Biotech Strategy Blog

Commentary on Science, Innovation & New Products with a focus on Oncology, Hematology & Immunotherapy

Posts tagged ‘Vinod Balachandran’

We are still on a quest – a patient journey, if you like – to find new agents capable of addressing the inherent issue of why do some patient’s tumours lack immune infiltrate and how do we go about fixing it?

Chihuly Glass sculptures always remind me of upregulating MHC

Over the last decade on BSB we have explored a veritable telephone directory of immune agonists, cancer vaccines, cytokines, bispecific and trispecific antibodies, additional inhibitory checkpoints, oncolytic viruses, small molecules, chemotherapy, CAR-T cell therapies, and various others.

Few have got the job well done in advanced solid tumours. Once MHC is downregulated, it becomes much harder to generate an immune response.

Stop and think about this for a moment.

It’s been a long slog to find the next big thing and a frustrating one at that for cancer researchers slaving away at the coal face. A lot of promising agents have come and gone – some quietly, others loudly – to end up in what Dr Patricia LoRosso wittily described as ‘dog drug heaven’. It is also dispiriting to write about so many ending in failure.

The good news is there are some new signs of life coming through, although it’s too early to declare a spring rennaisance. Over the next couple of weeks we’re going to highlight a number of young biotechs with encouraging or fresh ideas being explored in the clinic.

I also don’t want to raise too many hopes – especially as I have long been sceptical about some approaches with all their breathless hype – but here’s something to keep an eye on with an open mind because if it holds up where others failed then the company could be on to something…

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Pancreatic adenocarcinoma is a tough disease to deal with given that it is portends poor clinical outcomes, aggressive tumour biology, and early metastatic spread. Not surprisingly, we have seen very little improvements in terms of clinical outcomes with anti-cancer therapeutics. Surgery (for early stage disease) and intense chemotherapy (for metastatic disease) remain the bedrocks of treatment to this day.

From an immunotherapy perspective, there are also additional barriers and hurdles to overcome including, for example, lack of high mutational load, a complex inhibitory tumour microenvironment, and even a physical barrier in the form of the stromal layer.

Not surprisingly, all of these factors combine to make companies reluctant to rush into clinical trials with immune checkpoint blockade, accepting that we really need to understand the underlying tumour biology better before attempting such an endeavour.

At a recent cancer conference we heard an uplifting talk from a research group who are attempting to tackle this issue and offer some pointers on where there may be some near-term opportunities that are worthy of discussion.

Before we can even consider what delivery system or adjuvant to use, we first have to do the scientific investigations into what’s special about exceptional responders and characterize those.

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