In September 2022, we attended the Immuno UK conference. Held over 2 days in London, UK, this conference brought together over 260 people from industry and academic research. We heard the latest updates in the field of “immune oncology”. This can be described as developing therapies that use the body’s own immune system to better treat cancer. There were talks on CAR therapy and panel discussions on biomarkers and combination therapy. In this report, we highlight some of the major topics that were discussed.
Advances in CAR Therapy
CAR therapy normally involves taking a person’s immune cells and modifying them so that they can recognise and kill cancer cells. It is estimated that around 15,000 people have been treated with CAR therapy to date. However, there are only a few cancers that CAR therapy is approved to treat, and these are all cancers of the blood. Targeting blood cancers is much easier than solid tumours. We blogged about the challenges of CAR-T therapy recently. One challenge is balancing precision with breadth. If a treatment is too precise, it may not kill enough of the cancer. However, if a treatment is too broad, there are often large side effects. Zelluna Immunotherapy are trying to overcome this through a type of therapy called TCR-NK cell therapy. They are developing this therapy in a number of solid cancers including synovial sarcoma.
Another challenge is overcoming the tumour microenvironment (TME). The TME is the area that surrounds a tumour. It is made up of lots of different types of cells and can often suppress the immune system. We heard from Leucid Bio who described a therapy called “parallel CAR” therapy. This involves altering the CARs to have molecules that can stimulate the immune system. This can help overcome the suppressive TME. Another approach could be to identify cells within the TME that suppress the immune system. These cells could then be targeted to make the TME more favourable for the immune system.
Having a better understanding of which people may benefit from which type of treatment is important. A panel discussion on biomarker development was held to talk about ways to improve responses to treatment. A biomarker is a molecule that can be detected and may provide information on a process or disease (e.g. cancer) within the body. Biomarkers may help identify the best kind of cancer treatment for each person. However, identifying biomarkers can be difficult. An ideal biomarker would be one found in the blood, so that it could be detected through a simple blood test. Biomarkers may change as the cancer progresses. It is important to fully understand at what stage of cancer the biomarker should be used. It is also important to make sure that the biomarker can be used easily in the clinic.
Another consideration when testing biomarkers is that lots of research and clinical trials are done on people with cancer that has not responded to previous treatment. The biomarkers identified in this group of people may not be the same as those in people who have received no treatment. However, enrolling someone in a clinical trial that could otherwise benefit from the standard treatment can raise ethical concerns. Getting patients involved with research at earlier stages of their cancer treatment could help with this to test new biomarkers.
Cancer is often treated with multiple different types of therapy at the same time. Identifying which treatments to combine and test can be difficult. A panel discussion on this topic was held. Practical matters such as the availability of the drugs to test is often a factor. However, in an ideal world, the combinations of drugs would be prioritised based on research. A personalised approach, based on the profile of the tumour could also be used. However, this would be difficult to test in a clinical trial setting. It would be challenging to get enough people with the same drug combination to provide enough data.
The next generation of immunotherapies needs to tackle the challenges highlighted in this report. There has been so much progress made in the immune oncology field in the last 10 years, it is exciting to see what will happen in the next 10 years and beyond. Through the Myrovlytis Trust, we fund research into new therapies for osteosarcoma. Find out what we are currently funding and sign up to our newsletter to receive funding updates.