LSX World Congress Europe Panel on Oncology’s Next Frontier: Future Opportunities in an Ever-Growing Market
As oncology continues to evolve beyond checkpoint inhibitors, where do the next big opportunities lie?
That was the central question behind the panel “Oncology’s Next Frontier: Future Opportunities in an Ever-Growing Market,” moderated by David Solomon, CEO of Thalia Therapeutics. Bringing together leaders from biotech and pharma, the discussion explored the mechanisms and modalities shaping the next fronteir of oncology therapeutics, from T-cell engagers and cancer vaccines to mechanistically differentiated small molecules and epigenetic approaches.
Joining the panel were Sonal Patel, VP, Oncology Scientific Innovation at Johnson & Johnson Innovation, Alan Rigby, CEO of Epitopea, Ana Slipicevic, CEO of One-Carbon Therapeutics, and Carlos Buesa, CEO of Oryzon Genomics.
Across the discussion, one theme came through clearly: innovation in oncology is no longer defined by novelty alone. This next generation of therapeutics must focus and deliver on the promise of durability, a measurable improvement of quality of life and translate into real, scalable benefit that patients and drug developers have long desired.
Different modalities, shared ambition
Opening the discussion, Solomon reflected on how many of today’s therapeutic approaches would once have seemed aspirational. Framing the session around the next 10 to 20 years of cancer care, he invited panellists to consider where genuine innovation is emerging — and how it could and should reshape patient outcomes.
For Ana Slipicevic, that includes reaffirming the role of small molecules in a landscape increasingly dominated by newer modalities. While approaches such as CAR-Ts, ADCs and cancer vaccines may capture attention, she argued that small molecules remain critical — particularly in their ability to access intracellular targets that biologics cannot, and in offering advantages in safety, manufacturability, accessibility and cost. Their continued presence in regulatory approvals underscores their enduring relevance.
From a large pharma perspective, Sonal Patel emphasised that innovation begins not with modality, but with it deep connection to biology. At Johnson & Johnson Innovation, the focus is on disease-area “strongholds” and understanding which therapeutic approach is most likely to deliver a transformative effect based on the underlying biology. In that sense, the future is inherently modality-agnostic — with success determined by how effectively biology and technology are matched.
Alan Rigby, however, introduced a more disruptive perspective — outlining Epitopea’s work developing precise, off-the-shelf RNA-based vaccines capable of treating large cancer patient subsets. He described the company’s approach as disruptive, building on the clinical efficacy of today’s personalised neoantigen vaccine strategies, but built and optimized to drive a more predictive efficacy across patient subsets diagnosed with the same cancer. Rather than relying on algorithms to predict which antigens might be present on tumour cells, Rigby described Epitopea’s approach as an empirical interrogation of a patients tumor identifying what is actually presented on the tumour surface. This has revealed a broader and more abundant set of wild-type, non-canonical antigens derived from the previously understudied region of the genome, the dark genome.
His comments raised a broader question for the field: are current approaches optimising around what is easiest to predict, rather than what is most biologically relevant?
Durability as the defining benchmark
Durability of response emerged as a central measure of meaningful innovation.
Patel pointed to the progress already being made with T-cell engagers, particularly in haematological malignancies such as multiple myeloma, where durable responses — including minimal residual disease negativity and time off treatment — are increasingly realistic goals. However, she noted that solid tumours remain more challenging, largely due to the suppressive tumour microenvironment, which continues to limit long-term immune activity.
Rigby reinforced that durability is not simply a function of modality, but of antigen selection, patient selection and clinical timing. He argued that vaccine-based approaches are most likely to succeed when integrated into clinical treatment early, while the immune system remains ‘capable’ of inspiring an immune response, to the right antigen class.
For Slipicevic, durability also depends on maintaining a diverse therapeutic toolkit. Small molecules, she suggested, will continue to play an important role — particularly in combination settings where they can further modulate the tumour microenvironment and enhance immune responses.
Combination strategies move to the centre
If there was one area of clear consensus, it was the importance of combination therapy.
Carlos Buesa described cancer as a complex and rapidly evolving disease that requires multiple escape routes to be addressed simultaneously. From his perspective, combination strategies are not optional — they are essential.
He highlighted the role of epigenetic approaches, particularly LSD1 inhibition, in both increasing tumour visibility to the immune system and enhancing immune cell activity. This dual mechanism provides a strong rationale for combining epigenetic therapies with immunotherapies, particularly in solid tumours.
Slipicevic echoed this view, noting that small molecules are well positioned to fill key gaps within combination regimens — whether by modulating the tumour microenvironment, improving response rates or re-sensitising tumours at progression. Crucially, she emphasised the need for combinations to remain tolerable and to avoid overlapping toxicities.
Patel added that in solid tumours, improving durability will likely depend on more sophisticated approaches — including multispecific targeting, prevention of antigen escape and strategies to actively reshape the tumour microenvironment.
Innovation must include the patient experience
When the discussion turned to how innovation should be defined, there was strong alignment around one point: patient benefit must be central.
For Patel, this means not only improving efficacy, but enabling treatments that fit more seamlessly into patients’ lives — including shorter treatment durations and the possibility of time off therapy.
Rigby pushed this further, arguing that the field should not settle for incremental gains alone. Instead, innovation should be judged by its ability to deliver meaningful, durable responses without compromising quality of life — a principle that underpins Epitopea’s own approach and mission with patients as the company’s ‘North Star’.
Slipicevic added that innovation does not always require entirely new biology. Using existing knowledge more effectively — particularly to improve safety and tolerability — can be equally impactful for patients.
Buesa noted that while patients may accept challenging treatments if the potential for cure is clear, tolerability remains a critical factor. Even incremental improvements can be meaningful if they improve how patients live with their disease.
Biotech ambition meets practical reality
The panel also addressed the commercial realities shaping oncology innovation.
Patel highlighted that for larger organisations, scientific promise must be matched by scalability, manufacturability and the ability to deliver therapies in real-world settings.
For smaller biotechs, the challenge is often one of focus. Buesa noted that even when multiple promising avenues exist, companies must prioritise those with the clearest and shortest regulatory pathway.
Slipicevic added that first-in-class innovation often comes with additional regulatory complexity, making prioritisation even more critical for resource-constrained teams.
Rigby reflected that at Epitopea, innovation has meant not only exploring a different part of the genome, but doing so in a way that remains grounded in clinical reality — balancing scientific ambition with practical execution.
Looking ahead
While the panel covered a broad range of perspectives, its conclusions converged around a shared idea: the next frontier in oncology will not be defined by any single modality.
Instead, progress will come from a more intelligent, biology-led and patient-centred integration of approaches — from T-cell engagers and cancer vaccines to small molecules and epigenetic therapies.
Ultimately, the most meaningful advances will be those that deliver durability, improve quality of life and bring more patients closer to truly transformative outcomes.
