Biotech Strategy Blog

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

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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North Shore Surf Shop SignAloha! The BMT Tandem meeting (Twitter #BMTTandem16) is underway in Honolulu, and we’re looking forward to the scientific presentations that start tomorrow, Thursday.

This preview highlights some of the presentations that may be of interest to subscribers at the meeting over the next 5 days when they’re not surfing waves at the North Shore! The meeting ends on Monday Feb 22.

If you can’t make it to Hawaii, then I expect the BMT community will be sharing updates from the meeting via Twitter. Do follow: @DrMiguelPerales, @DrKomanduri, @sgiraltbmtdoc, @DrMvandenBrink, @BldCancerDoc, @MSKBMTTandem & others (this is not intended to be a definitive list, only a starting point).

We won’t be doing a daily blog, but will be generating some commentary and analysis, as the opportunity presents.

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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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Aloha! If you have plans to be in Honolulu next week for #BMTTandem16, then one of the “must do” sights is the walk to the top of Diamond Head. It towers over Waikiki and is a major landmark for anyone travelling in an easterly direction.

Waikiki from Diamond Head

One way to get there is to start early and take the #23 The Bus ($2.50 fare, exact change) from Ala Moana & Waikiki to the state park entrance. The path starts off deceptively easy, kicks in with some uneven surfaces and hits you with a pile of steps near the top. Sensible shoes, water and sunscreen recommended.

The spectacular views at the end are well worth it, especially if you catch the sunrise/early morning light and manage to avoid arriving at the summit at the same time as busloads of Japanese tourists with the same idea. It’s a popular attraction!

One of the reasons for going to the top of hills and mountains is to see the “big picture” of the landscape below. In writing and reporting on the latest innovations in biomedicine, we often focus on the results of one trial or news from one company; yet it’s also important to see how the pieces of the jigsaw fit together.

That’s why pharmaceutical marketers and new produce development specialists often commission custom reports that review the strategic landscape in a therapeutic area.

As part of our coverage of #BMTTandem16, we’re taking a look at some of the strategic trends and drivers in the Graft versus Host Disease (GvHD) space.

It’s an area of unmet medical need and market opportunity.

Anyone with an interest in allogeneic “off the shelf” CAR-T cell therapy should already appreciate the significance of GvHD as a potential complication. If you don’t, then you’ve not been reading BSB…

In case you missed it, do listen to Dr Marcel van den Brink talking about GvHD on the Novel Targets Podcast. (Episode 9: Targeting the Microbiome)

This post is not intended to be a substitute for a landscape report, but offers some top line thoughts on some of the strategic drivers to look out for.

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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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Aloha! It will soon be time to pack your Hawaiian shirts for the forthcoming BMT Tandem Meeting in Hawaii (Twitter #BMTTandem16 – what a long hashtag!!)

ASBMT_2016WebBanner_b

Commonly known as “Tandem,” it’s the combined annual meetings of the Center for International Blood & Marrow Transplant Research (CIBMTR) and the American Society for Blood and Marrow Transplantation (ASBMT).

Hawaii is great location for a meeting in February, and one that I’m sure will generate a lot of envy for those who can’t attend and are stuck in the winter cold and chill. Who said we don’t go the “extra mile” for BSB subs?

One of the presentations I’m looking forward to hearing at Tandem is by Ann Leen, PhD, who is an Associate Professor at Baylor College of Medicine.

Dr Leen will be talking about “Immunotherapy for Lymphoma using T cells Targeting Multiple Tumor-Associated Antigens.

At last December’s ASH annual meeting, Dr Leen presented preliminary data with this novel approach in patients with Hodgkin’s Lymphoma (HL) and non-Hodgkin’s lymphoma (NHL). After her ASH presentation, she kindly spoke to BSB.

This post is part of our post-meeting ASH15 coverage, and our ongoing coverage of some of the exciting developments in immuno-oncology.  In case you missed it, do check out the ASH interview with Seattle Genetics CEO Clay Siegall, PhD.

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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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Streets of San FranciscoOne of the interesting immuno-oncology presentations at the recent ASCO Genitourinary Cancers Symposium held in San Francisco from Jan 7 – 9, 2016 was presented by Dr Matt Galsky (Mount Sinai, New York).

Dr Galsky presented the results of a phase II trial of gemcitabine plus cisplatin plus ipilimumab in patients with metastatic urothelial cancer: HCRN GU-148 (Abstract 357).

The trial failed to reach its primary endpoint of showing a 20% increase in 1 year overall survival by the addition of ipilimumab compared to historical data for Gem + Cis in this patient population.

Many in the media don’t write up what is in essence “negative” data, but this trial is highly informative for those with an interest in urothelial cancer and in the optimal strategy for cancer immunotherapy. The GU16 discussant Dr Elizabeth Plimack (Fox Chase) raised many questions that merit consideration by those in the field.

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San Francisco Cable CarWe’re continuing our post-meeting coverage of the 2016 Genitourinary Cancers Symposium (ASCO GU) that took place earlier this month in San Francisco.

In this post we’re taking a look at the results of a clinical trial with a non-invasive liquid biopsy which in a cohort of patients with prostate cancer identified increased risk of death on abiraterone and enzalutamide, but not taxane chemotherapy.

What struck me listening to this presentation was the simple elegance of an approach, which the presenter likened to the equivalent of “facial recognition” of prostate cancer cells.

As the ASCO GU discussant noted, this could have an impact on clinical trial design, potentially leading to more rapid prostate cancer drug approvals.

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