ADAP- Adaptimmune

Can't comment on the financial status of the company, but boy howdy immunotherapy of all stripes is lighting up a lot of tumors. When it comes to ADAP's approach, I'm healthily skeptical only because it's not yet strongly demonstrated that adaptive immune strategies are effective in solid tumors. CAR-T cells have been really, really good so far in leukemia, but solid tumors tend to be a different, more heterogeneous and complicated beast.

Definitely not saying it won't work! But at the same time it's not quite on my radar as a viable strategy just yet. By that, I mean doctors will not be taught about these just yet, especially with so much success for the immune checkpoint inhibitors, which require less technical input and can provide an off-the-shelf effective treatment for these tumors that ADAP is looking to attack.

I'm certain there are other companies pursuing this, but I'm not aware of them. There are other adaptive immuno approaches being explored in glioblastoma, pancreatic, and other tumors, though...like DCVax and rindopepimut, which have shown some promise!

The issue they need to overcome with a highly specific CAR-T-like approach is, in my mind, identifying a good-enough target. Tumors emerge from natural cells, so they generally have the same signaling in place, just amped up or suppressed. Therefore, you have a risk of collateral damage with adaptive cell therapy if you pick the wrong target. 

Take the example of, say, HER2 in breast cancer. In 20% or so of the tumors, HER2 is amplified and overexpressed on the cells. So it would seem like a logical target. But when you block it with Herceptin, you kill tumor cells and cause heart toxicity and lung toxicity. But if they get too problematic, you withdraw drug and wait until it gets better. With adaptive therapy, though, you're training the body to target HER2. And, in effect, you may be training the body to kill ITSELF. With the flagship case of acute lymphoblastic leukemia, you can target molecules like CD19 because these are only expressed in cells that have a B cell origin. The body will wipe out the tumor and its B cells, but you can survive this. In fact, B cell death is one of the ways they measure the "dose" of CAR-T cells still in the body.

With solid tumors, however, you're often not talking about unique cell origins. They're often epithelial or something, meaning they have a common origin with some vital organ. You can survive the body wiping out its B cells. You can't survive your body assaulting your heart . 

Definitely not saying I'm pessimistic, but these challenges make it easy for me to see why solid tumor adaptive therapy lags behind heme cancers. And if it DOESN'T pan out, reasons like the ones I cited might help to explain why.

Not pumping, but something is going on. Volume up and pps is up 7%, and 15% over last few days.

Keeping to their guidance, this IND was supposed to be due Q3'16, but was then moved earlier to this Q2. Seeing a bullish pps over that last few days and a little spike today.
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