Frederick L. Hall, Sant P. Chawla and Erlinda M. Gordon
The Sarcoma Oncology Center, Santa Monica CA 90405 and Counterpoint Biomedica LLC, Santa Monica CA 90405
The high costs of cancer in terms of social and economic losses, as well as the inefficiencies and toxicities associated with so-called standard care, have ushered in a new era of "Precision Medicine," which combines the virtues of personalized medicine, targeted therapies, and immunotherapies to improve diagnosis and treatment, overcome drug resistance, and promote innovation in clinical trials. While monoclonal antibodies (mAbs) and are now well established as "targeted therapies" for a wide variety of malignancies, there remains a host of problems with systemic biodistribution, target selectivity, poor tumor penetration, and untoward toxicities, which limit clinical utility. Likewise, the promising new generation of mAbs designed to activate anti-tumor immune responses offers another avenue of tumor control, albeit with limited response rates, while the ungoverned biodistribution of these immune checkpoint inhibitors introduces a wide array of autoimmune disorders and serious immune-related adverse events (irAEs). Here, we address the growing need for pro-active tumor-targeted drug delivery, and we introduce fundamental and distinguishing aspects of the tumor microenvironment that are amenable to the bioengineering and development of novel platforms for precision drug delivery.