Tackling the tumour microenvironment

Is this the final frontier, as Star Trek fans like to think of it?

As tumours grow, they also activate numerous inhibitory pathways to ensure protection against therapeutic intervention.

These might take the form of multiple checkpoint brakes, an increase in immunosuppressive cells such as MDSCs or Tregs, various immune escape mechanisms are activated and barriers such as the stromal or vascular layers prevent the infiltration of immune cells intent on killing the cancer cells.

There are also other ways to prevent the immune system from 'seeing' all that is there, including antigen loss, MHC Class I down regulation, fatty acid metabolism, and even biochemical fog to deter the armies in the immune system from doing their job properly.

Over the next two years or so we are going to see a wealth of new approaches start to read out. Some will be home runs, some handy tools in certain tumour types, while others will sadly fail.

One area that caught my attention was the biochemical fog concept, which I first noticed at AACR in 2015 when AstraZeneca presented some elegant preclinical research. Since then, several other companies have moved into this space and now we have a new niche of thriving research... already in the clinic.

Indeed, one of the new kids on the block has a phase I trial up and running with over 500 patients - talk about going for it!

So who's bigging it up and making the bold play?

You can find out more about this promising new approach here.