Biotech Strategy Blog

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

One of the ongoing challenges with cancer immunotherapy is monitoring response to treatment.

Even if you are one of the minority of people who do respond to cancer immunotherapy, many responders go on to develop acquired resistance or experience immune escape resulting in a loss of response to therapy, which means we need to be able to detect what is happening in the immune system of a cancer patient in order then identify the next treatment option.

Dr Whiteside in the poster hall at #AACR18

Could the proteins and nucleic acids carried by virus sized microvesicles called exosomes – present in their billions in blood plasma – provide insights into biomarkers of response to therapy and what is happening in the tumour?

Some people think they can, while others remain skeptical.

We think it’s cool area of research, worthy of consideration and following as we continue to explore various biopsy and blood/plasma approaches.

One person at the forefront of exosome research is Dr Theresa Whiteside from the University of Pittsburgh, where she’s a Professor of Pathology, Immunology and Otolaryngology.

At the recent 2018 annual meeting at AACR, she kindly spoke about her innovative work over the past year in what is now an exploding field of research…

To learn more from our latest thought leader interview and get a heads up on our oncology insights, subscribers can log-in or you can click to gain access to BSB Premium Content.

The #ASCO18 poster hall scrum

Wrapping up our cytokine mini-series, we have our latest expert in the BSB hotseat discussing concepts and future developments, as well as strategically drawing things together in a way that makes sense.

It has become increasingly clear that a hostile tumour microenvironment may account for one of the reasons why many patients don’t respond to cancer immunotherapy.

How do we go about figuring out the whys and wherefores in order to significantly improve on the results seen to date with monotherapy treatment?

There are quite a few angles to look at this conundrum, so we decided to explore some concepts and analogies, as well as look at what’s going on under the hood of IO clinical trials to address the thorny issue of tumour heterogeneity.  We also discuss some of the top-line data in the cytokine niche presented at ASCO and look at the outcomes in the context of what we learn and where we going next.

There’s a lot to take in and process here, but that’s part of the fun!  As often is the case, some of the best gems are in the poster halls or poster discussion sessions…

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The potential of cytokines in cancer immunotherapy is now attracting a lot of attention with many in industry assessing whether they need a cytokine in their pipeline and if so which one may make the optimal combination partner.

We’ve been writing about cytokines for several years now and have been following several cytokine molecules, including Nektar’s novel pegylated IL–2 (NKTR–214) approach and Armo’s pegylated IL–10 (AM0010). Other technologies in early development include an IL–8 agonist from BMS and an IL–15 superagonist fusion protein from Altor Bioesciences.

#ASCO18 Blisterwalk to Developmental Therapeutic sessions

What does the future hold for cytokines – are they really the “best thing since sliced bread,” as we say in England or will they fizzle out and not prove to induce additive effects over and above monotherapy with checkpoint blockade?

For a view of where the field is at and where it might be going, while in Chicago we spoke with Dr Mario Sznol, who is a medical oncologist at Yale Cancer Center in New Haven, where he treats melanoma and kidney cancer patients.

He’s one of the leading translational researchers in cytokine drug development and is also the in-coming president of the Society for Immunotherapy of Cancer (SITC).

Readers of Biotech Strategy will recall that we last spoke with Dr Sznol at the 2015 SITC annual meeting where he talked about his renewed interest in cytokines, and in particular, interleukin–2 (IL–2) (See post: Novel immunotherapies and combinations). Since then, much has happened and there are now even more targets being investigated, as well as a wider cadre of researchers actively involved in this field.

Being president of a medical or scientific association takes up a lot of time, so it was a privilege to talk with Dr Sznol again, before he takes up his new honorary position in 2019.

To learn more from our latest thought leader interview and get a heads up on our oncology insights, subscribers can log-in or you can click to gain access to BSB Premium Content.

Palace guard in Stockholm

Stockholm, Sweden – The annual meeting of the European Hematology Association (EHA) is in full swing with updated data from two blue companies, Blueprint Medicines and bluebird bio of interest to BSB readers.

There is often beauty and simplicity to be found in nature that also applies to oncology R&D.

One of those aspects can be found in the concept of targeting particular aberrations or molecular rearrangements that driven oncogenic activity.  Once you connect the dots to arrive at these key targets, you can develop therapeutics that inhibit the activity, resulting in cessation or reduction in proliferation.

In our latest post, we focus on an update on Blueprint Medicine and take a look at their various programs in early clinical development, as they have quite a lot going on with multiple targeted compounds in different areas, including hematology.

To learn more from our latest analysis and get a heads up on our oncology insights, subscribers can log-in or you can click to gain access to BSB Premium Content.

