The future of affordable cancer immunotherapy

Language
en
Document Type
Article
Issue Date
2023-09-20
First published
2023-09-06
Issue Year
2023
Authors
Schaft, Niels
Dörrie, Jan
Schuler, Gerold
Schuler-Thurner, Beatrice
Sallam, Husam
Klein, Shiri
Eisenberg, Galit
Frankenburg, Shoshana
Lotem, Michal
Khatib, Areej
Editor
Publisher
Frontiers Media S.A.
Abstract

The treatment of cancer was revolutionized within the last two decades by utilizing the mechanism of the immune system against malignant tissue in so-called cancer immunotherapy. Two main developments boosted cancer immunotherapy: 1) the use of checkpoint inhibitors, which are characterized by a relatively high response rate mainly in solid tumors; however, at the cost of serious side effects, and 2) the use of chimeric antigen receptor (CAR)-T cells, which were shown to be very efficient in the treatment of hematologic malignancies, but failed to show high clinical effectiveness in solid tumors until now. In addition, active immunization against individual tumors is emerging, and the first products have reached clinical approval. These new treatment options are very cost-intensive and are not financially compensated by health insurance in many countries. Hence, strategies must be developed to make cancer immunotherapy affordable and to improve the cost-benefit ratio. In this review, we discuss the following strategies: 1) to leverage the antigenicity of “cold tumors” with affordable reagents, 2) to use microbiome-based products as markers or therapeutics, 3) to apply measures that make adoptive cell therapy (ACT) cheaper, e.g., the use of off-the-shelf products, 4) to use immunotherapies that offer cheaper platforms, such as RNA- or peptide-based vaccines and vaccines that use shared or common antigens instead of highly personal antigens, 5) to use a small set of predictive biomarkers instead of the “sequence everything” approach, and 6) to explore affordable immunohistochemistry markers that may direct individual therapies.

Journal Title
Frontiers in Immunology
Volume
14
Citation
Frontiers in Immunology 14 (2023): 1248867. <https://www.frontiersin.org/articles/10.3389/fimmu.2023.1248867/full>