Adoptive Cell Therapy in Solid Tumors: Who, How, and When?
Just 7 years since Novartis paid UPenn $20M to access Carl June’s anti-CD19 CAR-T technology, the field of adoptive cell therapy (ACT) in cancer has expanded dramatically, both in investment activity and technology proliferation. At present, it is estimated that there are at least 150 pre-commercial ACT-focused companies in the US and EU alone, many of which are less than 5 years old. While some of these newcos are pursuing fast-follower strategies, many are developing novel technology platforms, each with a unique value proposition that has proven sufficient to incentivize investors.
Whereas future projections for ACT-based revenues currently stem from products in heme malignancies, the lion’s share of hope (or hype) in ACT hinges on whether it can effectively treat solid tumors in a durable and reproducible manner. Many would agree that solid tumors are more challenging due to complexities within the tumor microenvironment requiring innovations that address cell trafficking and immunosuppression, among other parameters. Furthermore, few (if any) antigen targets are expressed solely on tumor tissue, raising the specter of off-tumor toxicity in the absence of dual-targeting or suicide switches, targeting of intracellular antigens or neoantigens, and/or engineering novel cell types such as NKs, macrophages, and gamma-delta T-cells.
While ACTs have yet to score any major wins in solid tumors beyond the early success of TILs, many early-stage clinical programs are slated to readout within the next few years.
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