Biotech Strategy Blog

Commentary on Science, Innovation & New Products with a focus on Oncology, Hematology & Cancer Immunotherapy

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Prof Fran Balkwill Barts Cancer InstituteWhen it comes to cancer immunotherapy drug development, one of the challenges is that we can’t accurately predict from preclinical mouse models what will happen in people. The result is a rush into the clinic to test in human subjects.

We do need better preclinical models, which is why it was interesting to hear recently on an episode of Health Check (BBC World Service) about a 3D tumour model that is being developed at Barts Cancer Institute.

Professor Fran Balkwill (pictured), who leads the Centre for Cancer and Inflammation, kindly spoke to BSB about the work she and colleagues are doing to model the tumour microenvironment (TME) in high-grade serous ovarian cancer.

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Like the Battle of Britain, the cancer immunotherapy landscape is a dynamic one where tactical decisions can make the difference between “winning” and “losing.”

As Bristol Myers recently found out in first-line NSCLC, if you choose the wrong trial design or adopt an overly-aggressive strategy, you can end up losing badly (see post: Detailed thoughts on BMS CheckMate 026 1L trial in NSCLC)

A recent trip to the operations bunker at former RAF Uxbridge, from where the fighters of 11 Group were directed, shows how close we came to losing the Battle of Britain.  Had the German Luftwaffe continued to target RAF airfields instead of diverting their efforts on London, the outcome of the war is likely to have been quite different.

History provides a valuable lesson that strategy and tactics can and do matter; in R&D the targets you choose and how effectively you execute on a plan can make a big difference to outcome.

Battle of Britain Bunker Plot

Pictured: the RAF 11 Group Operations plot as it looked on September 15, 1940.

In Part 2 of the BSB interview with PsiOxus Therapeutics CEO Dr John Beadle, we discuss corporate strategy, and some of the challenges faced by an emerging Biotech company, many of which are likely to be shared by other small companies in the field.

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To be successful as a cancer immunotherapy company, you not only have to be science driven (that’s a given) and offer an approach that could make a difference, you also need a vision and the ability to execute ahead of competitors in a fast moving and competitive landscape.

Dr John Beadle

Dr John Beadle

We’re continuing our series on emerging cancer immunotherapy companies with an in-depth look at PsiOxus, and the vision of CEO Dr John Beadle (pictured right) for it to be a world-leading immuno-oncolytic virus company.

PsiOxus is based just outside of Oxford – it’s part of the so-called “golden triangle,” the area between London, Oxford and Cambridge in the South of England that is a driver of UK science and innovation.

The company is located in a nondescript business park 45 minutes by train from Paddington to Didcot Parkway, followed by a taxi or bus ride. You have to want to make the trip from London!

Dr Beadle kindly spoke to BSB about the competitive advantage the PsiOxus oncolytic virus platform offers, their path-to-market strategy and how he sees the company developing in the future.

With clinical data due in 2017, PsiOxus is a cancer immunotherapy company to watch out for.

Part 1 of the interview focuses on the scientific platform and cancer new products in development that are driving the company forward.

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Lung cancer, along with metastatic melanoma, has been very much to the forefront of attention in cancer immunotherapies with both nivolumab (Opdivo) and pembrolizumab (Keytruda) garnering approval as monotherapy from the FDA in second line treatment of NSCLC. A third molecule, atezolizumab (Tecentriq) has also been submitted to the authorities for this indication and a decision is expected soon.

Morgan Grafitti Wall

Street art in the Chicago West Loop

While no one is in any doubt that the response rates with monotherapy are low (in the 20% range) and the majority of people do not respond, the important thing so far is that when they do, they appear to be very durable responses. People are living longer, much longer than the 2–3 months of incremental improvement we are used to seeing with chemotherapy or targeted therapies.

The race is now on to see how we can improve things for the 80% of people with lung cancer who don’t respond to single agent therapy:

  • What can we do to help them?
  • Which combinations look more encouraging?
  • Should we treat beyond progression?

