Immunological tumor heterogeneity and diagnostic profiling for advanced and immune therapies

If you stand too close to the painting for too long observing all the details, you begin to lose sight of what those brush strokes have created. Only when you step back to take in the scene can you have a full understanding and appreciation for how the individual elements come together to create a work of art.

Despite advances in immunotherapy, it’s clear that only a minority of patients respond. Therapies that rely on immune activation, such as checkpoint inhibitors, have been shown to be especially difficult due to the complex and heterogeneous immune escape mechanisms which can develop in each patient. Clearly there’s much anticipation and focus on new contenders for successful combination checkpoint therapy.

It is clear that “zoom fatigue” has set in, and some of the novelty of virtual conferences has worn off in the past year; having said that, they are likely here to stay, even as in-person events return with hybrid events in 2022.

Adapted from a line in “Ode to a Mouse” from fellow countryman Robert Burns, the phrase, “the best-laid plans of mice and men often go awry”, indicate that no matter how carefully a project is planned, something may still go wrong with it unfortunately speaks to the reality of clinical trials for novel therapeutics, with approximately only 11% of drugs that begin phase I clinical trials eventually being licensed.

It’s clearly a very timely discussion with many recent articles reviewing the complexities of the tumor microenvironment and overall tumor heterogeneity that have been implicated in late-stage clinical failures, underscoring an urgent need for tests that accurately predict response to the growing number of available therapies.

I’ve always been curious, with a need to be on the cutting edge of scientific innovation, so after a successful academic career I moved to the rapidly evolving world of biotech. A 15-year journey in this space ultimately led me to Ultivue, their novel InSituPlex® assay, and following advances in tissue multiplexing.

Alfred Hitchcock once said, “The more successful the villain, the more successful the picture”, for the immunotherapy picture, that successful villain is M1 macrophages.

This year, after two long years of convening virtually, it was great to see so many unite in the city of New Orleans for #AACR2022.