Biotech Strategy Blog

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

Posts tagged ‘renal cell carcinoma’

Scaling the ramparts in Real Madrido

It feels slightly surreal to be writing about this year’s annual ESMO confab instead of attending in person in Madrid, Spain.

While much of the time and attention at ESMO is usually focused on the major phase 3 readouts from various clinical trials, we will be covering these during the meeting as they are presented to avoid repetition since many of the topline company trial results have already been announced.

In this year’s conference Preview series, I wanted to take a step back and explore early new product development in several forms:

  • Biomarkers and potential new ways of predicting outcomes in development
  • Emerging novel targets of interest
  • Developmental therapeutics – trials and tribulations

This initial review will tackle some important developments pertaining to various biomarkers of interest.

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Looping across different types of analyses can yield intriguing and unexpected results

Not in Chicago It still feels surreal not to have been to windy city and back for the annual meeting at ASCO this year, such was the ongoing effect of the pandemic in the oncology world.

That said, the virtual meeting has produced some gems this year, including some very important findings many may have missed.

In our latest post meeting report we focus on both biomarkers and clinical findings.

We look at how there are various elements may interplay in unexpected ways, whether signatures from one trial are helpful in another, are there likely to be changes in treatment patterns as a result of data presented and where some emerging early signals might be useful.

One other aspect which crossed my mind was how a deep scientific approach used in one particular cancer might have potential applications in other tumour types with few somatic mutations present such as TNBC, prostate cancer or soft tissue sarcomas.

The results might produce quite different results, yet the process itself might be rather useful to consider…

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There are multiple players in the Magic Roundabout, but are some more important than others and will different culprits turn out to have hidden meanings? You may never see Ermintrude in the same way again 😉

Without a doubt, there are multiple potential ways we can go about improving responses to cancer immunotherapy, not just in terms of targets, combination approaches, different modalities etc, but also by manipulating the tumour microenvironment or thinking about directing different immune cells in positive ways.

In our latest review, we look at one area where emerging work appears to bearing fruit as multiple groups suddenly get one of those, a-ha! moments.

It’s not just happening in one tumour type either, nor is it limited to one type of therapy or modality, which makes it all the more intriguing to think about.

We heard about one example of this mechanism last year and now it’s time to explore things in more detail. This also means companies quick on the uptake could well take advantage ahead of their competitors.

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We’ve been writing about PARP inhibitors since 2006!  Who knew this target would have multiple legs over a dozen years on?

Barcelona

In this post we’re taking a look at some of the noteworthy presentations at ESMO19 around targeting DNA damage repair (DDR) and how they act through synthetic lethality and/or the generation of immune response to kill cancer cells in GU cancers.

It’s a fascinating area where we are seeing convergence between immunotherapy and genomic instability, one of the hallmarks of cancer.

The abstracts for ESMO19 are not yet available, so in this post we’re only providing context and setting the scene for some of the presentations we are looking forward to, as well as raising some key questions that we hope will be answered in Barcelona.

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In wave 3 of the immuno-oncology surge things have slowed down, partly due to a raft of combination trials yet to read out and partly because the reality has finally hit that tumour heterogeneity means there will be variable patient responses.

Just getting from room to room on time can be a real challenge with 40,000 other people present!

This complexity can come about in many forms… immunosuppression, alterations in gene functions, resistance and immune escape, to name a few.

If we want to help more people respond to these therapies then before we can rush headlong into another round of combination trials, we first have to go back to looking carefully at the underlying biology of the diseases and listen to what the patient’s tumours are telling us in order to fix things.

To accomplish this feat requires considerable time, energy, effort, and a lot of bioinformatics.

In this post we explore five key talks that highlight different aspects of biomarkers of response and mechanisms of resistance.  From there, we may see additional validation and prospective testing to determine how best to segment people so that they have the greatest chance of responding to the therapy administered.

One thing that most people don’t have these days is time, which is how we can help you because here’s a handy short cut to finding out more about five complex and diverse areas on biomarkers or IO resistance quickly and easily…

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In the third part of our ASCO GU coverage from San Francisco, which includes previews and post-match commentary, it’s time to turn our attention to renal cancer. This isn’t one disease, but a broad tumour type with multiple subtypes, some based on histology, with perhaps others to emerge down the road as we learn more about the disease and immune profiling.

