Due to the development of immunology and oncology, and their cross infiltration and integration, immuno-oncology (IO) has gradually become a innovative hot area, which shed new light on cancer therapy. IO therapies fight tumors through activating or normalizing the body’s immune system, such as T cells, NK cells, etc., aiming to achieve disease remission or cure.. Along with the in-depth research, a variety of new IO therapy drugs have been approved and showed the unprecedented universality in a spectrum of cancer types. However, improving patient response rate is still a critical issue in the field. This article will analyze the opportunities and challenges in the process of IO therapy development from the perspectives of new IO target discovery, the combination strategy and the application of biomarkers.
The illustration of human immune system has been substantially clearer than 20 years ago with the credit of a vast amount of comprehensive studies for decades. In particular, its role in tumor development has attracted unprecedented attention. It has been found that the molecules of the immune system can be utilized very effectively to control cancer development and even cure cancer completely. At the early days, this phenomenon was only sporadically spread in professional circles, but since cancer immunotherapy became the winner of Science’s top ten breakthroughs of the year in 2013, publics have been constantly refreshed by the results of immunotherapy. The climax of this phenomenon is reflected in the 2018 Nobel Prize judges who were unable to hold on their usual cautious and awarded the Medical and Physiology Award to two immunologists in recognition of their discovery of the regulatory mechanism of two important immune molecules, PD-1 and CTLA-4, since antibodies targeting these two molecules show predictable effects in tumor immunotherapy. A further affirmation is that half of the Nobel Prize in Chemistry of the same year was awarded to the inventors of phage-display technology for generation of antibodies. Therefore, immunotherapy has become an important approach of cancer treatment, and it has become an indisputable fact that it is listed as the fourth treatment mode after surgery, radiotherapy and chemotherapy. Tumor immunotherapy can be achieved by biologics or by immune cells. The latter is to modify and expand the relevant immune cells by cell engineering technology, and then infuse the cells to the corresponding patients to enhance the patient’s anti-tumor immunity, and ultimately achieve the purpose of eliminating tumor cells. In this paper, the concepts of T-cell immunotherapy and the current development of its application are briefly described. In addition, the first clinic stage product TAEST16001 and the companion diagnostic kits of Guangdong Xiangxue Life Sciences Ltd., a subsidiary of Xiangxue Group, has been briefly presented.
Cancer immunotherapies has become one of the important approaches in advanced malignant tumor treatments. The immunotherapies attack tumors by reinvigorating the human immune system, which will change the paradigm of cancer treatment. The immunotherapies, including anti-PD-1/L1 and anti-CTLA-4 antibodies, have improved the five-year survival rate of patients with malignant tumors, and have been recognized as the most promising treatments to cure cancer. However, only a subset of patients benefits from the immunotherapy, and there are problems such as drug resistance, hyperprogression disease, and immune-related adverse events. Thus, the early selection of the most sensitive patients is key, and the development of predictive biomarkers is one of the biggest challenges of cancer immunotherapy development. Many biomarkers are under investigation, and they are potentially applicable to the clinical selection of patients for immunotherapies, but each has limited utility. Comprehensive evaluation of multiple indicators around the sensitivity and the adverse events of immunotherapies will be the direction of the future. In this article, we will review the research progress in cancer immunotherapies and comprehensive evaluation of precision cancer diagnosis.
Since the concept of precision medicine was proposed in 2015, more and more attention has been paid to biomarkers and precision medicine. Biomarkers is widely used in the screening and treatment of major diseases such as virus and cancer. The application and development of new circulating biomarkers have made great achievements in the development of HBV, HPV detection and tumor targeted drug therapy, cell therapy, immunosuppressant and cancer vaccine. Compared with traditional medical methods, biomarkers have significant advantages in both research and development and in the treatment of detection and treatment mode assisted by precision medicine. Therefore, this paper reviews the application of biomarkers and precision medicine, and focuses on the latest research progress of biomarkers and precision medicine in recent research reports.
Medical imaging, such as MRI, PET, and CT, is playing a more and more important role in drug development and precision medicine. It can be used to diagnose disease, evaluate drug effect, select the right patient, or determine the most appropriate drug dose. With the advances in artificial intelligence, especially the extensive applications of machine learning and deep learning in medical imaging, it is possible to use shorter time or less radiation dose to acquire high quality images. AI also help radiologists improve the performance of diagnosis. Moreover, machine learning methods are very useful in quantitative analysis, and gaining insights about the relationship between images, genotypes, and clinical phenotypes. This paper gives an overview of applications of medical imaging in drug development and precision medicine based on the modality of the technologies, as well as how machine learning methods were used in these applications. Challenges and opportunities are discussed in the end.
Precision medicine integrates multiple types of data, including -omics, clinical, environmental and behavioral data to facilitate the personalized therapy, prevention and management. The cost reduction of gene/genome sequencing, the understanding of cancers from pathology to molecular level, and improvement of some subjects and technologies promoted the formation and development of precision medicine. The precision medicine will have a huge impact on human health. In this article, concept, purpose and application of precision was introduced, and application of next-generation DNA sequencing in precision medicine was also presented. The foundation of the precision medicine is genomic data, sample management of samples, and data quality control. Artificial intelligence is the future of precision medicine. Meanwhile, the characteristics of genomic data and the management of various health-related data are also a huge challenge for precision medicine.
