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A look ahead to key trial readouts at ESMO

New combinations and novel mechanisms on show

The countdown to Europe’s premier oncology conference ESMO has begun, and once again it promises to deliver an astonishing array of new studies with the potential to move cancer treatment forward.

There will be the usual crop of new studies for established immuno-oncology and targeted cancer drugs, as their developers work to expand into new cancer indications, plus a host of novel agents – given alone and in combination – that are working through the pharma industry’s pipeline.

In immuno-oncology, this year’s offering includes a first showing for data in first-line advanced renal cell carcinoma for Merck KGaA/Pfizer’s Bavencio (avelumab) in the JAVELIN Renal 101 study, the first time that a checkpoint inhibitor has shown an increase in progression-free survival (PFS) when combined with a tyrosine kinase inhibitor – in this case Pfizer’s Inlyta (axitinib) – for this type of kidney cancer.

Roche’s Tecentriq (atezolizumab) will feature in the Impassion 130 trial as a first-line treatment for triple negative breast cancer (TNBC) as a combination with nab-paclitaxel, with a positive PFS read-out that puts it in the lead amongst checkpoint inhibitors in this indication.

Keytruda

Keytruda continues to set the pace – but there are plenty of emerging and novel mechanisms

Merck & Co/MSD – already dominating non-small cell lung cancer with Keytruda (pembrolizumab) – will have overall survival data for its drug in first-line squamous head and neck cancer from the KEYNOTE-048 study. It  will also have mid-stage data on the drug as a first-line monotherapy for non-muscle invasive bladder cancer (KEYNOTE-057).

It also has some interesting combination studies on the programme, notably KEYNOTE-200 that pairs Keytruda with recently-acquired oncolytic virus Cavatak, the COMBAT trial alongside BioLine’s CXCR4 antagonist BL-8040 in pancreatic cancer and a phase 1 study of the drug with CTLA-4 inhibitor MK-1308 in solid tumours.

The highlights of the targeted cancer therapy track include the SOLO-1 trial of AstraZeneca’s PARP inhibitor Lynparza (olaparib) as a maintenance treatment for BRCA1/2-mutated ovarian cancer, and new data for Ignyta’s ROS1-targeting entrectinib in solid tumour trial STARTRK-2.

In breast cancer, Novartis will be presenting its SOLAR-1 study of alpha-specific PI3K inhibitor alpelisib (BYL719) in HR+/HER2- advanced breast cancer with PIK3CA mutations, and Clovis Oncology’s VEGF/FGF/PDGF inhibitor will give an update on lucitanib – also in HR+/HER2- breast cancer.

Looking at some of the new mechanisms on show, Merck/MSD will also have the first clinical results for its STING activator MK-1454, Adaptimmune will have first-in-human results for its MAGE-A10-targeting cell therapy in non-small cell lung cancer, and there will be new data for AZ’s ATR serine/threonine kinase inhibitor AZD6738 and Roche’s RG7461, a targeted immunocytokine combining an engineered interleukin-2 variant with an antibody against fibroblast activation protein (FAP).

Finally, other studies to look out for at ESMO cover the safety of immunotherapy for HIV patients with cancer, whether women and men experience the same side effects from chemotherapy, if Twitter is a reliable information source for cancer patients, and whether adolescents and young adults are fairly represented in clinical trials.

ESMO runs from 19-23 October at the Messe München in Munich, Germany, and a total of 2,051 abstracts will be presented during the event.

Article by Gemma Jones
10th October 2018
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