The oncology field has exploded in the past 20 years and pharma companies now have a wide range of approaches available to them as they look to identify, treat, and in some cases even cure, cancer patients. Here, five industry experts weigh in on the exciting new tools and technology coming through, and why greater understanding of cancer biology and combination approaches will be crucial moving forward.
Speaking as part of a recent FT Live panel entitled ‘Reshaping pharma pipelines for a new era’, Susan Galbraith, executive vice president, oncology research and development at Anglo-Swedish giant AstraZeneca called our era “a golden age of cancer drug discovery,” noting that the new tools and technology now coming through are opening up the understanding of cancer biology, creating new mechanisms of action to treat cancer and targeting drugs to treat cancer in different ways.
Galbraith feels that innovations such as CRISPR are creating greater understanding of what drives resistance and improvements in predictive modelling are finally allowing researchers “to predict the true prevalence of different subsets of cancer.” Most notably, Galbraith added that the shift to more targeted precision medicines is fully underway, with nearly half of all current Phase III trials being conducted by the top oncology companies including a companion diagnostic.
When I joined the industry in 2001, we had essentially one modality – synthetic small molecules – and one target – next in class incrementally innovating on whatever was working at the time
Andy Plump, Takeda
For Roche, the revolution in oncology has led to a diversified ability to hit targets. William Pao, head of pharma research and early development at Roche Pharmaceuticals told the FT that “historically, we have hit protein targets with small molecules and antibodies, but we are now interested in RNA as a target.” Expanding on the potential in this field, Pao added that “there are about 20,000 protein coding genes in the human genome, only about four percent of which are currently druggable. [Moreover,] there are 280,000 mRNA transcripts in the human genome, of which 80,000 or more are potentially protein coding.”
Also on the FT panel, Takeda’s Andy Plump, who serves as the Japanese firm’s president of R&D, was keen to highlight the astonishing progress made in the oncology field in the past 20 years. “When I joined the industry in 2001, we had essentially one modality – synthetic small molecules – and one target – next in class incrementally innovating on whatever was working at the time,” he said. Now, as Plump pointed out, there is a huge novelty and diversity of approaches in cancer drug discovery and far less interest in bringing ‘me-too’ drugs to market from both scientific and commercial teams.
It is now crystal clear that a one-size-fits-all approach is not the way to go in oncology
These new approaches include targeted therapies, immuno-oncology, radioligand therapies, cell therapies, and various combinations therein. As John Tsai, head of global drug development and chief medical officer at Novartis told the FT, these combinations are leading not just to slight improvements but potentially remissions in many cases.
Carlo Toniatti, chief scientific officer at Italian contract research organisation (CRO) IRBM agrees. “We need to find a better way to use all our knowledge from each of these areas to develop appropriate combination therapies. This is where the oncology field is going.” Drawing on years of experience at MSD and the renowned MD Anderson Cancer Center in Boston, Toniatti underlines that this diversity of approaches is wholly necessary as “it is now crystal clear that a one-size-fits-all approach is not the way to go in oncology.”
He adds, “Immunotherapy is providing some nice data, and PD-1 is a good example, but it does not work for all tumours. Cancer is an extremely complex set of diseases, and it is unlikely that every drug developed has the potential to make it to patients. Every cancer is different, and we will need to identify the sub-populations which respond best to certain technologies. This means that we need to focus on the biology and modelling of cancer. The phrase used in the past was ‘from bench to bedside’, but perhaps today a better phrase is ‘bench at bedside.’”
