The news from ESMO: The latest on anti-TIGIT data, a PD-(L)1 injection, and more

This is the online edition of ESMO in 30 Seconds, a pop-up newsletter from the European Society for Medical Oncology’s annual meeting in Barcelona, Spain. Sign up for the remaining editions here.

One of the big presentations of this year’s ESMO (at least in our view) comes tomorrow morning bright and early. David Spigel of Sarah Cannon Research Institute in Nashville will unveil results from the GALAXIES Lung-201 study of an anti-TIGIT therapy from iTeos Therapeutics and GSK in non-small cell lung cancer.

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It’s a big moment for both iTeos and the broader efforts to develop TIGIT-targeting treatments. (To get up to speed, check out my colleague Adam Feuerstein’s preview of the presentation here.) While TIGIT was once hyped as the next great immunotherapy target, a number of failed trials has cooled that sentiment, and some drugmakers have pared their TIGIT programs. 

We’ll have a story on the results and what they could mean for TIGIT up tomorrow morning local time — just one of several stories we have planned for the weekend. (At this point, we’ll note that these will be STAT+ stories. We just so happen to have quite a deal on a STAT+ subscription — $5 for three months! — running at the moment. Details here.)

An injectable PD-(L)1 is here

Roche announced Friday that it had received FDA approval for an injectable form of its PD-(L)1 inhibitor Tecentriq, the first subcutaneous version of any such drug to reach the U.S. market. 

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In a conversation with STAT Friday at ESMO, Charlie Fuchs, the company’s head of oncology, said the new formulation could be a boon for both patients and cancer centers. 

Patients can now get their medicine administered in an injection that takes about seven minutes, compared to the 30 to 60 minutes that the IV infusion takes, according to Roche. Fuchs, who used to oversee infusion centers in his old role as director of the Yale Cancer Center, also said it would allow those centers to see more patients by freeing up chair space.  

There’s plenty of potential upside for Roche as well, he acknowledged. 

“The things that you can make more attractive to patients and to providers and where you have many alternatives in terms of your ability to treat with checkpoint inhibitors, well, that’s probably good for the bottom line,” he said. “But I want to be clear, what principally motivates us is to do the right thing for patients.”

A number of other countries have already approved subcutaneous Tecentriq. In the U.K., Roche has been seeing “reasonably good market penetration,” Fuchs said, both from patients who would’ve received the IV form, “but also patients who could consider alternatives.”

Much of the attention on subcutaneous PD-1s has focused on Merck’s efforts to develop an injectable form of Keytruda, which could help boost sales of its blockbuster as biosimilar competition looms in the next few years for the IV version.

ESMO goes negative

Studies that could change practice or bring new treatments to market dominate discussion at medical conferences. But of course, plenty of trials don’t work out. 

ESMO on Friday gave a prime presentation slot to the Phase 3 Capitello-290 study of capivasertib (AstraZeneca’s Truqap) in triple-negative breast cancer — “our elusive foe,” as the discussant Karen Gelmon of the University of British Columbia called it. The company announced in June, though, the study did not meet its primary endpoint of improving survival in patients overall or in a subgroup of patients.

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Still, the presentation allowed Heather McArthur of UT Southwestern to detail the full results in front of thousands of people. Poring over studies that don’t work can point to progress in the future, and in this case, researchers raised such questions as whether the problem might be the target or the drug, and whether the tumors were developing resistance.

Susan Galbraith, AstraZeneca’s head of oncology R&D, whom STAT chatted with on Friday, noted that Truqap “is doing extremely well” commercially in the breast cancer indication it is approved in. She added that the company is continuing to explore it in other forms of breast cancer, as well as prostate cancer.

In her discussion, Gelmon noted that there was a glimmer in the full data that the drug had had some effect on response rates and on progression-free survival. 

“So the study did not meet its primary endpoint, but was it a negative trial?” she said. “I would say no, [though] maybe that’s my oncological self speaking, not liking negativity.”

Checking in on the oncology workforce

At a press conference kicking off this year’s ESMO, the group’s leaders highlighted a range of practice-changing research that was to be presented here this year. But Andrés Cervantes, ESMO’s president, also took time to discuss the pressures that the oncology workforce faces. 

The group has conducted surveys of thousands of doctors, finding that more than 70% of young doctors are showing signs of burnout. 

“More than one third of those young people answering surveys were considering abandoning the profession because it’s too stressful for them,” Cervantes told reporters. 

Earlier this week, an ESMO task force published recommendations to manage risk of burnout and improve clinician resilience, which include strategies to promote psychological and physical health, to offer more training and support for clinicians, and to advocate more strongly for the workforce’s well being. 

As a professional society, Cervantes said, ESMO is focused on “taking care of patient outcomes, but also taking care of a better life” for clinicians. 

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ICYMI: There’s a new brain cancer drug

This isn’t exactly ESMO related, but we’ll just flag this STAT story today on Voranigo, the first targeted therapy developed specifically for low-grade gliomas. In trials, the drug showed it extended the time patients with these tumors could go before turning to toxic treatments like chemotherapy and radiation.

Up next, researchers are testing Voranigo in combination with other therapies in higher-grade brain tumors. Doctors are also hoping that the drug’s approval — a rare success in neuro-oncology — could inspire more companies to invest in the field.

More from ESMO

While the headline ESMO presentations remain under embargo, many abstracts were released earlier this week. Here’s coverage of a few that caught our eye:

  • ApexOnco outlines breast cancer data from Summit and Akeso. (Perhaps you’ve heard of them?)
  • And Endpoints has the story on Bicycle Therapeutics and its early-stage bladder cancer trial.