Biotech Strategy Blog

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

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!

King Kamehameha Statue Honolulu HI

King Kamehameha Statue, Honolulu HI

Honolulu: we’re continuing our coverage of the 2016 BMT Tandem meeting with a thought leader interview about a novel cancer immunotherapy approach that we’re excited about.

The cancer cell therapy landscape is still vastly uncharted territory in many respects.

The first CD19 targeted CAR T cell therapies expected to reach the market in 2017 are unlikely to be best-in-class, which leaves the commercial door open for other approaches that may be better, cheaper or more accessible.

If you are in the CAR T cell therapy space, there are plenty of competitive threats on the horizon, and the novel approach discussed in this post is one of them!

We’d heard a little about it, but hadn’t explored the concept in any detail, so were delighted to talk with a leading expert at the BMT Tandem meeting in Honolulu.

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Honolulu: Yesterday we learnt the sad news that Dr Holbrook Kohrt (pictured) had died.

Dr Holbrook Kohrt He was a Stanford hematologist/oncologist and rising star in the cancer immunotherapy field. Our thoughts go out to his family and friends.

I had the privilege to interview him last May at the Immunology 2015 meeting in New Orleans. His voice lives on in Episode 6 of the Novel Targets Podcast. One area of Dr Kohrt’s research was in combination immunotherapies, and how we can optimize efficacy, while avoiding significant immune adverse events.

So are checkpoints playing with fire when given in combination?

That was one of the provocative questions to come out of a scientific session entitled, “Fast Cars and No Brakes: Autologous Stem Cell Transplantation as a platform for Novel Immunotherapies” at the BMT Tandem meeting in Hawaii last weekend. The session, chaired by Miguel-Angel Perales (@DrMiguelPerales) from Memorial Sloan Kettering Cancer Center, was both informative and interesting.

All the presentations were excellent, but one by Philippe Armand from the Dana-Farber Cancer Institute in Boston, “Checkpoint Blockade in SCT, Data & Hope, Promise & Peril” stood out for me. Dr Armand discussed checkpoint data pre and post stem cell transplantation and offered a perspective I had not heard before.

One of the provocative questions it raised was could checkpoints be playing with fire in some patients? Dr Armand kindly spoke with BSB after his talk.

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Honolulu: At the BMT Tandem meeting that ended yesterday in Hawaii, one of the hot topics was CAR T Cell Therapy. This should, perhaps, come as no surprise to readers given that bone marrow transplanters are not only the investigators doing the clinical trials, but will be the initial target market for this product.

Dr Micheal JensenOne of the pioneers in the development of adoptive cellular therapy is Michael Jensen (pictured) who is Director, Ben Towne Center for Childhood Cancer Research at Seattle Children’s Research Institute (SCRI) and the Sinegal Endowed Professor of Pediatrics at the University of Washington School of Medicine. Dr Jensen is also a scientific co-founder of Juno Therapeutics, Inc.

He’s been doing research in the field for over 20 years, and told me that not so long ago there would only be a handful of people in the room for a CAR T cell presentation!

In a plenary scientific session at the Tandem meeting, he presented to over 3,000 attendees on “CD19-Specific CAR T Cells as a Post-ALLO HSCT Relapse Salvage Therapy.”

After his presentation, he kindly spoke with BSB. This post describes some of the key take-homes from his talk.

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Dr David Porter, U Penn

Dr David Porter, U Penn

Honolulu: The BMT Tandem meeting kicked off yesterday with an excellent plenary session on “CAR T Cell Therapy: CD19 and Beyond.” The three presenters were:

  • David Porter (University of Pennsylvania) CAR T cells for Leukemia
  • Martin Pule (UCL) Building a CAR
  • Michael Jensen (Seattle Children’s) CD19-Specific CAR T Cells as a Post-Allo HSCT Relapse Salvage Therapy

Dr Porter (pictured) is Director of the Blood and Marrow Transplant Program at the University of Pennsylvania. I spoke with him after his talk. This post gives a quick overview of some of the key points I took away.

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