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The future of immuno-oncology drug development majorly relies in the combination therapies, where immunotherapy modalities are tested in rational combinations with other immunotherapies or targeted therapies for synergistic effects. Combination immunotherapy has the potential to deliver long-term survival benefits that may be unavailable with current approaches.
 
As other types of immunotherapy classes eventually saturate the immuno-oncology market, new developers are looking for ways to differentiate themselves by investigating various combinations of immuno-oncology treatments, with either other immuno-oncology or non-immuno-oncology products.
 
According to the new report of RNCOS “Immuno-Oncology Market, By Type [mAb (Naked, Conjugate), Cancer Vaccines, Immune Checkpoint Inhibitors (PD-1, PD-L1, CTLA-4]), By Application (Lung, Melanoma, Leukemia, Lymphoma) - Global Forecast to 2022,” various companies are exploring effective combinations of immunotherapy with chemotherapy, other immunotherapy or targeted therapy. Roche is developing the biggest number of combination therapies, followed by Merck, Bristol-Myers Squibb, and Novartis. AstraZeneca is also exploring novel combinations of immunotherapies based on innovative antitumor strategies to fight a wide range of cancers. Indeed, AstraZeneca has the most late-phase combination trials, investigating its internally-owned immuno-oncology combination product in a number of cancers.
 
One of the rapidly emerging trends is the evaluation of combinations of immunotherapy (with two immune checkpoint inhibitors, an immune checkpoint inhibitor and a small molecule targeted therapy, or an immune checkpoint inhibitor with chemotherapy, radiation therapy, or peptide vaccines). Many targeted therapies modulate immune response (eg, T-cell proliferation and responsiveness to tumor antigens). This makes them attractive candidates for combination with immunotherapy because of the potential for additive effects. Small molecules, including BRAF- and MEK-inhibitors, have shown a number of immunomodulatory properties that could improve response to checkpoint inhibitor therapy, such as inhibition with PD-L1. Moreover, clinical trial collaborations to evaluate immune checkpoint inhibitors as combination therapies are very common. For instance, 12 such collaborations for a number of molecules were observed in 2014.
 
Such novel combinations will allow late-to-market entrants to achieve significant sales in the coming years.
 
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