In sur­pris­ing set­back, com­bo of Roche’s Tecen­triq and chemo fails to help pa­tients with triple-neg­a­tive breast can­cer

Roche broke ground last year when they se­cured the first FDA ap­proval for a check­point ther­a­py in triple-neg­a­tive breast can­cer, a no­to­ri­ous­ly dif­fi­cult-to-treat in­di­ca­tion that has been passed over by the wave of tar­get­ed ther­a­pies.

Now, though, doc­tors are puz­zling over why a com­bi­na­tion of drugs meant to make that ther­a­py more po­tent in­stead ap­peared to make it less ef­fec­tive.

Roche said Thurs­day that in a Phase III tri­al, com­bin­ing their PD-1/L1 check­point ther­a­py Tecen­triq with the chemother­a­py pa­cli­tax­el, did not sig­nif­i­cant­ly im­prove pro­gres­sion-free sur­vival for pa­tients with lo­cal­ly ad­vanced or metasta­t­ic triple-neg­a­tive breast can­cer over giv­ing those pa­tients chemother­a­py alone. In fact, pa­tients on the Tecen­triq-chemo arm had low­er over­all sur­vival than pa­tients on chemo, al­though the drug­mak­er cau­tioned that the tri­al was not pow­ered for that end­point and the da­ta were im­ma­ture.

The fail­ure is a set­back for triple-neg­a­tive breast can­cer pa­tients who, de­spite new med­i­cines such as Im­munomedics’ an­ti­body-drug con­ju­gate Trodelvy, con­tin­ue to face worse odds and few­er treat­ment op­tions than oth­er breast can­cer pa­tients.

It is al­so a set­back for Roche. Trail­ing Mer­ck and Bris­tol My­ers Squibb in the check­point space, and with As­traZeneca as­cen­dant, the Swiss phar­ma had hoped to carve a strong niche in triple-neg­a­tive breast can­cer.

Re­searchers have long com­bined chemother­a­py with new­er drugs such as check­point in­hibitors and tar­get­ed agents, so some were sur­prised that the com­bo would have lit­tle ef­fect. A few doc­tors de­bat­ed it on Twit­ter, with Sherene Loi of the Pe­ter Mac Can­cer Cen­tre in Aus­tralia of­fer­ing that the fail­ure may have been a prod­uct of the chemother­a­py and a steroid pa­tients re­ceived be­fore treat­ment: By low­er­ing white blood cell counts, it could have in­ter­fered with the ef­fects of the im­munother­a­py.

Levi Gar­raway

In a state­ment, Levi Gar­raway, CMO of Roche’s big biotech sub Genen­tech, hint­ed at a sim­i­lar hy­poth­e­sis, say­ing that re­searchers need to bet­ter un­der­stand how can­cer, the im­mune sys­tem, and the dif­fer­ent ther­a­pies doc­tors throw at them all in­ter­act.

“To­day’s re­sults un­der­score the need to bet­ter un­der­stand the can­cer and im­mune sys­tem in­ter­ac­tions, in­clud­ing the chemother­a­py back­bone and as­so­ci­at­ed reg­i­mens,” he said.

At the In­flec­tion Point for the Next Gen­er­a­tion of Can­cer Im­munother­a­py

While oncology researchers have long pursued the potential of cellular immunotherapies for the treatment of cancer, it was unclear whether these therapies would ever reach patients due to the complexity of manufacturing and costs of development. Fortunately, the recent successful development and regulatory approval of chimeric antigen receptor-engineered T (CAR-T) cells have demonstrated the significant benefit of these therapies to patients.

Stéphane Bancel, Moderna CEO

'This is not go­ing to be good': Mod­er­na CEO Ban­cel warns of a 'ma­te­r­i­al drop' in vac­cine ef­fi­ca­cy as Omi­cron spreads

Even as public health officials remain guarded about their comments on the likelihood Omicron will escape the reach of the currently approved Covid-19 vaccines, there’s growing scientific consensus that we’re facing a variant that threatens to overwhelm the vaccine barricades that have been erected.

Stéphane Bancel, the CEO of Moderna, one of the leading mRNA players whose quick vault into the markets with a highly effective vaccine created an instant multibillion-dollar market, added his voice to the rising chorus early Tuesday. According to Bancel, there will be a significant drop in efficacy when the average immune system is confronted by Omicron. The only question now is: How much?

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 124,400+ biopharma pros reading Endpoints daily — and it's free.

