If medicine developers are to invest heavily in immunotherapy, oncologists, authorities and insurers need clear guidance on who will benefit
By Pierre Meulien, IMI Director
CAR -T and the 'knowledge gap'
It wasn’t obvious at first what a public-private partnership could bring to cancer research, not a neglected disease area by any stretch of the imagination. But it became apparent that companies were ready to bet their portfolio on investing in immunotherapy, and there were still outstanding questions about why only some people respond to treatment.
In the case of CAR-T technology, which entails the manipulation of a special set of immune cells that can kill cancer cells, some patients respond amazingly and are even cured. However, other patients die as a result of the treatment, and for others it’s about as effective as a sugar pill.
If someone had told me four years ago that IMI would do a topic on CAR-T, I wouldn’t have believed them because the field was so competitive, but that’s when we found a knowledge gap. The pharmaceutical companies had hit a brick wall. Oncologists were unsure if they could use the very expensive new therapies. They, along with health authorities and insurers, were put in a situation where an extremely expensive therapy could end in treatment-related death. The market responded; the pharma companies realised they needed to solve this problem and solve it together in a pre-competitive space.
"Cancer looms large in the imagination"
IMI has only recently begun to fund research on immunotherapy-related topics. So far in the whole of IMI we have funded 11 projects in cancer, and the last two funding calls could result in three more. We want to look at tumour microenvironment, the environment they create around themselves that helps them grow and evade host anti –tumour responses. There are many different tumours with different microenvironments, and a lot of data has been produced. If the private sector partners pool their data, there’s much we can learn from it to advance the field for all. Again, this is a problem that no one company can solve on their own.
Chronic obstructive pulmonary disease kills more people than cancer, but cancer looms large in the imagination because it can strike down young people in their prime. That’s why the first mission in Horizon Europe is going to be on cancer. There’s a huge expectation that IMI will be contributing to that mission, and that it will help to defragment the cancer ecosystem in Europe, which I think is a good thing.
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