Immuno-oncology drugs and agents with novel MoAs to further influence treatment paradigms in cancer indications in 2020, says GlobalData

As 2020 commences for the pharmaceutical industry, Fern Barkalow, PhD, Senior Director of Oncology and Hematology, as well as members of her analyst team at leading data and analytics company GlobalData comment on some of the key trends that will continue to influence clinical development in both solid tumors and hematological cancers in 2020, including the influence of immuno-oncology (IO) drugs on treatment paradigms and increased clinical research into drugs with new mechanisms of action for various cancers.

Dr. Barkalow notes that market analyses underway on her team at GlobalData have revealed a major role for IO drugs, particularly combination approaches, in reshaping the treatment paradigm in several cancer indications.

Elena Tzima, MS, Oncology Analyst at GlobalData, comments: “The treatment paradigm in renal cell carcinoma (RCC) is shifting from tyrosine kinase inhibitor (TKI) monotherapy to immune checkpoint inhibitor combinations. Immune checkpoint inhibitors are increasingly taking over the first-line of therapy.  Although TKIs will not disappear from the treatment algorithm they will be overtaken by immune checkpoint combinations in first line and will be pushed down to later lines of treatment.”

On the other hand, ongoing market research at GlobalData in bladder cancer has revealed variable trends predicted for uptake of the checkpoint inhibitors in the 7MM that are due in part to cost issues but also a result of the introduction of novel therapies in an area that has just recently seen a large increase in approvals of targeted therapies.

Barath Muralidharan, MBS, Oncology Analyst at GlobalData, notes: “We will see increasing use of checkpoint inhibitors for bladder cancer in Japan and the EU for advanced disease despite the pushback from payers for these premium priced drugs.  However, in the US, there will continue to be a slight decline in overall sales of checkpoint inhibitors due to the launch of Balversa and Padcev in 2019, which according key opinion leaders interviewed by GlobalData, will see increasing adoption in the treatment of advanced bladder cancer in 2020.”

Dr. Barkalow continues: “While IO drugs will certainly continue to dominate oncology drug development, 2020 will see a high degree of clinical research in other drug classes with new mechanisms of action, which promise to go a long way to fulfilling unmet needs for more therapy options in certain cancers.”

Sakis Paliouras, PhD, Oncology Analyst at GlobalData, comments: “Since 2017, the previously-limited options for acute myeloid leukemia (AML) patients upon relapse have been enriched with agents of greater tolerability. Starting in 2020 and over the next 5-10 years, more novel drugs with different mechanisms of action will be proceeding to late-stage development and be poised to enter the AML treatment landscape. This should allow sequential treatment and extension of patients’ survival over multiple lines of therapy.”

Another area of high unmet need, triple negative breast cancer (TNBC), will see developments in 2020 as both checkpoint inhibitors and novel antibody-drug conjugate drugs gain approvals.

Adam Pearson, PhD, Oncology analyst at GlobalData, comments that: “Checkpoint inhibitors will move closer towards becoming the standard of care in first-line metastatic TNBC patients who are PD-L1 positive, with further approvals expected in 2020 for Tecentriq, and a probable approval for Keytruda in this population of patients.” 

Not only will there be more checkpoint inhibitor options leading to further uptake in TNBC patients.

Dr. Pearson also notes that: “In 2020, we are expecting to see approval for the antibody-drug conjugate, sacituzumab govitecan in later lines of therapy in TNBC after previously being rejected on issues related to ‘chemistry, manufacturing, and control matters’.  GlobalData has noted enthusiasm from key opinion leaders concerning this drug and it will likely be approved in Q1 2020. Sacituzumab govitecan will be a welcome addition to the increasingly personalized arsenal to tackle triple negative breast cancer and provide a drug, with a novel mechanism of action, to treat a historically difficult to treat cancer.”

Dr. Barkalow concludes: “As we enter this next decade, the shift away from chemotherapies and even some targeted therapies as standard of care in a variety of cancer indications, towards safer and more effective IO combinations and therapies of novel mechanisms of action will be even more pronounced than in previous years, which is good news for patients as well as drug development stakeholders.”

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