2014 is the year of Immuno-Oncology

One of the hot topic of conversation amongst the VCs at the JP Morgan Healthcare conference in San Francisco this past week was the field of immuno-oncology.

As AstraZeneca CEO Pascal Soriot noted in his JPM meeting presentation, ASCO 2013 was a major tipping point in immunotherapy and the future of cancer treatment.

We have already seen significant excitement in anti-PD1/PD-L1 drugs and their early promise in melanoma, renal and lung cancers.  As Soriot noted though, the future of immunotherapy is most likely in combination with other drugs.

Pharma companies with a broad pipeline of drugs suitable for evaluating combinations will be well positioned to take advantage of this paradigm shift in the treatment of cancer.

Taking a more strategic view, however, the question is how will immuno-oncology change the treatment landscape on a broader scale?  It is possible that many drugs that are currently in front-line use may be relegated to second or third line use if immuno-oncology combinations become the preferred initial treatment option.

One big question many are asking is how durable are the responses with the new immunotherapies, whether they be checkpoint inhibitors, immune stimulants or even chimeric antigen receptor (CAR) T cell therapies?

We have seen the development of resistance in oral TKIs that showed dramatic initial responses e.g. vemurafenib in melanoma, so will patients see a wearing off effect from immunotherapies, and if so, how will the resistance manifest itself? What new strategies will be important to consider going forward?

By using drug combinations, the hope is that you can achieve greater therapeutic index and close off the escape route of resistance, leading to a longer more durable response.   Companies in this space, including Roche, BMS, Merck and AstraZeneca are beginning to explore the opportunities for novel combinations, as this latest example from Merck shows:

Screenshot from clinicaltrials.gov of MK-3475 combination trialThere’s a lot we currently don’t know, but it looks as though this field is set to get much more exciting as companies explore new frontiers rather than sit still.

We’ll soon be publishing a short report on how the strategic landscape for oncology new product development is already changing as a result of the latest developments in immuno-oncology.

We expect to hear more on where the field is going at the forthcoming annual meeting of the American Association for Cancer Research (AACR) in San Diego.

In the meantime you can read more about the latest developments in immuno-oncology on Biotech Strategy Blog. Exciting times!

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