When kids are playing soccer, parents often find that they all run for the ball at the same time even when their parents tell them from the sidelines to maintain their positions. That’s the metaphor that Adam Schechter used to describe the current state of drug development, with the soccer ball representing oncology.

Schechter, who is adviser to Merck & Co. CEO Kenneth Frazier, provided his insights at the Veeva Summit in Philadelphia Tuesday in a fireside chat with Veeva President Matt Wallach to discuss commercial models for bringing breakthrough therapies to patients.

“It’s a big part of the future,” Schechter said, referring to oncology. “But there are still significant unmet needs in so many areas, even cardiovascular disease.”

It’s no secret that oncology and rare diseases are a major focus of drug development right now. A presentation before the fireside chat noted that of the 59 drugs that the Food and Drug Administration approved last year, 58 percent were for orphan indications; 40 percent were personalized medicines; and 27 percent were in oncology. But only one drug approved was for cardiology.

Data from other sources back those numbers up. Silicon Valley Bank’s 2019 healthcare report, released in January, showed that oncology led Series A venture capital financing, with $1.3 billion in Series A investments – up from $1.1 billion in 2017 – and nearly $4.9 billion in venture capital investments overall in oncology companies. That counted for more than a quarter of the $4.8 billion in Series A rounds and $16.2 billion in venture capital investments in biopharma overall.

The industry’s march toward specialty drugs – particularly those for cancers, rare diseases and also sophisticated therapies like gene and cell therapies – has been ongoing for several years now. But Schechter saw it as a pendulum swing. “I think it’s just the cyclical nature of our industry,” he said, adding that there should be a renewed focus on primary care, which still has many unmet needs. “We need to accomplish more in those areas,” he said, referring to cardiovascular disease, Alzheimer’s disease and others.

According to the SVB report, neurology – which includes Alzheimer’s and many other disease states – saw $612 million in Series A investments and $1.4 billion overall. The figures for anti-infectives were $114 million and $1.1 billion, respectively. For orphan and rare diseases, they were respectively $640 million and $1.6 billion.

Even Jeff Marrazzo, CEO of gene therapy company Spark Therapeutics, foresees gene therapy having a place in primary care conditions. Gene therapy tools that exist today are a highly targeted technology and designed to fix the underlying genetic bases of diseases, he said in a fireside chat with Wallach Wednesday. “It doesn’t mean the drug is aiming at a ‘specialized’ market,” he said. “One of the next phases for genetic medicine is broader application to other types of disorders.”

Photo: Alaric DeArment, MedCity News

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