To answer these questions, we interviewed Dr Stephen Liu and discussed his views on some of the cancer immunotherapy combination studies presented at ASCO last week.

Dr Stephen Liu

Dr Stephen Liu at ASCO 2016

Dr Liu is a lung cancer expert at the Lombardi Cancer Centre at Georgetown University, and is actively involved in numerous clinical trials, particularly in Developmental Therapeutics.

Georgetown’s founding principle is Cura Personalis, which translates as care of the whole person. It “suggests individualized attention to the needs of others, distinct respect for unique circumstances and concerns, and an appropriate appreciation for singular gifts and insights.”

Dr Liu embodies this ideal, advocating for his patients for access to the best research advances, including genomics and clinical trials of promising agents.  At ASCO, he kindly highlighted some of the important findings from Chicago and offered context on why they matter to the field.

He told us one combination was “potentially transformative” and could be “practice changing” in lung cancer with more data.

Intrigued? To find out what these important trials are and which ones to watch out for, subscribers can log-in to read the article or you can sign-up by clicking on the Blue Box below.

Chicago ArchitectureChicago – the ASCO 2016 annual meeting is in full swing. This is the third and last day of our rolling blog where we’re providing updates with top-line commentary throughout the data.

If interested, you can also check out the many updates from Day 1 and Day 2.

There’s a lot happening at ASCO today, including a presentation by Vice President Joe Biden later this morning. Allow extra time for security checks if you plan to listen to him in person, and I expect there’ll be delays to the hotel shuttle buses around Chicago as roads are closed to accommodate the VP’s motorcade.

Many people chose not to come to ASCO this year – but it’s turned out to be a great meeting. We’ve heard a lot of new data which are likely to have an impact on future clinical trial strategy, as companies look to bring new products to market in what is a competitive field, particularly in cancer immunotherapy. There are how many PD-1 checkpoints in development now?

A word of warning to the wise – not all these IO molecules are going to win – some are going to fail, some will be useful tools in various subsets and some are going to be new home runs.

If you’d like to read our coverage of Monday at ASCO 2016, you can login if already a subscriber, or you can purchase access below by clicking on the Blue Box below.

ASCO 2016 Annual MeetingChicago – at the 2016 annual meeting of the American Society of Clinical Oncology (ASCO), two global prostate cancer experts told me that a phase 3 prostate cancer immunotherapy trial in the pre-chemotherapy setting “read out” as negative last year, but they haven’t seen the data presented at a major medical meeting, published in a journal, and to the best of my knowledge, no press release has ever been issued.

(correction: the trial failure was mentioned in a 2Q 2015 earnings press release on July 23, 2015, but no separate press release was issued in the same way one would have been for positive data. As one senior PR person told me at ASCO, only announcing it in a financial news release, “doesn’t count.”)

I have been following prostate cancer for several years and was surprised by the news (that I and others clearly missed), especially as many in the field had hoped the trial might be positive and that the lack of news was a positive. In event driven trials, a later reaching of a milestone or data read out is usually good news – it means people lived longer!

The company in question is Bristol Myers Squibb, a publicly traded global oncology company. At the ASCO 2016 annual meeting, they are presenting the results of multiple clinical trials that show promising data for checkpoint inhibitors such as nivolumab, as well as combination trials with nivolumab plus ipilimumab.

BMS appears to only want the oxygen of publicity from positive data.

BMS (NYSE: BMY) is a company that has no problem issuing press releases about “positive data” – indeed, over the last two days alone they have already issued four so far to announce encouraging activity with nivolumab and ipilimumab in various tumour types. They are not so quick, however, to issue a press release to announce negative data.

Dr Oliver Sartor, the Laborde Professor of Cancer Research in the Medicine and Urology Departments of Tulane School of Medicine in New Orleans told BSB:

Good news travels at lightning speed and bad news is never heard. This is something I learned many years ago when it comes to clinical trials.

