All of us. Thanks to James Allison and Tasuku Honjo, winners of the 2018 Nobel Prize in Medicine, we now have a much better understanding of cancer, and how to treat it. Allison and Honjo characterized two very important and potent pathways – called “immune checkpoints” – that can shut down the immune response (CTLA-4 and PD-1). Anyone heard of “monoclonal antibodies?” Of course you have, and well, that’s thanks to these two smart people. For a really good article on their discovery and what it has led to go here. Dr. Allison is currently working at MD Anderson and you can see a short video of him here. MD Anderson has a very nice 3-minute video on “What is immunotherapy” that is worth a watch. Everyone together now, say “thanks guys”
From the “this is really cool” department comes a research study where scientists discovered immune cells called Natural Killer cells. These cells accumulate in tumors and release chemicals that attract specialized dendritic cells (cDC1)—white blood cells known for triggering anti-cancer immune responses—to the tumor. Researchers are hoping these molecular ‘magnets’ can improve cancer immunotherapy. Know what they’re not hoping for? To run into these two at a local diner. According to the authors, “Genes associated with Natural Killer cells and cDC1 correlated with cancer patient survival in a dataset of over 2,500 patients with skin, breast, neck and lung cancers. A similar correlation was seen in an independent group of breast cancer patients, with a particularly positive outcome for women with triple negative breast cancer, which typically has a poor prognosis.” BTW, AstraZeneca has a pretty good site for learning more about immunotherapy.
There’s always healthy skepticism whenever something is called a ‘cure for cancer.’ Most healthcare professionals (hopefully, a percentage in the high nineties) are aware that cancer is a catch-all for a host of diseases that involve abnormal cell growth. But a cure for cancer seems a bit more realistic when immunotherapy is in the picture. Stanford researchers recently published study results detailing an unexpectedly highly effective method of body-wide tumor reduction in mice. The mice’s tumors were injected with two immune-stimulating agents, which led to the elimination of all metastases in the rodents, including in untreated areas. Senior author Ronald Levy’s work has previously led to the development of rituximab, one of the first biologics, so you know the research is legit.
Check out more of the really cool stuff happening in the oncology space in InsightCity’s HealthyDose of Oncology Trials.
How about some exciting, multi-billion dollar deals to spice up the first quarter? First, Sanofi acquired Bioverativ, a hemophilia-focused biopharmaceutical company that spun out of Biogen last February. Since losing patent protection, Sanofi has seen flagging revenue from their flagship Lantus products—which occupy the #4 and #15 spots on IQVIA’s list of Top Medicines by Invoice Spending—and they’re hoping Bioverativ can give their treatment portfolio a boost. Similarly, Celgene boosted their pipeline prospects by acquiring Juno Therapeutics, who have a promising CAR-T candidate expected to be FDA-approved in 2019. Celgene also recently bought Impact Biomedicines, all part of a strategy to preemptively address profit losses when their blood cancer drug Revlimid goes off-patent in a few years.
And soon it starts to add up. This week the NIH announced a pretty cool partnership with the private pharma industry. The Partnership for Accelerating Cancer Therapies (PACT) is a five-year public-private research collaboration totaling $215 million as part of the Cancer Moonshot project. 11 pharma companies (AbbVie, Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Genentech, Gilead Sciences, GlaxoSmithKline, Johnson & Johnson, Novartis, Pfizer) will contribute $1M each for five years. The NIH will contribute $160 million. The goal: “to identify, develop and validate robust biomarkers — standardized biological markers of disease and treatment response — to advance new immunotherapy treatments.” Sweet. If you want to read what pharma PR folks have been up to you can read their responses here. For the top 10 private-public immuno-oncology collaborations, look here.
Last week, the FDA approved Novartis’ Kymriah—a “living drug” that works by making immune cells realize they should get rid of those pesky leukemia cells making a mess of things. We’ve been following this story since June, because it’s really cool for a couple reasons. First, it marks the first time a gene therapy has been approved for use in the US, although more CAR-T treatments are in the pipeline. Second, the treatment is designated for the most prevalent form of childhood cancer in the US—acute lymphoblastic leukemia (ALL). There is a bit of worry that the treatment is prohibitively expensive, which is what sunk the first gene therapy approved in the EU, but maybe competition will help drop prices.
Yay, we get to write another article about fewer needles in the lives of diabetics! Researchers in London are working on an immunotherapy approach to slow down the progression of Type I Diabetes, which would ideally result in a future where those diabetics won’t have to inject insulin daily. The disease works by attacking insulin-producing cells, so the scientists decided to try to get the lazy part of the immune system that wasn’t stopping that—regulatory T cells—to stop playing video games and get a job! (Sorry. Too close to home?) The scientists proved the safety of this approach in a recent Phase I study, so it will be a while before anything is marketed to the general public, but we just think this immunotherapy stuff is the bee’s knees.
An FDA advisory board voted unanimously for the approval of a CAR-T cancer therapy for acute lymphoblastic leukemia, or ALL. This could be the first gene therapy—where one’s own genes are altered to create “killer T-cells” to attack cancerous cells—approved in the US. CAR-T cell therapy is a one-time treatment and shows promise in its ability to knock out ALL where other cancer drugs have failed. Novartis, the drug developer, reported 83% of the patients achieved complete remission within three months and a high probability of being relapse-free at 12 months. The new treatment isn’t without safety concerns, but traditional treatments are more toxic than CAR-T, must be taken long term and eventually stop working. Take THAT, childhood cancer!