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ideasIdea

Engineered immune surveillance: long-lived programmed immune cells that patrol for early cancer

For people at very high cancer risk, install a small population of engineered immune cells that live for years and destroy cells showing early cancer signals before a tumour forms.

Immune surveillance normally eliminates most incipient tumours; carriers of BRCA, Lynch or TP53 mutations and people with clonal haematopoiesis face lifelong high risk. Advances in memory stem T cell engineering, logic-gated receptors responsive to stress ligands or shared neoantigens, and safety switches make a persistent, low-level engineered surveillance population conceivable. The proposal is a research programme to define target ligands of pre-malignant cells, engineer persistent gated cells with off-switches, and demonstrate prevention in genetically engineered mouse models before first-in-human studies in the highest-risk carriers.

Hypothesis
Engineered surveillance cells reduce tumour incidence by more than half in high-risk mouse models without autoimmunity, and persist for over a year in humans with an acceptable safety profile.
Rationale
Cell therapies persist for years in some patients; logic gating and stress-ligand recognition have preclinical proof; prevention needs far fewer cells than treating bulk disease.
What would test it
Five-year preclinical programme with a go/no-go on incidence reduction and safety in two mouse models, then a phase 1 in Li-Fraumeni or Lynch carriers with persistence and safety endpoints.
Maturity
speculative
Who has to act
research
Cost to try
Large (over $50M)
Years to first evidence
12
Bottlenecks it attacks

Connected

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