The amazing and strange complaint against an industry often suspect of economizing on research to fund marketing efforts, but some of the executives and the scientists say the drugmakers are doing too many clinical trials in the hot new field of immunotherapy.
The first wave of the immunotherapy is dominated by the Merck and Bristol-Myers Squibb with their “checkpoint inhibitors”. This release brakes in the immune system so that it can attack tumors. Roche, AstraZeneca, and Pfizer are trying to catch up by the introduction of opposing varieties. Almost $9bn worth of these checkpoints has been sold since they went on sale two years ago.
The enthusiasm for the medicines has set the way for the determination to push response rates higher than before. The minority of the 20 to 30 percent of patients respond well to drugs, living for months or years longer than their doctors would expect. The majority derive no benefit.
Jill O’ Tormey, chief executive of the Cancer Research Institute said: “There is some pushback, are there too many trials? Are we just throwing spaghetti at the wall, by taking compound ‘X’ or ‘Y’ and adding it together just to see what happens?”
Most of the scientists say checkpoints do not need to replace with something else. The new drugs can further cajole the immune system into fighting cancer. This has led to an extraordinary amount of clinical research sponsored by drugmakers, which are combining checkpoints with other medicines to try to find a magic bullet to treat cancer.
Almost 800 clinical trials involving a checkpoint are under the way in the US. The government database gives information that more than 700 clinics are testing drugs in combination with one or more additional medicines. This compares with about 200 in 2015.
Dr. Israel Lowy, a vice president at Regeneron said: “We fully recognize there are others out there, but we decided our own because we felt it was a necessary ingredient, we wanted the flexibility to trial it in combinations.”
“There is a lot of room to improve if we do come up with the right combination. That’s the future. We are only at chapter one in the book of immunotherapy.”