Cana can’t – can Cantargia?

 Novartis’s canakinumab always looked like a long shot in cancer, and today the company confirmed the worst: the Canopy-2 trial, in second or third-line metastatic non-small cell lung cancer, has failed. The anti-IL-1 beta antibody is still in a couple more pivotal NSCLC studies, but these must now be regarded as pretty slim hopes. The Swiss group's stock sank 1% today, but a bigger loser was Cantargia, the developer of the next most advanced similar project: Can04 or nidanilimab, which inhibits the IL-1 receptor accessory protein, is in a phase II study in several solid tumours and could yield data next year. Can04, like canakinumab, is also being tested in combination with Keytruda. Its 2026 sales forecasts sit at $564m, according to EvaluatePharma’s sellside consensus. Cantargia’s investors have been spooked by the cana readout; the company’s shares are down 23% so far today. Meanwhile, Novartis has another shot at IL-1 with VPM087, or gevokizumab, which is in a phase I basket trial. An allosteric inhibitor of IL-1 beta, gevokizumab has a slightly different mechanism than the competitive inhibitor cana, but success for the follow-on project now also looks dicey.

Anti-IL-1 projects in development for cancer
Project	Company	Description	Indication(s)	Trial details & readouts
Phase III
Canakinumab	Novartis	Anti-IL-1 beta MAb (competitive inhibitor)	NSCLC	Canopy-2, 2L (NCT03626545), failed; Canopy-1, 1L, Keytruda combo (NCT03631199), data due H2 2021; Canopy-A, adjuvant (NCT03447769), data due 2022
Phase II
Can04 (nidanilimab)	Cantargia	Anti-IL1RAP MAb	Solid tumours incl pancreatic cancer & NSCLC	Ph2 Canfour (NCT03267316), completed Dec 2020; Ph1 Keytruda combo (NCT04452214), completes Jan 2022
Phase I
VPM087 (gevokizumab)	Novartis	Anti-IL-1 beta MAb (allosteric inhibitor)	Colorectal, renal & gastro-oesophageal cancers	1L (NCT03798626)
Source: EvaluatePharma & clinicaltrials.gov. https://www.evaluate.com/vantage/articles/news/snippets/cana-cant-can-cantargia