ANXV and the cancer challenge

Cancer is a leading cause of death worldwide, accounting for nearly 10 million losses of life in 2020, which accounts for nearly one in six deaths. The most common cancers are those in the breast, lung, colon and rectum, and prostate. There are still significant, yet unmet, clinical needs, where ANXV could potentially help many patients.

Growth of abnormal cells

Cancer, malignant tumours and neoplasms, are terms for a heterogenous group of diseases that can affect any part of the body. The key defining feature of cancer is the rapid growth of abnormal cells that can invade parts of the body and spread to other organs, the latter process is referred to as metastasis. Widespread metastases are the primary cause of death from cancer.


Factors behind cancer

Cancer can arise from the transformation of any healthy cell into a tumour cell in a multi-stage process. The incidence of cancer rises dramatically with age, most likely due to a build-up of risks for specific cancers that increase with age

Around one-third of deaths from cancer are due to tobacco use, high body mass index, alcohol consumption, low fruit and vegetable intake, and lack of physical activity. Cancer-causing infections, such as human papillomavirus (HPV) and hepatitis, are responsible for approximately 30 per cent of cancer cases in low- and lower middle-income countries.

The change from a healthy cell to a tumour cell is the result of the interaction between a person’s genetic factors and external agents, including:

  • Physical carcinogens, such as ultraviolet and ionising radiation
  • Chemical carcinogens, such as asbestos, components of tobacco
    smoke, alcohol, aflatoxin (food contaminant), and arsenic (drinking
    water contaminant)
  • Biological carcinogens, such as infections from certain viruses,
    bacteria, or parasites

Source: WHO

Unmet medical need

Many cancer patients have poor chances of survival

Despite significant recent progress in treatment of cancer, there are still patients that do not respond to currently available therapies. ANXV has a potential to help these patients.

Although cancer treatment has been the focus of many investigational drugs under development during many years, there is still a gap in the cancer treatment arsenal. Patients with cancer still need more treatment options as many have poor chances of survival. Research with Annexin A5 shows promising results, and thereby a potential for ANXV to be a valuable treatment for cancer treatments, either as a therapeutic or as delivering an active compound directly to its target.

"ANXV is a potential First-In-Class asset targeting phosphatidylserine biology, in the context of cancer. As an experienced oncologist, I consider ANXV has outstanding potential within oncology."

Alain Thibault, Therapeutic Area Head Oncology

How is ANXV expected to help?

Immunotherapy possibilities

The effect of ANXV may be comparable to checkpoint inhibitors, cancer treatments that are currently gaining momentum with the aim of curing cancer.

Several preclinical studies have shown that the active protein in ANXV, Annexin A5, acts as a potent immunomodulating anti-cancer agent via the blockage of phosphatidylserine (PS) on cancer cells. The concept of using Annexin A5 as an immune checkpoint inhibitor has been confirmed by independent researchers, where the effect of Annexin A5 was comparable to that of well-established and marketed checkpoint inhibitors such as PD-1.

ANXV represents an attractive method to mask the immunosuppressive effects of PS on tumour cells, and may be a clinically relevant answer to the persistent, unmet medical need of cancer resistance to current CTLA-4 and PD-1 based immunotherapy standards.

Reference: Kang et al., 2020 Nature Commun

The oncology market

Immuno-oncology – a significant market

The global market for cancer drugs within immuno-oncology is significant, currently valued somewhere between 30 to 70 billion dollars, and expected to grow by around 15 to 20 per cent (CAGR) per year up to at least 2030.

Immuno-oncology is a relatively new market, with therapies that utilise the immune responses of the human body to target cancer. One of the major immuno-oncology drugs, the PD-1 antibody Keytruda, had a market of approximately 17 billion dollars in 2021, although only 20 to 40 per cent of all cancers respond to a PD-1 treatment.

In 2020, the number of new cases of cancer reached above 19 million. Almost 10 million deaths related to cancer were reported that same year. The number of new cancer cases is expected to increase to 29 million by 2040 – a 60.6 per cent increase in men, and 48.8 per cent increase in women.

With the increase of cancer cases, and availability of new immuno-oncology treatments, the current immuno-oncology market of 30 to 70 billion USD is expected to grow by around 15 to 20 per cent annually (CAGR), to reach around 150 to 160 billion dollars by 2030.

Reference: International Agency for Research on Cancer, GLOBOCAN 2020; World Cancer Research Foundation International; Spherical Insights LLP; Data Bridge Market Research