Immune effector cell (IEC) therapies, commonly referred as cell therapies, utilize human cells to cause or enhance an immune response against tumor cells. Following remarkable successes with several patients in the early 2010s – most notably, the case of Emily Whitehead, the first pediatric CAR-T patient, who recently celebrated 10 years of being cancer-free – IECs have become a key focus of investigations to help treat multiple types of cancer, resulting in several approved therapies and hundreds of ongoing trials.
Here, we briefly define the four main groups of IECs currently under research: chimeric antigen receptor T cells (CAR-T), engineered T cell receptor (TCR) T cells, tumor-infiltrating lymphocytes (TILs), and natural killer (NK) cells, with a view towards advantages and disadvantages of each approach.
CAR-Ts: the first and currently only approved IEC therapy, autologous CAR-Ts take advantage of the patient’s own T cells to fight the tumor. Circulating T cells are collected and engineered ex vivo to express a customized receptor, the CAR, which recognizes and binds to a surface protein (antigen) in the tumor cell, inducing cell death.
CAR-Ts can also be generated from allogeneic sources (i.e., T cells collected from healthy donors rather than the patient’s own T cells), reducing costs and shortening time to treatment; however, allogeneic cells require additional precautions to prevent graft vs. host disease. Data for allogeneic CAR-Ts remains in the early stages, and no allogeneic CAR-Ts have been approved so far.
TCR Ts: as in autologous CAR-Ts, T cells are collected and engineered ex vivo, in this case, to express engineered TCRs. The chosen receptor usually derives from a library of endogenous TCRs that are known to target tumor-associated antigens.
TILs: unlike CAR- and TCR-Ts, TIL therapies are not engineered to target a specific antigen; instead, they are naturally occurring T cells with antitumor activity. TILs are collected from a solid tumor sample, separated from the tumor cells, expanded ex vivo, and tested for tumor recognition. The lymphocytes (T cells) that successfully target and kill tumor cells are delivered back to the patient.
NK cells: a rapidly emerging field in IEC, NK cells play a role in immunosurveillance and are guided to tumor sites by chemokines and their associated receptors. NK cells do not naturally express TCRs but could be engineered to express TCRs or CARs.
There are now six autologous CAR-T therapies approved by the FDA, all of which target either CD19 (for ALL and non-Hodgkin’s lymphoma) or BCMA (for multiple myeloma). These therapies have demonstrated high and durable response rates in late-stage diseases, which are likely to be cures in some cases.
All these successes have come in hematologic malignancies, but even in those indications, less than 50% of patients achieve long-term remissions. Therefore, there is substantial room for improvement, and many next-generation approaches are under investigation, including multi-antigen targeting, resistance to immunosuppression, and checkpoint inhibition.
New approaches aim to both improve outcomes in hematologic malignancies and drive meaningful efficacy in solid tumors, which are more complex and difficult to treat. Furthermore, cost and time requirements will drive advances in allogeneic, off-the-shelf products and point-of-care manufacturing with the goal of expanding accessibility of these life-saving therapies.
To facilitate understanding and tracking of the complex and rapidly growing field of IEC therapies, SAI’s team of experts has developed CellTraQ, a comprehensive database of cell therapy assets and clinical trials. Whether you want to discuss our strategic consulting capabilities in Oncology or discover the power of CellTraQ, please contact us today.
CellTraQ data search of oncology studies involving T and NK cells divided by tumor type.
SAI MedPartners has recently taken on a strategic investment from Northlane Capital Partners, a leading private equity firm focused on the healthcare sector. This investment will provide growth capital to enable SAI to accelerate key initiatives to strengthen our client engagement model, augment our suite of services and further expand our global footprint.
I really believe we had reached an inflection point in our journey, which has been characterized by rapid expansion and double-digit revenue growth for over a decade. Our established global footprint, leadership position in the core strategic intelligence offering, and portfolio of nascent new offerings will all benefit tremendously from the additional capital and thoughtful external perspective that this partnership with NCP brings.
From a strategic perspective, the growth capital will help us become a better thought partner and allow us to broaden the range of services that we can provide to our clients. Since our inception, SAI has been laser-focused on keeping clients apprised of threats and opportunities within the competitive landscape in which they operate. However, our clients are increasingly seeking partners who can also incorporate other elements of decision support such as forecasting, market access, and pricing strategy development. In short, clients seek partners which can provide a more strategic perspective that incorporates many of these elements. And while we have already developed some of these internal capabilities to fulfill our clients’ needs, we see a fantastic opportunity to deploy capital to accelerate that effort.
Clients can, first and foremost, expect the same level of commitment, responsiveness, and high-quality strategic intelligence partnership which they have come to expect over the years. Beyond that, our new partnership will accelerate critical initiatives which will enable more effective client engagement tools, knowledge-based content assets, and additional services. The acceleration of IntelliTraQ 2.0 (our proprietary portal platform) and additional content data assets to augment our exciting CellTraQ and GeneTraQ data offerings are only two examples. Our clients are looking for a smaller number of strong partners to support their strategic planning needs effectively and broadly. The capital deployment capability of NCP’s investment will enable us to do that.
SAI’s foundation and success in the market are, and always have been, built on the exceptional talent, experience, and passion of our team. As we look to expand our offerings, the additional capital we now have available to us will support the aggressive acquisition of talent specific to different functionalities and strengthen our key therapy area teams. SAI is committed to continuing to build deep functional and therapy area expertise in key areas of growth within the pharmaceutical sector from a human capital perspective. We are excited that Northlane Capital shares our vision to invest in the recruitment and retention of the very best talent available.
Within our competitive set, Asia is a strategic differentiator for SAI which allows us to provide a truly global support capability that is unique and of tremendous value to our clients. There really is no other competitive intelligence provider that has a comparable footprint in the region which, for us, is anchored in our team of over 40 full-time employees between our Beijing and Shanghai offices. Our new partnership with NCP provides an opportunity to “double down” on our Asian leadership position by expanding the range of functional offerings to our clients in China and promoting further geographic expansion into Japan and other markets within Southeast Asia.
As an organization, we are intensely focused on the execution of our three-year plan to drive growth along three dimensions. First, we are doubling down on the investments we have made in our TheraTraQ content databases, IntelliTraQ platform, and syndicated offerings. Second, we are expanding our adjacent offerings in forecasting and portfolio strategy, market access and pricing strategy support as well as targeted qualitative market research. Third, we are aggressively growing our geographic footprint, particularly looking at Japan, South Korea, Taiwan, and Singapore. Our ultimate objective is to firmly establish SAI as one of the world’s leading broad-based strategy support partners for our clients. Successful execution of the three-year plan will take us a long way toward achieving this goal.