The Breakthrough: Immunotherapy and the Race to Cure Cancer

As of June 2018, there were reported to be some 940 new immuno-oncological drugs being tested for breakthrough designation and FDA approval. Another 1,064 new immunotherapy drugs are in the labs in preclinical phase. That’s 2,004 new cancer drugs in just a few short years. This speed of change is highly unusual in medicine, and totally unprecedente

That includes a class of immunotherapies that simply works as a universal adaptor on the molecular scale, chaining T cells (or natural killer cells) to the cancer cells with protein handcuffs. Called bispecific antibodies, or BsAbs, these bioengineering marvels are like an aggressive matchmaker at a high school dance. There’s currently hope that su

Most cancer immunologists point to the problem of so many new therapeutic options for patients who can ill afford the time or resources of the wrong approach. Tests are needed, capable of categorizing both a patient’s immune system and the specifics of their cancer, in order to help clinicians of the future determine the most effective therapy. Som

But what can be helpful to keep in mind is that what most (not all) immunotherapies have in common is the T cell. IL-2 grows and energizes them, adoptive T cell therapy grows and farms them, checkpoint inhibitors unleash them, vaccines inform and activate them, and CAR-T is them, the robocop version. Immune response is complex. There are many playe

If you change the way you look at things, the things you look at change. —MAX PLANCK

It’s not reasonable to guess at what will work next, but as of this writing the greatest demonstrated promise—the closest to a sure thing in terms of what’s been demonstrated in the clinic—seems to come from the expanding CAR-T therapies and CD3 bispecifics. Watch this space. It’s moving fast.

The cartoon version of antigen presentation, T cell activation, and immune response suppression via checkpoints, part of the dance Chen and Mellman would term “the Cancer Immunity cycle.”

We search where there is light. —GOETHE

There are now reportedly 164 PD-1 / PD-L1 drugs in the pipeline between preclinical testing and consumer marketing, and industry insiders suspect there may be many more being developed in China. This redundancy isn’t the best use of intellectual or physical resources; one hopes it will result in more competition and lower prices. (A