Immunotherapy

Antibody manufacturing means growing antibody drugs like pembrolizumab or trastuzumab in vats of engineered hamster cells, then purifying them. It is the industrial base for most modern cancer drugs.

Using viruses that infect bacteria, not human cells, as programmable delivery shells for cancer drugs and vaccines.

A bispecific antibody is one antibody with two different grabbing arms, so it can block two targets at once or pull an immune cell onto a cancer cell.

Vaccinating people who do not have cancer yet but are very likely to get it, against the antigens their future tumour will carry.

Instead of attacking the cancer cell, engineering T cells to strip away the scaffolding and the suppressive immune cells that protect it.

Giving the same drug at a different time of day, because the body clock changes how much damage it does and how well the immune system responds.

Cytokine therapy gives immune-signalling proteins as drugs. High-dose interleukin-2 was the first immunotherapy to cure some melanomas, at great toxicity.

Patients who eat plenty of fibre and avoid probiotic pills seem to respond better to immunotherapy for melanoma, probably because fibre feeds the right gut bacteria. A proper trial is under way.

Bacteria that seek out the low-oxygen core of tumours, then manufacture a drug on the spot.

Transplanting gut bacteria from patients who responded to immunotherapy into those who did not. In small studies a minority of resistant melanomas started responding. Randomised trials are running.

Destroying a tumour mechanically with sound, rather than heat, leaves the debris intact enough for the immune system to learn from it.

Antibodies that release the brakes on immune cells so they can attack the cancer. They cure a minority of patients across many cancers, something chemotherapy rarely does.

An immune-stimulating antibody conjugate (ISAC) is an ADC whose payload wakes up the immune system inside the tumour rather than poisoning the cell.

PET scans built from radiolabelled antibodies or their fragments, to see any protein an antibody can reach, including immune cells inside tumours.

Treating one tumour so aggressively that the immune system learns to attack every other one, using the tumour itself as the vaccine.

Injecting the gene for a powerful immune cytokine into a tumour and using an electric pulse to push it into the cells, so the cytokine is made locally rather than flooding the body.

Treating early bladder cancer by putting the drug straight into the bladder through a catheter, so the whole body is spared.

Deliberately treating a big tumour unevenly, with a lattice of very high dose peaks inside it, instead of a uniform dose.

Changing the gut bacteria of a patient whose immunotherapy stopped working, in the hope of restarting the response.

Lab-made immune proteins that lock onto one target, either blocking it or flagging the cell for destruction.

Vaccines against mutations or proteins shared by many patients, so they can be made in advance.

Viruses engineered to infect and burst cancer cells while leaving normal cells alone, and to alert the immune system in the process.

A vaccine made for one patient, encoding the unique mutations in their own tumour, to train the immune system to hunt it.

An antibody carries a light-sensitive dye to the tumour; shining near-infrared light then bursts the cells.

Plasmid DNA and mRNA raw materials are the DNA templates and enzymes behind viral vectors and mRNA vaccines. They are invisible to patients but decisive for supply.

Antibiotics in the weeks before immunotherapy are linked with worse outcomes, and shop-bought probiotics may not help and might hurt. Avoiding both where possible is a low-cost precaution.

RNA drugs that copy themselves inside the cell, or are made as a loop so they last longer. Both aim to get more protein from a smaller dose.

Sterile fill-finish is putting the finished drug into vials under sterile conditions. It is a frequent cause of shortages when capacity is tight.

Drugs that trigger the cell's built-in 'virus alarm' inside tumours to summon immune cells.

An off-the-shelf drug that physically links a killer T cell to a cancer cell, forcing the attack.

Giving the innate immune system a memory, so monocytes and NK cells respond harder the next time they meet a tumour.