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Special Focus: Recruiting the body in the war against cancer

DDNews checks in on the growing and promising activity around immuno-oncology
Written byJeffrey Bouley
| 16 min read

Special Focus on Cancer: Immuno-oncology

Recruiting the body in the war against cancer

DDNews checks in on the growing and promising activity around immuno-oncology

For a while, it was all the rage on Facebook to claim that the pharma industry was hiding the cure for cancer to keep people hooked on long-term therapies, as if there was some single silver bullet that could address the myriad types of cancers—and as if any company would pass on the opportunity for exclusively marketing a treatment that would redefine the very term “blockbuster drug.”

More recently, it seems my social media feeds more often feature posts and memes about how no one really needs pharma to treat cancer because with a few natural products and the right diet, our bodies will never see malignancies rear their ugly heads.

The notion that supplements and lifestyle choices alone will stave off disease, especially something as insidious as cancer, is a naive one, to be sure. But that doesn’t mean the basic idea isn’t a good one—that is, making the body do the work instead of trying to kill off tumor cells with a drug or some other kind of direct-acting therapeutic like radiation. After all, that is the core concept behind immuno-oncology—the idea that if we can get the body to recognize and mount a vigorous defense against cancerous cells, then we won’t need to rely as much on drugs to kill them.

And immuno-oncology has been taking off in recent years; it may be far from refined as a truly effective approach yet, but there is much promise.

Promising enough that GlobalData has visited this area of pharma and biotech several times in recent months with predictions and observations. For example, the research and consulting firm noted in May that cellular immunotherapies, which encompass dendritic cell therapy and chimeric antigen receptor T cell (CAR-T) therapy, will likely show promising results in combination treatments over the next few years, but maintained that they are unlikely to make a significant impact on the immuno-oncology market in the short term.

“Sales of cell therapies will be very low to 2024, especially when compared to checkpoint inhibitors. CAR-T cells, because of their high administration costs, are only primarily being developed in blood cancer populations, and GlobalData envisages that they will have overall low uptake and will be restricted to selected patients in large academic centers during the forecast period,” wrote GlobalData oncology and hematology analyst Dan Roberts. “However, the research being conducted into these kind of immunotherapies is indicative of an innovative and changing immuno-oncology arena that offers considerable opportunities in the long term.”

Roberts noted in a different report around the same time period that the total immuno-oncology market will be worth approximately $14 billion by 2019, rising to $34 billion by 2024, as the treatment of cancer patients undergoes drastic changes over the next decade. GlobalData feels that this will largely be driven by increased recognition of the potentially long and durable tumor responses of such therapies, which are similar to targeted therapies—in addition, such treatments have shown efficacy in a wide variety of indications and do not tend to be associated with the adverse side effects produced by something like chemotherapy, which tends to involves fatigue, neutropenia and/or alopecia.

Roberts noted that “Immuno-oncology products have demonstrated comparable respective efficacy and safety profiles, so their commercial success will largely rest on the speed with which they enter the market, their clinical and commercial positioning, target patient populations and the marketing power of the relevant pharmaceutical company.”

In other immuno-oncology prognostication, GlobalData noted in the spring that the termination of Celldex’s Phase 3 trial for its peptide-based vaccine therapy (Rintega) in newly-diagnosed glioblastoma patients was a blow to that treatment space that might very well see efforts increase to instead make drugs that combine peptide vaccines with immuno-oncology products.

Maxime Bourgognon, another oncology and hematology analyst at GlobalData, predicted recently that a combination immunotherapy from Merck KGaA and Pfizer—bringing together the checkpoint inhibitor avelumab and anti-angiogenesis tyrosine kinase inhibitor Inlyta—is likely to become an integral element of renal cell carcinoma treatment.

Leerink Partners analysts, for their part, took note of a new private company, Vor BioPharma, which is focused on CAR-T and was launched with technology licensed from Columbia University. Although Leerink sees the emergence of that company to be neutral to the market space right now, it did make note of the company’s desire to expand CAR-T use beyond B-cell cancers, which could be another sign of the broadening of immuno-oncology and some increasingly ambitious and creative thinking in the space.

And looking even more broadly at the market, Partners HealthCare announced its selections for the second annual “Disruptive Dozen,” in the spring, noting the 12 emerging technologies with the potential to revolutionize cancer care over the next decade. The first two technologies mentioned in the list were both immunotherapeutic in nature—cellular immunotherapy and immune modulators/vaccines.

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