Biotech Strategy Blog

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

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The next generation of cancer therapeutics at ESMO

After a decade chasing the promise of combination immunotherapy, oncology faces an uncomfortable paradox.

Quite simply, the more combinations we test, the clearer it becomes most will fail and fall by the wayside.

Yet buried in sessions held in Berlin there are signs some researchers have finally made progress, although not through brute force pairing of agents, but by understanding why tumours resist in the first place.

The big question isn’t whether ESMO 2025 will deliver practice changing data because this is clearly coming. It’s whether the field has learned the right lessons from its expensive mistakes in the next generation agents coming down the pike.

The latest data will reveal whether we’re witnessing genuine evolution in drug design, or just more sophisticated ways to fail…

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Purple Cows at ESMO: six ADC trends worth watching

There has been numerous highlights and reviews on the various phase 3 readouts coming up at the European Society of Medical Oncology (ESMO) annual meeting in Berlin from October 17–21st. Rather than rehash what’s already been covered, I thought we would kick off the BSB Preview series with a look at what’s coming through in Developmental Therapeutics.

More specifically, we’re going to highlight half a dozen emerging topics to watch out in the antibody-drug conjugate (ADC) niche, along with several illustrative examples of each genre.

Never seen a purple cow, although these purple flowers were a standout in Berlin this summer!

The variety of targets, linkers, and payloads, as well as molecule designs for single versus dual targets or payloads is gradually beginning to expand, as are the combination regimens being evaluated in the clinic.

Gone are the days of yet another new HER2 or TROP2 ADC with a topoisomerase-I inhibitor payload – it’s becoming much more interesting now as companies seek to push the envelope further.

While more variety is welcome, standing out from the fray is becoming increasingly trickier over time…

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Deeper, Longer, Broader: Arcus unpacks its strategic evolution

Arcus Biosciences held an R&D Day on Monday largely expecting updates on casdatifan, their HIF2α inhibitor challenging Merck’s belzutifan in clear cell renal cell carcinoma (ccRCC). What they delivered instead was a strategic coming out party for an inflammation and immunology (I&I) pipeline few anticipated.

Fall cancer season is in full swing

Whilst the casdatifan data provided more reassuring evidence of best-in-class potential, it was the reveal of a raft of novel small molecule programs in traditionally biologics-dominated territory, which genuinely surprised.

For a company previously pigeon holed as a pure oncology play, this represents a bold diversification into a therapy area where mechanistic innovation could disrupt entrenched competitors.

In our latest post we explore both the casdatifan updates as well as the early stage I&I pipeline news…

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Engineering Next Generation Proteins

The history of cancer therapeutics can pivot on a few contrarian bets, which inevitably surprise a few people when they are subsequently proven correct.

Combining chemotherapy with immunotherapy seemed foolish until it worked. Linking checkpoint inhibitors to angiogenesis inhibitors looked redundant until the clinical data showed otherwise, at least from a progression-free survival (PFS) standpoint.

The dawn of a new ADC era?

Each advance required someone willing to challenge consensus when mechanistic understanding pointed in a different direction.

Some people make a career out of these contrarian positions, defending unpopular combinations against sceptical audiences and building technologies others dismissed as impossible.

In the first of our expert interviews on antibody-drug conjugates (ADCs), we’re kicking off with a broader discussion about ADCs versus T cell engagers and insights on synthetic immunity with Dr Dan Chen, formerly at Genentech and IGM Bioscience, who is now CEO at Synthetic Design Lab.

In an engaging and wide ranging discussion, he lays out his vision for where next generation proteins might be heading…

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What Genmab saw in petosemtamab others missed

When Genmab announced their $8 billion acquisition of Merus this morning, some Wall Street analysts were quick to dismiss the deal as overpriced late stage desperation…

The response rates looked good, yet were considered hardly revolutionary, while the head and neck cancer market seemed too small and likely to plateau for others. And besides, hadn’t the response rates actually dropped between last year’s presentation and this year’s?

When the LiGeR-HN1 phase 3 trial reports its first interim analysis, some of the same analysts may well find themselves recalculating their models. Something in the petosemtamab data told a story not immediately obvious from the top line numbers – and Genmab was willing to bet $8 billion they’d read it correctly.

The question is did everyone else miss it, or did Genmab simply run out of time to wait?

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Upregulating the unexpected

What if the key to unlocking immunotherapy resistance and immune escape was hiding in plain sight in clinics across the world?

Yet when we consider how cancer hijacks cellular processes to ensure its own survival, perhaps we shouldn’t be surprised when certain approved drugs might hold the key to unlocking the mystery.

Sometimes the most unexpected opportunities for critical upregulation of antigen presentation happen when we’re not even looking for it…

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Why Big Pharma is circling China’s latest early stage ADC

When whispers of licensing talks surfaced this morning involving household names like Johnson & Johnson and Roche, most observers likely assumed it was another biotech rumour mill story.

Is the Chinese ADC dragon roaring again?

The Chinese company at the centre of these speculations (Fosun’s Henlius) has quietly assembled clinical data suggesting something far more significant than typical pharma dealmaking.

The numbers emerging from their latest trial do not represent the usual incremental or modest progress. Rather they hint at a potential shift in how we could approach one of oncology’s most challenging disease subset.

While one big Pharma previously spent $43 billion acquiring yesterday’s antibody-drug conjugate (ADC) technology, a different approach was taking shape in Shanghai laboratories.

This is one which might rewrite the playbook for ADCs in a different way from what many realise…

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Who’s still standing after WCLC 2025?

In our latest review on research presented at the World Conference on Lung Cancer (WCLC) in Barcelona, we highlight five different presentations where there are some important nuggets to discover.

Some companies offered headlines with a flourish and stylish looking press releases.

When you dig into the details though, does the data hold up under scrutiny or are there some icy patches ahead…

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WCLC25: The wow factor in SCLC wasn’t an ADC after all

And no, it wasn’t one of the hot bispecific antibodies either!

Finding gold at WCLC25

If you’ve been following the small cell lung cancer (SCLC) space, you’ve probably heard the same refrain; ADCs are the future…

Higher response rates, validated targets, new Topo-I payloads, precision medicine at its finest.

Many in the investment community certainly seems to think so, with every new agent sparking fresh excitement about who might capture market share based on the most tumour shrinkage.

But what if everyone’s been looking in the wrong direction?

In this review, we look at a dozen developments across multiple targets and modalities to find the most promising ones to watch out for in SCLC…

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The sword of Damocles

In ancient Syracuse, Damocles learned how power comes with peril when a single horsehair held a blade above his head.

At this week’s World Congress on Lung Cancer, Summit Therapeutics discovered combining trials to inflate your data comes with similar risks, especially when regulators are watching.

Sometimes being too clever by half creates the very problem you’re trying to solve.

In this critical review, we offer up our assessment of three phase 3 trials with three different outcomes… yet only one company is sitting in Barcelona this week knowing they’ve painted themselves into a regulatory corner of their own making.

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