What is Immuno-Oncology: The Next 3 Big Advancements in Cancer Treatment
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What is Immuno-Oncology: The Next 3 Big Advancements in Cancer Treatment
What if the future of cancer treatment doesn’t lie in stronger drugs or extreme procedures but in leveraging the immune system? Could we turn the immune system into a precision weapon against cancer? In 2022, the World Health Organization reported a global incidence of 20 million cancer cases and 9.7 million deaths. About 1 in 5 people develops cancer in their lifetime. Approximately 1 in 9 men and 1 in 12 women die from the disease. These figures have risen over the years, making cancer the second leading cause of death globally.
Fortunately, recent advances in immuno-oncology are offering new hope. These studies show that by leveraging the body’s natural defenses, researchers are unlocking therapies that could change survival outcomes for millions of patients.
This article explores what immuno-oncology is, how it works, the current techniques in use, the latest breakthroughs, and the next three big advancements that could change the way we treat cancer in the future.
Introduction to Immuno-Oncology
Since the 1940s, therapies like surgery, chemotherapy, and radiation have been the main ways to shrink tumors or kill cancer cells. While often life-saving, these approaches can also harm normal tissue and cause significant side effects.
This is where immuno-oncology, also known as cancer immunotherapy, plays a role. Instead of relying solely on drugs or radiation to kill cancer cells, immuno-oncology empowers the body’s own immune system to recognize, attack, and remember cancer cells long after treatment.
Think of it as teaching the body’s natural defense system to tell the difference between healthy cells and dangerous cancer cells. With this approach, the immune system is no longer just a bystander; it becomes the central weapon against cancer.
What is immuno-oncology?
According to Cancer Research Institute, immuno-oncology, also known as cancer immunotherapy, is an approach to treating cancer that uses the body’s own immune system to prevent, control, and eliminate cancer. Rather than simply attacking tumor cells directly with chemicals or radiation, immuno-oncology aims to empower immune cells, such as white blood cells and cytotoxic T cells, to recognize, target, and destroy cancerous cells while minimizing damage to normal tissue.
This field employs tools, including monoclonal antibodies, chimeric antigen receptors (CARs), vaccines such as cancer vaccines, and others, to direct the body’s immune system to recognize and attack specific cancer cell markers.
How it leverages the immune system
The immune system is composed of many cell types, such as the adaptive immune system and the innate immune system. The key plates include B cells, T cells (cytotoxic T cells, regulatory T cells), natural killer (NK) cells, dendritic cells, etc. The immune surveillance helps prevent tumor formation by recognizing abnormal cells (malignant cells, cancer cells) and eliminating them. However, cancer cell populations can evade immune detection through various mechanisms, such as suppressing immune signals, hiding antigens, or creating an immunosuppressive tumor microenvironment. In some cases, this can result in attacking normal cells or damaging tissues if immune activity is not well-controlled.
Immuno-oncology approaches reverse or block these immune evasion tactics. For example:
- Checkpoint inhibitors release the brakes on immune cells so that T cells can attack cancer cells.
- Adoptive cell transfer (CAR T cell therapy) inserts or modifies immune cells ot better bind tumor antigens and kill tumor cells.
- Cancer vaccines train the immune system to recognize specific tumor cell antigens.
These strategies aim to treat cancer by enabling the immune system to destroy cancerous cells, reduce tumor growth, and maintain long-term surveillance.
Key Mechanisms of Immuno-Oncology
Immuno-oncology works by training the body’s natural defense system to find and destroy cancer cells. To do this, therapies rely on specific biologicalmechanisms that allow the immune system to recognize cancer as a threat.
Major mechanisms include:
- Immune checkpoint blockade: Many cancer cells exploit checkpoints like Programmed Cell Death Protein 1 (PD-1)/PD-L1 and Cytotoxic T-Lymphocyte-Associated Protein 4 (CTLA-4) to evade detection. Drugs known as checkpoint inhibitors block these pathways, freeing T cells to attack tumors.
