ASH: After a pilot study offers a glimpse of hope for Tessa’s CD30-targeting CAR-T, execs sprint toward a pivotal trial

CAR-Ts tar­get­ing CD19 — like Yescar­ta, Kym­ri­ah and the re­cent­ly ap­proved Breyanzi — have shift­ed the par­a­digm for the treat­ment of B cell lym­phoma, ac­cord­ing to Sairah Ahmed, a long­time re­searcher in the field. Now, as prin­ci­pal in­ves­ti­ga­tor, she’s lead­ing ef­forts to see if Tes­sa Ther­a­peu­tics’ CD30-tar­get­ing CAR-T can do the same for pa­tients with clas­si­cal Hodgkin lym­phoma (cHL). More than half of the pa­tients who took Tes­sa’s can­di­date TT11 in the pi­lot stage of a Phase II study saw their can­cer dis­ap­pear, the com­pa­ny said at this year’s ASH con­fer­ence. Of 15 heav­i­ly pre-treat­ed pa­tients with re­lapsed or re­frac­to­ry CD30-pos­i­tive cHL, 11 saw dis­ease con­trol at the da­ta cut off, in­clud­ing eight com­plete re­spons­es, two par­tial re­spons­es and one case of sta­ble dis­ease, ac­cord­ing to re­searchers.

That all adds up to a 71.4% over­all re­sponse rate and a 57.1% com­plete re­sponse rate. The ther­a­py was well-tol­er­at­ed, with no re­ports of neu­ro­tox­i­c­i­ty, and one case of Grade 1 cy­tokine re­lease syn­drome, an acute sys­temic in­flam­ma­to­ry syn­drome com­mon­ly caused by CAR-Ts.

‘This is dif­fer­ent than the oth­er CAR-T cells that are out in the mar­ket for dif­fuse large B-cell (lym­phoma) that have a very high rate of cy­tokine re­lease syn­drome,’ Ahmed told End­points News. 

The pa­tient re­cov­ered with­in five days with treat­ment, Ahmed added.

Pa­tients in the CHAR­I­OT tri­al went through a me­di­an of six and as many as 18 lines of ther­a­py. Like oth­er CAR-T ther­a­pies, TT11 works by har­vest­ing a pa­tient’s own T cells, then mod­i­fy­ing them by in­tro­duc­ing a CAR to tar­get and kill can­cer cells that ex­press CD30. The pro­tein is ex­pressed in 98% of cHL cas­es, as well as a sig­nif­i­cant pro­por­tion of cer­tain non-Hodgkin lym­phoma cas­es, ac­cord­ing to Tes­sa.

‘That may be for some pa­tients a bridge to trans­plant, so a bridge to a cu­ra­tive treat­ment. But for oth­er pa­tients, it may be the cu­ra­tive treat­ment in and of it­self,’ Ahmed said of TT11. The re­cent re­sults are in line with ear­li­er re­sults from Phase I/II tri­als that were pub­lished in the Jour­nal of Clin­i­cal On­col­o­gy, CMO and CSO Ivan Ho­rak said. Ac­cord­ing to those re­sults, 94% of treat­ed pa­tients were still alive af­ter one year, and 61% of pa­tients who saw a com­plete re­sponse had no ev­i­dence of re­cur­rence.

Tes­sa plans on ini­ti­at­ing the sec­ond, piv­otal stage of the CHAR­I­OT tri­al in 2022.

‘The cur­rent stan­dard of care for re­lapsed or re­frac­to­ry clas­si­cal Hodgkin lym­phoma can cause high tox­i­c­i­ty and long-term mor­bid­i­ty, with par­tic­u­lar­ly poor tol­er­a­bil­i­ty not­ed among el­der­ly pa­tients,’ Ho­rak said in a state­ment. ‘Thus far, TT11 has proven to be well tol­er­at­ed by pa­tients, while demon­strat­ing strong clin­i­cal re­sults as a third- and fourth-line monother­a­py.’

These aren’t the on­ly da­ta Tes­sa’s bring­ing to ASH. Over the week­end, the com­pa­ny un­veiled some Phase I da­ta for TT11x, its CAR-mod­i­fied Ep­stein-Barr virus-spe­cif­ic T cell (EBVST) ther­a­py, show­ing four com­plete re­spons­es in a group of sev­en pa­tients.

Sensor-based technology for clinical trial data collection represents the latest medical paradigm shift. There are more than 700 clinical studies involving wearable devices currently underway in the United States. A study from Intel IT projects their inclusion in clinical trials will surge to 70% by 2025.

Apps, biosensors and patient-centered technologies increase visibility of comprehensive patient data. Pharma leaders anticipate the benefits of wearables to include better data (58%), faster results (33%) and lower trial costs (10%).

