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Over the past year, a variety of promising immunotherapy (I/O) treatments has risen to the forefront of biotech, creating an exciting set of implications surrounding this prevailing breakthrough in modern medicine.

Here is a quick look at current developments, failures and future projections surrounding 2018’s biggest I/O products.

 

Incyte’s Epacadostat

Though Epacadostat’s future is currently undetermined, the I/O product entered 2018 as one of the most anticipated treatments of its kind. The investigational drug had been intended as an inhibitor of indoleamine 2,3-dioxygenase-1 (IDO1), and had presented intriguing — albeit scrutinized — implications for treatment of melanoma patients in Q1 2018.

However, last month, Incyte announced that it would be ending its late-phase epacadostat program after a “pivotal failure of Keytruda combination,” a setback exposed during nine closely monitored phase 3 trials observing epacadostat in combination with Keytruda (by Merck) and Opdivo (by Bristol-Myers Squibb).

  • Projected Sales: Epacadostat originally enjoyed revenue projections of around $3 billion by 2020. However, it has since dropped to a best-case scenario of $600 million.
  • Current Clinical Trial Phase: Epacadostat has been withdrawn from phase 3 trials, back into phase 2.
  • Results (to date): The Keytruda-combination trial setback does not necessarily spell the end for Epacadostat, but they have challenged Incyte to be more thorough in future trials and mitigate previously unforeseen risks.

 

BMS’s Relatlimab

Bristol-Myers Squibb’s (BMS) Relatlimab is a Lymphocyte-activation gene 3 (LAG-3) drug designed to fight PD-1 resistance; it works by binding itself to LAG-3 on T-cells, stimulating these cells to attack cancer cells.

Relatlimab began to receive widespread attention when it entered late phase trials in Q3 2017. Like Epacadostat, the treatment saw early potential as a means of treating patients with advanced melanoma. It continues to be investigated, both alone and in combination with other treatments, as a potential treatment for several other types of cancer.  

  • Projected Sales: Hard-and-fast sales projections for Relatlimab are still generally undetermined.
  • Current Clinical Trial Phase: Relatlimab underwent a phase 1/2 study in late 2017, investigating its safety, tolerability, and effectiveness when paired with BMS’s other treatment, Opdivo.
  • Results (to date): Aforementioned trials found a general tolerance for the Relatlimab-Opdivo combination, in 68 melanoma patients – with around 11.5 percent of patients responding to the treatment. Currently, this study is undergoing a recruiting process to “further evaluate the combination treatments in patients with melanoma and other solid tumours.”

 

Nektar’s NKTR-214

Yet another I/O partner of BMS, Nektar Therapeutics has been developing its NKTR-214, a CD112 agonist that, like Relatlimab, stimulates the immune system’s T-cells and natural killer cells to attack cancerous tumours. Recently, Nektar has been noticeably proactive in scheduling a variety of trials testing NKTR-214 in combination with other treatments (among them: Opdivo, Keytruda, and Tecentriq).

  • Projected Sales: In March, Nektar’s stock was found to have significantly outperformed the industry’s average in a year’s time. However, this stock has fallen by nearly 25% in recent weeks – with some analysts projecting additional drops of up to 15%.

aramis-khorchidian-graph

A graph illustrating Nektar’s stock at the time of its March 2017 price drop (Yahoo Finance).

 

  • Current Clinical Trial Phase: Nektar commenced phase 1/2 studies on NKTR-214 last month, in which it tested the treatment in combination with its other I/O treatment, NKTR-262. The primary purpose of these trials was to evaluate the combination’s safety and tested patients’ tolerability.
  • Results (to date): Last month’s phase 1/2 results were presented at the American Association for Cancer Research (AACR) Annual Meeting 2018; they observed that “NKTR-262 and NKTR-214 combination demonstrated efficacy in a broad range of syngeneic tumour models with diverse histologies.” The study’s other conclusions can be found here

Previously, another phase 1/2 study, conducted last November as a joint effort with BMS, reflected a 91%                disease control rate among melanoma patients and an 85% rate for patients with renal cell carcinoma.