Remember the good old days, when professors let you bring to an exam one 8.5″x11″ single-sided cheat sheet crammed with your tiniest scrawled notes about what you expected could be on the test? The landscape of immuno-oncology is changing so rapidly that in January I longed for a “cheat sheet” to keep up with the conversation. The problem is that nothing helpful was found through googling. So, I stayed up all night using my brain (and this list of FDA approvals) to create a simple one-page summary to visualize it all together.
This “cheat sheet” may be useful for others too, so I am sharing it with you. Download the printable PDF here and see my note about crowdsourcing updates below.
This selection of immunotherapy products was gathered through reading some reviews and painstakingly searching through FDA approvals from January 2010 through through December 2017. I include bi-specific antibodies, adoptive cell therapies, checkpoint modulators, cytokines, oncolytic virus therapies, and vaccines.
Color corresponds to manufacturers (n = 14) in the game right now. Their products (n = 20) are connected to the indications approved by the FDA through December 2017. Some products have many indications; some cancers have several immunotherapy products. The overview lets me quickly identify which cancers have more than one immunotherapy product available and eyeball how many manufacturers are currently competing in that market.
immuno-oncology drugs stimulate the patient’s own immune system to respond to the cancer
Notice the dynamics over time. Ipilimumab was groundbreaking in 2011, and it cost other companies years of lag time to catch up with that class of innovation. I find it interesting to observe companies marketing a single product with many indications (added over time) as compared to other companies that continue to innovate new products (with fewer added indications per product, so far). I read a report from PhRMA showing more than 240 immuno-oncology products in clinical trials.
The trend leads me to suspect that there was a spillover benefit from a breakthrough in knowledge in 2011. Spillover benefits occur when society or third parties benefit from the actions of others. Whether or not Bristol-Myers Squibb has been, or will be in the future, adequately rewarded for their innovation could be a hot debate.* Considering the high list prices at launch, I understand the huge incentive for pharmaceutical companies to invest in this area.
The trick to immunotherapy nomenclature
Dr. Elizabeth Duke at the Fred Hutchinson Cancer Research Center taught me her trick for extracting some meaning from the crazy names assigned to these immunotherapy products. The nomenclature gives us a clue about how the product is derived.
|Meaning (“the product is derived from…”)
It is hard to find a comprehensive and frequently updated list of immuno-oncology products online, and it would be impossible for me to keep this resource updated alone. I invite you to post a comment below if you have a correction, suggestion, or resource to contribute. If there is interest, I will periodically update data and and re-post the figure.
- Food and Drug Administration. Drugs@FDA Database. Accessed 11 Jan 2018.
- Food and Drug Administration. Hematology/Oncology (Cancer) Approvals & Safety Notifications. Accessed 11 Jan 2018.
- Geynisman D, Chien CR , Smieliauskas F, Shen C, Shih YC. Economic evaluation of therapeutic cancer vaccines and immunotherapy: A systematic review. Human Vaccines & Immunotherapeutics. 2014; 10:11, 3415-3424.
- Ben-Aharon O, Magnezi R, Leshno M, Goldstein DA. Association of Immunotherapy With Durable Survival as Defined by Value Frameworks for Cancer Care. JAMA Oncol. Published online December 28, 2017. doi:10.1001/jamaoncol.2017.4445
- Pharmaceutical Research and Manufacturers of America. Medicines in Development for Immuno-Oncology 2017 Report. June 2017.
*I am not supported by industry funding and have no conflicts of interest to declare at the time this post was written.
WARNING: THIS POST AND FIGURE PROBABLY HAVE SOME ERRORS AND WILL BE OUTDATED FASTER THAN CDER CAN SAY “PDUFA FIC BLA.”