Inhaled immune therapy to make the lung hostile to arriving tumour cells
Breathing in an immune-activating drug could turn the lungs into bad soil for cancer seeds, at doses far too low to cause body-wide side-effects.
Inhaled GM-CSF was tested in paediatric osteosarcoma lung metastases and inhaled interleukin-2 in renal cancer, both with local immune activation, acceptable safety and underpowered efficacy. Modern versions — an inhaled interleukin-15 superagonist, an inhaled STING agonist or an inhaled anti-CD47 — could be aimed at lung-metastasis prevention rather than treatment, where the target cell burden is tiny.
- Metastasis is understood least and studied last · Metastasis causes about nine in ten cancer deaths but gets a small fraction of research money and almost no trials of its own.
- Cold tumours and the immunosuppressive microenvironment · Most tumours keep the immune system out or asleep, so immunotherapy helps only a minority.
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