It’s not go­ing to come as a sur­prise to any­one who’s been pay­ing at­ten­tion to drug R&D trends that can­cer is the num­ber 1 dis­ease in terms of new drug de­vel­op­ment projects. But it is amaz­ing to see ex­act­ly how much on­col­o­gy dom­i­nates the in­dus­try as nev­er be­fore.

At a time the first CAR-T looks to be on the thresh­old of a pi­o­neer­ing ap­proval and the first wave of PD-(L)1 drugs are spurring hun­dreds of com­bi­na­tion stud­ies, can­cer ac­count­ed for 8,651 of the to­tal num­ber of pipeline projects count­ed by the Analy­sis Group, crunch­ing the num­bers in a new re­port com­mis­sioned by PhRMA. That’s more than a third of the 24,389 pre­clin­i­cal through Phase III pro­grams tracked by Eval­u­atePhar­ma, which pro­vid­ed the data­base for this re­view.

That’s al­so more than the next 5 dis­ease fields com­bined, start­ing with num­ber 2, neu­rol­o­gy — a field that in­cludes Parkin­son’s and Alzheimer’s. Psy­chi­a­try, once a ma­jor fo­cus for phar­ma R&D, didn’t even make the top 10, with 468 projects.

Mov­ing down­stream, can­cer stud­ies are over­whelm­ing­ly in the lead. Sin­gling out Phase I projects, can­cer ac­count­ed for 1,757 out of a to­tal of 3,723 ini­tia­tives, close to half. In Phase II it’s the fo­cus of 1,920 of 4,424 projects. On­ly in late-stage stud­ies does can­cer start to lose its over­whelm­ing dom­i­nance, falling to 329 of 1,257 projects.

PhRMA com­mis­sioned this re­port to un­der­score just how much the in­dus­try is com­mit­ted to R&D and sig­nif­i­cant new drug de­vel­op­ment, a sub­ject that rou­tine­ly comes in­to ques­tion as an­a­lysts eval­u­ate how much mon­ey is de­vot­ed to de­vel­op­ing new drugs in­stead of, say, mar­ket­ing or share buy­backs.

The re­port makes a few oth­er points to un­der­score the na­ture of the work these days.

— Three out of four projects in the clin­ic were an­gling for first-in-class sta­tus, spot­light­ing the em­pha­sis on ad­vanc­ing new med­i­cines that can make a dif­fer­ence for pa­tients. Me-too drugs are com­plete­ly out of fash­ion, un­like­ly to com­mand much weight with pay­ers.

— Of all the projects in clin­i­cal de­vel­op­ment, 822 were for or­phan drugs look­ing to serve a mar­ket of 200,000 or less. Or­phan drugs have per­formed well, able to com­mand high prices and ben­e­fit­ing from in­cen­tives un­der fed­er­al law.

— There were 731 cell and gene ther­a­py projects in the clin­ic, with bio­phar­ma look­ing at pi­o­neer­ing ap­provals in CAR-T, with No­var­tis and Kite, as well as the first US OK for a gene ther­a­py, with the first ap­pli­ca­tion ac­cept­ed this week for a pri­or­i­ty re­view of a new ther­a­py from Spark Ther­a­peu­tics.

Dis­tri­b­u­tion of prod­ucts and projects by ther­a­peu­tic area and phase

Source: Analy­sis Group, us­ing Eval­u­atePhar­ma da­ta

Unique NMEs in de­vel­op­ment by stage (Au­gust 2016)

89bio said its drug was better than placebo at lessening fibrosis without worsening nonalcoholic steatohepatitis, or NASH, in two of three dose groups.

The San Francisco biotech said it thinks the Phase IIb data pave the way for a potential Phase III, following in the footsteps of another biotech in its drug class, Akero Therapeutics. To fund a late-stage study, CEO Rohan Palekar told Endpoints News 89bio “would need to raise additional capital,” with the company having about $188 million at the end of last year.