Every ESMO conference is eventful, but the drama kicked into gear earlier than expected this year when the eagerly anticipated phase 3 data for Moderna and Merck & Co.’s cancer vaccine were leaked two days before the Presidential Symposium.
Shweta Jain, vice president of global clinical development and oncology clinical research at Merck, acknowledged to Fierce in an interview that the leak was “unfortunate,” but explained that the Big Pharma and its partner had stuck to their plan on how to present the data on Saturday.
Going public with the headline data earlier than expected certainly didn’t deter delegates from queuing up for the Saturday symposium. As with previous ESMO show-stoppers, interest was so high that latecomers were reduced to standing around the sidelines of the cavernous Alicante Auditorium.
But it’s easy to assume that the slightly muted atmosphere during the presentation would have been more electric if the audience had been in genuine suspense about the data being unveiled.
Jain may have been resigned to the leak and wanted to focus attention on the trial's “convincing data,” but the ESMO organizers weren’t quite as relaxed. For this conference, Fierce—along with all journalists—was barred from entering either of the exhibition halls under a new policy preventing access to non-healthcare prescribers.
ESMO’s press office told Fierce they “understand your disappointment … and appreciate the frustration this has caused.” But they laid the blame at European legislation governing the promotion of medical products.
Biopharma executives who spoke to Fierce under condition of anonymity speculated that this hard-line approach was in fact a knee-jerk reaction to the negative publicity surrounding the vaccine data leak.
For Merck’s Jain, the intismeran autogene readout was just the most high-profile announcement in a packed ESMO package from the Big Pharma that featured around seven oral presentations alongside “many, many, many abstracts and posters.”
That included two other presidential symposia to showcase Chinese phase 3 data for the Kelun-Biotech-partnered antibody-drug conjugate (ADC) sacituzumab tirumotecan (sac-TMT), as well as the potential for Keytruda to treat patients with a type of endometrial cancer.
Merck also reminded everyone that it has a contender in the hotly contested KRAS G12C inhibitor space by offering early data on how calderasib performed against solid tumors.
“I would say, put together, it just generally shows that we are working towards a more diverse portfolio,” Jain concluded.
At last year’s conference in Berlin, the general consensus was that next-gen ADCs were the stars of the show. But during Fierce’s conversations with senior executives from over 10 Big Pharmas and biotechs, as well as doctors and other attendees milling around the walkways of the sun-dappled IFEMA venue in outer Madrid, there was an altogether different vibe.
In fact, the overarching view was that this year’s theme was: there was no theme.
“I don't see a theme, right?” Incyte’s Global Head of R&D Pablo Cagnoni, M.D., told Fierce in an impromptu interview in the empty ESMO press conference room.
With Incyte keen to pitch its KRAS G12D inhibitor INCB161734 as the only real rival to Revolution Medicine’s Rasonque follow-up zoldonrasib, Cagnoni acknowledged his focus at the conference had been on “a lot of KRAS stuff happening.”
Despite this tunnel vision, Cagnoni was still able to see the bigger picture.
“I walked into a couple of presentations randomly, and they were talking about applications of AI from anything from diagnosis to patient care-directed applications,” he said. “So I think that’s a big theme.”
“I think it’s impossible at this ESMO to not talk about the Moderna [cancer] vaccine,” he continued. “There’s strong passions on both sides—I happen to think the data are really good.”
“And the third point I would make is I was struck by the quality of the ovarian cancer readout from Genmab on Friday,” said Cagnoni, referencing the Danish biopharma’s phase 3 win for its Elahere rival Rina-S.
“A first analysis of a study showed survival hazard ratio 0.43,” he explained. “I think that is a really important data set for patients with ovarian cancer.”
Stefan Frings, M.D., Ph.D., deputy chief medical officer at Roche Pharma, had a similar take.
“I would expect that there’s not a single theme, but rather many attractive modalities,” he summarized of the current state of the oncology R&D space.
“We tailor … the target to the modality,” Frings explained. “Sometimes it can be an ADC, sometimes immunotherapy.”
“Sometimes combination targeted molecules like divarasib are still very attractive,” he said, namechecking Roche’s own KRAS G12C inhibitor that aced Amgen’s Lumakras and Bristol Myers Squibb’s Krazati in a phase 3 non-small cell lung cancer study.
“It showcases here that we are making progress in treating cancer,” he concluded.
For the duration of the conference, Roche set up shop in an elegant hotel a couple of miles away from IFEMA. The Swiss pharma weren’t the only ones to seek some calm away from the bustle of the ESMO crowds.
Next, Fierce headed to a Novotel a stone’s throw from the venue to catch up with Yusri Elsayed, M.D., Ph.D., global oncology therapeutic area head at Johnson & Johnson Innovation, to get his take.
J&J had some exciting early-stage data from the regulated induced proximity targeting chimera (RIPTAC) platform acquired in its Halda Therapeutics buyout last year. But Elsayed was similarly open-minded about the most exciting mechanisms on display at this year’s ESMO.
“We are very excited about the RIPTAC, of course,” he said. “But we are also very excited about ways of trying to reach patients, minimizing toxicities and increasing efficacy.”
“For example, we are working now on degrader-antibody conjugates,” he said, alluding to a platform J&J picked up in its Firefly Bio acquisition in June. “You don't hear about it a lot, but definitely for next ESMO.”
Elsayed and his team were also “excited to hear about” Merck and Moderna’s vaccine success, he pointed out.
As to the reduced emphasis on ADCs this year, “I don't think that’s a bad thing,” he said.
“The emergence of new mechanisms of action, I think, is very exciting.”
That’s not to say that ADCs were kept a low profile at this year’s ESMO. As well as Merck's sac-TMT, GSK unveiled fresh phase 1 data from its Hansoh-partnered B7-H4-directed mo-rez, while AstraZeneca insisted to Fierce that the mixed phase 3 gastric cancer data for its Claudin18.2-targeting sono-ve will be enough to win over regulators.
Takeda used ESMO to lift the lid on its own late-stage success for a CLDN18.2 ADC, called arcotatug tavatecan. As far as P.K. Morrow, M.D., head of Takeda’s oncology therapeutic area unit, was concerned, the modality still has plenty to offer.
“What you saw here—not just with this, but other data across ESMO—is how do we continue to optimize the tolerability profile so we can deliver the degree of efficacy to patients,” she told Fierce.
“So ADCs really are here to stay,” she added.
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