Philip Dormitzer, new GSK global head of vaccines R&D

Glax­o­SmithK­line poach­es Pfiz­er's vi­ral vac­cines lead in rush to cap­i­tal­ize on fu­ture of mR­NA

GlaxoSmithKline has appointed Philip Dormitzer, formerly chief scientific officer of Pfizer’s viral vaccines unit, as its newest global head of vaccines R&D, looking to leverage one of the leading minds behind Pfizer and BioNTech’s RNA collaboration that led to Covid-19 jab Comirnaty, the British drug giant said Tuesday.

Dormitzer had been with Pfizer for a little more than six years, joining up after a seven-year stint with Novartis, where he reached the role of US head of research and head of global virology for the company’s vaccines and diagnostics unit.

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 124,400+ biopharma pros reading Endpoints daily — and it's free.

In­tro­duc­ing End­points Stu­dio, a new way to ad­ver­tise with End­points-craft­ed brand­ing cam­paigns

Since our start in 2016, Endpoints has grown fast while executing our mission to cover biopharma’s most critical developments for industry pros worldwide. As readership has grown, our advertising business has too. Endpoints advertising partners support the mission and engage their desired audiences through announcements on our email and web platforms, brand recognition in our event coverage and sponsorships of Endpoints daily and weekly reports.

Reshma Kewalramani, Vertex CEO (Vertex via YouTube)

Bat­tling a line­up of skep­tics, Ver­tex claims an­oth­er ear­ly clin­i­cal win — this time in kid­ney dis­ease

Vertex claimed its second early-stage win of the fall Wednesday, announcing positive results in a small study on a genetically defined form of kidney disease.

The 16-patient, Phase II trial focused on patients with focal segmental glomerulosclerosis, a rare disease where kidneys are unable to filter blood properly. Over 13 weeks on an experimental pill, the level of protein in the patients’ urine fell by an average of 47.6%.

With on­ly burns to show in gene ther­a­py, Astel­las inks deal with AAV spe­cial­ist Dyno in push for a bet­ter cap­sid

On the hunt for a better AAV capsid for gene therapy, Eric Kelsic’s Dyno Therapeutics has set itself apart with its focus on machine learning to help speed discovery. Now, Japanese drugmaker Astellas — fresh off a slate of gene therapy burns — is taking a bet on Dyno as it looks to the future.

Astellas and Dyno will work together as part of an R&D pact to develop next-gen AAV vectors for gene therapy using Dyno’s CapsidMap platform directed at skeletal and cardiac muscle, the companies said Wednesday. Under the terms of the deal, Dyno will design AAV capsids for gene therapy, while Astellas will be responsible for conducting preclinical, clinical and commercialization activities for gene therapy product candidates using the capsids.

As first Omi­cron case in US crops up, re­searchers won­der: which an­ti­bod­ies, vac­cines will hold up?

As Covid-19 drug and vaccine developers race to figure out which of their products might be hampered by the new variant, the CDC on Wednesday afternoon announced the first confirmed case of the Omicron variant (B.1.1.529) in the US, found in San Francisco.

The unidentified individual was a traveler who returned from South Africa on Nov. 22, 2021, was fully vaccinated, and had mild symptoms that the CDC described as improving. All close contacts have been contacted and have tested negative, the centers said.

As lead drug runs in­to a wall, De­ci­phera slims down its pipeline, puts 140 jobs on the chop­ping block

Barely a month after disappointing data shattered hopes for a major label expansion for the GI tumor drug Qinlock, Deciphera is making a major pivot — scrapping development plans for that drug and discarding another while it hunkers down and focuses on two remaining drugs in the pipeline.

As a result, 140 of its staffers will be laid off.

The restructuring, which claims the equivalent of 35% of its total workforce, will take place across all departments including commercial, R&D as well as general and administrative support functions, Deciphera said, as it looks to streamline Qinlock-related commercial operations in the US while concentrating only on a “select number of key European markets.”

Endpoints News

Keep reading Endpoints with a free subscription

Unlock this story instantly and join 124,400+ biopharma pros reading Endpoints daily — and it's free.

How to use reg­istry da­ta to sup­port FDA de­ci­sion mak­ing: Agency ex­plains in new guid­ance

Drugmakers looking to design a new registry or use an existing one to support a regulatory decision on a drug’s effectiveness or safety will need to consult with a new draft guidance released Monday by the FDA.

The agency’s reliance on registry data for regulatory decisions dates back more than two decades, at least, as in 1998 Bayer won approval for its anticoagulant Refludan (withdrawn from the market in 2013 for commercial reasons) based in part on a historical control group pulled from a registry.