Biotech Strategy Blog

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

Posts tagged ‘ASH 2013’

One of the fun aspects of the American Society of Hematology (ASH) conference last month was interviewing several thought leaders and CEOs about the latest developments that were emerging rapidly almost every single day.  Now, some medical meetings can be rather dreary if there’s no new or exciting data to pique the interest of the foot weary attendees, who tend to run on coffee and adrenalin for four days, but this ASH was rather different.

Looking at the program the first morning, I realised that I hadn’t felt so much anticipation since the 1999 meeting, when the phase I imatinib (Gleevec) data was presented in the plenary session by Brian Druker.  This time around there was a lot of buzz in so many areas from CLL and NHL to myeloma and ALL, it was pretty exciting to run from session to and see many packed rooms filled with an air of expectancy.  One evening, I hesitated at the top of an escalator and dithered over which of three very interesting sessions to dash to, as a bunch of researchers crashed into me all distracted by the exactly same dilemma!

If many of us could have made one request of the ASH organising committee it was clearly start offering a virtual meeting for all the oral sessions, something ASCO do incredibly well.

At ASH if you miss a presentation, it’s gone forever.

This is quite a pain if you really wanted to see the data from Agent X in CLL, Compound Y in CAR T cells and Drug Z in myeloma, as well as the one you actually attended.  All those sessions ran simultaneously.  It also means the sessions are still running at 7pm (yes, they were still packed even at that hour!) and many of us had an early start with 7am sessions or meetings.

The huge distances between rooms (#blisterruns), coupled with a stubborn insistence in putting almost all the oral sessions on Monday and Tuesday, together with long waits between interesting sessions over the weekend, makes for a very frazzled and disjointed schedule. Patience and stamina are the name of the game here.

Despite scattered logistics, the conference was actually a lot of fun. If I had to compile a top 10 of key abstracts I really liked in New Orleans then it would take a long time, simply because there was so much new data requiring much agonising over what to leave out.

Stephan GruppThat said, one interview I particularly enjoyed was with Dr Stephan Grupp, a pediatric hematologist who is the Director of Translational Research, Center for Childhood Cancer Research at The Children’s Hospital of Philadelphia (CHOP).  By an odd quirk of the schedule, it seemed that he and I always seemed to be in the same sessions, although we actually spoke by phone afterwards, given the craziness in both our schedules.

There were two events in particular that were notable highlights:

  • A fascinating and well-thought out hour long seminar that Dr Grupp and Dr Elizabeth Shpall (MD Anderson) hosted on “Featured Topic: Chimeric Antigen Receptors (CAR): Driving Immunotherapy!” where they summarised the progress in this field in a lively, very fair minded and balanced fashion.
  • An oral presentation on the “Chimeric Antigen Receptor Modified T Cells Directed Against CD19 (CTL019 cells) Have Long-Term Persistence and Induce Durable Responses In Relapsed, Refractory CLL” [Abstr #4162]

The lunchtime seminar was simply outstanding and incredibly educational, with attendees jam packed into a tiny hall they could probably have filled three times over. It was worth the registration fee for this one event alone, it was that good. Definitely one of my top 10 highlights.

The refractory pALL study was my favourite data from the conference, though it was sadly not in the plenary. Many attendees present in New Orleans whom I spoke to, however, clearly thought it was very worthy of a such a slot. The approach and results were groundbreaking and impressive.

If you are interested in reading the interview with Dr Grupp and our insights on this area, please sign in or sign up in the box below to continue.

Last night Luke Timmerman of Xconomy posted a nice article on the formation of a new Seattle startup, Juno Therapeutics, which aims to develop the chimeric antigen receptor therapy (CART) based on autologous T cells developed by Memorial Sloan Kettering (MSK) in New York, Fred Hutchinson Cancer Center (FHCC) and the Seattle Children’s Hospital, both in Seattle.

Juno secured $120M in Series A funding, which is pretty good for a two month old startup and shows how much excitement there is for this exciting technology.

How does this new development impact the CART landscape and in particular, the U Penn and Novartis partnership?

The chronic lymphocytic leukemia (CLL) landscape has been one of the most dynamic and exciting over the last 12 months, with many new therapies emerging against different targets from CD20 to BCR signaling, Bcl2 to the PI3K pathway. Other new targets may also soon emerge.

The annual meeting of the American Society of Hematology (ASH) in New Orleans sets the scene for the rollout of more mature data and affords an early evaluation of where the various companies competing in this space may shake out.  Given that we are moving beyond traditional chemoimmunotherapy to evaluate several newer classes of therapy including B cell receptor (BCR) and PI3K signaling, anti-CD20 antibodies, anti-CD19 chimeric antigen receptor T cell technology (CART) it looks to be shaking out to an exciting conference.

Companies mentioned: Roche/Genentech, Gilead, Pharmacyclics, Abbott, Celgene, Infinity, Incyte, ONO, Amgen, TG Therapeutics, Novartis

Products discussed: rituximab, bendamustine, obinutuzumab, idelalisib, ibrutinib, ABT-199, CC-292, GS-9973, IPI-145, ONO-4059, INCB40093, AMG 319, TGR-1202, CTL-019

This year at the American Society of Hematology (ASH) there are over 800 abstracts on multiple myeloma alone. Obviously, one can’t possible do them all justice, but there are a number of important ones that are well worth highlighting, especially given the raft of new products in development, as well as some solid data from existing approved products.

Myeloma has long been dominated by proteasome inhibitors and immunomodulatory (IMiD) agents in combination with prednisone, dexamethasone, melphalan or as a triplet such as RVd, VMP etc. In Europe, melphalan still dominates as part of the base therapy, while in the US, dexamethasone (dex or simply d) is preferred partner since the tolerability is much improved along with a lower risk for secondary primary malignancies (SPMs).

In this detailed preview, the following companies and products are covered:

Companies: Millennium, Celgene, J&J, Amgen, Novartis, GSK, Array, Actelion, Biotest, KaloBio, Curis, Verastem, Karyopharm, Aeterna Zentaris.

Products: Ixazomib, lenalidomide, pomalidomide, carfilzomib, panobinostat, daratumumab, ibrutinib, CC-292, afuresertib, GSK2857916, ARRY-520, ACY-1215, indatuximab ravtansine, CUDC-907, VS-5584, selinexor, LCL161, BYL917, perifosine.

I also discuss some controversial topics such as lack of overall survival in the Revlimid trials and the risk of cardiovascular adverse events with Kyprolis. There are also an exciting raft of new compounds with new targets in various stages of development.

Obviously there will be more to come at the meeting, but for now, there’s plenty to discuss and review ahead of time.

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