What to Expect in Cancer Immunotherapy in 2021: COVID-19, Biomarkers, and Clinical Trial Design

Cancer immunotherapy’s positive impact in the clinic continues to grow, playing a contributing role in the recent announcement of the largest recorded one-year drop in cancer mortality.

Unfortunately, immunotherapy still doesn’t work for most patients. But we’ve barely even scratched the surface when it comes to taking advantage of the immune system’s power against cancer. There are teams of dedicated doctors and scientists tackling the most important unanswered questions in the field, and this provides hope when it comes to realizing more of immunotherapy’s potential for patients.

To get a better idea of where the field is, and its trajectory over the next year, we invited Kunle Odunsi, MD, PhD—the director of the University of Chicago Medicine Comprehensive Cancer Center (and recent former deputy director of the Roswell Park Comprehensive Cancer Center) and an associate member of the Cancer Research Institute (CRI) Scientific Advisory Council—to join us for the first installment of 2021 in our “Cancer Immunotherapy and You” patient education webinar series.

In 2020, people with cancer and those caring for them had to confront an additional foe: COVID-19. Odunsi explained that people with cancer are more likely to have severe cases of COVID-19 if they become infected by the SARS-CoV-2 coronavirus. That’s because cancer, as well as certain types of cancer treatments like chemotherapy, can suppress the immune system and weaken its protective ability, including against viruses.

Odunsi praised the approval of two mRNA vaccines against COVID-19, which he believes will benefit people with cancer, including those still undergoing treatment. He cautioned that we still don’t have an overwhelming amount of data on how patients react and that patients should always consult their oncologist. Nevertheless, he saw no reason why the vast majority of people with cancer would be more likely to experience a negative vaccine reaction.

As the end of the pandemic now appears to be within sight, Odunsi shared his immense pride in his colleagues and the field as a whole. “The scientific community has risen up to the challenge with unprecedented collaborative efforts, unprecedented new ways of thinking about how we take care of cancer patients.”

Regarding efforts to improve cancer immunotherapy, Odunsi highlighted new applications for checkpoint inhibitors and adoptive cell therapies being explored in clinical trials.

To maximize immunotherapy’s benefits, especially when it comes to the finding the right therapeutic combinations for individuals, doctors will need to develop biomarkers that more accurately reflect the complex relationship between cancer and the immune system.

The designs of cancer clinical trials are starting to adapt, making it easier for doctors to look for specific biomarkers. Wider adoption of these sampling approaches, including the use of blood tests, will help us hone in on important insights that can be used to improve clinical care and pave the way for the next generation of immunotherapies.

New technologies, and the speed and depth of analyses they can provide, are also key.

“Because technology has advanced so much, we can understand a whole gene expression profile of a tumor within a matter of a few days,” said Odunsi. “By incorporating all of those types of technologies in our clinical trials, that will accelerate the pace by which we discover biomarkers.”

“This whole area of identifying biomarkers is so crucial, because if we find a biomarker, let's say in ovarian cancer, maybe it will help a patient with colon cancer, or with kidney cancer,” Odunsi continued. “We can deploy knowledge of biomarkers to say, even if this is a rare cancer, it has this genetic feature, or it has this molecular feature. Therefore, it should respond to this or that type of immunotherapy.”

To learn more about this what might be in store for cancer immunotherapy in 2021, be sure to watch our full-length webinar with Dr. Odunsi, and for more on other cancer immunotherapy-related insights, watch our past CRI webinars.