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New Orleans Jazz

New Orleans Jazz

Most of the abstracts for the 2016 annual meeting of the American Association for Cancer Research (Twitter #AACR16) in New Orleans are now available online, which raises the intriguing question:

What are the top 10 abstracts at AACR 2016? 

If you’re a subscriber, take a moment to think which ones would be on your list, BEFORE you read this post.

Rather than give chapter and verse on a long raft of abstracts, in this second preview post I’ve chosen to focus on a few interesting, intriguing or important issues. Clearly, everyone will have their own way of defining a top 10 list, never mind choosing them! I do hope this starts a debate in your group, it’s always cool discussing science, after all.  Which ones would you choose and why?

What I wanted to do was highlight some of the critical scientific or clinical questions that I have written down in my little black book over the last year or so for which we need solid answers in order to move our understanding of the cancer research along. That list is very long and always seems to be getting longer!  The good news is that we may have answers to some of them at AACR next month. 

Here goes, in no particular order…

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New Orleans riverfront streetcarThe 2016 annual meeting of the American Association for Cancer Research (AACR) takes place next month in New Orleans. (Twitter #AACR16).

While many people have focused on the presentation of clinical data at ASCO, we have long argued that emerging scientific data at AACR actually give early hint of what’s to come down the pipeline.

Anticipating these trends and spotting promising new compounds or combinations is probably more art than science, but nonetheless is a very useful and important exercise.

AACR is the most important meeting of the year for cancer new product development! 

Tomorrow, we will be reviewing the actual abstracts, posters, late breakers and what they entail, including important new data such as BMS’s CheckMate–141 exploring nivolumab in Head & Neck cancer as well as the combination of nivolumab plus ipilimumab in CheckMate–069 for advanced melanoma.

In the meantime, what are the main hot topics emerging from this year’s meeting in targeted therapies and immunotherapies?  What do the key scientific sessions tell us about new directions that lie ahead?

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AACR Annual Meeting 2016 BannerOne of the hot topics at the forthcoming 2016 annual meeting of the American Association for Cancer Research (AACR) in New Orleans is likely to be CAR T cell therapy (Twitter: #AACR16).

Several research groups have shown impressive results in acute lymphoblastic leukaemia (ALL), but challenges remain in using adoptive cell therapy to treat other leukemias such as CLL, as we heard from Dr Porter at the recent BMT Tandem meeting. See post: Challenges and Opportunities of CAR T cell therapy in CLL. Perhaps more significantly, there’s a long way to go before CAR T cell therapies hit prime time in solid tumours.

What is fascinating is the pace of scientific research in the field. By the time the first CAR-T cell therapy is FDA approved, the second generation constructs used in them will most likely be obsolete.

This post reviews completely new research, which we’ve not written about before, that I expect we’ll hear more about at AACR, and discusses novel concepts about how to make CAR T cell therapy more effective in both leukemia and solid tumours.  It’s a good pre-AACR preparation for those interested in cancer immunotherapy and the emerging CAR T cell therapy landscape.

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EBCC10

EBCC-10 Cancer Conference

Amsterdam: The 2016 European Breast Cancer Conference organised by the European CanCer Organization (ECCO) is underway (Twitter: #EBCC10 – it’s the 10th official one they have organised).

We thought it would be a good opportunity to take a break from our coverage of #BMTTandem16 to look at some of the posters that are of interest at the meeting.

As regular readers know, we spend a lot of time reading posters – it’s where we pick up new trends and early data. Most go unnoticed or unpublicised in press releases.

For this post, I’ve highlighted four posters that I’m quite interested in and that merit further discussion.

They range from basic and translational research to clinical new product development. By chance, they are evenly split between immunotherapy (PD-L1 and TILs) and acquired drug resistance to different targeted therapies.

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Koko Crater Botanical Garden

Hawaii, 2016

One of the most common questions we have received from subscribers in the last 6 months relates to Bellicum Pharmaceuticals (NASDAQ: BLCM) and the opportunity for their adjunct T Cell therapy in development for allogeneic hematopoietic stem cell transplantation (HSCT), BPX–501. This product is given after the transplant and uses genetically modified donor T cells incorporating a CaspaCIDe safety switch.

We first wrote an in-depth piece about Bellicum and BPX-501 back in January 2015 with an interview with their CEO and CMO for those interested in more background (Link).

At the recent 2016 BMT Tandem meeting in Hawaii, we had the opportunity to hear the latest data on trends in haplo-identical (Haplo) bone marrow transplants. This posts reviews some of the data presented and considers the implication of this on the market opportunity for Bellicum.

