Cancer Immunotherapy – Less Invasive But Long Lasting

The idea that a human body should be able to remove a tumor in pretty much the same way it removes other invading microbes has been around for over a century. However, it is only recently that research has begun to elucidate ways in which a patient’s immune system can be harnessed to inhibit tumor growth. We take a look at what the technology is about and why there is so much hype surrounding it.

So, What Exactly Is Cancer Immunotherapy?
Cancer Immunotherapy deals with ways in which host immune systems can be used to fight late-stage cancers. This can be done by stimulating a person’s own immune system to attack cells or administering man-made, immune-system proteins to combat the disease. Immunotherapy has a long-lasting impact on individuals, largely because the technology involves training the immune system to defend itself against invading cancers. Once trained, the body automatically remembers what a cancer cell looks like and how best to tackle it.

Why The Hype?
American Cancer Society estimates that cancer affects about 12.6 million people around the world, which makes oncology a multi-billion dollar market. The most common type of cancer includes breast cancer, which impacts 75,000 US citizens per year, followed by advanced melanoma, which impacts 25,000 US residents annually. AstraZeneca (AZN) launched a drug that is a substitute for chemotherapy as far as breast cancer is concerned; however, no such alternatives for skin cancer existed until Bristol-Myers Squibb Co (BMY) harnessed the cancer immunotherapy technology into producing Yervoy. Yervoy’s revenues increased 36% in 2013 to $960 million and are expected to reach a total of $1.54 billion by 2018.

American Academy of Dermatology reported that prior to the launch of Yervoy, the five-year survival rate for people with early detected and treated melanoma came out to 98%; while the five-year survival rate for late-stage melanoma was only 16%.

Even though research on Cancer Immunotherapy is in its nascent stages, the technology has proven to be successful in increasing survival rate in the sample size. Yervoy has a survival rate of 25% when tested alone. The drug was then tested as part of a combination therapy treatment, for which results indicated that when Yervoy was combined with Bristol’s nivolumab, two-year survival rates climbed up to 88% for patients with late-stage cancer. The combination therapy treatment is still awaiting FDA approval.

How’s the Market Reaction?
Goldman Sach’s 2013 list of disruptive technologies included new therapies to fight cancer, with cancer immunotherapy topping the list. The same year saw the Science Magazine, which is a weekly issue published by the American Association for the Advancement of Science, label cancer immunotherapy as the “breakthrough treatment of the year.”

Pipeline
Galena BioPharma Inc (GALE) is one of the many small biotech companies researching on cancer immunotherapy. The company’s immunotherapeutic drug, NeuVax, which aims to target and treat breast cancer, yielded positive results in Phase 2 trials. Subsequently, the FDA granted the drug a Special Protocol Assessment (SPA) status for its Phase 3 trial.

Similarly, NewLink Genetics Corp (NLNK) is testing two products in its hyper-acute immunotherapy portfolio. The company is working on immunotherapeutic solutions for pancreatic cancer and lung cancer. NewLink’s Phase 2 report on pancreatic cancer after the use of algenpantucel-L demonstrated disease-free survival in 62% of patients after a year. The company is currently conducting Phase 2b trials on tergenpumatucel-L to demonstrate the effect of the drug on improving survival while enhancing response rates for subsequent therapies as far as lung cancer is concerned.

Oncothyreon Inc (USA) (ONTY) is another company that is trying to develop an immunotherapy portfolio. The company has two immunotherapeutic drugs in its pipeline. Its drug, ONT-10, is in its phase 1. This trial is aimed at reducing the size of solid tumors. The company’s second immunotherapeutic drug, Tecemotide, is in phase 3 trials for treating lung cancer.

Vaccinogen Inc. (VGEN), another small pharmaceutical involved in cancer immunotherapy research, is currently preparing for a pivotal Phase IIIb clinical trial of OncoVax. The therapeutic vaccine is anticipated to be a cure for colon cancer, melanoma, and renal cancer.

Merck & Co., Inc. (MRK) signed three collaboration agreements with Amgen, Inc. (AMGN), Incyte Corporation (INCY) and Pfizer Inc. (PFE) in February 2014 for conducting clinical trials by combining its MK-3475 (Pembrolizumab) with the anti-cancer compounds produced by these companies. Early stage data released by Merck regarding its PD-1 drug, Pembrolizumab, revealed tumor reduction in 35% of patients in the trial. These results earned Pembrolizumab the rare designation of “breakthrough therapy” from the FDA in April 2014. As of now, the drug is in its third phase of testing.

Is Immunotherapy a Permanent Solution?
Immunotherapy is seen as a very hopeful alternative but not a “no side-effect” solution to cancer. This treatment comes with its set of side effects, which in some cases have been severe. For example, The New York Times reported that 46 people suffered serious side effects while three people died when Bristol- Myers tested its two-drug-combination therapy for advanced melanoma patients.

Potential
The importance of the technology was underscored in April this year at the “Xconomy Forum,” when academic experts and industry players came together at the “Fred Hutchinson Cancer Research Center” to speak on the most recent developments in the technology.

The event’s keynote speaker, Dr. Stanley Riddell, who also co-founded Juno Therapeutics, said improvements in patient survival rates resulting from cancer immunotherapy treatment were similar to those seen when bone marrow transplantation altered our conception on how blood cancer was treated.

Perhaps what makes advancements in cancer immunotherapy research even more dramatic is the fact it has the potential to treat a wide variety of tumor types. Researchers have only begun to scratch the surface, and therefore, there is no telling what the future holds as far as cancer treatment is concerned.

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