Biohacking Cancer: Activating Your Own Immune System

Immuno-oncology (IO) aims to rev up a patient’s immune system to recognize and kill cancer cells. IO strategies include monoclonal antibodies, checkpoint inhibitors, cytokines and CAR T–cell therapy. Early results have been extremely promising. The checkpoint inhibitor dostarlimab produced 100% remission in patients with rectal cancer in a small trial published in the New England Journal of Medicine in June 2022. In November, Nature published results from the first human trial in which CRISPR-engineered immune T cells successfully blocked cancer progression, paving the way for improved CAR T–cell therapies using CRISPR technology.

Cancer vaccines are also a promising new cell therapy that can treat cancer by helping the immune system recognize and attack tumor cells. Similar to vaccines for infectious diseases like Covid-19, these vaccines can be made from mRNA-encoding cancer peptides, effectively teaching immune cells what to go after. If a current crop of early-stage trials proves successful, some will be approved within the next decade.

The gut microbiome also plays a role in immune responses, cancer growth and treatment outcomes. Recent CAR T immunotherapy studies showed that use of antibiotics therapy disrupted the gut microbiome and was associated with worse outcomes. Future treatment strategies that enlist the microbiome include highly personalized probiotics, targeted antibiotics, fecal transplantation and targeted microbiota injection into a tumor.

Political leaders will increase their bets on immuno-oncology. The US Patent and Trademark Office is fast-tracking immunotherapy applications, and an immuno-oncology expert, Dr. Elizabeth Jaffee, was appointed as chair of the President’s Cancer Panel.