Pharmaceutical companies are investing billions of dollars in a new age of oncology. The more than 900 cancer medications in the pipelines at drug companies and academic institutions constitute nearly 40% of all the drugs under development, according to industry analysts.
Such development efforts have brought several novel cancer treatments to market in recent months and promise several more advances in the coming months.
Which are the most exciting new medications and, more importantly, what specific trends will emerge this year to help bring effective, individualized treatment for more patients with cancer?
Here are thoughts from 6 oncologists at the forefront of drug research and testing at some of the nation’s most prestigious cancer treatment centers.
Kenneth C. Anderson, MD
Program Director and Chief
Division of Hematologic Neoplasias
Dana-Farber Cancer Institute
Kraft Family Professor of Medicine
Harvard Medical School
Anderson expects good things from several new myeloma medications, including carfilzomib. The proteasome inhibitor, which appears to be active in relapsed multiple myeloma and seems very well tolerated by most patients, was accepted for FDA review in late November.
The researcher, however, is most excited by several general trends that may expedite drug testing and reduce failure rates.
Like everyone interviewed for this article, Anderson believes targeted medications, paired with diagnostic tests, will increasingly achieve both goals. Even when targeted medications fail in initial trials, he said, researchers understand them well enough to devise possible fixes rather than abandoning development.
A scientist at a Roche laboratory tests pharmacokinetic properties of drug candidates. Genentech, a member of the Roche Group, is developing new targeted oncology agents.
“Elotuzumab, when tried on its own, largely failed,” he noted, referring to a monoclonal antibody directed against the glycoprotein CS1 that is under investigation in myelomas. “In the past, that would have been the end of the story, but enough was known about the compound to predict that pairing it with lenalidomide would boost response, and trials of the combo have been outstanding.”
Anderson expects to see many drugs rescued from oblivion in similar fashion and to see a general trend toward more potent drug combinations. “Combination therapies have always been the norm, but we’re only just developing the tools to systematically optimize them,” he said. “These tools will allow us to better leverage every medication, old as well as new.”
Complementing these scientific advances, Anderson said, are major improvements in communications among pharmaceutical companies, academic researchers, government regulators, patient advocates, and other interested parties. These groups are working together better than ever to exchange thoughts and negotiate standards, leading several drugs to reach patients in record time and offering hope that many more will do likewise.
Edith A. Perez, MD
Mayo Clinic Cancer Center
Serene M. and Frances C. Durling
Professor of Medicine
Mayo Medical School
Perez looks forward not only to pertuzumab, a targeted drug now under FDA review for previously untreated metastatic breast cancer, but also to seeing major improvements in traditional cytotoxic chemotherapies.
Pertuzumab attacks the same types of HER2- positive cancers as trastuzumab (Herceptin) but, according to Perez, it is anything but a me-too drug.