ESMO24: Cancer Cachexia Drug, VEGF Excitement, and Immunotherapy's Survival Impact

Over the weekend at the European Society for Medical Oncology's (ESMO) annual meeting in Barcelona, significant advancements in cancer research were revealed through various clinical trials. Detailed reports included iTeos Therapeutics' TIGIT drug data and Bristol Myers Squibb's decade-long outcomes from Opdivo and Yervoy. Here are some other key findings from the event.

Cancer cachexia, a severe metabolic condition causing weight loss and reducing treatment efficacy, currently lacks effective treatments. However, Pfizer presented promising results for ponsegromab, a drug targeting a protein called GDF-15. Clinical trial outcomes showed that ponsegromab helped patients with cancer cachexia regain weight, improve appetite, alleviate symptoms, and enhance physical activity levels. Pfizer posits that these results validate GDF-15 as a crucial factor in cachexia, opening a potential pathway for treatment.

Johnson & Johnson revealed Phase 2 trial results for TAR-200, a medical device that delivers chemotherapy directly into the bladder. This device was tested in combination with J&J's experimental immunotherapy, cetrelimab, in patients with muscle-invasive bladder cancer. The study found that 42% of the patients receiving both treatments showed no cancer evidence on tumor scans, compared to 23% in those treated with cetrelimab alone. The combination therapy achieved an overall response rate of 60%, while cetrelimab monotherapy had a 36% response rate. TAR-200 is also undergoing late-stage testing for non-muscle invasive bladder cancer.

A week before ESMO, Summit Therapeutics presented Phase 3 trial data demonstrating, for the first time, a drug outperforming Keytruda in first-line lung cancer treatment. This has spurred interest in similar drugs, including BioNTech's, which targets both the PD1 protein, like Keytruda, and VEGF. At ESMO, BioNTech shared three early datasets, while Instil Bio discussed its development plans for a similar drug. Analyst Daina Graybosch from Leerink Partners noted that while there is growing awareness of the opportunity, the scientific complexity and lengthy development process must be considered.

On Sunday, researchers disclosed studies revealing the long-term benefits of cancer immunotherapies for melanoma patients. One study highlighted that patients with advanced melanoma treated with Merck & Co.'s Keytruda had a 29% lower death risk compared to those given Bristol Myers Squibb's Yervoy. Keytruda recipients lived a median of 33 months, compared to 16 months for Yervoy patients. After ten years, 34% of the Keytruda group were still alive, versus 24% in the Yervoy group.

Relay Therapeutics aims to improve PI3Ka inhibitors, a type of cancer drug often limited by toxicity. On Sunday, Scorpion Therapeutics presented initial data on STX-478, their experimental drug for solid tumors with PI3Ka mutations. In breast cancer patients, monotherapy with STX-478 resulted in a 23% tumor response rate, and a 21% response rate across various tumor types. Importantly, no patients discontinued the trial due to treatment-related side effects, which were generally mild to moderate.

These findings collectively underscore significant advancements in oncology, offering new hope and directions for cancer treatment and management.