Paradigm Advantages
For cancer researchers
The Reality of Tumor Diversity and Mutational change
However, there is often dissimilarity between cells down to a tumor level, and mutational drift; cancers mostly lack uniform, consistently present targets. Cancer cells are very difficult to fully differentiate from normal cells, or from one another; they are not homogenous, consistent, or immutable. They differ in many ways, even in the same tumor, or same patient, and can mutate over time.
In laboratory terms, in order to implement the approach of "targeted" medicine, the first requirement is to find a cancer-specific identifier, notably a Tumor Specific Antigen or TSA. In their absence, the next type of targets where identifiers are also found in normal tissues (but "overexpressed" in cancers), is the Tumor Associated Antigen (TAA); unfortunately, targeting to TAA could lead to immunological damage to healthy tissues.
For pharmaceutical partners
For investors
For Patients and Clinicians
The Hurdles of Precision Immunotherapy Against Tumors
The Reality of Tumor Cellular Diversity and Recurrence from Resistant Mutation.
However, there is often dissimilarity between cells down to a tumor level, and mutational drift; cancers mostly lack uniform, consistently present targets. Cancer cells are very difficult to fully differentiate from normal cells, or from one another; they are not homogenous, consistent, or immutable. They differ in many ways, even in the same tumor, or same patient, and can mutate over time.
In laboratory terms, in order to implement the approach of "targeted" medicine, the first requirement is to find a cancer-specific identifier, notably a Tumor Specific Antigen or TSA. In their absence, the next type of targets where identifiers are also found in normal tissues (but "overexpressed" in cancers), is the Tumor Associated Antigen (TAA); unfortunately, targeting to TAA could lead to immunological damage to healthy tissues.
Tumors are not homogenous but contain diverse cells
Cancer Cell Diversity and Variation in time and place. Tumors may have multiple different antigens, many of which are vary according to a given cancer, a given patient, and a given tumor mass. In addition, tumors often mutate, and future generations could develop into recurrences from resistant mutants.
Targeting - Somewhat vs Highly specific: TAA vs TSA
There are few Tumor Specific Antigens (TSA), so most immunotherapies target less-specific Tumor Associated Antigens (TAA), also found on normal cells. The use of TAAs, given the paucity of TSAs, as immunotherapy targets risks autoimmune effects on normal tissues.
Cancer Cells don't all have identical traits
Most cancer cells do not have identical traits, but differ between patients, between locations in the same body, and even with a given tumor. This means that targeted approaches will, at best, work in a portion of a tumor, in a portion of patients, or, for a period.
Recurrence come from Resistant Cancer Cells
Recurrences grow either from a subset of pre-existing cancer cells resistant to the first treatment, or that mutate to from new resistance; both phenomena lead drug failure.
Current: Incremental approach, combining different agents.
Combination of single mechanism agents, intended to be combined with other therapies
Proposed: Multifunctional, Integrated approach
Attacking cancer defenses on multiple fronts using a single platform bearing multiple mechanism.