Biotech Strategy Blog

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

Posts tagged ‘urothelial bladder cancer’

A decade or so ago, the annual conferences for the European Congress of Clinical Oncologists (ECCO) and European Society of Medical Oncologists (ESMO) were considered convenient dumping grounds for negative or failed trials. This was largely because they received much less attention than their big brother, the American Society of Clinical Oncology (ASCO).

In the last few years, this trend has shifted with excellent clincial and scientific data being presented at both meetings – they alternate as hosts each year – under the European Cancer Congress (ECC) umbrella.

Just to confuse a global audience long used to referring to the meetings as ESMO and ECCO, while the logical Twitter hashtag might appear to be #ESMO14 and #ECCO15, respectively, based on the standard nomenclature of conference acronym followed by the year, the vagaries of European politics mean we end up with… #ECC2015.

It will be interesting to see how they compete for attention because this hashtag signal will be dirty (more than one usage) and noisy (many disparate voices) with the European Curling Championship, a European Cheerleader Convention and another on e-cigarettes and vaping, all seemingly using the same moniker!

ECCO 2015 Vienna

Still, what many readers are really eager to learn though, is this a great, middling, or poor year for exciting new data in the field of cancer research and what can we expect to hear about in Vienna later this month?

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Gumbo Shop New OrleansThe annual meeting of the 2015 American Urological Assoication (AUA) is being held in New Orleans… Yes, we’re on the third and final leg of our Louisiana trip encompassing AAI, ASGCT and now the triumvirate of AUA-SBUR-SUO.

This morning, I attended the Urologic Oncology Research Symposium, “High impact science in urologic oncology and progress in biomedical imaging.”  In particular, I was keen to hear about the latest research in urothelial bladder cancer (UBC) with regards to checkpoint blockade with anti-PDL1 and PD-1 therapies.

In the past, any session on bladder cancer guaranteed the lucky (or hapless) presenters with an audience of a dozen or so people.  Not any more – the room was packed with standing room only very quickly – a nice change for a disease that has seen no new therapies for 30 years.

Part of this renewed enthusiasm is due to the excitement for the checkpoint therapies making a huge impact in this disease, at least in clinical trials to date. While waiting for the session to start, one urologist I spoke to told me he bought the ASCO Virtual Meeting last year just to hear Dr Tom Powles talk on anti-PDL1 therapy with MPDL3280A in advanced urothelial cancer. What did you think of it, I asked?

“Wow, just wow!”

Later this month an update on the more mature data from that phase I trial is due at the American Society of Clinical Oncology (ASCO) from Dr Daniel Petrylak (Yale)… who just happened to be one of the presenters at AUA this morning.

He discussed the checkpoint data with atezolizumab (MPDL3280A) in urothelial bladder cancer, as well as the pembrolizumab data from ESMO last fall and what’s happening with nivolumab. These drugs are quite different in many ways, not just in terms of the efficacy, but also in terms of the biomarker data, as we discovered today.

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As we’re coming to the end of our European Association Urology (EAU) coverage for 2015, I wanted to discuss at a rather more quirky, off-the-wall topic and look at one of the gems from the poster halls at this conference.

This year, it’s the turn of urothelial bladder cancer (UBC), a topic that doesn’t usually get much coverage or respect when it comes to new product development. Part of the challenge is the need for new targets to aim at because the particular patient population doesn’t tolerate high dose chemotherapy very well.

At ASCO last year, perhaps the surprise (and most stunning) data of the meeting was the anti-PDL1 checkpoint data (Genentech’s MPDL3280A) in refractory UBC, a disease where there are a lot of elderly and frail patients who are challenging to treat in many ways. This certainly put more attention on the disease and raised awareness to the potential opportunities for new, targeted and altogether more benign approaches to treatment. Subsequently at ESMO last fall, we also saw early data for an anti-PD1 antibody (Merck’s pembrolizumab) in advanced urothelial cancer.

Checkpoint blockade is not the only potential way to treat UBC though, so what other novel therapeutics are in development in this space?

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It’s now time to turn our attention to genitourinary oncology and, in particular, prostate, renal and urothelial bladder cancers. This week brings this ASCO GU meeting (#GU15), which is being held in Orlando this year and began this morning.

There are quite a few interesting topics being covered here, particularly in the poster sessions over the next three days. Hopefully, 2015 will also bring more good news in this space as 2014 was a rather dismal one on several fronts!

We decided to highlight some of the most interesting abstracts on castrate resistant prostate cancer and urothelial bladder cancer in our latest conference preview.

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One of the most exciting presentations that I heard at ASCO 2014 – the sort that give you goosebumps and elicit a wow from people sitting next to you – was not in the plenary or even a tumour type oral session, but a clinical science symposium.

The subject? Bladder cancer.

The situation? Phase I clinical trial.

The therapy? Anti-PD-L1 therapy with MPDL3280A.

Prof Thomas Powles, Barts Cancer Institute, London

Prof Thomas Powles, Barts Cancer Institute, London

As the presenter, Prof Thomas Powles (Barts), dryly observed to the packed auditorium, it made a welcome change from the ten people who usually show up for bladder cancer sessions! After all, there have been no new approved therapies for this disease for some thirty years.

It wouldn’t have been out of place in the Plenary session, frankly.

By the time the ASCO selection committees cotton on to the fact what many of us know – that immuno-oncology is not only hot, but here to stay and actually changing the way we think about and treat some advanced cancers – some of these new checkpoint inhibitors will already be approved by the FDA.  As one thought leader grumpily said to me:

“It’s not something they understand, nor does it involve the traditional things like breast or prostate cancers, plus it’s all political anyway.”

Ouch. Still, there was a lot to learn from this data, not just in terms of the results in an area of high unmet medical need, but also in our understanding of the immune system and where some future opportunities lie.

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