- T-cell activation and expansion: Some therapies stimulate or engineer T cells to target tumor-specific antigens and multiply in large numbers.
- Immune memory formation: Some treatments strengthen long-term immune memory, so if cancer returns, the body can respond quickly.
These mechanisms form the scientific foundation of immuno-oncology. Understanding them helps explain why therapies can achieve durable, life-long immunotherapy treatment success compared to traditional approaches.
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Immune system’s role in cancer prevention
Even before therapies are introduced, the human immune system plays a vital role in preventing cancer cells through a process called immune surveillance. Natural killer (NK) cells and cytotoxic T cells constantly monitor tissues for abnormal protein markers that signal early cancerous changes. When such cells are identified, the immune system only partially clears these abnormal cells, leaving behind resistant ones in a process called immunoediting, which can influence how tumours evolve.
People with a suppressed immune system, such as transplant patients on immunosuppressants, are at higher risk for certain cancers, highlighting how critical immune surveillance is. By supporting immune health and strengthening surveillance, immuno-oncology not only treats but also holds potential for preventing cancers before they form. This forms part of ongoing immunotherapy clinical trials that explore cancer prevention and treatment in diverse patient groups.
Key tools: antibodies, vaccines, cytokines
Immuno-oncology doesn’t rely on just a weapon; it uses a toolkit of biological agents designed to enhance immune activity.
Main tools include:
- Monoclonal antibodies: These lab-made molecules can tag cancer cells for destruction, block growth signals, or deliver toxic agents directly to tumors.
- Cancer vaccines: This can be preventive, as with HPV vaccines to prevent cervical cancer, or therapeutic, training the immune system to fight cancer. RNA-based vaccines, peptide vaccines, etc. Recent work includes RNA cancer vaccine trials across cancer types.
- Cytokines: Signaling proteins like interleukins and interferons stimulate white blood cells, boosting their ability to fight cancer. The Food and Drug Administration (FDA) approved cytokine interleukin-2 (IL-2) has been used for melanoma and kidney cancer, while newer engineered cytokines aim for fewer side effects.
Antibodies, vaccines, and cytokines are the frontline tools that make immuno-oncology therapies effective, and ongoing research is making them more precise and powerful.
Current Techniques in Cancer Immunotherapy
Here are some of the major immunotherapy techniques already in use or under clinical development:
- Targeted antibody therapies: These are monoclonal antibodies designed to bind to specific cancer cell antigens, such as human epidermal growth factor receptor 2 (HER2), EGFR, and PD-L1, either blocking growth signals or marking tumor cells for immune destruction.
- Tumor-infecting (oncolytic) viruses: Viruses engineered to selectively infect and kill tumor cells, also stimulating immune responses.
- Adoptive cell transfer, including chimeric antigen receptor T (CAR T) cell therapy: Modify a patient’s T cells ex vivo to express a receptor that recognizes a tumor antigen, then expand and infuse them back to attack abnormal cells.
- Cancer vaccines: These aim to train the immune system to recognize and destroy cancer cells by exposing it to tumor-associated antigens. The best-known example is sipuleucel-T (Provenge), approved for prostate cancer, while newer approaches, such as peptide-based and neoantigen vaccines, are under study for more personalized treatments.
- Checkpoint inhibitors: Immune checkpoint inhibitors such as PD-1/PD-L1, CTLA-4, and LAG3 work by removing inhibitory signals and enabling T cells to attack tumor cells. This therapy can sometimes trigger immune-related adverse events by mistakenly killing healthy cells alongside tumor cells.
These therapies are already approved for many cancer types, including melanoma, lung cancer, kidney cancer, hepatocellular carcinoma, and are the standard of care in many settings.
Recent Breakthroughs in Immuno-Oncology
The recent breakthroughs in immuno-oncology are not just lab curiosities. Many are entering or already in clinical trials, some are being approved, and together they suggest immunotherapy’s role in cancer treatment will only grow.
