We are still on a quest – a patient journey, if you like – to find new agents capable of addressing the inherent issue of why do some patient’s tumours lack immune infiltrate and how do we go about fixing it?

Chihuly Glass sculptures always remind me of upregulating MHC

Over the last decade on BSB we have explored a veritable telephone directory of immune agonists, cancer vaccines, cytokines, bispecific and trispecific antibodies, additional inhibitory checkpoints, oncolytic viruses, small molecules, chemotherapy, CAR-T cell therapies, and various others.

Few have got the job well done in advanced solid tumours. Once MHC is downregulated, it becomes much harder to generate an immune response.

Stop and think about this for a moment.

It’s been a long slog to find the next big thing and a frustrating one at that for cancer researchers slaving away at the coal face. A lot of promising agents have come and gone – some quietly, others loudly – to end up in what Dr Patricia LoRosso wittily described as ‘dog drug heaven’. It is also dispiriting to write about so many ending in failure.

The good news is there are some new signs of life coming through, although it’s too early to declare a spring rennaisance. Over the next couple of weeks we’re going to highlight a number of young biotechs with encouraging or fresh ideas being explored in the clinic.

I also don’t want to raise too many hopes – especially as I have long been sceptical about some approaches with all their breathless hype – but here’s something to keep an eye on with an open mind because if it holds up where others failed then the company could be on to something…

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