Cancer drug developments follow a rather predictable course.
A new breakthrough is followed by a flurry of interest as the large pharmaceutical companies develop drugs to target the finding. More often than not, however, the drug companies all develop the same drug or something so close that they can’t be distinguished in activity or toxicity.
With signal transduction inhibitors, the targeted agents that focused on specific mutations, not one or two but three, four or more drugs all targeted the same mutation.
The result – cancer patients were presented with a panoply of "me too" drugs.
The use of immunotherapy in cancer, nothing short of a breakthrough, has again boiled down to redundancies as biotech companies scramble to develop their very own checkpoint inhibitors. There are now hundreds of clinical trials comparing one checkpoint inhibitor combination to another.
Cancer Research Scientist Weighs In
This was the subject of a recent commentary by Dr. Jay Bradner, President of the Novartis Institute for BioMedical Research whose prior seminal work provided the first ever agent to inhibit the MYC oncogene.
His work led to an entirely new class of drugs for cancer therapy, a class of drugs that we have found active in many human tumors as we reported last year. (Nagourney RA et al Proc. AACR, 2017)
The reason Dr. Bradner's comments regarding "me too" drugs are so important is that he had the guts to take on the tough problem of drugging an “un-druggable” cancer gene and won. Now as a leader of one of the largest biotech companies, he is to be commended for standing up against the current trend.
Bradner states the biotech industry is not over-invested in cancer medicine, just wrongly invested.
One need only examine the current field of cancer drugs to realize they all boil down to just a few classes of agents.
Like waves emanating from a splash in the water, one advance leads to innumerable “copy cats” emanating from the same discovery. We don’t need more "me too" drugs; we need more novel, active agents with efficacy against the difficult targets.
Our laboratory has the luxury of comparing one drug to the next in the same patient’s tumor.
The Big Question
In our experience a large number of the drugs that target specific oncogenes so closely mimic one another that they are virtually indistinguishable.
The question one must ask is - why are we spending billions of dollars for these duplicative efforts?
Cancer drug discovery is so sophisticated that few people can understand its complexity.
The biotech companies have tended to chase the low-hanging fruit, first with tyrosine kinase inhibitors and now with immune checkpoint inhibitors, but in reality they are often competing for the same niche.
What We Need
If we are to see meaningful advances in cancer, we will need to dedicate more time and effort to the development of drugs with novel mechanisms of action directed against the processes that actually drive cancer.
We don’t need more “me too” drugs.
As always, I appreciate your thoughts and comments.
Dr. Robert Nagourney, has been internationally recognized as a pioneer in cancer research and personalized cancer treatment for over 20 years. He is a TEDX SPEAKER, author of the book OUTLIVING CANCER, a practicing oncologist and triple board certified in Internal Medicine, Medical Oncology and Hematology helping cancer patients from around the world at his Nagourney Cancer Institute in Long Beach, California. For more info go to NAGOURNEYCANCERINSTITUTE.COM