ASCO Soundbites, 2018 edition: Comments candid—and not so much—from industry executives

CHICAGO—This weekend’s American Society of Clinical Oncology featured plenty of major data, and it also featured plenty of opportunities for us to catch up with executives around the industry. Below, we’re bringing you some of our favorite conversation snippets that capture the joy, fear, “ho hum” moments and everything in between that come with the territory when you’re running a cancer drugmaker.

  • When it comes to IDO—perhaps in particular Incyte’s epacadostat, which flopped a key study that ultimately killed pivotal trials in tandem with both Merck’s Keytruda and Bristol-Myers Squibb’s Opdivo—Roche hates to say I told you so. “We backed away” from IDO over a year ago “because we didn’t think it was going to end up being a very important target for next-generation I-O,” Dan Chen, VP and global head of cancer immunotherapy development for Roche’s Genentech unit, said. “There are going to be some dominant drivers of immuno-suppression that you want to go after—PD-L1 is one of them—but there are going to be a lot of other things that are perhaps a drop in the ocean.”
  • Merck, though, doesn’t appear to be losing too much sleep over its IDO gamble. Instead, it spent the spring cementing its leading position in the all-important first-line lung cancer market—particularly with chemo combo data showing Keytruda could cut patients’ risk of death by more than half. When the slide with those data went up at April’s American Association for Cancer Research annual meeting, “I looked and all of my colleagues, everyone had tears,” Roy Baynes, Merck SVP and head of global clinical development, said. “It was just a realization of a dream that you could actually change the outcome of cancer for so many patients. I think that’s what’s been so inspirational: how uniquely privileged we are to participate in what is really a sea change in how cancer patients have been looked after.”
  • Meanwhile, AstraZeneca, which fields immuno-oncology therapy Imfinzi, is still looking to break into that first-line market, but it’s nevertheless convinced it can grow into a top-tier cancer player. “We believe that we’re on a trajectory to be one of the top three global oncology players in the next five years,” Dave Fredrickson, VP and head of AZ’s global oncology business unit, said. Outside of Imfinzi, the company will be counting on PARP contender Lynparza to generate a big sales haul, and extra marketing firepower from last year’s multi-billion-dollar partnership deal with Merck should help achieve that end. “As we get ourselves prepared for all of the upcoming, we hope, launches, we believe that it’s really important that we are not trading off one indication for the other. We need to hit on all of them,” Fredrickson said.  “This is part of the benefit that comes from working with a commercial partner—we don’t have to actually make choices.”
  • Speaking of PARP inhibitors, Tesaro chief medical officer Marty Huber explained the lack of buzz around the ovarian-cancer-fighting class this year, particularly after a big ASCO 2017. “What has happened is very rapidly, that’s become—I hate to say it—almost ho hum. It’s the standard of care,” he said. “We’re kind of in this interesting period. The scientific excitement has happened, and now it’s the translation of that into practice, and that takes” time, education and more. And while Tesaro’s Zejula did post data this weekend that the company finds “very exciting,” it’s still phase 2 data, and “that’s why when you get to ASCO, which is this massive meeting, you don’t feel quite the same sense” of excitement you would at a gynecologic-focused meeting such as the Society of Gynecologic Oncology's, Huber said. “Sometimes it gets lost when you have … all the major phase 3 presentations coming out on PD-1s.”
  • Another headline-making class from ASCOs past is the CDK 4/6 breast cancer drugs, and from that group, Novartis’ Kisqali put up solid numbers among first-line metastatic HR-positive, HER2-negative patients. The data’s impact, though, remains to be seen, study investigator Dennis Slamon, M.D., Ph.D., said. He harkened back to the days after Roche’s Herceptin made its case for first-line use, when doctors—“who tend to be quite conservative in their approach”—continued to use chemo before the eventual blockbuster. “I’d like to tell you I think (Kisqali is) going to be used a lot more given these data, but just given what I’ve seen in the past, it’s going to be interesting” to see how prescribing patterns play out, Slamon said.
  • When Takeda showed up at last year’s ASCO, it was a company in transition. The multiple myeloma specialist was just moving into solid tumors for the first time, and “I don’t mind telling you—I think at the beginning you could say the word ‘scary,’” to describe the experience, Steve Noga, Takeda VP of U.S. medical affairs for oncology, said. Any trepidation, though, disappeared with the approval of ALK lung cancer med Alunbrig, Noga said, adding, “I think people got into it really fast.”