8APRIL - 2023TECH OUTLOOKTHE CANCER IMMUNOTHERAPY TREATMENT PARADIGMBy Charles Drake, M.D., Ph.D., Vice President, Immuno-Oncology, The Janssen Pharmaceutical Companies of Johnson & Johnson [NYSE:JNJ]IN MY OPINIONPlease comment on your current role and responsibility in leading the cancer immunotherapy research and development at Janssen? I lead the immuno-oncology team at Janssen where our efforts are focused on the discovery and development of next-generation approaches to immunotherapy that include antibody-based drugs, cell therapies, and novel cancer vaccines. One especially promising approach that we are working on is allogeneic cell therapy, derived from induced pluripotent stem cells (IPSC). The objective is to convert these IPSC into immune cells that can fight cancer by engineering them ex vivo. This is incredibly significant as these stem cells can grow perpetually in culture, becoming a potentially inexhaustible source for treating cancer in a wider array of patients.What are some of the challenges you have witnessed in the cancer immunotherapy space, and how do you align yourselves accordingly?There are a number of challenges involved in bringing cancer immunotherapy to the patients that could benefit. One major difficulty is translating laboratory data into clinical data, i.e. predicting which agents will work in patients as our current models are reasonable, but far from perfect. Take for instance lymphocyte activation gene-3 (LAG-3), which was discovered as an immune checkpoint in 2004, showing that it was synergistic with anti-PD-1 in terms of anti-tumor effects. Those studies were performed in animal models in the first line setting. But when this drug was taken to the clinic, it was tested after initial therapies, i.e. mostly in the second and third line settings. So, its activity was not impressive. Finally, after many years, the clinical studies were aligned with the initial murine studies, i.e. the anti-LAG-3 / anti-PD-1 combination was tested in the first line in patients with melanoma. Those data were impressive, the combination doubled progression-free survival, leading to approval. On the other hand, there have been a fairly large number of trials in which promising laboratory results just did not pan out as expected. Take for example T cell immunoglobulin and ITIM domain, or TIGIT, where laboratory studies targeting TIGIT were quite impressive. Beyond that, a reasonably-sized randomized clinical trial in patients with lung cancer showed Charles DrakeCharles Drake is VP, Immuno-Oncology at Janssen Pharmaceutical Companies of Johnson & Johnson. Prior to Janssen, Dr Drake was the Director of Genitourinary Oncology, Co-Director of the Cancer Immunotherapy Program, and Associate Director for Clinical Research at New York-Presbyterian/Columbia University Irving Medical Center. Dr Drake's areas of expertise include immunotherapy and the diagnosis and treatment of cancers of the prostate, kidney, bladder, and testes. His work focuses on using the power of the immune system to fight advanced-stage cancers. He is known for rapidly incorporating discoveries made in the research lab into innovative clinical trials, including antitumor vaccines. His most recent work has focused on the body's immunological response to radiation therapy and how immunotherapy and radiation therapy can be used in concert to treat cancer.
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