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One of the most important challenges in cancer immunotherapy is overcoming immune resistance. For example, even with the high response rates seen in acute lymphoblastic leukemia (ALL) with CAR – T cell therapy, a significant number of patients relapse after an initial response.

Chinatown Honolulu

Chinatown, Honolulu 2016

Could immune resistance be reversed or prevented by the addition of appropriate checkpoint blockade? Which ones matter though, that is the critical question?  Rather than randomly picking ones to try, we need scientific evidence regarding these choices.

This post explores some of the latest data presented at the BMT Tandem meeting on the role of T cell immunoglobulin mucin–3 (TIM–3) and PD–1 upregulation in causing resistance.

If you’re not already a sub and want to read our coverage of ASH, BMT Tandem and the forthcoming AACR 2016 annual meeting, you can purchase individual access below. This week only – inspired by the story of Eddie Aikau in Hawaii – we have a special offer that we’ve never done before (and may never do again) of $75 off a quarterly subscription. The deal ends tomorrow Friday March 4th at 12 noon HST. Check it out!

Subscribers can login to read more about the latest data on how alternative checkpoint inhibitors may have a role to play in cancer treatment.  Welcome to the new folks who signed up this week, good to see y’all!

Aloha! The Eddie Aikau Big Wave surf contest only happens on Waimea Bay on the North Shore of Oahu in a year when there are 40 ft swells. It’s six years since the last one took place.

Surfing Waimea Bay

Waimea Bay Surfing on Feb 10th 2016

Yesterday, at the last minute the big waves failed to show up as an expected storm took a different track.

In R&D terms this is a bit like a phase 3 trial that was expected to be positive, only at the last minute reads out negative.

Last year was an exceptional year in multiple myeloma with several new approvals. It was a “Grand Cru” year, but there is already another wave on the horizon…

Whether it’s a 40 foot Eddie Aikau wave remains to be seen, just like the bay and weather dictates the waves, clinical trial data and physician experience ultimately drive uptake.

This post continues our in-depth post-ASH analysis and pre-TANDEM coverage, with a look at the new wave in myeloma that’s coming our way.

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Cell therapy is one of the hottest topics in cancer immunotherapy; however, it remains a field still in it’s infancy as companies and researchers work on strategies and concepts to increase efficacy and overcome resistance. The strategic landscape is still being defined. In cell therapy the ultimate winner may not be the company that is first to market.

Unum C suite

Drs Seth Ettenberg and Michael Vasconcelles, Unum at #ASH15

In this post, we’re continuing this week’s theme of posts around novel cell therapies. Unum Therapeutics is a company that is no doubt already on your radar if you are into CAR-T cells.

Back at ASH 2015, I had the pleasure of interviewing Dr Seth Ettenberg (CSO) on the left and Dr Michael Vasconcelles (CMO) on the right.

We talked about what differentiates their approach from others in the CAR T cell space.

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Updated data are often presented at conferences and therefore the results can differ from the submitted abstracts, which are sometimes submitted as placeholders based on immature data cutoffs. That was certainly the case in several examples at the ASCO GI conference in San Francisco last weekend.

San Francisco HerculesAfter Monday’s look at new developments in the lower GI tract, we now turn our attention today to the upper GI tract with a focus on oesophageal, gastric (stomach), and gastro-esophageal junction (GEJ) cancers.

Over the last five years we have seen new approvals for targeted therapies such as HER2+ gastric cancer and relapsed refarctory gastric cancers with a VEGF inhibitor. Will that trend continue over the next five years or will we see new approaches such as immunotherapy enter the market and dominate?

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Franciscan Crab Restaurant San FranciscoWe saw at ASCO last year that response to checkpoint immunotherapy is feasible in some patients with colorectal cancer, but what about other gastrointestinal tumours such as pancreatic, duodenal and biliary cancers?

Can their activity extend beyond the obvious hypermutated tumours such as melanoma, lung, renal and bladder cancers?

Many of you will know that most pancreatic cancers, for example, are detected late and prognosis in metastatic disease is generally poor. You also typically don’t see much coverage of the other GI non-CRC cancers from cancer conferences in the medical media outside of pancreatic cancer occasionally.

At the ASCO Gastrointestinal symposium (#GI16) this past weekend, there was some new data of note in these tumour types that is well worth highlighting and discussing because it may have a major impact on the GI landscape.

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