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Saturday, December 16, 2017 2:38:53 PM
CAR-T State of Affairs: one person opinion, and lots of others in comments; Query---do any of them know what they are talking about?
https://seekingalpha.com/article/4131946-ash-just-change-juno-best-class-thesis?li_source=LI&li_medium=liftigniter-widget
Interesting discussion re the three current leaders in the Car-T arena. Most interesting was the author's belief that safety {emphasizing the reduction of instances of CRS} would be the primary differentiating factor leading to a "best in class" CAR-T designation.
At a current valuation of just over $5.0 Billion, implies that the market believes that JCAR017 will likely get to market, but with a profile that is likely to be competitive with existing products from Gilead and Novartis. This suggests that the market currently expects JCAR017 will be no better than the competition.
However, with reduced CRS alone JCAR017 can still establish itself as best-in-class even with efficacy comparable KYMRIAH and YESCARTA.
Further, if CRS can be reduced enough to shift use to the out-patient setting, it has potential to become the clear market leader and disrupt the competitive landscape. However, risks remain for new cases of severe CRS appear and/or complete responses rates continue to deteriorate.
This last paragraph also deserves a comment: Applying the same reasoning as does the above author re the reduction of CRS, if the addition of Bavi to the Yescarta CAR-T procedure "Eliminates Advanced Tumors without Off-Target Toxicities" {See Below from AACR 2017} the restrictions for the Yescarta CAR-T procedure would likely be substantially reduced thereby allowing GILD to offer the Best in Class option to many more patients, at lower cost, and in an out-patient setting at many more facilities.
Hummmm . . . . . This sounds like GILD - as they don't want to just compete in a market - they want to dominate a market - at least for awhile anyway - perhaps they are about to do just that : )
So North, Based on the foregoing - I offer another Query? Just how much will the current "safety" results for Yescarta improve if Bavi is indeed added to the mix?
A review of of your oft sited AACR 2017 results {below} should of course factor mightily into the discussion.
AACR’17 2. 4-3-17/8am #1651 - Session: TUMOR MICROENVIRONMENT & CHECKPOINTS [color=red][Joint PPHM & Memorial Sloan Kettering][/color] “Targeting Phosphatidylserine in Combination with Adoptive T Cell Transfer Eliminates Advanced Tumors without Off-Target Toxicities in a Melanoma Preclinical Model”
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FROM PPHM’s 4-3-17 PR: ir.peregrineinc.com/releasedetail.cfm?ReleaseID=1019762
…”Latest Findings from Ongoing Collaboration with Memorial Sloan Kettering (MSK) Support Potential Applications for Combining CAR T & Anti-PS in Treatment of Solid Tumors”… For this study, a team of MSK researchers led by cancer immunotherapy thought-leaders, Taha Merghoub, Ph.D. and Jedd D. Wolchok, M.D., Ph.D., evaluated and compared the anti-tumor activity and off-target toxicities of adoptive T cell transfer therapy in combination with either PS-targeting antibodies or anti-OX40 antibodies in mice with advanced melanomas. Whereas PS-targeting and anti-OX40 demonstrated comparable tumor regression when administered in combination with transferred adoptive T cells, only the PS-targeting combination achieved these results without any off-target toxicities. By contrast, the anti-OX40 treatment combination triggered off-target inflammatory destruction of healthy tissues. Additional study results demonstrated that the PS-targeting antibodies decreased tumor-induced immunosuppression as evidenced by a decrease in immunosuppressive regulatory T cells (Tregs) and M2 macrophages. This finding is consistent with Peregrine’s belief that bavituximab may modulate the immunosuppressive tumor microenvironment and enhance the activity of immunotherapy agents.
Taha Merghoub, Ph.D., Co-Dir. of the Ludwig Collaborative Laboratory at MSK: “While adoptive T cell transfer remains one of the most exciting new approaches to treating cancer, to date the toxicity associated with the treatment has limited its potential. We are encouraged that these study results showed that the combination of anti-PS and adoptive T cell treatment led to enhanced anti-tumor effect without any evidence of additional off-target side effects. “We believe that these findings may support potential applications for this combination in solid tumors in the future.”
Enjoy your weekend.
James
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