~ Dr Oliver Sartor

On clinicaltrials.gov the phase 3 trial of iplimumab in men with advanced prostate cancer prior to chemotherapy  (NCT01057810) is simply shown as “completed” with “no study results posted” – see below:

Screen Shot 2016-06-05 at 05.03.12

Over 600 men took at 134 centres around the world took part in the Randomized, Double-Blind, Phase 3 Trial to Compare the Efficacy of Ipilimumab vs Placebo in Asymptomatic or Minimally Symptomatic Patients With Metastatic Chemotherapy-Naïve Castration Resistant Prostate Cancer.

It is, of course, possible that BMS may have told analysts or buried the news in some financial report, but if they did I missed it (update: yes, it was in the July 23, 2015 2Q 15 financial results press release).

Dr Sartor told me:

“I think around December I heard the news via the grapevine. It’s never been presented and it has gone underground. Apparently the sponsor does not want it to see the light of day, which is not appropriate.” 

We all have negative trials and I cannot help but wonder if there was something else to the story. Was there some toxicity issues or other negative issues that were not aware of? Why is the data not being presented?

I can tell you that I have heard it is a negative trial but I’ve never seen anything in writing myself. I’ve never seen the written disclosure.”

Another global prostate cancer expert told me the same story, the trial “read out” last year and he was informed it was “negative” after ASCO 2015.

This thought leader told me that BMS have since shared no data, had not published the data at any meeting, or published the results. They were keeping the data to themselves, which did nothing to advance the field.

To clinical scientists and researchers at the ASCO annual meeting, the meeting theme of “Collective Wisdom” means sharing data about what works and what doesn’t work. Science moves forward by learning from experiments that work and those that don’t work. Often a negative result can be as important as a positive if it leads to greater understanding.

ASCO 2016 Collective WisdomThe failure of BMS to disclose the results of a phase 3 study is a disservice to all who invested their time to make the trial happen, and lack of duty of care to all the men with advanced prostate cancer who participated, not only with the hope that they would live longer, but that they would contribute to research that might help others too.

It is inexcusable for a global company such as BMS to behave this way. If the data read out last year, the data could have been presented at the ASCO GU 2016 meeting, something that BMS did at ASCO GU 2013 when they presented the failure of their phase 3 prostate cancer trial with dasatinib.

Why was the pre-docetaxel ipilimumab trial negative?

On the Novel Targets podcast recorded at ASCO 2015 last year, Dr Sartor talked about the how close the post-docetaxel trial of ipilimumab in advanced prostate cancer came to being positive… but for the inclusion of men with visceral metastases, this trial would have been positive.

The ipi pre-chemo trial did not include patients with visceral mets, leading to the hope that it might be a positive trial if those men were excluded. Sadly, those hopes did not materialise.

Dr Sartor offered his clinical perspective:

“With regard to why it was negative, one can only speculate. The poor prognosis associated with visceral disease in the post-chemotherapy trial was a post hoc analysis.

Please remember that early in the post chemotherapy trial that more men died in the ipi arm compared to the comparison arm. It is conceivable that toxicity was to blame. This can be a toxic drug for some.

It is also possible that multiple lines of therapy given post protocol treatment contributed to a dilution of a positive affect. I believe this happened in the TAK 700 trial.

The bottom line is this drug was simply not active enough, or it was too toxic, or some combination of the above. Until we see more data it is hard to know. In the absence of data being presented, one might assume that toxicity played a role.”

Researchers in the field do need to know the reasons for the failure, especially given the interest that BMS have in combining ipilimumab with other cancer immunotherapy regimens, including those that do not have a high mutational load. Simply put, the data needs to be presented and published, it is unethical to do otherwise.

Update 1.35pm. Negative Trial mentioned in 2Q 2015 earnings release on July 23, 2015 – almost a year later the data remains unpublished!

