We were delighted to attend the 2022 ESMO Immuno-Oncology Congress. Held over three days, the event welcomed 1700 people both online and in person. We heard the latest research in the immune-oncology field and how it is being applied in clinical practice. In this report, we highlight the areas of research of particular interest to the Myrovlytis Trust.
Cancer vaccines can help the immune system to recognise and destroy cancer cells. Provenge was the first cancer vaccine to be licenced for prostate cancer. Although it increased survivorship it also highlighted how little we understood about how they worked. Why did some people respond and others didn’t? When was it best to give cancer vaccines? It’s now understood that the body’s own immune system can suppress cancer vaccines. Researchers are combining cancer vaccines with other drugs to overcome this.
Oncolytic Viral Therapy
Oncolytic viral (OV) therapy involves modifying viruses to infect and destroy cancer cells. It can also teach the immune system to recognise and attack cancer cells. However, it can cause the immune system to clear out the OV instead of the cancer. Researchers are finding new ways to overcome this. This includes modifying OVs and giving them in combination with other drugs such as HDAC inhibitors. These can supress the anti-OV activity and increase their effectiveness.
Adoptive Cell Transfer Therapy
Adoptive cell transfer therapy (ACT) is a subset of immunotherapy treatments. Immune cells are isolated from the body and genetically engineered to target cancer cells. They are then infused back into the patient. Clinical trials have shown that ACT can rapidly shrink tumours. This makes ACT an attractive cancer treatment to study.
CAR-T therapy, a type of ACT, involves the modification of T cells. It has been an effective treatment for blood cancers. However, there has been less success in solid cancers. Several reasons for this have been identified. Firstly, CAR-Ts are modified to target a specific cancer antigen. It can be difficult to find a target antigen that is highly present in the solid cancers and not in healthy tissue. Then, even if a target is found, the CAR-T may not move to the cancer. Lastly, the tumour microenvironment may actively suppress their activity. Overcoming these barriers is essential to creating a successful CAR-T therapy. Read our blog to find out more.
A similar treatment has been designed called CAR-M therapy. It uses immune cells called macrophages instead of T cells. Macrophages do not normally target one specific antigen. Instead, they react to many different antigens. They also release pro-inflammatory cytokines. These cytokines can alter the tumour microenvironment. In CAR-M the macrophages have been engineered to target specific antigens and ‘eat’ cancer cells. In a study of HER2+ cancer, CAR-M therapy successfully shrunk tumours in mouse models. It is now being tested in a phase 1 human clinical trial.
Artificial intelligence (AI) has the potential to improve patient care. It can be used to interrogate data and make predictions about patient outcomes. This includes whether a patient may respond to a certain treatment. However, for AI to make these predictions it first needs to learn from large data sets. This is more difficult in rarer cancers such as osteosarcoma where there is not as much data. Therefore, when designing studies involving AI it is important to combine data from multiple centres.
The work presented at the 2022 ESMO Immune-Oncology congress highlighted both the challenges of creating effective immunotherapy and how these challenges are being overcome. Through genetic engineering, combination therapy and AI new treatments are being developed and tailored to an individual’s cancer. We look forward to seeing what the future brings.