Raiders of the lost art: finding immuno-oncology treasure

If you want to be technical about it, immuno-oncology dates back thousands of years when the first anecdotal reports of spontaneously disappearing tumors were reported in Ancient Egypt [1]. Fast forward to the early 19th century, and the first reports of spontaneous tumor remission following erysipelas infection begin to emerge. Shortly thereafter William Bradley Coley treated bone cancer by inoculating inoperable patients with streptococcal bacteria and following a successful clinical trial, ‘Coley’s toxin’ became commercially available in 1899. The evolution continued when in 1959, Ruth and John Graham created the first ever cancer vaccine for cervical cancer from tumor lysate demonstrating a 22% stable disease (SD) rate [2]Decker WK, da Silva RF, Sanabria MH et al. Cancer immunotherapy: historical perspective of a clinical revolution and emerging preclinical animal models. Front. Immunol. 2017; 8, 829. . This was followed by the approval of Bacillus Calmette-Guerin (BCG) made from a live attenuated strain of Mycobacterium bovis in 1976 for treating bladder cancer. In 1992 the FDA approved the use of IL-2 as an immunotherapeutic for metastatic renal cell carcinoma, and in 1997, rituximab (passive immunotherapy) became the first monoclonal antibody ap-proved for cancer. However, we would argue that the flood gates really opened and the field of immunothera-py gained significant steam upon the approval of Ipilumimab in 2011, followed by the approvals of Keytruda and Opdivo in 2014. Subsequently, the field of immuno-oncology has expanded exponentially. A number of cancer immune therapies approved or in development span across a diverse spectrum of therapeutic modalities including cytokines, antibodies against a variety of targets, and cell therapies, to name a few. These therapies have proven particularly successful in the clinic, and appear to be driving the future of a new era of immu-no-oncology.

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