Here are some of the latest strides of progress medical research has made into cancer immuno-oncology:
- Antibody-Drug Conjugates (ADCs) are becoming more precise
According to the National Cancer Institute, ADCs are monoclonal antibodies linked to cytotoxic payloads, so they deliver a warhead directly to cancer cells, sparing healthy tissues. Recent approvals and successes include enhancements in payload selection, linker technologies, target antigen selection, and the use of bispecific ADCs, which combine features of bispecific antibodies with ADCs to improve specificity and reduce off-target toxicity.
- Personalized immune stimulation / RNA-based and peptide vaccines
There has been marked progress in RNA cancer vaccine development in 2024-2025. For example, mRNA-4157 (V940) in combination with pembrolizumab shows sustained benefit in recurrence-free survival compared to pembrolizumab alone. Trials include historically challenging cancers with few mutations, such as pancreatic cancer and others. Also, there is work on off-the-shelf vaccines targeting common driver mutations like KRAS in pancreatic and colorectal cancer to prevent recurrence.
- Bispecific T-cell engagers
These are antibodies engineered to bind simultaneously to a tumor antigen and to an immune effector cell, often CD3 on T cells, thereby bringing T cells closer to tumour cells and enhancing cytotoxic attack. Examples include therapies in multiple myeloma, diffuse large B-cell lymphoma, and others. There has been growth in agents like epcoritamab, glofitamab, and novel bispecific ADCs.
Another recent breakthrough in immuno-oncology is cancer vaccines. They are a new immunotherapy approach that builds on the success of checkpoint inhibitors by altering cancer cells to produce proteins that trigger killer T cells to recognize and attack tumors. Early studies, including work from Dana-Farber Cancer Institute, show these vaccines can help control cancer growth, and while still experimental, the promising results have already earned international recognition for their researchers.
Challenges and Future Directions in Immuno-Oncology
Even with all the excitement, there are real challenges. Scientists and researchers continue to battle with some challenges that come with immuno-oncology. Here are some critical ones and directions to overcome them
- Overcoming tumor resistance: Tumors evolve. They may downregulate antigen expression, mutate the target, or adapt their microenvironment to suppress immune attack via regulatory T cells and immunosuppressive cytokines. Resistance to checkpoint inhibitors is well-documented. Designing therapies that can adapt, such as antigen targeting, bispecifics, and combination therapies, will be essential.
- Enhancing precision in immune responses: Avoiding collateral damage, such as killing healthy cells or immune-related toxicities, is key. Precise targeting, like antigens specific to tumour cells, managing cytokine release syndrome, which is a known risk for CAR T and bispecific T cell engagers, and better biomarkers to predict who will respond or who might suffer severe adverse events. Also optimizing dose, route, timing, like sequencing immunotherapy with surgery, radiation, or chemotherapy.
- Expanding immunotherapy access globally: Many advanced immunotherapy treatments are expensive and logistically complex, such as manufacturing individualized therapies, cold chain, and expertise. Ensuring global access, particularly in low- and middle-income countries, will require cost reductions, scalable technologies, and broader participation in cervical cancer and other regionally common tumor types.
These challenges highlight the need for a deeper understanding and more refined strategies. Overcoming these obstacles will require collaboration across science, technology, and healthcare systems. As breakthroughs continue to emerge, the future of immuno-oncology points toward more precise, accessible, and effective treatments that could redefine cancer care for generations to come.
Potential Impact on Cancer Treatment Paradigms
Looking at how the three areas above mature, they have the potential to transform treatment paradigms by shifting care away from one-size-fits-all approaches toward more personalized, precise, and durable solutions. Here’s how immuno-oncology may reshape the broader paradigm of cancer therapy.
- Combining immuno-oncology with traditional treatments: Rather than replacing chemotherapy or radiation wholesale, combinations are increasingly showing synergy. For example, using checkpoint inhibitors with chemo or radiation can enhance antigen release from tumour cell death, improve immune visibility, and reduce doses of chemotherapy needed.
- Reducing reliance on chemotherapy and radiation: As immunotherapy becomes more effective and precise, for certain cancers or early stages, the goal is to reduce the toxicities associated with chemo/radiation, or even avoid them. Immuno-oncology could shift treatment toward less systemic toxicity and a better quality of life.