Thanks to @AndyBiotech for drawing my attention to when the negative data was announced – in the 2Q 2015 earnings press release that went out on July 23, 2015. Link

“The company announced today that two Yervoy Phase 3 trials, Study -095 in metastatic castration-resistant prostate cancer and Study -156 in newly diagnosed extensive-stage disease small cell lung cancer, did not meet their primary endpoints of overall survival versus standard of care and have been discontinued. No new safety concerns with Yervoy were identified in either study. The company will complete a full evaluation of the data and work with investigators on the future publication of the results.”

If the trial had been positive or encouraging it would no doubt have merited a press release in its own right rather than a mere mention in a finance press release.

If a global prostate cancer expert, only heard from others in December (5 months after the news was buried in a financial press release) then the company has a problem in how it communicates with the prostate cancer community.

The point of this piece remains, that almost a year later the data remains unpublished and unpresented despite several opportunities to do so at major medical meetings such as ECCO 2015, ASCO GU 2016 and ASCO 2016.

If anyone from BMS wishes to advise when the data will be published or wants to dispute the accuracy of what two global prostate cancer thought leaders told me, they are welcome to send me a comment, and I will publish any response below.

Update Jun 6 BMS Promises to Publish

Thanks to Matt Herper (@MatthewHerper) from Forbes who used his influence to obtain a response from BMS to the question of where is the data? Do read his story on Forbes (link)

The company said they have plans to submit the data for publication in Q3 2016 – which probably means they are working on it now! Publication over a year after they announced the failure of their phase 3 ipilimumab trial in advanced prostate cancer is too long and reflects a double standard. The company wouldn’t wait 18 months to publish or present the data if it were positive; the same standard should apply either way.

As cancer immunotherapy moves forward into combinations, many companies are rushing from early signs of efficacy into large phase 3 trials in order to obtain a competitive advantage, with the hope of being first in that indication or beating others who have the potential to do a similar combination trial.

Only yesterday we saw early data presented in colorectal cancer (CRC) for atezolizumab (Roche/Genentech’s anti PD-L1 monoclonal antibody) in combination with a targeted therapy, the MEK inhibitor cobimetinib. Based on 4 partial responses (PRs) in a small group of patients with microsatellite stable disease (MSS), the company have initiated a phase 3 trial.

This trial has a lot of promise and potential, but it highlights how companies are moving fast on small amounts of data. Not every phase 3 trial is going to work in cancer immunotherapy. The field can’t wait 18 months for the publication of trial results when it does. The media need to write about failed trials too and hold companies accountable. What we do shouldn’t just be about eulogising the positive and new. While we all want to offer hope, at the same time we need to offer an honest reality check to the public.

Cancer immunotherapy still has a long way to go, not every person is going to respond and not every trial is going to work.

Dr Sartor would like to see the ipilimumuab prostate cancer data presented at a major medical meeting, and not just published in a journal:

I’m hopeful that we can learn from the trial even though it was negative. Results presented in a scientific form allow researchers to better understand the data. I certainly understand the financial implications and appreciate that Wall Street needs to know about negative data. Scientist have different needs. Every experiment has value and the fact that it was negative does not mean that we will not learn from it. 

I honestly feel that the companies that run trials have an obligation to promptly report the results of both positive and negative trials in a scientific forum. 

Why not submit the data for presentation at the European Society for Medical Oncology meeting in Copenhagen in October, for example?

Medical societies have no problem accepting abstracts, they recognise that debating and discussing why a trial failed to work can be as informative as discussing why something does. Meetings such as ASCO and ESMO should not just be for reporting positive data and an echo chamber for companies to share positive news.

I hope that BMS will present the data, as well as publish it. If the data was positive it would be at ESMO or another major medical meeting.

I’d like to thank Dr Sartor for being willing to share his views. Thanks also to Matt Herper for picking up the story and shining a spotlight on the topic. We’ll update the post with a link to the presentation or publication when it eventually comes out.

