Something has been left behind in the billion-dollar “frothy” excitement over immuno-oncology therapies: recurrence of cancer and the inability to treat metastatic cancer.
“We’ve seen everyone running to one side of the boat,” said Jeffrey Bockman, a VP at Defined Health. “Yet at the end of the day it is highly unlikely that immuno-oncology therapy will be curative because there are latent cells still residing in the body that are less easily hit by most types of agents, and are less immuno-recognizable. This may turn out to be very controlling.”
For BIO-Europe Spring®, Bockman gathered a panel of executives from three companies focused on tumor initiating cells for a discussion centered on “Therapeutics Targeting Cancer Stem Cells.”
“These companies are more focused on outcomes, not on tumor shrinkage,” he said. “The idea running though this panel is that they may hold a key component of why cancer recurs and how targeting cancer stem cells may be essential to the elimination of, or the functional cure, of cancer.”
The Chief Operating Officer at Verastem, Dan Paterson was more blunt in saying tumor shrinkage does not translate to a patient benefit. Cancer stem cell therapy is doing something different, which is blocking the ability to seed new tumors. But large pharma companies do not do differently. They are focused on tumor reduction and it is a feeding frenzy where we see USD 800 million in upfront payment for immuno-oncology agents with Phase I data. We are told by companies they cannot even meet with us unless we have an immuno-oncology agent.”
Verastem currently is running three drug candidates through clinical stage trials, “and these assets remain unpartnered, we own them completely,” he said, adding that the company expects in 2017 to bring its first product to the market.
“The solution for a durable clinical response to cancer will be a combination of cancer stem cell agents with tumor reduction agents,” he said, setting a theme for the panel’s discussion.
The Chief Medical Officer for OncoMed Pharmaceuticals, Jakob Dupont said his company has been focused since 2004 on developing first-in-class agents that target tumor initiating cells.
“We have a pipeline of key agents, all of them discovered ourselves. We have six drugs in 16 clinical trials and we are about to file a seventh IND. That’s a very large pipeline for a small company,” he said.
“We are really getting close to answering our questions about cancer stem cells,” he added.
While he agreed that the biotech industry is awash in a wave of heightened interest in immuno-oncology, the work at OncoMed has been developed in partnership with three large pharma companies, Bayer, Celgene, and GlaxoSmithKline.
“We have a high engagement of our partners. We are not trying to beat them, we are joining with them in an effort that is very synergistic. We believe our drugs are great candidates for use in combination with immuno-oncology agents,” said Dupont.
Hiroyuki Kouji is the CEO for PRISM Pharma, which is focused on developing small molecule technologies to modulate the Wnt/beta-catenin signaling pathway.
“Targeting the pathways that control cellular differentiation and proliferation has potential to treat a range of conditions that are driven by cell division,” he said. Clinical trial data for patients with solid tumors demonstrated the company’s lead candidate PRI-724 led to a decrease in the expression of the surviving protein in circulating tumor cells, a biomarker of on-target drug effect.
“It is the complete elimination of both the tumor and cancer stem cells that will be the key for true patient benefit, and a good combination therapy of a cancer stem cell agent with chemotherapy will be the right solution,” he said.
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