Abstract 3186
Background
A bran-new landscape of immuno-oncology (IO) is arising in China rapidly, with IO development a hotspot in biopharmaceutical industries. Moreover, a paucity of data on the panorama of IO clinical trials in China inspired us to present the systemic analysis for stakeholders in this field.
Methods
Based on the Platform for Registry and Publicity of Drug Clinical Trials, a national authoritative database by China Food and Drug Administration, the trials for IO agents issued from 2013 to 2018 were explored using newly developed agents (by six types of mechanism and targets) and the number of initiated trials as key indicators. The clinical development stages of all agents were presented by targets. In addition, time trends in annually initiated trials and cumulative indication distribution were investigated.
Results
There were 62 IO agents and 230 initiated trials in China from 2013 to 2018, with 46 (74.2%) agents and 154 (67.0%) trials from domestic firms. The 62 agents modulated 18 targets focusing on PD-1 (17, 27.4%), PD-L1 (12, 19.4%) and unspecified tumor-associated antigens (5, 8.1%). Only 8 agents of cell therapy were ever developed for registration purpose. PD-1/L1 targets were most extensively investigated with a total of 180 (78.3%) trials and 4 agents approved. The annual number of trials showed an upward trend, and the sharp increase for trials of T-cell targeted immuno-modulators was seen with an average growth rate of 199.1% since 2016. In terms of cancer types, solid tumor (56, 24.3%), non-small cell lung cancer (45, 19.6%) and hepatocellular cancer (20, 8.7%) were the most common. Only 14 (6.1%) trials applied a biomarker enrichment strategy.Table:
1293P The landscape of immuno-oncology targets in clinical development in China since 2013
| Types | Targets | Agents N = 62 (%) | Trials N = 230 (%) | |||
|---|---|---|---|---|---|---|
| Total | Phase I | Phase II/III | Approv ed | |||
| T-cell targeted immuno- modulator | PD-1 | 17 (27.4) | 6 | 7 | 4 | 129 (56.1) |
| PD-L1 | 12 (19.4) | 5 | 7 | 51 (22.2) | ||
| CTLA-4 | 3 (4.8) | 1 | 2 | 11 (4.8) | ||
| IDO1/TDO | 2 | 2 | 2 | |||
| IDO1 | 1 | 1 | 1 | |||
| CD137 | 1 | 1 | 1 | |||
| LAG3 | 1 | 1 | 1 | |||
| OX40 | 1 | 1 | 1 | |||
| PD-1/CTLA-4 | 1 | 1 | 1 | |||
| PD-L1/CTLA-4 | 1 | 1 | 1 | |||
| PD-L1/ TGF-βRII | 1 | 1 | 1 | |||
| Other immuno- modulator | Unspecified | 1 | 1 | 5 (2.2) | ||
| CD47 | 1 | 1 | 1 | |||
| MUC1 | 1 | 1 | 1 | |||
| Cancer vaccine | TLR | 2 | 2 | 2 | ||
| EGF | 1 | 1 | 1 | |||
| MUC1 | 1 | 1 | 1 | |||
| Cell Therapy | Unspecified | 4 (6.5) | 2 | 2 | 4 (1.7) | |
| CD19 | 3 (4.8) | 3 | 3 (1.3) | |||
| BCMA | 1 | 1 | 1 | |||
| Oncolytic virus | GM-CSFR | 4 (6.5) | 1 | 3 | 9 (3.9) | |
| CD3-targeted bispecific mAb | CD19 | 1 | 1 | 1 | ||
| HER2 | 1 | 1 | 1 |
Conclusions
Though a gap exists in the number of agents and targets between China and the global pipeline, the rising capability of IO has been achieved in China recently. Efforts should be further made in novel targets, cell therapy for registration purpose, Chinese unique cancers and new trial designs.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5218 - Elevated driver mutational burden or number of perturbed pathways and poor response to abiraterone or enzalutamide in metastatic castration-resistant prostate cancer
Presenter: Bram De Laere
Session: Poster Display session 3
Resources:
Abstract
2452 - High proportion of multiple KRAS mutations in circulating tumor DNA and tumor tissue of pancreatic ductal adenocarcinoma
Presenter: Min Kyeong Kim
Session: Poster Display session 3
Resources:
Abstract
3328 - Biological difference of tumor mutational burden (TMB) and microsatellite instability (MSI) status in patients (pts) with somatic vs. germline BRCA1/2-mutated advanced gastrointestinal (GI) cancers using cell-free DNA (cfDNA) sequencing analysis in the GOZILA study
Presenter: Yasuyuki Kawamoto
Session: Poster Display session 3
Resources:
Abstract
3022 - Cell-Free DNA to Detect Focal Versus Non-Focal MET Amplification in Metastatic Colorectal Cancer Patients: Combined Analysis from Japan and the United States
Presenter: Mishima Saori
Session: Poster Display session 3
Resources:
Abstract
2833 - Presence of circulating tumor DNA in surgically resected renal cell carcinoma is associated with advanced disease and poor patient prognosis
Presenter: Andres Correa
Session: Poster Display session 3
Resources:
Abstract
1376 - Combined genomic and epigenomic assessment of cell-free circulating tumor DNA (cfDNA) for cancer diagnosis and recurrence-risk assessment in early-stage lung cancer
Presenter: Junghee Lee
Session: Poster Display session 3
Resources:
Abstract
4050 - DEMo: a prospective evaluation of a prognostic clinico-molecular composite score in NSCLC patients treated with immunotherapy.
Presenter: Arsela Prelaj
Session: Poster Display session 3
Resources:
Abstract
4727 - Bespoke circulating tumor DNA (ctDNA) analysis as a predictive biomarker in solid tumor patients (pts) treated with single agent pembrolizumab (P)
Presenter: Cindy Yang
Session: Poster Display session 3
Resources:
Abstract
3662 - Dynamic changes in whole-genome cell-free DNA (cfDNA) to identify disease progression prior to imaging in advanced solid tumors
Presenter: Andrew Davis
Session: Poster Display session 3
Resources:
Abstract
3817 - Evaluation of Microsatellite Instability Testing Through cell-free DNA sequencing
Presenter: Shile Zhang
Session: Poster Display session 3
Resources:
Abstract