Panel
Preserving the Promise of Cancer Immunotherapy
Milken InstituteLouise Perkins, Pablo Legorreta, Johanna Mercier, Jill O'Donnell-Tormey, Antoni Ribas, Greg Simon
- U.S. melanoma projections indicate 91,000 new diagnoses and over 9,000 deaths this year, equating to one death per hour, with a specific organizational goal to eliminate this suffering.
- L'Oréal Paris has pledged to commit $100 to melanoma research (MRA) per skin check pledge, capped at $250,000, while anticipating that increased skin checks will prevent melanoma and other cancers.
- Current metastatic disease outcomes show at least one-third to nearly half of patients surviving a normal life, though the remaining population requires more aggressive action and new combination therapies.
- Research strategies focus on utilizing patient samples to identify immune cycle deficits, determining necessary combinations for non-responders to single checkpoint blockade, and developing IO-IO or standard therapy regimens over three to five years.
- Clinical trial models are shifting toward platform trials, adaptive designs for unmet medical needs without control arms, and the use of standard control arm data from collaboration to prevent wasting patients.
- Industry efforts are expanding into community oncology settings where 80% of patients are treated, utilizing tools like "Study Connect" and engaging patient-reported outcomes to improve translational medicine.
- Funding dynamics involve increased participation from Royalty Pharma in clinical trials, a potential investor pullback due to poor returns, and a critical need for continued federal or non-profit funding to sustain innovation.
- Drug development faces challenges from "Me Too" compounds, a crowded immuno-oncology space, and the high costs of combination therapies, necessitating smarter funding priorities and avoidance of redundant research.
- Systemic barriers include a 1985-era research infrastructure, patient resistance to distant trials, and a decade-long lag in adopting breakthroughs in non-academic regions like Memphis, prompting the need for decentralized trial availability.
- Future visions emphasize the "Blood Profiling Atlas Consortium," the Biden Cancer Initiative's immunotherapy repository, and the sequencing of every cancer patient to enable precision medicine, alongside a strategic shift from tumor destruction to containment.
- Knowledge gaps regarding metastasis prevention, the optimal use of chemotherapy and radiation as immune system boosts, and the high cost of future treatments requiring two or three drug combinations necessitate deeper preclinical data and reverse translation.
- Collaboration is identified as the essential mechanism for success, requiring data sharing, standardized science and protocols, and the pooling of portfolios across companies to de-risk development and accelerate the identification of responders and non-responders.
- The sector is moving toward a patient-centric model where every decision considers patient needs, supported by patient engagement in trial design over the last two years and the expectation that society will benefit from lower long-term costs of combination therapies.