The European Society for Medical Oncology’s annual meeting this week featured the hottest emergent areas of cancer treatment—antibody-drug conjugates, bispecifics and radiopharmaceuticals—while anti-TIGIT therapies made a bit of a comeback.
The oncology space is riding a high this week. A tsunami of trial data for novel therapies was released at the 2024 European Society for Medical Oncology (ESMO) Congress, held Sept. 13 to 17 in Barcelona, Spain. Meanwhile, in the U.S., the American Association for Cancer Research this week released its annual report, which showed that established treatments are helping people live longer.
To that end, Bristol Myers Squibb presented Phase III results at ESMO for its already approved Opdivo-Yervoy combination demonstrating that after 10 years, 43% of patients who received the combo for melanoma were alive with many not needing subsequent therapy. That’s a vast leap for a cancer that just a decade ago was an almost certain death sentence.
When it comes to novel therapies, TIGIT made a bit of a comeback at ESMO after a string of failures in the drug class, as GSK and iTeos revealed data for their inhibitor belrestotug—in combination with Jemperli—which elicited promising response rates in patients with non-small cell lung cancer (NSCLC).
Still, with higher immune-related toxicity, GlobalData argued that the TIGIT combo “will have to deliver a convincing [overall survival] benefit to switch physicians’ prescribing habits from the existing PD-1 regimens and to build resiliency against emerging first-line threats from pipeline antibody-drug conjugates and bispecific antibodies.”
Indeed, bispecifics and antibody-drug conjugates (ADCs) were both on prominent display at ESMO. For ADCs, Jefferies analysts flagged data readouts in ovarian cancer for more than 10 candidates in various clinical stages.
Results from the Phase II TROPION-PanTumor03 study showed that AstraZeneca and Daiichi Sankyo’s ADC datopotamab deruxtecan (Dato-DXd) exhibited promising antitumor activity and manageable toxicity in patients with advanced ovarian and endometrial cancer post-platinum chemotherapy. Sutro Biopharma also saw positive antitumor activity in updated data from a Phase Ib study of its ADC Luvelta, in combination with bevacizumab, for patients with epithelial ovarian cancer, with an overall response rate of 35%.
And on the biospecifics front, BioNTech made a splash at ESMO when it reported that its PD-L1- and VEGF-A-targeting antibody BNT327 elicited a 57.8% confirmed objective response in a Phase II trial of patients with EGFR-mutant NSCLC. These data follow those from Summit Therapeutics, which impressed at the World Conference on Lung Cancer earlier this month with late-stage data for its bispecific ivonescimab, declaring victory over Merck’s blockbuster Keytruda, which has historically led the NSCLC treatment space.
“This [bispecific] therapeutic modality has definitely arrived,” Ryan Schoenfeld, CEO of The Mark Foundation for Cancer Research, told BioSpace this week.
Prostate Cancer Radiopharma to ‘Go Nuclear’
There were also significant developments at ESMO in the radiopharmaceuticals space, with Lantheus Holdings presenting data from an analysis of its Phase III SPLASH trial showing that its radioligand therapy PNT2002 significantly improved progression-free survival in PSMA-positive metastatic castration-resistant prostate cancer (mCRPC).
However, William Blair analysts were underwhelmed, writing in a note to investors that the new data “did not materially alter” their view of PNT2002, which they see as inferior to Novartis’ Pluvicto. GlobalData forecasted this week that revenue for Pluvicto will jump from $980 million in 2023 to $4.3 billion by the end of the decade, dominating sales of radiopharma options for prostate cancer, which GlobalData predicted will “go nuclear.”
Pluvicto, which was approved by the FDA in March 2022, is indicated for mCRPC patients who are positive for the PSMA protein. Novartis is seeking a label expansion to enable physicians to prescribe Pluvicto for patients with mCRPC who have not yet undergone chemotherapy. In addition, Novartis presented data at ESMO showing Pluvicto’s activity in combination with docetaxel in metastatic hormone-sensitive prostate cancer.
“It is expected that Pluvicto will be at the forefront of the drug class in terms of market dominance until the turn of the decade, when alternate radiation-emitting ligands can make their mark,” Thomas Wales, oncology and hematology analyst at GlobalData, said in a statement.
With worldwide sales of radiopharma drugs for prostate cancer expected to reach $6.3 billion by 2030, according to GlobalData, it’s no wonder that Novartis earlier this month announced it is building a new facility in California—the company’s third U.S.-based radioligand therapy production site—and expanding an Indianapolis site for producing isotopes for cancer treatment.
It seems Novartis is making moves to remain king of the red-hot radiopharma space.
