Biliary Tract Cancer

Biliary Tract Cancer (BTC) consists of gall bladder cancer, cholangiocarcinoma (CCA)(both intraheptatic and extrahepatic) and cancer of the ampulla at Vater.

Globally, CCA is the second most common form of liver cancer. BTC is a heterogeneous and poorly understood diseases with very limited treatment options. Currently, there are no approved targeted therapies for the treatment of BTC. There is strong scientific rationale for HER inhibitors in BTC, demonstrating aberrant pathway activity with disease progression. [1],[2].

There is a reported higher prevalence of biliary tract cancer in Asia versus the rest of the world, with very high incidence rates reported in northeast Thailand (where CCA represents approximately 85% of total primitive liver cancers), as well as in China and Korea[3].

ASLAN is currently planning clinical trials in BTC, targeting HER pathways.

Breast Cancer

Breast cancer is the second most common cancer in the world and the most common cancer amongst women. In 2012, an estimated 1.67 million new breast cancer cases were diagnosed (25% of all cancers). In terms of mortality, breast cancer is the fifth most common cause of death from cancer (522,000 deaths)[1]. The prognosis for breast cancer is favourable when patients are diagnosed and treated early. However, there exists a large unmet medical need for metastatic breast cancer. Metastatic breast cancer refers to the stage of disease when cancer has spread beyond the breast to other organs in the body via the bloodstream or the lymphatics. A large proportion of patients with metastatic breast cancer may develop or present with resistance against existing approved HER2 therapies.

There is strong scientific rationale for the development of a small molecule inhibitor targeting multiple HER family members, and ASLAN is conducting on-going trials for ASLAN001 in metastatic breast cancer.

Gastric Cancer

Gastric Cancer (GC) is the fifth most common cancer worldwide, with 952,000 cases diagnosed in 2012[2], constituting 6.8% of total diagnoses. The current prognosis for gastric cancer is poor, with the five-year relative survival rates of patients with gastric cancer below 30% in most countries.[2] According to the World Cancer Research Foundation, the highest incidence of stomach cancer is in Asia, Latin America and Caribbean, with the rate of new cases of stomach cancer being more than four times higher in Asia compared with Africa[3].

Gastric cancer is a heterogeneous disease and the molecular pathogenesis is complex. However, current treatment of gastric cancer still insufficiently accounts for the molecular and clinical heterogeneity of the disease. Current clinical guidelines recommend use of trastuzumab combined with chemotherapy for HER2+ (amplified) patients with advanced gastric cancer. However, the majority of gastric cancer patients do not have HER2 amplified tumours and there remains a great need for novel therapies. In second-line treatment, only one agent, ramucirumab, has been approved for treatment of gastric cancer.

The scientific rationale for EGFR and other HER family inhibitors, as well as cMET inhibitors, is strong with protein over-expression demonstrated in more than 50% of gastric cancer tumours. ASLAN is currently conducting phase 2 trials for its pan-HER and cMET/RON inhibitors in the gastric cancer patient populations.