Biotech Strategy Blog

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

Posts from the ‘Cancer’ category

Through the keyhole look at an emerging area of drug development

Every now and then one comes across a scientific paper detailing a novel approach, which leads to a resurgence of interest and endeavours from the field at large.

A time when you sit, eagerly read the prose carefully and think, ‘Wow, just wow!’

This is one of those such quiet groundbreaking moments… and the future impact may well be more far reaching in oncology than many first realise.

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To degrade or inhibit, that’s the question

Continuing our coverage of the targeted protein degradation niche, we take an in-depth look at the updated clinical data on bavdegalutamide and put the initial findings in some context.

While it’s always fun to write about the early science and preclinical data, the proof of the pudding ultimately comes from the clinical trials and whether a novel agent can impact people with cancer in positive ways such that they feel better and live longer.

In this latest example, we look at what’s happening in advanced prostate cancer, an area where we are seeing a new renaissance with a variety of therapies being tested…

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Pulling a rabbit out of a hat

It’s time to tackle some controversies in advanced prostate cancer and look at exactly who’s pulling a rabbit out of a hat?

At ASCO GU we saw new phase 3 data from the 1L metastatic castrate resistant prostate cancer (mCRPC) setting with very different results produced for olaparib and niraparib, generating quite a bit of debate.

Here we explore half a dozen key issues in the context of both trials and look under the skin at the important subtleties and nuances to think about…

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Sotorasib impresses unexpectedly in pancreatic cancer

It’s time to go through the keyhole and take a look at progress with the KRASG12C inhibitors beyond lung cancer.

Years ago, there really wasn’t much hope in pancreatic cancer – it was an area big Pharma avoided because just about nothing worked well.  But those were the days of chemotherapy and promiscuous dirty kinases akin to a blunderbuss approach.

As we learn more about the biology of the disease and develop more selective inhibitors against oncogenes known to be active, have things improved at all?

In our latest cancer conference Preview, we pivot from a cell therapy meeting to the ASCO plenary series and take a look at how Amgen’s sotorasib is doing outside of lung cancer, an area where Mirati’s adagrasib was thought by some to have an advantage.

It’s always tricky to make judgment calls on the basis of a few patients in a catch all phase 1 trial – sometimes it’s better to wait until there’s a larger sample in a given cohort before rushing to declare winners and losers.

Often though, the data is something of a kaleidoscope – it depends on which angle or lens you view the data from.

In this post we include some expert reaction and commentary too…

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Olaparib drives earlier and deeper responses in mCRPC

With two oncology data drops running this week in the ASCO Plenary session plus the GU sympoisum, it’s time to switch our attention from cell therapy novelties to new developments in targeted therapies.

In this discussion, we take a look at an important phase 3 trial readout being presented this week in metastatic castration resistant prostate cancer (mCRPC).

For far too long the GU oncologist’s choices were pretty much limited to androgen receptor (AR) antagonists such as enzalutamide and abiraterone and chemotherapy (docetaxel and cabazitaxel).

Then along came PARP inhibitors such as olaparib, rucaparib, and more recently niraparib, largely limited to men with homologous recombination repair deficiencies who had received prior therapy, with the first two receiving full or accelerated approval in first half of 2020 on the basis of the PROfound and TRITON2 studies, respectively.

The third PARPi is further behind the others, finally just publishing their phase 2 monotherapy data from GALAHAD earlier this month.

Now there’s a new phase 3 data readout to explore and consider in the context of earlier in the disease setting…

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What’s the next stop in CAR T cell therapy?

I can’t believe it’s two years since we last attended a medical or scientific meeting in real life, but the last time we had “boots on the ground” was in pre-Covid times, at a CAR T cell meeting held in Sitges, a small coastal town and former fishing village south of Barcelona with phenomenal light.

