It’s no secret that combination studies featuring PD-1/PD-L1 checkpoint inhibitors and cancer vaccines have been popping up left and right. Now, an EP Vantage snapshot shows just how many trials are underway—and which drugmakers are leading the pack.
Released in conjunction with the annual meeting of the American Society of Clinical Oncology, EP’s report documents 16 vaccine combo trials for Bristol’s Opdivo in a variety of indications, including lung cancer, brain cancer, ovarian cancer, melanoma and others. Of the PD-1 and PD-L1 drugs included in the report, Opdivo is in more vaccine combo studies than competitors in the drug class from Merck, Roche, AstraZeneca and Pfizer.
Merck’s Keytruda ranks next, however, with 14 vaccine combo trials, in indications such as bladder cancer, prostate cancer, colorectal cancer and pancreatic cancer.
Still, vaccine trials are only a small fraction of the combo studies Merck and Bristol-Myers are pursuing for their blockbuster immunotherapies. Merck is running 268 total companion studies for Keytruda and Bristol-Myers has 242 in the works for Opdivo, according to the report.
AstraZeneca’s Imfinzi is in six vaccine combo trials, while Roche’s Tecentriq is in three, and Pfizer and Merck KGaA’s Bavencio is in one, according to EP Vantage. In combinations incorporating an oncolytic virus, Keytruda is in 11 studies, compared with three for Opdivo and one for Imfinzi.
As report author Jacob Plieth notes, there’s been a “sharp increase” in such combo studies over the last year and a half as neither cancer vaccines nor oncolytic viruses have registered major individual successes.
But, he wrote, “combinations could provide both with a bigger role, as long as the additive effect is greater than that of either monotherapy.”
The many combo studies mark something of a revival in the cancer vaccine world. After two late-stage cancer vaccine failures from Merck KGaA and GlaxoSmithKline left a cloud over the field back in 2014, a trial investigator for the latter study, Johan Vansteenkiste, said that a combo approach with checkpoint inhibitors may offer a path forward.
Since then, top drugmakers including BMS and AstraZeneca have inked partnerships to pair their checkpoint inhibitors with cancer vaccines from smaller biotechs Bavarian Nordic and Inovio. And they’re not alone, as the new report shows.
For the biotechs involved, success could mean big payoffs in the hundreds of millions of dollars. Back in 2015, BMS bet up to $1 billion to grab rights to Bavarian Nordic's Prostvac, with $60 million up front and up to $915 million in milestones. AstraZeneca's deal with Inovio is worth up to $727 million.