Physician-scientist. Immunologist. CEO of Candel Therapeutics ($CADL), focused on development of new immunotherapies for cancer. Views expressed here are my own
A quick personal update: I have stepped down from my previous roles as SVP R&D Pipeline, Chief Immunology Officer and Development Lead at GSK to become Venture Partner at Flagship Pioneering. Very excited by the new opportunity!
Posting comments about the interpretation of clinical trial data comes with a responsibility to get it absolutely right, especially as it relates to cancer patients who are urgently waiting for better treatments.
Let's dissect why this post was misleading. A thread.
$CADL's data set has multiple red flags:
-OS without a control arm is meaningless, the term "improved survival" in the PR is misleading
- No objective responses
- Evaluable population is 60% of enrolled patients (and we know the other 40% did much worse because ITT OS is lower)
I am excited to announce that I have joined Kintai Therapeutics. Their significant discoveries in just two years since inception are a testament to the remarkable team that I now have the privilege of working with towards our goal of bringing revolutionary medicines to patients.
‘The whole idea of CAR-T is becoming a failed theory’. Seriously?
Frankly, no expert in the field would be surprised if the discovery and development of CAR-T cell therapies would ultimately be rewarded with a Nobel Prize. It’s been a scientific breakthrough without any doubt.
I am going to make a radical statement, but it is now true. 90% of companies in the cell therapy space are a waste of time and money to even invest in. The whole idea of CAR-T is becoming a failed theory. The data has been disappointing over and over again.
Thank you for the questions; happy to address them.
1. Good news, you don't need to wait 5 years! In April 2024, we already presented overall survival (OS) data based on a randomized phase 2A clinical trial of CAN-2409 in pancreatic cancer: median OS (mOS) was 28.8 months in the
@paulpetertak
$CADL ok then, now have to wait 5 years to figure out if your drug worked? Where is your ORR data as monotherapy? CADL& $pdsb refuse to run studies with control arm, so no one can actually interpret the data
More exciting news from Candel. We have been working for years to get to this point where we have 6 important inflection points, all in one year. Today: late-breaking presentation at AACR.
$CADL
#CandelTherapeutics
More encouraging news from Candel Therapeutics: CAN-3110 has now also received Orphan Drug Designation, further highlighting the potential of this therapy for patients with recurrent high-grade glioma.
#viral
#immunotherapy
#CAN
-3110
#glioblastoma
$CADL
Today we announce that Candel Therapeutics received FDA Orphan Drug Designation for CAN-2409 for the treatment of pancreatic cancer. The FDA has granted Candel with both Orphan Drug and Fast Track Designation, as we seek to reshape the treatment paradigm in this disease. $CADL
The PRAIRI study has been published: first experimental evidence for a preventive window of opportunity in rheumatoid arthritis. Up to a new paradigm of much earlier intervention.
Big thank you to the study participants and my colleagues!
#
We are on track for topline data from our fully enrolled phase 3 (intermediate/high-risk; n=711) and phase 2b (low/intermediate risk, active surveillance population; n=187) randomized controlled clinical trials in early, localized prostate cancer in Q4 2024.
#viral
#immunotherapy
It is estimated that there will be approx. 299k new cases of
#prostatecancer
cases in the United States in 2024. At $CADL, we're advancing our viral immunotherapy, CAN-2409, designed to empower the immune system to fight cancer, including
#prostatecancer
more effectively.
The most objective and meaningful response is overall survival. Every other endpoint, such DCR, ORR, and PFS is meant as potential surrogate marker of overall survival. This is what matters most to patients and regulators.
As a professor of medicine, I have been Principal Investigator for more than 30 clinical trials, before I became Global Development Leader of GSK and the Chair of GSK's Scientific Review Board. Experience helps to understand what should be achieved in phase 2A clinical trials.
This trend of failure in big pharma discovery is expected to continue, unless top scientists with strong leadership skills are supported to change the culture, and foster creativity, collaboration, consistency and rigorous decision making.
Returns on R&D investment for large-cap biopharma hit 9-year low according to new Deloitte report
Average cost of bringing a new drug to mkt almost doubled to > $2B, meanwhile forecast peak sales have more than halved since 2010
@Biotech2k1
Market cap is a very poor surrogate marker of scientific and clinical success in a dysfunctional market. Financial success lags behind because of poor scientific insight, the impact of ‘the echo chamber’, and more fundamentally the structure of scientific revolutions (Thomas S.
Two Candel abstracts accepted at ASCO:
1. Data from the ongoing phase 1 clinical trial of CAN-3110 in patients with recurrent high-grade glioma (glioblastoma).
2. Topline overall survival data from the phase 2 clinical trial of CAN-2409 in non-small cell lung cancer.
$CADL
Candel Therapeutics develops CAN-3110, a second-generation herpes simplex virus engineered for replication in tumor cells, for the treatment of recurrent high-grade glioma (glioblastoma). Results based on experimental treatment of the first 41 patients with a single injection of
I had a wonderful experience today. I was not able to buy a bottle of wine at
#Target
in Cambridge MA today! Both a Dutch Identity Card and a Dutch driving licence were not sufficient to convince the cassier that my 21st birthday happened a few years ago. Very young again!
