Biotech Strategy Blog

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

Posts tagged ‘cancer metabolism’

This is the penultimate post in our mini-series looking at the potential of immunometabolism for cancer new product development. The initial plans for six posts ended up being revised with a seventh and final article based on an additional thought leader interview.

What’s the immunometabolism prize?

Like a series of postcards from our travels, the aim was to offer a flavor of different approaches in the field, some of which are already being translated and evaluated by biotech companies in clinical trials.

Along the way, like conversations on a journey, we spoke to several scientists working at the forefront of this research. As regular readers know we don’t just interview the ‘great and good’ – the established PI’s but in this series – we also spoke to some emerging up and coming researchers too. Each offered a unique personal perspective on different aspects of metabolism and its potential role in cancer research.

In today’s post, we share an interview with a young researcher working on a novel and intriguing approach, which could improve adoptive cell therapy.

We expect to hear a lot more about many of the immunometabolic strategies we’ve highlighted over the course of coming months, so this is a theme we will return to as new data emerges.

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The past year has seen hype and hope over targeting KRAS mutant cancers and many challenges still remain to be addressed. We’ve seen the emergence of selective G12C inhibitors, as well as others targeting SOS1:RAS upstream and even related pathways to address cross-talk such as SHP2 and ULK1, for example. The oncology R&D ecosystem is beginning to motor again as new competitors start entering the niche.

Riding the KRAS wave

To put things into broader perspective, however, despite all the positive news in lung cancer, consider the colorectal carcinoma data was less impressive than lung because of more complex, heterogeneous disease.

Meanwhile, Lilly recently announced the discontinuation of their selective G12C inhibitor, LY3499446, due to adverse toxicity, so clearly it is not all going to be plain sailing in this landscape!

Let’s also not forget the G12C mutation is not the only viable target in this context. People with advanced lung cancer can also present with one or more of several co-occurring mutations such as the serine/threonine kinase 11 gene (STK11) and kelch like ECH associated protein 1 gene (KEAP1), for example.

Unfortunately those presenting with both STK11 and KEAP1 mutations – independent of KRAS status – often have a poorer prognosis and there remains an unmet medical need for effective new treatments.

In this fourth postcard in our summer mini-series on the potential of immunometabolism for cancer immunotherapy, we’re taking a look at a novel way to target KRAS mutant lung cancer and, in particular, those with an STK11 and KEAP1 mutation who tend to do poorly on current therapies.

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It’s the dog days of summer and time for some meaty controversy to read!

For the longest time there have been several cancer types which have been incredibly difficult to treat therapeutically.

Metastatic melanoma and non-small cell lung cancer (NSCLC) both used to be in this category, as did glioblastoma and advanced pancreatic ductal adenocarcinoma (PDAC).

We have made great strides in changing the face (and more importantly outcomes!) for people with both metastatic melanoma and lung cancer, so what’s happening on the pancreatic cancer front?

The last two years gave certainly thrown up a series of disappointing clinical trial readouts such as RESOLVE, HALO–301, CanStemIIIP, and SEQUIOA, for example, where in each and every case the findings favoured the control arm of gemcitabine plus nab-paclitaxel over the experimental arm in terms of improving survival.  Not one of them was able to raise the bar and show a significant improvement over standard therapy, which is pretty disappointing.

So what can be done to change the face of PDAC?

If we want to improve further then we need to go back to basics and enhance not only our understanding of the funadamental biological mechansisms and processes, but also the models we use to interrogate the systems involved.

In this post, we look at six key new areas of research in PDAC and explain what we’ve learned and why they matter if we are to see new therapeutic developments arise from the ashes of the past…

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MD Anderson Cancer Center

Houston, Texas – Advanced pancreatic cancer is a very tough disease to treat, so it is not surprising that by 2030 it will be the No. 2 cancer killer in the United States, according to one of the speakers at the recent 1st Annual Symposium on Pancreatic Cancer held at the MD Anderson Cancer Center earlier this week.

There’s also high unmet medical need for new effective therapies for pancreatic cancer, which is why events that promote collaboration and cross-fertilization among leading experts are important.

I found out about the event from Twitter thanks to tweets by Dr Anirban Maitra (@aiims1742) who shares a lot of information. Do follow him if you don’t already.

