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World Lung and SITC – two more doses of oncology

Date October 11, 2017

With 2017 drawing to a close investors still have at least two oncology-focused conferences to look forward to before Ash kicks off in December. The first of these, the World Conference on Lung Cancer, starts in Yokohama, Japan this weekend.

This will feature the ongoing battle between Loxo and Ignyta in mutated NSCLC, as well as data from a low-key asset Spectrum licensed from Hanmi in 2015. Later, the SITC meeting in November is where Juno will at last reveal findings from Rocket, and investors should look out for an explanation of the neurotoxicity that scuppered this study last year (see tables below).

Both meetings have a strong leaning towards early-stage work, though there are exceptions. The highlight of World Lung’s plenary, for instance, features more data on Imfinzi’s Pacific trial, which at Esmo gave Astrazeneca new hope in lung cancer – specifically in the little-noticed setting of stage III NSCLC.

Biotech focus

Biotech investors’ attention will be elsewhere, however. While the terms under which Spectrum had licensed poziotinib from Hanmi were not disclosed, the company had made much of this pan-Her inhibitor’s potential in breast cancer patients who had failed Her2-directed therapies including Herceptin and Tykerb.

At World Lung results from eight platinum-refractory NSCLC patients with exon 20 insertion mutations will be presented. Updates will also come from Chi-Med’s savolitinib and fruquitinib in combination with Tagrisso and Iressa, and from Pharmamar’s ongoing phase III Atlantis trial of Zepsyre in SCLC.

Perhaps the most interest will fall on a battle between Loxo and Ignyta in NSCLC with TRK, Alk and Ros1 fusions – and the potential for a tumour-agnostic indication – that has already played out at several scientific meetings, most recently Asco (Asco – Loxo nudges ahead of Ignyta with tumour-agnostic therapy, June 3, 2017).

Ignyta’s update is from its Startrk-2 study of entrectinib, while Loxo’s falls on LOXO-292, a follow-up to its lead, larotrectinib. Loxo's other follow-on, LOXO-195, has already shown early promise in patients relapsed on larotrectinib, and the World Lung abstract describes an initial response with LOXO-292 in a patient who acquired resistance while being treated with Ignyta’s own follow-on asset, RXDX-105.

Selected abstracts from the World Conference on Lung Cancer, in Yokohama, Japan, Oct 15-18 
Project  Lung cancer focus  Company  Study detail  Trial ID 
Imfinzi  Stage III NSCLC  Astrazeneca  Plenary presentation  NCT02125461 
Opdivo  Malignant pleural mesothelioma   Bristol-Myers Squibb  Merit study (late breaker) 
Keytruda + chemo  1L NSCLC  Merck & Co  Keynote-021G update  NCT02039674 
Alunbrig  Xalkori-refractory Alk+ NSCLC  Takeda  Alta study (phase II)  NCT02737501 
Savolitinib  2nd-line NSCLC  Chi-Med  Combo with Tagrisso (Tatton study)  NCT02143466 
Fruquitinib  EGFR-mutant NSCLC  Chi-Med  Combo with Iressa  NCT02976116 
Zepsyre  2nd-line SCLC  Pharmamar  Update from Atlantis trial (due to end recruitiment Q1 2018)  NCT02566993 
Poziotinib   EGFR Exon 20 mutant NSCLC  Spectrum/Hanmi  8 platinum-refractory pts  NCT03066206 
Entrectinib   Ros1 NSCLC  Ignyta  Startrk-2 study  NCT02568267 
LOXO-292  Ret-fusion lung cancers  Loxo  Patients refractory to earlier Trk-directed therapy  NCT03157128 

Meanwhile, late-breakers from the SITC (Society for the Immunotherapy of Cancer) conference are not yet available, and only titles have been published for the meeting’s other abstracts.

However, Evercore ISI’s Umer Raffat reckons Bristol-Myers Squibb has scored an SITC late-breaker covering a dose-escalation trial of its irreversible IDO inhibitor BMS-986205, and Incyte bulls will be keen to see whether this backs up Bristol’s claim to have the best asset in this class, which could hit Incyte’s rival agent epacadostat.

Interest has also been generated by Juno’s decision to present full data from Rocket, an adult ALL trial of JCAR015, which until recently had been its lead CAR-T project. This trial, and the asset, were scrapped after five deaths due to cerebral oedema; the precise mechanism of this sudden adverse event is still unclear, and investors will look to Juno to shed light on the matter.

Cell therapies also feature from the relatively unknown private biotechs TCR2 Therapeutics, Pique and IRX, and an academic group looking at anti-CD3/anti-Her2 “armed activated T cells”. And, in biotech’s continuing search for slightly improved me-too targets, Macrogenics and Aduro will respectively present their anti-PD-1 and anti-CTLA4 MAbs.

SITC is a long-standing meeting that has only relatively recently caught the attention of investors, but in the craze for all things immuno-oncology it can no longer be ignored.

Selected abstracts from the SITC meeting, National Harbor, MD, Nov 8-12 
Project  Therapy focus  Company  Data type 
JCAR015  Adult ALL  Juno  Phase II Rocket trial (NCT02535364) 
Allogeneic vaccine (PT 107)  2nd-line NSCLC  Pique Therapeutics  Phase II 
Anti-CD3/anti Her2 activated T cells  Her2- breast cancer  Phase II (possibly NCT01022138) 
IMCgp100  Uveal melanoma   Immunocore  Phase I (NCT02570308) 
Dendritic cell vaccine  Melanoma  TCR2 Therapeutics  Comparison vs autologous tumour cell vaccines 
Citoplurikin + TILs  Breast cancer (neoadjuvant)  IRX Therapeutics  Phase I (NCT02950259) 
Tremelimumab  Urothelial cancer  Astrazeneca  Efficacy & tolerability data 
CB-839 + Opdivo  Solid tumours  Calithera  Phase I (NCT02771626) 
MGA012 (anti-PD-1 MAb)   Solid tumours  Macrogenics  Phase I monotherapy (NCT03059823) 
ADU-1604 (anti-CTLA4 MAb)  Characterization of a "novel differentiated" MAb  Aduro  Preclinical data 

To contact the writer of this story email Jacob Plieth in London at jacobp@epvantage.com or follow  @JacobPlieth on Twitter

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