Biotech Strategy Blog

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

Posts tagged ‘Pancreatic Cancer’

Sometimes initial phase 1/1b readouts at cancer conferences produce quite different reactions from a live and remote audience while at other meetings, the Developmental Therapeutics talks produce little or no interest at all. It’s often hard to guage which way they will go.

At SITC this weekend, several talks generated some contentious, and at times quite heated, debate and intense interest.

One of these was an oral presentation by Dr Zev Wainberg on the first-in-man data with the anti-CSF1R and anti-PD1 inhibitors, cabiralizumab and nivolumab, from Five Prime and BMS respectively, in an advanced pancreatic cohort.

Dr Zev Wainberg at SITC 2017

There was a surprising amount of confusion surrounding the initial results and other issues last week, with Five Prime’s stock dropping before we’d even got to Dr Wainberg’s talk.

What became increasingly obvious over the weekend was a clear difference in investors perceptions versus what the scientific community actually thought.

Here we take a look at the data and explain what to watch out for and why…

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National Harbor, MD – Day 2 of #SITC17 brought some interesting highlights on a number of fronts, not all of which may be apparent at present, but there are a few readouts that will have a broader impact going forward.

SITC 2017 Stars?

As we move into an era where we see more combinations evolve in immuno-onology, things are likely to get more confusing rather than less so and it could well be another 3-5 years before things truly settle down and more concrete trends emerge.

Here, we reviewed 10 different areas of interest with a strong clinical relevance and explored the topics further.

Please note that some of these will also have follow-on posts with thought leader interviews and related poster reviews.

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With the annual meeting of Society for Immunotherapy of Cancer (SITC) fast approaching this week, it’s time for a look at some of the final highlights to watch out for.

National Harbor from Gaylord HotelIn this latest conference preview, we have chosen a dozen key topics of interest that readers may find worth checking out plus an honourable mention for early compounds in development that we may well hear more about going forward.

Some of the early warning signs were offered up in the earlier Previews and with the abstracts now available, things are getting very interesting indeed…

How are things panning out so far with the abstract drop and are the new products in development living up to the hype and expectations?

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Before we move on to the Society for Immunotherapy of Cancer (SITC) meeting later this week, it’s time to wrap up the exciting AACR-NCI-EORTC molecular targets conference, which along with the CRI-CIMT-EATI-AACR international cancer immunotherapy conference in Mainz, have been my two favourite oncology meetings of the year so far.

Who would have predicted that back in January?

A scoot around the narrow #Targets17 poster hall…

It would be hard not to close out coverage without a popular Gems from the Poster Halls post.

Typically, we have focused this theme from cancer conferences around the following:

  • A new target
  • An interesting molecule
  • Intriguing basic or translational science of note
  • A particular tumour type
  • Insightful sentiments from thought leaders

In this latest version, we have examples of each.  We also have my favourite quote and discussion from the meeting, which perhaps not surprisingly, comes from a CAR T cell therapy discussion.

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Over the last four or five weeks we have seen some truly remarkable research published by numerous cancer researchers around the globe… which means that it’s time for another Journal Club review of key research to feature some cool science.

Here, we have selected half a dozen key papers of interest in both solid tumours and hematological malignancies that are well worth reading and digesting.  The impact from many of these may well lead to new molecules being explored.  We also include at least one review paper for BSB readers to peruse.

While much of the focus is inevitably on lung cancer and melanoma of late, we also highlight important research in pancreatic cancer, aggressive lymphomas and AML.

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Dr James Gulley is Chief of the Genito-Urinary malignancies branch and Director of the Medical Oncology service at the National Cancer Institute (NCI) in the National Institutes of Health. He’s a world-leading GU cancer expert and at the forefront of pioneering research to make cancer immunotherapy work in prostate cancer.

We last spoke to him at ASCO 2015 (See post: The future of prostate cancer immunotherapy). You can listen to excerpts from this interview on Episode 4 of the Novel Targets podcast (See: The non-inflamed tumour show).

Almost two years on, and new research by Dr Gulley and colleagues from the NCI shows that the STING pathway may have an important role to play in prostate cancer immunotherapy. Activation of this pathway through a novel mechanism could turn a cold non-inflamed tumor into a more inflamed or hotter one in men with advanced prostate cancer. How cool is that?!

At the 2017 annual meeting of the American Association for Cancer Research (AACR) that was recently held in Washington DC, Dr Gulley graciously spoke to BSB about some of the novel trials that are underway at the NCI, with the aim of making cancer immunotherapy work in men with advanced prostate cancer.

Dr Jim Gulley, NCI at AACR17

This is the seventh expert interviews in our series from AACR17 where we explore the conundrum:

How does Dr Gulley plan to light the immune camp fire in prostate cancer?

