ASCO is a focal point for major clinical data readouts in oncology. L.E.K. Consulting used social listening to gauge the sentiment of virtual attendees at the June 2021 meeting. This revealed a notable focus on lung and breast cancer, and particularly positive sentiment around leukaemia and renal cell cancer readouts. Focusing in on the major data readouts driving sentiment highlights themes such as breakthroughs in adjuvant settings, the rise of novel checkpoint inhibitors, and a growing pipeline of novel modalities such as bispecific antibodies, ADCs and TILs.
The 57th annual meeting of the American Society of Clinical Oncology (ASCO) took place virtually during 4-8 June 2021. The meeting is a focal point for readouts of data from oncology trials and this year incorporated more than 2,400 abstracts covering more than 200 drugs. L.E.K. Consulting has used its Data & Analytics team’s capabilities to undertake social listening to gauge the sentiment of conference attendees during and after the event.
Significant social media focus on lung and breast cancer
Lung and breast cancer were the diseases most mentioned by ASCO attendees, with both having four to five times more mentions than any other disease. The other most talked about diseases were prostate cancer, renal cell cancer, melanoma, leukaemia and multiple myeloma (See Figure 1).
Mentions were categorised as containing positive, neutral or negative sentiment and net sentiment scores calculated. Sentiment was most positive for leukaemia and renal cell cancer (30% and 27% net sentiment scores, respectively), and lowest for prostate cancer (4% net sentiment score). The latter could have been negatively impacted by the termination of Tmunity Therapeutic’s CAR-T cell therapy trial due to patient deaths, which was announced days before ASCO.
Multiple data readouts drive positive sentiment
Analysis of social media and ASCO abstracts allowed the identification of Phase II or III data readouts that were major drivers of sentiment (See Figure 2). Lung and breast cancer had the most of these major drivers (seven and five, respectively), which correlates with also being the most talked about diseases.
Twenty-four major readouts were identified across the most talked about diseases, and these were studied further to identify key themes
Breakthroughs in adjuvant settings
Data readouts for Olaparib (Lynparza; AstraZeneca) in HER2-negative breast cancer and pembrolizumab (Keytruda; Merck & Co.) in clear-cell renal cell cancer were notable as both demonstrated benefits in adjuvant settings. Both drugs were used following surgery and were shown to reduce the risk of disease recurrence or death. These and other drugs are aiming to move earlier in the treatment paradigm and follow the success of osimertinib (Tagrisso; AstraZeneca) which was approved for adjuvant use in EGFR-mutated NSCLC last year. Being used to prevent recurrence requires meeting a significantly higher standard for safety than when being used to treat active disease in later lines. This is because side effects are less acceptable in populations in which only a subset experience disease recurrence.
Rise of novel checkpoint inhibitors
Categorisation of the mechanisms of action of the 24 major readouts reveal clustering within immune checkpoint inhibitors, oestrogen receptor antagonists (in breast cancer), PSMA inhibitors (in prostate cancer), kinase inhibitors and immunostimulant cell therapies (See Figure 3).
Within the lucrative checkpoint inhibitor category there were several readouts for the established PD-1 and PD-L1 antagonist mechanisms. There is representation for LAG-3 antagonists, which is a highly anticipated mechanism being pursued by over 25 preclinical and clinical programs currently. Adenosine receptor antagonists are another novel checkpoint inhibitor mechanism which is being pursued by a similar number of programs.
Beyond these novel mechanisms, the next wave of innovation is expected to be in bispecific checkpoint inhibitors. They target various combinations of PD-1, PD-L1, CTLA-4, LAG3 and other targets, and there are more than 30 in Phase II development and earlier.
Growing pipeline of bispecifics, ADCs and TILs
The 24 major readouts span a range of therapeutic modalities (See Figure 4). Innovative modalities include antibody drug conjugates (ADCs), bispecific antibodies and tumour infiltrating lymphocytes (TILs). ADCs consist of an antibody bound to an anticancer drug which specifically delivers the payload to target cells. Building on several ADC approvals in the past few years, there is a deep pipeline of over 250 in development. Bispecific antibodies and TILs are more novel approaches but still have pipelines of over 250 and over 25 candidates, respectively. Bispecifics allow the dual binding of two targets, with significant activity around checkpoint inhibitor targets, as previously mentioned. TILs are a form of cell therapy that utilise the fact that this cell type can penetrate tumours and specifically target cancerous cells.
Analysing social media for comments from ASCO attendees revealed a notable focus on lung and breast cancer. Sentiment was most positive around leukaemia and renal cell cancer readouts. Identifying 24 major clinical readouts across the most talked about diseases identifies breakthroughs in adjuvant settings, novel checkpoint inhibitors, and a growing pipeline of novel modalities such as bispecific antibodies, ADCs and TILs.