Biotech Strategy Blog

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

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Breathing fire into early onco pipelines

Dragon outside ‎⁨Kiyomizu-dera Temple⁩, ⁨Kyoto⁩

It’s time to review some key highlights from ESMO in the early stage pipeline products.

There were so many on our list this year we split the review into two parts.

One challenge many biotechs face is the decision on whether or not to present initial clinical data before the full cohort has completed enrolled.

Do they go for a quick snapshot demonstrating some activity in a truncated waterfall plot as an ‘encouraging sign’ or wait for the full picture and hope it holds up over time?

It’s interesting to see this played out every year at ESMO.

At ASH and ASCO an early look will likely end up in a poster, but at ESMO there are far more slots available for developmental therapeutics, even in tumour type oral proferred papers or mini-oral sessions.

If the reaction isn’t what you expect then it can unwittingly become an actionable event for a public company.  This comes with both blessings and a curse so choose wisely.

In this review we have a mix of small and large companies, as well as regional diversity from UK/EU, US,  and Asia…

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A tale of two cities

The Tree of Life, Kenrokuen Gaden, Kanazawa

We can easily imagine a ‘tree of life’ metaphor to illustrate the philosophical idea of how advancements in cancer therapeutics can represent a growing, intricate system with many branches.

While these branches – representing novel therapies – can offer hope and potential for improved outcomes, the complexity and resource requirements might not reach all branches of the population equally.

Increasingly there is disparity between those who benefit from cutting edge treatments and those who, due to geographic or systemic barriers, remain underserved.

In today’s post from the annual meeting of the European Society of Medical Oncology (ESMO), we highlight a couple of developments where the results might factually be considered practice changing owing to improvements in outcomes, yet for various reasons may not actually move the needle in the real world…

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IO bispecifics compete with ADCs and make an impact

Bridging between cancer conferences

For all the breathless hype and attention focused on antibody-drug conjugates (ADCs) of late, you might well be forgiven in thinking other modalities have been broadly abandoned or forgotten completely.

This isn’t actually the case since there are quite a few developments on the bispecific front, which are quietly moving along and showing some intriguing data in certain areas.

As we bridge between World Lung and the ESMO meeting this weeknd, this is a good opportunity to take a look at some of the progress being made off many people’s radar…

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Ivonescimab Opportunities and Challenges

Who’s stamping their authority in 1L NSCLC?

I can’t quite believe this is the second post in a week where we find a biotech company making a claim not fully borne out by the data.

Much depends upon what yardstick you use to make these claims and often, the devil is in the details, especially when it comes to IO trials.

In this review we explore the controversial phase 3 trial for ivonescimab in first-line non-small cell lung cancer (NSCLC) from Summit Therapeutics/Akeso Bio and whether it stands up under scrutiny.

As is often the case in these kind of situations, when every one zigs – zag!

Here we explain why things may not be all they seem…

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Pointers to consider in SCLC developments

Wait, what did you say?!

How many times in the past have we seen gaudy initial high response rates from traditional chemotherapies in small-cell lung cancer (SCLC) only for people to experience early relapse due to lack of persistence and durability?

Are we doomed to repeat this process with ADCs?

The initial attempts with Stemcentrx/AbbVie’s Rova-T, a DLL3 directed ADC ended in abject failure.  Proving the target wasn’t the issue, this hasn’t stopped a bispecific T cell engager (tarlatamab) from Amgen gaining approval in extensive stage disease (ES-SCLC).

Suppose we tweak a few elements with the next generation of ADCs and try swapping out the linker, payload, and antibody target – what then?

Perhaps another target with a chequered history to date has been B7-H3, with several modalities tested and a number of companies giving it a good go without much to show for their efforts.

This weekend we saw some new clinical data with a B7-H3 ADC. First reactions were positively rosy, yet there are a number of early warning signs and nuances to watch out for, as we explain in our latest review…

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New directions in autoimmune conditions

New directions coming up for a number of agents – who are the likely winners?

It’s nearly a decade since I was last in Copenhagen for a conference and oddly, it seems to be a venue signalling new directions are taking place for pipeline agents.

Last time around it was a watershed moment of sorts for the DDR niche with a raft of key data presented on PARP inhibitors in ovarian cancer.

This time around the focus is on a completely different niche and indication altogether!

Ahead of some key phase 2 and 3 clinical data coming up this month, here’s our latest conference preview with a look at what to expect and watch out for…

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ESMO24 Preview 7 – Lighting Up Early Stage Research

While many observers following ESMO and WCLC next month will be keen on watching the phase 3 trial readouts, there’s plenty of insights to be gleaned from other research too.

For example, if we want to maintain market share of existing therapies on the market then we may need to devise solid strategies for handling combinations in the face of new competitors.

Ideally, these should be rational based on information around acquired resistance or immune escape.

Increasingly research on biomarkers as well as genomic and even transcriptomic data is becoming more commonplace.

Here we shine a light on a number of key studies, which may help us move forward with future clinical trials…

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Early Developmental Therapeutics Trends from ESMO 2024

The ESMO 2024 database currently houses over 1,820 poster titles, with no abstracts available for review yet.

In the absence of detailed insights, sifting through the massive trove for gems in Developmental Therapeutics becomes both a challenge and an opportunity.

What’s cookin’ this week in the BSB kitchen?

We’ve scoured the listings and curated a selection of promising early-stage therapies that could signal emerging trends or novel approaches.

In this preview – our sixth from ESMO24 – we explore intriguing clinical leads in the ongoing quest to address unmet clinical needs in oncology…

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ESMO24 Preview 5 – Late Breaking standouts

Standing out from the crowd

In the fifth of our ESMO 2024 Previews we turn our attention to the late breaking abstracts since the majority of the titles were released this week.

The European Society for Medical Oncology has long been renowned for its late breakers and on clinical data, in particular.

Out of all of the available options – there were over 70 of them so far – which ones stood out from the crowd and why?

The selection chosen here are varied in nature and range across seven different categories…

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We may never know

Time for some quiet contemplation and reflection

One of the single biggest challenges we face in cancer research is what we don’t know – or the unknown unknowns.

This is especially true for companies either facing new targets or those cases where we have seen quite a few failures in the clinic despite a seemingly logical and rational target to aim at.

What gives and why don’t things always go to the clinical plan?

Here we take a look at what’s under the hood on some key IO programs and some of the scientific concepts which may have an impact on the outcomes…

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