How an AstraZeneca exec is leading the charge in the next immuno-oncology era

During her more than 20 years in the biopharma industry, Shubh Goel has seen firsthand the power of immuno-oncology as the field offers longer lives to patients with even the toughest cancers.

Now, as the head of immuno-oncology and the gastrointestinal tumors franchise at pharma giant AstraZeneca, Goel is leading revolutionary progress in the field. This summer, the company announced results of a long-term study of the checkpoint inhibitors Imfinzi and Imjudo in patients with advanced liver cancer — 25% of whom were alive after four years receiving the drug combo, an unprecedented result for a disease that has historically seen only 7% of patients surviving five years.

“What matters to a patient is the potential to survive a certain milestone — am I going to be here to see the next anniversary, the family wedding? And we talk about that a lot in oncology,” Goel said. “For the first time when following immuno-oncology therapies through the tail, and seeing that longer-term survival, we’re actually beginning to measure the benefit of it.”

Checkpoint inhibitors, now a mainstay in cancer treatment, entered the scene just over a decade ago with the FDA approval of Bristol Myers Squibb’s CTLA-4 blocker Yervoy in 2011. A few years later, the PD-1 pathway brought blockbusters like Merck & Co.’s Keytruda and BMS’s Opdivo into the mix, which continue to rack up indication approvals.

AstraZeneca entered the fray in 2017 with the approval of Infinzi, a PD-L1 inhibitor for patients with advanced bladder cancer. Since that time and in multiple indications, Imfinzi has been used to treat more than 200,000 patients globally. For Goel, who joined the company early last year, the next stage of immuno-oncology work at AstraZeneca is focused on combination therapies at the forefront of treating patients with difficult cancers.

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“It’s always been an exciting space in terms of trying to understand how we can harness our own immune system to fight an ongoing growth that shouldn’t be in our bodies, and that’s been a goal for many years.”

Shubh Goel

Head of immuno-oncology, gastrointestinal tumors franchise, AstraZeneca

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“I’ve been really lucky over the last 20 years to have worked in a number of different areas, across multiple different products and mechanisms of action that included touching some immuno-oncology along the way, but the foray at AstraZeneca is the deepest I’ve gone,” Goel said.

A journey into immuno-oncology

After working for several years as a research associate at Pfizer in the area of immunology, Goel entered the world of cancer treatments when she joined Millennium Pharmaceuticals (now Takeda Oncology) to promote the multiple myeloma chemotherapy Velcade in the early 2000s, prior to the first checkpoint inhibitors entering the market.

From there, Goel’s career encompassed oncology marketing roles at household names like Bayer and Celgene as well as smaller companies like AVEO Oncology, Ordonate Therapeutics and Fennec Pharmaceuticals. The common thread was that Goel was all-in on cancer treatments, leading to her role at AstraZeneca to navigate immuno-oncology commercialization strategies in what has become a crowded field.

From small companies to international powerhouses, Goel said the goals of companies are more similar than they are different.

“What’s driven me, and what I’ve pursued and followed, are innovative science and a focus on unmet medical need — whether it’s a small biotech or AstraZeneca, that has always been at the forefront,” Goel said. “What really strikes me about our immuno-oncology portfolio is that focus on unmet medical need in a unique way.”

And as far as immuno-oncology goes, Goel believes the concept  exudes a sort of simple beauty.

“It’s always been an exciting space in terms of trying to understand how we can harness our own immune system to fight an ongoing growth that shouldn’t be in our bodies, and that’s been a goal for many years,” Goel said. “When the first PD-1s became available, that really brought immuno-oncology to life, and we’re beginning to understand that better now.”

From the beginning of immuno-oncology’s place in the cancer treatment landscape, finding the right patients has been key. From tumors to immune systems, every patient is slightly different, and an immunotherapy will only work for certain parts of the population, making biomarkers and precision drug combinations an important next step in immuno-oncology innovation, Goel said.

In the case of Imfinzi, a PD-L1 inhibitor, and Imjudo, a CTLA-4 inhibitor, the combo is a one-two punch.