Drugs and Products to Watch in 2018
Regina Au presents a list of drugs and medicines to watch in 2018.
The full list of drugs and products to watch in 2018 would be extensive as there are numerous diseases that currently have no treatment or suffer from the fact that not all patients will respond positively to one medication.
If one were to look at the trends in the market for the past six months, immuno-oncology, gene editing and gene therapy are still "hot" for pharma and biotech professionals. For medical devices the trends are still around patient monitoring devices with apps for preventive measures in delivering better patient care.
However, for the purposes of this first piece I'll be focusing on immuno-oncology, gene editing and gene therapy as a class rather than any specific product for pharma/biotech, with respect to advancement since these products are still in their infancy.
For medical devices, in one of my later pieces I'll be covering one specific device for heart failure (HF), a progressive medical condition that doesn't leave a lot of options once a patient exhausts all drugs available. The only option is a Left ventricular Assist device (LVAD) which is limited to certain types of patients or a heart transplant which is also limited to certain patient criteria.
Immuno-oncology: Check-point inhibitors
Researchers have found that using a patient's own immune system to recognize and target cancer cells, not only needs a drug to help the immune system recognize the cancer cell, but they also need to consider the micro-environment in getting the drug to hone-in to where the tumor is located and penetrate it to the core.
For example, Roche’s Tecentriq drug was able to have the immune system recognize and attack tumors but reportedly failed to work in a section of patients within their bladder cancer trial. Upon further analysis of their trial data, they discovered two biomarkers: 1) PD-L1, that drives a good response to drugs that inhibit the checkpoint PD-L1, like Tecentriq; and 2) TGF-beta, a protein that drives resistance. The TGF-beta protein levels were high in tumors of patients who did not respond well to Tecentriq.
Roche scientists discovered that non-responders were either severely lacking cancer-fighting T cells, or T-cells were stuck to a wall made of collagen that prevented them from getting inside cancer cells. When they used a combination of anti-PD-L1 and an anti-TGF-beta therapy, it allowed more T-cells to penetrate to the center of the tumor, reducing the size of the cancerous mass. This discovery further supports the theory of combination therapy.
Other combinations to boosting immune checkpoint inhibitors are being studied such as combining checkpoints with pentoxifylline, a drug that’s currently used to improve blood circulation for melanoma in mouse models at Columbia University Medical Center. The cocktail helped control the activity of regulatory T cells (Tregs) by preventing them from suppressing cancer-killing T cells. In addition, Memorial Sloan Cancer Center in New York found that in animal trials, an inactivated formulation of the vaccinia virus helped boost tumor-fighting T cells when given along with checkpoint inhibitors.
Other companies have conducted trials with TGF-beta inhibitors but have had mixed results indicating that more research is needed to find better TGF-beta inhibitors.