- Emerging Pharma Leaders
- The Rising Tide of Next Generation Cancer Treatments
- Recent Advances in Cancer Research and Therapy | ScienceDirect
- Recent Advances in Cancer Research and Therapy
Emerging Pharma Leaders
Even though we are now several years out from the initial launch of these agents, and expectations have been slightly tempered by real world experience, immunotherapy continues to generate considerable excitement. This is certainly supported by data from the Ipsos Global Oncology Monitor, which show continued growth of the anti-PD L -1 market since these drugs were first approved for use see Figure 1. Since initial approval, both Opdivo and Keytruda have been approved for use in multiple cancers in both the US and EU.
Likewise, approvals within certain cancer types continue to increase as data becomes available for use by biomarker status, for earlier treatment lines, and in combination with other agents.
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The impact of newer anti-PD-L1s is still largely unknown; in fact, in the US, where both drug classes are available for use, anti-PD-L1s are more often seen as distinct from anti-PD-1s. Interestingly, as seen in Figure 2, oncologists who perceive a distinction between the two drug classes and express a preference are more likely to prefer the newer anti-PD-L1s.
The Rising Tide of Next Generation Cancer Treatments
While anti-PD L -1s are the stars of today, there are yet more advancements on the horizon, with the most immediate being the continuing evolution of anti-PD L -1s and the looming availability of CAR-T technology — which has the potential to redefine the current treatment landscape. Clearly, the next step in the evolution of anti-PD L -1 agents is combination use.
According to Evaluate Ltd, there has been a huge rise in the number of anti-PD L -1 combination studies. To put some numbers to this, combination studies using Keytruda went from 70 in to in For Opdivo, the figures were 73 and , respectively. Meanwhile, CAR-T therapies are likewise generating considerable interest, despite the onerous manufacturing process, logistical limitations in securing facilities capable of administering, and unknown reimbursement challenges.
Recent Advances in Cancer Research and Therapy | ScienceDirect
And what drives this excitement? Regardless of the anticipated new cancer therapy, the reason is clear: It remains to be seen if these new options will live up to the hype, but trial data so far has been encouraging. Following the mention of efficacy, physicians are also intrigued by the novel MOAs of these future options.
Of course, how treatment is determined is also evolving, with new markers and metrics emerging. Now that immunotherapy has been embraced as a standard option, the next step — 2. We are already seeing evidence of this occurring.
This allows physicians another means of tailoring treatment to appropriate patients, especially those with hard to treat triple negative breast cancer see Figure 4. Some of these tumor-specific, activated T cells then leave the original tumor to find and destroy other identical tumors throughout the body. The approach worked startlingly well in laboratory mice with transplanted mouse lymphoma tumors in two sites on their bodies.
Recent Advances in Cancer Research and Therapy
Injecting one tumor site with the two agents caused the regression not just of the treated tumor, but also of the second, untreated tumor. In this way, 87 of 90 mice were cured of the cancer. Although the cancer recurred in three of the mice, the tumors again regressed after a second treatment. The researchers saw similar results in mice bearing breast, colon and melanoma tumors. Mice genetically engineered to spontaneously develop breast cancers in all 10 of their mammary pads also responded to the treatment. Finally, Sagiv-Barfi explored the specificity of the T cells by transplanting two types of tumors into the mice.
She transplanted the same lymphoma cancer cells in two locations, and she transplanted a colon cancer cell line in a third location.
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Treatment of one of the lymphoma sites caused the regression of both lymphoma tumors but did not affect the growth of the colon cancer cells. The current clinical trial is expected to recruit about 15 human patients with low-grade lymphoma.
If successful, Levy believes the treatment could be useful for many tumor types. He envisions a future in which clinicians inject the two agents into solid tumors in humans prior to surgical removal of the cancer as a way to prevent recurrence due to unidentified metastases or lingering cancer cells, or even to head off the development of future tumors that arise due to genetic mutations.
Stanford Medicine News Center.
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