It’s time for an update on TLRs – Toll-like receptors – as a way of igniting the fire of the tumour microenvironment. We have repeatedly seen how only a minority of patients respond to immune checkpoint blockade and how there are a multitude of reasons for why this is the case.

In some patients, the immune response is stalled in some way, thereby necessitating a jumpstart. Reasons for this might include lack of recognition of the cancer cells, poor antigen presentation, immunosuppression, immune escape and so on.

In other words, we need more firepower and novel rational combination approaches to stimulating both the innate and the adaptive immune systems in order to derive a more potent and durable response in a larger number of patients. That’s where TLR agonists come in.

As always in oncology R&D, there have been some failures already but we have also seen more promising compounds emerge as well as improved understanding of the science behind the immune system defects that occur in cancer.

Armed with this knowledge, will the current crop of molecules produce better results? To find out, we took at look at some of the recently available data and also interviewed an emerging new company in this niche to learn more about their quite different approach to the challenges…

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