March 8, 2013 By Steven E. Greer, MD
We interviewed three of the oncologists and industry executives who spoke at the Damon Runyon Cancer Research Foundation in Cambridge, Massachusetts in March. They were:
- Richard B. Gaynor, MD, Chair, Accelerating Cancer Cures; Vice President, Cancer Research/Clinical Investigation, Eli Lilly
- Michael J. Vasconcelles, MD, Senior Vice President, Oncology Clinical Development Millennium; The Takeda Oncology Company
- Catherine Wu, MD, Dana-Farber Cancer Institute
The first topic of discussion was the emerging appreciation for cancer being caused by not just one mutated signaling pathway, but rather a circuitry of pathways all interacting with one another. For example, B-RAF and MEK pathways are both important for melanoma and are targeted by newly approved Zelboraf and Yervoy.
We then discussed how clinical oncology trials differ now compared to five years ago. What is new and paradigm changing is the early selection of patients and tumor types based on genetic profiling, which allow for the phase 2 and phase 3 stages to me more highly selective. By realizing early on whether the drug being tested acts of the tumor, the likelihood of successful trial outcome increases, and overall drug development is expedited. New cancer drugs are going before the FDA for review faster than ever before.
Another new trend in clinical cancer trials is the testing of combination of drugs that work on different pathways to reduce tumor resistance. In previous decades, corporations were hesitant to work with other drug makers, and also were reluctant to minimize the total patent population by using genetic subsets. However, after a span of drug trial failures and a contraction on the entire industry, new CEOs with new visions are changing the way cancer drugs are developed.
We finished the panel discussion by asking which late-stage molecules, close to FDA approval, interested them the most. Roche’s PD-L1, molecules conjugated to chemotherapies (like Roche’s TDM-1 or “Super-Herceptin”), and other B-RAF targeted drugs were mentioned.