Global VISTA Inhibitor Clinical Trials and Market Opportunity Insight 2023 Report Highlights:
Immunotherapy has become one of the pillars of cancer treatment along with the three conventional treatment approaches: surgery, chemotherapy and radiation therapy. This has largely been made possible because of the promising results this new modality has shown when targeting immune checkpoint proteins, modulators of the body’s immune system. CTLA-4 and PD-1 were the first checkpoint proteins to be identified and with vigorous efforts, we have entered a new era where more novel immune checkpoints have been identified. The VISTA protein is one of these newer proteins that have been identified. Through preclinical and clinical studies, VISTA has shown its applications to be used in the treatment of diseases where the immune system plays the central role.
VISTA wields inhibitory effects on the immune system and helps control its activities. This can be especially detrimental in the case of cancer, where the patient’s inbuilt immune system is important for fighting the disease. Inhibition of the VISTA has therefore come to light in regards to cancer and a number of VISTA-directed drugs have been developed and have entered clinical trials in the past few years. One of these is CI-8993, a first-in-class VISTA inhibitor developed by Janssen and ImmuNext as part of a collaboration agreement. The candidate is now licensed to Curis, who is working ImmuNext to develop and commercialize the drug once it gets approval. With two anti-VISTA drugs in its portfolio, Curis is one of the frontrunners in the RandD landscape for developing therapeutics against VISTA.
Similar to other immune checkpoints, VISTA inhibitors have been theorized to generate favorable results when used in combination with inhibitors of other checkpoint protein. To verify this, clinical trials are now being conducted globally and promising results are expected. Merck, which does not have a VISTA inhibitor under development, has signed collaboration agreements with developers of some VISTA inhibitors and as part of the agreement, Merck will supply them its blockbuster PD-1 inhibitor Keytruda (Pembrolizumab) to assess the synergized anti-cancer effects of both VISTA and PD-1 inhibition in solid cancers. Research studies have confirmed that VISTA and PD-1 exert their effects in a non-overlapping fashion which is why simultaneous inhibition of the drugs is expected to demonstrate highly favorable results.
Research and development activities for VISTA inhibitors are still in their nascent phases and not a lot of companies have been reported to be working on these. It has been estimated that there are not more than 10 candidates in early stages of clinical trials which have been developed by different pharmaceutical companies and small biotechnological companies around the world. This can be rightly attributed to the absence of commercially available VISTA inhibitors, thereby lack of information about its commercial performance and other real world data. This can also be accredited to the dearth of candidates in later phases of clinical trials because of which the information and popularity of VISTA as a therapeutic target is still less.
In addition to cancer, preclinical trials also been conducted to assess its utility in the treatment of diseases where the immune system needs to be stimulated to manage the condition. Research studies have also identified that treatment with VISTA agonist can inhibit inflammation and increase tolerance. Therefore, many experimental VISTA agonists have been evaluated in animal models of rheumatoid arthritis and GvHD which have demonstrated favorable results, giving rise to another indication where targeting VISTA can be helpful. According to the global clinical trials database, none of the reported VISTA-targeting drug candidates have been indicated for the treatment of such inflammatory and autoimmune diseases, hence research and development activities are needed to be directed towards these to increase the usability of targeting VISTA.
The identification VISTA as an inhibitor and a costimulator of the immune system brought along with it the excitement about the development of potential new therapies and this idea has translated into clinical trials as well. Cancer is a highly prevalent disease and accounts for a majority of disease-related deaths in the world, therefore new treatment strategies are required to manage the disease. Moreover, with its emerging potential role in the treatment of autoimmune diseases, VISTA has been surprising researchers with new information in every research study. The protein holds much potential, which remains largely untapped, and is expected to be highly successful in the market once it gets approved as has been the case with previous inhibitors of novel checkpoints.