Cancer Immunotherapy Combos: The Future Despite Fuzzy Road Map

Cancer immunotherapy was a hot therapeutic topic at the recent J.P. Morgan Healthcare Conference, which makes sense given the efficacy of various checkpoint inhibitors, i.e. drugs like Yervoy, nivolumab and so on. The space has seen considerable investment from large-cap companies like Bristol-Myers Squibb (BMY), Merck (MRK), Roche, and AstraZeneca (AZN). Smaller companies like Agenus (AGEN) and private companies like CoStim are getting into the act as well. As you might expect, there are as many approaches to the use and development of checkpoint inhibitors as there are companies involved.

I had the chance to talk to a number of the companies, investors and scientists involved in cancer immunotherapy to get a sense of where the field might move over the next couple of years. Perhaps the biggest and most important takeaway was the future is not checkpoint inhibitor monotherapy. Companies are actively looking to position themselves as part of potential combinations.

Bronson Crouch, CEO of Science Seed and investor in CoStim, noted the interest in combinations comes partly from the science but also from the desire of large pharmaceutical companies and current reimbursement models. In fact, he noted that part of his interest in checkpoint inhibition came from "the interest of pharmaceutical partners prior to the company being formed."

Of course, combinations can be more than simply adding additional checkpoint inhibitors to one another. While the potential for additional efficacy exists, you also run the risk of generating a stronger autoimmune response. In fact, it was these fears that led to the recent sell-off in Bristol. Investors are not as sure that combining two checkpoints will be tolerable.

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