Pascal Touchon, Atara CEO

After more than two decades in the clinic, Atara Biotherapeutics’ T cell therapy tabelecleucel is finally headed to the FDA — but not without a pivotal readout at this year’s ASH conference.

About half of patients responded to tab-cel, Atara’s candidate for Epstein-Barr virus-positive post-transplant lymphoproliferative disease (EBV+ PTLD), a rare complication that can occur after solid organ or hematopoietic stem cell transplant.

The current generation of cell therapies has proven a game changer in terms of treating aggressive blood cancers, but the tech has its limitations. Novartis, one of the biggies in the current generation of these drugs, is now taking lessons learned from CAR-T Kymriah to supercharge a ‘second-generation’ of CAR-Ts putting superior cells into patients faster.

Novartis on Monday rolled out early Phase I data for a pair of autologous CAR-T cell therapies developed through the drugmaker’s T-Charge platform, a process designed to promote T cell ‘stemness’ — a measure of a cell’s ability to self-renew — by cutting manufacturing times and spurring cell proliferation primarily in patients’ lymph nodes.

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When Bristol Myers Squibb celebrated the approval of ozanimod — branded Zeposia — in ulcerative colitis earlier this year, the company touted the first gastrointestinal indication for an S1P receptor modulator.

Now Pfizer wants to give the pharma rival a run for its money.

Pfizer is dropping $6.7 billion to acquire Arena Pharmaceuticals, whose lead drug, etrasimod, targets the sphingosine 1-phosphate receptor.

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Frank Neumann, Kite global head of clinical development

With the cell therapy field largely pivoting to the next generation of those drugs, established players like Gilead’s Kite and Bristol Myers Squibb are still carving away at new routes into earlier lines of care. This weekend, Kite churned out more data for its CAR-T Yescarta in first-line lymphoma patients as part of a hopeful push for a greater market share.

In updated results from the Phase II ZUMA-12 study, Yescarta posted a 78% complete response rate among 37 patients with high-risk large B cell lymphoma at a median follow-up of just shy of 16 months, the drugmakers said Monday at #ASH21.

Precision CMO Alan List (Diane Bondareff/AP Images for Moffitt Cancer Center)

The next generation of cell therapies have focused in large part on the development of allogeneic — better known as ‘off-the-shelf — drugs that can cut manufacturing times and hopefully evade a patient’s immune system. One of the early players in that race has new data at #ASH21 that show deep responses but will also raise fresh concerns about these therapies’ durability.

Precision Biosciences’ PBCAR0191, a CD19-directed allogeneic CAR-T cell therapy, posted a complete response rate of 59% in 22 heavily pretreated patients with various forms of relapsed or refractory non-Hodgkin’s lymphoma and acute lymphocytic leukemia, six of whom had previously received an autologous CAR-T before dosing, the biotech said.

Stéphane Bancel, Moderna CEO (Endpoints JPM20/Jeff Rumans)

Last fall, as their Covid-19 vaccine crossed the finish line, Moderna unveiled plans to take its newly proven mRNA platform and use it to effectively change how the world blocks humanity’s most persistent viral foes.

In addition to their pre-existing vaccine programs, executives announced new ones for flu, where vaccines have chronically underperformed, and HIV, which has eluded every inoculation effort over nearly 40 years. In flu, the other mRNA vaccine companies — BioNTech (with Pfizer), Translate Bio (under Sanofi), and CureVac (with GSK) — all had similar ambitions, hoping to make shots that were as high as 80% effective.

Roberto Bellini, Bellus Health CEO

Do investors want the good news, or the bad news first? Bellus went with the good news, sharing that its chronic cough contender hit the primary endpoint in a Phase IIb trial, lining it up for a Phase III study in the second half of next year where it could pose stiff competition for Merck.

Amidst all the commotion, the Canadian biotech also revealed that the same candidate flunked a proof-of-concept trial in atopic dermatitis, and the company will now steer the program away from pruritic conditions.

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Li Ning, Junshi Biosciences CEO

Four months after its first upbeat interim analysis, Shanghai’s Junshi Biosciences and California biotech Coherus BioSciences are touting a statistically significant improvement in overall survival for patients treated with toripalimab plus chemotherapy as a treatment for advanced squamous or non-squamous NSCLC.

The drug, an anti-PD-1 mAb already approved in China as Tuoyi, previously beat placebo as a first-line treatment when combined with chemotherapy. Among 465 advanced NSCLC patients who have never received therapy (both squamous and nonsquamous), investigators observed a ‘significant improvement in progression-free survival.’
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