Less than a month after taking over as interim CEO of Legend Biotech, Alan Bash is signaling continuity rather than a reset.
Bash joined Legend in October 2024 to lead its Carvykti business after two oncology biotech CEO roles and 23 years at Bristol Myers Squibb. Now, he’s overseeing the company as its commercial engine expands and its next generation of cell therapies move into view.
Carvykti, the autologous CAR-T treatment Legend markets with Johnson & Johnson for relapsed or refractory multiple myeloma, generated approximately $657 million in second-quarter net trade sales, up 50% from the same period last year. Legend said in its second-quarter update that the therapy is now available at 348 sites across 19 markets.
But commercial growth does not erase the long-standing burdens of delivering a personalized cell therapy. Patients still must travel to an activated treatment center, undergo apheresis, wait while their cells are reengineered, return for infusion and remain under close monitoring. Bash said widening access requires as much attention to those logistical steps as to the underlying science.
Legend is also testing whether in vivo CAR-T could eventually remove several links from that chain. Its investigational therapy LB2501 generated early clinical proof-of-concept data in a small phase 1 study in relapsed or refractory B-cell non-Hodgkin lymphoma, but the approach still must establish safety, durability and competitive efficacy in larger studies.
Here, Bash discusses his immediate priorities, the access lessons Legend learned from Carvykti and what in vivo CAR-T must prove before it can fulfill its broader promise.
This interview has been edited for brevity and style.
PHARMAVOICE: Having led the Carvykti business before becoming interim CEO, what are your immediate priorities — and where should we expect continuity versus change?
ALAN BASH: My focus right now is maintaining all of our aligned strategic priorities. There are no changes in terms of the company’s strategic direction. We’ve set that as a board and management team, and we are executing on it.
Those priorities are continuing to advance Carvykti and advancing our pipeline. My job as interim CEO is to make sure we stay on track with those.
As Carvykti expands globally and into earlier treatment settings, what are the biggest remaining barriers to reaching more eligible patients?
CAR-T is a very specialized therapy, and it has the potential in a one-time infusion to cure patients. We have more work to do to realize that full potential, but that is the promise.
At the same time, the specialized nature of the therapy creates logistical barriers. A patient first needs to undergo apheresis so their cells can be collected. We bring those cells to our manufacturing facilities, reengineer them over a period of about four weeks and then notify the treatment center that the patient’s cells are ready. The patient returns, receives the infusion and is monitored afterward.
That means several visits to an activated treatment center. Our job, along with our partner Johnson & Johnson, is to remove those barriers, increase access and bring the therapy closer to patients.
What is Legend doing now to reduce that burden on patients?
One way is generating data showing that Carvykti can be administered safely and practically in the outpatient setting. Patients may be able to receive treatment in an outpatient wing and go home that day, which frees capacity at hospitals and academic centers and can make for a better patient experience.
We are also educating patients about the MyCarvykti Patient Support Program. Eligible patients may receive support with travel-related expenses, including transportation, lodging and meals, when they need to travel to an activated treatment center.
Another major advance came when the FDA eliminated the CAR-T REMS last year and updated the product labeling. The driving restriction was reduced from eight weeks to two weeks, which can make a meaningful difference for patients who need to commute or operate machinery for work.
What has Legend learned from scaling Carvykti that it could not have anticipated during development?
A significant investment is required to identify the access and logistical barriers and remove them. It is not something one company can do alone. There are efforts across companies, trade associations, conferences and other organizations dedicated to bringing CAR-T into the community.
At the end of the day, we can have a wonderful technology, but if it does not reach all the patients who could benefit, we are not doing right by the myeloma population.
Where does autologous CAR-T fit as Legend develops allogeneic and in vivo approaches — and what must LB2501 prove before in vivo CAR-T can deliver on its promise?
Legend is looking at different ways to advance CAR-T across autologous, allogeneic and in vivo approaches. We have a leading autologous franchise with Carvykti and pipeline programs exploring off-the-shelf solutions. We are also excited about in vivo CAR-T, although it is still early.
With LB2501, a patient receives a direct infusion of a lentiviral vector carrying the genetic material that enables T cells to express the chimeric antigen receptor. Your body is essentially the manufacturing facility. The body performs the T-cell engineering, potentially removing apheresis, external manufacturing turnaround time and the lymphodepletion used before reinfusion of manufactured cells.
We need additional clinical data. First is safety: whether the treatment can be administered safely, how acute events such as cytokine release syndrome are managed and whether any later safety events emerge with longer follow-up.
The other piece is efficacy. If we are going to provide a one-time in vivo treatment, we need a similar level of efficacy to the alternatives. It does not have to match autologous CAR-T exactly one to one, but it has to be in the neighborhood so patients can see that the trade-off is worthwhile. A useful benchmark could be other off-the-shelf options, such as bispecific antibodies or allogeneic treatments.
What would success for Legend look like over the longer term?
There are still too many families learning that someone they love has been diagnosed with cancer, has had a recurrence or is losing their battle with cancer. I cannot personally rest until we are treating and curing more patients.
Looking five, 10 or 15 years ahead, I want us to say that we are curing many more patients in earlier lines and giving patients the chance to receive CAR-T earlier in their treatment journey, so that more patients can get off treatment and live their lives.