Breaking news from Candel Therapeutics: Improvements in estimated median overall survival of 28.8 months after experimental treatment with CAN-2409 versus only 12.5 months in control group in borderline resectable pancreatic ductal adenocarcinoma.
Think of it, in 70% of the patients with progressive tumor growth despite optimal standard of care, we could stop the tumors from growing. More importantly, many of these patients lived much longer than would be expected. The long tail of survival you would hope for.
@zerohedge
So many smart and amazing people in the US. It should be possible to find better candidates to become
#president
of the USA across both political parties?
#POTUS
Finally, CAN-2409 is not an oncolytic virus. It's a virus designed for in situ vaccination against the patient's injected and uninjected tumors. The strong immunological biomarker data are consistent with its mechanism of action. Off-the-shelf product, individualized response.
You always need to consider you may be wrong. More: ‘seeking out experts who disagree with you and weighing the strength of logic and evidence’ please.
Because, unfortunately, patients with progressive, metastatic cancer despite chemotherapy and immune checkpoint inhibitor treatment do not exhibit placebo responses or regression to the mean. They die despite standard of care docetaxel chemotherapy.
See also: Society for Immunotherapy of Cancer (SITC) recommendations on intratumoral immunotherapy clinical trials (IICT): from premalignant to metastatic disease (Luke JJ et al. J Immunother Cancer 2024;12:e008378).
"The reasonable man adapts himself to the world: the unreasonable one persists in trying to adapt the world to himself. Therefore all progress depends on the unreasonable man." — George Bernard Shaw
Biotech leaders who want to revolutionize drug discovery and create new modalities: 🧬💊
This is the quote
@JMaraganore
closed his fireside chat with at Ginkgo Ferment last week.
Put this quote on your wall and live by it every single day.
I understand that it may be
@drkeithsiau
One immune-mediated inflammatory disease doesn’t exclude another one - in fact increases the chances of having another one. Could be dactylitis/arthritis and nail abnormalities in psoriasis.
Candel Therapeutics, Inc. (Nasdaq: CADL) will present a company overview at the Jefferies Global Healthcare Conference in New York City on Wednesday, June 5, 2024 at 5:30 p.m. ET. Hope to see you there!
It's entirely appropriate to conduct an open label phase 2A trial in therapy-resistant cancer, and much better than going straight from phase 1 to a randomized phase 3 clinical trial. Positive results of an open label clinical trial in this population are meaningful. Why?
The interesting thing is that the check-the-boxers are often more interested in the surrogate endpoints than the endpoint that really matters to patients and regulators: improved survival with a good quality of life.
I am supported by a world-class leadership team with decades of experience in drug development. Our Research Advisory Board, which is close to our programs, reads like the who-is-who in immuno-oncology.
It’s looking like Candel Therapeutics has created a best in class cancer treatment, now effective across multiple cancers. What a breakthrough!
Congratulations
@CandelTx
$CADL
Congratulations to President and CEO,
@paulpetertak
, MD, PhD, FMedSci, for being named 1 of 30 influential leaders in biopharma on the
@medicine_maker
Power List 2023! We’re proud to have your guidance and leadership!
We're proud to announce our CEO
@PaulPeterTak
is a recipient of this year’s
@PharmaVOICE
100! This annual award celebrates those in the life-sciences industry whose approach to addressing challenges inspires colleagues & peers. Learn more here:
Phase 2A clinical trials are designed to explore efficacy and learn about optimal regimen and protocol, which will inform phase 2B/3. Therefore, the per protocol population is appropriate and consistent with the statistical plan. It allowed us to show the long tail of survival.
We have previously presented encouraging DCR and ORR data in this therapy-resistant population, and now confirm ORR of 8% and DCR (disease control rate) in 70% of the NSCLC patients with progressive disease despite ICI treatment at enrollment.
The field of in situ vaccination against solid tumors is maturing. We expect updated overall survival data for CAN-2409 in pancreatic cancer in Q2 (fast track designation), top line overall survival data for CAN-2409 in NSCLC in Q2 (fast track designation)
Book your place for our BSI
#ImmuneTherapies24
! 🔗
This summit will bring together sector leaders from across
#ImmuneTherapies
research to discuss challenges & advances in the field 💡
We will also welcome Dr
@paulpetertak
for an inspiring keynote 🌟
It takes time before a new modality starts to transform the lives of patients and results in significant value creation. Oncolytic viral immunotherapy is at the tipping point and can be expected to create significant value based on recent data in mice and men.
@BRAINCURES
@Nature
@KevinJTraceyMD
It works:
Proc Natl Acad Sci U S A, 2016;113:8284-9
Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis
Koopman, FA et al.
We are proposing a radical new approach to immune-mediated inflammatory disease, moving the field from one that is based on clinical signs and symptoms to one that is based on immunological and molecular mechanisms.
