What's the Role of Non-Immuno-Oncology in an Immuno-Oncology World?

18 January, 2017

An Interview with Jeff Bockman, PhD of Defined Health 

Jeff was a panelist in our January 26th 2017 web discussion on non-IO and IO partnering and development. Click to request a video of the web panel. 

Jeff_Bockman_pic.jpgDr. Jeff Bockman, Vice President of Defined Health, has scientific expertise that encompasses a broad range of therapeutic disciplines. He also has a wide commercial and strategic perspective on the pharmaceutical and biotech industries and has directed hundreds of in-depth assessments of licensing opportunities and valuations. In an oncology world that is increasingly dominated by immuno-oncology therapies, we were curious to find out from Jeff if non immuno-oncology therapies will maintain a role in oncology's future. 

What excites you most about the immuno-therapy landscape?

Well, it’s exciting because it's both a qualitative and quantitative change in how we think about and treat cancer, and it’s led to a major shift in resources in biopharma. The oncology drug development space has been shaken by the results that immunotherapy drugs have had to date.

This is the first wave, and immunotherapy drugs will continue to improve; their efficacy will increase, and there will be further learnings on dose and how to combine them with other Immuno-Oncology (IO) and non-Immuno-oncology (non-IO) agents for tolerability.

Of course, the range of different IO agents will not address all cancers in all patients. That’s why we are having our web panel discussion on non-IO agents because they can be very successful with recalcitrant forms of cancer. While the checkpoint inhibitors have proven very successful for subsets of patients across various solid tumors, and less so in heme malignancies, the adoptive, personalized therapies like CAR-T cells are having the most success in heme cancers and have been pretty unsuccessful to date addressing solid tumors. The limitations of current IO is changing to combinations, such as when checkpoint inhibitors are coupled with other IO and non-IO agents, but there is still a need to couple them with other treatment methods.

biotechmoney600400xx304-304-0-19.jpgIs there controversy in partnering non-IO with IO therapy methods?

On the one hand, there is the very logical tried and true oncology development aspect: layering on any new agent on top of a standard of care. There are a number of clinical development discussions where checkpoint inhibitors are being added on top of chemotherapy, radiation, small molecules or tyrosine kinase inhibitor (TKI) model combinations.

At the end of the day, one could argue that every agent that has been used successfully in oncology patients and has had good responses (although for limited duration) has been enabled, abetted, and improved by the fact that the immune system is being engaged. Therefore, the idea of using non-IO agents to work alongside the IO agents makes sense. Using these elements together will likely benefit more patients.

Do you think non-IO organizations in the oncology space have pressure to partner with an Immuno-Oncology therapy organization given the landscape?

The need for IO and non-IO partnerships are both practical and scientifically driven because of the obvious clinical results benefit of combining both IO and non-IO agents together.

It is true that funding organizations are spending less time lately looking at companies outside of the IO space, unless they have stellar preclinical data or frankly really meaningful clinical results. While there are still non-IO deals being done, the amount of money being put into the IO deals is so much more significant. The non-IO companies are repositioning and engaging in clinical studies to show that they have an effect on the immune system or are compatible with an IO agent.

Could anyone have predicted that Immuno-Oncology (IO) therapies would supplant the standard of care for oncology?

I speculate that people did not envision that IO agents would supplant standard of care frontline. Instead, they most likely thought that they would be used in later lines of therapy.

If you look at lung cancer, no one guessed that IO agents would work so successfully, yet low and behold it’s one of the largest markets and where most IO agents are approved. These checkpoint inhibitors are performing well as a frontline regimen, without the need for chemo.

In the past, everyone was very careful to avoid the word “cure” when discussing oncology treatments. Do you think that in the future, the word “cure” could be used in an oncology setting?

We should still be cautious. However, by combining IO agents with each other and with non-IO agents, we are far exceeding what the previous median survival rates were for a number of cancers, so people can now begin to talk about ensuring that these long, durable remissions be maintained and that more patients in more cancers can benefit from them. So the idea of developing a “cure” is now not so much about “in the distant future” but may in fact be in the foreseeable future.

Has the FDA kept up with this seat change?

If you look at IO development, there has been breakthrough designations and accelerated approvals: some agents have jumped from phase I to phase III. This has not been such a common occurrence, and I don’t know how much of this is driven by the nature of checkpoint inhibitors or is driven by incentives to bring these agents to market. Certainly both have greatly enhanced the speed of development. And the regulatory agencies have been very helpful in facilitating these quicker timelines.

To learn more about partnering non-immuno oncology in an immuno-oncology world, register for our January 26th 11am PST web panel: 

Register for the Web Panel

About Jeff Bockman, Ph.D. Vice President, Defined Health

Jeff leads the Oncology and Virology Practices at Defined Health. Jeff has extensive commercial and strategic perspective on the pharmaceutical and biotech industries. He has directed hundreds of in-depth licensing opportunity and valuation assessments during his tenure at DH. He often speaks at conferences on scientific and commercial issues in cancer, biologics and personalized medicine.

Before joining Defined Health, Jeff was a Senior Research Scientist and Research Project Leader in the commercial development of oligonucleotide therapeutics for viral diseases and cancer at Innovir Laboratories; and an Assistant Research Professor at The George Washington University School of Medicine. He has worked closely with two Nobel Prize recipients: Dr. Sidney Altman on ribozymes, and Dr. Stanley Prusiner on prions, and holds four patents in the use of ribozymes.

He received a BA from University of California at San Diego, a PhD in Medical Microbiology from the University of California at Berkeley, and an MA in English/Creative Writing from New York University.

Jeff is a member of the Licensing Executives Society (LES), the American Association for Cancer Research (AACR), the American Society of Clinical Oncology (ASCO), the American Society of Hematology (ASH), and the American Society of Gene and Cell Therapy (ASGCT).