Immunotherapy from zero
How the immune system sees cancer, how tumours hide, how checkpoint inhibitors work, and where engineered immunity is heading.
- 1FrontImmunotherapy
Immunotherapy helps the patient's own immune system recognise and destroy the cancer.
Why here The front.
- 2PathwayPD-1 / PD-L1 immune checkpoint & T-cell activation
How T cells decide to attack. A T cell needs to see the target (TCR-MHC) and get a 'go' signal (CD28). PD-1 and CTLA-4 are 'stop' signals; tumours exploit them. Checkpoint inhibitors remove the stop.
Why here The pathway, with an analogy and a diagram.
- 3TechnologyStandard of careImmune checkpoint inhibitors
Antibodies that release the brakes on immune cells so they can attack the cancer. They cure a minority of patients across many cancers, something chemotherapy rarely does.
Why here The drugs that release the brakes.
- 4TrialPositiveCheckMate 067
The trial with the longest immunotherapy follow-up: about half of patients on the combination are alive at 10 years.
Why here Ten-year survival data that proved cures are possible.
- 5TermImmune-related adverse events (irAEs)
Immune-related adverse events (irAEs) are the autoimmune side effects of checkpoint inhibitors: colitis, thyroid problems, rash, hepatitis, pneumonitis.
Why here The cost: autoimmune side effects.
- 6TermHot vs cold tumours
'Hot' tumours are full of immune cells and respond to immunotherapy; 'cold' tumours have kept the immune system out.
Why here Why most patients still do not respond.
- 7TermNeoantigen
A protein fragment created by a tumour mutation that the immune system has never seen before, so it can attack it without harming normal cells.
Why here What a personalised vaccine actually targets.
- 8ProductPhase 3Intismeran autogene
A custom mRNA vaccine encoding up to 34 of a patient's own tumour mutations. In August 2026 it became the first personalised cancer vaccine to win a phase 3 trial.
Why here The first personalised vaccine to pass phase 3.
- 9TechnologyApprovedT-cell engagers (bispecific)
An off-the-shelf drug that physically links a killer T cell to a cancer cell, forcing the attack.
Why here Off-the-shelf T-cell redirection.
- 10TechnologyApprovedCAR-T cell therapy
A patient's T cells are removed, given a synthetic receptor that recognises the cancer, multiplied, and put back as a living drug.
Why here Living drugs and their solid-tumour frontier.
- 11RoadmapImmunotherapy roadmap: Coley's toxins → checkpoint inhibitors → engineered immunity
The immunotherapy roadmap is a 130-year arc from injecting bacteria into tumours to releasing immune brakes, and now to designing the immune response itself with vaccines, engagers, and cells.
Why here From Coley's toxins to in vivo CAR-T.