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A $4.9B acquisition that gave Gilead full ownership of Forty Seven's immuno-oncology pipeline, targeting the CD47 "don't eat me" pathway in blood cancers. The deal quickly soured, with the lead program later shelved amid safety and efficacy setbacks.
Ranks computed across 828 graded deals (Critic + Outcome Score both present).
Gilead acquired Forty Seven for $4.9B for immuno-oncology.
Gilead reassessing magrolimab after FDA placed a partial clinical hold on four mid-stage solid-tumor trials (colorectal, breast, head & neck) in Feb 2024, one…
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Gilead acquired Forty Seven for $4.9B for immuno-oncology.
Hematopoietic stem-cell transplant (HSCT) conditioning is split between toxic standard-of-care and emerging non-genotoxic antibody approaches. Alkylating agents / cytotoxic chemotherapy (standard of care): busulfan (Busulfex, Otsuka/generic), cyclophosphamide (Cytoxan, generic), melphalan (Alkeran, GSK/Evomela, Acrotech), fludarabine (Fludara, Sanofi/generic) and total body irradiation remain backbone myeloablative regimens. Antibody-drug conjugates: Mylotarg (gemtuzumab ozogamicin, Pfizer CD33-ADC, AML-adjacent conditioning research use). Anti-cKIT antibodies (non-genotoxic): FSI-174 (magrolimab + anti-cKIT combo, Gilead/Forty Seven, Phase 1); briquilimab (JSP191, Jasper Therapeutics, Phase 1/2 SCID, MDS/AML, severe aplastic anemia); KER-050 (elritercept, Keros, conditioning-adjacent for ineffective hematopoiesis). Anti-CD117 ADC: emapalumab (Gamifant, Sobi) for pre-transplant HLH not same class. Immune-depleting agents: Thymoglobulin (anti-thymocyte globulin, Sanofi), alemtuzumab (Lemtrada/Campath, Sanofi). Commercial read: the anti-cKIT conditioning niche remains small (estimated fewer than 25,000 allogeneic HSCTs annually in U.S./EU) and has been deprioritized by Gilead following 2024 magrolimab program halt. Jasper's briquilimab is the leading external asset; commercial viability is gated by transplant-center adoption economics and payer acceptance of premium pricing vs. generic conditioning chemotherapy.
MDS treatment stratifies by IPSS-R risk and MOA class across six active competitive segments. Hypomethylating agents (HMA; higher-risk standard of care): Vidaza (azacitidine, Bristol Myers Squibb/generic, approved May 2004), Dacogen (decitabine, Otsuka/generic), Inqovi (oral decitabine/cedazuridine, Taiho/Otsuka, approved July 2020 with oral convenience advantage). Erythropoiesis-stimulating agents (ESAs; lower-risk anemia): Procrit/Epogen (epoetin alfa, Johnson & Johnson/Amgen and biosimilars), Aranesp (darbepoetin alfa, Amgen). TGF-beta superfamily ligand traps (lower-risk anemia): Reblozyl (luspatercept-aamt, Bristol Myers Squibb; COMMANDS trial positive vs ESA in 2023, with first-line label expansion August 2023) generated approximately $1.6B in 2024 BMS net sales. Maintenance hypomethylator: Onureg (oral azacitidine, Bristol Myers Squibb, AML maintenance label). HIF-PH inhibitor: roxadustat (Evrenzo, AstraZeneca/FibroGen, approved outside U.S. for renal anemia, tested in MDS). Anti-CD47: Magrolimab (Gilead) ENHANCE-MDS Phase 3 failed futility analysis October 2023, MDS program discontinued, driving Gilead's over $2.7B impairment of Forty Seven goodwill. Splicing modulators and novel small molecules: emavusertib IRAK4 (Curis, Phase 1/2), H3B-8800 SF3B1 splicing modulator. Lenalidomide (Revlimid, BMS/generic) anchors del(5q) MDS. Commercial read: Reblozyl owns lower-risk ESA-refractory anemia; azacitidine plus venetoclax is the emerging higher-risk combination. Magrolimab MDS opportunity is effectively zero; the $4.9B Forty Seven thesis was predicated on MDS and AML wins that did not materialize.
