Today, being the second Friday in September, is Stand Up To Cancer Day, a day to talk about next-generation treatments that are on the verge of making it into clinical practice. Oncology is a vast field, with many modalities being developed, and myriad indications – which are increasingly defined not just by their bodily location, but by their pathological drivers and genetic signatures.
According to the report, what treatments have the greatest potential to move the dial in the years ahead? Where does the greatest unmet need remain? And what gives today’s leaders at the forefront of innovation in cancer hope? To answer these questions, Stephen Adams spoke with a selection of top-level biotech leaders who are advancing a wide range of modalities.
Oncology Innovation
Sam Cobb, founding CEO of Currus Biologics, said that taking the extraordinary advances seen with immunotherapy and cell therapy and making them work much more effectively in solid tumours has the greatest potential to improve outcomes for cancer patients over the next five years. The Australian biotech is developing a universal bispecific antibody platform to unlock CAR T-cell therapies for the treatment of solid tumours.
CAR T-cells’ very limited efficacy in solid tumours has been a major stumbling block for some years now, and Cobb said the challenge “isn’t simply getting immune cells to recognise a cancer cell.” They also need to expand, persist, and remain functional within a very hostile tumour microenvironment (TME), while overcoming tumour heterogeneity and immune suppression.
Cobb added that increasingly sophisticated approaches were being advanced to overcome these hurdles, including engineered and ‘armoured’ cell therapies, in vivo CAR generation and bispecific approaches and therapies designed to actively modify the TME. Huge hopes are also being pinned on creating CAR-Ts in vivo, as this method opens up the possibility of overcoming many of the manufacturing and access challenges of today’s [ex vivo] autologous therapies.
This approach is particularly significant, as it could enable the development of more targeted and effective treatments for solid tumours, which are often more challenging to treat than blood cancers. Furthermore, the ability to create CAR-Ts in vivo could also reduce the costs and complexities associated with current CAR-T cell therapies, making them more accessible to a wider range of patients.
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Unmet Needs in Cancer
Unsurprisingly, aggressive solid tumours top the list in terms of indications. Currus’s Cobb said that unmet need is also reflected in other aspects, such as durability (or, rather, the lack of it) and lack of access to potentially transformative – but prohibitively expensive, medicines. All those interviewed identified refractory and treatment-resistant cancers as a major unmet need.
Tremble said: “We are almost there, but we haven’t seen as many drugs working through the regulatory paths as we would have hoped.” Schann highlighted non- or poor responders to checkpoint inhibitors, arguing: “Approaches that target immune suppressive mechanisms within the tumour microenvironment, including selective targeting of highly suppressive immune populations, such as CCR8+ regulatory T-cells, are among the most promising for expanding the benefits of immunotherapy to patients who currently have limited options.”
Kelly said: “New modalities such as ADCs, T-cell engagers, radioligand therapies, molecular glues, and cancer vaccines offer real promise to deliver more precise, durable treatments with less toxicity.” On Stand Up to Cancer Day, what gives the biotech leaders the greatest reason for optimism about the future of cancer research and treatment?
Reasons for Optimism
Kelly and Schann both cited deeper biological insight and Cobb said this was leading to a “sheer breadth of progress”. The increasing understanding of the complex interactions between cancer cells and their microenvironment is enabling the development of more targeted and effective treatments. Additionally, advances in technologies such as gene editing and gene expression analysis are providing new tools for researchers to study cancer biology and develop innovative therapies.
Curve’s Prinjha reflected on how personal experience had made him more hopeful for the future. “To see my close family, friends, and colleagues happy and thriving, having successfully come through cancer treatments, fills me with joy and optimism,” he said.