👏 We're excited to share the publication of the final results of our CORE-001 Phase 2 trial of cretostimogene in combination w/pembrolizumab are available in
@NatureMedicine
. Co-authored by
@UrogerliMD
, this study advances treatment options for
#NMIBC
.
#Omicron
variant of
#SARS_CoV2
: if a virus mutates significantly, resulting in higher transmissibility, it may have become less lethal. This would be the best outcome for humans AND the virus. We’ll find out in the next few weeks.
#COVID19
CAN-3110 has received FDA Fast Track Designation for the treatment of recurrent high-grade glioma, a significant milestone in the development of this innovative viral immunotherapy. According to data published in Nature, CAN-3110 has shown a strong anti-tumoral response. $CADL
#FlashbackFriday
to last week’s summer celebration.
After months of hard work, we took the well-earned time to celebrate summer with
#Candoers
at our annual summer party.
It’s a great pleasure to announce that during the summer I have joined Candel Therapeutics as its CEO. We will work relentlessly to develop novel viral oncolytic immunotherapies for patients with cancer.
#Oncolyticvirus
#cancer
#candeltherapeutics
Excited to announce the launch of Centessa Pharmaceuticals!
A next generation pharma company founded by
@medicxi
to improve R&D productivity by delivering asset-centricity at scale. Led by CEO Saurabh Saha and CSO Moncef Slaoui
It is possible to improve these success rates: optimize therapeutic target selection; focus on the quality of the therapeutic molecule; use early, high-density-of-data experimental medicine clinical trials to inform go/no go decisions; use good judgement based on data.
J&J’s William Hait highlighting the burden on pharma to launch products : 40 phase 1 ➡️ 3 BLAs! Hence $2B+ per drug launched.
#AACR24
“Path to Entrepreneurship” session
Successful academics do not necessary leave academia because ‘there is a problem’ in academia, but because they may have a bigger impact and learn new skills elsewhere.
Chris is the fourth person I know and have worked with to leave academia in the last four months - all people with "permanent" faculty positions. Small pebbles presaging a serious problem in academia?
Thank you, Arthur Franken, Nathalie ter Wengel, Kathereh Ahmadi, George Schragel and Nerida Scott for a great panel discussion about deal making at
#BioEquity
in San Sebastian!
@CandelTx
Agreed. Candel Therapeutics presented data on its virtual R&D Day (Dec 6) showing disease control in 77% of patients with progressive NSCLC during ICI treatment after administration of CAN-2409 (in situ vaccination). There was a decrease in size of uninjected tumor in 67%. $CADL
Great to see ‘cancer vaccine’ and ‘good news’ used in the same sentence. Using vaccines as therapeutics against metastatic disease for so long in the past was the dark ages. Playing a role like adjuvant use and other earlier settings leverages a naturally stronger immune system.
Leadership without bossy, controlling behaviours is critical to foster a culture of innovation and creativity and to help people get the best out of themselves.
#leadership
Easy.
N Engl J Med, 2024 vol. 390(8) pp. 687-700.
‘CD19 CAR T-Cell Therapy in Autoimmune Disease - A Case Series with Follow-up.’
Major development in immune-mediated inflammatory diseases.
Interesting illustration of what you may find, developing successful immunotherapies for solid tumors: improved overall survival in the absence of Overall Response Rates (a surrogate marker that was not developed for the evaluation of immunotherapies)
We continue to make great progress with the development of CAN-3110 for recurrent high-grade glioma (glioblastoma).
#viral
#immunotherapy
#glioblastoma
$CADL
HSV-1 does work beyond the skin: Nature, 2023 vol. 623(7985) pp. 157-166.
Clinical trial links oncolytic immunoactivation to survival in glioblastoma.
$CADL
$KRYS is a company using HSV-1 to delivery gene therapies. I know this management well as I was in early for this company and owned it on and off for years. I love what they are doing in skin, but I have doubts if HSV-1 works beyond the skin. I have it on my list already.
Really happy that our hypothesis published in 2009 has been confirmed. Several companies, including
@SetPointMed
and
@GalvaniBioelec1
, are pursuing bioelectronic stimulation of the cholinergic anti-inflammatory pathway as a new treatment for rheumatoid arthritis.
In a 2009
@NatRevRheumatol
review,
@paulpetertak
's team proposed that it may be possible to stimulate the anti-inflammatory pathway using small molecules to activate the alpha-7 receptor or a bioelectronic approach using electrical stimulation of the vagus
3 weeks ago I posted about the possibility that hydroxychloroquine could perhaps work in covid-19. Since then: not learned anything meaningful from clinical trials/experience and political noise. We need proper randomized, controlled trials urgently!
#COVID19
#Hydroxychloroquine
There are many interesting new studies like: "In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" (via
#pubmedontap
)
"Chemists are dreamers. We think up new molecules and bring them to life."
Listen to chemistry laureate Carolyn Bertozzi's speech from this evening's
#NobelPrize
banquet, where she described how this year's chemistry achievements have made the previously impossible reality.