Immunocore is a biotechnology company pioneering T-cell receptor–based medicines that redirect the immune system to target cancers, infectious diseases, and autoimmune conditions.
What were the origins of Immunocore and what made you join it?
The company originated at Oxford University, in the lab of our chairman, John Bell. The original idea was to crystallize the T-cell receptor, which is a very important receptor, and to do that it needed to be made soluble. That work laid the foundation for what ultimately became the technology we have today.
When I was approached to join the company in 2019, what truly fascinated me was the power of the science and the technology. I was initially hesitant because there was a lot of baggage the company needed to address. But once I saw the data and spoke with investigators, it was clear to me that this was something truly unique and worth committing to, even with the challenges that needed fixing.
Immunocore is known for T-cell receptor medicines. How does this approach differ from other immunotherapies and what new possibilities does it open in cancer treatment?
The key aspect of our technology is that it redirects the host immune system, specifically T-cells, to kill infected or tumor cells. It harnesses the power of the immune system in a very direct way by redirecting T-cells to the cells we want to eliminate.
This is different from checkpoint inhibitors, which stimulate T-cells that are already present in the tumor. Our approach takes advantage of the entire T-cell repertoire. Another important distinction is that while antibodies have been very successful therapeutically, they can only target molecules on the surface of cells.
Our technology allows us to look inside the cell, unlocking targets that were previously considered undruggable.
You have an approved therapy for metastatic uveal melanoma. What have the results shown so far and why are they significant?
Uveal melanoma is a rare cancer that originates in the back of the eye and is very different from skin melanoma. Unlike skin melanoma, it has been extremely resistant to immunotherapy and chemotherapy. For more than 40 years, there were no effective treatments for patients once the disease metastasized, which happens in about 50 percent of cases, with most metastases occurring in the liver.
Our therapy was the first to show an impact in this disease. In our Phase 3 trial, we demonstrated a hazard ratio of 0.51, meaning at least 50 percent of patients lived longer and benefited from treatment. We have published three-year survival data and are preparing five-year survival data, which is unprecedented in metastatic uveal melanoma. These outcomes translate into real lives changed, including patients who were told they would not live to see major family milestones and are now living full, active lives years later.
Beyond uveal melanoma, how are you expanding your melanoma strategy and which programs are most advanced?
We currently have three Phase 3 trials underway. One is in advanced cutaneous melanoma, where the same target we use in uveal melanoma is also expressed. This trial focuses on patients who have failed existing therapies, including PD-1 and CTLA-4 inhibitors. In earlier studies, we saw improved survival compared with historical outcomes, which led us to advance into Phase 3 with overall survival as the primary endpoint.
The second trial is an adjuvant trial in uveal melanoma, with the same target as in metastatic uveal melanoma. After removal of the primary tumor, about half of patients are at high risk of developing metastases, yet currently have no treatment options beyond surveillance. This “wait and worry” period is extremely difficult for patients. Our goal is to slow or prevent metastasis altogether. This trial is being conducted in collaboration with a European research group and is now enrolling.
The third Phase 3 trial is in first-line cutaneous melanoma with our next most advanced oncology candidate targeting PRAME.
From an operational perspective, how do you compare working across the UK, Europe, and the US?
Operating in the UK has been very positive, particularly after Brexit. The MHRA has been efficient and, in our experience, has moved even faster than before, with no delays. The transition has been seamless for us, which has been encouraging.
We also work closely with the FDA and are familiar with the available regulatory pathways in the US. Overall, we are fortunate to be able to operate effectively across the UK, Europe, and the US. Beyond regulation, success often comes down to access to talent and strong relationships with investigators.
You are now moving beyond oncology into autoimmune disease. What is the rationale and what should we expect?
What attracted me to this platform is that it is transformative rather than incremental. In oncology, we showed that with our T-cell redirecting approach. The same platform allows us to move into infectious diseases and autoimmune conditions.
In autoimmune disease, specifically type 1 diabetes, the immune system mistakenly attacks beta cells. Our approach is organ-specific. One part of the molecule targets the beta cells, while the other activates PD-1 to dampen the overactive T-cells locally. This program is currently with regulators and we hope to start a Phase 1 clinical trial this year. If successful, it could represent a much more precise alternative to broadly immunosuppressive treatments.
Looking ahead two years, where do you hope the company will be?
My vision is for the company to have multiple approved T-cell receptor therapies across solid tumors, infectious diseases, and autoimmune conditions. I want this platform to become the third pillar of immuno-oncology, alongside checkpoint inhibitors and cell therapies.
Ultimately, I would like the company to be synonymous with TCR medicine, in the same way that Genentech is synonymous with antibodies. Everything we have in the pipeline today is aimed at making that vision a reality.
From a business perspective, how significant is the patient potential and how important are partnerships?
Today, our approved therapy has helped thousands of patients. If we are successful in advanced cutaneous melanoma, we could reach up to approximately 4,000 additional patients, and up to another 1,200 in the adjuvant uveal melanoma setting. That would bring the total to around 6,000 patients. With our third Phase 3 trial in first-line melanoma, the market opportunity is around 10,000 patients. We have seen consistent quarter-over-quarter growth in the market and longer treatment durations in real-world use than in clinical trials, which is critical validation.
Looking ahead, opportunities in other tumor types and in type 1 diabetes are substantial. Collaboration is extremely important to us. No single company has all the innovation, and anything that helps bring medicines to patients faster should be considered. At the end of the day, we do this for patients, and partnerships can be a powerful way to maximize impact.
