JP Morgan preview – Clues on CAR-T uptake and oncology timings

The annual JP Morgan healthcare conference is traditionally a hotbed of deal-making, and some companies are getting in on the action early – witness Biontech’s mammoth $270m series A round this morning, which reportedly values the German group at up to $3bn.

But innovation is still biopharma's bread and butter, and attendees at next week’s meeting in San Francisco will be listening for hints about the prospects for some of the most exciting developments in recent years: CAR-T therapy and immuno-oncology.

CAR-T uptake

A key question about CAR-T is whether it can live up to the hype, something that is unclear so far with disappointing – but early – uptake figures for Gilead’s Yescarta, the second CAR-T therapy to be approved after Novartis’s Kymriah.

As of mid-December, only five lymphoma patients had reportedly received Yescarta in the commercial setting amid problems with getting the therapy paid for.

Any clues from Gilead and Novartis about their CAR-T launches will no doubt be seized upon, and will also affect others in the space, especially as many CAR-T players saw their stock rocket in 2017. The biggest riser was Nanjing Legend's parent company, Genscript, which has risen sevenfold over 12 months, helped by Nanjing's surprise Asco win (Asco – Mystery Chinese group gives Bluebird a run for its money, June 5, 2017). 

Other CAR-T companies due to present at JP Morgan also saw impressive gains, with Bluebird Bio and Juno up 189% and 142% respectively in 2017. Whether this rise can continue will hinge on CAR-T’s commercial success.

Investors will also be looking for reassurance on Monday from another CAR-T player, Cellectis, after criticism around last year’s Ash meeting that the company was progressing far more slowly than had been expected.

Immuno-oncology readouts

While CAR-T is flavour of the month, immuno-oncology is still a huge topic, and attendees would welcome any clarity around the timings of key readouts in this space.

Several trials are due to report in the first-line lung cancer battleground in the first half of 2018: Bristol-Myers Squibb’s Checkmate-227 study of Opdivo and Yervoy; Merck & Co’s Keynote-042 trial of Keytruda monotherapy in PD-L1-positive patients; and Roche’s Impower-130, 131 and 132 of various Tecentriq/chemo combos, which the Swiss group will hope can build on its recent win in Impower-150.

Meanwhile, Astrazeneca has a chance to salvage something from the Mystic trial with overall survival data, which could be presented at Asco.

Selected upcoming first-line lung cancer readouts
Study Drug(s) Trial ID
Checkmate-227 Opdivo +/- Yervoy +/- chemo NCT02477826
Keynote-042 Keytruda vs chemo NCT02220894
Impower-130 Tecentriq + chemo NCT02367781
Impower-131 Tecentriq + chemo NCT02367794
Impower-132 Tecentriq + chemo NCT02657434
Mystic Imfinzi +/- tremelimumab NCT02453282
All trials vs chemo alone; Source: Clinicaltrials.gov.

Another important upcoming study, which could make or break Incyte, is Echo-301, testing the company’s IDO inhibitor epacadostat in combination with Keytruda in first-line melanoma. Disappointing results would not only hurt Incyte and its $21bn market cap, but also others looking at IDO, and maybe even the whole I-O combo space.

While detailed clinical data are unlikely to emerge at JP Morgan, there should at least be some guidance about when to expect key results, setting up another big year for oncology.

To contact the writer of this story email Madeleine Armstrong in London at [email protected]. For live updates from the JP Morgan healthcare conference in San Francisco on January 8-11 follow @ByMadeleineA on Twitter.

See our full coverage from the JP Morgan conference here.

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