Page 12 - The Indian EYE 062626

Op-Ed JUNE 26, 2026 | The Indian Eye 12

A New GPS for the Immune System:

HOW SCIENTISTS ARE REDIRECTING

T CELLS TO TREAT CANCER

The message emerging from ASCO 2026 was both hopeful and realistic. Researchers have

not eliminated all the roadblocks. But they are learning how to navigate around them

to use these treatments safely.
Early studies required intensive
monitoring because patients could
develop inflammatory side effects,
including cytokine release syndrome
and neurologic complications. Over
time, physicians learned how to re-
duce these risks through gradual
dose escalation, preventive medica-
tions, and careful monitoring strat-
DR NILESH D MEHTA egies. These advances are allowing
more patients to receive treatment
or years, immunotherapy has in outpatient settings rather than re-
been one of the most exciting quiring prolonged hospital stays.
Fadvances in cancer treatment.
In some patients, it has produced re- The next challenge is
markable and durable responses. Yet determining which patients are
many cancers have remained frus- most likely to benefit.
tratingly resistant. Cancer has an extraordinary ability to adapt. Many patients eventually develop resistance, and Researchers are studying tumour
Scientists often refer to these scientists still do not fully understand why (File photo) markers, immune signatures, tissue
as “immune-cold” tumours. These testing, circulating tumour DNA,
are cancers that somehow manage and other biomarkers to better un-
to evade meaningful immune attack. happen efficiently. There may be too aging responses with T-cell engagers derstand which tumours express the
The immune system is present. The few immune cells within the tumour, targeting proteins such as STEAP1 targets these therapies need. The
soldiers exist. Yet they never seem too few recognisable warning signals, and PSMA, suggesting that cancers goal is precision medicine in its tru-
to arrive in sufficient numbers where or too many suppressive factors that previously thought to be beyond the est form: matching the right patient
they are needed most. prevent an effective immune response. reach of immunotherapy may not be to the right immune strategy at the
Imagine a city where every road as unreachable as once believed. right time.
leading to a dangerous neighbour- T-cell engagers offer a unique
hood has been blocked. Patrol cars strategy. The potential impact extends Even with this progress,
are available. Trained officers are Think of it as giving the im- beyond simply helping immune important questions remain.
ready. Yet they never reach the scene mune system a sophisticated GPS cells locate cancer. Cancer has an extraordinary
because the roads have been closed, navigation system with a dedicated Researchers believe these thera- ability to adapt. Many patients even-
detoured, or hidden. traffic controller. Instead of waiting pies may actually help transform an tually develop resistance, and scien-
for immune cells to discover cancer immune-cold tumour into a more tists still do not fully understand why.
For decades, many solid tumours on their own, these drugs physically immune-active, or “hot,” environ- Understanding how tumours escape
behaved in exactly this way. bring a T cell directly to a cancer cell ment. Physically drawing T cells into these therapies may be one of the
At the 2026 American Society and force the two to meet. They help the tumour may populate previously most important challenges facing
of Clinical Oncology (ASCO) An- bypass some of the biological road- quiet neighbourhoods with immune cancer research over the next decade.
nual Meeting, researchers discussed blocks that cancer has spent years activity. In essence, they are not The message emerging from
a new generation of immunothera- constructing. merely redirecting traffic. They may ASCO 2026 was both hopeful and
py that may help solve this problem. This approach is generating ex- be changing the entire landscape of realistic. Researchers have not elimi-
These treatments, known as T-cell citement because it appears capable the neighbourhood itself. nated all the roadblocks. But they are
engagers, are showing encouraging of working in tumours that were Several successful therapies learning how to navigate around them.
activity in cancers that have histori- once considered poor candidates for have helped validate this strategy. For patients with cancers once
cally responded poorly to traditional immunotherapy. Drugs such as tebentafusp-tebn in considered invisible to the immune
immunotherapy. One example is prostate can- uveal melanoma and tarlatamab in system, a new route may finally be
Traditional immunotherapy often cer. Historically, prostate cancer small cell lung cancer have demon- opening, one guided by a smarter
relies on the immune system recog- has been viewed as an immune-cold strated that targeted immune redi- immune GPS and powered by the re-
nising cancer and finding its way to disease where checkpoint inhibitors rection can produce meaningful clin- markable ability of T cells to do what
the tumour. In many immune-cold have produced only limited success. ical benefit. Their success has also they were designed to do: find cancer
cancers, that process simply does not Researchers are now seeing encour- provided valuable lessons about how and destroy it.

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