Biotech Strategy Blog

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

Posts tagged ‘Immunoscore’

Marseille – When it comes to biotech clusters for immunotherapy, Marseille, the second city of France, has to be right up there along with Boston, San Francisco in the United States and the “Golden Triangle” of Oxford, Cambridge and London in the UK.

ciml40I’m here in Marseille thanks to an invitation from Professor Eric Vivier to attend the 2-day scientific conference that the Centre d’Immunologie de Marseille-Luminy (CIML) have organized as part of their fortieth anniversary celebrations (1976-2016). It starts today (Twitter #CIML40).

Surrounding CIML in the picturesque national park (Parc National des Calanques), just outside the city, are innovative biotech companies focused on immunology and cancer immunotherapy. The combination of companies, research institutes and academic hospitals in the region has created the Marseille Immunopôle (@Immunopole). The area should already be on your radar if you are following the field.

haliodx

Yesterday, I visited HalioDx (@HalioDx), a start-up company a stone’s throw from CIML. It was founded in 2015 to commercialize Immunoscore, a novel biomarker in colon cancer that can be used to stage patients based on their immune response.

Vincent Fert CEO HalioDx

Vincent Fert, CEO of HalioDx

We’ve been following the work of Dr Jérôme Galon on the blog for some time (see posts from European Cancer Congress 2015 and ASCO 2016), so it was a pleasure to talk to Vincent Fert, CEO (pictured right) and co-founder of HalioDx, about his plans to commercialize Immunoscore in Europe and the United States.

If you want to know more about the science behind Immunoscore, do listen to the recent Novel Targets Podcast (@TargetsPodcast) interview with Dr Galon, where he talks about the data he presented at ASCO 2016 (link to Episode 13: Immunotherapy or Bust).

The field of cancer immunotherapy is making rapid progress. It is already reaching the point where — in order to optimize the chance of a durable response — doctors need to know what a patient’s underlying immune response to cancer is, in order to direct therapy.

Vincent Fert and HalioDx are leading the way with the commercialization of a new diagnostic approach for colon cancer based on a patient’s immune profile. He kindly spoke with BSB about his plans for the company and making Immunoscore available in the US and Europe.

haliodx-marseille-luminy

This is the first post in a mini-series from the Marseille Immunopôle.

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ASCO 2016 Collective WisdomContinuing part two of our mini-series on colorectal cancer, today we move from the big scale Immunoscore study to small subsets of disease that are looking interesting in several ways.

For years, advanced colorectal cancer has been dominated by chemotherapy (FOLFOX or FOLFIRI) with and without targeted therapies (VEGF and EGFR antibodies), with very little new to talk about. Part of the challenge here is how do you add something the existing standard of care and move the needle significantly. In front-line, for example, the OS is already out 2-plus years, so these are long and risky trials to undertake. Not surpisingly, many companies have sought to evaluate their agents in tumour types where they consider the risk of development to be lower.

Unless… we can find creative approaches that turn the paradigm on its head and identify a clearly defined niche that can be carved out separately from allcomers.

This is where we’re at now – identifying subsets that might respond exquisitely to novel approaches based on a rational understanding of the underlying biology.  One obvious subset might be BRAF, which can be treated with a BRAF inhibitor with or without other targeted therapies as Dr Pietrantonio and colleagues (2016) literally just showed for example, but what about others of potential interest?

Colorectal cancer with microsatellite stable (MSS) disease represents 95% of metastatic patients. These are people whose mismatched repair system is proficient and actively functional in fixing the DNA strand breaks that occur during the course of life.

In contrast, those with microsatellite instability (MSI) are the minority of people with colon cancer (and some other cancers too) whose mismatched repair system is deficient and unable to adequately repair the DNA strand breaks. Ironically, this leads to thousands of mutations that can be recognised by the immune system to help detect the presence of cancer. It also tends to occur in hereditary cancers such as Lynch Syndrome.

We’ve been following the MSI vs MSS story for a while now, but at ASCO this year there was more data available and things appear to be getting clearer on the commercial front too.

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We’ve been following the work of Dr Jérôme Galon, a French immunologist, on Immunoscore for a while now, and many readers will remember the last interview he kindly gave BSB from the European Cancer Conference in September [Link].

IMG_6454In 2015 the large global trial to validate Immunoscore as a biomarker was still ongoing, so if you want some background to this important concept, do check out Dr Galon’s interview as it’s well worth reading as a primer on immunosurveillance, the importance of immune cells – the type, density and location, as well as background on the Immunoscore test as a marker of outcome.

Since then, the group have also published some related data that both moves the field forward and offers a way to unify some important concepts in colorectal cancer.

In Chicago, the really good news was that the final results of a large global study involving nearly 4,000 patients were presented to a packed audience in the main hall where the plenary is held. It’s not often you see the gastrointestinal oral session allocated the prime time room over lung or breast cancers – the atmosphere was certainly electric with anticipation!

This week’s post ASCO mini series focuses on colorectal cancer, with a look at several important aspects of this disease as we learn more about the underlying biology, as well as how the immune system functions and how we can use that scientific knowledge to improve outcomes for patients, sometimes in a dramatic way.

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We have selected five key strategic trends that are emerging that will be critical to follow, understand, and even implement if you are on the coal-face of clinical research and new product development.

ASCO16 Chicago 5We aren’t talking about financial things such as cost toxicity, or even how doctors should be paid, but meaty scientific aspects that we need to watch out for. If we are going to improve on cancer research and R&D in the future, these issues will be important.

For companies and academic researchers alike, there is much to learn from the tsunami of data that hit this week if you have a keen interest in the field and a bent for making sense of patterns out of an amorphous mass of data.

Not paying attention to evolution in clinical development can mean the difference between being in the winners circle, on the outside looking in, or falling way behind your competitors. Playing catch up is never anyone’s idea of fun in this market – oncology moves at a lightning fast pace compared to many other therapy areas.

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The 10 abstracts selected here are actually not in order of magnitude, preference or weight… with the lone exception #1, an incredible piece of work that was a decade in the making.

Chicago!

Chicago!

Few of these choices are in the press briefing, none are in the Plenary session – they’re often hidden gems that many will miss in the hurly burly of the data drop and noise.

They’re also 10 abstracts that I feel are worthy of highlighting with some additional commentary.

Some of the ideas here illustrate some intriguing trends that are emerging, others may have a big impact on the cancer immunotherapy space, either because of the novel concept idea, or because the data are very compelling, if you understand the science.

You can decide for yourselves – which ones would you pick and why?

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Dr Jerome GalonDr Jérôme Galon is a leading Immunologist and Research Director at INSERM in Paris.

At the recent European Cancer Congress in Vienna he gave an engaging presentation in the scientific symposium on Cellular Immunotherapy of Cancer.

Afterwards, Dr Galon (pictured right) kindly spoke to BSB about:

  • What is immunosurveillance?
  • How the type, location and density of immune cells present within tumors predicts clinical outcome.
  • The potential of the Immunoscore assay to classify cancers based on their immune profile
  • What the future may hold in terms of personalized cancer immunotherapy.

One only has look at the impressive list of companies for which Dr Galon is a consultant or scientific adviser to see how valued his work in the cancer immunotherapy field is; it was a privilege to talk with him. The excerpts of the in-depth interview he kindly gave make for a good weekend read!

Grab a coffee & bagel and enjoy!

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