Dr Adi Diab (MD Anderson) at SITC18
Washington DC – At the Society for Immunotherapy of Cancer (SITC) meeting on Friday evening, Dr Adi Diab (right) presented an update on the NKTR–214 plus nivolumab data from the phase 1b/2 dose escalation and RP2D expansion trial (PIVOT–02) in patients with 1L metastatic melanoma in the cytokine session chaired by Dr James Gulley (NCI) and Dr Darrell Irving (MIT).
Nektar also held an investor meeting over the weekend to discuss the data as well as where they are headed with their early pipeline compounds.
As we seek to find new and effective partners to add to immune checkpoint blockade, there are going to be some hits and misses in the mix. This year alone April turned out to be a pivotal month in the calendar, as chemotherapy plus pembrolizumab was a big hit in 1L NSCLC from the KEYNOTE-189 trial at AACR, while Incyte’s IDO inhibitor, epacadostat, bombed as 1L treatment of unresectable or metastatic melanoma in the phase 3 ECHO-301 study.
Cytokines have definitely garnered a lot of interest of late, with some very creative molecules now emerging to address the systemic toxicities associated with traditional approaches. We’ve been covering the Nektar pegylation story for several years now with numerous updates, so how are the data looking this time around?
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We’re at a crossroads in the IO space, where much of the low hanging fruit has been already plucked and now we could be in limbo for the next 2–5 years while we wait to see which of the IO-IO or IO-other combos pan out as winners.
Part of the problem is that we don’t yet know all the potential mechanisms of resistance or immune escape involved, so imagine figuring out how best to optimally modulate the tumour microenvironment on top is going to be challenging – each tumour type is heterogeneous and highly complex.
In addition, the field has heavily skewed towards obsessing almost exclusively over T cells, which may or may not be a good thing. There are alternative approaches that are starting to generate interest and results.
As Andrew Shepherd, the fictitious leader of the free world in the American President famously said:
“We have serious problems to solve, and we need serious people to solve them.”
One promising company in this space is Nektar Therapeutics. At SITC this week they had some elegant and intriguing early data that combined an innate immunotherapy approach with checkpoint blockade. We have been following their progress for a while now and it’s a great time for an update!
Dr Adi Diab NKTR-214 #SITC2017
Here we explore the data and have our latest expert interview that is not merely a couple of paragraphs long with a few platitudes or topline quotes… this is, quite frankly, a comprehensive review and strategic roadmap of what Nektar Therapeutics are doing in the IO space, why they are doing things a certain way, and where they are headed – in their own words…
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National Harbor, MD
The range of different types of cancer immunotherapies in the clinic now is fairly broad, with many promising approaches being evaluated.
Cytokines, despite their initial challenges with toxicities, are an essential pillar of this approach, along with checkpoint inhibitors and agonists, adoptive T cell therapy, and now even neoantigen approaches and cancer vaccines.
Nektar Therapeutics ($NKTR) are developing two intriguing immuno-oncology compounds based on cytokines, which are in early development called NKTR–214 and NKTR-255.
The idea behind this approach is that they are immuno-stimulatory therapies designed to expand T cells and Natural Killer (NK) cells directly in the tumour microenvironment, thereby increasing expression of PD-1 on these immune cells. Subsequent checkpoint therapy could potentially be made more effective. We already know that those patients with few or no T cells are less likely to respond (cold or non-inflamed tumours) so the hunt is on finding ways to address this particular challenge. Can it be done therapeutically?
Data was presented this past weekend at the Society for Immunotherapy of Cancer (SITC).
Was the data encouraging enough to justify further clinical development or is this a compound headed to dog drug heaven?
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