Immunotherapy is an area of cancer research that has attracted much attention in recent decades, and this has allowed it to gradually become part of the established arsenal for treating patients. As promising as cancer immunotherapy seems, it remains a fact that such treatments can be incredibly costly. With hefty price tags often hovering over US$150,000 per patient for treatment.
Nearly half of the 20 million people diagnosed with cancer in 2020 succumbed to the deadly illness, according to the International Agency for Research on Cancer. Moreover, the number of people suffering from the medical condition is expected to expand further to reach 25 million by 2030 and 30 million by 2040.
It is particularly striking that some regions are more affected by the disease than others. Asia has the world’s largest share of people diagnosed with cancer, understandably due to its huge population. Nonetheless, cancer is also on its relentless march in the rest of the world.
Cancer burden worldwide (2020–2040)
Given that cancer is one of the major public health challenges of the 21st century, it does not come as a surprise that scientists and academics have been intensifying their research into different types of cancer treatment in recent decades. Not only does research aim to improve patient outcomes, but it also creates national wealth through homegrown innovations in the field of oncology.
However, bibliometrics lay bare a significant discrepancy in research activities across countries. Larger nations, such as China and the US, and wealthy ones, such as Japan and South Korea, and a few affluent European countries like Italy, Germany and the UK, account for the majority of cancer-related publications.
CANCER RESEARCH OUTPUT BY COUNTRY (2020)
The promise of cancer immunotherapy
By stimulating the natural defenses of our immune system, which comprises a network of biological processes that protect the body against infections, tumour cells lurking in a patient’s body can be more easily located and eliminated. However, immunotherapy is not yet effective for all types of cancer patients living with the disease. As Johns Hopkins School of Medicine revealed, around 15 per cent of patients achieve durable results from the therapy.
While some people with melanoma, bladder, and lung cancers are likely to respond to the treatment, those with breast and pancreatic cancers rarely do so. Nonetheless, the still-low patient outcomes have not put a dent into the ever-growing body of scientific research into the various types of immunotherapies – such as vaccines, monoclonal antibodies, checkpoint inhibitors, cytokines, and chimeric antigen receptor (CAR) T-cell therapies.
Research output in the field of immunotherapy (1960–2021)
In the case of inoculation, two types of immunotherapy vaccines have been approved by the US Food and Drug Administration for the purpose of preventing cancer. One protects against the human papillomavirus (HPV), which is a sexually transmitted disease that can lead to cancers relating to the cervix, genitalia, and the back of the throat.
Another type of vaccine protects individuals from hepatitis B. Chronic hepatitis B infection may lead to more serious illnesses, such as the scarring of the liver caused by long-term liver damage (also known as cirrhosis) and liver cancer. Although vaccines such as these two are at the vanguard of effective cancer immunotherapies, further research and development are still required before such vaccines become a potent preventive strategy against other types of cancer.
Investment conclusion
Although immunotherapy works for a handful of cancers at present, it offers great hope in the treatment of certain cancers associated with the skin, lungs, kidneys and bladders. After all, cancer immunotherapy has begun to yield clinical dividends after years of setbacks.
While the high costs associated with immunotherapy may restraint industry growth since many patients may be compelled to forego the expensive treatments as a result of inadequate insurance coverage or personal savings, harnessing the power of the individual’s immune system to fight against tumour cells gives rise to the hope for a revolutionary shift in the way cancer care is delivered. Put differently, the growing availability of immunotherapy – with or without other forms of treatment like chemotherapy and surgery – will offer a better chance of survival and recovery for many cancer patients.
The global oncology industry remains largely characterised by large pharmaceutical companies, and the cancer immunotherapy sector, which broadly comprises pure-play firms with much lower market capitalisation (under US$2 billion), plus privately held biotech companies. In the US alone, oncology is estimated to be worth over US$500 billion by 2040, which is higher than many other therapeutic areas like cardiovascular diseases and dermatology.
From an investor’s perspective, we see the greater risk associated with smaller firms due to a smaller drug portfolio that has greater likelihood of failure than the larger players. In other words, the reward may be extremely high, but the risk is as well – especially in the case of single-company investments.
Hence, we recommend investing in oncology overall. We believe that over time this area will expand its footprint in immunotherapy to offer the most holistic and personalised cancer treatments possible.
Damien Ng is a Next Generation Research Analyst at Julius Baer.
This article appears in the latest issue of Omnia Health Magazine. Read the full issue online today.
