Transforming cancer care through collaborative research

The discovery and development of innovative therapies that can transform cancer treatment is a challenging process often reliant on close collaborations, involving multiple partners and including industry and academia. The pharmaceutical industry plays a pivotal role in drug development, providing funding and resources for large-scale clinical trials. However, industry resources are finite and not all studies can be prioritised due to competing precedencies or insufficient commercial interest. To bridge this gap, investigator-initiated studies can play crucial roles in addressing critically important scientific questions driven by advances in cancer biology and can pave the way for the development of transformative novel treatments for patients. Such studies can provide insights into topics that may otherwise remain unexplored.

In recent years, the treatment of prostate cancer has been transformed by the development of a number of therapies resulting from successful partnerships between academia and industry. For example, the poly ADP ribose polymerase (PARP) inhibitor olaparib was first investigated for patients with advanced prostate cancer in the investigator-initiated TOPARP phase II clinical trial programme (New Engl J Med. 2015;373:1697–1708; Lancet Oncol. 2020;21:162–174). These findings were later confirmed by the industry-sponsored PROfound phase III trial, which demonstrated that olaparib improved both progression-free and overall survival in patients with metastatic castration-resistant prostate cancer and alterations in genes with a role in homologous recombination repair (New Engl J Med. 2020;382:2091–2102; New Eng J Med. 2020;383:2345–2357). Similarly, the discovery and early clinical discovery and development of the androgen biosynthesis inhibitor abiraterone – first synthesised and generated at The Institute of Cancer Research – involved close collaboration with a team of academic researchers (J Clin Oncol. 2008;26:4563–4571). Subsequently, abiraterone was shown to improve clinical outcomes in phase III studies in patients with metastatic, castration-resistant prostate cancer who had previously received chemotherapy (New Engl J Med 2011;364:1995–2005) or who were chemotherapy naïve (New Engl J Med. 2013;368:138–148).

Another example of the importance of academic-led research in prostate cancer is the recent development of the selective CXCR2 antagonist, AZD5069. Preclinical investigations revealed that this agent could reduce tumour growth in mice with prostate cancer by impact the chemoattraction of myeloid cells into tumour through the senescence-associated secretory phenotype or SASP (Nature. 2014;515:134–137; Nature. 2018;559:363–369). Subsequently, in an investigator-initiated phase I/II trial, AZD5069 combined with enzalutamide exhibited antitumour activity in patients with metastatic, castration-resistant prostate cancer (Ann Oncol. 2022;33(suppl_7):S197–S224).

Despite such collaborations between industry and academia, many challenges persist. Drug development continues to be expensive and time-consuming, with each new therapy requiring an investment of more than $2 billion and spanning a duration of 10 to 15 years from discovery to approval. Scarcity of resources continues to be a hurdle for both academia and industry, a challenge that is exacerbated by the current economic climate. While pharmaceutical companies may be reluctant to take the risk of investing in collaborative clinical trials for certain cancers, the result of these efforts can result in major benefit for all involved, and most importantly for cancer sufferers. Collaborative efforts involving industry and multiple, broad-ranging cooperative research groups on a global level offer a means not only of overcoming dwindling resources, but also boosting research efforts to maximise the chances of transforming cancer care.