After decades of valiant but futile efforts, the past ten years have finally seen the breakthrough of cancer immunotherapy - for a short history of the immontherapy products authorized in Europe, see: https://www.bfarm.de/EN/BfArM/Tasks/EU-and-International/CHMP-Committee/Meeting-Highlights/2021-08.html
After PD1, PD-L1, what do you think will be the next big development in cancer immunotherapy that will reach clinical routine use?
I think we can safely say the next big event has already emerged - car t cell therapy. I can see that this will undergo adaptations to reduce side effects as well as expand on the number of possible tumor associated targets.
CAR-T cells are definitely already a "big thing", but I think there's a long way to go regarding the cost per patient to put CAR-Ts in the routine clinical use, specially in developing countries
As others have mentioned, CAR T is already a "big thing" particularly in the liquid world. However, there's still a long way to go, and the transition to solids seems like a large hurdle, especially with so many heterogenous tumor types. Other forms of adoptive therapy will continue to make strides (TCR, NK, TIL), including more efficient screen/neo-antigen discovery times, shorter and more reliable product manufacturing times, and improved models of immunogenic prediction. Antigen specific T cells, although not a new topic of investigation, have great promise, particularly as computational discovery improves seemingly daily, which may permit the targeting multiple antigens simultaneously. I think the ability to tackle multiple tumor targets simultaneously is the next "big thing".
Thanks for your interesting and valuable thoughts. Indeed, there is an obvious gap between the higher number of mabs against haematological neoplasia and the significantly lower number of mabs against solid tumors. Combination of different principles of immunotherapy, e.g. checkpoint inhibitors combination with vaccination may become another important step. In case vaccination is personalized, however, availability or access may become a bottleneck (?).
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