There’s quite a bit to discuss this year, some of it quite complex and nuanced.

In the old days, much of the focus was on sequencing single agent TKIs in clear cell carcinoma, now it’s getting much more complex as scientists and researchers figure out combinations and regimen approaches, never mind what to do with the various histologies.

We walk readers through the latest information as we await the data presentations coming out tomorrow…

 

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We’ll have “boots on the ground” for the 2018 Congress of the European Society for Medical Oncology (Twitter: #ESMO18) that starts out of the gate on Friday in Munich.

The Fall cancer conference season is in swing…

Our conference coverage is not only about what data we think matters, particularly in the fast-moving world of immuno-oncology, but more importantly, why it matters.

Next up in our ESMO18 Previews, we take a closer look at renal cancer, an area that received some attention in Madrid last year and is likely to receive renewed focus again.

We also include a look at the broader RCC landscape in terms of US physician prescribing habits (i.e. KOL and Community oncologists), including some trend data to explore the impact of the nivo/ipi combination and cabozantinib data, as well as excerpts from an expert interview we conducted with Dr Awny Farajallah, Head of U.S. Medical at Bristol Myers Squibb.

Finally, we also highlight some key abstracts to watch out for in renal cell carcinoma (RCC) that are expected to be presented at ESMO18 and explore their relevance.

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What we wanted to accomplish in our latest thought leader interview was to peek under the hood with someone active in this field who is an experienced participant in phase 2 and 3 trials, as well as being a solid translational researcher capable of thinking outside the box critically.

Stacking up the evidence from IO trials

Today we cover a global KOL’s perspectives on cancers of the lung, renal, bladder, and even melanoma, in a wide ranging discussion about immunotherapy trials and some of the pitfalls and opportunities to watch out for.

It makes for an intriguing read as there are likely a few issues that many have not thought about in great depth.

This is an important discussion in the context of not just data that was recently presented at several conferences including AACR, but also with the upcoming monotherapy and chemo combination trials (including squamous and non-squamous lung cancer) expected at ASCO in a few weeks time.

We discuss quite a few of the key challenges and opportunities relating to the broader picture and highlight some of the important issues to watch out for…

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At the 2018 AACR annual meeting, one of the noteworthy talks given to the 22,000+ attendees in Chicago was a plenary lecture by Charles Swanton from the Francis Crick Institute in London. He’s a Professor of Personalized Cancer Medicine at University College London and chief clinician for Cancer Research UK (CRUK).

Professor Swanton is the leader of a landmark clinical study, TRACERx (TRAcking Cancer Evolution through therapy (Rx)) study, which involves analyzing how cancers and in particular, lung and renal cancers, evolve over time.

There’s a lot of heavy science and jargon inherent in this niche that often frightens off people, but that need not always be the case.

What is fascinating, though, is the very idea that tracking the development of early stage cancers might teach us new insights and lessons about alternative approaches to oncology R&D.

We have all seen the limitations of chemotherapy, targeted therapies and even immune checkpoint blockade, so what other approaches can be considered that link back to the biology of the disease and how it evolves over time?

What we wanted to achieve here was a clear and elegant story about what Prof Swanton and his colleagues are doing, as well as a simple grounding on the basics of disease progression and how that can translate clinically into new therapeutics that might make a real difference to the lives of people with cancer.

It’s a fascinating story and may well be one of the most underappreciated recent developments in cancer research…

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It’s that time of the year again already… the ASCO GU Preview series!  The good news is that there is a bumper crop of intriguing data to discuss this year.

Golden Gate Bridge, San Francisco

With the ASCO embargo on the GU Symposium in San Francisco lifting at 5pm, there’s a lot to consider not merely in terms of the data itself, but more importantly, in terms of a broader context and the landscapes involved in prostate, renal and urothelial cancers.

Here we take a look at some of the key highlights to watch out for and what they mean in context.

A separate post on the phase 3 PROSPER data for enzalutamide in prostate cancer with a discussion on the ongoing enzalutamide/abiraterone/ADT/chemotherapy debate as part of the GU18 coverage is also available.

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