AML is a mutation-stratified market with MOA-segmented competition across seven active mechanism classes. Hypomethylating agents (HMA) backbone: Vidaza (azacitidine, Bristol Myers Squibb/generic), Dacogen (decitabine, Otsuka/generic), and Inqovi (oral decitabine/cedazuridine, Taiho/Otsuka) anchor frontline unfit therapy. BCL2 inhibitors: Venclexta/Venclyxto (venetoclax, AbbVie/Roche, approved 2018 in combination with HMA or low-dose cytarabine) generated approximately $2.6B in 2024 AbbVie sales across indications and is standard of care for unfit patients. FLT3 inhibitors: Rydapt (midostaurin, Novartis), Xospata (gilteritinib, Astellas), Vanflyta (quizartinib, Daiichi Sankyo, approved July 2023 for newly diagnosed FLT3-ITD). IDH inhibitors: Idhifa (enasidenib, Bristol Myers Squibb/Servier IDH2), Tibsovo (ivosidenib, Servier IDH1), Rezlidhia (olutasidenib, Rigel IDH1). Menin inhibitors: Revuforj (revumenib, Syndax, approved November 2024 for KMT2A-rearranged relapsed/refractory AML); ziftomenib (Kura/Kyowa Kirin, Phase 3). Anti-CD33 ADC: Mylotarg (gemtuzumab ozogamicin, Pfizer). CD47 antagonists: Magrolimab (Gilead) discontinued AML development in 2024 after ENHANCE-2 futility and safety findings (excess deaths); Pfizer/Trillium's maplirpacept (TTI-622) is Phase 1b. Commercial read: the CD47 franchise thesis collapsed; Gilead's $4.9B Forty Seven acquisition faces near-total impairment in AML. Venetoclax plus HMA owns the unfit frontline; mutation-targeted agents fragment the remaining share.
DLBCL is a crowded B-cell lymphoma market with MOA-stratified second-line and beyond. CAR-T cell therapies: Yescarta (axicabtagene ciloleucel, Gilead/Kite) earned $1.5B in 2024 sales and won 2L indication post-ZUMA-7; Breyanzi (lisocabtagene maraleucel, BMS) and Kymriah (tisagenlecleucel, Novartis) are the peers. CD20xCD3 bispecifics: Columvi (glofitamab, Roche, approved June 2023) and Epkinly (epcoritamab, Genmab/AbbVie, approved May 2023) compete in 3L+ at convenient dosing schedules. Antibody-drug conjugates: Polivy (polatuzumab vedotin-piiq, Roche CD79b) approved first-line combo 2023, Zynlonta (loncastuximab tesirine, ADC Therapeutics CD19-ADC). Immunomodulators: Revlimid (lenalidomide, BMS/generic). XPO1 inhibitor: Xpovio (selinexor, Karyopharm). Anti-CD47: Magrolimab (Gilead) discontinued DLBCL development after sub-optimal Phase 1b/2 data in rituximab combo and Gilead's 2024 program-wide halt following AML failures. Backbone R-CHOP with or without Polivy remains first-line. Commercial read: Gilead already owns the dominant DLBCL asset in Yescarta; the magrolimab DLBCL thesis is effectively written off, and the franchise now competes on Yescarta CAR-T positioning against Breyanzi 2L expansion.
Gilead completed $4.9B acquisition of Forty Seven Inc., gaining magrolimab, an anti-CD47 antibody targeting the 'don't eat me' signal on cancer cells.
Gilead discontinued ENHANCE Phase 3 trial of magrolimab in MDS after the drug failed to show efficacy, marking a critical setback for the $4.9B acquisition thesis.
Gilead removed all magrolimab programs from pipeline after EHA data showed the drug was potentially harmful, with 20.3% increased death risk vs control.
Widely considered one of pharma's worst recent M&A outcomes. Magrolimab failed all pivotal trials and was completely abandoned, resulting in near-total loss on $4.9B.
| Deal | Year | Value | Outcome |
|---|---|---|---|
| Gilead Sciences Inc. / Forty Seven Inc. (this deal) | 2020 | $4.9B | 18 |
| Gilead Sciences Inc. / Pharmasset Inc. | 2011 | $11.2B | 98 |
| Gilead Sciences Inc. / Triangle Pharmaceuticals Inc. | 2002 | $464M | 96 |
| Gilead Sciences Inc. / CymaBay Therapeutics | 2024 | $4.4B | 76 |
| Gilead Sciences Inc. / Nurix Therapeutics Inc. | 2019 | $2.3B | 69 |
| Gilead Sciences Inc. / Immunomedics Inc. | 2020 | $21.0B | 68 |
| Gilead Sciences Inc. / Kite Pharma, Inc. | 2017 | $11.9B | 67 |
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