Update July 8: FDA set to fine companies $10K a day for late publication of clinical trial data

As reported by STAT news on June 29, Dr Francis Collins Director of the NIH announced that the FDA is set to crack down on companies and institutions that fail to report the results of clinical trial data in a timely manner. Link to Stat News story.

“Dr. Francis Collins, the director of the National Institutes of Health, later told reporters that a proposed rule — soon to become a final rule — should help by giving the agency more “clout” to crack down on institutions, not just individual investigators, when clinical trial data isn’t reported.

“That final rule is close to appearing,” he said. When it does, “we can basically say to Harvard, ‘Sorry, we’re not giving you any dollars until this principal investigator who ran a clinical trial deposits the data.’”

He also said the Food and Drug Administration will have the ability to impose $10,000-a-day fines on companies it regulates if they don’t comply with the reporting law.”

Quote from Stat News June 29 Story: “Biden threatens funding cuts for researchers who fail to report clinical trial results.

While this blog post highlights one particular phase 3 trial prostate cancer immunotherapy trial, the bigger issue remains highly topical and is one companies, and those in PR should take note of: negative data needs to be reported in a timely manner.

Unless an exception or waiver is given by the Director of the NIH, my understanding of the current FDA regulations requires posting of the results of clinical trials to clinicaltrials.gov within 12 months of study completion. This is defined as the earlier of the estimated completion date of the trial or the actual completion date.

In practice this is not an onerous burden given the speed with which companies show they can generate presentations and publications when the data is positive!

The 12 month publication time is a statutory requirement set forth in Section 801 of the Food and Drug Administration Amendments Act (FDAAA 801).

As of the time of writing (July 8, 2016), BMS have yet to post any data for the failed phase 3 ipilimumab prostate cancer trial on clinicaltrials.gov. If the 12 months clock starts from the July 2015 actual completion date, then they are certainly taking it to the wire and run the risk of non-compliance, and potential penalities should the FDA seek to take enforcement action.

As outlined on clinicaltrials.gov website,

“FDAAA 801 establishes penalties for Responsible Parties who fail to comply with registration or results submission requirements. Penalties include civil monetary penalties and, for federally funded studies, the withholding of grant funds.”

Whether the FDA would seek to enforce the failure of a major company to comply with FDAAA801 remains to be seen, and BMS may yet deliver depending on what the actual completion date is and when that expires.

However if I was in corporate compliance, I don’t think I would be taking it to the wire or potentially playing with fire given that timely trial reporting is now a matter of public policy that has attracted the attention of politicians and regulators.

Both Vice President Biden and Dr Collins have sent an unequivocal message recently. Companies should take note and act accordingly, otherwise somebody will be fined, if only “pour encourager les autres.”

The prospect of an FDA rule with a $10,000 a day fine for late publication should certainly focus attention, if it hasn’t done so already.

Update August 23, 2016 Trial Results Posted on ClinicalTrials.Gov

On August 17, 2016 Bristol Myers finally posted the results of their phase 3 study of ipilimimumab to treat prostate cancer in the pre-chemotherapy setting. This was updated was processed on August 22 2016 by ClinicalTrials.gov. (link to results).

The primary completion date of the trial was April 2015, which means the 12 month data reporting clock started then, and according to Dr Deborah Zarin, Director of the National of Library Medicine, from her perspective the clock stops when the results are publicly available (note: this may change when new rules/regulations are published). Publicly posting data 16 months after the primary completion date is non-compliance by Bristol Myers; they get a D grade in my book. When you see the data, however, it is perhaps not surprising they were less than enthusiastic and chose to bury the initial announcement in an “earnings call” then finally post the data without annoucement in the dog days of summer.

When men with advanced prostate cancer are seeking treatment or considering a trial, they want to know the answer to the follow questions from their doctor, “if I take [fill in the blank}”:

  • Will I live longer?
  • Will I feel better?

