Checkpoint Inhibitor Deals: Searching For IO Combinations To Unlock Cancer’s Black Box

Merck and Bristol-Myers Squibb's market-dominating checkpoint inhibitors are competing to find the next combination therapy to treat more cancer patients, in more types of cancers. Recent failures and new regulatory pressure, however, may have a cooling effect, even as researchers come full circle with PD-l/PD-L1 and CTL-4 combinations. The race is also on to pull new combinations from emerging cell therapy and precision oncology drug candidates.

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3D RENDERING OF PEMBROLIZUMAB MONOCLONAL ANTIBODY • Source: Shutterstock

Immunotherapy treatments for cancer, and the potential synergistic effects of combining established PD-1/PD-L1 checkpoint inhibitors with other experimental candidates and mechanisms, will continue to drive oncology deal-making in 2020. As of November 2019, there were 2,251 active PD-1/PD-L1 combination therapy trials testing 295 different targets, according to the Cancer Research Institute, a non-profit that supports research and development of immunotherapy treatments for cancer. Clinical successes, however, have slowed from the heady days of the early and mid-2000s, when it seemed as though checkpoint inhibitors might become the cancer cures patients and pharmaceutical companies hoped would beat back the disease once and for all.

Almost 10 years have passed since the initial FDA approval of Bristol-Myers Squibb Co.’s cancer drug Yervoy (ipilipumab), an antibody demonstrating that T cells in the immune system can be assisted in the fight against certain tumors by blocking cytotoxic T-lymphocyte antigen 4 (CTL-4). In healthy individuals, CTL-4 is a necessary restraint on the immune system, preventing T cells from attacking healthy tissues

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