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According to the World Health Organization (WHO), cancer was the leading cause of death globally in 2020 — impacting 10 million lives. By 2040, the number of patients diagnosed with cancer is expected to increase to 29.5 million, 39% higher than in 2018. Traditional cancer treatment includes radiotherapy, chemotherapy, and/or surgery, which may cure the disease or prolong quality of life for the patient. These treatments, while lifesaving in many cases, are not without challenges for patients.

Trends in treatment

Scientists are currently focusing in on using the human body’s own immune system to fight this disease. An example of this novel approach is CAR T therapy, a treatment that takes a patient’s own immune cells and genetically manipulates them to identify cancer cells. These modified cells now can target and eliminate cancer cells via the immune system.

Yet, current limitations in technology and a list of other obstacles prevent immunotherapies from reaching millions of cancer patients. These issues need to be addressed as scientists move forward with the development of novel immunotherapies. For example, what is the best way to collect and use a patient’s immune cells to treat cancer? Are Chimeric Antigen Receptor (CAR) T cell therapies the best at harnessing the power of immune cells? CAR T cells are typically grown in a laboratory for two to three weeks before being infused back into the patient and have successfully been used to treat blood cancers.

In addition, can the tumor microenvironment be overcome to increase the efficacy of CAR T cell therapies? Solid tumors continue to cause T cell fatigue and dysfunction. Is it possible to develop a 3D model to help understand anti-tumor therapies? Since 85% of new cancers are solid type, this modeling is important to utilize resources efficiently. As immunotherapies are successfully developed, will the platform used involve the personalization of each treatment or can safe and effective cells be engineered from healthy donors for universal use? With an increase in demand for immunotherapies, will industry use viral vectors to genetically engineer T cells?

Navigating uncertainties

The future, although it may currently appear out of reach, is still largely undefined. To achieve a successful outcome, the pharmaceutical industry will need to determine how to scale immunotherapy production without compromising safety. This will require a rigorous effort to control manufacturing processes that includes the adoption of good manufacturing practices (GMP) as well as the implementation of consistent QC standards. Pricing for immunotherapy also remains extraordinarily high. Treatment costs and access will require careful management to ensure accessibility for all who need these lifesaving therapies.

Looking ahead

Genetic engineering is paving the road toward more innovative therapeutic development. In the works are armored CAR T cells that have potential to survive in a hostile tumor microenvironment, which would be a tremendous success. Current clinical trials are engaging the possibility of combination therapies to minimize the chance of recurrence. Finally, autologous and allogenic platforms must be leveraged in order to scale manufacturing. Every development effort that addresses a current challenge increases hope for future treatment options for these patients. Learn more.