Analysis of the clinical immuno-oncology landscape

This post highlights a new paper providing a comprehensive analysis of all cancer immunotherapies in development and their clinical trials - aiming to improve efficiency, reduce duplication and encourage innovation.
Analysis of the clinical immuno-oncology landscape

A team at the Anna-Maria Kellen Clinical Accelerator of the Cancer Research Institute (CRI) in New York have published an important new paper in the Annals of Oncology (doi:10.1093/annonc/mdx755) – helping the cancer community to stay informed of the current immuno-oncology (IO) landscape and identifying a number of key trends.

Illustrating the rapid progress in the immuno-oncology field over the last 30 years, the authors highlight that since the approval of the first immunotherapy (interferon-α), a further 25 agents have followed - and an impressive 17 types of cancer now have at least one agent approved as a treatment option.

And more recently, we have witnessed a transformation in the IO landscape - starting with the approval of ipilimumab for advanced melanoma in 2011. In the past three years alone, eight new immunotherapies were approved - which in most cases, provide desperately-needed new options for patients with advanced, refractory or relapsed cancers.

However, with this success brings a new challenge. With huge investment from industry in and a plethora of companies entering the field, there is now an unprecedented number of new immunotherapy agents at various stages in the drug development pipeline. And this makes it difficult – and potentially overwhelming - to keep track of what’s going on!

As the authors describe: “..the fast-expanding and ever-changing IO field could overwhelm even the most experienced clinical investigators as they seek treatment options for their patients.”

To help address this, the team set out to curate a much-needed comprehensive overview of this rapidly evolving landscape. Collecting information from a number of trusted and publicly available sources (up to a cut-off date of September 2017), they have created two new databases tracking:

  • A total of 2,004 immuno-oncology agents (940 in clinical stage and 1,064 in pre-clinical testing)
  • The 3,042 active clinical trials – covering all common cancer types and the majority of the less common ones. These collectively aim to recruit 577,076 patients.

Through analysing these data, they identify some important key trends:

  • A large number of overlaps, with companies chasing the same targets
  • An avalanche in the number of studies involving anti-PD-1/L1 combinations, many of which are testing the same combinations
  • A big increase in small studies, initiated by researchers

In their discussion, the authors recognise the need for finding innovative new coordinated approaches to collating data and keeping it up-to-date in this rapidly evolving field - with a specific mention for our interactive cancer-immune setpoint framework.

“Public IO-focused information hubs would help coordinate efforts, optimize research resources, and identify rising opportunities in the field. In basic research, the online cancer-immunity cycle, which evolved from a recent landmark review paper, serves as a centralized information hub for new IO targets and factors that affect tumour immunology,” they say.

The team aim to work with the clinical community to build an unbiased, neutral comprehensive information hub for IO. Along with the publication, they are making all their resources available on CRI’s website and will update their analyses on a quarterly basis.

We agree with them - publicly-available data hubs are invaluable resources for the cancer community and will help maximise progress in developing effective new immunotherapies and ensuring they reach cancer patients faster.

But the evolution of the cancer-immune setpoint will only succeed if you - the community - contribute your ideas. Please go to the framework and add your comments - to improve on what’s included and to update it as new data are published (n.b. you’ll need to be on a computer, rather than mobile!).

To help get you started, please follow our a simple step-by-step guide in our ‘how to’ post.