ASLAN PHARMACEUTICALS AND NATIONAL CANCER CENTRE SINGAPORE COLLABORATE

Mike…we are caught in the whirlwind of cancer science.
Physicians often are asked about the effectiveness of targeted therapies and request molecular testing to assess their tumors.
I like to refer to a physician’s statement: “The truth is that scientists and clinicians don’t know what to do with many of these marker. Physicians have no idea how impactful they are when applying a therapy. Sometimes, there are opportunities to use a molecular tumor board to have a forum discussion about markers and treatments. But everyone is still learning. There is no instruction booklet that tells us, ‘If A, use B.’ The levels of evidence vary, and there can be a lot of bias in the decision-making.”
The NCI MATCH trial and the ASCO TAPUR study are designed especially for the purpose of finding answers to these questions. But, it will take a few years before we have conclusive answers. Take a look:
http://am.asco.org/asco-nci-announce-plans-precision-medicine-trials

Hugs,
Marion

ASLAN was kind enough to respond and informed us that ASLAN001 is a targeted inhibitor of all of the active HER-family kinases. The frequency of HER receptor expression in cholangiocarcinoma is variably reported in the literature, with most studies suggesting that 30-40% of tumours express one or more HER receptors. It is not clear at this stage what the relationship is between expression levels of the receptor and the efficacy of the compound.
Our intention in this study is to treat a group of patients with recurrent cholangiocarcinoma regardless of the apparent level of expression, and to retrospectively correlate expression with efficacy.

I would like to add that we will see more of these type of investigational studies relying on publications and/or specific literature only as clinical data has yet to be accumulated. This falls in line with the ASCO TAPUR study as well as the NCI Match trial.

Hope this answered your question, Mike.
Hugs,
Marion

Mike….I reached out to ASLAN. Let’s hope we will receive a response.

Thanks so much Marion.

I’ve been speaking with the clinical trial docs in Singapore, and they have been very helpful – but they cannot answer this question.

I do not have any contacts at ASLAN, so very interested if you can ask someone at ASLAN.

And yes – amazing speed these therapies are being developed. My hope/guess is that they are targeting markers, but learning along the way of potential non-targeted efficacy. The ASLAN one is very interesting in this regard since they had early breakthrough with CCA, but a lot of these markers are not prevalent in CCA I don’t believe.

Thanks so much

Mike B

Thanks to both of you

One clarification. The CCA-focused trial is phase 2 I believe: https://clinicaltrials.gov/ct2/show/NCT02609958?term=ASLAN001&rank=4 This is in Asia, and a mono study.

I still don’t understand the following – and not sure if relevant, or who could answer:

Although it’s a HER+ targeted therapy, they have opened some of the studies are open to non-HER (non-molecularly selected).

is this a normal step to open-up beyond target? Or would they only do this if they have some hope of non-target efficacy?

Thanks! Mike B