Download the Presentation

IMMUNOTHERAPY
The Future of Cancer Care
Brad Loncar
• Biotech commentator
and investor for 8+ years.
• Manager of a biotech-focused family office.
• Franklin Templeton Investments and U.S.
Department of the Treasury.
•
@BradLoncar - A widely followed voice on
social media.
• Blogger at LoncarBlog.com and previously Xconomy
CANCER IMMUNOTHERAPY
Cancer Immunotherapy Big Picture
 Immunotherapies can be a better way of treating cancer.
• Chemotherapy can be toxic and affect the whole body.
• The immune system is natural. It can learn and adapt.
 Immunotherapies are producing unprecedented results.
• Immunotherapy has revolutionized the treatment of some cancers.
• Cell-based therapies have awed in some early blood cancer trials.
 The first generation of immunotherapies are FDA approved and
on the market now.
• Immunotherapies from have been approved in over 6 unique cancers
and are offered by large pharmaceutical companies.
 Second and third generation immunotherapies will likely drive
this trend for many years to come.
• Smaller biotech companies are driving this trend.
INCREASINGLY IN THE NEWS
Cancer Immunotherapy In the News
In the news (continued)
TYPES OF CANCER
IMMUNOTHERAPY
Immunotherapy Approaches
Immunotherapy is NOT one thing.
•
•
•
•
•
•
•
Checkpoint Inhibitors
Oncolytic Viruses ✔
Bi-specific Antibodies
Cancer Vaccines ✔
CAR-T
Natural Killer Cell
T-cell Receptors
✔
✔
•
•
•
•
DART
STING
Cytotoxic T-cells
Tumor Infiltrating
Lymphocytes
• More…
✔ = FDA Approved
CHECKPOINT INHIBITORS
Checkpoint Inhibitors | Approved Today
• Checkpoint inhibitors could be a foundational care for cancer and
could have a huge impact on society.
• They work by taking the brakes off the immune system. Checkpoints
lower a stop sign that cancer cells usually present to immune cells.
Bristol Myers - Opdivo
Merck - Keytruda
Checkpoint Inhibitors | Place in Cancer Care
Foundational
• Checkpoints are already approved in 6 unique cancers: Melanoma,
Non-Small Cell Lung Cancer, Kidney, Bladder, Hodgkin Lymphoma,
and Head and Neck Cancer.
• In some cases these drugs are being used as on their own, and they
will also be used as a base in combination with other drugs.
The KEYTRUDA research program includes more than
300 clinical trials evaluating KEYTRUDA across more
than 30 tumor types. To date, clinical activity has been
shown in more than 20 tumor types.
Checkpoint Inhibitors | A Famous Patient
• Late stage melanoma that
had traveled to the brain and
liver.
• Given Merck’s KEYTRUDA
in September 2015
• Cancer was no longer
showing up on scans in
December 2015.
Tolerability and quality of life can be just as important as efficacy.
• President Carter is 91 years old.
• You might not even offer chemotherapy to someone that age
because it can be so debilitating.
• He was able to continue daily life while on the immunotherapy.
Checkpoint Inhibitors | Meaningful Results
Melanoma
• 40% of advanced melanoma patients taking Keytruda were alive after
3 years. That compares to about 10% to 20% of patients on standard
chemotherapy treatments.
Non-Small Cell Lung Cancer
• 39% of recurrent NSCLC patients taking Opdivo were alive after 18
months compared to 23% for those treated with the standard
chemotherapy Docetaxel.
Kidney Cancer
• Advanced kidney cancer patients treated with Opdivo lived an
average of 25 months after starting treatment compared to 19.6
months in those treated with the standard of care Afinitor.
CELLULAR THERAPIES
CAR-T
• Reprogram a patient’s own TCells to search for a marker that
is over-expressed on cancer.
JUNO
• Think of this as attaching a GPS
device to immune cells.
• Has shows meaningful results in
blood cancers.
• Celgene signed a 10-year
partnership with Juno and gave
them $1 billion in up-front
investment.
KITE
CLLS
Meaningful
Results
- Juno Therapeutics
JCAR017
- A phase 1 study of
22 children who had
untreatable
leukemia (ALL)
- 20 (91%) had a
complete remission
of their cancer
- The goal is to race
to market in ALL &
NHL, and learn to
use CAR-T in more
cancer types.
CAR-T Therapy | Meaningful Results
“In my years as an oncologist and as a research scientist, I have never seen a
treatment that has that spectacular of a response rate in its initial testing in
patients.”
