Biotech Strategy Blog

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

About Pieter Droppert

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Posts by Pieter Droppert

Can we use immunotherapy to treat or delay Alzheimers Disease?

Berlin Wall Museum

Preserved section of the Berlin Wall

I have a personal interest in Alzheimers Disease, my mother Audrey died from it three years ago back in 2014.

Since then, I’ve watched with fascination and excitement the progress made in using the body’s own immune system against cancer. There’s still a long way to go, but a revolution in treating cancer is underway, as we’ve been documenting on this blog and the Novel Targets Podcast.

In recent years in the United States we’ve also seen grand initiatives targeting cancer such as Vice President Biden’s Moonshot, as well as large philanthropic support e.g. the creation of the Parker Institute for Cancer Immunotherapy.

Sadly, we’ve not seen the same level of interest in targeting dementia or funding research into new treatments for Alzheimers disease.

In the United States, the media doesn’t talk much about Alzheimers (compared to cancer), unlike for example, in the United Kingdom where any promising data is heralded with headlines that frequently deliver “hype over hope.”

Alzheimers is an insidious disease that removes the ability of the person to advocate and care for themselves, instead placing the burden on families and caregivers, often for extended periods of time. Ultimately many people end up in supported living or nursing homes.

As we debate healthcare insurance in the United States, who is going to pay for the cost of dementia care as the population grows older? Caring for dementia is arguably the greatest public health challenge that the western world faces.

Which is why I was excited to talk with a researcher who is thinking outside of the box and leading the way in how we could use our immune system against Alzheimers.

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Paris Immuno-Oncology Summit 2017

Paris, France – Last week I had the pleasure of attending a two day Immuno-Oncology Summit, an industry sponsored CME event organized by the European Academy of Tumor Immunology (EATI) and Miltenyi Biotec.

The summit was held at the Centre de Recherche des Cordeliers (CRC) in the quartier Latin on the historic left bank of Paris, a short walk away from Notre Dame cathedral.

Paris Immuno-Oncology Summit 2017

Most of the attendees were French researchers so this opportunity afforded them a chance to hear from leading researchers at the forefront of cancer immunology, including several who travelled from the United States to speak at the event.

CRC Courtyard Statue

I have yet to attend a cancer immunotherapy meeting where I didn’t come away with new insights into what is a fast moving field, where it’s important to see “connections” beyond a tumor type or target.

This post offers top-line commentary highlights on five key presentations at the summit. There were two parallel tracks and a lot of interesting speakers at what was an enjoyable meeting, so think of this like a postcard from Paris.

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Why did Atezolizumab fail in advanced Urothelial Bladder Cancer?

Florence, Italy: Today at the EACR-AACR-SIC Conference on “The Challenges of Optimizing Immuno and Targeted Therapies,” Tom Powles MRCP MD, Clinical Professor of Geniturinary Oncology at Barts Cancer Institute in London, gave a special lecture on the IMvigor211 trial (NCT02302807).

EACR AACR SIC Conf Banner

This was a phase 3 study of the PD-L1 checkpoint inhibitor atezolizumab compared with chemotherapy in participants with locally advanced or metastatic urothelial bladder cancer.

Prof Tom Powles (Barts)

Prof Tom Powles (Barts Cancer Institute)

Readers may recall we interviewed Prof Powles back in August 2015 about the potential for the PD-L1 checkpoint inhibitor atezolizumab in urothelial bladder cancer? (See post: Atezolizumab PD-L1 Checkpoint Inhibitor will Change Bladder Cancer Treatment.)

We also featured the atezo data presented by Dr Jonathan Rosenberg (MSKCC) at ESMO 2015 on Episode 7 of the Novel Targets Podcast, where we also heard Prof Powles tell us about the long durable responses he had obtained in clinical practice in some of his patients.

Subsequently on May 18, 2016 the US Food and Drug administration (FDA) granted accelerated approval to atezolizumab (Tecentriq) for urothelial bladder cancer (link to news release).

Fast forward a year to May 9, 2017 and the surprise announcement that the confirmatory phase 3 trial (IMvigor211) failed to meet its primary endpoint (link to Genentech press release).

So what happened? Why did the atezo phase 3 trial end up being negative when we saw durable responses in the randomised phase 2 trial and other PD-1 checkpoint inhibitors have shown an overall survival benefit in the same indication?