The answer to both questions from the failed ipilimumab phase 3 trial is unfortunately, “No.”

Of the 837 men with advanced prostate cancer who were enrolled on this phase 3 trial, 602 were randomized and 598 were treated. 199 received placebo, 399 received ipilimumab 10mg/kg IV on days 1, 22, 43 and 64.

Median overall survival was 29.73 months in the placebo arm (26.12 to 34.17) compared to 28.65 months on ipilimumab (24.48 to 32.46).

Ipilimumab OS Pre-Chemo Prostate

In other words, men receiving placebo did better. The hazard ratio was 1.11, which means they had an 11% higher risk of death if you started on ipi!  What we don’t know is if there was a subset of men who may have benefited. More data is required.

Progression free survival was slightly better on the ipi arm, with a median of 5.59 months (95% CI of 5.32 to 6.28) compared to a median of 3.81 months on placebo (95% CI of 2.76 to 4.11). We don’t know if this is statistically significant, but the favourable hazard ration of 0.67 suggests it most likely is.

Ipilimumab PFS Pre-Chemo Prostate

 

Time to subsequent non-hormonal cytotoxic chemotherapy was 10.91 months (95% CI 8.44 to 14.59 months) in the placebo arm compared to 18.04 months in the Ipi arm (15.18 to 24.80). However, this delay to chemo did not translate into a better long term outcome for the IPI arm – the gold standard in cancer is how long do you live, which was the primary endpoint of the trial.

Ipilimumab Time to Cytotoxic Chemo

Overall, the OS data looks like it was the killer. We will no doubt learn more about the possible reasons for the negative overall survival when this data is published and/or presented.

It is an ethical requirement under the Declaration of Helsinki (7th Revision) that all clinical trial data be published:

“Negative and inconclusive as well as positive results should be published or otherwise made publicly available.”

It remains a disservice to the research and medical community, as well as the men who participated in this trial, to delay publication of data. Bristol Myers have offered no valid reason why it has taken 16 months for this data to be made publicly available.

View from ASCO annual meetingChicago – it’s “Plenary Sunday” at the 2016 annual meeting of the American Society for Clinical Oncology (ASCO).

Cancer immunotherapy has arrived at ASCO! Not so long ago cancer immunotherapy presentations were in small meeting rooms and had only a few attendees – at this meeting cancer immunotherapy data is being presented to thousands of attendees in large meetings rooms, including the B1 plenary hall. What a difference in the space of a few years!

Today at ASCO there are several noteworthy cancer immunotherapy presentations. We’ll be writing about them here on the blog during the day.

Part of the opportunity of coming to a meeting such as ASCO is the networking opportunities it affords.

While in Chicago I heard about a phase 3 trial from a global pharma company that failed to meet its primary endpoint last year, however, – to the best of my knowledge – there’s been no publication or presentation of the negative data that may help the field move forward. The investigators have been told “it’s a bust.”

Not to publish or present negative data is a disservice to the patients that enrolled on the trial. Many would have believed their participation would contribute to the advancement of science and medicine, and potentially benefit others.

Want to know what the trial is and the company involved? Subscribers can login to find more or you can purchase access below to read more, along with our coverage of Sunday at ASCO 2016.

Update 12.30pm. Occasionally we decide something we talk about needs to be “open access” so we’ve published a short post. It is freely available to all. Turns out the negative data from BMS was mentioned in a July 23, 2015 financial results press release. Almost a year later, the negative data has still not been presented or published.

Chicago RiverChicago – the annual meeting of the American Society for Clinical Oncology (Twitter #ASCO16) starts in earnest today, yesterday was primarily education sessions and a travel day for many.

Starting today and for tomorrow and Monday, we’ll be producing a daily rolling blog with top-line commentary around sessions we attend, experts we talk to and what captures our interest and attention at the meeting. It won’t be real-time, but schedule and wi-fi permitting, we’ll be providing updates throughout the day.

