With the initial promise of immunotherapy use in oncology, we need to continue supporting cross-industry collaborations among leaders from the biopharma community, academia, regulators, and private sector investors.
February 4 is World Cancer Day, a global annual event to raise awareness and education about challenges we face and accomplishments we have achieved in the fight against cancer. This year in particular, there is much to celebrate. Thanks to the commitment by leading cancer researchers, along with innovative partnerships between pharma, academia, and the government to share knowledge and work collaboratively, we have made significant strides in developing new technologies and treatments for this disease. And many of the most innovative accomplishments involve immunotherapy.
Immunotherapy, which harnesses the power of the immune system to attack cancerous cells, has played an integral role in oncology research for more than a century, but in the last few years we’ve seen many extraordinary discoveries that are transforming our approach to cancer care and dramatically improving the number of patients receiving treatment and duration of their survival.
Why Immunotherapy Works
The immune system is an ideal anti-cancer agent because it controls an array of diverse immune cells that have a high degree of specificity and the ability to distinguish minute chemical alterations. It also has a long memory, which means once a body develops immunity to a specific cancer, that immunity can last for up to several decades after effective antigen priming. Immunotherapy can also be delivered in various therapeutic formats.
One of the most exciting formats is checkpoint inhibitors, which work by releasing the natural brakes on the immune system so it can attack cancer tumors on its own. This is a game changing development that promises to have a huge impact on patient outcomes, because checkpoint inhibitors cause the immune system to target the tumor in real time, rather than waiting for lab tests to hunt down vulnerabilities in the tumor, which can change over time and delay treatment.
From a research perspective, immune checkpoint inhibitors are leading the way in clinical discovery and enthusiasm, given the exciting data yielded to date. As further research continues to elucidate the biology behind the anti-tumor immune response that is released by these checkpoint inhibitors, they are beginning to clarify why certain patients and indications may be more amenable to this class of agents, all of which helps us hone our ability to deliver precision medicine and improve outcomes for cancer patient worldwide. And while checkpoint inhibitors alone are good, there is much more work needed. Combining them with other immune therapies or more traditional methods such as surgery, radiation therapy, chemotherapy, and new therapies targeted at a specific mechanism is likely to be beneficial.
Opportunities to Accelerate Development
Such dramatic innovations are likely to continue in the oncology, thanks in part to new collaborations developed to support work in this space. For example, The National Immunotherapy Coalition (NIC) was recently established to bring expert and industry leaders together to drive the next generation of immunotherapy in cancer research. This unprecedented collaboration of multinational pharmaceutical, biotechnology companies, academic centers and community oncologists will make possible access to over 60 novel and approved agents under exploration, and will enable rapid testing of novel immunotherapy combination protocols. It will also form the basis of The Cancer MoonShot 2020. The NIC expects to design, initiate and complete randomized clinical trials in cancer patients with cancer at all stages of disease in up to 20 tumor types in as many as 20,000 patients by the year 2020.
Similarly, three research centers in the UK are collaborating to advance academic discoveries into commercially viable immuno-oncology cellular therapy. The venture, which includes Cancer Research Technology, Cancer Research UK’s commercialization arm; Cell Therapy Catapult, an organization working to move cell and gene therapy from academia to industry; and the University of Birmingham, is grounded on a new-generation chimeric antigen receptor T cell (CAR-T), directed toward a new and highly specific marker of CLEC14a tumor angiogenesis. The therapy acts as a vasculature disruptive agent that compromises the tumors’ oxygen supply, inhibiting growth. The approach is expected to enter into clinical trials as soon as preclinical development is finished.
Regulatory agencies, including the FDA and European Medicines Agency (EMA), are also showing significant interest in the potential of immunotherapy, further validating the impact of this treatment path.
Such advances are generating incredible excitement in the field of oncology, and giving hope to millions of cancer patients who no longer need to think of their diagnosis as a death sentence. But this is just the first wave for immunotherapy development and we have so much more to discover. While the initial promise of immunotherapy rests largely in its aptitude for broad application in various patient populations, the algorithm for effective use in oncology is excruciatingly nuanced, and reduces the reality of broader success at this time. The real hope now is to understand why immunotherapy can work, and when it cannot.
To do that we need to continue supporting cross-industry collaborations among leaders from the biopharma community, academia, regulators, and private sector investors, who have the resources and passion to drive these discoveries forward; then creating environments in which they can share ideas and brainstorm solutions. Such collaborations are the best hope for driving this research forward, and accelerating delivery of much-needed, new cancer therapies to patients.
Terry Murdock is Vice President, Head, Oncology Center of Excellence, at Quintiles.