies, (b) carrying out a phase II trial of the combination before carrying out the phase III trial and (c) following up the anthracycline limb of the phase III trial. He considered these options to be very limited and none of them to detract from the obviousness of carrying out the phase III trial of trastuzumab and taxane.
vi) Next the judge considered what he called the scientific context. This included (a) the general rationale for combined therapies and (b) the prior work on trastuzumab and combinations thereof. As to (a), he held that the skilled person would know that combined therapy was a well-established approach to the treatment of cancer and that the combination of trastuzumab and a taxane fitted the rationale for combining agents. This conclusion refers back to an earlier section in the judgment at paragraph 37 where the judge explained the rationale in the following terms:
"The evaluation and use of combination therapy, i.e. administering combinations of different drugs, was common. The idea behind combination therapy is to kill the cancer cells to the greatest extent possible in a single course of treatment by using different agents with differing methods of action and minimal overlap in toxicity profiles. In some instances combination therapy turned out not to provide any additional benefit, but these examples did not detract from the general understanding that a logical combination of two drugs which were individually effective, which were directed at different targets and which did not have significantly overlapping toxicity would be expected to have greater efficacy than either drug individually. It was standard practice to start to experiment with combinations even before a licence was obtained for monotherapy with a new agent."vii) Under the heading "No lions in the path", the judge dealt with an argument by Genentech that, as taxanes were among the leading chemotherapeutic agents available, it was a "big ask" to try and obtain any increased efficacy as compared with the taxane alone. The judge accepted this, but did not think it detracted from the message conveyed by Baselga 97.
viii) Finally in this section the judge dealt with failure rates in phase III trials. The judge accepted that the skilled person would know that it was not at all uncommon for phase III trials to fail and would appreciate that the fact that a phase III was being undertaken would not necessarily mean that it would be successful.
"39. There is disagreement between the parties as to how reliable positive results in mouse xenograft studies were perceived to be as predictors of efficacy in humans. Genentech contend that mouse xenograft data were recognised to be unreliable, whereas Hospira contend that they were universally used to judge whether to progress a drug to clinical trials and were a good model for testing drug interactions. In my judgment the evidence demonstrates that both parties are correct.
40. As Prof Barrett-Lee explained, mouse xenograft models had a number of well-recognised shortcomings, in particular the fact that the rest of the biological system was murine and that the mice did not have functioning immune systems. As a result, as he put it, "it was well-known that mouse xenografts were not always reliable predictors of clinical efficacy in humans [my emphasis]". Accordingly, he said, "evidence of activity [in mouse xenografts] provided little assurance that the agent would ultimately demonstrate clinical efficacy in humans [my emphasis]". Prof Calvert agreed that mouse xenograft models did not always predict efficacy accurately. He insisted, however, that they were universally used to decide whether to take drugs forward. Prof Calvert also said that they were a good model for testing drug interactions. I did not understand Prof Barrett-Lee to dispute these points, subject to his overriding point that mouse xenograft models were not considered to be reliable predictors of clinical efficacy in humans."
"Prof Calvert's overall view was that the skilled person would have a reasonable expectation of success in the Phase III trial. Prof Barrett-Lee was not prepared to go that far, but he accepted that it was justified to proceed with the Phase III trial. In my judgment the conclusion to be drawn from the matters considered above is that the skilled person would have had a fair expectation of success in the sense defined above. Accordingly the claimed inventions were obvious."
The appeal
"..an illegitimate amalgam of the requirements of inventiveness (Art. 56 of the EPC) and either sufficiency (Art. 83) or support (Art. 84) or both. It is the claimed invention which has to involve an inventive step. … The alleged inventiveness lay in the claim that the product would have a particular property, namely to prevent or treat restenosis. … So the question of obviousness was whether it was obvious to use a taxol-coated stent for this purpose."
"In my opinion it is absolutely clear that the teaching of the specification, so far as it supported claim 12, was that a taxol-coated stent would prevent or treat restenosis. …
The question was whether that was obvious and not whether it was obvious that taxol (among many other products) might have this effect."
"Would the trial be burdensome? It is common ground that Phase III trials were regarded as logistically complicated, time-consuming and expensive. But that does not mean that the Phase III trial described in Baselga 97 would be regarded as technically burdensome. Counsel for Genentech submitted that the trial would be burdensome because of the need for anyone other than Genentech to make, purify and formulate an anti-HER2 antibody and conduct pre-clinical and clinical trials on it before starting the Phase III trial. (Rightly, he did not rely upon the fact that no one else could use trastuzumab itself because of Genentech's basic patent.) As counsel for Hospira pointed out, however, this is no more than the skilled person would have to do in order to implement the Patent. If the skilled person could not do these things without undue burden, the Patent would be insufficient. Although the Patent contains instructions on how to do these things, it is not suggested that those assisting the skilled person would not know how to do them without such instructions, nor is it suggested that the instructions would reduce the amount of work required. Thus the work would take time and money, but it would not be technically burdensome."
"… I do not consider that the excitement generated by the presentation of the Phase III results at ASCO 1998 assists Genentech. The excitement was generated by the confirmation of a new and more efficacious therapy for HER2-positive breast cancer. That represented an important advance, but it does not show that the skilled reader of Baselga 97 would not have had a fair expectation of success. That is particularly true if, as is implicit in Genentech's case, those who were excited at ASCO 1998 were not familiar with Baselga 96 (in which case they would unlikely to have been familiar with Baselga 94 either)."
Conclusion
Lord Justice Kitchin
Lord Justice Longmore