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ASCO Roundup: Checkpoints, Pushback Against Prices, CAR-T & More

Xconomy National — 

As has been the case the past few years, the annual American Society of Clinical Oncology meeting, which just wrapped up in Chicago, was the latest referendum on immunotherapy. But this year, not only did the meeting feature scientific developments for these new types of cancer fighters that rev up patients’ immune systems, but it also included a warning that the price of these drugs, especially if used in combination, could drive up healthcare costs and leave some patients out in the cold.

Drawing from our own coverage and that of others, let’s round up the major cancer developments from the past few days.

—So far, so-called checkpoint inhibitors, which block a protein tumors use to hide from the immune system, are approved for the severe skin cancer called melanoma and for certain less common forms of lung cancer. But the repertoire could soon expand. Several big drug makers, led by Bristol-Myers Squibb (NYSE: BMY), Merck (NYSE: MRK), Roche’s Genentech unit, and AstraZeneca trotted out their latest data, which included promising new findings from trials treating liver, colon, head and neck, and more prominent lung cancers.

More options to treat more forms of cancer: Sounds great, but how will we pay for all these drugs, especially if they’re being used in combinations? One of the most important discussions at ASCO this year was underscored with a talk by Memorial Sloan-Kettering Cancer Center oncologist, Leonard Saltz, who zeroed in on immunotherapy drug pricing. Saltz drove home the point that the improvement in care these drugs represent don’t justify the leaps in cost their makers are charging. (Here’s the Wall Street Journal’s article on his high-profile speech.)

For example, a course of one checkpoint inhibitor carries a six-figure price tag. A combination, like the one Bristol said this week worked better than one of its drugs alone could possibly cost close to $300,000.

—On Friday, reporters from Forbes, TheStreet.com, and FierceBiotech provided overviews of the flood of data released at the conference. These stories include updates on Merck’s pembrolizumab (Keytruda), Bristol’s nivolumab (Opdivo), and the unearthing of a new, potentially valuable genetic biomarker in colon cancer.

—The search for ways to create immunotherapy combinations—one-two punches to beat stubborn cancers—continued apace, with news of deals released to coincide with the ASCO spotlight. Merck, for instance, cut separate deals with Dynavax Technologies (NASDAQ: DVAX) and Tesaro (NASDAQ: TSRO) to test pembrolizumab in combination with Dynavax’s toll-like receptor-modulating drug SD-101; and with Tesaro’s niraparib, part of a class of drugs called PARP inhibitors.

—Yes, folks, there are cancer drugs being developed that aren’t immunotherapy agents. ASCO was the venue for the latest update on the race to market between Boulder, CO-based Clovis Oncology (NASDAQ: CLVS) and AstraZeneca, each with a drug to treat lung cancer patients with a specific genetic mutation. Both presented updates for their drugs—rociletinib for Clovis, and AZN9291 for AstraZeneca.

It’s tricky to compare across trials, but upon the data release, investors nonetheless sank Clovis shares about 6 percent. Clovis did, however, also report news from a mid-stage study of its second drug, rucaparib, for ovarian cancer—a rival to AstraZeneca’s recently approved olaparib (Lynparza). The drug had an 82 percent response rate and staved off tumor progression for a median of 9.4 months in patients with a BRCA mutation, and 7.4 months in those with a so-called “BRCA-like signature.” Check out this report from FierceBiotech for more on the Clovis data.

—Back to immunotherapy, where Juno Therapeutics (NASDAQ: JUNO), Novartis (NYSE: NVS), and Kite Pharma (NASDAQ: KITE)—not to mention others with different approaches like Cellectis (NASDAQ: CLLS)—are testing methods to genetically modify peoples’ immune cells to kill cancer.

These therapies have a long way to go—particularly if they’re to be widely commercialized, and used for common “solid tumor” cancers in the lung, breast, and elsewhere—but they’ve produced impressive results so far for certain blood cancers like acute lymphoblastic leukemia. At ASCO, Juno and Novartis added another blood cancer, non-Hodgkin lymphoma (NHL), to the list. Both presented updates from early studies testing their cellular immunotherapies in NHL patients: Juno said 12 of 19 NHL patients responded to its treatment, while Novartis said 13 of 19 patients did in a different study. Forbes had more on those updates here. (During the conference, Juno also announced the acquisition of an antibody technology company to add to its T-cell engineering capabilities.)

—Exelixis (NASDAQ: EXEL) unveiled data at ASCO for its two main drugs, but as Xconomy explained in this story, the results in a mid-stage lung cancer trial and more only set the stage for bigger news coming in the third quarter. Exelixis’s hopes for a turnaround—and potentially a return to its heyday as … Next Page »

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