Eric Lefkofsky’s technology company, Tempus, has added immunotherapy to its repertoire of cancer data analytics and precision medicine. As part of their patient report, the company will help physicians identify which cancer patients are likely to respond favorably to what is regarded the next generation of cancer care. This is of particular importance as immunotherapy, while a powerful weapon against cancer, still has to overcome its biggest challenge, namely its large variability in efficacy among cancer patients.
Immunotherapy falls into the category of precision medicine, a system that customizes cancer care. The therapy stimulates a patient’s immune system to fend off diseases such as cancer by working harder or smarter to attack cancer cells. Several efforts have been made to battle cancer via the immunotherapy route – despite some challenges, there have been recent advancements.
The first example of immunotherapy as a means to treat cancer dates back to 1891, when a New York doctor, William B. Coley, injected a mixture of beef broth and Streptococcus bacteria into a 40-year-old’s arm who was suffering an inoperable neck tumor. The patient’s first reaction included fever, chills and vomiting. However, a month later, the cancer had shrunk drastically. Coley had subsequently repeated his procedure in over 1000 individuals with variable outcomes. He was eventually shut down by the US Food and Drug Administration.
The oncology realm has since mostly turned to radiation and chemotherapy, while immunotherapy’s range of treatments have remained on the outskirts of medicine. However, recent intriguing clinical results have renewed interest in immunotherapy as a cancer treatment and triggered funds from investors and pharma executives.
At the time, Coley did not have the means to investigate why his method was successful. His forced infections triggered the body’s immune system to go into overdrive and thus eliminate cancer cells. Despite the fact that the FDA does not yet have a formal definition for more modern immunotherapies, at least eight drugs that fit the category have been approved, albeit with varying patient success rates. While the approved drugs resulted in more funding support for relevant clinical trials, some scientists feared that there is more hype than hope for the patients.
It could be said that immunotherapy is bittersweet – when it works, it really works. However, this is not true for the majority of cancers as well as patients. According to Vinay Prasad, an Oregon Health and Science University oncologist who is also regarded as a professional cancer care critic, only an estimated 10% of patients dying from all types of cancer might benefit from immunotherapy. However, the field is rapidly expanding, and Prasad’s view is regarded as an understatement as he was referring to the most widely used immunotherapy drugs. While these first checkpoint inhibitors just worked by turning on T cells, later models are more selective. They block a signal by using the same method as tumors when they avoid T cells. These drugs are highly effective in cancers such as Hodgkin’s lymphoma, renal cell carcinoma and non-small cell lung cancer, and that leaves two-thirds of terminal cancer patients without immunotherapy treatment.
Merck and Bristol-Myers Squibb sold almost $9 billion worth of checkpoint inhibitors during the first wave since 2015. Roche, AstraZeneca, Novartis, Eli Lilly, Abbvie and Regeneron followed and spent billions on startups and advancing their in-house pipelines. Also, there are currently 800 clinical trials involving checkpoint inhibitors in the US, which is 600 more than in 2015.
Some scientists believed that this number of trials was not sustainable. However, in September of this year, after more than a decade of investigating checkpoint inhibitors, the FDA cleared CAR-T therapy, the first ever gene therapy that involves extracting and genetically rewiring a patient’s T-cells so they are better at attacking tumors in the body. Developed by Novartis, CAR-T is a treatment for children with advanced leukemia. Following CAR-T, Kite Pharma’s live cell treatment was approved, and it successfully treated 50% of adult lymphomas in clinical trials. Ever since the two launches, more than 40 other pharma companies and startups are currently establishing their immunotherapy pipelines.
What would make immunotherapy truly efficacious is knowing exactly which patients would respond favorably to it and which would not. Tempus’s immunotherapy platform, regarded as one of the most comprehensive immunology platforms available, is driven by a state of the art integrative molecular profiling approach that relies on DNA and RNA data and immunohistochemistry and TCR sequencing. It allows physicians access to molecular data such as specific gene alterations and mutational burden as well as immune infiltration, HLA type, neoantigen predictions, and immunotherapy targets.
This would provide solutions to the FDA approved drugs that work for some patients and not others. Certainly, knowing that ahead of time, physicians would have a much higher success rate treating cancer patients. This, on the other hand, would inadvertently lead to more cancer survivors.
About Eric Lefkofsky
A Chicago native, Lefkofsky has several other entrepreneurial ventures, including Lightbank, a venture fund that focuses its investments on disruptive technologies, Groupon, a global e-commerce marketplace, Uptake Technologies, an analytics platform for the world’s largest industries, Mediaocean, an integrated media procurement technologies provider, Echo Global Logistics, a technology-enabled transportation and logistics outsourcing firm and InnerWorkings, whose focus is on providing managed print and promotional solutions globally. He is also an avid philanthropist as well as academic. For more information, visit lefkofskyfoundation.com.
Tempus provides DNA/RNA genomic sequencing services molecular and therapeutic data analysis. It offers an interactive and analytical machine learning platform through which it enables physicians to deliver personalized cancer care for patients. The company’s goal is to provide physicians with tools that learn as Tempus gathers more data and enable each patient to benefit from the treatment of others who came before. For more information, visit tempus.com, “Tempus Labs” on Facebook and @TempusLabs on Twitter.