1. Science is gaining an appreciation for the heterogeneity of cancer and immune cell responses.
An ongoing challenge for the immuno-oncology field is the lack of a comprehensive understanding of the tumor microenvironment. Advanced computational analysis has revealed that cancers vary by tumor and tissue type as well as by patient. Scientists are beginning to appreciate the role that myeloid cells play in the immune response to cancers and how they can be leveraged with immunotherapy treatments.
There is still a vast amount of unknown information surrounding myeloid cells and their role in patient immune responses. But researchers like Dr. Miriam Merad, PhD, from Mount Sinai have accepted the challenge and are working to untangle the role these cells play in oncology -- starting in preclinical models with the aim of translating the science to cancer patients.
2. Can we preserve T-cell differentiation potential?
T cells have long served as the foundation of cancer immunotherapy research and clinical usage. But as noted in several presentations throughout the meeting, tumor resistance to T-cell therapy and other traditional immunotherapies targeting T-cell activation (immune checkpoint blockade) is a significant concern.
Tools like single-cell analysis have enabled the enhanced characterization and classification of subsets of T cells so that scientists can gain a deeper understanding of their contributions to cancer killing over time. Based on this information, researchers know that T cells can become "exhausted" and, as a result, become ineffective at killing cancer. The focus of many researchers in the field is now on the ability to reactivate T cells so they provide prolonged protection against cancers.
3. Combination therapies are the future of cancer immunotherapy.
Many researchers at the meeting commented on the importance of multimodal combination immunotherapy treatments for the treatment of cancer. As the field matures and scientists learn more about the molecular underpinnings of cancer and the immune system, it becomes clear that no single treatment or therapy is going to be effective for all cancers. What works for one type of cancer may not be suitable for a different type of cancer. This was evidenced in a presentation by Dr. Crystal Mackall who demonstrated that T-cell therapy can be used to treat certain types of solid tumors -- a remarkable innovation in the field.
A second consideration with combination immunotherapies, but also with standard-of-care treatments like radiation and chemotherapy, is how the field will validate each combination. According to Dr. Tom Marron, PhD, there is simply not enough patients to test every iteration of combination therapies in large phase II clinical trials. Therefore, Marron is focused on working with clinical tissue samples to validate combination immunotherapies before they enter the clinic. The neoadjuvant platform should inform which cancer immunotherapy combinations are effective.
4. Scientists have the tools and technologies available to ask the right questions.
Technology is enabling a transformation in the immuno-oncology space. Many leaders noted what an exciting time it is to be developing cancer immunotherapies. Advanced computational tools are allowing scientists to ask questions about the human immune system, tumors, and their interactions -- and to discover the answers to those questions.
However, as Dr. Alessandra Cesano, PhD, noted, "The more we know, the more we learn about what we don't know." Cesano expressed her excitement about the future of cancer immunotherapy and her confidence that the answers to the toughest questions in biology are around the corner.
5. Collaboration is necessary to beat cancer.
COVID-19 has united the scientific community with a common cause. It demonstrated how fast the industry can move to bring lifesaving drugs to patients. This monumental effort -- as Dr. Tal Zaks, PhD, noted -- was only possible because of decades of foundational research and a team-based approach.
Many leaders in the field expressed their hope that the sense of urgency taken on during the global pandemic will be applied to cancer research. Cancer, too, is an emergency, with more than 9.5 million individuals dying of cancer each year, according to the Institute for Health Metrics and Evaluation. Knowledge, experience, and sharing data among all sector stakeholders will advance the field forward to achieve the ultimate goal of beating cancer.