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ASCO 2024 preview – new Car-T target shows liver cancer promise

Targeting GPC3 has scored a win for AstraZeneca’s Chinese partner, after Takeda drew a blank.

A curious tie-up between AstraZeneca and China’s AbelZeta has yielded what looks like a promising new Car-T project. C-CAR031 has shown a 50% confirmed response rate in its first-in-human study in the tough setting of heavily pretreated liver cancer, with no dose-limiting toxicities, its just unveiled ASCO abstract has shown.C-CAR031 targets glypican-3 (GPC3), a protein said to be expressed in hepatocellular carcinoma, and is also “armoured” with TGFβRIIDN. It comprises the same construct as Astra’s own AZD5851, and both assets are cross-licensed under a deal struck last December, shortly after AbelZeta rebranded away from its former name of Cellular Biomedicine Group.AZD5851 also features at ASCO, but only in a trials-in-progress poster, as does Sotio’s lead cell therapy candidate, the anti-GPC3 Car BOXR1030. Meanwhile, a poster on Takeda’s earlier attempt at this modality, TAK-102, paints a disappointing picture, likely explaining this project’s recent discontinuation.ImpressiveThe C-CAR031 study comprises 24 patients with second to seventh-line hepatocellular carcinoma, 22 of whom were evaluable for efficacy at a 5 January data cutoff. The already impressive 50% ORR rises to 55% if an additional unconfirmed PR is included, and the authors highlight tumour shrinkage in lesions outside the liver.The results comprise four dose levels, and only the lowest (one patient treated) hasn’t yielded a response. On safety there was no neurotoxicity, and grade 3 cytokine release was seen in only one patient. However, grade 3 or higher transaminase elevation occurred in 16.7%, one patient had grade 4 myelosuppression and another grade 3 interstitial pneumonitis.Astra has China co-development rights to C-CAR031, while separately developing AZD5851 outside China; under December’s deal AbelZeta obtained a milestone and royalty interest in the latter. It seems likely that the two companies had been working on the same construct, and the cross-licensing arrangement was a means of agreeing how to proceed without one group encroaching on the other’s IP.The C-CAR031 data will come as an additional boost for AbelZeta, whose rebranding drew a line under its past as Cellular Biomedicine Group (CBMG), an entity once listed on Nasdaq but later taken private. The Astra deal came seven months after a tie-up with Johnson & Johnson worth $245m up front for two other Car-T projects.Takeda outFor its part, Takeda recently scaled back its cell therapy pipeline in a cull that saw TAK-102 discontinued. The project had been licensed from the Japanese group Noile-Immune Biotech in 2017, and Takeda put it into phase 1.The abstract of an ASCO poster on TAK-102 details those phase 1 data, and while there are also no DLTs or neurotoxicity there aren’t any responses either, the best result among 11 solid tumour patients being stable disease. TAK-102, which after Takeda's discontinuation remains in Noile-Immune's pipeline as NIB102, is also “armoured”, but encodes IL-7 and CCL20 rather than TGFβRIIDN.The ASCO data might also be of interest to Gilead, which in an April 2022 oncology deep dive presented the Car-T therapy KITE-509, which targets GPC3 and also blocks the TGFβ signal. However, despite Gilead promising clinical trials “in the near future” these have yet to materialise. Cross-trial comparison in anti-GPC3 Car-T therapyProjectCo-expressesCompanyTrialEfficacySafetyC-CAR031TGFβRIIDNAbelZeta/ AstraZenecaNCT0515518911 cPR + 1 uPR in 22 pts16.7% gr3+ transaminase elevation, 4.2% gr4 myelosuppressionTAK-102/ NIB102IL-7 & CCL20Noile-Immune (discontinued by Takeda)NCT044057780 responses in 11 ptsNo DLTs or neurotoxicityBOXR1030Glutamic-oxaloacetic transaminase 2 (GOT2)SotioDuet-01None, ASCO TiP poster onlyAZD5851TGFβRIIDNAstraZeneca/ AbelZetaAthenaNone, ASCO TiP poster onlySource: ASCO & OncologyPipeline. The ASCO annual meeting takes place in Chicago on 31 May to 4 June. 
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