At Biotech Strategy, we’re fans of science-driven companies, and one that we’ve been keen following for over three years now is Nektar Therapeutics (NASDAQ: NKTR).

Drs Jonathan Zalevsky and Adi Diab

We last spoke with the “dynamic duo” Nektar’s Dr Jonathan Zalevsky (CSO) and Principal Investigator, Dr Adi Diab (MD Anderson), back at SITC17.

Since then, much noise and attention has focused on cytokines and the potential they have to improve responses with checkpoint blockade. There are plenty of sceptics out there who don’t believe they add anything in combination, while others are equally adamant that they do.

It was a pleasure to catch up with them again at ASCO 2018, and in this post we take a closer look at what the NKTR–214 data presented in Chicago does in fact tell us.

Is it hype over hope, or is it the real deal?

What did we learn about NKTR–214 at ASCO18 and how should we interpret this data from a clinical and scientific perspective?

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It is always a pleasure to talk with experts who have a clear vision of not just what the current treatment landscape looks like, but where the field is going.

Dr Stephen Liu at ASCO18

Dr Stephen Liu is a medical oncologist and assistant professor at Georgetown University Medical Center in Washington DC, where he specializes in thoracic oncology.  He’s also actively involved in clinical trials and developmental therapeutics.

We last interviewed him at ASCO 2016 – you can also hear him on Episode 13 of the Novel Targets Podcast – where he shared his thoughts on some of the early lung cancer immunotherapy combination trials underway.

As regular readers know, we like to follow stories over time and also catch up with thoughtful, intelligent people we’ve talked to in the past whose opinions we value.

Dr Liu kindly shared his highlights of ASCO 2018 in lung cancer, and in a wide ranging discussion, also offered some thoughts on what the future may hold and where we may be going next.

There was a lot to learn from Chicago this year, with plenty of nuances and subtleties to consider. If you read only one post on lung cancer from ASCO18, this interview tells you all you need to know!

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Beyond Loxo’s RET inihibitor, LOXO–292 in RET+ cancers, there were quite a bit of other targeted therapy data to mull over at ASCO this year.

ASCO18 Gems from Poster Halls

We highlighted a few of these in our Preview series in terms of what to watch out for, so I wanted to take a moment and explore some of them in a more detail now that the data have been presented.

Did they live up to the initial promise or not? What can we learn from trial failures? Sometimes this can be even more valuable than positive trials.

To find out, we took a careful at some of the readouts and assessed what looked better or worse than expected to help readers make sense of the tsunami of data that were presented in Chicago.

Inevitably, some of the selections we chose are gems from the poster halls

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This year’s annual meeting of the American Society of Clinical Oncology (ASCO) conference has proven to be both enjoyable and thought provoking with plenty of new data to peruse and learn from.

In this latest round-up we explore and discuss some of the key oral and poster sessions from yesterday, which was a frenetic day from beginning to end, including thought leader interviews in between sessions.

The last morning of the final day of ASCO or AACR is always a bit eerie for the committed diehards who remain to the bitter end for the science in the all important tumour biology session:

To learn more from our latest ASCO highlights and get a heads up on our oncology insights, subscribers can log-in or you can click to gain access to BSB Premium Content.

Chicago June 3, 2018: The data for the phase 3 KEYNOTE–042 trial has just been presented in the plenary session of the 2018 annual meeting of the American Society for Clinical Oncology (#ASCO18).

Data for this positive phase 3 study was presented by Dr Gilberto Lopes (@GlopesMd), Associate Professor at the Sylvester Comprehensive Cancer Center at the University of the Miami.

The trial in previously untreated patients with metastatic non-small cell lung cancer (NSCLC), who didn’t have an ALK translocation or EGFR mutation, sought to answer the question of whether the anti-PD–1 checkpoint inhibitor pembrolizumab (Keytruda) would be better than chemotherapy in patients whose tumours had an expression of PD-L1 between 1–49%.

Readers may recall that pembrolizumab has already received FDA approval for the treatment of first-line NSCLC in patients with greater than 50% PD-L1 expression, based on data for the KEYNOTE–024 trial that was presented back at ESMO 2016 by Dr Martin Reck.

So what’s the verdict? 

Dr Lopes kindly spoke to Biotech Strategy and shared his perspective on the trial data he shared with ASCO. Will the KEYNOTE–042 trial change the standard of care, and how does it fit in with the KEYNOTE–189 trial data that we heard about at the 2018 AACR annual meeting back in April?

To learn more from our latest assessment and get a heads up on our oncology insights, subscribers can log-in or you can click to gain access to BSB Premium Content.

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