The cancer medicine industry is going all out
Drug developers are investing billions to create cancer-targeting medications, similar to guided missiles.
Most of the focus and progress has been on antibody-drug conjugate therapies, which aid in the delivery of chemotherapy directly to tumors: Last year, the field became even hotter when Pfizer acquired biotech Seagen Inc. for $43 billion.
Another idea that is quietly gaining traction is radiopharmaceuticals. Recent months have seen an uptick in dealmaking as a result of increased interest in this field. A radioactive particle, rather of chemotherapeutic medications, is administered to the patient together with a chemical that can target tumor cells; this concept is comparable to ADCs.
Although the technology is still in its early stages, it has the potential to play a pivotal role in the battle against cancer in the next ten years or so, thanks to a continuous increase in venture capital funding and acquisitions by major pharmaceutical corporations.
For many years, radiation has been an integral part of cancer treatment, with over 50% of patients undergoing radiation therapy. Typical procedures include the use of equipment that emit powerful radiation beams capable of penetrating deep into the body and destroying cancer cells. Unfortunately, external radiation is only effective on smaller, more confined tumors and can harm healthy tissues in the vicinity.
Radiotherapy has been the subject of drug company experiments for quite some time, but the industry as a whole has failed to materialize. Novartis, a Swiss pharmaceutical corporation, piqued interest in 2017 with two acquisitions valued at multibillion dollars.
In 2022, the FDA authorized Pluvicto, a medicine that Novartis acquired in one of those acquisitions, for a subtype of advanced prostate cancer; the drug was sold for $980 million last year. By 2027, according to the analysts surveyed by Visible Alpha, sales will have reached $3 billion.
Rival companies are now investigating precision therapy in an effort to replicate Novartis’s success. A few months after RayzeBio’s IPO, Eli Lilly paid $1.4 billion to acquire the startup, and in December, Bristol-Myers Squibb agreed to pay $4.1 billion to acquire the company.
Two other firms made substantial proposals, according to RayzeBio’s proxy statement. The recent skyrocketing stock prices of Fusion Pharmaceuticals and Perspective Therapeutics can be attributed to this encouraging development for other biotechs operating in this field.
The supply chain poses the greatest threat to the radiopharma industry. Dedicated nuclear reactors or generators create radioactive isotopes, which are subsequently transported to a manufacturing facility and fused with a molecule that targets specific cells. Before the product can be sent to clinics, it must first be tested and packed. Due to the rapid decay of the medicine’s radioactive components, accuracy and speed are of the utmost importance.
According to Zhiqiang Shu, a biotech analyst at Laurion Capital Management, the recent acquisitions between Eli Lilly and Bristol were partly driven by the desire to obtain production capacity and isotopes, which are in short supply, as a result of the intricacies of the supply chain.
While the medications now approved by Novartis use beta-emitting isotopes, he predicted that alpha-emitting isotopes, which are more concentrated and perfect for targeted therapy, would be the focus of the next wave of innovation in radiopharma.
Last year, Novartis’s Pluvicto ran out of stock due to manufacturing issues; however, according to Victor Bulto, president of the U.S. unit at the company, the capacity to manufacture 250,000 doses this year should be more than enough to satisfy patient demand, thanks to the new facilities that have come online.
The fact that this method can be used for both diagnosis and treatment is a positive feature. Doctors can detect cancer in the body by injecting a substance that is identical to the medication and produces an energy that scanners can detect.
The speaker, Bulto, said that one could obtain “very granular intelligence of where the bad guys are” by drawing on a military comparison. Patients often experience metastases to other areas of the body, which can go untreated, therefore that is crucial. The rapid elimination of the medicine through urine, as opposed to biologics like ADCs, is another major benefit, according to Bulto. This could result in a less severe side effect profile for patients.
It is possible to enhance patient outcomes by combining radiopharmaceuticals with ADCs, two components of a larger arsenal of cancer treatments. Puja Sapra, who heads Biologics Engineering & Oncology Targeted Delivery at AstraZeneca—a frontrunner in ADCs and a partner in Fusion’s radiopharmaceutical development—said that a lot of the research that has improved ADC capabilities is now going into radiopharmaceutical development.
The objective, she continued, is that “in the future, instead of chemotherapy or external beam radiation, patients will be treated with an antibody-drug conjugate or a radio conjugate or combinations of these therapies.”
To uncover the full potential of these treatments, we must invest billions of dollars and years of research. We are not yet there. The pharmaceutical industry, however, is unlikely to lose interest in developing more precise cancer targets.
