The Age of Targeted Therapies: Bridging the Divide between Autoimmunity and Oncology

Targeted Therapies

The once-distinct landscapes of rheumatology and oncology are undergoing a fascinating metamorphosis. The emergence of targeted therapies, designed to disrupt specific molecular pathways underlying disease, is blurring the boundaries between these fields. This convergence is fostering a new era of treatment possibilities, with medications traditionally used for autoimmune diseases demonstrating efficacy against certain cancers, and vice versa.

The recent ASCO2024 and EULAR 2024 congresses serve as a testament to this exciting trend.

Meet our expert team IMAGE ANALYSIS GROUP at EULAR2024 this week!

The Common Thread: Inflammation and the Immune System

While seemingly disparate, both rheumatologic and oncologic conditions share a common thread: inflammation and the intricate dance of the immune system. Autoimmune diseases, like rheumatoid arthritis (RA), arise when the body's immune system mistakenly attacks healthy tissues. Similarly, cancer cells often evade immune destruction by manipulating the immune response, creating a permissive environment for tumor growth.

The power of targeted therapies to bridge this divide is exemplified by Janus kinase (JAK) inhibitors. Originally developed for RA, these drugs suppress the activity of JAK enzymes, critical for inflammatory signaling. ASCO2024 / EULAR 2024 presentations highlight the expanding role of JAK inhibitors in treating Myeloproliferative Neoplasms (MPN), a group of blood cancers characterized by abnormal bone marrow cell growth. Studies presented at the congress demonstrated the effectiveness of JAK inhibitors in reducing symptoms and improving patient outcomes in MPN patients.

Immunotherapy: Unleashing the Body's Defense System

An exciting area of convergence lies in the realm of immunotherapy. Traditionally employed in oncology to harness the immune system against cancer cells, these therapies are now being explored in rheumatology. Immune checkpoint inhibitors, which block molecules that dampen the immune response, are showing promise in treating severe and refractory autoimmune diseases. EULAR 2024 featured presentations on the potential of these drugs for patients with conditions like #lupus and #vasculitis, where traditional therapies have proven less effective.

Medical Imaging: A Window into Treatment Response

Medical imaging, including molecular imaging techniques like positron emission tomography (PET) scans and radiological scans such as magnetic resonance imaging (MRI), plays a critical role in assessing the efficacy of these new treatment approaches.

• Monitoring Disease Activity: In rheumatology, imaging techniques like MRI can be used to visualize joint inflammation. By comparing pre- and post-treatment scans, doctors can assess a patient's response to JAK inhibitors or other targeted therapies. Similarly, in oncology, PET scans can be used to track tumor size and metabolic activity, providing valuable insights into how a patient is responding to immunotherapy.
• Identifying Early Response: Medical imaging can offer an earlier indication of treatment efficacy compared to traditional clinical measures like symptoms or blood tests. This allows physicians to adjust treatment strategies quickly if a patient is not responding as expected.
• Personalized Treatment Decisions: Advanced imaging techniques can help identify patients who are most likely to benefit from specific therapies. For instance, PET scans can reveal specific molecular signatures in tumors that predict their response to immunotherapy.
• Guiding Treatment Doses: Imaging can be used to guide the precise delivery of targeted therapies. For example, radioimmunotherapy, which combines radioactive isotopes with antibodies that target cancer cells, can be tailored based on information gleaned from PET scans.

Meet our expert team IAG, IMAGE ANALYSIS GROUP to discuss the optimal imaging for your trial design!

Challenges and Considerations: Tailoring Treatment to the Individual

Despite the burgeoning enthusiasm, this evolving landscape presents challenges. One key area of focus is identifying the appropriate patient populations for these repurposed drugs. Not all patients with a particular cancer or autoimmune disease will benefit equally. Biomarkers, which allow for personalized medicine approaches, are crucial in this regard. EULAR 2024 discussions emphasized the need for robust biomarker development to guide therapy selection and optimize patient outcomes across both fields.

Collaboration for Shared Success

As highlighted in a number of keynote speeches this year, the potential for repurposing existing therapies underscores the importance of collaboration between rheumatologists, radiologists and oncologists.

Sharing knowledge and clinical expertise is vital to effectively translating findings from one field to the other.

Our teams at IAG help to facilitate this exchange, with dedicated sessions fostering interdisciplinary dialogue and paving the way for future joint research endeavors. This collaborations starts in PoC studies and carry the ideas through into multi-center global trials.

The Road Ahead: A Future of Shared Progress

The convergence of rheumatology and oncology represents a paradigm shift in the approach to these complex diseases. By leveraging targeted therapies and harnessing the power of the immune system, researchers are creating a future of shared progress. EULAR 2024 provides a glimpse into this exciting new frontier, where the boundaries between these fields are blurring, leading to a more comprehensive understanding of disease and ultimately, improved patient care.

About the Author

Dr. Olga Kubassova is a mathematician and entrepreneur who is a leading figure in the field of applying artificial intelligence (AI) to drug development and clinical research. Dr. Kubassova founded IAG, a company that uses AI and medical imaging to improve clinical trials. She served as the CEO until 2024. .She is a recognized expert in the field and serves as a scientific advisor and venture partner to various investment funds, biotechnology companies, and government bodies, bringing experience in managing innovation for life science companies and identifying promising new approaches in clinical research, disruptive technologies, and novel therapeutics

• IAG Website: https://uk.linkedin.com/in/olgakubassova
• QCon London Speaker Profile: https://www.researchgate.net/publication/333920152_Artificial_Intelligence_in_Clinica

About IAG, Image Analysis Group

Leading imaging Clinical Research Organization that combines medical and operational expertise with cutting-edge proprietary A.I. capabilities to power drug development, and to deliver the potential for companion diagnostic tool. IAG has been serving biotech and pharma clients globally since 2007, reliably supporting all aspects of phase I to III imaging trials across multiple indications. With a pioneering proven innovation strategy, we enhance the value and market potential of novel therapeutic assets, as demonstrated through successful pharmaceutical partnerships.