Biotech Strategy Blog

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

Posts tagged ‘DLBCL’

When the going gets tough

Walking into stormy waters may require some chutzpah

Sometimes oncology new product development can be fascinating to watch from the sidelines.  There are always up and downs as well as many hurdles and challenges to address.

In a relatively short time the B cell malignancy niche has become a highly crowded space full of tough competitors, with numerous T cell engagers and CAR-T cell therapies already approved and more coming along.

If you’re late to any given market then you will need to stand out as the best-in-class in order to succeed.

There are some companies who execute flawlessly, others well, they can have a rather bad habit of shooting themselves in the foot when least expected…

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Look for what is missing

A beautiful crystal structure at the heart of these pipeline agents    Source: Alphafold

All too often in oncology we look for where there is too much of something such as oncogenic signalling.

Rarely do we actually look at what is missing – and I don’t mean in the context of protein loss like tumour suppressors.

In this case, there is yin and yang at play in terms of R&D. The good old Chinese philosophical concept of dualism is a handy analogy for today’s drug development story.

As one leading big pharma drug in a particular class slinks away quietly – almost unnoticed – to dog drug heaven, another candidate from a small biotech is marching almost stealthily towards the clinic in 2024.

There’s a catch though – while they may share a common target, the fundamental mechanism of action is an entirely different one!

What this means is we may now need to consider additional potential opportunities and complications likely not present with the existing class of agents already in the clinic…

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Targeted Therapy Trials: Why some drug developers keep missing the mark

Post Banksy exhibition – Wellington has now gained an extra cone. It reminds me of what cell/compartment should we be targeting in oncology trials.

Some of the challenges with personalised medicine is we often see companies either treating a targeted therapy in an untargeted fashion thereby diluting the signal or enriching for one not yet conclusively and clinically established.

In both cases, the results are inevitably suboptimal.

Additionally, not all drugs within the same category are the same.  They often have dissimilar scaffolds or target different cells and compartments, all of which can have a positive or negative impact on clinical outcomes.

In our latest post, we explore and discuss emerging insights around strategies undertaken in clinial trials and how they may offer some clues for certain company readouts over the next quarter…

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New directions in lymphomas

The landscape in various lymphoma subsets has changed in ways many may not have expected a decade or so ago and will continue to evolve further as new treatments against novel targets start to show their true colours.

Let’s not forget the original emergence of BTK inhibition caught a lot of people by surprise, so if we think about the next five years ahead, where might some of the next innovations come from and how might different segments potentially look in terms of new regimens?

In our latest expert interview, we take a look at an emerging pipeline in this hematologic niche and discuss where some of the early stage data might lead us to going forward.

Of course the caveat in oncology is most products will not actually make it to phase 3 development or even succeed there, yet the big attraction is in exploring emerging products to see where the trends might lead, because you never know which ones will shine down the road…

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New developments on the lymphoma horizon

Up in the air

Last week and this week have been a crazy time in the cancer conference schedule…

To see what I mean, we attended the AACR specialist meeting on aggressive lymphomas (DLBCL) on Thursday and Friday, then Monday and Tuesday heralded silly o’clock (5am) starts for the 3rd Annual Crick International Cancer Conference in London, now we’re dialed into another AACR specialist event on Tumour Immunology and Immunotherapy, not to mention the Targets/TRIPLE meeting coming up later this week as well.  There were also a couple of excellent lunch time lectures thrown in to the mix as well.

It’s all systems go, Thunderbirds!

Sometimes it’s as though we’re living in a modern Third Life during the pandemic where remote events allow one to easily ‘fly’ around the globe, eagerly dropping into intriguing meetings we likely wouldn’t otherwise be able to get to in person.

The good news is one gets to learn an incredible amount from the sessions and doesn’t accidentally switch into a giant skeletal Zombie avatar (yes I did that once, much to my embarrassment), the bad news is finding the time to actually sit down, think clearly, and write up one’s chicken scratch notes to share with readers.

Before I dash off again to listen to some cool keynotes from Drs Miriam Merad and Crystal Mackall, it’s take to take a deep breath and explore some of the learnings from the Lymphoma meeting as a kind of early ASH21 Preview because there will be important readouts coming out in December…

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Making a difference in aggressive lymphomas

Lugano is such a glorious place to hold a cancer meeting!

You can tell how much fondness attendees and presenters have for a meeting location when many start off their talk with a shot of the scenery and remember fond times of past conferences.

Lugano and the International Conference on Malignant Lymphoma (iCML) – held every two years in odd numbered ones – is clearly one such event.

It is here where we learn about the broader context in terms of how various phase 3 trials truly fit in the landscape and whether or not they are practice changing, what the skinny is on a raft of new products in a given category from practitioners in the trials, including problematic or emerging side effects, or how agents might be more effective in one particular subset but not another, and so on.

