Biotech Strategy Blog

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

Posts tagged ‘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).  You can also hear Prof Powles on the Novel Targets Podcast (Episode 7).

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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At the 2016 San Antonio Breast Cancer Symposium (#SABCS16) one of the mini-symposia that caught my attention was on “Harnessing the Immune System in Breast Cancer.”

A line-up of top researchers and clinicians shared the latest on breast cancer immunotherapy:

  • Laurence Zitvogel MD PhD (Gustave Roussy), “From Breast Cancer Surveillance to Immunotherapy
  • Leisha Emens MD PhD (Johns Hopkins), “Breast Cancer Immunotherapy: Building on Clinical Success”
  • Andy Minn MD PhD (Univ of Pennsylvania): “Identification of Resistance Mechanisms to Checkpoint Blockade for Cancer”
Dr Laurence Zitvogel SABCS16

Dr Laurence Zitvogel at SABCS16

Readers of the blog will recall we last spoke with Dr Emens at the AACR 2015 annual meeting (is it really that long ago?!) where she presented the first data for the PD-L1 checkpoint inhibitor atezolizumab in Triple Negative Breast Cancer (TNBC). See post: “Checkpoint data rocks AACR 2015.”

You can also hear Dr Emens talk about the data on Episode 1 of the Novel Targets Podcast.

What’s new in breast cancer immunotherapy and how have things advanced since then?

At SABCS16, we heard about a novel immunotherapy strategy targeting adenosine in breast cancer, and the trial with an adenonsine antagonist, CPI-444 (Corvus Pharmaceuticals, NASDAQ: CRVS) that’s now underway.

Last September, Corvus senior scientist Stephen Willingham, PhD and Chief Business Officer, Jason Coloma, PhD spoke to BSB about the data they were presenting at the 2016 CRI-CIMT-EATI-AACR Cancer Immunotherapy Conference in New York. See post: “Corvus moves fast to target the tumor microenvironment and improve checkpoint responses.

Corvus had a presentation at the 2017 JP Morgan Healthcare conference (#JPM17) yesterday, and we’ve included some additional commentary on that in this post.

After the SABCS16 cancer immunotherapy mini-symposium, Dr Leisha Emens, Associate Professor of Oncology at the Johns Hopkins School of Medicine, kindly spoke to BSB.

Dr Leisha Emens SABCS16

Dr Leisha Emens at SABCS16

She’s one of the rock stars of breast cancer immunotherapy, and it was truly a pleasure to catch up with her again in San Antonio.

This is the second in our series of expert interviews from #SABCS16. In case you missed the prior posts and want to bookmark for the upcoming ones, you will find them on the conference page (Link).

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Like migrating birds, the San Antonio Breast Cancer Symposium (SABCS) has many regular attendees who return each year to enjoy the location and opportunity to hear about latest advances in breast cancer. One leading academic clinician told me she’d been to every meeting for the past 20 years.

The Alamo, San Antonio TX

The Alamo

SABCS offers a unique mix of academic and community doctors, translational researchers, basic scientists and patient advocates. The only downside is that at times the meeting (to an outsider) does feel like a club or family with it’s own idiosyncrasies.

This year, a leading breast cancer oncologist characterized the meeting to me as a “negative one,” meaning several clinical trials were presented that reported essentially negative results.

Although these are an important part of science, and it was good to see them presented, like most of the media, even medical oncologists want to see the “positive” news and that’s understandable. There was no practice changing phase 3 data as in previous years. The trial we most anticipated being at SABCS was delayed due to slow events and that’s a good sign as it most likely means women are living longer…

As readers of the blog will know, we’ve yet to find a medical/scientific meeting that did not offer up pearls, and #SABCS16 was no different in this regard.

Whether you have to spend time in the poster halls or go to obscure sessions, they are there to be found somewhere.

I came away from #SABCS16 with fresh insights into new targets, biomarkers, and also how the world of cancer immunotherapy will interface with genomics. It is these advances in basic and translational science that drive future clinical research.

Experts I spoke to at San Antonio were generous with their time and insights and we’ll be rolling out a series of thought leader interviews in Q1, 2017.

In this post, I wanted to set the scene with what I thought were 3 trends emerging from SABCS16. This is of course, an entirely subjective choice and if you went to the meeting, and/or are an expert in the area, your list would most likely be different.

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SABCS BannerSan Antonio – The San Antonio Breast Cancer Symposium (Twitter #SABCS14) is underway, and one of the key questions everyone is asking is do checkpoint inhibitors work in Triple Negative Breast Cancer (TNBC)?

TNBC is defined as the absence of estrogen receptor (ER), progesterone receptor (PR) and HER2 protein expression. This means that treatments aimed at these targets such as aromatase inhibitors and Herceptin are unlikely to work in TNBC.

TNBC represents approximately 15% of breast cancer patients in the U.S, and to put this number into perspective, around 200,000 women have the disease, with 40,000 deaths each year. Globally, there are an estimated 1 million cases of breast cancer, of which 170,000 are triple-negative (ER-/PR-/HER2-).

The only currently available treatment for TNBC is chemotherapy, but sadly patients often do not live long, and rapidly progress. Progression-free survival (PFS) is estimated to be around 4 months in TNBC. This means there is a real unmet medical need for effective new treatments.

Checkpoint inhibition of the programmed-death 1 receptor (PD-1) such as pembrolizumab (Merck) and the ligand (PD-L1) e.g. MPDL3280A (Genentech/Roche) can increase the effectiveness of a body’s T cells to fight cancer. Are checkpoint inhibitors the future in TNBC and will they offer hope to patients?

Some early preliminary clinical data is being presented this week at SABCS. Subscribers can login below or you can purchase access to read more about what this data signals about the potential of checkpoint inhibition in TNBC.

It’s a funny old world sometimes… I was planning to post a mini series on immuno-oncology presentations from ESMO this week and review what we had learned from the new data, good and not so good. This morning’s sudden announcement from Genentech regarding their latest collaboration is therefore rather timely:

“An exclusive worldwide licensing agreement and research collaboration with NewLink Genetics for the discovery and development of IDO (indoleamine-(2,3)-dioxygenase) pathway inhibitors for the potential treatment of cancer.”

There are a number of reasons why they might do this that make a lot of solid scientific sense.

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