Cancer Escapes Covid Shadow, Tackling Tough-to-Beat Diseases

(Bloomberg) -- For more than a year, the coronavirus has remained the focus of the health-care sector and all that exists in its orbit, demanding the attention of U.S. health officials, hospitals and headlines.

But now the hottest and most heavily invested-in area of drug development -- cancer -- is starting to step out from the shadows. Drugmakers at the American Society of Clinical Oncology meeting that began Friday and runs through Tuesday are eager to rekindle interest in a business that saw its market value drop and its products underperform sales estimates as the pandemic played out.

While there are no clear blockbusters this year, research presented at the ASCO meeting by Novartis AG, as well as AstraZeneca Plc and Merck & Co., showed significant progress against some tough-to-beat malignancies.

Among the gains: A key expansion to an emerging class of drugs that deliver radiation directly to cancer cells; a pill with promise against hard-to-treat triple-negative breast cancer; a first-of-its-kind blood test available by prescription to detect malignancies; and an early entrant to a coming wave of Chinese drugs that could offer cheaper alternatives to costly existing therapies.

Here’s a breakdown:

• Combining Junshi Biosciences Co.’s toripalimab for nasopharyngeal cancer with chemo outperformed the standard treatment alone, according to a study presented at the meeting. Known as checkpoint inhibitors, these drugs are designed to free the immune system to attack tumors. The Junshi drug is one of several such treatments expected to come from China that may be less expensive than existing blockbuster therapies that include Merck’s Keytruda and Bristol Myers Squibb Co.’s Opdivo.
• A Novartis drug that precisely delivers a blast of radiation to prostate cancer cells boosted survival by four months in a late-stage study in patients failed by other treatments. Novartis now plans to submit the drug, 177Lu-PSMA-617, to regulators for approval in the U.S. and Europe later this year. It’s also starting two trials on the therapy’s effect in earlier stages of the disease.
• AstraZeneca and Merck said Lynparza, a drug already on the market, cut recurrence risk by 42% in adjuvant treatment of patients with germline BRCA-mutated high-risk early breast cancer in a late-stage study. The drug demonstrated a clinically meaningful improvement in invasive disease versus placebo, as well as distant disease-free survival.
• Illumina Inc. stock climbed after Grail Inc. announced it would sell a first-of-its-kind blood test for cancer by prescription in the U.S. Grail, which Illumina agreed to buy last year, also revealed updated results from the test, called Galleri, at the meeting. Liquid biopsy is an alternative to more complex tissue biopsies. The potential market for screening of this kind: more than $30 billion.
• Cancer patients in U.S. states that limited Medicaid use with higher income barriers were more likely to die than those in states with lower limits. A study of 1.4 million people diagnosed from 2010 to 2013 illustrate the impact of denying more of the nation’s poor to to enroll in Medicaid under the Affordable Care Act. Patients with early-stage breast cancer were 31% more likely to die over eight years of follow-up in low-access states.
• Not all companies won out at ASCO. Harpoon Therapeutics Inc. plunged the most ever after a disappointing update on its experimental prostate cancer medicine HPN424. While the number of circulating tumor cells dropped in a number of men, the improvements didn’t appear to correlate to increasing doses of drug.

The ASCO meeting kicked off Friday with a celebration of the 50th anniversary of the National Cancer Act. ASCO officials also touched on lessons learned about cancer care during the pandemic throughout the meeting, and outlined recommendations on how to ensure clinical trials are more nimble, affordable and accessible into the future.

The pandemic “required ASCO to reconsider assumptions and prior decisions, and take unprecedented actions,” said Clifford Hudis, the society’s chief executive officer, at the meeting.

While the cancer-focused companies continued to conduct R&D throughout the pandemic, their products saw revenue slashed. Fewer routine doctor visits and procedures led Merck and Bristol Myers blockbuster immuno-therapies, Keytruda and Opdivo, to underperform sales expectations as recently as the first quarter.

However, health insurer Cigna Corp. said it made strides to drive patients to mammographies, colonoscopies, and cervical cancer screenings. The result: The amount of preventive care received by its members rose to match levels seen before the pandemic began, Cigna reported on May 7. Now, medical experts and analysts will await second-quarter results to see if the industry continues to bounce back.

The medical field must place special emphasis on ensuring that cancer care in the post-Covid era is equitable, said Narjust Duma, a medical oncologist at the University of Wisconsin, in a presentation about treatment disparities amid the pandemic.

“Disparities in cancer care persist. There are here. They haven’t gone anywhere, and during COVID-19, they only have worsened,” Duma said. “We’re going to see the consequences of the pandemic, particularly in vulnerable populations, many years from now. This story doesn’t end today.”

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