Many in the media only want to write about positive data, but in science we often learn as much from our failures as we do from our successes, perhaps even more sometimes.

IMvigor211 was expected to be a positive trial especially after the recent Merck success gaining an overall survival benefit for pembrolizumab, so the negative result is noteworthy and one that anyone in the field of cancer immunotherapy drug development will want to understand.

Professor Powles kindly spoke to BSB and shared his perspective.

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Gems from the ASCO17 Poster Hall Part 1

One of my favourite pastimes at cancer conferences is discussions with up and coming young researchers about their current experiments and what they learn from them.

The poster hall rugby scrum at #ASCO17

In the spotlight today is one of the gems from the poster halls at ASCO this month…

Here we explore how liver mets, which is a common site of metastases from a number of primary cancers can influence the response of cancer immunotherapy.

The findings from this research highlight some intriguing biology as well as offer some hints about where to go next.

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New IO developments in breast cancer

#ASCO17 Poster Hall aka rugby scrum

There were a lot of gems in the poster halls at ASCO this year, a fact that is partly a reflection of the wealth of new data with various IO combos and also the early cutoff date.

Now I jested before the meeting that these sessions were akin to a rugby scrum and lo and behold (see photo right) they were even more jam packed than usual!

If you wanted to best the eager and energetic Wall St analysts then remembering your ruck and maul skills were not a bad thing to have in muscle memory… It was not something I attempted in the Go-Cart this year for fear of bowling people over in the stampede to nab the QR codes 🙂

Much of the previous readouts have been with monotherapy in immunogenic tumours such as melanoma, lung, bladder, gastric, renal cell carcinoma etc. Objective response rates in metastatic triple negative breast cancer (TNBC) have generally been under 20%, however.

Lately, the focus has turned to the deepening of responses in these tumours with various combination approaches and also moving earlier in the disease setting, where immunotherapies might be expected to be more effective with a lower tumour burden.

While in Chicago, we spoke to a breast cancer specialist about where IO combos are going and his thoughts on future opportunities in our third post in a series on various aspects of new developments in breast cancer.

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Do Exosomes Matter?

At AACR17 one of the fascinating topics that came up in several presentations was exosomes, what they are, and how the information they contain can be used to best effect.

One of the evangelists of exosomes, and their potential in cancer research is Theresa Whiteside, PhD who is a Professor of Pathology, Immunology and Otolaryngology at the University of Pittsburgh.

At the recent 2017 American Association for Cancer Research (AACR) annual meeting, Dr Whiteside gave two fascinating talks in education symposia.  Afterwards, she kindly spoke to BSB about her research.

Love them or hate them, exosomes were a hot topic in Washington DC and something you should be aware of, if you aren’t already.

This post continues our volley of expert interviews from AACR17 and is the ninth in the series.

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Potential of CAR T cell therapy targeting Glioblastoma

Long time attendees at the annual meeting of the American Association for Cancer Research (AACR) know that there are usually interesting posters and sessions buried on the last day of the meeting.

This year was no exception, with a major symposium on “CAR T Cell Cancer Immunotherapy” chaired by Michael Jensen MD (pictured right).

BSB readers will recall we interviewed him at the 2016 BMT Tandem meeting in Honolulu (See post: Optimizing CD19 CAR T cell therapy).

The CAR T symposium on the last day of AACR was one of my highlights of the meeting. The three speakers were:

  • Michael Jensen, MD (Seattle Children’s) Engineering Next Generation CAR T cells using Synthetic Biology-Inspired Technologies
  • Terry J. Fry, MD (National Cancer Institute) Defining and overcoming limitations of CD19 CAR immunotherapy in pediatric ALL
  • Christine E. Brown, PhD (City of Hope) Progress and Challenge in CAR T Cell Therapy for Brain Tumors

Each of these presentations would merit a full blog post in their own right, but in this particular post we’re focusing on CAR T cell therapy targeting glioblastoma multiforme (GBM).

GBM is the most common primary malignant brain tumor, and one with a dismal prognosis – the 5-year survival rate is only around 5%, so there is also a high unmet medical need for new effective treatment options. This devastating disease has proven to be a miserable graveyard for Pharma over the last decade, with many agents unfortunately ending up in dog drug heaven.

After her AACR17 presentation, Dr Brown kindly spoke to BSB.

