Cancer immunotherapy, which uses the body’s natural defense against cancer, has emerged as the next generation of treatment, with checkpoint inhibitors being the first type of treatment to be approved. In particular, the CTLA-4 inhibitor ipilimumab was approved in 2011. Since then, 5 PD-1/L1 molecules have been approved: pembrolizumab (2014), nivolumab (2014), atezolizumab (2016), avelumab (2017), and durvalumab (2017).
While there are still significant unmet needs in oncology, especially for metastatic cancers, there is high hope surrounding the potentially long-lasting clinical benefit of checkpoint inhibitors in most tumor types where they have been approved. Given this, we anticipate the landscape to evolve considerably over the next 5 years. While the next wave of checkpoint inhibitors (e.g., OX40, LAG3, TIM3, IDO1, etc.) is expected to arrive in that timeframe, PD-1/L1s will likely remain the backbone of therapies, with the new checkpoint inhibitors being used in combination. These agents hold both significant promise and high uncertainty for pharmaceutical manufacturers, researchers, prescribing physicians, and patients. This white paper provides an overview of how the advent of PD-1/L1 therapies has disrupted the stakeholder value chain in oncology.