It really kills us to do a semi-live blog, but our subscribers love it – they tell us that even if they’re not at ASCO, they feel like they are with us following along remotely. We’ll of course be generating a series of posts with more in-depth coverage after the meeting when we’ve heard the data.

If you’d like to join an exclusive club of companies and individuals, you can purchase a subscription below.

As a special offer throughout ASCO 2016, if you buy a quarterly subscription and then want to upgrade to an annual subscription, all you have to do pay the difference before your quarter expires. Offer to new subscribers and new purchases only. Buying a quarter is a great way to check out what we do!

Aduro Biotech LogoWe’re almost at the end of our coverage of AACR 2016. Post number 30 (!!) is on Aduro Biotech ($ADRO) and their STING (Stimulator of interferon genes) agonist currently in development.

On the final day of AACR, in a packed session chaired by Tom Gajewski, MD PhD (Chicago), the meeting heard from Tom W. Dubensky, Jr, PhD Chief Scientific Officer of Aduro Biotech in a presentation (SY39-02) entitled:

“Direct activation of STING in the tumor microenvironment leads to potent and systemic tumor regression and immunity.”

Dr Tom Dubensky Aduro CSO

Dr Tom Dubensky, Aduro CSO

I spoke with Dr Dubensky (pictured) afterwards. In my interview recording you can hear Vice President Biden’s cavalcade arrive at the Ernest Morial convention center in New Orleans for his plenary presentation.

Since AACR 2016, Aduro announced that the first patient has been dosed with ADU-S100 (MIW815) in a May 12 press release.  This triggered a $35M milestone payment from Novartis, who are undertaking the clinical trial (NCT02675439).

In March 2015, Aduro entered a collaboration with Novartis that, according to the Aduro press release, led to an initial payment of $200M and an additional $50M in equity investment.

After the recent failure of their pancreatic cancer vaccine, announced in a May 16 press release, there is a lot riding on ADU-S100 for both Aduro and Novartis.

I had the privilege to interview Dr Gajewski last year at Immunity 2015, where we talked about his work on STING (see post: Tom Gajewski takes the STING out of cancer). You can hear a short excerpt from the interview on Episode 2 of the Novel Targets Podcast.

So a year later it’s a good time to return to the STING pathway and take a fresh look at what Aduro/Novartis are doing.

For this post, I’ve chosen to write this up as a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis of ADU-S100 based on what I learnt at AACR from talking with Dr Dubensky and other experts.

Your SWOT analysis of ADU-S100 may be different from mine, you may have access to other sources of information, an alternative opinion, or reach an entirely different conclusion. There is no right or wrong answer. We all view the world through our own individual bias and lens.

Before you read this post, I heartily encourage you to map out on the “back of an envelope” – or as I’d say in England, on the “back of a fag packet” – what your SWOT analysis looks like. That way you can compare yours to mine.

By definition, we’re dealing with a new product in early clinical development, where many questions remain unanswered. It’s always easier to see the picture after all the cards have been dealt……

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New Orleans Sign advertising Voodoo

New Orleans Sign Advertising Voodoo

What I learnt at the recent AACR annual meeting in New Orleans is that cancer immunotherapy studies are requiring industry to think differently about clinical trial design.

As we move into combination trials of novel/novel combinations, how do we efficiently work out not only that each drug is safe, but in what patients they are likely to be most effective?

Readers who listened to the recent Novel Targets Podcast, “Of Mice and Men” will hear about some of the challenges associated with mouse models and how decisions are made moving into the clinic.

What I learnt from the podcast (and I hope you did too) is that if you are doing an immunotherapy trial in patients, the type of mouse model can really matter when it comes to interpretation of the preclinical data.

In response to a subscriber request, today’s post is about some of the statistical challenges in designing combination immunotherapy trials. To many, statistics is like voodoo, so this post does not go into any maths!

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