Immunotherapy Will Have A Diverse Impact In Respiratory Disease Trials

Pictured: A schematic of how immunotherapy could be used against respiratory allergies. Published by Sari Sabban in “Development of an in vitro model system for studying the interaction of Equus caballus IgE with its high-affinity Fc epsilon RI receptor.” [Licensed under CC BY-SA 3.0], via Wikimedia Commons.

It’s no surprise that immunotherapy is a hot topic in clinical trials in the respiratory space.

With activity ranging from respiratory rheumatology to immunotherapeutic oncology monotherapy to the use of immunotherapeutic adjuvants alongside traditional oncology therapies, the field of immunotherapy is having a moment.[1]

Clinical trials within the respiratory immunotherapy space have a longer history than other immunotherapeutic contexts, owing to the obvious application of immunotherapy to respiratory allergy. While robust trial results indicating success against respiratory allergies using immunotherapies are still in the works, it’s worth taking a look at why they’re likely to succeed.

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Respiratory Rheumatology

A schematic of how immunotherapy could be used against respiratory allergies. Published by Sari Sabban in “Development of an in vitro model system for studying the interaction of Equus caballus IgE with its high-affinity Fc epsilon RI receptor.” [Licensed under CC BY-SA 3.0], via Wikimedia Commons.

The most common allergies like dust mite allergy and pollen allergy have been on the chopping block for immunotherapies for quite some time, and a massive amount of progress has been made.[2]

Many of the clinical trials in this space are easily filled with recruits, as inclusion criteria could be as broad as experiencing allergic rhinitis when exposed to an allergen in the air. The easy populating of rheumatological immunotherapy trial cohorts has been a massive boon to the field’s advancement, as has proactive standardization of study elements and investigative avenues since 2007.[3]

Happily, immunotherapy is a hit when it comes to respiratory allergies, delivering robust and safe symptom remission across many demographics and reproduced in many studies.[4][5] Regulators are thus amiable to initiating new studies within the respiratory immunotherapy space.

 

Oncology Monotherapy and Adjuvant Therapy

Immunotherapy’s biggest hopes lie in its applications in respiratory oncology.[6] Regulators have been a bit more conservative with trials attempting to enter this space, even after successful phase 3 trial results.[7] Researchers have reacted to this hesitation by starting trials in which their immunotherapeutic drug candidate takes a back seat.

Recently, trials examining combination or adjuvant therapies are in vogue.[8] The advantage of combination or adjuvant therapies is that the immunotherapeutic drug candidates can ride on the established effectiveness of an already proven therapy and offer positive study results. Positive results help patients, whether or not the adjuvant immunotherapy helps them vastly more than the standard line treatment that the adjuvant accompanies.

With some luck and a lot of work, the winners of the respiratory oncology immunotherapeutics will make their way into the hospital and revolutionize healthcare.[9]

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[1] http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30521-1/fulltext

[2] http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2004.00508.x/full

[3] http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2006.01312.x/full

[4] https://waojournal.biomedcentral.com/articles/10.1186/s40413-016-0132-1

[5] http://www.jacionline.org/article/S0091-6749(13)02507-4/abstract

[6] http://jxym.amegroups.com/article/view/3700

[7] http://www.sciencedirect.com/science/article/pii/S1470204516000991

[8] http://www.sciencedirect.com/science/article/pii/S155608641631142X

[9] https://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1602-8

 

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