Asco 2022 movers – cell therapy wins, but it’s not the whole story

It is probably fair to characterise the mood over the Asco conference as negative, at least among biotech investors, who are struggling with plunging market valuations and saw a number of companies sell off after data presentations over the weekend.

But an Evaluate Vantage analysis comparing share prices at the end of Asco against when the abstracts went live throws up impressive gainers, notably the cell therapy players Arcellx and Adicet, and a strong showing from Merus and biotechs involved in Tigit blockade. Some might see in this signs that the market crash is bottoming out, though what it does not capture is moves during the meeting, like Astrazeneca’s perverse fall on presentation of Asco’s most momentous dataset.

That was of course the groundbreaking data from the Destiny-Breast04 study of Enhertu, the ADC Astra licensed from Daiichi Sankyo. But it is key to remember that this study was toplined back in February, since when both companies enjoyed strong run-ups into Asco. As such the slight selloff merely shows that expectations had been priced in.

Specifically this analysis compares share prices at market close on Tuesday, formally Asco’s last day, against May 26, when all regular abstracts went live after market close. But late-breakers only went live on the morning of their presentation, and many regular presentations contained new data that were not in the abstracts. This analysis therefore does not capture stock fluctuations that occurred during this period.

Kras again

A good example is Mirati, which during this Asco period appears as a virtually irrelevant 1% gainer. However, the stock had crashed in response to the May 26 abstract, when questions were raised about the durability of its Kras G12C inhibitor adagrasib in second-line lung cancer.

But Mirati recovered the losses when a late-breaker showed a 32% ORR in brain metastases, spurring hopes of differentiation versus Amgen’s rival product Lumakras. A separate update from the phase 2 Krystal-7 trial, with an adagrasib/Keytruda combo in first-line NSCLC, also impressed analysts – particularly its 77% ORR in patients with ≥50% PD-L1 expression. Amgen now has a bar to hit when it presents its own combo data in late summer.

Arcellx sold off on Tuesday after presenting an important update on its BCMA-directed Car-T therapy CART-ddBCMA, but over the whole Asco period was an impressive 77% gainer. The stock is trading above its February IPO price at last.

Another cell therapy company, the gamma-delta Car-T player Adicet, also had a good Asco, despite leaving durability questions unanswered. And, concerns over a Parkinsonism side effect aside, an update to the Cartitude-1 trial cemented Carvykti's unassailable status in the first wave of BCMA-directed therapies, and lifted Legend Biotech.

A curious thing happened regarding Tigit blockade. Roche’s SCLC study Skyscraper-02 was revealed to be an unmitigated disaster, but an important detail regarding statistical analysis emboldened those betting that Skyscraper-01, a study in the more important setting of front-line NSCLC that failed at first interim analysis, could still yield a positive readout.

With Tigit expectations at rock bottom this lifted the stocks of Iteos and Arcus, two Tigit players without significant Asco updates, as well as that of Mereo, a distressed company that did present a poster on its anti-Tigit MAb etigilimab.

In a battle in NRG1 fusion cancers Merus came out on top, helped by a head start over its closest competitor, Elevation Oncology. Elevation came out swinging, with its chief executive, Shawn Leland, telling Evaluate Vantage that its MAb seribantumab could have broader activity than Merus’s bispecific zenocutuzumab. Elevation will report data in more patients next year, but over the Asco period this micro-cap biotech slumped.

Although PMV Pharmaceuticals enjoyed an Asco abstract bump it came down to earth over questions that its p53 reactivator PC14586 might lack a therapeutic window, and the stock ended down over the Asco period.

Sanofi had data at the meeting but its move was probably down to a Libtayo development that did not concern Asco, while conversely Affimed was off after ultimately being unable to present a promised paper.

But, in terms of sentiment, it was perhaps Gilead that had the worst Asco. First came a late-breaker detailing Trodelvy’s Tropics-02 study – to be fair this was not as bad as the biggest doom-mongers had feared – and then Destiny-Breast04 threatened to relegate that drug to a tiny breast cancer niche.

The icing on the cake came with the anti-CD47 MAb magrolimab, which has recently had its clinical hold lifted, but which continued to disappoint. Azacitidine combos in both high-risk myelodysplastic syndromes and AML produced waning complete response rates versus earlier data cuts.

A complete listing of Vantage’s Asco coverage can be found on our conference page.