This year’s meeting is no different despite the virtual nature of the event.  After a couple of recent on-line meetings were a bust due to an inability to host the volume of attendees, one might be forgiven for being a tad nervous this one might go the same way – but these fears were not realised, I’m delighted to say!

Instead, we were treated to a very well organised event with a series of high quality talks and posters on a variety of lymphoma related issues, including rapid turnaround for the on-demand recordings the next day for any sessions one missed.

BSB subscribers can read more on our latest look at key hematologic developments relating to lymphomas  – you can log-in or click to access our ongoing oncology coverage.

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New developments in hematologic malignancies to make your head turn

Years ago it used to be that whenever we mentioned hematology trials or new products in development outside of the ASH meeting there was a distinct drop off in attention… with the blossoming of many new therapetic approaches, oh my, how things have changed!

Lymphoma cells  Source: NCI / Dr Lance Liotta’s lab

As we segue between the EHA and iCML conferences I wanted to highlight a couple of important developments, which may well have disappeared off many people’s radar.

As we gather additional clinical evidence with more patients and longer follow-up at therapeutic doses over time, I find myself struck by how much these oft forgotten agents might actually have some legs, meaning they look promising enough to be considered as potential approval candidates.

Obviously a randomised controlled phase 3 trial will likely be needed at some point, but given the attractiveness of the data so far, more observers would do well to pay attention to these compounds, especially as they are not from companies we traditionally think about about in terms of hematological malignancies.

These two selections have grown quite a bit since the first-in-human trials with noticeably much more robust data to evaluate and consider…

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A look at 6 key developments in advanced hematologic malignancies

Stacking up the evidence

Not everything at ASCO is necessarily focused on solid tumours, there’s often some useful hints of progress on the hematologic malignancies front too.

Here we look at the building evidence for half a dozen such developments across myeloma, lymphomas, and acute leukemias.

To be clear this doesn’t mean they will all be of the good news type because sometimes early developments promise much and fizzle out over time.

This is the advantage of following compounds and technologies in new product development over time – you get to see them as they really are and not through the lens of rose tinted glasses….

BSB subscribers can read more on our latest update regarding immunotherapies not checkpoint blockade in hematologic malignancies  – you can log-in or click to access our ongoing ASCO21 coverage.

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A critical review of bispecific antibodies at ASH20

We are big fans of the American Society of Hematology (ASH) annual meeting, it certainly is the global meeting for hematology! The quality of research presented is very high; it’s where you see groundbreaking and practice changing hematology data, sometimes from unexpected sources.

Last year brought us long lines, crowded escalators, and jam packed halls, especially for the niche sessions.  It’s hard to imagine any of these in pandemic these days, especially if someone were to start suddenly coughing and sneezing in the seat behind…

A bit of nostalgia from ASH19: Up close and personal

Will we all be together again for #ASH21? According to virology experts, we’ll need 70% of people (around the world, not just in one country!) to have had a COVID-19 vaccine before we can lower our masks and do away with social distancing.

Even if 70% of health care professionals are vaccinated, a not unrealistic figure if you look at the flu vaccine uptake, going to an in-person meeting means you still have to navigate the cumulative risk associated with airports, flights, hotels, ground transportation, plus eating out in an urban environment where the very visible inequality that exists in America means it is highly unlikely everyone you may come into contact with, directly or indirectly, will be vaccinated.

There’s also the uncertainty of how durable any vaccination is, raising the prospect that any COVID-19 vaccination is unlikely to be “once and done” – will we all need boosts six months later? The logistics for all of this are just mind blowing.

Despite the exhortations from ASH leadership that they look forward to seeing us in Georgia next year at #ASH21 and we should all plan to be there, as things stand we don’t recommend booking your flights to Atlanta and #ASH21 just yet.

BSB expects 2021 to be another year of virtual meetings!

Meanwhile, on with the business of exploring the emerging data from ASH 20.

In this latest post, we are highlighting a few of the presentations that caught our attention on the various bispecific antibodies and T cell engagers in advanced lymphomas and multiple myeloma…

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Pillars of future strategies in tackling aggressive lymphomas

Are new pillars emerging in DLBCL?

It’s time to take a short break from the immunometabolism mini-series and turn our attention to aggressive lymphomas such as diffuse large B cell lymphomas (DLBCL).

This week heralded the latest AACR virtual meeting on Advances in Lymphoma in conjunction with iCML.  There were plenty of science focused talks to listen to and learn from, including new developments in oncogenic targeting.

What if we can learn from what the patients underlying biology can teach us in terms of more rationally designed clinical trials?

We know these are diverse and heterogeneous tumours, but this doesn’t mean we can’t take a more precision medicine approach to treating patients.  What can we learn from early trial readouts and genetic analyses?

It turns out, the answer is quite a bit and more information might be available at the forthcoming ASH meeting, so let’s look at what we can piece together from the available data now…

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