- Dr. Stanly Riddell, Fred Hutch Cancer Research Center
BI-SPECIFIC ANTIBODIES
Bi-Specific Antibodies
• Bi-specifics are a competitor
to CAR-T due to their relative
ease of use.
• One end of the drug attaches to a
marker on the cancer cell, another
attaches to a marker on the
immune cell, and then an
introduction is made.
•
Amgen’s Blincyto is FDA
approved and on the market for
acute lymphoblastic leukemia
(ALL).
AMGN
XNCR
MGNX
CANCER VACCINES
Cancer Vaccines
• Cancer vaccines are used to
prime the immune system to
attack cancer.
• Some use bioengineered
bacteria to signal an immune
system response.
• Vaccines will one day be
personalized to the makeup
of each patient’s specific
tumor.
ADXS
ADRO
Private
WHO IS INVESTING IN CANCER
IMMUNOTHERAPY?
Investing in immunotherapy | Government
The Cancer Moonshot aims to leverage the unique promise of
today’s new treatment approaches and make as much
progress against cancer in 5 years as would normally take 10
years. Over $1 billion has been allocated to invest in this.
Investing in immunotherapy | Philanthropy
$125 Million
$250 Million
Bloomberg-Kimmel Institute
for Cancer Immunotherapy at
Johns Hopkins – March 2016
Sean Parker Institute for
Cancer Immunotherapy –
April 2016
Investing in immunotherapy | Private Sector
WHERE DOES
IMMUNOTHERAPY FIT WITHIN
BROADER BIOTECH?
Biotech is Not One Thing!!!
TECHNOLOGY
•
•
•
•
•
•
•
•
•
Cyber Security
Semiconductors
Telecom Equipment
Software
Social Media
Devices and Smartphones
Cloud Computing
Storage and Data
Networking
Is the Nasdaq-100 still relevant?
BIOTECHNOLOGY
• It’s all the same thing
Biotech is Not One Thing!!!
TECHNOLOGY
•
•
•
•
•
•
•
•
•
Cyber Security
Semiconductors
Telecom Equipment
Software
Social Media
Devices and Smartphones
Cloud Computing
Storage and Data
Networking
Is the Nasdaq-100 still relevant?
BIOTECHNOLOGY
•
•
•
•
•
•
•
•
•
Cancer Immunotherapy
Vaccines
Antibiotics
Autoimmune Diseases
Price Gougers (Valeant)
Diagnostics
Diabetes
Cardiovascular Diseases
Central Nervous System
Is the Nasdaq-biotech still relevant?
Biotech is Not One Thing!!!
• Not all areas of biotechnology represent high
innovation just as not all areas of technology
represent high innovation.
• Cancer immunotherapy is a high innovation
area within biotech.
• Some areas of biotech like insulin/diabetes
represent incremental improvements.
Immunotherapy is not incremental to cancer. It
is a breakthrough new approach.
INNOVATION IS COMING AT
THE RIGHT TIME
The Bad News: A Growing Problem
The global market for cancer drugs has
been growing
• The global market for cancer medicines has surpassed $100 Billion,
and is estimated to be higher than $150 Billion by 2020.
Source: IMS Institute 2015 Cancer Dynamics report
HIGH STAKES FOR DEVELOPERS
Immunotherapy is highly competitive
Bristol 1st Line NSCLC Trial Failure – Aug 5
Immunotherapy is highly competitive
FDA’S ROLE
How Does FDA Fit Into This Picture?
• FDA approved new drugs
at 19-year high rate.
• They have been fasttracking immunotherapy
drug applications.
• Announced in June a new Oncology Center of
Excellence. Intended to accelerate cancer drug
development.
• Breakthrough therapy designation has helped.
WHERE TO LEARN MORE
Where to learn more
Loncar Investments’
Charitable Partner
• A nonprofit organization
dedicated exclusively to
harnessing the immune system’s power to conquer all
cancers.
• Founded in 1953.
• Awards research grants and fellowships to support
scientists at leading research universities and clinics
around the world.
• www.CancerResearch.org
SUMMARY
Summary
 Immunotherapies can be a better way of treating cancer.
 Immunotherapies are producing unprecedented results.
 The first generation of immunotherapies are FDA approved and
on the market now.
 Second and third generation immunotherapies will likely drive
this trend for many years to come.
THANK YOU
We hope this presentation has made you an optimist!