Shedding light on the CAR-T space – research, clinical activity and targets of interest

We experienced a phenomenal level of interest in our recent webinar on the topic of identifying rising star’s in the CAR-T space and we received a lot of follow-up questions. Many of these revolved around the current CAR-T landscape and inquiries for data-driven insights to feed into your organizations. Because of this, we wanted to follow up with a blog post in which we aim to address at least a few of them.

CAR-T - which involves removing and genetically engineering a patient’s T cells, then infusing them back into the person’s body - has been celebrated as a breakthrough technology. And for many, it is considered one of the most promising cancer treatments. To this day, the global research community has mainly focused their efforts on studying the CD19 molecule as a target antigen. However, it was only recently that an exploratory study at Stanford underscored that there’s substantial promise in expanding the scope of targets beyond CD19. Crystal Mackall, one of the leading expert in the field at Stanford University recently told the New York Times that

“It’s important to understand that CD19, for all its remarkable effect in offering a beacon for cell therapies, is not some kind of unicorn (…) The idea that we could have one magic bullet is naïve”

So, which targets - other than CD19 - are experts in the field investing time and resources in and which hold the greatest potential? Which indications are CAR-T expert most frequently evaluating? Where is the most cutting-edge research being performed and by whom? To many, the state of the CAR-T landscape is shrouded in mystery. In this blog post, we try to turn a few stones and shed some light on a some of these questions.

A rapidly expanding research space

The field has grown rapidly over the course of the last few years as research in the area started to really take off in 2014. Since then, the number of published peer-reviewed articles in this space has grown at an astonishing CAGR of 90% with a geographical dominance in the US and China.

Similarly, the rate at which CAR-T trial are initiated has been growing exponentially. In 2017 alone, more than 100 CAR-T cell trials were started, most of which were Phase I studies. So far, the lion’s share of all trial sites are in the US, followed closely by China. The trial activity in Europe however, is considerably lower with less than 15% of all initiated trials.

It is obvious that the field is continuing to evolve at a swift pace and with that the target scope expands. As noted before, research is no longer only geared towards CD19-targeted therapies. With this in mind, we were interested in learning more about which targets that CAR-T experts are most frequently work with.

The targets of interest

As expected, CD19 tops the charts as more than half of all CAR-T expert have experience in working with this target - followed by CD20, CD22, CD30 and BCMA, ROR-1 and TACI.

Originally, the idea and treatment was envisioned as a treatment for solid tumors but the CAR-T approach has proven efficacy in a range of cancer types. Early indications for CAR T-cell therapy included melanoma, gynecologic cancers and neurological malignancies (source). However, the most success reported so far has occurred in hematologic malignancies and the potential for CAR-T spans across many indications. But which cancer types are most researchers working within this space?

Investigated indications and deal activity

We have dug into the global expert landscape and executed an analysis of each CAR-T publication and their authors. As displayed in the diagram below, most experts in the field have a history of executing research within different types of blood cancer. Most notably within acute myeloid leukemia followed by acute lymphoblastic, chronic lymphocytic leukemia and squamous cell carcinoma.

Without a doubt, we’re on the brink of a new era in the treatment of cancer. A fact well reflected in the deal activity within the space. Novartis was the firm big pharma to enter in 2012 through its alliance with the University of Pennsylvania, but has since been joined by a number of actors. It was only a few weeks ago that Celgene finalized its acquisition of Juno Therapeutics for $9B, in its quest to become a preeminent cellular immunotherapy company. This took place only a few short months after Gilead bought Kite Pharma for $11.9B.

With only a few hundred patients ever treated with their therapies, the accumulated $20B represents a lot of promise in both their lead products and the space itself. But this is only the beginning, and the pace at which novel leaps forward are made makes it increasingly important to identify and partner closely with the right external stakeholders to stay ahead in the intense competition.

What impact do you think CAR-T will have on the future of cancer treatment? Reach out to us to share your thoughts and subscribe to our newsletter - this way you can make sure you don’t miss future posts!