It started well before last weekend.
For months, rumors flew that this year’s American Society of Clinical Oncology annual meeting would lack some of the excitement market watchers have come to expect in recent years.
And as attendees streamed into Chicago’s McCormick Place Friday, Credit Suisse analyst Vamil Divan called out the “clearly … different feel” to this year’s confab. Noticeably absent, he noted, were investor events from oncology giants Bristol-Myers Squibb and Merck.
There’s “still a lot of impactful data, even at a ‘quieter’ ASCO,” he reminded clients, suggesting they look “at the forest instead of the trees.”
Now, with 2019’s ASCO officially in the rearview mirror, the question remains: Was this year’s conference “quieter” than in years past? And if so, why?
Turns out, there’s no consensus—at least among the execs we talked to. Some, such as Sanket Agrawal, general manager of Amgen’s KRAS program, and Dave Fredrickson, EVP and global head of AstraZeneca’s oncology business unit, pointed to their companies’ own data to contend that the meeting wasn’t quiet at all—and with good reason, given the headlines they made over the weekend.
“There is tremendous excitement in the community on finally, after 30 years, being able to drug the undruggable,” Agrawal said.
“The news of a positive phase 3 study in pancreatic cancer, which is the first that we’ve had in decades, is unbelievably exciting and actually suggests this is an ASCO that we should all be celebrating,” Fredrickson added.
They weren’t the only ones who felt plenty occupied over the weekend. “We’re in launch mode. This is our first ASCO after the approval” of PD-1 inhibitor Libtayo, said E.B. Brakewood, VP and general manager of Regeneron’s oncology business unit. “This is anything but quiet. To us, this feels like the busiest ASCO ever.”
Others suggested that underwhelmed attendees had grown “spoiled” over the last few years with “new mechanisms really blossoming,” as Rod Humerickhouse, asset strategy leader at AbbVie, put it.
“There have just been so many great things over the last five years, that tends to be the expectation—that we’re going to come here and hear something that wows us. It’s not a realistic expectation all the time,” Craig Tendler, Johnson & Johnson’s VP of oncology clinical development and global medical affairs, said, though he added that he “still would not characterize it as quiet.”
But others still did acknowledge that the data people often find most exciting does come in waves.
“I think if you look at ASCO over the years, the sort of intensity of the meeting does wax and wane a little bit. It’s all dependent on phase 3 readouts, and really, it’s all phase 3 data that drive the perception of treatment,” Roy Baynes, Merck SVP and head of global clinical development, said.
Clay Siegall, CEO of Seattle Genetics, harkened back to the days of the first presentations for Roche giants Rituxan and Herceptin. “It was the era of the the antibodies being ushered in. It was very exciting. Then it was the era of the new immuno-oncology agents,” including Merck’s Keytruda and BMS’ Opdivo. “It goes through different eras of what are the most exciting programs,” he said.
“Some ASCOs are sort of really what I call milestones in the field that you see develop,” Sanofi’s global head of R&D, John Reed, agreed.
And then there’s another possibility: That the rise of other cancer confabs, such as the European Society for Medical Oncology and American Association for Cancer Research meetings, has spread groundbreaking data throughout the year.
In the oncology world, “it used to be that you had one clinical meeting a year, and that was ASCO. That’s the place where—you were really going to ASCO to see what the hell was going on,” said José Baselga, AstraZeneca’s president of oncology R&D.
Now, though, there are “many more conferences, and with technology and the ability for data to be disseminated, people aren’t holding their data until ASCO," said Andy Schmeltz, global president and general manager of Pfizer’s oncology unit. "As soon as you have the data and it’s completed, you want to put it out into the public domain where it can be assimilated into clinical practice and you can advance things."
For that reason, Baselga said, these days, “these meetings are less in my mind. That’s why you’re asking me, when people say, ‘Oh this year’s ASCO is less exciting’—yes! And it’s going to be less exciting every year coming forward because it’s not going to be any longer the place where the news is being disseminated because the news is being disseminated in real time” whenever it happens.
So what does that mean for the meeting’s future? The way Baselga sees it, “these meetings have to change.”
“They have to become more thematic and they have to be more, I think, more opinion forums where to engage in discussions and where to engage in debates and where to engage in educational opportunities more than just the pure novelty of clinical studies.”
And that’s exactly what Credit Suisse analyst Divan encouraged his clients to look for. “The intense scrutiny on detailed data points … has been replaced” somewhat, he wrote, in part by “a focus now on bigger picture themes.”
“We look for insights into how physicians/payers are incorporating biosimilars into their practices, how patients/physicians are managing the costs/side effects related to various therapies, as well as how our healthcare system may need to evolve to accommodate the large number of novel but expensive therapies that have shown impressive clinical results in recent years,” he said.