In this interview, Hans Bishop, CEO of Juno Therapeutics, discusses the company’s strategic partnership with Celgene, emphasizing Juno’s goal of remaining an independent, science‑driven biotech. He outlines an event‑rich 2018, highlighting the pivotal trial of their lead CAR‑T product Lysocell (liso‑cel), plans to file for approval later in the year, and expansion of the therapy into earlier lines of lymphoma, chronic lymphocytic leukemia (CLL), and a new BCMA‑directed CAR‑T for multiple myeloma. Bishop addresses the competitive landscape, noting existing CAR‑T approvals from Gilead and Novartis, and argues that Lysocell’s high complete response rates and favorable safety profile could differentiate it. He evaluates the emerging off‑the‑shelf CAR‑T approach, expressing skepticism about its efficacy and safety due to immunosuppression requirements. The conversation also touches on commercial rollout challenges, such as limited early adoption and the need for robust data to drive physician adoption. Finally, Bishop shares Juno’s broader R&D ambitions, including applying CAR‑T and TCR technologies to solid tumors (lung, breast, ovarian cancers) with first data expected within the year, while acknowledging the additional scientific hurdles these indications present.
Chapters
There is a deal in the drug world this morning, and it's not for your company. Celgene, a company with which you have a partnership, is buying Impact and not Juno. How come?
Oh, you have to ask them that. But we're focused on building an independent company. It's our most— in our partnership with Celgene is our most important strategic partnership. The, the whole idea behind it was to work with what I think is the world's leading hematology company. We're good at the science of developing cell therapy and figuring out the manufacturing technologies about how to scale these things. And they've got global reach. So together we think our skills are very synergistic.
Have you ever had a conversation with them that contemplated the purchase of Juno?
We're focused on building an independent company.
Hans, 2017 was a very promising year for your company. What are you looking forward to in 2018? What should we look forward to?
Well, it's an event-rich year for us. Our lead product, Lysocell, is in a pivotal clinical pivotal trial. We expect to file for our, for our first approval for Lysocell in patients battling a lethal form of lymphoma. Second half of this year, if everything goes to plan, we could be approved by the end of the year. We're also taking that drug and putting it into earlier lines of lymphoma and some, and some new diseases, including CLL, where there are many patients that still need better treatments. We're going to be going into the clinic with our first CAR T-cell for patients with multiple myeloma. It's a CAR that directs an is directed to an antigen called BCMA. And this is the year where we'll also be reporting our first data from trials in solid tumors.
All of the focus is on immunotherapy and this JCAR17 therapy that you've developed. What stands in the way of its approval and getting to market?
Well, there are already two CAR-T cells, which is our particular form of immunotherapy approved, one in pediatric leukemia. Thank goodness those patients definitely need better therapies and another in lymphoma. We're encouraged about our place in that market because of the clinical profile we're seeing with Liso-cel. So in these patients that are so sick, you know, months, just a few months left to live, we're showing very high complete response rates. And importantly, the drug is well tolerated.
And the reason, perhaps, than those of your competitors?
Well, we have to, we have to wait and see, but we think so. The, the— when you look at the common toxicities of CAR-T cells, they're infrequent with this drug. And the reason that's important is most of the Patients with this disease don't get treated in the big academic medical centers. And with this tolerability profile, we think we can go to where the patients are.
It is, however, surprisingly getting to be a crowded space, as they call it. Gilead and Novartis have CAR-T therapies in the market. They are approved and they're seeking approval for further applications. The longer they're in and you're not, the more entrenched they become. What can you do about that?
Well, I would tell you the competition is cancer, which unfortunately all too often beats all of us. So competition between companies is a good thing because it will focus all of us on making better therapies. And if we're right that Lysocell has got these very encouraging levels of efficacy without the side effect penalty, that will be a drug that doctors and patients will want to use.
So you think the doctors will willingly, even if they've been prescribing it for some time, drop the Novartis drug or drop the Gilead drug in favor of yours?
I think there's clearly room for more than one drug, by the way. I mean, if you just look at the relapse refractory setting in lymphoma and myeloma, just, just those most sick patients in Europe and the US, that's more than 120,000 patients battling that disease. You go to first line, the numbers get much bigger. So actually, to help those patients, we all need to do well. And I do feel very confident that the profile we've got means we're going to be highly competitive against those existing incumbents.
Patients and doctors would agree with you. There is room for many different therapies. One of the potential therapies that from the way I see it potentially poses a risk to you is this idea of the off-the-shelf CAR-T therapy. What happens if those actually begin to work and potentially begin to work better than yours?
Well, we think they're much more difficult to use, and it's not clear. It's early, I grant you, but it's not clear that they've got competitive levels of efficacy with the CAR-T cells made from patients' own cells. And one of the big challenges about them is to avoid my cells being rejected by you. The patient's got to be given really heavy immunosuppression, and that comes with lots of risk. So we feel the data we've got, both the efficacy and safety data, really points to an advantage. And ultimately, doctors don't choose drugs for convenience. They choose drugs that are going to help their patients.
Is what you describe one of the principal reasons why commercial use of CAR-T therapies has been so limited thus far?
I think it's early, Eric, honestly. I mean, people obviously are watching exactly how many patients have been treated, but It's literally just been several weeks since these first ones were approved, particularly in lymphoma. So I think it's too early to conclude that the first part of the launch of our colleagues, you know, is fast or slow. I think we need to wait and see.
You talked about some of the other things you're doing beyond Lysocell. What are some of the most exciting innovations in your R&D pipeline? Well, things to look forward to beyond 2018.
But then we move to looking at how to make CAR-T cells and TCRs work in solid tumors. I think most reasonable people would agree that these treatments are going to completely change the way we treat blood cancers. We've already got the clinical data in our hands and the approvals, I think, I think to show that. But what we haven't shown yet is how we can use these medicines to treat lung cancer or breast cancer or ovarian cancer. And that works earlier. And indeed, it's going to be more difficult. There are some different challenges that solid tumors present, but we are optimistic. We think that this technology can have a big impact there.
How many years away do you think we are from seeing the first results of, of those efforts?
We're going to— well, we're going to be publishing first data from those efforts this year. But as I say, more challenges. People shouldn't expect that the first results are going to be anything like the first results in blood cancer, because these solid tumors have got barriers of defense that we still need to systematically figure out how we knock down.
So that's something to look forward to. What about the next batch of data from JCAR-17?
Well, we're going to see more data from JCAR-17 in earlier lines of disease. We're also going to take this drug to where the patients are. So we're going to have data this year where the drug is given outside of the academic medical center. That's important for expanding the reach to a bigger group of patients. We're also going to be treating for the first time with liso-cel patients with CLL, and we'll have data on that this year. So it's a big year for liso-cel.