This post is part of our series of thouight leader interviews from AACR17. It also continues our ongoing posts on the adoptive cellular therapy landscape, and in particular, CAR modified T cells.

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Dan Chen outlines his vision for the Future of Cancer Immunotherapy at AACR17

Dr Daniel Chen, Roche/Genentech at AACR17

Dr Daniel Chen in the Meet the Expert session at AACR17

At the recent annual meeting of the American Association for Cancer Research (AACR17) one of the 7am “Meet the Expert” sessions was with Dr Daniel Chen.

Chen is a medical oncologist and immunologist. He’s also Vice President, Global Head of Cancer Immunotherapy at Genentech and Roche.

He’s perhaps best known in the cancer immunotherapy field for his publication on the Cancer Immunity Cycle with fellow Genentech VP, Dr Ira Mellman. They have a new publication out on the Cancer-Immune Set Point that takes this forward. (See post: Understanding the Cancer-Immune Set Point).

At AACR17, Dr Chen kindly spoke to BSB about his vision for cancer immunotherapy. Anyone who has seen the film, “Jerry Maguire” starring Tom Cruise will remember the moment when Jerry drafts the memo on “The future of our business.”

What does the future of cancer immunotherapy look like from the perspective of a leading industry professional active in the field?

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What does atezolizumab TNBC data presented at AACR17 tell us about breast cancer immunotherapy?

Prof Peter Schmid

Prof Peter Schmid, Barts Cancer Institute

Peter Schmid FRCP, MD, PhD is Professor of Cancer Medicine at Barts Cancer Institute in London, where he is also Clinical Director of the St. Bartholomew’s Breast Cancer Centre and leads the cancer immunotherapy group.

One of my favourite interview quotes of all time comes from his fellow Barts cancer researcher, Professor Tom Powles who told BSB about the results he had seen with the anti PD-L1 monoclonal antibody, atezolizumab (Roche/Genentech) in urothelial bladder cancer:

“I have a cohort of men and women now, who had been told they have 6 months to live who are now two or three years down the line.”

This encapsulates the hope that cancer immunotherapy offers. (See post: Atezolizumab PDL1 Checkpoint Inhibitor will change Bladder Cancer Treatment).

Barts Cancer Institute in the City of London is pioneering research into cancer immunotherapy in both the clinical and preclinical arenas.

Readers may recall we previously interviewed Professor Fran Balkwill last year about the work her research group is doing into modelling the tumour microenvironment. This is an exciting area that we can expect to hear more about. (See post: Modelling the Tumor Microenvironment).

So where are we with breast cancer immunotherapy in triple negative breast cancer (TNBC)?

It’s now two years since the first atezolizumab TNBC clinical trial data was presented by Dr Leisha Emens (Johns Hopkins) at the 2015 annual meeting of the American Association for Cancer Research (AACR), how time flies!  (See post: Checkpoint Inhibitor Data Rocks AACR 2015)

As regular readers know, we like to follow stories over time and report on how the longitudinal data progresses.

Professor Peter Schmid kindly spoke to BSB at the 2017 AACR annual meeting in Washington DC where he presented more mature clinical trial data for the PD-L1 checkpoint inhibitor, atezolizumab, as a single agent in TNBC.

What are the key take homes from this data, and the ongoing challenges and opportunities in TNBC?  Prof Schmid shared his unique perspective.

This is the first in a series of expert interviews from #AACR17.

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Corvus CPI-444 Data Disappoints at AACR 2017

Washington DC – this is our final daily post from the 2017 annual meeting of the American Association for Cancer Research (AACR).

Starting on Monday we’ll be writing up expert interviews and providing commentary and analysis around some of the sessions we went to and the data we heard.

Tuesday at AACR17 was a day when the Corvus Pharmaceuticals stock dropped 50% following presentation of preliminary clinical data for their A2A receptor antagonist CPI-444.

It’s hard not to be disappointed when you see the waterfall plots skewed to the left and above the X axis, but we really don’t have enough data yet to determine whether CPI-444 on it’s own or in combination with atezolizumab may offer benefit to some cancer patients and if so, which ones.

The company have expanded the renal (RCC) and lung cohorts (NSCLC) in their initial trial, and they’ve told us to expect more data at ASCO17 in a few weeks time. Small cap biotech stocks can be a roller coaster when it comes to data presentations at major medical/scientific meetings.

What else caught our attention in the sessions we attended on Tuesday at #AACR17?

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