What's Happening at the 29th Annual Cancer Progress Conference?27 April, 2018
Since 1985, Cancer Progress has been the only oncology conference that invites a discussion of scientific progress within the context of development, regulatory, clinical, commercial and investment perspectives. During the two-day event, Cancer Progress provides a forum for vigorous debate on pivotal topics, interactive dialogue, and ample opportunities for networking during breaks, luncheons and receptions.
In advance of this year’s conference, which takes place on May 8thand 9th in New York City, we sat down with one of the conference’s organizers, Jeff Bockman of Defined Health, to find out what attendees can expect from this year’s conference.
ShareVault: Why do people come to Cancer Progress?
Jeff Bockman: People attend Cancer Progress because it’s the premier conference where there is a comingling of scientific, commercial and clinical issues all in one place. Attendees are able to enter into a dialogue on a variety of issues that often go beyond the science. In many ways it replicates the discussions that these companies are having internally between their R&D and commercial teams. Whether they’re large pharma or small biotechs, they’re trying to lay out the pros and cons of what they’re doing based on the science as well as on clinical and market issues. The conference provides a forum to have these discussions across a broader spectrum.
Another reason people come is because of the quality and the diverse perspective of the panel discussions. These aren’t commercials; they’re a chance to hear unique perspectives from various points of view. The small biotech has a different outlook than large pharma and a company with an early stage asset will have a different perspective than a company with a later stage asset. Companies focused on IO will have different points of view than companies focused on non-IO. There’s a lot of value in hearing that dialogue and learning how others are strategizing, whether it’s about the discovery process, the clinical development process or market and commercial challenges.
Cancer Progress is all about creating that dialogue between the R&D folks, the clinical development folks and the commercial or marketing folks, as well as the financial types, such as the VCs. It all takes place in a relatively intimate setting of several hundred colleagues as opposed to the thousands that attend meetings such as AACR or ASH or ASCO. It’s a small boutique meeting where attendees can mingle with their peers and have their voice heard, but still large enough to have the critical mass necessary for diversity of opinions and perspectives. The vast majority of people that come to the conference are repeat attendees and say that it’s by far the best meeting they go to annually.
SV: Cancer progress is moving fast. What was exciting last year and what’s exciting this year?
JB: Much of what was hot last year and over the last few years remains hot now, which is immuno-oncology. This year’s conference has three sessions focused on that subject. Of course, there are other things competing for the spotlight, such as the role of diagnostics in precision medicine and the application of precision medicine to immuno-therapies. We also continue to focus on the cancers that we call intractable, such as pancreatic cancer. This year we’ve tried to emphasize the more problematic hematologic malignancies and solid tumors. We tend to pat ourselves on the back for some of the advances we’ve made, but we need to remember that there are still some very serious unmet needs in some cancers that haven’t seen major advances in decades. That remains an ongoing theme of the conference.
Another issue that has moved to the forefront is pricing and payer access. Although everyone plans to price using the traditional oncology model of what the market can bear and based on how comparable agents have been priced, that business-as-usual model is unlikely to be sustained much longer. The big question is what the time period will be and what will the world look like when it does change? There’s little doubt that in the future there will be more rigor and cost restraints and scrutiny. So, although this isn’t a new issue, it is one that’s becoming more and more important.
SV: Is there still a hunger for early-stage IO partnerships?
JB: The short answer is that there still remains a healthy appetite for early-stage deals. That’s always been true in oncology, but it’s been exaggerated with immuno-therapies over the last several years. It slowed a little in 2017, both in the number and size of deals getting done. In 2015 or 2016 the majority of the top ten deals, both in total dollars and upfronts, were IO agents. Last year we saw about a fifty percent drop in upfronts for IO deals, which suggests that people are a little more cautious. There’s still a hunger to do those early-stage deals but people are becoming a little less willing to plop down huge amounts of money upfront for a preclinical asset.
SV: What’s the future role of non-IO mechanisms?
JB: We don’t have a session on the role of non-IO agents this year, as we did last year, but I’m sure it will come up in a variety of different sessions. Certainly the sessions on innate acquired resistance and the role of the tumor microenvironment will touch on it. There are more and more data coming out on the positive benefits of some types of chemo agents. We’re finding that patients that have gone through rounds of chemo will respond to checkpoints and other agents, but when you combine them with chemo agents you get some interesting behavior. Beyond that there are a lot of ongoing studies that are looking at combinations of checkpoints and other agents such as small molecule kinase inhibitors, TKIs or MTKIs. Many of these seem to show valuable combination results in the clinic. It remains unclear how many of them will pan out, but certainly there is potential. A few years ago, Axel Hoos at GSK wrote about the role of small molecule agents, not just IO agents, but also the classic approved kinase inhibitors that we have. Not only is there an important role for chemo and targeted agents to control cancer, but the role they may have in conjunction with agents like checkpoint inhibitors is certainly promising.
SV: Should oncology-focused biopharma entities collaborate or go it alone?
JB: Despite all the caveats about preclinical models, early collaborations will always be essential and valuable to large pharma. Right now there are somewhere in the neighborhood of 1200 combination trials being conducted. That’s a lot of spaghetti to throw against the wall to see what’s going to stick. For things that are more nascent or for which you can’t quite make the argument for ROI, relationships other than an outright licensing deal can broaden the range of opportunities to explore.
Collaborations also have value for the biotech. Pharma’s willingness to do deals or supply the drugs or align their drug with the innovator’s drug suggests a degree of confidence in the safety and efficacy of the agent. Collaborations will always be important for biopharma’s microenvironment.
SV: What’s on the horizon? What will cancer management look like in the next 5-10 years?
JB: Let’s look at melanoma, where we’ve had great success. It never quite goes away, but an increasingly significant percentage of patients are getting functionally cured with the new immuno-oncology agents; they’ve been put into a deep remission and we can keep it that way. Melanoma is the poster child for that. Many people believe that that’s what will happen with many cancers. I would not be surprised if five or ten years from now we will see more patients across more tumor types benefiting from the new drugs we are developing today; we will be much further along than we are now. This will be true for those cancers where we’re currently having some success as well as those cancers where we’ve had very little success. Precision medicine will continue to play a role as we get smarter and learn how to optimally deploy those drugs. We will get better at discerning what types of combinations to use and how to sequence combinations to successfully treat more patients across more tumor types. What remains to be seen is whether future oncology will be dominated by immuno-oncology agents or will they be most effectively combined with non-IO agents. What role will adoptive cell therapies play versus antibody-based approaches? There are still a lot of questions that remain regarding whether these targets or the particular modalities going after those targets, such as antibodies versus cell therapies, will come to dominate or will everything have its unique niche. And finally, what role will diagnostics play in making better decisions between using different drugs?