- Long-term cancer surveillance with immune support: One of the promises is that the immune system, once trained or reinvigorated, could provide long-term surveillance to prevent cancer recurrence or control minimal residual disease. This could turn some once-aggressive cancers into manageable chronic conditions, or push recurrence rates lower in cancers like pancreatic cancer, skin cancer, melanoma patients, and others.
These innovations could improve survival rates, reduce toxic side effects compared to chemotherapy and radiation, and open the door to long-term disease control or even cures for cancers once considered untreatable. In the long run, they may redefine cancer from a largely fatal disease to a more manageable, chronic condition.
Conclusion: The Promise of Immuno-Oncology
Immuno-oncology has already transformed how many cancers are treated. With tools like monoclonal antibodies, cancer vaccines, CAR T cell therapy, oncolytic virus therapy, checkpoint inhibitors, bispecific T-cell engagers, and antibody-drug conjugates, we are pushing the boundaries of what the immune system cells can do to attack cancer cells. Unlike older anti-cancer drugs, these approaches focus on biological precision.
The next few years hold the promise of breakthroughs that will be safer, precise, and accessible. As the field tackles tumour resistance, aims for measurable precision, and works towards equity in global access, cancer treatments may shift from heavy reliance on chemotherapy/radiation toward immune-based, biologically smarter modalities with fewer side effects. Such a shift will further establish cancer immunology as a pillar of oncology research.
We are likely to see combinations of immuno-oncology with traditional modalities, novel vaccines, better engineered adoptive cell therapies, and improved diagnostic/biomarker tools. These strategies not only target tumors but also preserve overall cell function and the patient’s immune system. All of this suggests that for many cancer patients, immune system-based therapies aren’t just an option; they may become first-line, life-long contributors to cancer control, supported by continued immunotherapy research worldwide.
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Frequently Asked Questions
What is the difference between immuno-oncology and immunotherapy?
Immunotherapy is a treatment that uses the immune system to fight diseases like cancer, while immuno-oncology is the specific field of research and treatment that applies immunotherapy strategies to cancer.
What are the top 3 worst cancers?
Based on mortality rates, late detection, and poor survival outcomes, the top 3 cancers are pancreatic, lung, and liver cancers.
What is the downside of immunotherapy?
The downside of immunotherapy is that while it can be highly effective, it doesn’t work for everyone and may cause the immune system to overreact, leading to serious side effects such as inflammation of healthy organs and tissues.
Why can’t you eat fruit on chemo?
It’s not that you can’t eat fruits during chemo. It’s about hygiene and the risk of infection because the immune system is weaker. Raw produce can increase infection risk.
What is the 7-day rule in chemotherapy?
The 7-day rule in chemotherapy says you must wait at least 7 days after treatment before giving another dose. This allows the bone marrow to recover from the drugs’ toxic effect.
References
Current Progress and Future Perspectives of RNA-Based Cancer Vaccines: A 2025 Update
Experts Forecast Cancer Research and Treatment Advances in 2025
Keeping the immuno-oncology flame burning
Antibody–Drug Conjugates (ADCs): current and future biopharmaceuticals
Antibody-drug conjugates in cancer therapy: applications and future advances
Off-the-shelf vaccine shows success against deadly cancers
Bispecific antibodies in the treatment of multiple myeloma
Advancing Antibody–Drug Conjugates: Precision Oncology Approaches for Breast and Pancreatic Cancers
Immunotherapy trial helps cancer patients with tumours live 40% longer
Clinical development of immuno-oncology therapeutics
Antibody drug conjugate: the “biological missile” for targeted cancer therapy
Bispecific T cell engagers: an emerging therapy for management of hematologic malignancies
An immunogenic personal neoantigen vaccine for patients with melanoma
Immuno-oncology: understanding the function and dysfunction of the immune system in cancer
Understanding the Role of Immuno-Oncology in Treating Cancer
Role of IL-2 in cancer immunotherapy
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