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Waiting in line for the White House Tour

The 2017 annual meeting of the American Association for Cancer Research in Washington DC (Twitter #AACR17) officially starts tomorrow, but today was a day full of educational sessions and workshops.

After a day of rain yesterday, it was good to have a dry day for the start of the world’s leading cancer science meeting.

In this post we offer some top-line commentary on those educational sessions we attended; the choice reflects personal interests or current fetishes.

By definition, there is far more excellent research at AACR than we can possibly cover on the blog; so we encourage you to check out the AACR webcasts if you have a specific interest or want to check out a particular session.

We’d also like to congratulate AACR for moving with the times and allowing personal photography and the sharing of content on social media, except where a slide or presentation says “Do Not Post.”

The few slides that I saw today that had “Do Not Post” showed unpublished data. Our longstanding unwritten policy has been not to tweet or share on social media data that clearly states it is unpublished, so this was not an unreasonable request and one we heartily concur with in principle.

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The race to the be first to market in the United States with a CD19 directed CAR-T cell therapy is a bit like the America’s Cup Challenge Race Series – one boat/company is ahead and then another is ahead, it’s an ever changing and fluid situation…

Americas Cup Portsmouth

In this post, we’re looking at questions from subscribers – so what’s in the July BSB mailbag?

* CAR T Cell Therapy: Is the recent FDA hold – that came and went in record time, a setback to Juno? Who will win the CAR-T race to market in the United States? What is the market opportunity in Europe?
* Jounce/Celgene Deal: Celgene have a reputation for doing deals with innovative biotech companies, but then what? Is the Jounce deal a good one, or is it a value destroyer?

There are a few other questions in the mail bag, but the above gives you a flavour of some of the commentary in this post.

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For years we’ve followed the trials and tribulations of targeted therapies seeing many approved and quite a few disappear forlornly (and officially) off to dog drug heaven. Many more sit in no-man’s land as companies eagerly wait in a holding pattern for other trial readouts in different tumour types. Sadly, sometimes these studies don’t generate enough compelling data either. With so much competition about, there are no shortcuts or low-hanging fruit in biotech or cancer drug development any more.

ASCO16 Chicago 1

En route to Chicago and ASCO!

Then along came antibody drug conjugates (ADCs), with some encouraging results in a range of cancers in both solid tumours and hematologic malignancies that lead to the approval of several new therapies.

After that, the next big advance was immunotherapies, specifically checkpoint blockade, with encouraging single agent activity in melanoma, lung, and even urothelial bladder cancer. We’ve also seen the promise fo combining two different checkpoints such as nivolumab and ipilimumab together in metastatic melanoma, albeit with an increase in toxicities.

This is all very well and good, although the challenge remains that the majority of patients either respond to therapy and relapse, or do not respond at all, depending on the circumstances, the tumour type and the regimen. We still have a long way to go in moving the needle and creating a new paradigm shift on a broad scale.

So what happens when we start to combine modalities – such as targeted therapies with immunotherapies?

Uh-oh, I hear the distant cries of disagreement erupt…

  • Remember vemurafenib plus ipilimumab in metastatic melanoma was scuppered by severe hepatitis?
  • What about osimertinib plus durvalumab in NSCLC and the increased incidence of ILD?

Both of these statements are true, and yet… we should not assume that all mixed therapy combination approaches are doomed on the basis of a mere n of 2. What happens if some are synergistic or additive? What happens of there are hidden gems that teach us new ways of doing things rather than doing the same old thing just because it’s always been done that way?

With this in mind, I’d like to open the door on our first ASCO 2016 Preview series with a look at novel combination approaches in development that caught my eye.

What are the early hints and signals that we can learn from the data? Which companies are evaluating imaginative new ideas that may turn the tables on traditional thinking?  The ideas discussed here may well surprise a few people.

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Franciscan Crab Restaurant San FranciscoWe saw at ASCO last year that response to checkpoint immunotherapy is feasible in some patients with colorectal cancer, but what about other gastrointestinal tumours such as pancreatic, duodenal and biliary cancers?

Can their activity extend beyond the obvious hypermutated tumours such as melanoma, lung, renal and bladder cancers?

Many of you will know that most pancreatic cancers, for example, are detected late and prognosis in metastatic disease is generally poor. You also typically don’t see much coverage of the other GI non-CRC cancers from cancer conferences in the medical media outside of pancreatic cancer occasionally.

At the ASCO Gastrointestinal symposium (#GI16) this past weekend, there was some new data of note in these tumour types that is well worth highlighting and discussing because it may have a major impact on the GI landscape.

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