Immunotherapies were back in the spotlight at the European Society for Medical Oncology’s congress this year, but its limitations are prompting a strategic realignment.
Back in style
Our analysis of last year’s ESMO congress discovered a notable focus on the emergence of novel therapeutic modalities, in particular antibody-drug conjugates (ADCs) and radioligand therapeutics (RLTs).
By comparison, our analysis of 501 English-languaged articles around this year’s ESMO found that at this year’s meeting, immunotherapies roared back into the spotlight:
And the reason for this was Merck’s Keytruda and Bristol-Myers Squibb’s Opdivo.
It was exactly 10 years ago that they were approved in their first indications – so the pervading theme was a reflection on all that the drugs have done, and all that immunotherapy still needs to achieve.
This made them the two most-talked-about drugs in the media debate:
The conference included a decade’s worth of data from some of the early Keytruda and Opdivo trials, with the takeaway being that roughly 50% of patients with metastatic melanoma will now survive over the long term.
Many articles called this result “a major change in cancer care”.
Another piece of notable immunotherapy news was AstraZeneca’s Imfinzi significantly extending survival for patients with muscle-invasive bladder cancer.
This was what helped AstraZeneca rank among Merck and Bristol-Myers Squibb as the most influential companies:
Array of challenges
But the media debate around the conference, while celebrating the progress, also noted the range of challenges that remain.
The most common criticism was its immunotherapy’s long-term efficacy and durability. While it has shown long-term survivorship benefits in cancers like melanoma, concerns were raised about its inconsistent effectiveness across different cancer types like triple-negative breast cancer are still being evaluated, with some data suggesting less pronounced benefits compared to other treatment options.
Another issue was immunotherapy’s limited applicability due to specific biomarker requirements, leading to concerns about patient accessibility and inclusivity.
For example, AstraZeneca‘s study on TROP2 as a predictive biomarker for non-small cell lung cancer treatment shows that only patients with high TROP2 expression significantly benefit from specific therapies like datopotamab deruxtecan.
There were also critiques regarding the interpretation of clinical trial results that emphasize progression-free survival (PFS) over overall survival (OS). Some studies presented at ESMO showed significant PFS improvements while overall survival data remained negative, raising questions about what constitutes “practice-changing” results in immunotherapy research.
The bottom line
Despite the practice-changing influence of immunotherapy over the past decade, optimism that a new generation of checkpoint inhibitors that offer similarly meaningful improvement over the standard of care will emerge appears to be lower than when we last analysed the immuno-oncology debate in 2022.
This sentiment has catalysed a strategic pivot in oncology towards multi-drug, multi-modal approaches, aligning with a broader industry narrative that prioritises the strategic orchestration of various treatment modalities over reliance on individual drugs.
For pharma PR and comms teams, the challenge is to communicate this evolution effectively, framing immunotherapies as critical components of a larger, more comprehensive treatment strategy.
This repositioning aligns with the industry’s move towards personalised, precision medicine, signalling a future where robust patient outcomes are achieved through tailored, collaborative treatment plans rather than one-size-fits-all solutions.