I have been attending the American Society for Clinical Oncology (ASCO) for well over a decade. Some years there are fireworks with step function advances, like the jaw dropping early data in PDL-1s/PD1s or ALL CAR-T. While this year was more quiet, multiple datasets supported our long-term theses in oncology therapeutics and diagnostics. Innovation marched on. Here are five observations from ASCO 2024:
- Antibody-drug conjugates (ADCs) and variations thereof have cemented as dominant modalities in a multitude of cancers. Drugs like Enhertu and Elahere are well on their way to multi-blockbuster status. ASCO 2024 supported these projections, with data showing practice-changing use of Enhertu in low HER2 expressors. However, interstitial lung disease (ILD) remains a safety issue, which, while well known to clinicians, is an area of potential improvement from emerging ADC approaches in the pipeline.
- Genomic profiling of tumors could become an increasingly important tool to support the evolution of therapeutic approaches. In many presentations, it remains clear that applications of cancer diagnostics in recurrence monitoring and treatment selection continue to expand. For example, as treatments continue to give rise to emerging pathways of tumor resistance, the necessity of tumor genetics (especially liquid biopsy) in understanding the cause of relapse and subsequently guiding therapy, is growing significantly. These trends mean that the growth prospects of core cancer Diagnostics businesses remain quite robust, while they themselves work on the intriguing holy grail of multi-cancer screening.
- Don’t forget immuno-oncology as just because an area is out of favor with investors doesn’t mean serendipity won’t occur.
- Next generation targeted agents were probably the star of the show showing outstanding data in ALK and EGFR, reinforcing massive progress over the past several years.
- And finally, though this year’s ASCO did not shock and awe, there are hints of progress in emerging modalities with the field on the cusp of seeing promising advances. Just within the field of cancer immunotherapy, CAR-T and TCRs are making inroads in solid tumors; mRNA vaccines are proving a viable approach in the field; TILs are finally entering the scene with recent approval of Iovance’s lifileucel; and bispecific T-cell engagers are demonstrating promise in solid oncology. The following slide from a presentation at ASCO reviewing progress in the field illustrates this final observation.