Thank you to everyone at MD Anderson for putting on a panel of excellent speakers. The meeting was well worth attending and I hope it will become an annual event.

In this post I’ve captured some of the key take-homes that I took from the symposium.

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ENA2014_Banner_400x250The annual Symposium on Molecular Targets and Cancer Therapeutics jointly run by the EORTC, NCI and AACR (aka “the Triple meeting”), starts tomorrow in Barcelona (Twitter hashtag #ENA2014).

This makes it a particularly busy week on the conference calendar as we segue from immunotherapy at SITC to Molecular Targets, not to mention the start of our previews on hematologic malignancies at the American Society of Hematology (ASH) coming up fast!

The Triple symposium alternates between the US and Europe. In case you missed it, here’s a link to our extensive coverage from last year’s Boston Molecular Targets Symposium that we attended.

This year in Barcelona, one of the highlights is the presentation of the latest clinical data for the phase 1 trial of AG-120 (Agios), an inhibitor of the IDH1 enzyme.

As the abstract that will be presented tomorrow by Daniel Pollyea, MD (University of Colorado, Denver) notes, “Cancer metabolism represents an emerging field of novel cancer target discovery.” Along with epigenetics, it’s an exciting area that we are actively following. For years metabolism has been promising to breakthrough with new ideas that move the needle in clinical research but few have lived up to the lofty expectations, with one exception.

We first wrote Agios back in 2012, when they showed that that mutations of the metabolic gene IDH1 were consistent with that of a cancer causing oncogene in glioblastoma.

Then at ASH 2013, we heard the preclinical data for AG-221 using IDH2 mutant acute myeloid leukemia (AML) xenografts and interviewed the Agios CEO, Dr David Schenkein. The story for AG-221 continued in a positive vein with early clinical data at AACR and ASCO earlier this year. You can read more in the related posts we’ve highlighted at  the end of this article.

Tomorrow at EORTC-NCI-AACR Molecular Targets in Barcelona we will hear about the preliminary results for the phase 1 trial of AG-120 in patients with advanced hematological malignancies including those with relapsed or refractory AML, myelodysplastic syndromes (MDS) and elderly untreated AML that harbor an IDH1 mutation.

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Biotech IPOs were a pretty hot topic in 2013, with some of the young stars in oncology seeing very good uptake and prices. Two companies that come to mind are Foundation Medicine and Agios Pharmaceuticals.  Last week, we covered Foundation Medicine (FMI) and their progress with genomic testing, which is used by a number of Pharma companies including Novartis, in their clinical trial program. Interestingly, another company using their platform is Agios (AGIO), a start up biotechnology company focusing on metabolism and its errant mechanisms in cancer related areas. Both Foundation Medicine and Agios are based in Cambridge, MA.

Agios have an impressive Founder list in Lew Cantley, Tak Mak, Craig Thompson, all strong scientists with an interest in biochemistry and metabolism. The Scientific Advisory Board is equally impressive and includes Charles Sawyers, Jeff Engelman, Pier Paolo Pandolfi and David Sabatini, to name a few luminaries. The last two are well known metabolism researchers who have published extensively on the PI3K pathway, as has Lew Cantley. Craig Thompson has published significant research on IDH metabolism and his lectures on the topic are always fascinating and educational.

You can imagine that board meetings at Agios could well be rather different from the average biotech if the founders or the advisory board decided to brainstorm or riff on the science… Whoa, who wouldn’t want to be a fly on the wall and learn from the experts?  For a CEO, though, it might be akin to herding cats!  That said, I’m impressed that the company has such a clear, focused approach.

The company have a number of industry partnerships, including a recent extension last month to their existing agreement with Celgene.

With my background in biochemistry, I’m naturally drawn to follow metabolism-based approaches including the PI3K-AKT-mTOR pathway and anything that involves the TCA cycle.  It’s a highly complex area, not least because most cancers have a high demand for metabolic inputs such as glucose and glutamine in order to constantly drive tumour proliferation and survival.

David SchenkeinAt the recent ASH meeting, they presented interesting preclinical data for AG-221 using IDH2 mutant AML xenografts. While in New Orleans,  I had the opportunity to sit down with the Agios CEO, Dr David Schenkein, and discuss their approach, challenges and direction in some detail. He is also presenting at the JP Morgan Healthcare Conference today and giving a business update on the company’s progress.

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