Immuno-oncology (IO) agents, particularly immune checkpoint inhibitors (ICIs) and CAR-T cell therapies, have extended the survival of patients in many cancer types and current investigational approaches in the industry and academia will lead to even further clinical improvement, says GlobalData, a leading data and analytics company.

The company’s latest report, ‘Immuno-Oncology – Market Analysis, Trends, Opportunities and Unmet Needs – Thematic Research’, reveals that developers are investigating new approaches that include next-generation co-stimulatory molecules, more rational combinations, utilization of novel biomarkers, clinical trials in earlier lines of therapy and better toxicity management.

Sakis Paliouras, PhD, Senior Oncology Analyst at GlobalData, comments: “With the advent of IO, patients with metastatic melanoma now routinely survive over five years after treatment with ICIs, which was nearly unimaginable before these drugs were discovered and has led to physicians even considering the possibility of curative treatment with Bristol-Myers Squibb’s Opdivo + Yervoy. Despite this outstanding outcome, primary resistance to ICIs is a real issue of this drug class and one that companies are pouring significant effort into solving. Key opinion leaders interviewed by GlobalData do believe that novel rational combinations and co-stimulatory molecules can move the needle.”

Even without any research on novel mechanisms of action, there are many things that can improve patient care with the agents already available. One of them is the move of IO agents into earlier lines of therapy. For solid tumors, ICIs can be increasingly used in the adjuvant setting, and for blood malignancies the use of CAR-T cells upfront in a minimal residual disease-guided approach, or even as a replacement for the toxic stem cell transplant procedure.

A need for predictive biomarkers is among the most important unmet needs in IO, and goes hand-in-hand with mitigating toxicity by not exposing patients to unnecessary side effects when clinical improvement is not likely. A number of approaches are coming closer to the clinic, with measures of tumor mutation burden being the most advanced and already authorized in the US.

Paliouras adds: “Other classes of IO, such as bispecific T-cell engager antibodies, while less proven in the clinic, have generated tremendous enthusiasm for their potential in taking established clinical targets and coupling them with a strong T-cell mediated tumor response. Many pharmaceutical companies are criticized for focusing on me-too IO drugs to generate revenue while leading to little, if any, innovation. While this is a valid criticism, the future of IO is by all accounts bright as the more industrial investment that is poured into the field of IO, the better patients’ outcomes will be overall.”