Finance Technology Leverage LLC

Innovation in immunotherapy

Frederick Giarrusso, Ph.D

Innovation in immunotherapy

In 2018, two scientists were awarded the Nobel Prize in Medicine for their revolutionary discovery of how to utilize human immune responses in cancer therapies. James P. Allison and Tasuku Honjo’s breakthrough in immunotherapy was a huge step forward in the fight against cancer, and one which inspired hundreds of other developments.

Now, with recent applications increasing survival rates in melanoma patients, immunotherapies offer the potential of a future where we can eradicate cancer within decades. But alongside improving the future health of our species, immunotherapies, like many other innovations in the life sciences, represent a rapidly growing market for investors.

What is immunotherapy?

The human immune system is incredibly good at fighting dangerous foreign cells within our bodies. But when it doesn’t recognise a cell as foreign, it leaves it alone – even if it’s causing harm.

Immunotherapy treatments effectively teach our immune system to recognise damaging cells, such as cancer, as foreign. This triggers an immune response that breaks the cells down. This video explains how they work:

Immunotherapy is divided into two categories, activation immunotherapies, which amplify a response from the immune system to attack specific antigens, and suppression immunotherapies, which reduce immune system responses to surface receptors.

The two are used in similar ways, depending on the treatment required, for example, cancer immunotherapies are used to destroy cancerous tumors by activating the immune system against them. Suppression immunotherapies, on the other hand, are used to aid the body’s acceptance of organ transplants and autoimmune diseases which mistakenly cause the body to attack its own cells.

Examples of types of immunotherapies:

  • Monoclonal antibodies (MABs) are manmade antibodies which include some immunotherapies. Each MAB is many copies of one type of antibody which targets antigens on cells and then triggers a response from the immune system to target and destroy the cells it has been coded to seek.
  • Checkpoint inhibitors – also a type of MAB – block proteins that prevent the immune system from attacking diseased cells, such as cancerous tissue. One of the immune cells that protects the human body is called a T cell, the checkpoint inhibitor works by helping T cells become more active or switch them off if they are destroying healthy cells.
  • Cytokines are a type of protein that boosts the immune system which scientists have managed to replicate in order to interfere with diseased cells. This works by stimulating the immune system T cells to attack cancer cells, and by encouraging cancer cells to produce chemicals which attract immune system cells.
  • CAR T-cell therapy is a specialist treatment which requires the removal of T cells from a sample of a patient’s blood and editing the cells so they will attack diseased cells more effectively once returned to the body. Once edited a T cell becomes a CAR T cell, standing for chimeric antigen receptor, designed to recognise and target a specific antigen.

How can immunotherapies change the world?

The most exciting application of immunotherapies is in cancer treatment. The technique is cited as one of the most important developments in oncology in the past decade, with untapped potential in other areas of medicine. It is also the area of the discipline that consistently receives the most investment.

Since 1950, there has been a 20% decrease in cancer mortality rates in the USA, largely due to improvement in the availability of new, constantly evolving treatments and a better understanding of the causes of cancer. Cancer was first identified in the mid-1700s and now, almost 300 years later, the unimaginable may become a reality: a cure for cancer. And not just cancer, but also allergies and autoimmune diseases like coeliac.

Within cancer treatment, a move has been made from immune editing, such as CAR T cells, to a new class of drugs called Immunotherapeutics, a less invasive method of immunotherapy. While all systems of immunotherapy are still being developed, there is a definite move towards more chemically advanced methods.

Cancer care is one of the largest areas of study and development for immunotherapies, with the number of cancers that can be treated increasing year on year. There are also numerous other areas where immunotherapies can be applied, outside of cancer, such as harnessing the body’s defences to fight disease and infection, reducing effects of allergic reactions and immune transplant and therapy.

Current innovations in immunotherapy

Researchers are currently investigating the possibility of using immunotherapies to help treat a number of other conditions, such as genetic disorders, diabetes and cardiovascular diseases.

Within existing immunotherapies, there is still a great deal of development to be done. For example, there is currently only a 40-60% response rate from melanoma and non-small cell lung cancer when treated with checkpoint inhibitor supporters. Advances in this area specifically are being pursued.

Biotech companies are also attempting to create a more affordable version of another important type of immunotherapy, CAR T-cell therapy. This is personalised medical treatment, as it is a patient’s own T cells that are genetically manipulated. The first company to have it FDA approved in 2017 are currently operating without competition, fuelling the race to create a rival CAR T-cell therapy.

FTL and immunotherapy

The benefits of immunotherapies go beyond medical applications, with the immunotherapy market is predicted to be worth over $120 billion by 2021

Cancer treatment is the largest and fastest growing component of the immunotherapy market. For the first time, immunotherapies are being viewed as an initial treatment option, as opposed to chemotherapy, so their prevalence and potential is attracting a great deal of investment and research.

Growth in the immunotherapies market is being fuelled by:

  • Need for targeted therapies with fewer side effects than existing treatments
  • Improvement in the drug approval process, which means medicines are being accepted and approved more quickly
  • High incidence of disease linked to lifestyle choice

One issue that faces companies developing immunotherapies is the difficulty in raising project finance. Life sciences projects like this require large amounts of capital to bring a new product to market. But investors are reluctant to commit the funds as the projects’ perceived risks are too high.

At FTL, we specialize in financing projects with high risk, long holding periods and large capital requirements. We sponsor innovative companies in the life sciences that struggle to find funding through traditional routes.

By providing companies with the finance they need we are helping fund the next wave of innovation that unlocks the potential of companies like those leading the wave of immunotherapy development. Serious projects require serious capital, and we are here to provide it.