A potentially new breakthrough for cancer

What is the hottest thing in oncology? You likely know it is immune-oncology, involving CTLA-4, PD-1, or CAR-T. A lot of euphoria has been created and definitely a lot of money will be made in this area. Right now, there is a new finding that may even create a much bigger and huge opportunity in immune-oncology. First just a little bit basics on the immune system. When the body encounters foreign invaders such as bacteria and virus etc, the initial immune reaction is often via a process called phagocytosis, which simply means the immune cells called macrophages will find, engulf and clean such foreign articles. Scientists recently found that the body immune systems is recognizing a signal protein called, CD47 that are widely expressed on the body healthy cells and with CD47 on their surfaces, the killing cells, macrophages, won’t attach such normal healthy cells. Interestingly cancer cells, even not healthy at all, will also expressed CD47 to avoid the attack by macrophages. Logically, if this signal can be turned off or blocked, this will create another efficient way to have cancer cells killed. The beauty of this means is that CD47 is not cancer type-specific and actually almost universally expressed by almost all the cancer cells, hemotologic malignancies or solid tumors. If this proves to be a valid pass way for treating cancers, you can imagine how lucrative a market will be opened for early birds.

 So who is the leading player in this new front? Well, it is a small biotech company, Trillium Therapeutics (TRIL). TRIL has a CD47 inhibitor under development, a fusion protein (SIRPαFc) that can binds to CD47, which will then block its signaling power. As such, the cancer cells without potent CD47 signaling can be killed by macrophages. This has been demonstrated in the animal studies for acute myeloid leukemia. Now TRIL is planning to start a phase 1 clinical trial in the 2nd half of 2015. If the trial of this agent proves to be safe and efficacious, the commercial potential for SIRPαFc is unlimited as this may be applied to a wide range of cancers. I think Trillium’s prospect is very bright, but will be associated with a lot of volatility and uncertainty.