Biotech Strategy Blog

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

Posts tagged ‘urothelial carcinoma’

Downtown Chicago

In our latest ASCO 2018 Preview series we take a look at some of the key highlights from urothelial and bladder cancers and look at how new developments in this space are progressing.

Historically in oncology, we see initial trials begin in advanced stage disease especially in the refractory metastatic setting and move up into earlier lines of therapy later as safety and efficacy become more established.

This situation has been very much the case in urothelial carcinomas, including bladder, penile, renal pelvis, ureter and transitional cell cancers. With the approval of pembrolizumab and atezolizumab in the relapsed setting following cisplatin therapy, much of the focus has now turned to earlier stage disease.

In our latest Preview, we explore some of the key combinations and look at whether or not they are more promising in terms of outcomes than the monotherapy readouts we have seen to date.  There’s a lot to cover and digest…

To learn more and get a heads up on our latest oncology insights, subscribers can log-in or you can click to gain access to BSB Premium Content.

This content is restricted to subscribers

As part of our annual AACR Preview series, we usually explore new developments in at least one tumour type and one new target of interest.

Bladder cancer cells infected with BCG Source: Dr M Glickman, MSK

This year is no different and there were plenty of opportunities to discuss.

We have already covered lung cancer given the intensive interest in the phase 3 trials being presented in the 1L setting, but I also wanted to cover another key tumour type that is generating a lot of keen interest in clinical development for numerous reasons.

Tomorrow we will be exploring a cancer target in detail, but there is much to cover in terms of new preclinical and clinical developments in certain carcinomas.

Without much ado about nothing since there is plenty of important things to discuss, so here’s a look at our second tumour type to watch out for given the sheer numbers of trials, including a variety of different targets to think about.

To learn more and get a heads up on our latest oncology insights, subscribers can log-in or you can click to gain access to BSB Premium Content.

This content is restricted to subscribers

Crowds of People at ASCO 2016

The ASCO Wall 2016

There has been much frustration on many fronts at the number of trials that do not see a relationship between PD-L1 expression and response. Some do, but many don’t. This has lead to quite a few investigators suggesting that the IHC assay may not be as useful as originally hoped, for predicting response to checkpoint blockade or selecting patients for therapy.

While we often do see a trend for more responders with higher levels of expression, the main issue is that PD-L1-negative patients can also see some responses, albeit at a lower rate.

There are many factors that can affect the measurement:

  • Fresh vs. archival tissue
  • Heterogeneity within the tumour
  • Tumour cells (TC) vs. immune cells (IC)
  • Different antibodies used for each assay
  • The dynamic nature of the tumour microenvironment – does timing of the biopsy matter?
  • Human error – a pathologist has to eyeball the IHC readouts and decide the level of staining intensity

And so on. These are just a few examples of the factors that can potentially affect the results, making it quite a challenging test to undertake. There is also time – does the level of expression vary temporally depending on which prior therapies are administered?

It would be easy to be disheartened by this, but fear not!

There were some impressive new data presented at ASCO that were not only intriguing, but also show us a way forward on how a multi-factorial approach could be used in different tumour types. By this I mean we might end up with different tests used in conjunction for several different cancers in order to a) predict responders and non-responders and b) better select patients for appropriate regimens or clinical trials.

It’s not going to be as easy as one size (or test) fits all.  Sometimes a more more sophisticated approach will be needed.  New data at ASCO gave us hints on what’s to come in this direction.

To learn more about these new developments, subscribers can log-in below or if interested in an individual or corporate license, click on the blue box below…

This content is restricted to subscribers

Free Email Updates
Subscribe to new post alerts, offers, and additional content!
We respect your privacy and do not sell emails. Unsubscribe at any time.
error: Content is protected !!