Highlights of the European Society for Medical Oncology (ESMO) Immuno-Oncology Congress

Cancerous Cells

By Tarek Plaza, Senior Analyst (Health Advances GmbH)


  • Advances in immuno-oncology (IO) R&D are yielding great progress in cancer care and the field is rapidly evolving as the number of companies in the space continues to increase
  • Convergence of development efforts on key targets could potentially be slowing innovation, and companies launching drugs with incremental efficacy gains will need to seek new avenues for differentiation
  • Nevertheless, the IO opportunity continues to grow as new areas of R&D, such as targeting the microbiome, present new dimensions in cancer treatment

Leading oncologists convened for the Annual Immuno-Oncology (IO) Congress in Geneva, December 7-10th, to discuss the latest advances in the field. Extraordinary progress was reported in lung cancer and melanoma, and advances in IO continue to rewrite the standard of care for many cancers. Key highlights included an analysis of the global IO pipeline by the Cancer Research Institute (CRI)1, and the emerging field of microbiome in cancer drug development as introduced by Prof. Laurence Zitvogel’s keynote lecture.

A Growing Pipeline
An unprecedented number of new investigational agents and companies are entering the field of IO. The CRI database actively tracks over 2,000 IO agents in development, from 864 companies worldwide, and illustrates the enormous enthusiasm from industry (see figure below). The large numbers of promising experimental therapies, active clinical trials, and push for increased personalized medicine suggest we are entering a new era that could realize the potential of IO across a broad spectrum of cancer types.


Converging Efforts
While the fast-expanding IO field is met with great excitement, authors of CRI’s IO landscape analysis note a concern that future innovation could be hampered as development efforts converge on few targets. For instance, almost half of the 940 clinical stage agents identified modulate only 40 targets. Most notably there are 164 agents in development that target PD-1/L1, despite the fact that five drugs have already been approved with this mechanism of action. As drugs with incremental efficacy gains reach the market, companies will need to innovate in solutions that address the growing treatment complexity and demand for clinical decision support.

New Frontiers
The microbiome is one area of growing scientific interest in cancer research, and it was postulated during the conference to be a new frontier in cancer drug development. A growing number of studies support the understanding that the microbiome can modulate the response to cancer therapy and susceptibility to toxic side effects2. Such findings are sparking immense interest in the development of novel microbiome-based therapeutics, particularly as potential avenues to enhance the rate of sustained clinical responses to checkpoint inhibitors3.

In light of rapid progress and an expanding pipeline, companies in the space will need to monitor recent developments and align R&D efforts with areas of unmet need. Despite signs of convergence on key drug targets, the IO opportunity continues to grow as new frontiers, such as targeting the microbiome, open new avenues for R&D.

About The Author
Tarek Plaza is a member of Health Advances European Practice Area, which helps clients navigate through the diversity of European healthcare systems to optimize commercialization strategies of pipeline and in-market products.

1 www.cancerresearch.org/IO-landscape
2 www.ncbi.nlm.nih.gov/pubmed/28529325
3 www.ncbi.nlm.nih.gov/pubmed/29097494

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