Organized jointly by the European Hematology Association (EHA) and European Society for Blood and Marrow Transplantation (EBMT), their annual CAR T meeting attracts “the great and the good” of cell therapy and back in 2020 we were able to interview luminaries such as Carl June, Stan Riddell, John Gribben, and Crystal Mackall in person.

This year’s CAR T meeting, now in its fourth iteration, offers a mix of clinical practice, practical advice for those running CAR T units, as well as offering keynote lectures and posters on new developments in the field. Attracting speakers from the US, EU and UK (sadly no longer part of the EU thanks to Brexit, a decision that is unlikely to make Britain great again), it has an inclusive feel about it with physicians, scientists, nurses, and patient advocates all part of the program.

Thanks to Omicron, EHA/EBMT had to pivot to a virtual meeting at the last minute, so everyone missed out on a jolly to Nice. The organizers are to be congratulated for making the meeting happen rather than postponing to the Autumn, as many have done recently thereby adding to what is already looking like a busy conference schedule for late 2022, presuming another Covid variant doesn’t come along to cause disruption…

So, what were the highlights from Day 1 of the 4th annual EHA/EBMT CAR T meeting and what did we learn about the direction of the CAR T cell field?

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Learning from what patients tumours are telling us

There’s gold in dem hills

Some time ago in an interview with a well regarded cancer expert, the topic of learning more from patients tumours came up, and with it some of the challenges inherent in the process, such as access to biopsy samples.

If you think about, while post mortems can tell us why an individual person’s lesions stopped responding to a particular therapy, it’s only when we have huge broad (many tumour types) and deep (primary and metastatic lesions) in datasets with a richness of data that we can truly learn about patterns and trends.

What truly drives metastases and when?  Can we determine novel and more accurate biomarkers earlier than we currently have?

There’s plenty of gold nuggets to be found in the latest genomics research…

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Hunting novel oncology targets

Source: Wikipedia

Today is Groundhog day in America, where an over large rodent is brought out as a seer of sorts to determine whether there is an early or late spring, depending on whether he sees his shadow or not.

The most famous character is Punxsutawny Phil in deepest Pennsylvania, who did indeed, see his shadow this year.

Of course, the scientist in me wonders every year if anyone has ever examined his annual predictions and determined the accuracy of his sage answers?

The metaphor might also seem somewhat apt on several fronts in the context of cancer research…

Firstly, there’s the obvious allusion to the dreaded shadow on scans and suchlike.

Secondly, I think many of us get very tired of so many companies jumping on the bandwagon and chasing the same old same old targets, like lemmings off a cliff or even… Groundhog day.

Thus I’m totally going to break with tradition and talk about a potential new onco target instead…

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Doubling down on modest data

In our latest post we’re going to explore some controversial data and look at various aspects surrounding the presentation and company messaging.

We don’t always highlight positive or even negative data – often in phase 1 or 2 trials the data is limited or mixed and companies have to make difficult decisions on whether to proceed with new product development based on imperfect or incomplete information.

Let’s also not forget there’s more than one way to string a molecule together and sometimes what failed in the past can receive a new lease of life with greater selectivity, switching binding substrates, or taking a different approach to modalities, for example.

For big Pharmas, it’s much easier to put projects in an ‘on hold’ bucket while they pursue more promising opportunities, whereas for small biotechs with limited cash flow they often have no choice but to keep going with the hype machine, especially if there’s little else in the immediate pipeline…

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Science drives innovation

With the increasing pipeline of novel targeted and IO agents emerging from company pipelines these days, one key question which often comes up is can we get rid of chemotherapy – even in the first line setting?

On the upside, many patients would likely prefer to avoid chemotherapy treatment where at all possible, but on the downside, most of these agents are now available cheaply as generics and switching in another therapy doesn’t mean the absence of any additional side effects, just different ones.

During the 2022–2023 time frame we are going to see a surge in IO-IO readouts from both phase 2 and 3 trials as the data begin to mature over time.

In our latest look at IO combination strategies, we take a look at one such approach and examine the pros and cons involved based on the data available…

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