The Future is Bright for Immunotherapies

The field of immuno-oncology (IO) has come a long way since the mid-19^thcentury, when William B. Coley “used a bacterial broth to shrink malignant tumors in patients with inoperable bone cancer” (McCarthy, 2006). And, science still has a long way to go when it comes to fully understanding the way our immune system fights cancer. Investment capital is being poured into biotech startups focusing on IO, and big pharma are increasingly partnering with or acquiring biopharma companies working in this space.

IO is a specialty with it origins in immunotherapy, the treatment of disease through altering the function of the immune system. The immune system is normally effective at fighting off disease via immunosurveillance, the ability of immune cells to recognise and attack pathogens and other abnormal cells in the body. Cancer cells are especially good at evading the body’s immunosurveillance, however, and IO uses treatment that aims to amplify the immune response, thus effectively detecting and fighting cancer.

There are a few well-established IO treatments that exist today. Chimeric antigen-receptor T cell therapy (CAR-T) works by removing and re-engineering the patient’s malfunctioning immune cells (T-cells) to give them the ability to detect the cancer, then re-infuses the new cells into the patient’s bloodstream (Ellis, 2017). The result can be long-term remission in certain cancers.

CAR-T is FDA approved for treatment of B-cell lymphomas. There is much development in the pipeline with CAR-T, and biopharma startups globally are investigating how to apply this technology to solid tumors, re-engineering cells other than T-cells, and using donor cells rather than the patient’s own.

Checkpoint inhibitors are another IO treatment that uses genetically engineered antibodies to detect cancerous cells. Drawbacks of checkpoint inhibitors are their cost and greater severity of side effects than CAR-T, but they work across a broader spectrum of malignancies and are becoming the standard of treatment for breast, colon, lung, and several other types of cancers, often in conjunction with other treatments.

Clinical trials using checkpoint inhibitors alone or in combination with other therapies such as chemo or radiotherapy have tripled in the last 3 years (Cancer Research Institute, n.d.), and both CAR-T and checkpoint inhibitor therapies are expected to lead the way in future, especially in combination treatment.

Emerging trends in IO are increasingly looking toward cancer vaccines, bio-engineered cytokines (proteins that play an important role in the strength of an immune system response), biomarkers (which reveal genetic traits of different kinds of tumours), and assessment of the tumour microenvironment, which may provide clues as to how tumours thrive and thus how their environment could be altered in some way to kill or suppress the tumour.

The “one size fits all” approach to cancer is long gone. Because the biotech world is increasingly incorporating gene and cell therapies into cancer treatment, the outlook for the global IO market is anticipated to cross $100B threshold by 2022. And in North America, the U.S. market is estimated to account for the largest share (BusinessWire, 2020).

Merck and Bristol Myers Squibb, both headquartered in New York, have been investing heavily in clinical trials to expand the use of checkpoint inhibitors, CAR-T, and trials involving medicines that could help make these drugs more effective. AstraZeneca, GlaxoSmithKline, Johnson & Johnson, and Novartis are big players in Europe, each having invested billions in immunotherapy.

What this means for executive search teams is that we should continue to see an increase in funding, an expansion of diverse and collaborative teams in the IO sphere, and an increase in partnerships and M&A between big pharma and smaller biotechs. The best biotech recruiters will be keeping a finger on the pulse of emerging advancements in IO and immunotherapy treatment.

“We are now beginning to understand the benefits, and perhaps more importantly the drawbacks of these cell and gene therapies to treat cancer,” says Alex Ellis, Divisional Director at G&E Partners Talent Management Agency. He continues, “Staying on top of ways that biopharma startups are looking to resolve these drawbacks, and enhance the benefits of these therapies is paramount.”

He concludes, “Collaboration between companies, making these drugs more affordable, more tolerable, and more effective is the way forward. It’s going to take skilled teams of executive biotech leaders with diverse backgrounds and patient-centered approaches to come out on top.”

If you’re interested in learning more about G&E Partners’ Talent Management approach to executive search, please contact Alex.Ellis@ge-partners.co.uk

References

BusinessWire. (6 February 2020). The global immuno-oncology market is anticipated to cross US $100 Billion by 2022 – ResearchandMarkets.com. https://www.businesswire.com/news/home/20200206005504/en/The-Global-Immuno-oncology-Market-is-Anticipated-to-Cross-US-100-Billion-by-2022—ResearchAndMarkets.com

Cancer Research Institute. (n.d.). PD-1 / PD-L1 landscape. https://www.cancerresearch.org/scientists/immuno-oncology-landscape/pd-1-pd-l1-landscape

Ellis, M. (20 September 2017). What is immune-oncology? Uncovering the future of cancer therapy. Proclinical. https://www.proclinical.com/blogs/2017-9/uncovering-the-future-of-immuno-oncology-cancer-therapies

McCarthy, E.F. (2006). The toxins of William B. Coley and the treatment of bone and soft-tissue sarcomas. Iowa Orthopedics Journal, 26, 154.

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