Thirty years ago, cancer therapy relied heavily on well-established methods of treatment such as surgery, chemotherapy and radiation therapy. While these treatments were effective to an extent, they lacked the ability to be targeted with precision and often caused significant damage to healthy cells in the process.
However, as the understanding of the science of cancer deepened, so too did the ability to develop more targeted and personalised treatment strategies. The decoding of the human genome in 2000 was a key breakthrough in this regard and was followed in the mid-to-late 2000s by the approval of a range of targeted therapies designed to exploit specific genetic mutations or molecular pathways driving cancer growth.
The 2010s then witnessed a flurry of ground-breaking developments that continue to reshape the landscape of cancer therapy. Among the most notable advancements were the introduction of CAR-T cell therapy and checkpoint inhibitors, which represented significant leaps forward in the field of immunotherapy.
CAR-T cell therapy involves reprogramming a patient's own immune cells to recognise and destroy cancer cells, while checkpoint inhibitors work by blocking the cancer cell’s ability to protect itself against the host’s immune system, thereby releasing the brakes on the immune system and allowing it to mount a more effective attack against cancer cells.
In 2024, the speed of progress in cancer therapy shows no sign of slowing down. In fact, the pace of innovation in biotechnology more broadly continues to accelerate and recent progress in targeted therapies, immunotherapy and early cancer detection technologies continue to hold promise for further improving outcomes and transforming the way we approach cancer treatment.
Cell therapies such as CAR-T still rely on harvesting a patient’s own cells and modifying them, which has side effects for the patients meaning that it is only available to the sickest patients for whom other treatments have failed. Sadly, the complexity and time it takes to prepare the treatment from their own cells can mean that the patient often fails to survive long enough to benefit.
Biotech companies are now working on allogenic cell therapies, which use ‘off the shelf’ donated cells, but have yet to find a way of creating a durable response in patients to this type of therapy. This next generation of cell therapies could radically simplify the treatment of advanced cancer, making it more readily available to these very sick patients.
While biotech companies have been reasonably successful in developing targeting therapies for certain cancers such as blood, lung and breast cancer, other solid tumour cancers such as liver and pancreatic are still treated in the same way they have been for decades. Finding a targeted treatment that is effective in solid tumours would represent a huge breakthrough for our sector and many companies are working on potential solutions.
The future, therefore, looks encouraging for cancer patients and for investors in biotechnology. Patent protection allows the developers of genuinely life-enhancing therapies to be ultimately well-rewarded for the risks involved with developing their technology through to commercialisation.
The expiry of patents means more patients can access generic drugs globally and makes them cheaper for society as a whole. Patent expiries fuel pharmaceutical companies’ hunger to replace lost revenues by investing in new drugs either by buying or licensing in individual projects or acquiring biotech companies.
This ecosystem ensures the flow of pharmaceutical revenues into biotech companies which ensures access to funding for the next generation of innovation. Investors in biotech companies also benefit from the premium paid by pharmaceutical companies eager to add exciting new treatments to their pipelines.
Over the past 30 years, significant medical breakthroughs have transformed the landscape of cancer treatment, offering many patients the possibility of managing cancer as a chronic condition rather than a terminal illness. Clearly, the many complexities of cancer in all its forms mean not all patients have yet seen such an improvement in treatment outcomes, survival rates or quality of life. On balance, however, the progress in oncology has been – and indeed continues to be – overwhelmingly positive.
Investing in this area requires a nimble approach to focus only on those companies that hold the greatest potential for success. This requires careful monitoring of all companies in this space as incumbent drugs or even drugs still in development can quickly be outclassed by a newer drug with better potential.
However, looking ahead, the accelerating pace of innovation in oncology and biotechnology more broadly holds great promise for patients and investors alike. With continued investment in oncological research and development, we should hope to see even greater breakthroughs in cancer therapy in the years to come.
Ailsa Craig and Marek Poszepczynski are the portfolio managers of the International Biotechnology Trust. The views expressed above should not be taken as investment advice.