AstraZeneca bets on combinations in cancer immunotherapy race


* AstraZeneca chasing Bristol, Roche and Merck

* Biotech unit MedImmune centre-stage in cancer research

* Broad pipeline offers scope for multiple combinations

By Ben Hirschler

LONDON, Oct 14 (Reuters) - AstraZeneca is betting ondrug combinations to help it catch up with industry leaders inthe race to develop new treatments that harness the body'simmune system to fight cancer.

Bristol-Myers Squibb, Roche and Merck & Co are currently out in front with such immunotherapies,which analysts believe may extend patients' lives significantlyand generate tens of billions of dollars in annual sales.

But AstraZeneca argues that the breadth of its portfolio ofexperimental cancer drugs - including both traditional "smallmolecule" pills and injectable biologics, made in living cells -puts it in a powerful position when it comes to producing drugcocktails.

Such combinations are expected to be crucial as oncologistsseek to block cancer on multiple fronts. The potential forcombining immunotherapies was highlighted in May in a study oftwo Bristol treatments for melanoma.

"We are completely changing the paradigm of how to treatcancer," said Bahija Jallal, head of the biologics arm ofAstraZeneca.

"The field is still very open for combinations and I thinkwe are very much in the race."

Although it is behind the three market leaders, Jallal said"very, very few" companies had the opportunity to choose fromboth small molecule treatments and biologics when designingfuture drug combinations.

Jallal is in charge of MedImmune - the U.S. biotech businessthat AstraZeneca bought in 2007 for $15.6 billion.

At the time, the MedImmune purchase was slammed by manyinvestors, who felt that David Brennan, the chief executive atthe time, had overpaid for a company with few promising newdrugs.

Six years on, however, MedImmune is emerging as a key plankof new CEO Pascal Soriot's bid to reinvent AstraZeneca's drugpipeline, following past disappointments.


Much of the attention is focused on the cancer immunotherapyportfolio.

The drugs may be at an early stage but the breadth of thepipeline is a big plus for AstraZeneca, especially given itshistoric success in developing cancer drugs such as tamoxifen,Arimidex, Faslodex and Iressa.

What is more, the pace of cancer drug development hasaccelerated markedly, making it possible for drug companies tocatch up fast.

Experimental AstraZeneca drugs with potential for use incombinations include MEDI4376, a PD-L1 drug that helps theimmune system fight cancer cells by disabling a protein thatacts as a brake on the body's ability to detect them.

AstraZeneca reported promising Phase I clinical trialresults with MEDI4376 last month and it is now set to be testedalongside other medicines, such as the established cancer pillIressa and the experimental antibody drug tremelimumab.

Tremelimumab works in a similar way to Bristol's melanomadrug Yervoy, which impressed oncologists last month when a studyshowed that some patients with the notoriously deadly diseasesurvived for up to 10 years.

Melanoma has been the initial focus of much immunotherapywork but the field is now widening out to other cancer types.

Citi analysts expect immune system drugs to form thebackbone of treatments for up to 60 percent of cancers over thenext decade and estimate that they could generate annual salesof $35 billion.

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